A sad, premature death cynically exploited by antivaccinationists

I must admit, I've been enjoying my vacation thus far and have hardly paid attention to the blog, other than a couple of quick posts. For me, this is quite amazing. Still, every so often there pops up a story that I can't resist commenting on, particularly given that I'm just sitting around watching the Olympics, and I'm deadly tired of beach volleyball. (As an aside, notice how it's always women's beach volleyball that NBC shows, not men's, no doubt because the powers that be think that toned young women in bikinis playing volleyball translate into big ratings. Unfortunately, they seem to be right.)

While I was sitting there thinking about changing the channel out of boredom, I happened to check out the comments on my post from a couple of days ago, when I noticed an off-topic discussion beginning (which, I guess, sometimes happens when my blogging activity falls off) that caught my attention. It's a story out of New Zealand about an 18-year-old woman named Jasmine Renata, who tragically died nearly three years ago of unclear causes, although what happened sounds consistent with the sort of idiopathic heart conditions that sometimes (and, fortunately, very uncommonly) cut short the lives of young people in their teens and early 20s. Now, Jasmine Renata might never have been known outside of her grieving family and friends, except for one thing. Her mother is convinced she knows the reason why Jasmine died. In brief, she has an explanation for her daughter's death that is simple, emotionally resonant, and almost certainly wrong, and that explanation is that Gardasil was the cause of her daughter's untimely death:

The mother of a teenager found dead in her bed has told an inquest that her daughter's physical and mental health deteriorated sharply when she was given the Gardasil cervical cancer vaccination.

Jasmine Renata, 18, died in September 2009 in a sleepout at her home in Upper Hutt, north of Wellington.

She had received the last of three injections of Gardasil six months earlier.

Once again, whenever I encounter a story like this, I am saddened, first of all because the life of someone so young ended so unexpectedly. It's quite understandable that a parent, faced with such a tragic loss and consumed with shock and grief, would look for an explanation and grasp at any seemingly plausible explanation she can find. In this case, Rhonda Renata has latched on to Gardasil, even though the timing doesn't even argue particularly persuasively for causation by Gardasil. In other words, while humans frequently confuse correlation with causation, in this case there doesn't even appear, on the surface at least, much evidence of correlation. Six months after the last booster shot of Gardasil is a long time. Now, nearly three years after her death, there is a coroner's inquest into Jasmine's death, and two familiar figures have entered the picture. More on that later.

By way of background, various reports suggest that Jasmine had suffered symptoms that could indicate that she had a cardiac anomaly. Sudden death among young people is rare, but when it happens, it's often due to cardiac causes, most commonly hypertrophic cardiomyopathy, coronary artery abnormalities, or the long QT syndrome (LQTS), the latter of which can cause a rapid, chaotic heartbeat and sometimes ventricular fibrillation and cardiac arrest. Since her daughter's death, Ms. Renata has steadfastly refused to have herself, her husband, or any of her family tested for gene mutations associated with sudden cardiac or tested for idiopathic heart disease because she knows of no history of heart disease in her family if you don't count the death of her daughter. While on the surface this sounds like a reasonable argument, it is not a good reason to conclude that Jasmine couldn't possibly have had an idiopathic heart condition. For example, some of the gene mutations that are associated with sudden cardiac death increase the risk of such an outcome; they don't guarantee it, and carriers might not be symptomatic or might be so mildly symptomatic that they are never worked up for a cardiac condition. More likely, Ms. Renata doesn't want to look for evidence that might disconfirm her now fixed belief that Gardasil killed her daughter, or, as she wrote two years ago:

Even though we have not yet received a final autopsy report and the pathologist has only recently begun doing tests based on my belief that the vaccine sent Jasmine's health on a downhill spiral to death. During the autopsy the pathologist did not find any health problem that could have contributed to Jasmine's death and I know in my every being that the vaccine was the cause.

In the same piece, Rhonda Renata describes a history of vague symptoms suffered by Jasmine:

During a routine visit, Jasmine's doctor persuaded her to get the Gardisil vaccine because it would help keep her safe from developing cervical cancer in the future. Jasmine received her first Gardisil vaccine in September 2008. Jasmine was always concerned about her appearance and she was quite distressed that shortly after the vaccine she noticed dry skin and warts appearing on her hands. She complained that she thought she was losing more hair than usual and that her pimples were getting worse. On the 20th of October Jasmine visited the doctor to treat her warts and dry skin. Jasmine had 4 or 5 warts frozen off. The doctor also said that her immunity was compromised so he prescribed a multivitamin as well as Locoid cream for the dry skin. The Locoid cream didn't help the dry skin.

What this means is unclear. For one thing, there appears to be no record, at least none mentioned in the press accounts that I've been able to find, of these complaints. Indeed, several press reports state that the nurse testified that she asked Jasmine whether she had had any problems after her Gardasil doses and whether she was feeling well. Jasmine reported no side effects. What we do know is that Ms. Renata somehow hooked up with an antivaccinationist named Hilary Butler, who blogs for the antivaccine crank organization the International Medical Council on Vaccination and blogs on her own at Beyond Conformity. Indeed, she has written several posts about Jasmine Renata, including Did Gardasil Kill Jasmine? It's full of conspiracy mongering, insinuations that some sort of coverup was occurring. It includes a link to the autopsy report, which showed no structural abnormalities in the heart or evidence of an inflammatory process. The report does note, however, that heart tissue had been taken and submitted to the Inherited Diseases Group in Auckland so that the "decendent's genetic structure and family can be investigated in case there is a molecular abnormality of the cardiac electrical conduction system that might result in sudden unexpected death." It was also noted that "this process usually takes many months and requires the cooperation of family members."

Interestingly, the pathologist also noted that Ms. Renata had contacted Dr. Christopher Shaw, who urged the use of the Morin stain to test for aluminum in Jasmine's brain. In response to this, the pathologist noted:

The pathology laboratory is unable to offer a routine specific test for aluminum in neurones (I believe that this is very much a research tool rather than a diagnostic tool). Even if aluminum were to be found, I would not know how to interpret its presence. I was unable to see evidence of damage to, or a reactive process involving, neurones in Jasmine's brain.

You might recall Christopher Shaw. He published a truly awful "review" of the medical and scientific literature trying to link aluminum-containing vaccine adjuvants to autism and appeared in the antivaccine movie The Greater Good arguing—you guessed it—that aluminum adjuvants cause autism. In fact, he went further than that and said in the movie that we’re all living in a “toxic” soup and that vaccines are part of that soup, all overlaid with a cartoon of green, stylized people floating in a disgusting soup of pollution, vaccines, and garbage. It turns out that Dr. Shaw was scheduled to testify at the inquest. Apparently, Dr. Shaw examined some of Jasmine's brain tissue. Anyone want to bet that Shaw will report that he found aluminum there and that it caused massive damage to Jasmine's neurons?

No, don't bother. That's about as sure a bet as I can think of, and only a sucker would bet against it. After all, Ms. Renata wouldn't have called Shaw to testify if he hadn't found what she wanted him to find. Given the time difference between here and New Zealand, it's likely that by the time you see this he will have already testified, and I'm sure readers will post news accounts in the comments. Oh wait, there already is. (Yes, I added this bit of paragraph after finishing my post and doing one more Google search.) Dr. Shaw behaved as expected, claiming he found both HPV and aluminum in Jasmine's brain, as well as unspecified abnormalities. This particular news report did not explain how Dr. Shaw found these things, and, given his track record, I'd want to know his methodology, in particular his negative controls for HPV before I'd believe him. Indeed, as I explained before, the amount of HPV DNA in Gardasil is minuscule; so it defies plausibility that the vaccine could be the source of so much HPV, if it really were there. Remember, in order to detect HPV DNA in the vaccines themselves, it took a super-sensitive PCR test (perhaps so sensitive as not to be specific). In other words, the amount of HPV DNA in Gardasil in the vaccine itself is minuscule, barely detectable only with an extremely sensitive assay. Now introduce it subcutaneously into someone's body, thus diluting it enormously, and then wait six months? No, it's utterly implausible to assume that the presence of HPV, if what Dr. Shaw is reporting is not a completely spurious result (which it probably is, given his track record), means that it could only have come from the vaccine.

Which brings us to the next "expert," another member of the rogues' gallery of antivaccine doctors and scientists, who testified before Dr. Shaw:

Dr San Hang Lee a pathologist at Milford Hospital in Connecticut gave evidence on the second day of the inquest by videolink.

He had been sent Jasmine’s post mortem blood and found her blood and spleen were positive for the human papillomavirus, or HVP.

The Gardasil vaccine is given to prevent some strains of HPV.

He said it was not the result of a nature HVP infection, most likely the DNA was bound to aluminium which was also found in Jasmine.

“The HPV gene is foreign DNA and its detection six months after injection is not normal,’’ he told the inquest.

He said the DNA may cause a reaction that could lead to lethal shock although it was not known if it caused her death but it needed further investigation.

He said it was not known if it was the cause of death but it needed further investigation.

Dr Lee said he also tested five samples of the vaccine sent from New Zealand and found HVP in each.

One wonders if the inquest board was aware that Dr. Lee was unceremoniously given the boot as director of the diagnostic laboratory at Milford Hospital in December 2010. His chairman also didn't recommend that Dr. Lee's medical staff privileges be renewed. Given that you can't get medical staff privileges without the endorsement of the chair of your department or the chief of your clinical service (in a nonacademic hospital that doesn't have chairmen, for example), that means Dr. Lee's chair basically fired him from the hospital altogether. The last time I blogged about this (October 2011), Dr. Lee was appealing and still had medical staff privileges. I also said at the time, if I were a new chair of a department and found someone like Dr. Lee consorting with a loony antivaccine group like SaneVax, I'd can him too.

As I pointed out above, the amount of HPV DNA in Gardasil is so tiny that it requires nested PCR to detect it. For all intents and purposes, it might as well be homeopathic. Actually, that gives me an idea. Maybe it was the memory of HPV that resulted in all that HPV being detected in the autopsy specimens! But apparently that tiny amount of HPV is so powerful that it can cause "microcompetition." Well, not really. As I explained before, the amount of HPV DNA involved is so tiny as to be inconsequential and it is not easy to get DNA into cells, much less to get it to express its proteins.

I do note, however, yet another morphing of a hypothesis. Or maybe I should call it the merging of two woos. Now it's not just the HPV DNA or the aluminum adjuvants. Now, apparently, somehow the evil aluminum combines with the dastardly HPV DNA (as tiny amount as it is) in order to become synergistically diabolical. One wonders how this came about. Maybe Drs. Lee and Shaw met at a SaneVax meeting. Who knows? However this happened, in retrospect I suppose I should have seen it coming. Now, not surprisingly, SaneVax is all over it, citing Dr. Lee as saying, "The naked DNA in the vaccine was probably stabilized through a chemical binding between the mineral aluminum and the phosphate backbone of the double-stranded DNA." One notes that there is not a plausible chemical mechanism by which aluminum can do this in the body in the manner that Dr. Lee claims.

In the meantime, what I see is a tragic story of a young woman cut down in the prime of her life, most likely (although not certainly) by a genetic defect in cardiac conduction that led to arrhythmias and sudden cardiac death. A grieving mother, shocked by the suddenness and randomness of the tragedy, is unable to accept the most likely explanation, particularly given the uncertainty, latches onto something she can blame. Why? Who knows? But it didn't help that she hooked up with antivaccinationists like Hilary Butler, who immediately began flogging the Jasmine Renata case as "proof" that Gardasil kills. The end result causes harm not just to public health but to Rhonda Renata as well. She'll never be able to let go and heal as long as she is convinced (almost certainly mistakenly) that Gardasil killed her daughter.

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Grant, you continue to lie! You said, "Regards the BZP advocacy thing Ron is raising – I’ve just learnt that Ron is a partner in ‘Stargate International’."

I am not a "Partner in Stargate International" and never have been... your statement is false; at least Alison acknowledges that, thanks Alison.

I have also NEVER EVER advocated the use of BZP. I have never used drugs. Our three children were brought up in a total drug-free home, including no alcohol.

Matt approached me unsolicited (I did not know who he was) in early 2004 when he saw a regulatory model I had developed for Natural Health Products... he asked if it would work for party pills... I said, absolutely... if party pills were unacceptably hazardous they would be banned... otherwise they would have restrictions put in place proportionate to any risks.

He asked if I would assess the risks... I said yes, on two conditions... firstly, that the outcomes were not predetermined, and secondly that he had no veto rights over the outcome. (plus, of course, he had to pay me... risk and policy advice is my business... still is.

I had privileged access to individual company sales records which I verified as best I could. I was able to determine approximate sales $, pills and 'doses.' I approached all EDs in the country and every database/source/expert I could to identify problems regarding the use of mainly BZP...

The outcome was the outcome... and my work provided the basis for the Misuse of Drugs Amendment Act 2005.

From there I developed a code of practice for the industry. STANZ code of practice was publicly notified in June 2004 for a round of public consultation.

Nearly 400 submissions were received, including submissions from a wide spectrum of organisations and individuals such as the Centre for Adverse Reaction Monitoring (CARM), the Pharmaceutical Society, District Health Boards, individual pharmacists, community organisations, manufacturers, distributors, retailers, consumers and Medsafe.

Apart from 2 or 3 extreme submissions opposing any controls, over 99% of government/quasi government, industry and consumer submissions endorsed the
proposed code of practice in principle.

Subsequently BZP became demonised, mainly driven by MP Jacqui Dean from Dunedin after 5 youths walked into the ED... that's right they walked in. They were reassured and sent home... it became headlines...

Well I'd have a word to Matt Bowden about his website Ron, because he clearly referrs to you as a partner. You might suggest he amends that to 'consultant' and since you're 'not anti-vaccine' you might also be concerned about your starring role in this particular tissue of lies and inaccuracies. It brings to mind the old adage about being judged by the company you keep! http://www.naturalmedicine.net.nz/vaccination/do-the-nz-ministry-of-hea…

By nz sceptic (not verified) on 22 Aug 2012 #permalink

I am not a “Partner in Stargate International” and never have been… your statement is false; at least Alison acknowledges that, thanks Alison.

I didn't acknowledge the statement to be false, Ron: I was pointing out that it was a possible interpretation of a statement on Stargate's webpage.

nz sceptic... LOL... on that basis, you are keeping company with very dodgy people... Enjoy it while it lasts... :-))

.

Alison, even you could see that "“Partner in Stargate International” was a disingenuous rewording of the truth... please don't stoop to the depths Grant has... you are way better than that.

As nz sceptic says, in that case you had better get Stargate to reword their website so as to avoid unfortunate misinterpretations.

Ron,

So you make a great big fuss about: 'advocacy'. Fine, put that one word aside if it makes you happy. It is fairly obviously I writing loosely, so there wasn't a need to dramatise that. You do this thing of picking on little bits rather than the actual message, the larger picture, all the time. Krebiozen noted similar earlier and, frankly, it's tedious.

Moving on from 'advocacy'.

As I was saying, 'Partners' is on their website - if you have a problem with that, talk to them about it. I didn't write that website.

nz sceptic: "You might suggest he amends that to ‘consultant’ "

It's curious still, as they write "contract the services of", which is more usually to outsource part of the company's work rather than the independent assessment that Ron described. But, "whatever".

Ron: "Alison, even you could see that ““Partner in Stargate International” was a disingenuous rewording of the truth…" - I notice you're inserting inappropriate accusations in again. Disingenuous implies deliberate, which is clearly false, so food for thought - given that I could then offer your same word back at you ;-)

"nz sceptic… LOL… on that basis, you are keeping company with very dodgy people… Enjoy it while it lasts… )"

LOL at yourself Ron. You're a graduate of the Winston Peters' School of Grandstanding aren't you? I remember you promising the great MeNZB denouement many years ago - but we're still waiting!

I guess Jasmine Renata will be much of the same.

By nz sceptic (not verified) on 23 Aug 2012 #permalink

@ Ron Law, more deflection? You are listed as a partner on the Bowden website; you're issue is with them, not with those who read and post information from that website. Additionally, if you are no longer a member of an organisation, it is tacky and dishonest to continue to list your affiliation.

I'm also still waiting for your explanation as to how a risk policy advisor can conflate clinical trial surveillance with recreational drug use reports. Also, how the deaths during the Gardasil trial warrant blaming the vaccine.

By Science Mom (not verified) on 23 Aug 2012 #permalink

Ron,
I have had to go through this several times as I found it hard to believe you have this so badly and embarrassingly wrong.

My point is that before the polio vaccine campaigns were introduced, most AFP cases were diagnosed as polio; there was no routine polio testing done. Once polio programmes are introduced the testing is routinely done and cases of AFP negative to polio virus are classified as NPAFP. This is exactly what happened in India, and was the point I made. The graph was created from official WHO data… it speaks for itself. the thousands of negative tests for polio in stool samples from AFP patients in India are not false negatives due to incompetence nor are they deliberately faked…. it’s just that before the vaccine was introduced they were classified as polio.

But that's simply not true. Only AFP cases that were diagnosed as polio were reported before 1997, as the ian National Polio Surveillance Project makes clear. You claimed on the BMJ site that:

Given that the WHO has recently announced to all and sundry that India is now officially polio free, let's look at the WHO's own data, from their website. Despite claims that there were 30,000+ cases of polio in 1995, only 1,005 cases of AFP were notified in 1996, all of them being diagnosed as polio. In 2011, there were 60,849 cases of clinically diagnosed polio-like paralysis, one (1) of which was confirmed as polio...

So are you claiming that India is not polio free or not? A fall from 4,322 confirmed cases in 1998 to only 1 last year looks like excellent progress to me. You're not making the mistake of thinking that the increased number of reported AFP cases is due to increased incidence instead of improved surveillance, are you? After all someone pointed that out to you on the BMJ website that AFP is a set of symptoms, with many causes other than polio, and that before 1997 AFP was reported by passive surveillance, which is why the number of reported cases has increased greatly since then, due to the 8,371 AFP surveillance reporting units now actively looking for AFP cases. You also wrote:

I wonder if the parents of those 60,000 children paralysed each year by what [mostly] used to be called polio, are celebrating that their children didn't have polio... whew, what a relief!

Except those cases didn't "[mostly] used to be called polio", as the WHO figures and NPSP make clear. The 1,005 cases reported as AFP in 1996 were all confirmed as polio, and the (presumably) several thousand other cases of AFP that were not reported were not diagnosed as polio. Active surveillance, not surprisingly, finds many more cases.

By Krebiozen (not verified) on 23 Aug 2012 #permalink

That should read "Indian National Polio Surveillance Project", but the link works OK.

By Krebiozen (not verified) on 23 Aug 2012 #permalink

INEFFICACY OF THE VACCINE AGAINST THE HPV SEEN BY DOCTOR OF
PERU DEPHT

From its inception until the appearance of tha uterine carcinoma of the cervix (UCC) take in average 25 to 30 years; the investigation on the vaccine against the human papilloma virus has begun the 2000; the scientific efficacy of this vaccine has just determined in the years 2025-2030
HPV not causes definitely the (UCC); in the onset of this disease are involve multiple risk factors, including suspected HPV, but there are security for epidemiology and statistics that sex generates the disease. Mix in 130.000 nuns not found not any UCC.
To accept that a virus or bacteria cause a disease must indefectible fulfill the 5 Koch postulates:
http://www.xatakaciencia.com/salud/los-postulados-de-koch
1. The agent must be present in each case of the disease and absent in healthy subjects.
2. The agent should not appear in other diseses,
3. The agent must be isolated in pure culture from the lesions of the diseases,
4. The agent has to cause the disease in an animal capable of being incoculated,
5. The agent must be newly in the lesions of animal in experimentation
http://es.scribd.com/doc/44558220/MICROBIOLOGIA-1
Consequently HPV do not fulfill not any of Koch's postulate; fulfill this postulate is accepted as dogma in medicine, scientifically we can sure that the HPV is not the
causative agent of the UCC
Until June 2012 solely in USA was 263, 328 advers efffects, disabling irreversible 8,860, death 1160, abnormal PAP 4900, dysplasia cervical 1950, cervical cancer 560.
http://du104w.dub104.mail.live.com/default.aspx#!/mail/InboxLight.aspx?… .
To accord of Vaccine advers effects reaction (VAERS) information that is denounced
solely between 1% to 10%
http://www.noticiero.enkoria.com/2011/diez-menores-que-sufrieron-reacci…
Dr. Harper, who helped develop the vaccine for Merck reports that the vaccine was not investigated in children under 15 years and the vaccine given to children under 11 years is a big public experiment.
http://offtheradar.co.nz/vaccines/53-researcher-diane-harper-blasts-gar…
The vaccine was approved to give girls not contaminated with HPV; Dr.Howenstinc say if women are vaccinated contaminated with HPV are able to acquire a 44.6% CCU http://www.newswithviews.com / Howenstine/james170.htm.
This vaccine is transgenic; the Sane vax has discover that Gardasil is contaminated with DNA recombinant (DNArPVH) and has raised its concern to the president of the FDA Margaret Hamburg; the FDA replied that its presence does not cause any harm.
A vaccinated girl became ill with rheumatoid arthritis, which is an autoimmune disease. 24 hours after vaccination and found that the DNArPVH adhered to aluminum, two years after vaccination.
http://www.mecfsforums.com/index.php?topic=9331.0
To introduce the vaccine are using the marketing of fear:
http://mujeresenaccion.over-blog.es/article-vph-la-vacuna-del-marketing… http://mujeresenaccion.over- blog.es/article-vph-la-vacuna-del-marketing-del-miedo-67210961.ht
HPV is ubiquitous and lives in wild and domestic animals, we pollute from birth, is on the doorknobs, on towels, on the nails, on fomites, in gloves and specula of gynecologists; sexual intercourse is not the solely means of contamination.
http://spa.myhealthygood.com/cancer-cervical-vacuna-contra-el-vph/inves…
HPV also lives in the 400 nm outermost of our skin and mucous membranes. ,
If live on our skin, our immune system produces cellular and humoral immunity; our body is naturally being vaccinated for HPV to live on our skin and mucous ..
http://www.conganat.org/seap/bibliografia/HPVToday/HPVToday007SEAP.pdf
The cervical carcinoma, neither the HPV are infections, contagious, epidemical, nor infectd only by the coitus
Gardasil is genetically modified;; known vaccines are made from killed or attenuated original bacterial or virus; it is UNKNOWN damage that produce in the future and is prepared to prevent infection only of HPVs 16 and 18; it is know that exist 200 species of HPV.
http://quimicaclinicauv.blogspot.com/2006/08/virus-del-papiloma-humano… http://www-lab.biomedicas.unam.mx/smpv/queeshpv.htm
The HPVs are not distributed uniformly over the world. It was found that in Canada the HPV 18 solely less than 3%, more prevalent is HPV 31, in my country Peru there are no studies that established the predominant types of HPV, gardasiul contains 225 mcg and cervarix 500 mcg aluminum that produce Alzheimer's, it is a mayor neurotoxine, disrupter of neurological funtion and immunoexcitotoxicity and polisorbato 80 which is a potent contraceptive that in the experimental animals produces sterility, atrophy of the testicles and funtional and morphological disturbance of the reproductive organs; are carcinogenic and mutagenic; also contains sodium borate considered poison, not used in medicinal preparations. http://www.telefonica.net/web2/paramahamsa/vacunaninosalerta.html http://detenganlavacuna.wordpress.com/2010/11/09/gardasil-cervarix/
Until now it is know 200 types og PVHs
http://quimicaclinicauv.blogspot.com/2006/08/virus-del-papiloma-humano… http://www-lab.biomedicas.unam.mx/smpv/queeshpv.htm
December 2012 FDA approved the gradasil to boys since 9 to 26 years to prevent the anal cancer and wart. It is a excess.
http://www.saludpanama.com/la-fda-aprueba-gardasil-para-su-uso-en-ninos…
http://salud.aollatino.com/2011/02/02/aprueba-fda-nueva-indicacion-vacu…
For the reasons from Peru, depth, Huancayo, I believe that this vaccine is a Fraud?, Robbery?, Swindle?, Rough Joke?; it is not scientifically proven at this time, its effectiveness will be verified just the years of 2025-2030.
Dr. Godfrey Arauzo
E mail: godo.ara@gmail.com
Tel.: 05164252052

By Godofredo (not verified) on 23 Aug 2012 #permalink

Ron, do you know how to post the real email, or do you just think typing some words into a comment box is evidence enough that you couldn't afford to pay your membership dues anymore?

I suspect that even if Ron does have evidence tucked in his sleeves somewhere, he wouldn't know what to do with it.

He certainly doesn't recognise evidence when it's shown to him. The rest of it just seems one large argument from authority.

