Antivaccine fear mongering? What antivaccine fear mongering? I don't see any antivaccine fear mongering.

Here we go again.

Every so often, criticism of the antivaccine movement builds to the point where it extends beyond the blogosphere to enter the national zeitgeist in a way in which people other than blogging geeks like myself start to take notice. It happened a few years ago, when washed up actress Jenny McCarthy teamed up with the antivaccine propaganda group Generation Rescue to sell her story of how she believes that vaccines caused her son Evan's autism and managed to score an appearance on The Oprah Winfrey Show. It happened again three years ago, as preparations for the H1N1 pandemic were in high gear and antivaccine conspiracy theorists were in even higher gear. Or maybe they were just higher, if the "quality" of their arguments were any indication. It happened again a couple of years ago, as Andrew Wakefield achieved his apotheosis among antivaccinationists at the same time he fell into utter disgrace among everyone else, having had his U.K. medical license stripped from him, seen his infamous 1998 Lancet article that launched the anti-MMR scare retracted, and had his position as "medical director" at the autism quackery clinic Thoughtful House stripped from him.

Now, I think it's happening again today. It's not entirely clear why, but I think it's in response to the recent string of measles and pertussis outbreaks. Whatever the cause and whether or not the disturbance I'm sensing in the Force is real or not, one thing you can almost always count on when criticism of the antivaccine crankosphere reaches a certain crescendo, it's that someone on ostensibly "our" side, someone respectable, will decide to start criticizing those of us who devote a significant portion of our writing time to studying and countering the antivaccine movement for being too "strident." Part of that critique almost always involves claiming that we are being too harsh on antivaccine parents, that we don't understand, and—oh, by the way—can't we all just get along? Yes, in essence, this countercriticism usually comes in the form of an article that is one massive exercise in tone trolling. This time around, it's by a Canadian academic named Alan Cassels for the blog Pharmawatch Canada in the form of a post with a title that will induce cringes (and probably more than a little bit of ridicule) from some of us who deal with antivaccine propaganda), entitled Time to outlaw vaccine propaganda: Are we taking the easy way out by labeling vaccine questioners anti-science loonies?. The short answer is no. (Actually, it's not just "no" but "Hell, no!"). The long answer follows.

Cassels begins by asking the following questions:

Are lifesaving vaccines being ignored by parents because of illegitimate safety concerns?

I could make this one of the shortest Orac posts ever written by using the short answer to this question ("yes"), but you know I have a hard time doing that, particularly when responding in longer form gives me the opportunity to produce entertaining riffs that amuse myself (and hopefully you). Before I do that, I'll point out that Cassels uses as examples of what he refers to as "prominent health pundits" commenting on the situation. For instance, he cites André Picard at The Globe and Mail saying that the decline in vaccination rates in the U.K. is the result of parents "shunning vaccination in small but significant numbers because of imaginary fears largely concocted by quacks and charlatans," a point I can't argue with and have made myself on numerous occasions. Also cited is a good bud, Steve Salzberg, who criticized certain well-known antivaccine doctors for using "their medical degrees and their faux concern ‘for the children’ to frighten parents into keeping their kids unvaccinated." Again, it's a point I fully agree with, as is Salberg's indictment of media complicity in spreading the antivaccine message. Indeed, these things are so mind-numbingly obvious to anyone of a science-based bent that it's hard to imagine that Cassels doesn't see them. Either he's not of a science-based bent or he has a bit of an ideological bug up his butt about vaccines. Alternatively, maybe he's one of those guys who just doesn't like "experts" and sees them as "arrogant." Let's find out.

Cassels grudgingly concedes that maybe, just maybe, the media might be feeding antivaccine hysteria and that we "certainly have our share of charlatans and quacks in cyberspace, aided and abetted by cyberchondriacs of all stripes," observations whose obviousness is only rivaled by its banality, not to mention the lack of mooring in reality his dismissal of antivaccine fear mongering as an important contributing factor to parents' fears demonstrates. In particular, the media in the U.K. was arguably the most important factor in allowing Andrew Wakefield to spread his misinformation pseudoscience about the MMR vaccine that blames it for causing autism in the face of no evidence that it does and overwhelming evidence that it does not. I've said it time and time again, the U.K. media aided and abetted Wakefield. In fact, you could even say that the U.K media created Wakefield. In any case, these faux profound observations lead Cassels to state that there is "real fear among parents, a fear that is palpable." Of course it is! It takes only a few minutes' online exposure to hype "illegitimate fears."