...Disengage people, disengage. He sidesteps the goals like an Olympic medal equestrian.

Take a look at what I wrote… then take a deep breath and chill… where did I say I saw someone in SE? I said, “I used to work with someone who had regular seizures… he’d fit once a week or so, despite the best of medication…

So, what, it was just a moment of free association? Try again, assmonkey.

Herr Doktor B. the LAST thing I'm interested in seeing is a photograph of the bulges in Ron's trousers, leprecahauns be damned.

@ Ron Risk Analyst: About our *debate* regarding status epilepticus...I first referred you to this Wikipedia article for the "harmless effects" of your *party pill*:

http://en.wikipedia.org/wiki/Benzylpiperazine

"Christchurch study

The majority of the toxic effects information came from a study conducted between 1 April 2005 to 1 September 2005. The study recorded all presentations associated with party pill use at the Emergency Department of Christchurch Hospital, New Zealand by recording them on a prospective data collection form. The aim was to study the patterns of human toxicity related to the use of benzylpiperazine-based 'party pills'. 61 patients presented on 80 occasions. Patients with mild to moderate toxicity experienced symptoms such as insomnia, anxiety, nausea, vomiting, palpitations, dystonia, and urinary retention. Significantly, fourteen toxic seizures were recorded with two patients suffering life-threatening toxicity with status epilepticus and severe respiratory and metabolic acidosis. It was concluded that BZP appears to induce toxic seizures in neurologically normal subjects.[25] The results of this study and others like it[22][26] showed that BZP can cause unpredictable and serious toxicity in some individuals, but the data and dosage collection were reliant on self reporting by drug users, which may result in under-reporting, and there were complicating factors like the frequent presence of alcohol and other drugs.[26]"

You then stated you have seen a colleague have weekly epileptic attacks, which according to your description are clonic-tonic/grand mal epilepsy attacks and, according to your description are definitely NOT status epilepticus.

Let me get this straight Ron Risk Analyst. You and your business associate are substituting *party pills* and other drugs to market to drug and alcohol addicts. Your *party pills* have already caused deaths. What's in the pipeline for alcoholics? You do know, don't you, about Antabuse which isn't addictive, which does not leave a person impaired and which, when prescribed to a motivated alcohol-addicted individual, is quite effective to end an alcohol addiction...

http://alcoholism.about.com/od/meds/a/antabuse.htm

Poor old Koch must be turning in his grave at the abuse his postulates receive these days.

By Krebiozen (not verified) on 23 Aug 2012 #permalink

Ron, you do have a tendency to describe comments you disagree with as 'vitriolic'. That word, I do not think it means what you think it means.

Godofredo, that's quite a long comment. I notice that it contains absolutely no published scientific evidence.

Take your NVIC copypasta somewhere else.

Godofredo,
I assume English is not your first language and in places I am not sure I properly understand you, but I will do my best to respond nevertheless.

the scientific efficacy of this vaccine has just determined in the years 2025-2030
The vaccine has been shown to prevent precancerous lesions, and these same precancerous lesions are known to progress to cervical cancer. How many people would die if we waited anther 30 years for the results that are almost certain to be seen, particularly when the HPV vaccine is so safe and effective?

To accept that a virus or bacteria cause a disease must indefectible fulfill the 5 Koch postulates:

Koch abandoned his first postulate, and it is now accepted that Koch's postulates are sufficient but not necessary to establish causation.

Consequently HPV do not fulfill not any of Koch’s postulate; fulfill this postulate is accepted as dogma in medicine, scientifically we can sure that the HPV is not the causative agent of the UCC

That's not true.

To accord of Vaccine advers effects reaction (VAERS) information that is denounced solely between 1% to 10%

VAERS is not a reliable source of information; the active surveillance done on HPV vaccines is much more reliable and does not suggest that they cause adverse effects more than placebo.

Dr. Harper, who helped develop the vaccine for Merck reports that the vaccine was not investigated in children under 15 years and the vaccine given to children under 11 years is a big public experiment.

There is no good reason to think these vaccines cause any problems and very good reasons to think they will save many lives and a great deal of human misery.

The vaccine was approved to give girls not contaminated with HPV; Dr.Howenstinc say if women are vaccinated contaminated with HPV are able to acquire a 44.6% CCU

Dr. Howenstic quotes Mike Adams of Natural News who is a very unreliable information source.

This vaccine is transgenic;

Not by any definition of the word 'transgenic' I am familiar with.

the Sane vax has discover that Gardasil is contaminated with DNA recombinant (DNArPVH) and has raised its concern to the president of the FDA Margaret Hamburg; the FDA replied that its presence does not cause any harm.

SaneVax is a notorious antivaccine organisation, this finding has not been independently replicated, appears to depend on highly sensitive nested PCR techniques and even if it is correct, there is no reason to think vanishingly tiny amounts of fragments of HPV DNA can cause any harm.

To introduce the vaccine are using the marketing of fear:

Are you suggesting that cervical and other cancers are not something to be feared?

HPV is ubiquitous and lives in wild and domestic animals, we pollute from birth, is on the doorknobs, on towels, on the nails, on fomites, in gloves and specula of gynecologists; sexual intercourse is not the solely means of contamination.

Yet you want us to believe that the tiniest trace of its DNA is dangerous?

If live on our skin, our immune system produces cellular and humoral immunity; our body is naturally being vaccinated for HPV to live on our skin and mucous

If that were true, none of us would get warts.

The cervical carcinoma, neither the HPV are infections, contagious, epidemical, nor infectd only by the coitus

Some HPV infections lead to a greatly increased risk of cervical cancer. HPV vaccines are very effective at preventing these infections. That is very clear from the clinical trials.

Gardasil is genetically modified;; known vaccines are made from killed or attenuated original bacterial or virus;

It is not itself genetically modified, it is made by baker's yeast into which HPV DNA has been inserted so it produces only the protein coat of the virus that our immune system recognizes and not the entire virus that can cause disease. This is a major breakthrough in vaccine production, a way of making vaccines that is safer and more effective than ever before.

The HPVs are not distributed uniformly over the world. It was found that in Canada the HPV 18 solely less than 3%, more prevalent is HPV 31, in my country Peru there are no studies that established the predominant types of HPV,

I'm sure that in the future HPV vaccines will be better targeted and will cover more strains, thus saving even more lives and suffering.

gardasiul contains 225 mcg and cervarix 500 mcg aluminum that produce Alzheimer’s, it is a mayor neurotoxine, disrupter of neurological funtion and immunoexcitotoxicity

Aluminum does not cause Alzheimer's, 500 µg of intramuscular aluminum will not disrupt neurological function or cause immunoexcitotoxicity, even in someone with renal impairment.

and polisorbato 80 which is a potent contraceptive that in the experimental animals produces sterility, atrophy of the testicles and funtional and morphological disturbance of the reproductive organs; are carcinogenic and mutagenic;

Please compare the tiny amount of polysorbate 80 in vaccines to the amount required to cause these problems, and note that it is a surfactant similar to dishwashing liquids and is used in many foods, including ice cream, in far larger quantities than in vaccines.

also contains sodium borate considered poison, not used in medicinal preparations.

Again present in tiny fractions of the amounts that could possibly be poisonous.

December 2012 FDA approved the gradasil to boys since 9 to 26 years to prevent the anal cancer and wart. It is a excess.

Why is this an excess? Do homosexuals and those who practice oral and anal sex not deserve to be protected from diseases for some reason? What about the sexual partners of these boys? Do they not deserve to be protected?

For the reasons from Peru, depth, Huancayo, I believe that this vaccine is a Fraud?, Robbery?, Swindle?, Rough Joke?; it is not scientifically proven at this time, its effectiveness will be verified just the years of 2025-2030.

I suggest you come back here then and admit just how wrong you are in your alarmist and dangerous doom-mongering.

By Krebiozen (not verified) on 23 Aug 2012 #permalink

Apologies for mangled blockquotes: annoyed and in a rush.

By Krebiozen (not verified) on 23 Aug 2012 #permalink

December 2012 FDA approved the gradasil to boys since 9 to 26 years to prevent the anal cancer and wart. It is a excess.

I got my teenaged sons vaccinated so I clearly don't think it's an excess. If it prevents genital warts in them and cervical cancer in their future partners, it's a good thing.

Krebiozen, can you explain the logic as to how 100% of 1005 AFP cases were there diagnosed as polio in 1996 but 100% of 60,000 AFP cases were there diagnosed as non-polio in 2011?

AFP is AFP... the clinical symptoms are identical whether polio or not. So what's caused this terrible epidemic of 60,000 cases of AFP in 2011 in india. Why would anyone be celebrating when the problem in the streets is (according to official figures) 60 times worse????

http://apps.who.int/immunization_monitoring/en/diseases/poliomyelitis/a…

Could someone get Th1Th2 on the blower to liven this dismal spectacle up?

Could someone get Th1Th2 on the blower to liven this dismal spectacle up?

No kidding.

Krebiozen, can you explain the logic as to how 100% of 1005 AFP cases were there diagnosed as polio in 1996 but 100% of 60,000 AFP cases were there diagnosed as non-polio in 2011?

He did, back at time stamp 8:29 AM today. Oh I see the problem; he DID use logic. You claim 35 years of "studying medical literature" and "lecturing on study methods" but you don't understand what passive and active surveillance can do to disease prevalence estimates? You still can't explain the difference in clinical trial surveillance and passive recreational drug adverse event collection? Do yourself a favour Ron and don't try to inflate your experience, you're embarrassing yourself in stunning fashion.

By Science Mom (not verified) on 23 Aug 2012 #permalink

Science Mom, he did not even understand that a genetic test cannot check for sequences that cause cardiac disorders that have not yet been discovered.

We've had Ron's peculiar ideas foisted on us in NZ for many years - often via press releases authored by himself - and quoting himself. I'd forgotten this one wherein the Auckland District Health Board was apparently 'condemning patients to death' if it didn't supply high-dose vitamin C treatments, despite any meaningful evidence of efficacy! As we wait for yet another promised 'big reveal' - in this case, pertaining to Jasmine Renata, it strikes me that Ron promises these dramatic denouments regularly but has never, to my knowledge, delivered!

By nz sceptic (not verified) on 23 Aug 2012 #permalink

Science Mom,... I didn't notice the logic... I noticed the reporting process...

So go to another page on his ref...

In May 1988, the World Health Assembly committed the member nations of the World Health Organization (WHO) to achieving the goal of global eradication of poliomyelitis. This goal is defined as:

· no cases of clinical poliomyelitis associated with wild poliovirus, and

· no wild poliovirus found worldwide despite intensive efforts to do so.

http://www.npspindia.org/Eradication%20Strategy.asp

So the celebration of the eradication of polio is based on the fact that there are now 60,000 reported cases of clinical poliomyelitis not caused by the polio virus.

Now that is a cause for celebration. 60,000 families of victims of clinical poliomyelitis are comforted by the fact that the paralysis/death was caused by something else... phew, what a relief...!!!

Prior to 1997 all polio cases were simply those notified by a doctor with no standard definition... so there was no way of knowing how many were actually caused by a wild polio virus.

In 1998 there were 9467 cases of AFP reported...4316 of these were confirmed positive for polio... 1932 of these being wild polio, so one assumes the balance were caused by the vaccine.

I fully understand the logic of Krebiozen's response... comparing pre and post polio case numbers is like comparing apples and oranges...

But try telling the families of the 60,000 paralysed/killed with non-polio AFP that they should be grateful that the polio vaccine was so successful that they should join in the polio eradication celebrations as their loved ones weren't paralysed/killed by polio...!

Whew... what a relief!

So, the original comment stands the test of science... even rabid self-proclaimed sci-bloggers...

Aluminium’s bioavailability is poor… about 0.1-0.3 percent of what is ingested. An adult absorbs, on average, about 7ug per day. A baby, about 1ug per day, a bit more with formula and soy fed babies…

A 6 week old baby in New Zealand at least, even premature babies weight 1-2 kg, gets injected with 1,320ug of aluminium… repeated at 3 months and 5 months… a total of 3,960 ug… over 108 days… that’s an average of 36 times the expected amount absorbed via food, in bolus doses.

It is not scientifically defensible to claim that the amount of aluminium injected into babies is the same as consumed via food… as a tiny fraction of what’s in the food gets absorbed.

Ron,

So the celebration of the eradication of polio is based on the fact that there are now 60,000 reported cases of clinical poliomyelitis not caused by the polio virus.

You are assuming that all those AFP cases are clinically identical to polio, which is not true as AFP is only one symptom of paralytic polio. This paperexplains the differential diagnosis of different cause of AFP.

There are many other possible causes of AFP including injuries such as car accidents and snakebites (there are plenty of both in India). The point of active surveillance is to take very close look at every possible case of paralytic polio, by checking each and every case of AFP, no matter how unlike paralytic polio it is. As the paper I cited above puts it, "To ensure the success of the poliomyelitis eradication initiative, it has become critical that surveillance be intensified so that the absence of wild poliovirus circulation can be verified with confidence in countries not reporting confirmed cases of poliomyelitis."

If you look at the WHO data again you will notice a column titled "Non-polio AFP rate" which has climbed from zero in 1996 to 16.1 in 2011. This is the number of cases of AFP found per 100,000 of the population screened, and is essentially the false positive rate. As that paper puts it, "The currently used case definition increases sensitivity in detecting the existence of AFP but tends to decrease specificity in detecting paralytic poliomyelitis." The fact that the false positive rate has climbed so dramatically shows that an increase in sensitivity has also resulted in a decrease in specificity.

To quote that same paper again, "For the eradication of poliomyelitis, a highly sensitive but relatively nonspecific case definition was selected by the World Health Organization. Officials in national poliomyelitis eradication programs first introduced highly sensitive case definitions to avoid missing true cases of the disease, though false-positive diagnostic errors could still occur because of low specificity. No single practical clinical case definition combining both high sensitivity and high specificity has become available; however, virologic isolation of poliovirus from stools of patients with AFP provides the necessary specificity for confirming poliomyelitis."

You appear to be attributing the increase in the false positive rate to an increased incidence, and complaining that the polio vaccine does not prevent AFP with causes other than polio which is, to put it as politely as I can, not justified.

By Krebiozen (not verified) on 24 Aug 2012 #permalink

Ron,

It is not scientifically defensible to claim that the amount of aluminium injected into babies is the same as consumed via food… as a tiny fraction of what’s in the food gets absorbed.

Good grief, do you still not get it? Regular ingestion of food containing a large amount of aluminum results in a small but constant absorption of aluminum into the bloodstream. Intramuscular injection of insoluble aluminum salts results in slow dissolution and a small but constant absorption of aluminum into the bloodstream. The end result is almost exactly the same.

By Krebiozen (not verified) on 24 Aug 2012 #permalink

You appear to be attributing the increase in the false positive rate to an increased incidence, and complaining that the polio vaccine does not prevent AFP with causes other than polio which is, to put it as politely as I can, not justified.

I applaud your efforts Krebiozen but it appears as though Ron has gone into bot mode and no amount of explanation will penetrate. Ron is an example of a little knowledge is a dangerous thing.

By Science Mom (not verified) on 24 Aug 2012 #permalink

@Science Mom

"A little knowledge"

I don't think you should credit him with that much, to be honest.

Science Mom,

I applaud your efforts Krebiozen but it appears as though Ron has gone into bot mode and no amount of explanation will penetrate.

I know, I have this vain hope that if I could frame it in the right way he would understand. I remember coming across the claim that polio had been dishonestly reclassified some years ago, but that was as aseptic meningitis not AFP, in IIRC Janine Roberts' 'Fear of the Invisible' (don't read that if you are a skeptic with high BP). I wondered if it could possibly be true, so I did a lot of digging and found that it isn't. That was what sparked my interest in polio and AFP. The illusory increase in AFP is similar to the illusory increase in autism, both caused by increased surveillance and changed criteria.

AFP had previously meant alpha-fetoprotein to me, as I was once responsible for developing a prenatal maternal screening program for Down Syndrome and neural tube defects. That's another kind of screening where sensitivity and specificity have to be balanced by adjusting false positive rates to decide who gets the diagnostic test (in that case amniocentesis).

By Krebiozen (not verified) on 24 Aug 2012 #permalink

@ nz sceptic: Great link to another of Ron Risk Analyst's pronouncements. Why do you think I asked him here to tell us why Grant shut down the comments on his Sciblog? I just *knew* Ron Risk Analyst would, given enough rope, hang himself. He's so busted now, that he will never recover.

I still find it hard to believe that Ron Risk Analyst ever attained an undergrad degree in any type of lab science. He is totally clueless what constitutes a "differential diagnosis"

Lilady, it was a diploma, not a degree. Big difference!

By sheepmilker (not verified) on 24 Aug 2012 #permalink

@ Krebiozen:

Janine Roberts!
It appears that we both have been slumming around the same tawdry backstreets: at the intersection of bad science and worse writing.

By Denice Walter (not verified) on 24 Aug 2012 #permalink

lilady,

I still find it hard to believe that Ron Risk Analyst ever attained an undergrad degree in any type of lab science.

Working in medical laboratory sciences gives you a lot of learning opportunities. If things are similar in NZ to the UK (and I suspect so as I have worked with some excellent lab workers who trained in NZ) you are required to pass exams in a wide variety of subjects, such as cell biology, physiology, genetics, immunology and others as well as lab work, which are equivalent to an undergraduate degree. For example I can strip down and repair a blood gas analyzer, but I also have to know what a set of blood gas results mean, as results that don't fit with the diagnosis are a good reason to doubt the integrity of the machine. If you work in a hospital you usually have access to a medical library, journals, lectures and case presentations and even the chance to attend ward rounds and sometimes watch autopsies and surgery.

There is little obligation to avail yourself of these opportunities, though you are supposed to maintain your professional development, and I have known several medical laboratory scientists who have specialized in technical aspects of the job, and have had little interest in the clinical side. It really depends on how curious you are and where your interests lie.

By Krebiozen (not verified) on 24 Aug 2012 #permalink

Krebiozen, I'm fully aware of the broader description of AFP, but, with respect, AFP as a result of a car accident or some other known cause is not the same as AFP used in polio surveillance.

Case Definition:

In the Global Polio Eradication Initiative (PEI), acute flaccid paralysis is defined as:

Any case of AFP in a child aged <15 years, or any case of paralytic illness in a person of any age when polio is suspected.

Acute: rapid progression of paralysis from onset to maximum paralysis
Flaccid: loss of muscle tone, “floppy” – as opposed to spastic or rigid
Paralysis: weakness, loss of voluntary movement

Any case meeting this definition undergoes a thorough investigation to determine if the paralysis is caused by polio.

http://www.npspindia.org/Surveillance%20Strategy.asp

Before the active screening was used in India, the definition for polio was whatever the doctor decided.

As for your comment denying the change in definition of polio in the 60's, have you read "The Present Status of Polio Vaccines" in the 1960

"Prior to 1954 any physician who reported
paralytic poliomyelitis was doing his patient a
service by way of subsidizing the cost of hospitalization
and was being community-minded in
reporting a communicaable disease. 'The criterion
or diagnosis at that time in most health departments·
followed the World Health Organization
definition: "Spinal paralytic poliomyelitis:
Signs and symptoms of nonparalytic poliomyelitis
with the addition of partial or complete
paralysis of one or more muscle groups, detected
on two examinations at least 24 hours apart.""
Note thatt "two examinations at least 24 hours apart
was all that was required. Laboratory
confirmalion and presence of residual paralysis
was not required. In 1955 the criteria were
changed to conform more closely to the definition used in the 1954 field trials: residual paralysis was determined 10 to 20 days after onset of illness and again 50 to 70 days after onset. The influence of the field trials is still evident in most health departments; unless there is residual involvement at least 60 days after onset, a case of poliomyelitis is not considered paralytic.

Have a read... it's a two part article... essentially a transcript with tables etc of a discussion on the politics and science surrounding the introduction, 'successes' and 'failures' of the initial polio campaigns. I'd be interested in your thoughts once you've read it.

Have you ever gone back through official stats and looked at the rise and fall of 'polio' and related/similar illnesses?

Krebiozen, if you were trying to reassure mums and dads that Aluminium injected via vaccine would you tell them that the amount of aluminium in a dose of an aluminium containing vaccine injected into a baby is the same as what the baby would;

1, normally consume in a day?

or

2, normally absorb in a day?

@Ron - so, in your humble opinion, where did smallpox go?

Krebiozen... for the record, your description of medical laboratory science training is very good.

I sat and passed 21 papers over 5 years, without failing any. Disciplines covered included Microbiology, Clinical Biochemistry, Haematology, Blood Transfusion, Immunology, Virology, Histology, Nuclear Medicine... I specialised in clinical biochemistry in my final two years (which included aspects of other disciplines such as immunology and nuclear medicine) and was top student in New Zealand for both years. I lectured in clinical biochemistry for 10 years and had the privilege of spending about a day a week immersed in medical literature in the medical library. I was one of the pioneers in using the library based academic 'internet' in the 1980's and have been an avid reader of medical science for over 40 years.

Lawrence, I don't have an opinion on smallpox as it is not something that I've invested time looking at.

One thing for sure, it went somewhere.

Have you ever gone back through official stats and looked at the rise and fall of 'polio' and related/similar illnesses?

Yes, and clearly some diseases were in the past misdiagnosed as polio. That doesn't make the success of the polio surveillance and vaccination programs any less admirable. Once polio has been eradicated I'm sure other enteroviruses will become a target for eradication, and I know that there are people currently working on Guillain Barre which is another common cause of AFP. In the case of other diseases I have wasted a lot of time looking at the figures antivaccine advocates present as evidence that vaccines are ineffective, and I have found that the facts have been twisted, misrepresented and in many cases have seen serious misunderstandings or deliberate deceit. Your apparent claims that attempts to eradicate polio have resulted in a huge increase in cases of AFP are a good example, or is that not what you are claiming? If not, perhaps you could make your position clearer.

Krebiozen, if you were trying to reassure mums and dads that Aluminium injected via vaccine would you tell them that the amount of aluminium in a dose of an aluminium containing vaccine injected into a baby is the same as what the baby would; 1, normally consume in a day? or 2, normally absorb in a day?

Why would I tell them either of those things when a) neither of them is true and b) that isn't what is important? I would tell them that the amount of aluminum that their child is injected with in all their childhood vaccines weighs less than one thousandth of a teaspoonful of water, that their child would absorb a similar amount of aluminum every day from the milk or food they eat and from the vaccines they are injected with, and I would also explain that their child's body is capable of easily excreting hundreds of times more aluminum without causing any problems at all.

By Krebiozen (not verified) on 24 Aug 2012 #permalink

One thing for sure, it went somewhere.

Lemme guess, it's now called monkey pox and chicken pox. (sorry Lawrence, I'm a glutton for punishment).

By Science Mom (not verified) on 24 Aug 2012 #permalink

One thing for sure, it went somewhere.
That would be the "conservation of disease" theory?

By aunt benjy (not verified) on 24 Aug 2012 #permalink

Krebiozen, if you were trying to reassure mums and dads that Aluminium injected via vaccine would you tell them that the amount of aluminium in a dose of an aluminium containing vaccine injected into a baby is the same as what the baby would; 1, normally consume in a day? or 2, normally absorb in a day?

Wait, is Ron admitting that the issue isn't vaccines are dangerous, the issue is that he would be more willing to recommend vaccines if the terminology doctors used was different? No, just a really obvious attempt at a "gotcha".

One thing for sure, it went somewhere.

Ah, the king of ambiguity strikes again...

This guy reminds me of Pegamily.

Snark aside, thanks to the regulars: I learn so much in these comment threads.

Krebiozen, you ask, "Your apparent claims that attempts to eradicate polio have resulted in a huge increase in cases of AFP are a good example, or is that not what you are claiming? If not, perhaps you could make your position clearer."

I haven't said that... that would imply causality. What I have said is that much of what was claimed to be polio still exists... before polio vaccine use was ramped up in India it was estimated by the WHO that there were 30,000 polio cases per year... only a few percent were reported. Now that they have a vigorous polio screening system in place the numbers have risen to 60,000 cases of polio-like AFP...

My point is that the problem has not gone away, yet they celebrate as if it has. Polio itself may have, but what used to be diagnosed as polio isn't now... why? Because they test everyone suspected of having polio.

Krebiozen, can you explain how this is true? "I would tell them that the amount of aluminum that their child is injected with in all their childhood vaccines weighs less than one thousandth of a teaspoonful of water, that their child would absorb a similar amount of aluminum every day from the milk or food they eat and from the vaccines they are injected with, "

A baby absorbs about 1ug of aluminium a day... in NZ at least they are injected with 1,320ug of aluminum at 6 weeks and twice more by 6 months... just in 4,000ug...

For the record, NZ parents are told this by the main govt funded vaccination promotion organisation.

"However with newer techniques miniscule concentrations can now be measured. Preliminary experiments have shown that aluminium adjuvants are dissolved by citrate that is present in the space between cells and then rapidly eliminated from the body. This rapid elimination may be responsible for the excellent safety record of these adjuvants. There appears to be little potential for toxicity with vaccine level exposures to aluminium."

and

Adjuvants

Most of the NZ schedule vaccines use aluminium-based adjuvants and until recently they were the only vaccine adjuvants licensed for human use. They induce a range of inflammatory factors to the injection site which helps the immune response. They have an impressive safety record with over 70 years of use. Some points about aluminium:

Eighth most abundant element on earth, most common metallic element
Found in the blood of all animals, including humans, constantly exposed
Average daily intake 10-15 mg
We get rid of aluminium from our bodies in our urine via kidneys
As an example, hepatitis B vaccine has 0.235 mg of aluminium, water has about 0.2 mg of aluminium per litre
One dose of hepatitis B vaccine contains less aluminium than one days worth of baby formula (infant formula has increased aluminium).

It's sad when science is unable to self-correct when it is found to be so blatantly misleading

Ron,

What I have said is that much of what was claimed to be polio still exists… before polio vaccine use was ramped up in India it was estimated by the WHO that there were 30,000 polio cases per year… only a few percent were reported. Now that they have a vigorous polio screening system in place the numbers have risen to 60,000 cases of polio-like AFP…

I don't want to be rude, but it seems to me you are either really dumb or you are playing silly games for some reason. When we didn't look very hard and relied on passive surveillance we found 1,005 confirmed cases of polio, and after 15 years of strenuous efforts to eradicate polio we looked really, really hard and found only 1 confirmed case. This is somehow a failure?

There were far more than 60,000 polio cases per year in India before 1980 when the OPV was introduced, and by 1985 there were still an estimated 50,000-150,000 cases of polio, not AFP, every year. For instance a survey in Lucknow in 1978 (I visited Lucknow 10 years later, incidentally, and saw many polio victims) found a prevalence of polio-like paralysis in urban areas of 8.2 per 1000, or 820 per 100,000 and "In the preschool age group almost 1 out of every 100 children was affected". Compare that to the 2011 non-polio AFP of 16.1 per 100,000 (actually since there was only 1 polio case that is the total polio and non-polio AFP rate). Bear in mind also that the population of India has almost doubled since then and the proportion of younger people vulnerable to polio and other causes of AFP has greatly increased.

As for the criteria used to diagnose polio, again from the Lucknow study, "Weinstein's (1970) clinical criteria were used to diagnose paralytic poliomyelitis which included acute onset of disease with a spell of fever; asymmetric distribution of paralysis; lower motor neurone type of lesions with muscle wasting; and pure motor involvement with absolute sparing of the sensory system." In other words more than just AFP was required for a polio diagnosis. Many cases of AFP picked up by active surveillance show no residual paralysis after 60 days (43% in 1998) and would not have been diagnosed as polio by any criteria.
Moving on to aluminum.

Krebiozen, can you explain how this is true?

Have you not read what I have written here and at Alison's blog?

“I would tell them that the amount of aluminum that their child is injected with in all their childhood vaccines weighs less than one thousandth of a teaspoonful of water,

A teaspoon of water weighs 5 grams, 5000 milligrams, or 5000,000,000 µg. The entire vaccination schedule contains 4 mg of aluminum (correct me if I'm wrong, I haven't added it up I'm going by a factsheet from a hospital), or less than the weight of 1000th of a teaspoon of water.

that their child would absorb a similar amount of aluminum every day from the milk or food they eat and from the vaccines they are injected with,”

I have posted links to studies that estimate the amount of aluminum absorbed from an i.m. injection of insoluble aluminum salts is less than 0.1 µg per day. I think we agreed that the amount of aluminum absorbed from breast milk and food by a child is in the order of 1-2 µg per day. Whether aluminum is passing unabsorbed through a child's GI tract, or sitting unabsorbed in a muscle, it is not bioavailable.

It’s sad when science is unable to self-correct when it is found to be so blatantly misleading.

So claiming that comparing ingested aluminum to i.m. injected aluminum when they have similar bioavailability is misleading, but comparing i.m. injected aluminum to that actually absorbed from food and drink is not? That's both dishonest and nonsensical.

By Krebiozen (not verified) on 25 Aug 2012 #permalink

ChrisP,
Hem 2001 is another useful source of information.

I have a comment in moderation replying to Ron, though no doubt I'm wasting my time.

By Krebiozen (not verified) on 25 Aug 2012 #permalink

Krebiozen, unless polio rates were known when the mass polio vaccines were started then you are comparing apples with oranges. It is well established that polio cases and deaths were in free-fall before polio vaccine was introduced, and that teh definition was changed dramatically when the vaccine was introduced which in itself reduced the number of cases.

As for the clearance of aluminum, reading all of the references put forward, it seems fairly obvious that no one knows where it goes once injected... it certainly isn't excreted.

Recent studies have even shown that immune response continues even if the injection site is excised... raising questions over what it's role post injection actually is...

No doubt that will start another round of, 'idiot' etc... that seems to be a standard response from defenders of the indefensible...

flip, I've never been anti vaccination... never... I am pro truth, pro evidence-based medicine.

When parents are reassured by authorities that aluminum is nothing to worry about because a baby is exposed to no more via injections than via food then they are being reassured based on lies... scientific fraud in fact.

Really Ron? I don't remember seeing you imploring anti-vax groups to desist from making you their poster boy when you and your friend were busy trying to derail the MenZB vaccine campaign in the mid-2000s. You simply had a vendetta against our Ministry of Health and I don't think you were bothered who 'used' you.

By nz sceptic (not verified) on 25 Aug 2012 #permalink

nz sceptic, nobody used me... what I did emerged from my involvement with the MOH expert working group that advised the DG of Health on the reporting and management of medical injuries in the health system. I had undertaken a risk assessment to establish relative risks related to various hazards in our lives... meningococcal disease never registered on any info I had, so I dug deeper... what I did was never about anti-vaccination... I never once talked about 'vaccination' ... I talked about the policy and scientific deficiencies re MeNZB.

When I spoke in [mostly] packed halls around the country I never once advised or even addressed vaccination per se. If I was asked about other vaccines, my comment was always the same... I am not anti-vaccine, never have been, but my issue was with the policy and science being used to push MeNZB.

If you have any evidence to the contrary, I'd be interested in seeing it.

R

@Ron,

When parents are reassured by authorities that aluminum is nothing to worry about because a baby is exposed to no more via injections than via food then they are being reassured based on lies… scientific fraud in fact.

Would we like evidence with that? Yes, we would. (Invisible super-secret documents not included)

OK Ron, so you were just joking when you said that you were 'proud to have dissuaded "10 to 15 per cent" of parents from having their children vaccinated' with the MeNZB?Please show us where (apart from some vague weasel words muttered lamely about not being anti-vaccine) you actually asked anti-vax organisations not to misrepresent you and your views as part of their mission to demonise all vaccines.

By nz sceptic (not verified) on 25 Aug 2012 #permalink

Ron says, "A baby absorbs about 1ug of aluminium a day… in NZ at least they are injected with 1,320ug of aluminum at 6 weeks and twice more by 6 months… just in 4,000ug"

I think your numbers are off there a bit, Ron.

The 6 week schedule in NZ calls for 2 injections:

Infarix-hexa
Synflorix

Infarix-hexa contains 700 micrograms of aluminum
Synflorix contains 500 micrograms of aluminum

http://www.gsk.ca/english/docs-pdf/Infanrix-hexa_PM_20080718_EN.pdf
http://www.medicines.org.uk/emc/medicine/22743/SPC/Synflorix+suspension…

So... where's the other 120 micrograms you're claiming coming from?

Ron,

Krebiozen, unless polio rates were known when the mass polio vaccines were started then you are comparing apples with oranges.

We may not we know exactly what the incidence of polio in India was before mass polio vaccination but we can make a good estimate. If you look on PubMed you will find many studies in the 50s-80s where exactly that was done, with several discussions about the best way to monitor the incidence of polio and the impact of vaccination. Even if we assume that all the polio case that were diagnosed before active surveillance was introduced would now be called AFP, there were still clearly many more cases before the eradication initiative was introduced. The 1978 study in Lucknow found incidence of polio in urban preschool children approaching 1 in 100. Since the population of India is now 1.24 billion and the birth rate is 22.22 births/1,000 population there must be at least 135 million children aged 5 and under. If 1 in 100 of those had polio or AFP there would be over 1 million of them, Instead, active surveillance last year found 60,000 cases of AFP and no cases of polio.

It is well established that polio cases and deaths were in free-fall before polio vaccine was introduced,

In India? Citation needed, especially since you claim we don't know how many cases there were before the vaccine was introduced. We know enough to know that incidence was falling before vaccination, but we don't know enough to say with any confidence that vaccination has had a massive impact? Nonsense.

and that teh definition was changed dramatically when the vaccine was introduced which in itself reduced the number of cases.

Again, citation needed. Even if we compare the lowest estimates of polio before vaccination, which you claim would now be called AFP, with the highest estimates of AFP now, there is an enormous fall in numbers.

As for the clearance of aluminum, reading all of the references put forward, it seems fairly obvious that no one knows where it goes once injected… it certainly isn’t excreted.

If you have read the same references I have it is very clear indeed that the vast majority of aluminum absorbed from any source is excreted in the urine. A small amount is retained in the body, mostly in bone, with a vanishingly tiny amount accumulating in the brain. One of those references estimates that at the normal rate of accumulation from food, water and vaccines, it would take 100-150 years to accumulate enough aluminum to cause neurological problems.

Recent studies have even shown that immune response continues even if the injection site is excised… raising questions over what it’s role post injection actually is…

Citation?

No doubt that will start another round of, ‘idiot’ etc… that seems to be a standard response from defenders of the indefensible…

If you put forward a rational argument supported by evidence, and addressed the points people make, instead of evading them and picking on irrelevancies, perhaps people wouldn't accuse you of being an idiot.

By Krebiozen (not verified) on 26 Aug 2012 #permalink

I haven’t said that… that would imply causality. [...] My point is that the problem has not gone away, yet they celebrate as if it has. Polio itself may have, but what used to be diagnosed as polio isn’t now… why? Because they test everyone suspected of having polio.

Heh.

Of course Ron is quite right, if there is more than one cause of acute flaccid paralysis, any attempts to combat it are a complete waste of time. Even if polio and other enteroviruses are eradicated, there is still Guillain Barre, car accidents and snakebites. In fact there's no point in any sort of medicine really, because people will still get ill. We might as well just abandon all hope now. [/sarcasm]

By Krebiozen (not verified) on 26 Aug 2012 #permalink

Ron Law:

flip, I’ve never been anti vaccination… never… I am pro truth, pro evidence-based medicine.

Then why did you say this:

It is well established that polio cases and deaths were in free-fall before polio vaccine was introduced, and that teh definition was changed dramatically when the vaccine was introduced which in itself reduced the number of cases.

Do then, tell us whre that free fall is before the vaccine was introduced in 1955?

Disease: Polio in the USA, from CDC Pink Book Appendix G
Year__Cases____Deaths
1950__33,300___1,904
1951__28,386___1,551
1952__57,879___3,145
1953__35,592___1,450
1953__35,592___1,450
1954__38,476___1,368
1955__28,985___1,043
1956__15,140_____566
1957___5,485_____221
1958___5,787_____255
1959___8,425_____454
1960___3,190_____230
1961___1,312______90
1962_____910______60
1963_____449______41
1964_____122______17
1965______72______16
1966_____113_______9
1967______41______16
1968______53______24
1969______20______13
1970______33_______7

An oscillation reflecting the cyclical behavior of disease epidemics doesn't count. The only "free fall" I see is after 1955. How can you be "pro-truth" when you say things that aren't really true?

Ooops, typo... 1953 is repeated.

The point of my last comment, should it not be clear, is that if there were 30-60 thousand cases of AFP (wrongly diagnosed as polio) in the USA in the 1950s, there certainly aren't that many any more. The dramatic increase in American hygiene since the 50s must be responsible, because it could not possibly be vaccination (I am in a sarcastic mood today I'm afraid).

By Krebiozen (not verified) on 26 Aug 2012 #permalink

Ron Law:

that teh definition was changed dramatically when the vaccine was introduced which in itself reduced the number of cases.

The definition change happens when there are better tools to diagnose the pathogen. Especially when they can even figure out which polio strain, and even a particular strain, including how long ago the infection occurred (due to evolutionary shifts). See this discussion of a case report: Poliomyelitis after a twelve year incubation period.

That blog is written by a virologist who spent most of his career studying polio. That is one of several articles on polio there. Even though much of it goes over my head, I have learned lots from that blog and listening to all of Dr. Racaniello podcasts.

Get over it nz sceptic... Speaking out about crock policy and research, and pr related to one product does not make one anti-vaccination... as for being responsible for what others say, well, that nothing I can control... besides, you wouldn't have a clue about anything i said/didn't say to people.

You're dredging... a typical skeptic source of evidence, me thinks.

Chris, that paper is a classic case report on a fatal medical injury... three issues involves... it was vaccine derived polio, neither she, nor family should have been given a live vaccine, and the immunoglobulins didn't do their job.

So by any definition, this is a death caused by a vaccine... and was fully preventable

Chris, before I get back re numbers, would you mind posting the hepatitis numbers for those years?

Ron

That's a good example of your usual obfuscation Ron; when Chris gives a good example of how polio infections can be identified and classified, you ignore her point and pick on an irrelevancy. No one is denying that live vaccines can cause problems in immunodeficient people. That's one reason the live vaccine isn't used in the developed world any more.

By Krebiozen (not verified) on 26 Aug 2012 #permalink

Chris, before I get back re numbers, would you mind posting the hepatitis numbers for those years?

Let me guess the underlying colossal failure here.

@Ron

Speaking out about crock policy and research, and pr related to one product does not make one anti-vaccination

The problem is, you've provided no evidence to show that it *is* a crock.

Ron Law:

Chris, before I get back re numbers, would you mind posting the hepatitis numbers for those years?

What does that have to do with your major failure at truth when you claimed that polio and deaths from polio were in free fall before the vaccine? Are you trying to deflect from being wrong by changing the subject?

Krebiozen:

That’s one reason the live vaccine isn’t used in the developed world any more.

And that article noted that since she had the immune deficiency, the OPV should not have been given to her children.

So Ron Law is creating another major fail by totally missing the point that technology moves forward.

@ Narad & Alison: Here's an expanded article, courtesy of rense.com about the Heptavax B vaccine and the *transmission* of SV-40, AIDS, and Kaposi Sarcoma. The *weird* thing is, none of the people who received the serum-derived Heptavax B vaccine, (my son included, 1985), never were diagnosed with any of these maladies. Odder still, is that once the Heptavax B vaccine was discontinued in favor of the rDNA vaccines, people who never received Heptavax B vaccine, contracted AIDS and other opportunistic diseases such K.S. Enjoy...

http://rense.com/general68/gayex.htm

The old Medical Hypotheses editor used to write the same Evo-psych editorial every two or three issues about the inherited nature of intelligence, raging about Fashionable Political Soundness within the psychology world that made it impossible to discuss group differences.

It hasn't been so funny since the publishers replaced him..

By herr doktor bimler (not verified) on 26 Aug 2012 #permalink

nz sceptic,

There was a thread on sciblogs where a commenter persistently asked Ron to name one vaccine he supports. (Don't ask me which thread! :-) )

nz skeptic... "OK Ron, so you were just joking when you said that you were ‘proud to have dissuaded"

There you go again, assuming that the media report accurately... Firstly, I never said that and it is not a quote. There were many errors of fact in that article... another one posted on here said I had more than one bachelor's degree...

As a self-professed skeptic you sure have shallow critical thinking skills.

@ Ron Risk Analyst: We know you don't support the meningitis vaccine, the polio vaccine and the HPV vaccines. So, which vaccines do you support?

Grant posted...

nz sceptic,

There was a thread on sciblogs where a commenter persistently asked Ron to name one vaccine he supports. (Don’t ask me which thread! :-) )

Grant, I'm surprised you haven't just linked to your threads... You don't get it, do you... I have never bagged vaccines per se... I have bagged bad/dubious policy/science/uncritical thinking...

As I've said many times, I'm fully vaccinated, my kids are fully vaccinated, their kids are fully vaccinated... what don't you get?

I don't like yoghurt... I'm not anti yoghurt... and I don't have to do around and say I like custard or rice pudding to prove I'm not.

It's not about vaccination... never has been.

Ron: "So by any definition, this is a death caused by a vaccine"

To elaborate on Krebiozen's reply:

I agree with Krebiozen, you regularly ignore the message to nitpick some irrelevancy. I presume it's your way of not facing the message using a form of goalpost shifting.

Leaving aside that Ron named only one factor (the vaccine) and left out others that were also relevant, it occurs to be me that his response also is an example of a fallacy that seems common among anti-vaccine advocates and some of those who pit 'natural remedies' in opposition to 'conventional' medicine - 'demanding' that the medical treatment be 'perfect', that if on rare occasions doesn't work as we'd all hope, it's a 'failure'.

What is sought is for the treatment (vaccination in this case) to be better than the alternatives, including no treatment.

I mean to add ages that my my 6:25am comment crossed-over earlier comments. (I was writing these in between other work, so I don't see new comments coming in; it's possible that I may have missed one or two entirely, it happens.)

Lilady, I'm not aware of any meningitis vaccine, where have I expressed opposition to either the polio vaccine or the Gardasil vaccine??????

As a so-called sci-blog adherent, please check your facts before engaging in comment.

Where in these comments have I ever expressed the view that I don't support vaccination...

What I don't support is parents being reassured with false information.

What I don't support is dubious data in part the result of changing definitions and effort to find/differentiate diseases being used as proof of effectiveness...

Ron Law:

As a so-called sci-blog adherent, please check your facts before engaging in comment.

The same could be said for you. You are regurgitating several anti-vax myths like polio cases/deaths were in a free fall prior vaccination. You would have saved yourself embarrassment if you had bothered to look it up in reputable sources before making a comment.

By the way, hepatitis b only became reportable in 1970. So, no there is no data from the mid-1950s. Though if you look at the CDC Pink Book Appendix G, you will see it start to decline slowly in the 1990s. Hepatitis a became reportable in 1966. It has also been declining since the introduction of its vaccine. Neither have anything to do with polio.

There you go again, assuming that the media report accurately… Firstly, I never said that and it is not a quote.

OK Ron, then what did you say that might have given the reporter this impression. If you were misrepresented, did you follow up with the reporter concerned and ask them to publish a correction?

Lilady, I'm not aware of any meningitis vaccine. No? http://www.scoop.co.nz/stories/HL0502/S00064.htm Or is this simply an example of you playing with words? If lilady had used the word 'meningococcal', would you have given the same response?

Ron Law:

Lilady, I’m not aware of any meningitis vaccine, where have I expressed opposition to either the polio vaccine or the Gardasil vaccine??????

Oh, really? So there is another Ron Law in New Zealand the subject of this article: Ron Law at his anti-vaccination wingnuttery again?

Now from the CDC Pink Book chapter on meningococcal disease:

Meningitis is the most common presentation of invasive meningococcal disease and results from hematogenous dissemination of the organism. Meningeal infection is similar to other forms of acute purulent meningitis, with sudden onset of fever, headache, and stiff neck, often accompanied by other symptoms, such as nausea, vomiting, photophobia (eye sensitivity to light), and altered mental status. Meningococci can be isolated from the blood in up to 75% of persons with meningitis.

Seriously, Mr. Law, are you still saying: I am pro truth, pro evidence-based medicine.?

ChrisP, can you point out where I have expressed anti-vaccination statements on rsole's link?

In case you missed it the discussion was about the relationship between paracetamol use and meningococcal disease.

http://www.ratbags.com/rsoles/comment/ias.htm

As a matter of interest, the NZ government has recently committed $3 million or so to studying one way or another these widely held concerns...

2009 Career Development Awards - Clinical Research Training Fellow
Sally Eyers
University of Otago
Effect of regular paracetamol on asthma control in mild to moderate asthma
$255,930
36 months

2010 Funding Round
Professor Richard Beasley
Medical Research Institute of New Zealand
A randomised placebo-controlled trial of paracetamol use in influenza
$747,053
18 months
2010 Funding Round
Professor Richard Beasley
Medical Research Institute of New Zealand
RCT of regular paracetamol in mild to moderate asthma
$342,220
24 months
2011 Funding Round
Professor Richard Beasley
Medical Research Institute of New Zealand, Wellington
Randomised Placebo-controlled Trial of Paracetamol in Febrile Septic Patients
$1,197,966
36 months

2012 Funding Round
Professor Richard Beasley
Medical Research Institute of New Zealand
RCT of Asthma Risk with Paracetamol Use in Infancy - A Feasibility Study
$149,000
12 months

http://www.hrc.govt.nz/funding-opportunities/recipients

http://jech.highwire.org/content/58/10/852.full

"Lilady, I’m not aware of any meningitis vaccine. No?"

Alison...I was just about to link to Ron Risk Analyst's "Meningococcal Gold Rush-Parts I, II and III". Here's my other link that attests to the success of the meningococcal vaccine in spite of RRA's *activities*:

http://journal.nzma.org.nz/journal/122-1291/3504/content.pdf

ChrisP, all yo have demonstrated is an ability to use Google to dredge for mud... who is JM O'Donnell? A student at the time... and are his statements as fact factual... ?

mmm... so let's see, sci-bloggers and their minnows have confirmed that evidence trawled from the bowels of the internet is proven factual because it was discovered while trawling the bowels of the internet... Nice one... but think about it... that invalidates the scientific process... it means that you accept anything you read...

Now that is a model of the scientific method... Not!

Alison, " If you were misrepresented, did you follow up with the reporter concerned and ask them to publish a correction? "

I did, and they wouldn't.

"Lilady, I’m not aware of any meningitis vaccine, where have I expressed opposition to either the polio vaccine or the Gardasil vaccine??????"

Really RRA????? Are you just JAQing off here on Respectful Insolence????? How about your questions about polio on other blogs, such as the BMJ?????

http://www.bmj.com/content/344/bmj.e1075?tab=responses

Re: Assaulting alternative medicine: worthwhile or witch hunt?
13 March 2012

"I note Debajyoti Datta is a Medical Student.

JAMA had an article in 1951 that described AFP thus, "Most patients with acute paralysis suffer from one of three conditions: poliomyelitis, hysteria or the infectious polyneuritis of Guillain-Barré..." [1]

A 1959 paper stated, "The accurate appraisal of the preventive value of such a vaccine will depend on our ability to diagnose poliomyelitis accurately. It had long been believed that the clinical features of acute paralytic poliomyelitis were sufficiently characteristic for a confident diagnosis to be made on clinical grounds alone.

This confidence has recently been shaken by
the finding that the virus of louping-ill (Russian spring–summer encephalomyelitis) may produce a similar clinical picture, even in the United Kingdom1. There is also suggestive but incomplete evidence that Coxsackie B, Echo2 and other viruses3 may occasionally cause acute flaccid paralysis.

The position of a “non-paralytic” poliomyelitis is even less secure4 and the diagnosis can no longer be established on clinical grounds alone." [2]

I recommend the reading of the Illinois Medical Journal editions for August and September 1960, a two-part transcript titled, the present status of polio vaccines. This transcript documents the history and politics of the early polio vaccination programme including detailed descriptions of the changing of the diagnosis of polio after the Salk vaccine was introduced to exclude polio-like illness which is now called acute flaccid paralysis.

A 2005 edition of the BMJ includes a detailed table of many illnesses that mascerade as polio-like illness and in pre polio-surveillance era were often diagnosed as polio. [3]

Pre vaccine polio numbers were ramped up through the use of lameness surveys and 'estimates' of polio cases not reported and included non-polio AFP cases. Post surveillance polio case number exclude polio-like paralysis due to AFP.

Whilst we celebrate the eradication of confirmed polio paralysis in India, over 60,000 children are now diagnosed as "paralysed by polio-like illness" aka AFP, each year with no apparent concern.

I wonder if the parents of those 60,000 children paralysed each year by what [mostly] used to be called polio, are celebrating that their children didn't have polio... whew, what a relief!

As a student of medicine, please look at the history of medicine; learn to critically analyse what your professors tell you... look at the evidence for yourself so that you can become a medical doctor with a compassionate heart.