He next asks, "What is at the heart of these concerns? Can it really be due to vaccine fear-mongering?" Once again, I'm half-tempted simply to say that, yes, it really can be due to vaccine fear mongering, but I do feel somewhat obligated to follow my answer up by asking Cassels: Are you on crack? Have you seen antivaccine websites? Have you ever personally delved into antivaccine discussion forums? Have you ever lurked at MotheringDotCom (MDC), that website for "natural" mothering that many new mothers find (because its forums rank high on Google searches for important parenting topics) whose forums are the most wretched hives of antivaccine scum and quackery? Have you ever read Mercola.com, which is as highly trafficked a website as the NIH website, a website that relentlessly attacks vaccines on a near-daily basis and whose owner has helped that antivaccine group National Vaccine Information Center to place its advertising in various high profile places? I think the answer is obvious. The answer is either "no," or it's that Cassels has antivaccine tendencies himself—or perhaps a combination of the two.

Because Cassels tells me that it's such a horrible thing to call people antivaccine, for the moment I'll choose the option that he is clueless about the antivaccine movement rather than sympathetic to it. However, as far as I'm concerned, it's not wrong to tell it like it is if you have evidence to back your opinion up, and when I see antivaccine words and actions, I call it as I see it, and what I see is Cassels regurgitating antivaccine propaganda that he clearly knows nothing about and does not recognize as antivaccine proganda. This parroting reaches its height in the following passages, in the first of which Cassels answers his own question about whether the fears of parents can be due to antivaccine fear mongering:

I don’t think it [parents' fear] is [due to antivaccine fear mongering]. Parents just want to keep potentially harmful things away from their children. And they turn to health experts for guidance, but here’s my take on things: health authorities often fail to acknowledge the risks of some vaccines, refuse to discuss uncertainty over a vaccine’s effectiveness, hype the seriousness of common everyday viruses (c’mon folks, really? The flu? Chicken pox?) and keep piling more and more vaccines onto the list of ‘recommended’ childhood shots threatening to turn our kids into pincushions. Now you’ve got a recipe for even more skepticism and fear-mongering.

All of which is utter nonsense, the proverbial load of rotting, fetid dingo's kidneys. First off, his dismissal of the flu reveals such enormous ignorance that it's hard to take him seriously. The flu can kill, and does kill, each and every flu season. (Perhaps Cassels doesn't think there could be another pandemic like the influenza pandemic of 1918, which killed millions and might have killed more people than the Black Death.) Chicken pox can result in serious complications.

Also, if Cassels thinks that health authorities don't discuss uncertainty about some vaccines with the public, he is obviously not paying attention. Yes, parents want to keep their children safe. No one, least of all those of us trying to do our best to counter the misinformation, pseudoscience, and fear mongering of the antivaccine movement, say otherwise. None of us doubt the sincerity of these parents. There is one thing that Cassels clearly doesn't understand. There are two general types of parents who fear vaccines. There are the leaders of the antivaccine movement, who do their best to spread misinformation and fear about vaccines in order to dissuade parents from vaccinating through the use of what I like to call "misinformed consent," in which they massively exaggerate (or outright make up) risks of vaccination and similarly massively minimize their effectiveness. Whatever their reasons for being antivaccine, be it the mistaken belief that vaccines somehow caused autism in their child, the usually mistaken belief that vaccines somehow injured their child, or philosophical leanings that make them distrust authority or pharmaceutical companies and believe that "natural is better," this is what they do.

Then there is the target audience for the antivaccine movement: The much larger group of great undecideds. These are parents who might have a tendency to distrust authority, prefer "natural" over pharmaceutical, or other leanings that might make them worry about vaccines. These parents are not antivaccine, but they are susceptible to the propaganda spread by the antivaccine movement. This is our target as well. I, for one, realize that I can't persuade die-hard antivaccinationists like J.B. Handley, Dan Olmsted, Jake Crosby, Mark Blaxill, or Barbara Loe Fisher that the "injuries" that they ascribe to vaccines have no basis in evidence. I can, however, persuade the fence-sitters. To Cassels, however, all of these parents, the hard core antivaccinationists and the undecideds, seem to be all the same.e

Cassels then refers to recent outbreaks of pertussis, which, as I've described, appear to be due to waning immunity, not because the vaccine doesn't work, as the antivaccine movement tries to claim (and, apparently, Cassels seems to be implying). Cassels then opines:

For some, the complications of whooping cough can be deadly and it can lead to pneumonia, convulsions, and even brain damage and death. It’s not to be trifled with. You’d certainly want to shelter your child from whooping cough if you could, but the advice around the vaccine is conflicting. Some groups, such as the CDC recommend vaccination of pregnant women and infants yet the vaccine leaflets themselves say it is unknown whether the vaccines cause fetal harm. Some say the vaccine is highly effective, while others point to studies showing even fully vaccinated children still get whooping cough. No one seems to know how many booster shots you need to keep your child protected. Clearly this is a breeding ground for confusion.