[1] E. M. Hammes Jr., M.D. PERIODIC PARALYSIS: A REPORT OF THREE CASES
http://jama.ama-assn.org/content/146/15/1401.short

[2] ED Acheson (1959) Am J Med, http://findacureclub.weebly.com/uploads/5/2/5/1/5251327/acheson_amjmed…

[3] Poliomyelitis and the postpolio syndrome
Robin S Howard, BMJ. 2005 June 4; 330(7503): 1314–1318. doi: 10.1136/bmj.330.7503.1314
PMC558211 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC558211/pdf/bmj33001314.pdf

Competing interests: None declared

Ron Law, Risk & Policy Adviser

Juderon Associates, 25 Mudgeways Road, Auckland, New Zealand"

Chris, so you know how to google-a-quote... good for you. The problem is it doesn't help you as there is no meningitis vaccine as claimed...

there might be several meningooccal vaccines... and I went public on one of those... an experimental one at that... one that the NZ Ministry of Health refused to give a permanent license to because even they concluded that there was no evidence it was effective for any length of time.

For the record, the mention of the word meningitis sends shivers down parents spines... but meningitis is not the main problem with meningococcal disease... septicaemia is...

Ron, it was your own e-mails that point out your anti-vaccine stance. When you claim you have never been anti-vaccine, we only have to find one example to prove your claim false. We have found more than one, but every time you claim that you were 'misreported'. That is why I went for your very own typed words that showed you for what you are.

Who the hell is JM O’Donnell? And what have they got to do with your e-mails? Are you suggesting you didn’t write those e-mails?

Lilady, glad you linked to the NZMJ article. You might like to post the links to the Meningococcal Gold Rush series too...

Here one td-bit... "At the end of the mass campaign in June 2006 over 90% of those aged under 20 years in the highest risk area (Counties Manukau) had received three doses with highest coverage achieved in Pacific children, the group who suffered disproportionately more from the disease. Nationally, 80% had received three doses, including 86% of
those aged 5–17 years.""

That's all true... in fact, the campaign was so successful that over 100 percent of pacific Island children were vaccinated in Sth Auckland.

ChrisP, humblest apologies... I got my Chris's Crossed... comment re Jim O'D should have been referred to Chris...

ChrisP... the emails were about paracetamol use... they were not about vaccination effectiveness.

Grant said, "Leaving aside that Ron named only one factor (the vaccine) and left out others that were also relevant, it occurs to be me that his response also is an example of a fallacy that seems common among anti-vaccine advocates and some of those who pit ‘natural remedies’ in opposition to ‘conventional’ medicine – ‘demanding’ that the medical treatment be ‘perfect’, that if on rare occasions doesn’t work as we’d all hope, it’s a ‘failure’."

Grant, I'm really, really, really surprised that you have re-entered this discussion with false-implied or otherwise and/or fabricated innuendo...

Your ability to create false statements and yet claim to be an objective sci-blogger beggars belief....

Ron, you are clearly trying to weasel your way out of this one as well. The e-mails were about paracetamol because of your claim that meningococcal disease was linked to paracetamol use and hence vaccination was pointless.

The statement about paracetamol was obviously and breath-takingly wrong, its sole use was to be part of an anti-vaccine gambit.

mmm… so let’s see, sci-bloggers and their minnows have confirmed that evidence trawled from the bowels of the internet is proven factual because it was discovered while trawling the bowels of the internet… Nice one… but think about it… that invalidates the scientific process… it means that you accept anything you read…

Says he of the Weak Greenberg Gambit.

Ron,

"Grant, I’m surprised you haven’t just linked to your threads"

As I said I don't know what one it was. I wasn't implying "my blog" (as you did); it'll likely be either Michael's or Alison's.

"It’s not about vaccination… never has been."

As I have tried to point out to you, it's about not your claiming "I'm not anti-vaccine" or not; but your actions. I 'get' that you want to say that—in fact, can't remember when I didn't—but that doesn't make you be doing that. A problem with many of your "scientific" arguments is that you proceed by trying to "show" that something is true by fitting data/arguments to it, then on managing to "fit" data to it declaring it "right".

"Grant, I’m really, really, really surprised that you have re-entered this discussion with false-implied or otherwise and/or fabricated innuendo…"

And you resort to making empty tit-for-tat accusations/baiting, i.e. trolling.

(The point you refer to wasn't about you in particular but stepping back to look at a wider general problem. You've left out the key point out by not quoting the following paragraph; the two go together.)

Ron Law:

Chris, so you know how to google-a-quote… good for you. The problem is it doesn’t help you as there is no meningitis vaccine as claimed…

Actually I just linked to something that was posted here on August 22, 12:37 am. You might actually try reading the replies here a bit closer, along with the links to real sources. The meningococcal vaccine prevents the meningitis caused by that particular bacteria, that just happens to cause a large percentage (75% !!) of ... wait for it... meningitis. Perhaps that is why the bacteria is called: Neisseria meningitidis.

So, again, you are not really bringing on the "truth" when you say "The problem is it doesn’t help you as there is no meningitis vaccine as claimed." Because, well, that is known as a falsehood, or more to the point: a lie.

Are you having trouble understanding that a vaccine that prevents the most common cause of meningitis is being called a "meningitis" vaccine because English might not be your native language?

Is this why when I showed your comment about polio cases/deaths were not free falling before vaccination, you decided to ask about hepatitis (and not specifying either a or b)?

Re: Ron Law
August 26, 8:04 pm

"Alison, ” If you were misrepresented, did you follow up with the reporter concerned and ask them to publish a correction? ”

I did, and they wouldn’t."

OK, Ron, can you just confirm that you weren't pleased and proud at having dissuaded many thousands of parents from having their child vaccinated against MeNZB, and that you were upset at having your own personal campaign against the ministry being used by anti-vax zealots to further their agenda?

Just a simple answer will suffice......

By nz sceptic (not verified) on 26 Aug 2012 #permalink

@ Ron

In case you missed it the discussion was about the relationship between paracetamol use and meningococcal disease.[...] As a matter of interest, the NZ government has recently committed $3 million or so to studying one way or another these widely held concerns…

Followed by a list of studies whose titles seem to me to imply that they are looking at paracetamol as a treatment for a variety of ills.
Widely held concerns, eh? Their concerns don't look like your concerns.

It's quite funny. On another thread, a reader is berating us for not looking at studies on chemotherapy's effects. You berate us for doing studies on paracetamol's effects (although I'm not sure that this is your point). Make up your mind, please.

To go back on these studies you quoted, I failed to see any mention of streptococci. Or vaccines.
I believe we scientists call the technique you are using as pissing on our shoes while trying to convince us it's raining.

By Heliantus (not verified) on 26 Aug 2012 #permalink

Sorry, I meant meningococci, not streptococci.

I blame the late hour, time for bed.

By Heliantus (not verified) on 26 Aug 2012 #permalink

@Ron

Ok, this pisses me off:

Alison, ” If you were misrepresented, did you follow up with the reporter concerned and ask them to publish a correction? ”

I did, and they wouldn’t.

The other commenters are far better at combatting the scientific stuff because, well, they're smarter than me.

But I have worked with a number of people in journalism, and they take quite seriously the accuracy of what they report in regards to interviews. Even if they're crappy reporters, once reported to the paper, they'd have a legal obligation to change the article or to write an apology/notification that they were incorrect. Furthermore, you'd have quite a good legal standing to challenge them in a civil lawsuit - I'm guessing in your line of work you might actually care about being accurately represented?

If more than one reporter is misrepresenting you in all these pieces, then none of their recording devices work (oh yes, who writes shorthand anymore?) or none of them keep emails (again, unlikely); or *cough* Bullshit *cough*.

If people are so busy misunderstanding you, did you ever think that *you're* the one with the communication problem? It's not up to us to correctly interpret your vague mumblings.

I still note that these invisible documents haven't appeared. What a pity.

@Narad

Weak Greenberg Gambit

Please enlighten me...

flip,
I'm not Narad, obviously, but I believe this is what he is referring to.

If declines in diseases happen naturally, I'm wondering when we in the UK are going to see the same 95% reduction in the incidence of chicken pox that the USA has seen since 1996 when the vaccine was (coincidentally of course) introduced. In the UK 90% of people still get chicken pox, though that has nothing to do with the fact that children are not routinely vaccinated against it here. Of course (still sarcastic today it seems).

By Krebiozen (not verified) on 27 Aug 2012 #permalink

To avoid misunderstandings I should point out that the two thoughts expressed in my previous comment are not directly connected. The Greenberg Gambit is the claim that diseases have not disappeared, they have just been relabeled as something else. The Natural Decline Gambit is a different entity, though often resorted to when the former fails and vice versa.

By Krebiozen (not verified) on 27 Aug 2012 #permalink

@Thanks Krebiozen. I think this is the first time I've ever bothered to read something on whale.to ;)

Chris said, " The meningococcal vaccine prevents the meningitis caused by that particular bacteria, that just happens to cause a large percentage (75% !!) of … wait for it… meningitis. Perhaps that is why the bacteria is called: Neisseria meningitidis."

Most cases on meningitis are caused by viral infections and resolve without much treatment. There are many causes of bacterial meningitis, of which meningococcal infections is but one... and the of course there are asceptic meningitis cases which often got diagnosed as polio back in the day...

se,... the scary part of meningococcal disease is the systemic infection that causes loss of limbs.

Heliantus, where did I " berate us for doing studies on paracetamol’s effects (although I’m not sure that this is your point)."

Who is US???

Personally, I have never berated anyone for doing studies on paracetamol... they should have been done yonks ago...

Heliantus, the fact is that Michael Baker's study into housing conditions in NZ found poor housing/overcrowding to be factors behind the meningcoccal disease in NZ a decade ago. His paper did highlight a relationship between meningococcal disease and paracetamol use and the abstract made different comments to those in the main part of the paper.

It is well established that the body raises the temperature as part of the immune response. quashing that process is well known reduce the bodies immune response... and prolong disease.

Krebiozen said, "The Greenberg Gambit is the claim that diseases have not disappeared, they have just been relabeled as something else."

In the case of polio, that is a irrefutable fact... the definition was changed.

Have any of you actually read the 1960 transcript in the illinois medical journal... I have, a number of times... Greenberg explains in simple terms how definitions were changed... he even says with regards to polio that effectively since 1955 they were dealing with a different disease because of these changed definition.

I have the paper if anyone wants to read it... it is very informative and bypasses all the secondary/tertiary clap trap as provided in the link... why don't people use first principles these days and verify the facts for themselves?

By the way, Lilady, your post highlights exactly what I've been saying... "Really RRA????? Are you just JAQing off here on Respectful Insolence????? How about your questions about polio on other blogs, such as the BMJ?????

http://www.bmj.com/content/344/bmj.e1075?tab=responses"

It's not anti-vaccine at all... pointing out that amplifying, obfuscating and even re-writing science is commonly used to make grandoise statements as fact... going back to source documents often highlight that what is stated as fact in fact isn't... Polio stats are one such example... changing definitions of polio itself, and even redefining what constitutes an epidemic makes it easy to justify a point.

The facts are that the Salk polio vaccine was made to look good by redefining the disease and manipulating the facts.

RRA: Still trying to score points, eh?

There comes a time when I no longer communicate with ignorant crank anti-vaccine posters. You are still busted RRA.

flip, I deal with journalists a lot and fully echo your comments. The overwhelming majority of journalists are keen for accuracy in their stories and if they trip up, a stern e-mail to the editor pointing out the error will lead to a printed apology.

The only time this won't happen is when the journalist has evidence (tapes for example) that you really did say what was written and confirmed it when asked.

So yes. Ron is talking bullshit.

On a further topic of bullshit, the paper Ron is refering to made it quite clear that the analgesics use was actually about recent illness. What Ron is doing is a practice all of us in the scientific community would recognise as cherry-picking. It is a form of lying.

Ililady... Not scoring points... just mentioning your link highlights the manipulation of evidence to support the cause... I get motivated by responses such as your last... when people attack to person rather than critique the evidence it suggests I'm on strong grounds... besides, point to a single "anti-vaccine" post of mine... no one has yet because I'm not ant-vaccine... just anti-abuse-of-science and the rewriting of history.

Ciao-4-Niao

Ron, pleased you admit you are "not scoring points". At least we can't list lack of insight as one of your failings.

Lilady, I'm still here... I must admit I was trying to work out what all that dribble was... now I know... saliva from toothless patbulls...

Back to the beginning... I came into this comments/discussion to challenge the lack of objectivity regarding comments made about Jasmine Renata's inquest.

the overwhelming conclusion drawn is that so-called objective scibloggers are no better in the main than those they write about... All of the evidence I've seen is hear say, inaccurate reports, or fragments. When quotes fro transcripts or evidence in briefs are given they are rubbished simply because they don't fit the hypothesis-de-jour. When given the opportunity to look at documents given in confidence they run a mile claiming the documents are fake without verifying the facts.

Here what I predict.

the coroner will reach an open verdict. Jasmine will officially died from Sudden Unexplained Death... he may refer to possible genetic heart disease even if all the evidence (to date) says otherwise. I doubt he'll implicate Gardasil for two reason... no-one has provided evidence of causality...

oh, and the second reason is that he wouldn't want to be labelled as a heretic.

"Back to the beginning… I came into this comments/discussion to challenge the lack of objectivity regarding comments made about Jasmine Renata’s inquest."

Actually your first comments here were about aluminium uptake, etc., in infants, which I repeated pointed out elsewhere has nothing to do with the Jasmine Renata inquest (she was a teenager). You were pushing your own ideas about aluminium in vaccines, not querying statements about the inquest.

When given the opportunity to look at documents given in confidence they run a mile claiming the documents are fake without verifying the facts.
well, actually, Ron - people asked for clarity on exactly what you were offering, & didn't receive any (for example, what 'a look' actually means in practice).

Ron,
Here's a simple question. Let's assume that all the approximately 30,000 - 50,000 polio cases per year reported in the US during the 1950s would now be diagnosed as AFP. Since the population has more or less doubled since then, wouldn't we expect to see somewhere around 60,000 - 100,000 cases of AFP every year in the US? How is that only about 1,000 cases of AFP were seen from 1992 - 1998? Where did all the AFP go?

By Krebiozen (not verified) on 28 Aug 2012 #permalink

That's an estimated 1,000 cases of AFP, to be clear.

By Krebiozen (not verified) on 28 Aug 2012 #permalink

the second reason is that he wouldn’t want to be labelled as a heretic.

Isn't it a little bit early to be impugning the coroner's integrity?

By herr doktor bimler (not verified) on 28 Aug 2012 #permalink

herr doktor bimler,

My thoughts too. Ditto for “even if all the evidence (to date) says otherwise”.

Oh, and Ron, a couple of questions:

1. If you aren't "antivaccine", I assume you'd have no problems ensuring your kid (if you have one) gets the full schedule of recommended vaccines. I'd apreciate your confirmation of this, or qualification about which vaccines you would give/not give.

2. Perhaps you could comment (using your renowned expertise as a risk analyst) on what the decision of a mother should be when deciding whether to vaccinate her child during an outbreak/epidemic of a nasty and often fatal disease, when the scientific evidence shows unvaccinated kids are 4 times liklier to get the disease than vaccinated kids?

@ChrisP

One of the reasons I mentioned recording devices: it's so much easier to accurately quote someone when you can transcribe the recording. If you watch any press conference these days (ie. Mars landing recently) you'll find the majority of people holding some sort of recording device - whether it's a dictator, or an mp3 recorder, or a computer... They probably do some shorthand to accompany it, but a majority don't seem to do it at all.

Hence me also calling bullshit, because the only reason they'd refuse to publish a correction is if they had accurately reported what Ron Risk Analyst said. Otherwise, all of the media is conspiring against him to promote Big Vaccines.

Granted recording devices aren't perfect and they can fail: which is why you test them before using them and make sure they are fully charged beforehand. Again, it comes back to a ) most reporters are lying, b ) most reporters aren't getting their devices/whatever working, c ) RRA is lying.

Occam's razor does the rest.

@ dingo199. RRA claims to have vaccinated his kids and his grandkids are also "fully vaccinated"....according to him.

How about the fact that kids not immunized against pertussis are twenty-six times more likely to contract pertussis, compared to fully vaccinated kids?

Alison and Grant. Don't you just *love* the treasure trove of pseudoscience that RRA has left here for future science bloggers?

Ron Law:

Most cases on meningitis are caused by viral infections and resolve without much treatment. There are many causes of bacterial meningitis, of which meningococcal infections is but one… and the of course there are asceptic meningitis cases which often got diagnosed as polio back in the day…

Those viral infections were mostly mumps and measles, and with vaccinations they do not occur very often.

I offered you some real references, perhaps you should actually become familiar with the CDC Pink Book. If you had checked that you would not have embarrassed yourself by claiming cases of polio were declining before the vaccine (which came before 1960).

Now try actually read this chapter of the CDC Pink Book where it says (and this is the second time I am posting this, you do seem to be a slow learner):

Meningitis is the most common presentation of invasive meningococcal disease and results from hematogenous dissemination of the organism. Meningeal infection is similar to other forms of acute purulent meningitis, with sudden onset of fever, headache, and stiff neck, often accompanied by other symptoms, such as nausea, vomiting, photophobia (eye sensitivity to light), and altered mental status. Meningococci can be isolated from the blood in up to 75% of persons with meningitis.

I am beginning to wonder if it isn't so much that you are not being truthful, but that you just can't understand what you read.

@lilady
I used the 4x risk example because this is the precise relative risk for invasive meningitis in those who do not get the meningococcal vaccine (the MenNZB one which made Ron spit his dummy out). I am wondering how a risk analyst can justify refusing something that works, and lessened the risks of getting severe invasive meningococcal disease/meningitis fourfold.

I know the risks for other diseases like pertussis is even greater for the unvaxed.

I have the paper if anyone wants to read it…

If anyone would prefer to avoid the step in which Ron rummages around in his underwear drawer for The Documents, there's a readable scan (in reverse page order) here.

Thanks Narad. I have combined those images into a PDF with (mostly) copyable text here.

By Krebiozen (not verified) on 28 Aug 2012 #permalink

Lilady, I’m still here… I must admit I was trying to work out what all that dribble was… now I know… saliva from toothless patbulls…

I think what Ron is trying to say is that we are barking up the wrong squirrel.

By Antaeus Feldspar (not verified) on 28 Aug 2012 #permalink

Thank you for being a breath of fresh air. As a single mother of 2 children with autism it is difficult to even mention vaccines. I am also a 3rd year Biochemistry PhD student (I am in the middle of written qualifying exam and decided to procrastinate in order to read your blog...bc that's better than pancreatic cancer ;)) Anyhow, I am appalled at the lack of vaccination. My children are fully vaccinated and will continue to get the rest of their shots (my daughter is 11 and son 9)............we need more people out there taking down these snakeoil salesman!!!!!

By livewithoutres… (not verified) on 28 Aug 2012 #permalink

alison, thanks for the headsup to that helping of previous Ron malignant stupidity.
What dumbfounds me is how someone who declares himself as being "not antivaccine" can argue so implacably and intrasigently against just about every vaccine.

I suspect he might be off now offering risk management advice to his MeNZB co-conspiracist, who's found herself in a spot of Facebook bother!

By nz sceptic (not verified) on 28 Aug 2012 #permalink

....is that about the Gates poster?

@ Alison and dingo199:

You both and Grant have been quite relentless in categorizing Ron for the anti-vaccine denying fool he is:

Here in the link that Alison provided, Ron is arguing about the 90% of kids who should be immunized against MMR to maintain "herd immunity"...with this inane post:

"Ron Law 314 days ago

Grant, that is a statement of opinion… it is not referenced.

I am aware of vaccination rates well over 90 percent with epidemics/outbreaks of measles so such a rate in a very small percentage of the herd provides zero certainty.

I would have thought that a person critiquing someone with an opposing view… especially if they were purporting to represent the good guys (science) would use referenced primary sources of evidence, not unreferenced opinion some 12 years old.

"NZ’s coverage for MMR is measured at 24 months, not 15 months… the vaccine hasn’t even been scheduled to be given till 15 months so its totally impossible to have 90 percent coverage at 15 months."

What he doesn't understand is that an audit of the current New Zealand Childhood Schedule compared against actual rates of immunization against MMR of 24 month old children, looks at AGE APPROPRIATE immunizing of kids with the FIRST of two MMR vaccines. If the records of children who are 2 years of age reveal that 90 % of them have had their FIRST MMR vaccine between between 15-24 months of age, then those kids are AGE APPROPRIATELY immunized against measles, mumps and rubella. (The recommended timing for the SECOND MMR vaccine is four-years-of-age).

http://www.health.govt.nz/our-work/preventative-health-wellness/immunis…

4 years

Diphtheria/Tetanus/Whooping cough/Polio
1 injection (INFANRIX™-IPV)
Measles/Mumps/Rubella
1 injection (M-M-R® ll)

And, Ron still claims he is not anti-vaccine....

Here's another article about New Zealand's Immunizations Rates:

http://www.bpac.org.nz/magazine/2010/july/immunisation.asp

"Targets for immunisation in children aged two years and under

The PHO Performance Programme (PPP) was established to improve the health outcomes of people enrolled in general practice and to reduce inequalities, especially in high needs populations (Māori, Pacific peoples and those living in lower socioeconomic areas).

An important focus of the PPP for younger patients is to ensure that they are receiving their necessary immunisations, by the recommended age milestones.

It is imperative that the majority of children are immunised against selected serious diseases in order to ensure that re-emergence of these diseases does not occur. As well as achieving immunisation coverage, it is equally important that children are vaccinated on time. Delay in receiving the first infant vaccinations (at age six weeks) is associated with subsequent non-completion of the immunisation schedule.1 Delays also increase the risk of contracting disease, e.g. one study found that children who had their pertussis vaccination delayed were four to six times more likely to be hospitalised for pertussis than those who received the vaccination on time.2

The PPP goal is for 85% or more of a PHOs enrolled population to have received their complete set of age appropriate vaccinations by their 2nd birthday.

The overall national immunisation goal set by the Ministry of Health is for 95% of children in New Zealand to be fully immunised by age two years.

Immunisation rates reach 85% in 2010

Immunisation rates among children in New Zealand have been increasing over recent years. Latest data from the Ministry of Health shows that 85% of children in New Zealand that turned two between January and March 2010, had completed their age appropriate immunisations. Rates varied by DHB region, from 72% in Northland to 94% in Otago."

@ Antaeus Feldspar:

" Lilady, I’m still here… I must admit I was trying to work out what all that dribble was… now I know… saliva from toothless patbulls…"

"I think what Ron is trying to say is that we are barking up the wrong squirrel."

Thanks for the opportunity Antaeus, to address Ron's "barking up the wrong squirrel"

Ron: Woof, woof, grrrrr...

http://www.youtube.com/watch?v=lvw-9XEyPKk

Clearly it makes sense to aim for 100% vaccine coverage. Certain "third world" countries, or places like Mexico achieve not far short of that for measles.
The higher, the better.

With measles, because it is so infectious (with one index case infecting around 15 others in a non-immune population, ie a reproductive number (Ro) of 15), one needs 14 out of every 15 of the population to be immune before transmission is interrupted (around 93%).

When you add the non-responders to the unvaccinated, then you see you need very high vaccination rates for measles to achieve this. NZ runs at a vaccination uptake of around 85% (which probably means 81-82% "herd" immune status when the non-responders are added in).
I blame people like Ron and his fellow sheep-shaggers.

Here is a great presentation on herd immunity:
http://www.who.int/vaccine_research/documents/WHE_Smith_presentation.pdf

Lilady, I got the vaccinationrates from the MOH National Immunisation Register...

http://www.health.govt.nz/our-work/preventative-health-wellness/immunis…

As I've said many times, objective minded folk should argue their case based on facts.

Look through the spreadsheets... you'll soon discover the stats I was quoting are official data from the MOH database, not some hypothetical figures plucked out of cyberspace.

lilady
August 29, 3:11 pm

Here’s another article about New Zealand’s Immunizations Rates:

http://www.bpac.org.nz/magazine/2010/july/immunisation.asp

“Targets for immunisation in children aged two years and under...

Again, you should not be using 2.1 year old articles (as noted on the webpage) of opinion/opine to argue a case when primary and up-to-date data is available... those of us who know this topic know where to go to get real data.

dingo199, again, why use some tertiary evidence source??? Having said that, it is entertaining to say the least... esp given the author is a so-called expert.

Quote: "For many infections, the level of herd immunity may have an effect on the transmission of the infection within the population and, in particular, may affect the risk of an uninfected becoming infected."

What he means is "may affect the risk of a non-immune individual becoming infected."

Quote: "• For such infections, increasing the level of herd immunity will decrease the risk of an uninfected person becoming infected."

The first mistake is repeated... he menas, non-immune, not uninfected... the hope is everyone will be uninfected, whether vaccinated or not.

Ron, I have forgotten which bit of anti-vaccine nonsense you are arguing at the moment. So what is it?

Are you arguing that your claim made a year ago of well over 90% vaccination is supported by data for the period up to June 2012? Are you a clairvoyant as well as a Risk Analyst?

Ron, the quote from the presentation that dingo linked to makes perfect sense in what it said. The risk of an uninfected person becoming infected is reduced with high levels of herd immunity.

As a risk analyst, I would have though this would have been bread and butter to you. So how do you go about your risk analysis?

ChrisP... he gets back on trak in the next slide...

"Infections for which herd immunity may be important in reducing the risk of infection in non-immunes in the population are those :"

He correctly talks in terms of the whole herd... not just 'the calves.'

Ron, has it never occurred to you that people might loose their immunity to infections over time?

So what about your clairvoyance?

One thing that puzzles me is that pre vaccine days we are told that 95% of people got infected... so if herd immunity was real then the disease would have burnt itself out, wouldn't it?

ChrisP, has it ever occurred to you that if the virus is still circulating then the immune system of 'the immune' should be continually primed as people keep coming into contact with the virus?

ChrisP... do you believe in clairvoyancey? It surprises me that a self-proclaimed objective kinda-person would hold such beliefs... If you spent half a minute looking at the NIR website you'd see actual (not surveyed) historic coverage.

Ron, back in the old days, lots of people would get the diseases, but not all at once. New children who were susceptible were always being born. There were always more potential victims out there. Epidemics occurred. One of the noticeable things about measles incidence prior to the introduction of vaccines was the biennial periodicity.

The clairvoyancy is all on your part Ron. You are the one who has used 2012 data to support a claim you made in 2011. How did you know the data were going to turn out that way?

A look at the year to July 2011 shows 89% coverage at 24 months. Somewhat short of your claim of well over 90%. The only way you can get over 90% is to shift the goal posts to 2012 into a future that had not happened when you made your claim.

One thing that puzzles me is that pre vaccine days we are told that 95% of people got infected… so if herd immunity was real then the disease would have burnt itself out, wouldn’t it?

What a rookie mistake. Basic epidemiology Ron; new susceptibles enter the herd via birth and/or waned immunity. I would imagine that such an enlightened risk analyst such as yourself with so many years of "studying the medical literature" would have devoted at least a modicum of time to understanding some statistics and epidemiology. The numbers of VPD pre and post vaccine are rather self-explanatory.

By Science Mom (not verified) on 31 Aug 2012 #permalink

ChrisP,

Coming in late!

The writing could be better, but that happens. As I think you've gotten, the author is likely not referring to the immunity status of the uninfected (as Ron refers to) but to the spread or dispersal of infection from infected people. The immune status of uninfected people isn't the question there; what is, is if immunisation prevented currently infected people from passing the infection on.

The herd effect looked at per individual in the herd isn't that individuals show immunity or no or limited illness — that's the protection effect to an individual — it's that they didn't pass on the infection - that's the protection effect to the population.

Ron Law:

so if herd immunity was real then the disease would have burnt itself out, wouldn’t it?

Do you live where no babies are born and children do not exist?

Ron,

You said "if herd immunity was real": are you disputing the mathematics or the mechanism?

By Niche Geek (not verified) on 31 Aug 2012 #permalink

Ron,

And a follow-up: are you assuming that all infectious diseases that infect humans are able to infect ONLY humans?

By Niche Geek (not verified) on 31 Aug 2012 #permalink

ChrisP... where did I say that NZ vaccination rates in July 2011 were well over 90%?

Why don't you requote what I actually said...

Niche geek... Herd immunity is a theory... predicated on most people in the herd having been infected naturally...

And, Niche geek, of course all infectious diseases aren't able to infect only humans. Some, such as tetanus, are not even infectious... so any herd effect would be irrelevant anyway.

Ron Law wrote

ChrisP… where did I say that NZ vaccination rates in July 2011 were well over 90%?

Why don’t you requote what I actually said…

Sure Ron.

Ron Law wrote in October 2011:

I am aware of vaccination rates well over 90 percent with epidemics/outbreaks of measles so such a rate in a very small percentage of the herd provides zero certainty.

http://sciblogs.co.nz/skepticon/2011/10/14/ias-complaint-part-4-anti-va…

The latest data at that point for NZ was 89% coverage at 24 months. A bit short of the Ron Law claim. When Ron Law gets called on the claim, he cites data from June 2012 - some 8 months after he made the claim.

Ron Law must be a clairvoyant ... or a bullshitartist. Take your pick. I know which one I am going for.

And while I am at it perhaps it is wise to put this claim of Ron Law's to the test too.

Ron Law wrote:

Herd immunity is a theory… predicated on most people in the herd having been infected naturally…

It seems not. http://en.wikipedia.org/wiki/Herd_immunity

Herd immunity is a theory

I think you missed a word: "only". That is, after all, how most ignorant-about-science-terms people say it.

Sigh... that's like not even high school science that you're misunderstanding there Ron.

Niche geek… Herd immunity is a theory… predicated on most people in the herd having been infected naturally…

Which is applied to vaccinated as well because of immunity not infection. Do you dispute herd immunity too?

By Science Mom (not verified) on 01 Sep 2012 #permalink

Ron,

Herd immunity is a theory… predicated on most people in the herd having been infected naturally…

That's not actually true. The theory was formulated to explain observations made of the natural cycle of contagious diseases and natural immunity, but is not predicated upon that. In non-vaccinated populations an epidemic occurs when each person infected infects more than one other person, causing an exponential growth in the number of infected people, and continues until there are not enough non-immune people left to continue that rate of infection. The disease then becomes endemic, where each infected person only infects (on average) one other person.

As more and more children are born, the proportion of non-immune people rises until there are enough to sustain an epidemic and sooner or later this occurs and the cycle repeats. The periodicity of an epidemic cycle is largely related to how contagious the disease is - the more contagious the disease, the higher R0 is, the higher the herd immunity threshold and the shorter the period of the cycle.

So herd immunity is really a mathematical model that successfully explains those observations, and observations of vaccinated populations, and allows us to make accurate predictions about the effects of various public health policies. Of course in the real world and on an individual level things are more complicated, as a lot of the assumptions made are not true in every case (random distribution of immune people in the population, the number of people a contagious person comes into contact with etc.). As has been discussed here before, it doesn't actually matter how immunity is achieved, whether naturally, by vaccinations or by a large enough proportion of the population wearing biohazard suits (not practical, obviously, but it suffices to make the point). The only important factor is that they cannot become vectors for spread of the infection; the rest of the model emerges from that.

By Krebiozen (not verified) on 01 Sep 2012 #permalink

Humph. Anyone know how subscript tags work here? Testing R0

By Krebiozen (not verified) on 01 Sep 2012 #permalink

Krebiozen,

“That’s not actually true. The theory was formulated to explain observations made of the natural cycle of contagious diseases and natural immunity, but is not predicated upon that.”

You bet me to it; nice description. (My earlier point was in the context of vaccination, following Ron and ChrisP's lead; Krebiozen has gone back to where the herd immunity concept comes from.)

Subscript tags are usually sub. Guess they work at sciblogs, but not here: let me try: H2O.

OK, no subscripts here. Oh, well.

Krebiozen,

Thank you. I was hoping you'd post that. If Ron is a risk consultant then I assumed he would be comfortable with probability math but from his answers he clearly isn't.

By Niche Geek (not verified) on 01 Sep 2012 #permalink

"Herd immunity is a theory… predicated on most people in the herd having been infected naturally…"

Hmmm, is that why smallpox has been eradicated from the face of the earth?

Is that why no polio cases have been acquired in the United States since 1971 and no polio cases have been acquired in the western hemisphere since 1997?

OK, no subscripts here. Oh, well.

There are probably goofy-looking ones: H₂O.

So does R&sub0; work, I wonder?

By Krebiozen (not verified) on 01 Sep 2012 #permalink

Evidently not.

By Krebiozen (not verified) on 01 Sep 2012 #permalink

Thanks Krebiozen for that great description of herd immunity. Bookmarked for future reference.

Krebiozen, it is actually true... the vaccination aspect was a simple top-up... to fill the gap... but it was predicated on the masses being naturally immune.

Herd effect/immunity has been/is being continually redefined... goal posts keep shifting... eg; http://www.springerlink.com/content/g65222662v6w5h34/

Krebiozen me thinks you've conflated the terms herd immunity and herd effect... they are quite different terms...

Krebiozen me thinks you’ve conflated the terms herd immunity and herd effect… they are quite different terms…

I am aware of the difference. They are both terms deriving from the same mathematical model, and there is still some disagreement about how the terms should be used. This does not affect the utility of the model itself.

By Krebiozen (not verified) on 03 Sep 2012 #permalink

Ron,
You are picking on irrelevant details yet again.

Krebiozen, it is actually true… the vaccination aspect was a simple top-up… to fill the gap… but it was predicated on the masses being naturally immune.

Perhaps you don't understand the word "predicate" to mean the same thing I do. If x is predicated upon y it means that x is necessary for y to occur. The herd effect does not depend on natural immunity, it depends on immunity of whatever origin.

By Krebiozen (not verified) on 03 Sep 2012 #permalink

Sorry, other way around, y is necessary for x to occur.

By Krebiozen (not verified) on 03 Sep 2012 #permalink

Hey Krebiozen, may I republish your comment of Sept. 1 at 9:39 am on my blog? My contact details = my name, no space, at gmail. Let me know.

^ Or, rather, the numerical values when there's no entity name, sorry; haven't had any coffee yet.

[offtopic]
Darwy wrote (on August 18, 4:54 am)

If the mother exercises at all, there will be lactic acid found in the breastmilk. As many mothers are pressured into losing the baby weight as fast as possible or to ‘regain their bodies’ – there is certainly an elevated amount of aluminum being taken up by their breastfeeding infants.

Speaking for myself, Darwy, I was pretty fit before and during my pregnancy, and resumed vigorous exercise as soon as possible following delivery, not to "lose the baby weight" or from "pressure" but to feel like myself again.
[/offtopic]

Krebiozen, Dingo posted a link to that paper back on ~28 Aug...

It is deficient in several ways.

Firstly, it talks in terms of uninfected being at risk... it should refer to 'susceptibles' or 'non-immune'... if 100 percent of people are uninfected but 95% are immune then only the 5% non-immune are at risk or susceptible...

Secondly, it shows bias and lack of understanding of immunity by only referring to vaccinated people as being protected... people who have been previously infected (either clinically or sub-clinically) will also be immune and therefore not susceptible... immunity can wane... a small number of susceptible individuals also helps maintain immunity of the herd by exposing those who are immune to the antigen thereby boosting their immunity.

Thirdly, the Herd Effect threshold is not defined, and the levels he provides would mean that at today's rates of immunity (whether through natural infection of vaccination) then the herd should be protected and therefore the disease should disappear.

Of course, many bacteria especially are not controlled by any vaccine... only systemic infection... The MENZB vaccine never worked on a herd effect basis as it never affeted carriage of the bacteria... but that never stopped vaccine mongers who knew from telling the public that they were putting others at risk if teh vaccination rate didn't get up over 90 percent... but that's another story.

If Smith's presentation is 'enlightening' then it suggests a very limited understanding of the concept of the herd effect.

Here's a good diagram describing herd immunity from a vaccinologist's perspective.

http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx

The fallacy is that in the top diagram, the red people [that survive] become immune and so they should become yellow as they are then immunised... the arguments made in the bottom diagram then apply.

When the concept of herd immunity was first applied to vaccination, the premise was that all vaccination had to do was mop up those who were susceptible (not immune) and 'voila' herd immunity...

Liz,
Feel free to use any of my comments on your blog.

Ron,

Either you have completely missed the point of vaccination, which is to achieve immunity with a much lower risk of death, morbidity and serious permanent sequelae than infection confers, or I have misunderstood where you are coming from. Immunity from vaccination is very much safer than immunity from the disease, whatever way you look at it. I just don't see what you are arguing about.

You also seem to assume that vaccination confers a shorter-lasting immunity than vaccination, which is not necessarily true. It is looking more and more likely that immunity from many vaccines lasts at least as long as natural immunity does. This was discussed on this blog at length not long ago, with evidence for this presented. Antigen-provoked antibody titers support the idea that most vaccines confer immunity that lasts for a lifetime.

Even if it doesn't last longer, surely it is better to get regular boosters of a vaccine with a serious adverse event risk of less than one in a million, than risking a disease that carries a risk of serious sequelae of somewhere between 1 in 100 and 1 in 20,000?

If Smith’s presentation is ‘enlightening’ then it suggests a very limited understanding of the concept of the herd effect.

I knew I had seen it before somewhere. It's a simplified explanation, which I vainly hoped you might grasp, and your criticisms are mere nitpicking that do not affect the central concept in the slightest. Who called it 'enlightening', by the way?

By Krebiozen (not verified) on 03 Sep 2012 #permalink

Ron Law with more anti-vaccine rubbish.

Ron Law said:

The fallacy is that in the top diagram, the red people [that survive] become immune and so they should become yellow as they are then immunised… the arguments made in the bottom diagram then apply.

Ron is, as usual, wrong. What happens is that a whole lot of new blue people are in the population, so it turns into a case analogous to the middle section.

Usually the whole population (or even more than 90%) does not get infected all at once. With vaccination immunity can be provided before the disease strikes creating the bottom scenario.

OK next argument Ron.

The point of vaccination is to go from being blue (at risk of disease) to yellow (immune from disease) without going through the intervening stage of red (sick, which is bad enough on its own and risks permanent sequelae such as death). It seems to me that arguing that we don't need to be vaccinated because we can achieve the required level of herd immunity naturally by getting sick is about as dumb as it gets. It's like arguing you can avoid your home burning down in a forest fire by dousing it in gas and throwing in a match, because ashes don't burn.

By Krebiozen (not verified) on 04 Sep 2012 #permalink

Krbiozen said... "The point of vaccination is to go from being blue (at risk of disease) to yellow (immune from disease) without going through the intervening stage of red (sick, which is bad enough on its own and risks permanent sequelae such as death)."

Agree.

Krebiozen said, "It seems to me that arguing that we don’t need to be vaccinated because we can achieve the required level of herd immunity naturally by getting sick is about as dumb as it gets."

Agree.

My point was that the diagrams make no provision for natural immunity... they assume everyone is susceptible unless vaccinated.

My point is that vaccination should have been a simple top-up of natural immunity...

My point is that if herd protection actually occurred then most diseases targeted by vaccination would have disappear yonks ago... unvaccinated folk would have been immunised via natural infection... immune folks immunity would have been topped up by bugs spread by the infected...

The bottom line is for most this has not happened.

ChrisP, I should have said,

The fallacy in the top diagram is tha the red people [that survive] become immune and so they should become yellow as they are then immunised… the arguments made in the bottom diagram then apply.

Mr. Law, you never answered my question posted at August 31, 6:58 pm... Do you live where there babies are never born and there are no children?

Think very carefully about that question and why it applies to your conception of herd immunity.

Can I suggest folk take some time out to read the 1960 record of events regarding the massaging of polio data.

Go here and read by clicking previous slides...

http://tinyurl.com/cy47clw

It's a very enlightening read... I'd be interested in comments by folk who've bovered to read it.

My point was that the diagrams make no provision for natural immunity… they assume everyone is susceptible unless vaccinated.

You're pitching a fit over the wording of the labels not suiting your taste?

Can I suggest folk take some time out to read the 1960 record of events regarding the massaging of polio data.

Can I suggest you take some time out and read the goddamned thread you're commenting on, in which your own source was supplied for you a week ago?

Perhaps, Mr. Law, could think about the question I asked him about the the lack of children where he lives. It is, in this part of reality, why epidemics have a cyclic nature.

So, Mr. Law, do you live where there are neither pregnant women giving birth and no children?

@Ron - your comments have just gotten inane - seriously, you don't know that new people are coming into the population all the time (i.e. the Blue people being born, etc)? That was the failing of natural herd immunity - sure, you would get a given population to the level of general immunity through sickness (or mass one-time vaccination), but when additional people come in - the bulk of whom are children with no immunity whatsoever, you are creating a whole new population that can be easily re-infected......moron.

Babies are being born - and we do have children, where Ron lives, which is why we could all do without his 'I'm not anti-vaccine,' anti-vaccine nonsense!

By nz sceptic (not verified) on 05 Sep 2012 #permalink

Ron seems to regard vaccination as having some sort of role as a "top up" of natural immunity.
When a new vaccine for a disease is first introduced, then this situation will apply, and herd immunity levels can be hopefully be boosted above the critical level.

Of course, the demographics of the population at risk are then altered. We expect and hope to see the new (uninfected, non-immune and susceptible/vulnerable) children receiving protective vaccine rather than catching the natural disease.

Ultimately, a disease for which there is a good vaccine and which has no animal reservoir or symptomless human carriers has the potential for total eradication (as happened with smallpox, and which could happen with measles, if enough people would just get on and damn well vaccinate!)

Once measles is eradicated, then no-one need have the measles vaccine, and we can all go home to bed, (antivaxxers claiming measles vaccine causes autism etc included).

I'm been quietly sitting on the sidelines, but excuse a brief comment -

RRA wrote: "My point is that if herd protection actually occurred then most diseases targeted by vaccination would have disappear yonks ago…"

No, it would depend on what species are primary hosts to the disease organism.

If the only primary host to the disease organism are humans this might happen - it's the case for smallpox, for example. Smallpox (variola) has no known non-human host.

If other species are the primary host, the disease organism will still persist in the other species and be 'out there' to re-establish infection in any people who have weakened immune systems, have yet to be immunised (by whatever means), whose immunity has waned, etc., are vulnerable. With a good vaccination program in place while there will still be a few (i.e. rare) disease cases, herd immunity will prevent the spread from those cases. In the absence of a vaccination programme a cycle of epidemics will establish as immunity wanes and then becomes re-established as happened in pre-immunisation times (and to a lesser extent during less effective vaccination programmes).

Opps, my comment crossed dingo199's.

Ron Law wrote:

ChrisP, I should have said,

The fallacy in the top diagram is tha the red people [that survive] become immune and so they should become yellow as they are then immunised… the arguments made in the bottom diagram then apply.

ChrisP had previously written:

Ron is, as usual, wrong. What happens is that a whole lot of new blue people are in the population, so it turns into a case analogous to the middle section.

Usually the whole population (or even more than 90%) does not get infected all at once. With vaccination immunity can be provided before the disease strikes creating the bottom scenario.

OK next argument Ron.

Your clarification Ron didn't make you any less wrong.

Risk analyst Ron, you never did answer how you would justify not vaccinating against a serious disease when remaining unvaccinated confers a measurably larger risk of catching it (eg 4 fold with Meningococcal disease/MeNZB vaccine; or 23-fold with pertussis/DTaP).

For someone like me who is clearly far more inexperienced in the arcane methods of risk analysis, can you demonstrate the exact workings of your analysis, and explain what you would advise a parent to do about vaccinating for these diseases and why?

I’d be interested in comments by folk who’ve bovered to read it

I read it and what I took away from it is that the original Salk killed polio vaccine was probably over-hyped, which is understandable, that some of its efficacy may have been due to some live viruses surviving in it, that live OPV is more effective than inactivated polio vaccine, and that booster vaccines are required to ensure a good level of immunity. As polio was eradicated it became clear that there were other diseases that caused similar symptoms, other enteroviruses and Guillain Barre for example, and some of these were previously diagnosed as polio. For some reason Greenberg sees what looks to me like a downturn in the normal cyclical nature of polio outbreaks as a natural decline, and compares it to a downturn in the natural cycle of infectious hepatitis outbreaks (presumably what we now call hepatitis A) which he also misinterprets as a natural decline with the same causes as the decline in polio. I think he was wrong in that interpretation, and had vaccination not been introduced the incidence of polio would have increased again in its usual cycle, <a href=
"http://www.who.int/csr/disease/hepatitis/whocdscsredc2007/en/index4.htm… hepatitis A did, ("In the United States, nationwide outbreak cycles appear every decade, as observed in 1961, 1971 and 1989"), but polio did not. In 1960 there was still a lot of debate about polio vaccines as it was a relatively rare disease in the USA. It is much better understood now, over half a century later, which is why live OPV is used in developing countries where polio is more common, and the IPV in developed countries where it has been eradicated. Have I missed anything important?

By Krebiozen (not verified) on 05 Sep 2012 #permalink

nz skeptic:

Babies are being born – and we do have children, where Ron lives,

So, Ron just does not understand that babies are not automatically immune? He does not understand that each group of children needs to get immunity, hopefully with vaccination and not illness? Wow, that is dense.

What we need is Th1Th2 troll thingy back to tell us about the differing Th responses involved in wP and aP vaccines.

sorrry that was meant for the pertussis thread

If anyone wants to see drivel regarding herd immunity one need go no further than this report...

http://tvnz.co.nz/national-news/protection-against-meningococcal-diseas…

There is no meningococcal vaccine in routine use in NZ, and the mass vaccine used previously, and one assumes given to the girl who died, was known and shown not to convey herd immunity anyway as it made no difference to carriage of the bug.

Narad, I know you posted the 1960 paper... I was just suggesting people read it... so they can make informed comment.

Niche Geek asked, "You said “if herd immunity was real”: are you disputing the mathematics or the mechanism?"

It's a model... the reality is quite different. Also, as pointed out, most models were developed around a base of natural immunity topped up with vaccination based immunity... but supporters usually ignore natural infection acquired immunity, and ignore the enhanced immunity developed as a result of natural spread of infection.

Grant, given your expertise in this field, perhaps you could enlighten us as to which of the diseases included in today's vaccine schedules infect and are spread by other species?

Krebiozen, what about changing definitions pre/post introduction of vaccination... occurred twice with polio... 1x diagnosis criteria, 1x definition of an epidemic.

Speaking of scare-mongering rubbish from anti-vax proponents close to the original topic, try this piece of ridiculous nonsense from Leslie Carol Botha: http://www.healthfreedomusa.org/?p=12749

Of interest to those here is the section towards the end titled "HPV rDNA Particles found in Postmortem Inquest of New Zealand Girl".

Almost every single paragraph of her writing (and some of what she quotes) in her article either contains grossly inaccurate statements or is irrelevant. After all these years I still sometimes wonder how people write things like this.

Ron,

Krebiozen, what about changing definitions pre/post introduction of vaccination… occurred twice with polio… 1x diagnosis criteria, 1x definition of an epidemic.

What about them? Science progresses, definitions change. Diagnostic criteria change as we learn more about a disease, the definition of an epidemic is used to decide when certain public health measures become necessary, and is changed from time to time. As I wrote above, the Salk vaccine was probably overhyped, and wasn't as effective as original clinical trials suggested, which is not unusual. I don't think it reflects some dastardly conspiracy, I think it reflects improvements in our understanding. I don't have time to dig it out right now, but one of the doctors involved in the Salk trials said that up to 50% of the cases diagnosed as polio back then were probably caused by something else. The history of medicine is full of false hopes, false starts, mistakes and misunderstandings, it's not perfect, but generally we move in the direction of progress. Vaccines in particular often have unintended consequences, and schedules are changed, boosters introduced etc.. That 1960 meeting gives us an insight into what problems people faced with polio and vaccination back then, and what misunderstandings and misconceptions were circulating, it's interesting from a historical point of view, but I don't really see what relevance it has today.

By Krebiozen (not verified) on 05 Sep 2012 #permalink

From another thread, web page of interactive calculation of a herd effect model - click on 'Documentation' for details of the modelling: http://op12no2.me/toys/sir.php

Krebiozen, the definitions were changed IMMEDIATELY after introduction... it was nothing to do with modern/better understanding...

I love the rationalisation... a classic 'skeptics' response.

R

Grant... it's a hypothetical model... unfortunately life's not like that.

Grant, Leslie Botha's piece even managed to include citations that were inaccurate, wrong or irrelevant.

but supporters usually ignore natural infection acquired immunity, and ignore the enhanced immunity developed as a result of natural spread of infection.

Really risk analysist Ron? Is that why the CDC and other public health organisations consider persons born before a certain date to be immune to measles, mumps and rubella? And why proof of natural infection to chicken pox is accepted? http://www.cdc.gov/vaccines/pubs/pinkbook/index.html

Krebiozen, the definitions were changed IMMEDIATELY after introduction… it was nothing to do with modern/better understanding…

Given your "understanding" of epidemiology, it's safe to say you are again wrong. I guess the addition of post-polio syndrome in the 1980s is also a conspiracy: http://www.acnr.co.uk/pdfs/volume5issue1/v5i1reviewFarbu.pdf

By Science Mom (not verified) on 06 Sep 2012 #permalink

Ron,

I love the rationalisation… a classic ‘skeptics’ response.