Notice where Cassels links. Does he link to the CDC? No. Does he link to the CHOP Vaccine Education Center? No. Does he link to any reputable site? Most assuredly not. He links to the NVIC, which is one of the oldest and most notorious antivaccine advocacy groups that there is, founded and still led by the grande dame of the antivaccine movement herself, Barbara Loe Fisher. This is a website that features a truly dishonest and pseudoscientific Vaccine Ingredient Calculator, as well as an "International Memorial for Vaccine Victims." It's a website chock full of antivaccine misinformation so wrong that its statements and reality are related by coincidence only, pseudoscience, propaganda, and pure nonsense. This is the same group that aired antivaccine ads on the CBS JumboTron at Times Square and insinuated its ads into Delta Airlines online entertainment. Either Cassels is unaware of this background, or he approves of the NVIC; I have a hard time thinking of other reasons why he would cite such a completely useless source chock full of misinformation and lies. Let's put it this way, there is no plausible scientific reason to think that the vaccine causes fetal harm if the mother is vaccinated.

As for the issue of fully vaccinated children getting whooping cough, Cassels needs to get a clue. No vaccine is 100% effective, and the waning immunity observed in some studies of the acellular pertussis vaccine doesn't mean the vaccine doesn't work. It means the vaccine schedule needs to be adjusted. Does all this seem concerning to parents? Sure. Could it cause confusion? Sure. That's the germ of truth that Cassels harps on. What he seems oblivious to is the fact that there really is an antivaccine movement that takes scientific uncertainty whenever it can and uses it to try its very best to amplify that confusion to the point where the public loses faith in the vaccine program. Indeed, no less a luminary in the antivaccine movement than J.B. Handley himself bragged about doing just that. No doubt Cassels is unaware of this, to the point where he concludes:

At the end of the day, most parents just want to know the answer to one simple equation: what is the likelihood that a vaccine will prevent a deadly disease, versus what are the chances of a serious adverse reaction to the vaccine? Shouldn’t this be a simple question to answer? But it isn’t. If public health authorities want to improve vaccination rates, they’d drop the patronizing assurances and start providing the public with some hard evidence of the benefits and harms of immunizing or not immunizing. And the media would help by not scorning parents who ask legitimate questions. Only then will you see vaccination rates improve.

Cassels seems to think that scientists and doctors don't bother to ask themselves and then answer the question, for both themselves and parents, the relative risk-benefit ratios of various vaccines. Gee, it's not as though scientists don't write about the relative risks and benefits of vaccines all the time. It's also not as though scientists don't try to communicate information to the public. In actuality, the reason why parents leaning towards antivaccine views are unhappy with the answers they're getting from health authorities is because the risks of vaccines listed by health authorities do not include the risks that the antivaccine movement attributes to them. Health authorities do not tell them that there is a risk of autism due vaccines because the best science currently available in copious quantities tells them that there isn't one, at least not a risk that large epidemiological studies can detect, which is the best that science can do. Health authorities don't tell them that there is a risk of sudden infant death syndrome (SIDS) due to vaccines, because the best science has failed to find it—and not for lack of looking, either. They are unhappy because health authorities do not tell them that vaccines cause autoimmune diseases, developmental disorders, and a whole host of other complications that the antivaccine movement attributes to them, because vaccines don't cause all those problems. Instead, health authorities tell it like it is, but because they don't include fantasy-based risks from vaccines they are dismissed as hiding something or somehow downplaying risks from vaccines. That's the bottom line. And who hypes these risks? The antivaccine movement. And, as multiple studies have shown, their primary tool for spreading such misinformation is the Internet. Worse, it takes very little exposure to antivaccine misinformation (or, as Cassels would call it, "illegitimate fears" of vaccines) to influence a parent to be fearful of vaccines. It's Dr. Google and Mr. Hyde.