What rationalization? Ron, what is your point? Please explain what you are hinting at clearly and concisely, without all this dancing around seemingly unwilling to state your position.

By Krebiozen (not verified) on 06 Sep 2012 #permalink

Ron,
Why do you think the definitions were changed? Was it part of the New World Order's sinister plans for world domination?

I also meant to mention that if many of the cases that were diagnosed as polio in the 50s were actually caused by other pathogens, that might go some way to explaining why the Salk vaccine didn't work quite as well as hoped, though it was a great deal better than no vaccine at all. Polio vaccine only prevents polio, not other enteroviruses.

By Krebiozen (not verified) on 06 Sep 2012 #permalink

Ron Law does a good impersonation of jelly being nailed to a wall. As soon as you demonstrate one of his statements is fatally flawed, he drops it and moves on to the next one. And so it goes around and around in circles.

try this piece of ridiculous nonsense from Leslie Carol Botha

Should anyone else follow Grant's link above this link by Dr. David Gorski (whoever he is) should bring you up to speed. I was entertained by following up a reference to The Center for the Biology of Chronic Disease having published this drivel. The CBCD is a not for profit organization whose sole purpose appears to me to be to promote "the natural antiviral supplement Gene-Eden". Is that even legal?

By Krebiozen (not verified) on 06 Sep 2012 #permalink

Ron Law does a good impersonation of jelly being nailed to a wall. As soon as you demonstrate one of his statements is fatally flawed, he drops it and moves on to the next one. And so it goes around and around in circles.

I think that's what the anti-vaxxers like to refer to as "open-minded". But yea, that's exactly what Ron is doing because you have to go 'round in circles when you lie and can't understand the evidence and need to desperately cling to false beliefs.

By Science Mom (not verified) on 06 Sep 2012 #permalink

Kriebozen - thanks

krebiozen said, "I also meant to mention that if many of the cases that were diagnosed as polio in the 50s were actually caused by other pathogens, that might go some way to explaining why the Salk vaccine didn’t work quite as well as hoped, though it was a great deal better than no vaccine at all. Polio vaccine only prevents polio, not other enteroviruses."

EXACTLY...!!!!!!!!!

Science Mom demonstrates an ability to google references... "Given your “understanding” of epidemiology, it’s safe to say you are again wrong. I guess the addition of post-polio syndrome in the 1980s is also a conspiracy: http://www.acnr.co.uk/pdfs/volume5issue1/v5i1reviewFarbu.pdf"

Read the ref... makes false claim in its opening gambit... Halstead did NOT introduce the term post-polio syndrome
in 1986... it had been used some time before that... the Post Polio conference in 1983 even referred to a preference to use another term...

It wasn't an addition or redefining as occurred with the definition of polio... the post-polio atrophy and related issues were well known...

Ah, sardonsim... Doesn't a sardonic comment express a feeling or attitude in a sour or bleakly world-weary way? ... missed that!

Perhaps 'sardonic' isn't quite the right word. Almost everyone knows who Orac is, but it's a sort of running joke here to pretend to maintain the fiction that he is anonymous. I shouldn't have assumed you knew that, but I couldn't find a sardonic emoticon.

By Krebiozen (not verified) on 09 Sep 2012 #permalink

Repsted in the vain hope Risky Ron will actually answer a question concisely and directly, rather than indulge in handwaving and evasion:

Risk analyst Ron, you never did answer how you would justify not vaccinating against a serious disease when remaining unvaccinated confers a measurably larger risk of catching it (eg 4 fold with Meningococcal disease/MeNZB vaccine; or 23-fold with pertussis/DTaP).

For someone like me who is clearly far more inexperienced in the arcane methods of risk analysis, can you demonstrate the exact workings of your analysis, and explain what you would advise a parent to do about vaccinating for these diseases and why?

Dingo199 asked, "Risk analyst Ron, you never did answer how you would justify not vaccinating against a serious disease when remaining unvaccinated confers a measurably larger risk of catching it (eg 4 fold with Meningococcal disease/MeNZB vaccine;..."

Alas, your "4 fold with Meningococcal disease/MeNZB vaccine is very illinformed... whilst there have been reports of such benefits they have not being based on sound science. Even the Ministry of Health rejected such claims (which were made in part by another wing of the MOH.)

You can see how 'protective' the vaccine was here...

http://img.scoop.co.nz/stories/images/0505/64dfd522489e6ded3bcc.jpeg

or here

http://img.scoop.co.nz/stories/images/0611/3194f611326777c15253.jpeg

or here

http://img.scoop.co.nz/stories/images/0611/1e9afd438e1c8d7bdf21.jpeg

or here

or here

http://img.scoop.co.nz/stories/images/0505/b3b6760c96f21e8e0982.jpeg

http://img.scoop.co.nz/stories/images/0611/fb229edee4aa4fa641e2.jpeg

Or how effective the Cuban equivalent was

http://img.scoop.co.nz/stories/images/0505/94b86ea400b963e52bd9.jpeg

I get it Ron, .....I ask for a risk analysis and you post graphs, by way of evasion.
I guess you think they prove something? I got news for you - they show nothing relating to either vaccine efficacy or effectiveness, or anything that can appropriately inform parental choice.

I asked how you might advise a parent about the risks entailed when one sees a serious disease for which going unvaccinated greatly increases the risks of acquiring the disease. We know this risk for MeNZB was 4 fold, but that is one disease only. At the other end of the spectrum is pertussis, where going unvaccinated is linked with a 23-fold risk of infection.

I would imagine you could paint a very nice picture for a parent by using an analogy like a car crash.

"Mrs Jones, reliable information tells us that if your child is strapped into a booster safety seat, she is 23 times less likely to suffer significant damage in a car crash than if you leave her unstrapped. The potential consequences are so serious that I recommend you use one, even though there are very rare reports of children being injured by the restraints on their booster seats."

I wouldn't say "See here", and leave her to look at several charts that plot child injuries in accidents against the number of cars on the road, or some similar vaguely associated but actually quite irrelevant information that doesn't put the situation into a meaningful individual context for the mother seeking the risk information to make an informed decision.

We have established you are a pretty lousy risk analyst if you ask me, but I do have just one question only:
Would you recommend parents vaccinate their kids against pertussis? Yes or no?

dingo199 says, "We know this risk for MeNZB was 4 fold, but that is one disease only. At the other end of the spectrum is pertussis, where going unvaccinated is linked with a 23-fold risk of infection."

Dingo, we don't know "the risk for MenZB was 4 fold" at all...

And where do you get a 23-fold risk for pertussis from? That would mean the vaccine was, what? 95 percent effective or there abouts? Pertussis vaccine? What a hoot...!

I'm guessing your reference relates back to a case controlled study out of Colorado... where 89 percent of the cases were in vaccinated children and supposedly 99.5 percent of under 18 year olds were vaccinated... so where was the so-called herd protection? Besides, if that's the study you are referring to, a comparative group with just 3 cases is hardly hi-stats...

Can you provide references to the x4 and x23 studies you use as evidence... then I'll comment.

By the way, can you see any impact due to the MeNZB vaccine in the graphs of MOH data I posted? A x4 effectiveness would have sent the graphs south... it made no difference... the disease was in natural decline before the vax was rolled out and stalled once rolled out... by the way, of the first 13 deaths after MeNZB was introduced none (NONE) occurred in children whose parents declined MeNZB. (that's according to figures released by the Minister of Health.)

The percentage attributable risk in the vaccine refuser population was 99.5% (95% CI: 98.1%-99.9%), and the total population attributable risk was 11.0% (95% CI: 5.8%-16.0%). These estimates suggest that all 18 of the unvaccinated pertussis cases were attributed to vaccine refusal, and 11% of the pertussis cases in the total population were associated with vaccine refusal.(my emphasis)

and Despite high pertussis immunization rates in Colorado, herd immunity did not prevent a high relative-risk for pertussis in vaccine refusers. This is likely because of a combination of waning immunity to pertussis in adolescents and adults, ongoing endemic circulation, the highly contagious nature of the bacterium, and frequent asymptomatic infections. Of note, herd immunity to pertussis may increase over time because of the impact of the newly recommended adolescent and adult pertussis booster vaccine

from Jason M. Glanz, PhD, David L. McClure, PhD, David J. Magid, MD, MPH, Matthew F. Daley, MD, Eric K. France, MD, MSPH, Daniel A. Salmon, PhD, MPH, & Simon J. Hambidge, MD, PhD (2009). Parental Refusal of Pertussis Vaccination Is Associated With an Increased Risk of Pertussis Infection in Children Pediatrics, 123 (6), 1446-1451

I’m guessing your reference relates back to a case controlled study out of Colorado…

Case–control, Ron. This means you have cases and controls.

Besides, if that’s the study you are referring to, a comparative group with just 3 cases is hardly hi-stats...

That's an outcome. What exactly do you imagine this complaint to mean?

Alison: I've got the abstract and the full PDF article you reference here:

http://pediatrics.aappublications.org/content/123/6/1446.full.pdf

And, how about more recent reports of pertussis outbreaks in Colorado?

http://news.yahoo.com/health-official-says-colorado-pertussis-cases-epi…

".... According to state information, from Jan. 1 to Aug. 11, 715 cases of pertussis were reported in Colorado. The average from 2007-2011 of the same calendar period was 158 cases.

* The highest rates of pertussis this year are among infants under 6 months old, followed by infants 6 to 11 months old, the Colorado Department of Public Health and Environment reported.

* Chief medical officer Dr. Chris Urbina stated that infants are particularly susceptible to pertussis and tend to have higher rates of hospitalization and deaths from the disease.

* Young infants with pertussis often do not present with a cough, but rather with apnea or gasping, the CDPHE stated.

* No deaths have been reported due to pertussis in 2012, the CDPHE reported, but it is recommended that those who care for infants and spend time around infants get vaccinated as infants are too young to have received all the doses of the vaccination.

* According to the state's fact sheet on the disease, the vaccine for pertussis is given in combination with vaccines for diphtheria and tetanus. The recommendation for the vaccination is that a total of five doses be given at two, four, six, 15 to 18 months, and between four to six years. Single doses are recommended for children 11 to 12 years of age or for those who have never received the vaccination.

* The majority of the Colorado pertussis cases this year have been reported in Adams, Denver and Jefferson counties, according to the CDPHE, though -- as of Aug. 20 -- the disease has been reported in 26 counties in all.

* The most active week of the disease this year was the week of Aug. 11, in which nearly 60 cases were reported. The number of cases has been increasing each week since July.

* According to the CDPHE's study of vaccine preventable diseases in Colorado from 2002-2012, most complete years don't see as many reports of pertussis as there have been just through August of this year. 2004 and 2005 appeared to be particularly hard-hit with 1,185 and 1,383 cases, respectively."

So Ron, now you have had a chance to digest the case-control study on pertussis, and realise that it is not about herd immunity at all but individual protection, and that it indeed shows unvaccinated kids are at much greater risk of this serious disease, what does your inner risk-analysis guru conclude?

Do you recommend parents vaccinate against pertussis?
Yes or no?

At what point does repeated denial of facts and evidence start to grate internally, Ron? How dissonant does your cognition have to get before your neurons combust?

At what point does a "risk analyst" come to appreciate that solely using extrapolations on disease incidence is an imperfect way to predict behavior of an epidemic or infection, and when does he start thinking about all the evidence of lowered individual risk of disease following vaccination?

lilady, that may all be true, and I'm not disputing it, but the whooping cough increases across many US states and countries around the world is due in part to increased testing in part due to use of PCR tests and in part due to short-term effectiveness of the acellular vaccine.

The Colorado study was in a community supposedly with a vaccination rate of 99.5%... implausible... the results of the study were predicated on one group having only three infected subjects.

The CDC Investigation of the Washington epidemic demonstrates multiple B. pertussis strains causing infection, primarily in vaccinated persons. Given the high transmissibility of B. pertussis, a proportion of vaccinated persons remains susceptible and can become infected during a pertussis outbreak...

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6128a1.htm

It's interesting that in NZ thirteen MeNZB vaccinated children died vs zero unvaccinated [MeNZB] children ... and the MOH wouldn't analyse the statistical significance because they said their weren't enough cases... that's over 1 million children...

I suspect significance depends on whether one gets the results one wants.

dingo199, who used extrapolations? The MeNZB data was actual data... 13 deaths in vaccinated... zero deaths in unvaccinated in districts where the MeNZB vaccine was offered...

In the effectiveness study, they made up the number unvaccinated... In the official vaccination records some areas had 110% vaccination rates... why? Because they compared real versus made-up data...

Here's a story that an analyst would see as a red flag to bright shiny science-looking studies...

Here's a state with apparently the second lowest vaccination rate in the country... and apparently falling... and yet the spokesperson quotes his own institutions '23 times' quote... based on 99.5% vaccination rate in a state with an acknowledged low rate...

Makes one think, doesn't it.

An analyst doesn't take things at face value... rather an analyst needs to be skeptical and run studies such as this past BS detectors and ask, do these results make sense???

In the case of pertussis with low vax rates, and poor efficacy, vax rates of 99.5% and effectiveness over 95% do not make sense... no matter how much they the data is massaged.

the results of the study were predicated on one group having only three infected subjects

No, you dingbat, the fact that there were only three vaccine refusers in the control group, which didn't have pertussis, is the result, not a "predicate."

And...

The Colorado study was in a community supposedly with a vaccination rate of 99.5%… implausible…

Given that you keep repeating this, I'm curious how you arrive at the assertion. I can guess, but let's have it from the horse's mouth.

Funny how in that flurry of comments, Ron Law failed at answering Dingo199's question:

Do you recommend parents vaccinate against pertussis?
Yes or no?

@Ron Law

It’s interesting that in NZ thirteen MeNZB vaccinated children died vs zero unvaccinated [MeNZB] children

Citation for this?

Not only will he not answer any questions, he responds by dumping non-sequiturs, red herrings and a liberal scattering of straw men. Methinks he is undone, and can't admit it without losing face.

Come on Ron, answer my question please.
What would a dinkum risk analyst advise a mum to do about vaccinating her child against pertussis - yes or no?

Another post on its way - held up by spam filter because of links, i guess

The Colorado study was in a community supposedly with a vaccination rate of 99.5%

Nope, sorry, try again.

the 99.5% claimed in the above practice

Getting closer, but still wrong.

We conducted a case-control study of children enrolled in the Kaiser Permanente of Colorado health plan between 1996 and 2007. Each pertussis case was matched to 4 randomly selected controls...There were 18 (12%) pertussis vaccine refusers among the cases and 3 (0.5%) pertussis vaccine refusers among the controls.

It was not 99.5% in a community. It was not 99.5% in a practice. It was 99.5% of those enrolled in a health plan that provides vaccine coverage AND who did not get sick.

One reason for lower vaccine rates is lack of health care coverage. That factor is not present in this study. Which means this is actually a very good study for examining the effect of refusal, since it doesn't have lack of access as a confounder.

BTW, If the 99.5% rate in this study is wrong, that means someone was conducting health insurance fraud. I'm sure Kaiser Permanente would appreciate you providing evidence, so that they could track down and prosecute those pediatricians committing fraud.

By W. Kevin Vicklund (not verified) on 11 Sep 2012 #permalink

Todd W asked for referenece; " It’s interesting that in NZ thirteen MeNZB vaccinated children died vs zero unvaccinated [MeNZB] children

Citation for this?"

Minister of Health. Information obtained under Official Information Act. Figures are for 2006, 2007, 2008.

And several answers to parliamentary questions...

6432 (2008). Sue Kedgley to the Associate Minister of Health (08 Jul 2008): Further to the answer to question for written answer 05977 (2008) have any statistical significance analyses been undertaken to establish the significance of the fact that all seven children who died from meningococcal disease in 2006 and 2007 had received the MeNZB vaccine and that no unvaccinated children died from any form of meningococcal disease; if not, why not; if so, what is the statistical significance?
Hon Steve Chadwick (Associate Minister of Health) replied: No statistical analyses have been carried out comparing the death rate from meningococcal disease in vaccinated and unvaccinated children because the number of deaths is too small to give a reliable estimate.

6583 (2008). Sue Kedgley to the Associate Minister of Health (11 Jul 2008): Further to the answer to question for written answer 05977 (2008) How many children under the age of twenty have died from meningococcal disease so far in 2008 broken down into bacterial type, age group, number of doses of the MeNZB vaccine, and District Health Board?
Hon Steve Chadwick (Associate Minister of Health) replied: I am advised that five people under the age of 20 years have died from meningococcal disease in 2008 to date. A further breakdown, as requested, is provided in the attachment.

None of the 12 had been vaccinated with MeNZB. Another vaccinated child died later in 2008 bring the total to 13... vs zero deaths in children not given MeNZB...

You can see the natural decline of total cases and deaths and MenB deaths that occurred before the vaccine was rolled out... and the lack of impact of the MeNZB vaccine on the downward trend.
http://img.scoop.co.nz/media/pdfs/0604/Meningococcal_Decline_to_March_2…

Indeed, the rates increased in infants, and the MOH initial work found that MeNZB given to infants INCREASED the risk of disease, but they refused to study this in detail.

Not only will he not answer any questions, he responds by dumping non-sequiturs, red herrings and a liberal scattering of straw men

Hahaha Ron keeps following the script letter for letter.

How about answering Dingo's question?

Do you recommend parents vaccinate against pertussis?
Yes or no?

So, We see Ron favours rumour and politicians (who of course are experts in the field of infection epidemiology).

Ron says this:

None of the 12 had been vaccinated with MeNZB. Another vaccinated child died later in 2008 bring the total to 13… vs zero deaths in children not given MeNZB…

Ron can’t even keep his own propaganda straight. I make that 12 deaths in unvaccinated kids, and one death in a vaccinated kid.

And then we have some real data, as opposed to hearsay:
Between July 2004 and December 2008 an estimated 210 epidemic strain cases (95% CI 100-380), six deaths and 15-30 cases of severe sequelae were avoided in New Zealand due to the introduction of the MeNZB vaccine.

From here – no link posted as none of mine are making it through.
Vaccine. 2011 Sep 16;29(40):7100-6. Epub 2011 Jul 29.
Effectiveness of a vaccination programme for an epidemic of meningococcal B in New Zealand.
Arnold R, Galloway Y, McNicholas A, O'Hallahan J

PS Ron.
1. How many of the deaths from meningococcal disease were due to Gp B?
2. And what do you advise that Mum again about pertussis vaccination for her kids?

I see Ron subscribes to the notion that AGW is caused by there being too few pirates.

Mmmm, Ron's offering a fine dish of copypasta there. For example, the link in his 4:11 comment is no longer valid. Fortunately, the wonders of Google cache (probably could have also used Internet Archive) allowed me to see the graph. However made the graph ought to be fired. It is a 12-month rolling average that ends (Mar06) only a few months after significant vaccine uptake (Nov05) [minimum 3 shots for full coverage, 4 recommended]. As such, most of the post-vaccination data is obscured by pre- and partial-vaccination data. However, it does look like vaccination was having an effect, but data collection is cut off before this can be confirmed.

By W. Kevin Vicklund (not verified) on 11 Sep 2012 #permalink

"We conducted a case-control study of children enrolled in the Kaiser Permanente of Colorado health plan between 1996 and 2007."

So they maintained a 99.5 percent vaccination rate over 10 years? For all ages? I don't think so... even their target is only 'over' 90 percent...

"Ron can’t even keep his own propaganda straight. I make that 12 deaths in unvaccinated kids, and one death in a vaccinated kid."

Should have have been one unvaccinated child in late 2008...

Dingo199, the Arnold paper is based on modeling, supposition and assumptions... they did not know how many unvaccinated children existed... they made that number up... they used the case fatality rate for all meningococcal deaths, and when their outputs are applied to real data their conclusions are not supported. The reason Arnold got the contract to do the study was because Professor Diana Lennon (who was the MeNZB lead researcher until she complained to the Ethics Committee that Chiron were withholding data from her so she was being forced to sign studies off without being able to verify the data, and they even bypassed her in submitting data for licensure without her knowledge) had publicly stated that the fact that the disease had waned naturally and that coincided with/preceded the introduction of the vaccine meant that it wouldn't be possible to undertake her planned controlled study... So the MOH dumped her and used a mathemagician instead... go figure...

For the record, Arnold's analysis showed greater risk for infants given the MeNZB.

Kevin, the link worked at 4:11 and it worked 10 seconds ago...

So, once more, how many deaths in vaccinated kids, Ron?
Can we see a citation to a reputable source of information, and not have to just take your [unreliable] word for it?

Linky to proper source pretty please?

Anyhow, here is a source that states unequivocally that meningococcus infection occurred in 34 vaccinated individuals during the period of the vaccination campaign. Data on 31 who were admitted reveals the average hospital length of stay was 4 days. Twelve cases were admitted to intensive care, and there were no deaths.

That seems to directly contradict the hearsay evidence given by Ron that there were 13 deaths in vaccinated children.

I know which source I'd rely on.
Surveillance of vaccine breakthrough cases following MeNZB vaccination. New Zealand Medical Journal 18-April-2008, Vol 121 No 1272
(Sorry I cannot post links - I get trapped in the filter for some reason)

These 34 cases represent infections with meningococcus that occurred despite vaccination (ie vaccine failures) during the course of the epidemic.

Of course, this has to be balanced by the calculations that the vaccine also prevented 210 epidemic strain cases of meningococcal disease (95% CI 100-380), six deaths and 15-30 cases of severe clinical sequelae.

So they maintained a 99.5 percent vaccination rate over 10 years? For all ages? I don’t think so… even their target is only ‘over’ 90 percent…

How many times does this need to be explained to you?

I have about 3 posts held up - each with links and explaining to Ron how he can fart and chew gum at the same time.

Ron, so you don't like the Arnold paper (I wonder why ... not because it blows you out the water, surely not god forbid?)

Indulge in some ad hominem as well about it if you must, that's about the only logical fallacy you haven't deployed recently in your attempts to mislead everyone and evade simple questions.

Your link still does not work Ron (but at least you can post them!)

Arnold’s analysis showed greater risk for infants given the MeNZB

AHH! I finally get it! Ron wants us to believe the Arnold study where it suits his purposes, but ignores the fact that for everyone except infants the study showed far LOWER risk if they were vaccinated.

And that lower risk wasstatistically significant, unlike the fractionally higher risk in the infants that Ron wants us to all crack a fat over.

Thanks Lilady
You're a beaut!

dingo199: I know absolutely nothing, nada, zilch about computer programs. I found that two links in one post get through...usually. Three links usually gets me stuck in the moderation hopper.

So just to keep you on message here Ron, we need the following from you:

1. A reliable, valid citation/source for the claims there were 13 meningococcal deaths in vaccinated kids and no deaths in unvaccinated kids. Provide a link to the original source evidence please.

2. An answer as to whether you would advise a mother to vaccinate her kids against pertussis, speaking from your professional perspective as an expert in risk analysis of course. And while you are at it, you could also tell us which other vaccines you would tell her to have or avoid, please.

Hah!
That link is to a study which showed that the under 5's had a five-fold less risk of getting infected with this awful disease.

Ron would have you believe that infants are more at risk if they are vaccinated. Not so. The difference in relative risk is tiny, and numbers in this group were too small to even make a valid statistical comparison, and likely to be spurious as the authors explain in one of their other studies.

And don't forget this was a 3 dose vaccine schedule given over 2 years, so infants are likeliest to be unprotected, having only very partial protection from one dose.

A reliable, valid citation/source for the claims there were 13 meningococcal deaths in vaccinated kids and no deaths in unvaccinated kids. Provide a link to the original source evidence please.

The 2008 number that he keeps bumbling is the attachment here. Add in the seven claimed for 2006 and 2007, and muse on whether coverage might have something to do with this.

I mean one or two doses. The vaccine is meant started at 6 months, and since it was a catchup, many infants (defined by Ron as those under 1 year) started their vaccine course when they were older than this.

Thanks Narad.
At least there is a source for the information - strange Ron couldn't link to it as asked.
Any chance of seeing the answer to 05977? Tried a search - couldn't find it.

I see that of the 5 deaths quoted as occurring in Men GpB vaccinated children in 2008, only 3 were confirmed as GpB, and 3 cases were in those who were partially vaccinated.

Any chance of seeing the answer to 05977?

The closest I'm getting is this.

From January 2005 to December 2007 a total of 167 epidemic strain cases occurred in those aged under 20 years, of which 55 were vaccine breakthrough cases including two vaccine breakthrough deaths (one in a child who was overdue for a fourth dose).

Ron asserts seven for 2006 and 2007, so it would seem that he's counting non-epidemic-strain mortality.

@Ron Law

Your link in your response to me doesn't work, as others have pointed out. Now, assuming that this:

None of the 12 had been vaccinated with MeNZB. Another vaccinated child died later in 2008 bring the total to 13… vs zero deaths in children not given MeNZB…

is a copy/paste from your link, then I have a couple comments. First off, it says, "none of the 12 had been vaccinated with MeNZB". It seems like you left out some text before that, but it suggests to me that 12 deaths were in unvaccinated individuals. Continuing on, 1 death was in a vaccinated individual, bringing the total death count to 13 (12 unvaccinated, 1 vaccinated). Your ellipsis has me wondering what was left out, but I'll let that go for now. The last bit, "vs. zero deaths in children not given MeNZB" suggests that the deaths occurred in teens or adults.

Now, back to that ellipsis. Given its position, we can't tell what came before the "vs.". Bottom line, without access to the original document, you have failed to support your assertion. Now, please support your assertion that "thirteen MeNZB vaccinated children died vs zero unvaccinated [MeNZB] children".

Given the other documents linked by dingo199, Narad and lilady, your case isn't looking to good.

Narad/dingo199/etc

I haven't time to sidetrack onto this, but I guess you're already aware there's an update to the stats in the Arnold paper available on the MOH website - ?

http://www.health.govt.nz/publication/poisson-regression-modelling-effe…

(Have to admit I was taken aback a bit by RRA objecting that Arnold's work was mathematical and made assumptions as risk analysis is mathematical and makes assumptions too!)

It seems like you left out some text before that, but it suggests to me that 12 deaths were in unvaccinated individuals.

I'm pretty sure that he's asserting that all deaths from 2006 to 2008 were in vaccinated individuals but can't make the words come out right.

I did point that out to him, and gave him the opportunity to correct his error, and he then changed the sentence, but only garbled it more by replying to my comment (“Ron can’t even keep his own propaganda straight. I make that 12 deaths in unvaccinated kids, and one death in a vaccinated kid.”) like this:
"Should have have been one unvaccinated child in late 2008."

Is it me or is it strange that Ron links to stuff on Scoop.nz - you'd think as a risk analyst he'd link to actual studies... or post those supersecret documents he has access to.

flip -

Scoop is a press release website. More-or-less anyone can post material there, in fact our blogs (sciblogs.co.nz) used to be directed there.

Ron has a long history of writing press releases, often quoting himself in the third person, then pointing to them as if they're some kind of evidence for his claims!

By nz sceptic (not verified) on 12 Sep 2012 #permalink

Funny how so-called skeptics ignore official information no matter how or who presents it.

Info re 12 of the deaths among the MeNZB vaccinated and zero deaths in [MeNZB] unvaccinated were provided by the Ministry of Health through the Minister of Health in response to a parliamentary question. And that's labelled as unofficial? The 13 death was provided in an OIA request.

The number of unvaccinated was unknown... so much so that 110 percent of some demographics were vaccinated in Counties Manukau... an area renown for having low vaccination rates.

Grant, Arnold's paper is seriously flawed on several points. One of which is that it uses CFRs averaged over all types instead of using CFRs for the MenB type which is much lower than average... Even Medsafe doubted the integrity of the paper!

Info re 12 of the deaths among the MeNZB vaccinated and zero deaths in [MeNZB] unvaccinated were provided by the Ministry of Health through the Minister of Healthn response to a parliamentary question. And that’s labelled as unofficial?

Who labeled anything "as unofficial," you jabbering robot? The issue was that you misstated your assertion and then further misstated the "clarification." In other words, your reading comprehension is well paired to your writing skills.

Ron, for the 7th time of asking, could you please tell us how you would advise a mother asking about whether she should vaccinate her child against pertussis, speaking from your professional perspective as an expert in risk analysis of course.
And while you are at it, you could also tell us which other vaccines you would tell her to have or to avoid, please.

Narad, this is not a peer reviewed journal... if it was, people like you would say, "Hey, Mr Author, there appears to be doscrepancy, or error, or whatever..." that happens every day in the scientific publication world... here, it seems whenever some makes a mistake in a 10-second sound bite they get ridiculed and vilified....

Well, I've aways been one to admit mistakes and publicly correct them when necessary... When I lectured I challenged every student to critique everything they were told/given... and to challenge me, in class if they wanted, if they though I made a mistake... it lead to many healthy discussions and I don't ever recall a student accusing me of being 'jabbering robot...'

That said, in my previous post I made an error... I said, "Grant, Arnold’s paper is seriously flawed on several points. One of which is that it uses CFRs averaged over all types instead of using CFRs for the MenB type which is much lower than average…"

I've been back and reread the five iterations of Arnold's papers I have and in an early unpublished draft they did that... in their other papers they averaged the CFR for the epidemic strain from 1999 in early versions and 2001 in the latest... they use an average CFR in their last paper (the one Grant posted a link to above) of 3.9 and calculate lives saved based on the [ongoing mainly natural] decline in cases.

They say, "Crude case fatality rates due to epidemic strain meningococcal B disease for the years 2001-
2008 are displayed in Tables 9 and 10. There was no evidence of a change in case fatality
rates over the years 2001-2008"

Go look at table 9. It shows the CFR had been dropping before the introduction of the MeNZB and then rose sharply. The above statement is patently false.

In 2006 I prepared a rolling 12 month CFR from Dec 1997... the trend down and then the upward shift is plain to see.

http://img.scoop.co.nz/stories/images/0611/7e8b4d00c61154bd7067.jpeg

In their paper they calculated the number of lives saved on the average CFR... they ignored the actual number of deaths. Given that none of the deaths in 2006, 2007, 2008 were in unvaccinated children it is odd that they didn't highlight the apparent increased risk of death in vacinated children. There are very good reasons for that... one was complacency. There were several deaths documented as occurring because the medical staff assumed the child was protected and therefore they failed to diagnose meningococcal disease.

Ron, I suggest people do contrast your own "data" as "published" on scoop with the detailed 90 page statistical modelling analysis by Arnold.

They may wonder why you have drawn a graph of case fatality rates, and taken a pen, closed your eyes, and drawn a "line of best fit" that is clearly not a line of best fit, but tweaked to exaggerate the fall and rise of CFR you try and demonstrate. Have you heard about correlation, and how to calculate the line of best fit? Clearly not.

That point aside, your own chart seems to show that CFR increased following the immunisation campaign. Even were this true, what does it mean? That the vaccine did not prevent cases of meningococcaemia? No. Just that relatively more of those with the disease died within one time frame than in another. And whether someone with the disease dies or not has nothing to do with any vaccine, but is a measure of how well the disease was clinically recognised, managed and treated. The CFR will obviously rise if you prevent cases of the disease, because the denominator drops dramatically. Like all antivaxers, you dwell on mortality as though this is a measure of vaccine efficacy - it is not. Yet another straw man, I am afraid.

The bottom line was that although this vaccination campaign was expensive, botched and delayed, it did prevent cases of meningococcal disease (and therefore also averted some additional deathg).

All the data demonstrate that the relative risk of acquiring disease was less in the vaccinated population. I hope you, an an expert in risk analysis understand what a relative "risk" is? (hint - you derive a ratio of the incidence rate in the unvaxed population to the rate in the vaxed population. Vaccine effectiveness can then be calculated from the RR).

Perhaps you can provide a coherent explanation for the finding that the incidence rate of epidemic GpB meningococcus within the vaccinated population was around half the rate seen in the unvaccinated population? There was even some cross protection provided to no-epidemic B strains and non B strains.

You seem to have read the Arnold paper, but are meticulously cherry-picking bits of data and presenting these out of context with your own narrative and distorted interpretation superimposed in a futile attempt to imply the vaccine did not work.

http://www.health.govt.nz/publication/poisson-regression-modelling-effe…

Oh, and Ron, for the 8th time of asking, could you please tell us how you would advise a mother asking about whether she should vaccinate her child against pertussis, speaking from your professional perspective as an expert in risk analysis of course.

And while you are at it, you could also tell us which other vaccines you would tell her to have or to avoid, please.

This is what you said, Ron:

They [Arnold] say, “Crude case fatality rates due to epidemic strain meningococcal B disease for the years 2001-2008 are displayed in Tables 9 and 10. There was no evidence of a change in case fatality
rates over the years 2001-2008″

Go look at table 9. It shows the CFR had been dropping before the introduction of the MeNZB and then rose sharply. The above statement is patently false.

However, this is what the paper actually says:

Crude case fatality rates due to epidemic strain meningococcal B disease for the years 2001-
2008 are displayed in Tables 9 and 10. There was no evidence of a change in case fatality rates over the years 2001-2008 (Poisson rates model, p-value=0.26),

You have heard of statistics, I take it Ron? Or do we have to explain to you what a p value is, and what it means?

When they say there was no difference between the fatality rates they mean there was not statistically significant difference, using the accepted Poisson method for events that are very few in number (like deaths in this case).

You are nothing but a devious antivax troll. A sophisticated one, but a troll all the same.

PS this might help:
http://www.umass.edu/wsp/statistics/lessons/poisson/index.html

Ron NEVER, EVER, concerned himself with meningoccal B victims who were handicapped but didn't die. As far as he and Barb were concerned, they didn't exist!

By nz sceptic (not verified) on 13 Sep 2012 #permalink

Looking at Ron's graph, apart from the amateurish charting and trend lines filled in "by eye" (and a wall eye at that), I wonder how he derived the data points, considering that for some years there were as few as 3 deaths.
http://img.scoop.co.nz/stories/images/0611/7e8b4d00c61154bd7067.jpeg

Ron, if you are still here, and better disposed to answer questions than you have been up to this point, can we see the source data for your case fatality rate chart (or a link to the original Ministry of Health data you claim your chart comes from), because without that I trust your graph about as far as I can chunder.

Leet's see. The age ranges with the highest CFR were also the age ranges with the lowest vaccine coverage. We would expect CFR to rise if the vaccine is working!

Also, note that there were 15 total deaths from 2004-2005. Yet Ron's crappy graph claims that in the period Apr04-Oct06, there were 13 excess deaths. That means he was expecting there to be less than two deaths in a 31-month period.

By W. Kevin Vicklund (not verified) on 13 Sep 2012 #permalink

Narad, this is not a peer reviewed journal… if it was, people like you would say, “Hey, Mr Author, there appears to be doscrepancy, or error, or whatever…” that happens every day in the scientific publication world… here, it seems whenever some makes a mistake in a 10-second sound bite they get ridiculed and vilified….

It sure sounds like Ron is saying "If I cited from peer-reviewed research, then people might point out where the research or [more likely] my interpretations of it are wrong. Therefore, the solution is clearly to cite press releases instead." Actually, the real solution is stop saying s*** that's wrong.

It seems like the approach to take with Ron now may be ultimatum questions. A single ultimatum question at a time gets asked and the person is warned that if they do not give an answer themselves within their next three comments on any thread, that will be interpreted as them having given an affirmative answer (probably one they won't like.) It's an effective way of dealing with people who like to change the subject rather than answering a question they find inconvenient.

By Antaeus Feldspar (not verified) on 13 Sep 2012 #permalink

Dingoxxx asks, "Perhaps you can provide a coherent explanation for the finding that the incidence rate of epidemic GpB meningococcus within the vaccinated population was around half the rate seen in the unvaccinated population?"

Dingo, perhaps you can provide a coherent explanation fro the finding that the rate of pneumococcal disease within the MeNZB vaccinated population was around half the rate seen in the unvaccinated (MeNZB) population?

W. Kevin Vicklund said, "Leet’s see. The age ranges with the highest CFR were also the age ranges with the lowest vaccine coverage. We would expect CFR to rise if the vaccine is working!"

The big, big problem you have here Kevin is that for the three years from 2006 to 2008 there were no deaths in children unvaccinated with MeNZB... only thirteen deaths in MeNZB vaccinated children. Arnold et al conveniently never looked at vaccinated vs unvaccinated death rates...

What is this - answer a question with a question day?

Dingo, perhaps you can provide a coherent explanation fro the finding that the rate of pneumococcal disease within the MeNZB vaccinated population was around half the rate seen in the unvaccinated (MeNZB) population?

Sure I can Ron, but please - after you....
(I did ask first.)

Again:
Perhaps you can provide a coherent explanation for the finding that the incidence rate of epidemic GpB meningococcus within the vaccinated population was around half the rate seen in the unvaccinated population?”

Arnold et al conveniently never looked at vaccinated vs unvaccinated death rates…

Yes they did.
But the crucial parameter when looking to see if a vaccine is protective against infection is ...... wait for it...... seeing if it is protective against infection. Which it is.

Ron, for the 9th time of asking.....
Would you recommend mothers vaccinate their infants against pertussis?
Yes or no?

I now decree this is an "ultimatum question, and if Ron refuses to answer it means his answer is "No".
In other words, he is an antivaccine zealot, and happy to be recognised as one.

And another unanswered question/request I have to repeat:
Ron, can we see the source data for your case fatality rate chart (or a link to the original Ministry of Health data you claim your chart comes from)?

Common courtesy dictates you should be able to point to the source of claims you make. If you cannot do so, then we must assume the claim itself is entirely bogus.

One thing I always find pathetic are classic dumbass antivaxxer comments like "the vaccination aspect was a simple top-up… to fill the gap… but it was predicated on the masses being naturally immune", asserting that herd immunity has nothing to do with vaccination. Wrong. The first print use of the term "herd immunity" was in the 1923 paper by Topley and Wilson "THE SPREAD OF BACTERIAL INFECTION. THE PROBLEM OF HERD-IMMUNITY." The concept of immune individuals changing the likelihood of infection spreading to non-immune individuals was acknowledged and anecdotal until this time. The paper clearly studies mice, not "herd animals", uses GI bacterial infections spread by an oral-fecal route, and specifically uses vaccination to investigate the changes to infectivity with a defined input of bacteria in the food pellets when the proportions of immune vs. non-immune individuals are changed.

Ron, vaccination was not a "top-up" it was the origin of the term.

By Jay Chaplin (not verified) on 19 Sep 2012 #permalink

Oh cripes, stick a fork in Ron Risk Analyst...he's *overdone*.

Gee RRA, I love how you nibbled at my bait to stay posting on Respectful Insolence...after Grant banned you from his SciBlog.

You've now provided Grant and all of us with the ammunition to use against you from now on...to eternity. Thanks chump.

dingo199 asked, "And another unanswered question/request I have to repeat:
Ron, can we see the source data for your case fatality rate chart (or a link to the original Ministry of Health data you claim your chart comes from)?"
.
I have provided this... it was provided by the MOH through the Minister of Health in answer to a parliamentary question.

dingo199 then spits the dummy from his/her cot... "Ron, for the 9th time of asking…..
Would you recommend mothers vaccinate their infants against pertussis?
Yes or no?

I now decree this is an “ultimatum question, and if Ron refuses to answer it means his answer is “No”.
In other words, he is an antivaccine zealot, and happy to be recognised as one."

Dingo, making a decree proves absolutely nothing other than you making stuff up. I haven't answered your question because it is a purely hypothetical question on two counts... firstly, it assumes there is a 'pertussis' vaccine... as far as I know there isn't one... there are combo ones, but not a pertussis one per se. Secondly, I don't recommend anything to anyone... I point people to evidence and let them make up their own mind.

You can protest as much as you like, but the simple fact is I've never advised anyone against giving their kids routine vaccines. I was fully vaccinated (I take no credit for that)... our three kids were fully vaccinated, our two grand children are fully vaccinated... you can spit your dummy as far as you like, and make decrees till the cows come home, and then claim you are an objective minded skeptic... that's your choice.

Oh, and I see that NZ's MOH's chief medicine's regulator has complained to the coroner that his evidence was quoted verbatim on here... what a hoot!!!

Oh, and have you seen the recent Kaiser analysis of their patients and whooping cough... they've concluded that the vaccine is not the sharpest knife in the draw when it comes to protecting kids from whooping cough... despite very high vaccination rates... and >80% of kids thought to have whooping cough infection had negative PCR tests. they even acknowledged they didn't know what the effectiveness of the vaccine was... despite some on here who claim it is >95 percent!!! It adds weight to my comments that their earlier paper out of colorado was junk-science.

dingo199 you say Arnold et al looked at vaccinated vs unvaccinated death rates…

Where, in their paper, do they do that? It's not there... if it was it would prove that no lives were saved... in fact it could be argued that MeNZB increased the risk of death (which it did).

Dingo, making a decree proves absolutely nothing other than you making stuff up. I haven’t answered your question because it is a purely hypothetical question on two counts… firstly, it assumes there is a ‘pertussis’ vaccine… as far as I know there isn’t one… there are combo ones, but not a pertussis one per se.

No, making a decree via ultimatum fights the slimeball tactic known as the 'Gish gallop.' Gish gallopers bombard their opponents with a huge volume of false and misleading claims, many of which they already know to be false; instead of winning because their logic and facts stand up to examination, they try to win by simply applying shameless dishonesty at a faster rate than their opponents can counter with painstaking truthfulness.

It's different when the gallopers realize that they may actually - gasp! - be expected to back up what they say, and face consequences if they can't back it up. "What? You mean I can't just change the subject when someone's pointing out my lies? But that always worked before!"

Your response is pretty poor. Dingo199's question did not presume the existence of a single-purpose pertussis vaccine, any more than "Do you think a municipality should maintain a unit that responds to fire emergencies?" presumes a fire department that responds only to fires and not to medical emergencies, the way real-life fire departments do. And your claim that you don't "recommend" anything to anyone is nothing but a technicality. No one bombards a comment section as relentlessly as you do without believing that there is some conclusion that everyone should be drawing and must be pushed into drawing. Refusing to come out and say what that conclusion is only makes you look evasive.

(Frankly, it reminds me of John Stewart's masterful takedown of Glenn Beck over Beck's relentlessly stoking H1N1 vaccine paranoia and then refusing to say whether he'd gotten the vaccine himself. "what?? You're okay with talking about your anal fissure on national TV, but now all of a sudden you're delicate and coy?")

By Antaeus Feldspar (not verified) on 20 Sep 2012 #permalink

Read the ref… makes false claim in its opening gambit… Halstead did NOT introduce the term post-polio syndrome
in 1986… it had been used some time before that… the Post Polio conference in 1983 even referred to a preference to use another term…

It wasn’t an addition or redefining as occurred with the definition of polio… the post-polio atrophy and related issues were well known…

Wrong again Ron; Halstead did in fact coin the term based upon the fact that a delayed re-emergence of polio symptoms had been previously observed. You missed the point entirely unsurprisingly and that is that a diagnosis of post polio syndrome did not exist prior to the acceptance of the term and suddenly, there were many who had a new diagnosis. No conspiracy, just medical science doing it's job.

By Science Mom (not verified) on 20 Sep 2012 #permalink

Way to spam comments, Ron. Given that you would not provide a straight yes or no answer to dingo199, we must therefore conclude that you do not recommend that mothers vaccinate their children against pertussis.

Also, you did not provide source data. You only provided links to documents that you put up. These are not the original documents. Given your dishonest behavior in the comments here, we cannot trust that the jpeg links you provided have not been altered or doctored in some way. This is why we ask for the original source materials - no one can make claims of lying or distortion.

[John Stewart NY mob voice]Y'know. This here pertussis vaccine's crap. I mean, it could kill ya and won't protect ya anyway. But, you do what you wanna do. I'm just statin' my opinion regardless of what science says. You choose for yourself; I don't make recommendations, know what I'm sayin'?[/John Stewart NY mob voice]

Let’s see. The age ranges with the highest CFR were also the age ranges with the lowest vaccine coverage. We would expect CFR to rise if the vaccine is working!

The big, big problem you have here Kevin is that for the three years from 2006 to 2008 there were no deaths in children unvaccinated with MeNZB… only thirteen deaths in MeNZB vaccinated children.

As I said, the death rate is highest in those age ranges where vaccine coverage is lowest. Partial vaccination is included in low coverage. Here's an example.

In the 6-11 month age range ( the highest CFR at over 8%!), the ratio of un-:patially: fully vaccinated is roughly 5:80:15. The protection for each category is 0%/25%/80%. Factoring in the protection, the ratio of unprotected children in that age range is 5:60:3. That gives us about a 7.4% chance that any given death in that age group will not be vaccinated. Or about 1 in every 13.6 deaths, which means we would expect less than one death in the unvaccinated group if all deaths occurred in that age group (they didn't, of course).

This is just illustrative, not intended to be a full statistical analysis.

By W. Kevin Vicklund (not verified) on 20 Sep 2012 #permalink

Ron,

I am delighted you fully vaccinated your family, and that you merely provide the true facts and let people make up their minds about vaccines. That being the case, they will rationally choose vaccinating over not vaccinating (since the risks of catching pertussis are 23 times higher if their child is unvaccinated than if they were vaccinated).

From this we can conclude you are "Pro-vaccine", and have left the dark side. Well done and welcome.

Second, regarding your evasion - see comments above. You still act like a slimy weasel, pro-vaccine or not.

Third, the data have not been made available for your ridiculous graph posted here:
http://img.scoop.co.nz/stories/images/0611/7e8b4d00c61154bd7067.jpeg
This chart you drew gives data points varying for each month from 1997 to 2006. Please can we see the data sources for these points. The MoH merely referred to some data on number of deaths, not fatality rates. As any idiot can see, your graph is of case fatality rates, which requires a denominator as well as a numerator to calculate it.
What were they and where did you derive the figures from?
In addition, can you explain why, if you had the data, you chose to draw by eye a "line of best fit" that was obviously done by hand and quite innacurate, and not a calculated line derived from linear regression?

Ron, you said:

"in fact it could be argued that MeNZB increased the risk of death (which it did)."

Can we see a p value for that?

Dude, Ron doesn't appear to even know what a Poisson distribution is. How do you expect him to be able to understand, let alone calculate a p value?

Any competent risk analyst should know this...

By W. Kevin Vicklund (not verified) on 20 Sep 2012 #permalink

Oh, and have you seen the recent Kaiser analysis of their patients and whooping cough…

Yes, and it's nothing like what you describe.

they’ve concluded that the vaccine is not the sharpest knife in the draw when it comes to protecting kids from whooping cough

No, they concluded that another booster was required, and that while it started out very effective (over 98%), the protection degraded over time, much like natural immunity to pertussis degrades. This led to a call for a better vaccine.

despite very high vaccination rates

Hey, you got something right! I guess my characterization of your description was somewhat in error.

and >80% of kids thought to have whooping cough infection had negative PCR tests

Where did it say that? "Children tested for" is a very different metric from "children thought to have". For example, many women are screened for breast cancer by mammography. That does not mean that all of these women are thought to have breast cancer! These days, children with persistent cough get screened for pertussis because they *might* have it, not because they are *thought* to have it.

they even acknowledged they didn’t know what the effectiveness of the vaccine was

Really? Where? They certainly seemed to give lots of hard numbers on the efficacy. Broken down by time since vaccination, even.

By W. Kevin Vicklund (not verified) on 20 Sep 2012 #permalink

I decided to search for the Parliamentary questions and answers on meningococcal disease in NZ that Ron referred to on 09/11 above. It's odd that Ron didn't appear to include the following:

6582 (2008). Sue Kedgley to the Associate Minister of Health (11 Jul 2008): Has the Ministry of Health undertaken or funded an updated effectiveness assessment of the MeNZB vaccine; if so, what is the effectiveness of the vaccine by age group, and number of vaccine doses administered; if not, why not?

Hon Steve Chadwick (Associate Minister of Health) replied: Yes, the Ministry of Health funded an updated assessment of the MeNZB vaccine effectiveness using data to the end of December 2007. I understand that the analysis estimated meningococcal disease rates to be 2.8 times higher in the unvaccinated group than the vaccinated group (95 percent confidence interval: 1.9-3.9), with a vaccine effectiveness of 64 percent (95 percent confidence interval: 49 percent-74 percent). There was no evidence of a partial vaccination effect and there was no evidence that the vaccine effectiveness differs by age. As the assessment is for all those less than 20 years of age, data is not available for particular age groups.

So, "the analysis estimated meningococcal disease rates to be 2.8 times higher in the unvaccinated group than the vaccinated group " and they estimated "vaccine effectiveness of 64 percent". That seems pretty good to me.

When vaccination rates are high, of course there will be more cases in vaccinated individuals than those unvaccinated, especially when partial vaccination is not very effective and full vaccination is only 64% effective. Is this the Nirvana fallacy yet again?

BTW, if death rates in vaccinated children are higher than those in unvaccinated children, isn't that likely to be due to poor immune function leading to a poor response to the vaccine and greater mortality? Also, what is it with assuming that a downward trend in an epidemic disease would continue without vaccination?

By Krebiozen (not verified) on 20 Sep 2012 #permalink

To clarify, I meant that death rates in vaccinated children who get meningococcal disease my be higher than in unvaccinated children who get meningococcal disease because they are more likely to have immune dysfunction that prevented them developing robust immunity from vaccination. I wouldn't want Ron to misunderstand me.

By Krebiozen (not verified) on 20 Sep 2012 #permalink

That's odd, I could have sworn I closed those bold tags in the right place. Oh well.

By Krebiozen (not verified) on 20 Sep 2012 #permalink

ToddW, being a self-claimed skeptic, I'm not surprised that you would make up your own beliefs... you can think what you like... that doesn't make it true...

Dingo199 says, "they will rationally choose vaccinating over not vaccinating (since the risks of catching pertussis are 23 times higher if their child is unvaccinated than if they were vaccinated)."

Except, dingo, Kaiser's latest paper in the NEJM makes a lie of that... it is impossible for a 95% effectiveness over all those years given their latest finding that the vaccine's efficacy deminished 45% per year after the 5th dose... and they don't know what the original effectiveness was... It's easy to pluck a paper and claim it as the golden standard... of all the vaccines given to children, the pertussis component is the blunt knife...

So even at 64% effectiveness, what are the chances of 13 vaccinated children dying and zero unvaccinated children dying???????

No, the paper isn't a lie; it was a retrospective cohort study. It found that the risk of catching pertussis was higher in unvaccinated children.

It wasn't evaluating the efficacy of the pertussis vaccine.

I come back after—what is it, a week?—and Ron is still evading and trying to have the last word! Ha. Excuse my replying to several people in one comment, not the done thing, etc.

dingo199,

“I am delighted you fully vaccinated your family,”

Given Ron's age, the real question is not if he vaccinated his family, but if he would now and more to the point to answer your question, "Would you recommend mothers vaccinate their infants against pertussis?", which he didn't in fact answer.

He referred to himself (irrelevant, that was his parents' actions), his children (but how many years ago and what is his view today?) and his grandchildren (besides the point as what's done to them is not his decision).

You'll note he did his usual word games to avoid saying 'pertussis vaccine' - silly really as he refers to vaccines targeted to pertussis throughout.

Ron,

"Oh, and I see that NZ’s MOH’s chief medicine’s regulator has complained to the coroner that his evidence was quoted verbatim on here… what a hoot!!!"

Care to supply a source? (as a link) What matters is specifically what was objected to.
If it were not supposed to be disclosed, then fair enough - and you'd think it would be the discloser that is at fault.

It’d be interesting to know what the genetics lab think of you quoting them too.

Krebiozen,

"That’s odd, I could have sworn I closed those bold tags in the right place. Oh well."

Join the club. I get that with a tags (links)!

Grant, I really surprised you've resurfaced. " I was fully vaccinated (I take no credit for that)…" What does that mean... mmmm, let me think!

I said that I don't give advice to people about vaccinations... I wonder what that means...???

You are quite clearly out of the loop re the coronial inquest, and yet you pretend to be the expert... for what it's worth, the MOH medicines regulator in chief included your sciblog in his complaint, which is interesting given you obviously haven't read/heard any of his evidence. He complained about Orac too...!

I see IMAC have released some science fiction... no doubt to try and influence the coroner... they can't even get the amount of aluminium in gardasil correct... or what Drs Shaw & Lee actually said in their contributions... no doubt it will all come out in the wash.

As a matter of interest, believe it or not, when we critiqued the MeNZB campaign people within the system, including the MOH, would send/point me to information/documents etc unsolicited... the system still leaks like a sieve...

Ron,

So even at 64% effectiveness, what are the chances of 13 vaccinated children dying and zero unvaccinated children dying???????

To answer that question we need to know how many were fully vaccinated, how many partially, how many unvaccinated, and what proportion of the population were fully vaccinated, partially or unvaccinated. We also need to know the efficacy of partial vaccination as compared to full vaccination.

What if 100% of these children had been vaccinated? Would zero deaths in the (non-existent) non-vaccinated group still mean the vaccine didn't work?

By Krebiozen (not verified) on 21 Sep 2012 #permalink

In the 6-11 month age range ( the highest CFR at over 8%!), the ratio of un-:patially: fully vaccinated is roughly 5:80:15.

So even at 64% effectiveness, what are the chances of 13 vaccinated children dying and zero unvaccinated children dying???????

Boy, are you ever incompetent, Ron. From the Arnold paper, we found that the effectiveness was 25% for partially vaccinated, and 80% for fully vaccinated. I even gave you the odds of any given death coming from the unvaccinated population.

The protection for each category is 0%/25%/80%. Factoring in the protection, the ratio of unprotected children in that age range is 5:60:3. That gives us about a 7.4% chance that any given death in that age group will not be vaccinated. Or about 1 in every 13.6 deaths, which means we would expect less than one death in the unvaccinated group if all deaths occurred in that age group (they didn’t, of course).

That means that there is a 92.6% chance of any given death being vaccinated. Using the Binomial distribution (look it up, you should know it, but you've already shown yourself to be incompetent at statistics), that gives a .926^13=37% chance that all 13 deaths were vaccinated.

Now it's not clear whether the 64% effectiveness applies to just fully vaccinated or all vaccinated, though it does say partial vaccination offers little to no protection. So let's redo the above analysis twice, with a 0%/5%/64% effectiveness and a 0%/64%/64% effectiveness.

Full vaccinated only
Factoring in the protection, the ratio of unprotected children in that age range is 5:76:9.6. That gives us about a 5.5% chance that any given death in that age group will not be vaccinated. Or about 1 in every 18 deaths, which means we would expect less than one death in the unvaccinated group if all deaths occurred in that age group (they didn’t, of course).

That means that there is a 94.5% chance of any given death being vaccinated. Using the Binomial distribution (look it up, you should know it, but you've already shown yourself to be incompetent at statistics), that gives a .945^13=48% chance that all 13 deaths were vaccinated.

All Vaccinated

Factoring in the protection, the ratio of unprotected children in that age range is 5:28.8:9.6. That gives us about a 11.5% chance that any given death in that age group will not be vaccinated. Or about 1 in every 8.7 deaths, which means we would expect more than one death in the unvaccinated group if all deaths occurred in that age group (they didn’t, of course).

That means that there is a 88.5% chance of any given death being vaccinated. Using the Binomial distribution (look it up, you should know it, but you've already shown yourself to be incompetent at statistics), that gives a .885^13=20% chance that all 13 deaths were vaccinated.

Whether its a 1 in 2, a 1 in 3, or a 1 in 5 chance of getting these results, it is clear that zero deaths in 13 being unvaccinated is not statistically significant. Although, I again note that this isn't a true, in-depth statistical analysis, but rather simplified in that it assumes all deaths to come from the 6-11 month age bracket, which is not true.

By W. Kevin Vicklund (not verified) on 21 Sep 2012 #permalink

Thanks Kevin. I was about to do something similar when I felt myself losing the will to live, so I resorted to a reduction ad absurdum to attempt to make my point instead.

By Krebiozen (not verified) on 21 Sep 2012 #permalink

Or even a reductio ad absurdum.

By Krebiozen (not verified) on 21 Sep 2012 #permalink

Ron, so we see you can't work out a p value, or estimate relative risks.

Yet you claim to be a risk analyst?
Can I sue you under the Trades Descriptions Act?

Dingo, it depends on if he is fraudulent or merely incompetent (services require mens rea -guilty intent- under the Act). You'd also have to hire him first, as I understand it.

By W. Kevin Vicklund (not verified) on 21 Sep 2012 #permalink

Yep, I'm incompetent! Folk are saying that MeNZB was 80% effective... yet Arnold et al said in their vaccine paper analysis estimates MeNZB vaccine effectiveness to be 77%, and then we have Krebiozen quoting saying the analysis estimated meningococcal disease rates to be 2.8 times higher in the unvaccinated group than the vaccinated group (95 percent confidence interval: 1.9-3.9), with a vaccine effectiveness of 64%. which Krebiozen said was pretty good. When one looks at Arnold's vaiicine paper he's saying that is for ALL strains of meningococcal disease... in other words, according to Krebiozen, this is a 'pretty good' vaccine for ALL strains of meningococcal disease which of course is a total nonsense... this becomes patently obvious when one realises that their analysis also revealed that MeNZB was 56.3 percent. What a load of pseudo-science... if MeNZB was this good and this universal it would have been introduced as the first universal vaccine ever.

Does anyone on the blog actually believe that a strain specific vaccine for meningococcal disease protected against all other strains as well as totally unrelated bacterial infections?

If you do then you believe in woo-science as well as pseudoscience.

And on that note, I'll leave you to it... in the knowledge that so-called evidence-based skeptics are just as biased as woo-believers... in fact, if you believe the above then you are, by definition, woo-believers.

Ciao-4-niao

Oops, my incompetence showed again... missed out the key evidence of wooness.

Should have read...

this becomes patently obvious when one realises that their analysis also revealed that MeNZB was 56.3 percent AGAINST PNEUMOCOCCAL DISEASE!!!!! What a load of pseudo-science… if MeNZB was this good and this universal it would have been introduced as the first universal vaccine ever.

Does anyone on the blog actually believe that a strain specific vaccine for meningococcal disease protected against all other strains as well as totally unrelated bacterial infections?

If you do then you believe in woo-science as well as pseudoscience.

And on that note, I’ll leave you to it… in the knowledge that so-called evidence-based skeptics are just as biased as woo-believers… in fact, if you believe the above then you are, by definition, woo-believers.

Ciao-4-niao

Incompetent... quite obviously.
And now we have the pleasure of watching Ron Risk Analyst displaying innumeracy as well as illiteracy.

Firstly he seems to think that a vaccine that is 56% effective demonstrates marvelous preventative superpowers, whereas a vaccine that is 77% effective is useless.

Then he demonstrates he is unable to read the detailed discussion in the Arnold paper (pages 60-64) which precisely explains why the pneumococcal notification rates were lower in the MeNZB vaccinated groups.

@dingo199

Let' see how long ron sticks the flounce.

Anyone who knows ron knows he doesn't flounce, and he deliberately doesn't talk scholar speak. I've asked him why on several occasions. his answer was simple. most people don't understand it , even many so called scholars. I've read Arnold's papers and no amount of rationalisation can validate the meningococcal vaccine used in new zealand being 57 percent effective for pneumococcal disease.

It's a shame Ron has gone, I was going to ask him what alternative he would suggest for dealing with a meningococcal disease epidemic. Ride it out until "natural decline" takes care of it? I suppose Arnold was mistaken in his estimate that:

Between July 2004 and December 2008 an estimated 210 epidemic strain cases (95% CI 100-380), six deaths and 15-30 cases of severe sequelae were avoided in New Zealand due to the introduction of the MeNZB vaccine.

By Krebiozen (not verified) on 22 Sep 2012 #permalink

Well, well, well. "DavidG" shows up less than 12 hours after Ron flounces, telling us that Ron's right even when "the scholars" can't follow his genius. I wonder what a sockpuppet check between Ron and DavidG would find...

By Antaeus Feldspar (not verified) on 22 Sep 2012 #permalink

The quote in my last comment was from Arnold 2011, just to be clear.

By Krebiozen (not verified) on 22 Sep 2012 #permalink

Antaeus Feldspar,

If true, it wouldn't be new for him - he tries to sockpuppet on my blog every now and then. (His earlier comment to me is clutching at straws, trying to insinuate fault in others whilst avoiding mentioning himself. That's not new for him either. *Sigh.*)

If anyone here looked at what happened in India with Gardasil - the death from "presumed snake bite" but with no evidence of a bite, the problems with not obtaining consents from the girls and or their parents. The "placebo" used etc etc they might not be so keen automatically absolve Merck, and more keen to actually start creating a proper vaccine reaction register - so that noise (people randomly getting sick) can be teased out of the figures because the rates of post vaccination problems can then be compared to "expected" levels. At the moment with such a poor reporting system in place and doctors and nurses not willing to register possible reactions. Believe me - they often don't even when the parent asks them to. The other thing I notice is MeNZB is being mentioned. While I'm sure many New Zealanders are proud that our kids were all fantastic test subjects for the latest Meningitis vaccine, I'm sure many of us would prefer that we as a country hadn't paid millions of dollars to be part of a drug trial - one that we weren't even allowed to independently verify. But it was a disaster - Meningitis deaths actually increased - although they were given to different strains to make it seem better. Far better we had paid money to improve the poor living conditions that spread the virus in the small part of Auckland where it was based. Yes there were cases in other parts of the country - but if you read the fine print almost all of them had come back from holidays with relatives in the affected region. Drug companies are powerful and have a lot of money to buy hearts and minds - but facts are what are needed to have the safest most effective vaccines and at the moment we are relying on the people who have the most to lose to provide us with those facts. It's not good enough and it's too naive to expect that they will be paragons of the truth when billions are at stake - even if they thoroughly believe in what they are doing - as our politicians did for MeNZB. So please cynic the heck up on both sides of this debate. Prevention of disease and sickness surely has to be the goal, but it can't be without a little scientific scepticism - and strong oversight of what are in fact money-making organisations. I think probably the worst one at the moment is chicken pox - because it's known to increase rates of shingles - an extremely dangerous complication - and one my relatives were not aware of because it is why they gave their kids the vacc - because shingles runs in the family. Better testing please. Better accountability please. And both sides should leave off parading the victims, because this debate needs to be decided on empirical evidence not horror stories. After all there is no such thing as a hundred percent safe, and anyone who thinks otherwise is simply kidding themselves.

Shorter AJ:

Until all vaccines are declared 100% safe, which of course they can never be, and until all fears that Big Pharma has faked important data relating to vaccines have been laid to rest, which of course by the nature of conspiracy thinking they will never be, we should err on the side of fearing vaccines and believing the worst rumors we hear about them. People on both sides need to think more critically, by which I mean people on the side of vaccines need to give more credence to the vague allegations that make me worried.

By Antaeus Feldspar (not verified) on 26 Sep 2012 #permalink

AJ,

So please cynic the heck up on both sides of this debate.

You should take your own advice, since almost everything you wrote is not true.
Gardasil in India? The problem there is not a dangerous vaccine, as Gardasil is about as safe as any vaccine could possibly be, but poorly carried-out trials leading to <a href="http://www.nature.com/news/2011/110622/full/474427a.html"unfounded fears about a lifesaving vaccine". In the developed world there are very robust vaccine safety trials and safety monitoring mechanisms in place, and in the last couple of decades far more problems have been caused by vaccines being withdrawn from use due to unfounded fears than from vaccines themselves.

MeNZB [...] Meningitis deaths actually increased

No they didn't. According to Hon Steve Chadwick (NZ Associate Minister of Health), during the 12 months preceding the MeNZB rollout, "15 people died from meningococcal disease in New Zealand." and during the 12 months following the completion of the mass MeNZb vaccination programme in mid-2006, "nine people died from meningococcal disease in New Zealand". Since the nature of epidemics is to wax and wane, it is difficult to say how many people would have died if the vaccine had not been used, it might well have been considerably more than 15, but as I quoted Arnold (2011) above, "Between July 2004 and December 2008 an estimated 210 epidemic strain cases (95% CI 100-380), six deaths and 15-30 cases of severe sequelae were avoided in New Zealand due to the introduction of the MeNZB vaccine".

If the vaccine had not been introduced and scores of children had died of meningitis, no doubt the same people now complaining about the vaccine would be howling for the blood of public health officials for not protecting them.

I think probably the worst one at the moment is chicken pox – because it’s known to increase rates of shingles – an extremely dangerous complication – and one my relatives were not aware of because it is why they gave their kids the vacc – because shingles runs in the family.

You have that completely wrong. Someone who has chicken pox is far more likely to get shingles than someone who has avoided chicken pox by getting the varicella vaccine. Your relatives have protected their children from getting shingles by vaccinating them. It is possible (but not yet certain) that in varicella-vaccinated populations older people may get shingles more than they used to as their natural immunity is no longer being boosted periodically by contact with children with chicken pox, but they can protect themselves from shingles by getting the zoster vaccine. Perhaps this is where you got your mistaken idea from?

Better testing please. Better accountability please. And both sides should leave off parading the victims, because this debate needs to be decided on empirical evidence not horror stories. After all there is no such thing as a hundred percent safe, and anyone who thinks otherwise is simply kidding themselves.

There is a risk associated with almost everything we do, and most of us simply minimize the risks we can control, and ignore the rest. We wear a seat belt when we drive, though we know there is a small chance of being injured or trapped in a burning vehicle by it in the event of an accident, because we know that the chances of serious injury or death are greatly reduced. Since whatever way you look at it vaccination greatly decreases our risk of illness or death, I truly don't understand what your point is. Have you looked at the safety and efficacy studies that have been carried out on vaccines? Perhaps you should take a look at some on PubMed. You seem to have come across some misinformation and accepted it uncritically, which is ironic as that is precisely what you are accusing others of doing.

By Krebiozen (not verified) on 26 Sep 2012 #permalink

AJ, others have addressed points in your post, but I'd like to ask you why you have resurrected the Indian Gardasil deaths issue.

The idea that gardasil caused deaths has been debunked. There were deaths following vaccination (in the same way that there are deaths after reading the Morning Herald), but they appear not to be due to gardasil (or the Morning Herald)

In an article from the April 9, 2010, edition of the Times of India, Dr. V.M. Katoch, director general of the Indian Council of Medical Research, stated that the four deaths in Andhra Pradesh were not due to the vaccine. He explained that, “two deaths were due to poisoning, one died of drowning, and another due to pyrexia of unknown origin.” The article went on to cite official reports from the relevant district officials that confirm that the deaths were not due to HPV vaccination. The two deaths in Gujarat were attributed to malaria and snake bite."

http://www.path.org/news/an100422-hpv-india.php
http://www.dancewithshadows.com/pillscribe/gardasil-study-death-of-6-gi…

Now what sources or evidence do you have to suggest that the girl who allegedly died of snakebite "had no evidence of snakebite"? I agree that these reports are slightly vague, coming indirectly from the Research Council Director General, and might just possibly be wrong, but you seem to have decided they definitely are wrong.

I'd just like to know why you think that. Without knowledge as to what evidence has informed your opinion, we have to conclude you are suffering some form of cognitive dissonance or confirmation bias.

Thank you Ron Law- wish there were more like you!
Diane Harper appears to be the most qualified to speak about Gardasil- I don't bother to read any more comments by
Orac's fanatical followers.
Latest earning figures for GSK as of 10/1/12-"Gardasil and GlaxoSmithKline Plc (GSK)’s Cervarix are the only two U.S.-approved vaccines to combat HPV. Merck’s Gardasil generated $1.2 billion in revenue last year, while Cervarix brought in $812 million for London-based Glaxo."
Connect the dots......

@ken

And why would that be relevant to the discussion, necromancer?

" Since her daughter’s death, Ms. Renata has steadfastly refused to have herself, her husband, or any of her family tested for gene mutations associated with sudden cardiac or tested for idiopathic heart disease because she knows of no history of heart disease in her family if you don’t count the death of her daughter."

I am saddened by the death of this woman's daughter. But, that said, I'm really not convinced
that she is in any way seriously sold on the idea that Gardasil killed her daughter. If she were
that convinced, she could have the tests done and use that as fairly convincing proof for her
case if the tests for anything hereditary came back negative. She cannot help but know this,
since it would no doubt have been pointed out to her.

I wonder if the anti-vax lot got to her first......

By David N. Andre… (not verified) on 06 Oct 2012 #permalink

David,

You wrote: “But, that said, I’m really not convinced that she is in any way seriously sold on the idea that Gardasil killed her daughter.” - At the risk of opening this up again, there are two different 'sides' involved here. It's reasonable to suggest that the mother isn't (completely) sold on the idea that Gardasil killed her daughter. There is also SANE Vax and their views as to if they can use the inquest to their advantage. (As you'll from Orac's article, they were very quick to write about it after the hearing.)

Regards: “She cannot help but know this, since it would no doubt have been pointed out to her.” - It was pointed out to her.

ken,

Diane Harper appears to be the most qualified to speak about Gardasil-

Do you mean Diane Harper who was involved in clinical trials of Gardasil and Cervarix, a href="http://www.badscience.net/2009/10/jabs-as-bad-as-the-cancer/">who says, "I fully support the HPV vaccines, [...] I believe that in general they are safe in most women".

I don’t bother to read any more comments by Orac’s fanatical followers.

Going to a blog and posting a comment saying, in essence, "Lalalalala, I can't hear you," seems more than a little childish to me. Perhaps you would be more comfortable better off sticking to the antivaxx echo chambers where your blinkered and rigid beliefs won't be challenged. Unless you have a little nagging doubt that they are feeding you lies, that is.

By Krebiozen (not verified) on 07 Oct 2012 #permalink

gaia-health.com/gaia-blog/2012-10-25/gardasil-is-probable-cause-of-girls-deaths-brain-histology-study/

casereports.bmj.com/content/2012/bcr-2012-006879.abstract

ken...do you think you could link to those reports of serious side effect/deaths from Gardisil vaccine?

As long as you vote for Obama I luv y'all.

Wow ken, gaia health and an abstract that you didn't even read the full text for. Stellar.

By Science Mom (not verified) on 25 Oct 2012 #permalink

I have been looking at that Tomljenovic and Shaw article. There seems to be a curious lack of any controls in the study, so we have no way of knowing if the HPV antigens they claim to have found in the brains of these two unfortunate girls, using antibody-based staining techniques, are artefacts or not. If they are correct that "cross reactivity between vaccine antigens and host vascular structures" occurs, this seems not unlikely. If they are not correct a major supporting leg of their convoluted theories collapses. It doesn't seem clear to me why they think there is a similarity between HPV proteins and cerebral blood vessels.

Their theory is that the HPV antigens in the vaccine were taken up by white blood cells and that the immune response to the vaccine caused the blood brain barrier to break down, allowing these white blood cells to enter the brain where they deposited these HPV proteins, which initiated an immune reaction which turned into a massive autoimmune reaction because of the similarity between these HPV proteins and the cerebral vasculature. The resulting cerebral vasculitis then killed the girls.

In Case 1 this occurred 6 months after her last Gardasil shot, and in Case 2, a 14-year-old with history of oral contraception and migraines, 14 days after her last Gardasil shot.

In Case 1, the autopsy found: "Histological analysis of the brain hippocampus, cerebellum and watershed cortex allegedly revealed no evidence of neuronal loss or neuroinflammatory changes". I just love the "allegedly" which apparently means that this cannot be true as it doesn't fit with their theories.

In Case 2, the autopsy, "revealed cerebral edema and cerebellar herniation [...] no evidence of inflammatory processes or microglial reactions in the patient’s brain [...] these changes were consistent with terminal ischemic-hypoxic encephalopathy", which you would expect after a cardiac arrest. It is worth noting that stroke and heart disease are surprisingly common in females of this age, especially if they have been using the OCP.

We are expected to believe these girls died of massive autoimmune cerebral vasculitis, despite there being no signs of this at all on autopsy. We are also expected to believe that the immune response to the vaccine results in a breakdown of the blood brain barrier sufficient to allow white blood cells to carry an aluminum adjuvant and HPV antigen complex into the brain.

If this was the case, wouldn't the vaccine allow all sorts of pathogens into the brain? Wouldn't we see a large number of people given the vaccine suffering from serious brain infections? This theory seems extremely speculative and far-fetched to me, not least because large studies (of more than 40,000 subjects) find no increased risk of adverse events of the sort described here at all.

As for the BMJ case history, I think the phrase, "the cause is unknown in 90% of cases" can be translated as "post hoc fallacy".

By Krebiozen (not verified) on 25 Oct 2012 #permalink

Thanks Krebiozen, S & T's one trick pony show has become so predictable and them so blatantly dishonest that I can dismiss what they write out of hand. Also given the vanity press journal they had to publish in to avoid any actual peer review, it's getting obvious where this dynamic duo is headed.

By Science Mom (not verified) on 25 Oct 2012 #permalink

In Case 1, the autopsy found: “Histological analysis of the brain hippocampus, cerebellum and watershed cortex allegedly revealed no evidence of neuronal loss or neuroinflammatory changes”. I just love the “allegedly”

The 'allegedly' is there (I imagine) because they are examining tissue slides from the brain of Ms Renata, and not having access to comprehensive samples, they are quoting the autopsy report from the NZ pathologist. So nothing sinister.

By herr doktor bimler (not verified) on 25 Oct 2012 #permalink

hkb,

I still haven't found time to read T&S's paper - still tied up with reading for my own work... Do T&S indicate the location of their cases? (I noted SANE Vax reporting something to the effect "opposite sides on earth", which struck me.)