My guess is that, if Cassels sees this post, he'll view it as just more "demonization" of antivaccinationists or of parents who "raise legitimate questions" about vaccine safety. Nothing could be further from the truth. It's Cassels who can't tell the difference between antivaccine ideologues and parents who are confused because of the misinformation on the Internet promoted by antivaccine ideologues, blurring the difference to the extent that he parrots antivaccine talking points, probably unknowingly, and tries to deny that antivaccine propaganda has an effect. He might also think that my use of the words "ignorant" and "clueless" are ad hominem attacks. They are not. They are simply observations about statements Cassels has made.

After seeing such a heapin', helpin' of dubious arguments, credulity towards antivaccine pseudoscience, and utter cluelessness, I wondered just who Alan Cassels is. Apparently he's written a book called Seeking Sickness: Medical Screening and the Misguided Hunt for Disease. Of course, the complicated issues behind screening for mammography and prostate cancer have been regular topics on this blog. The blurb for Cassels' book reads a bit more—shall we say?—stridently than my nuanced discussions of these issues. From the blurb on his book, Cassels seems to be a man who is deeply suspicious of medicine and thinks that screening tests are worthless. It isn't surprising that he would tend to think that, given the message of his book that the benefits of screening are oversold and the risks downplayed, that he would conclude that the reason for parents' fears of vaccines is the same. If the antivaccine movement didn't exist and weren't so vocal, maybe he'd have a point. As it is, he doesn't have much of one.

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He seem to attract mostly anti-vax commenter too...

Alain

By Alain (aka Aut… (not verified) on 31 Aug 2012 #permalink

Just to Make Trouble, I commented on Cassels' article linking to this one, opining that Orac "demolishes Dr. Cassels' argument in its entirety".

This should be fun.

By palindrom (not verified) on 31 Aug 2012 #permalink

I also liked the blurb on Amazon for Cassels previous book

"Alan Cassels is a drug policy researcher at the University of Victoria, in British Columbia, and is the co-author (with Ray Moynihan) of the international bestseller Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All into Patients."

Sounds like he doesn't like Big Pharma either.

If you link to NVIC without warnings or with any intent other than ridicule and loathing, you take the path of anti-vaccine crankery. Dr Cassels will have much odious company there.

Maybe his book was not selling well and he needed a boost from moron sales?

At the end of the day, most parents just want to know the answer to one simple equation: what is the likelihood that a vaccine will prevent a deadly disease, versus what are the chances of a serious adverse reaction to the vaccine? Shouldn’t this be a simple question to answer? But it isn’t.

Of course it is. Not only is it readily available, as I have mentioned before, we were given a handout with every vaccine our kids had that included the infoermation. So I call bullshit on his "all people want to know" nonsense.

No, the problem is not that the risks and bennefits are not available. I postulate the problem is that the risks listed do NOT include things like autism and aluminum or mercury toxicosis. For good reason, of course, since none are actual problems with vaccines, but people have been told they are and so view the lack of reported risks to be indicating lack of info.

So the problem with vaccines is not that people can't find risks of adverse events, but that the listed events do not include autism. That's it.

By Marry Me, Mindy (not verified) on 31 Aug 2012 #permalink

Come on. Just guessing, but I think his books may be a bit more nuanced than the Amazon blurb. At least have a 'look inside', see his argument and then do your thing.

By Devil_kap (not verified) on 31 Aug 2012 #permalink

"If public health authorities want to improve vaccination rates, they’d drop the patronizing assurances and start providing the public with some hard evidence of the benefits and harms of immunizing or not immunizing. And the media would help by not scorning parents who ask legitimate questions. Only then will you see vaccination rates improve."

Oh! Of course! When will those silly communications experts at the CDC finally realize that the general public prefers numbers and data to make rational decisions, as opposed to emotional stories?
Also: there are legitimate questions such as "what's the deal with this MMR and autism that people are talking about?" Then there are stupid, illegitimate questions such as "how can you say the whooping cough vaccine works when more vaccinated people than unvaccinated people get the disease?" Apparently Cassels had trouble finding the incredibly obvious and simple answer to that question (or maybe he just didn't understand the answer--you know, because it uses, oh, numbers and data?).

By Cynical Pediatrician (not verified) on 31 Aug 2012 #permalink

@Cynical Pediatrician
In an effort to boost vaccination rates, how about a video loop of a 2 month old whooping cough victim interspersed with a push to vaccinate the kids as well as getting boosters for the adults. 4 minutes of coughing, 1 minute of message ought to be about right.

I generally don't comment on your pro-vaccine posts, because I am a fervent supporter of vaccination campaigns for diseases that carry a high risk of death or serious complications - which extensive human experience tells us that chickenpox and flu in healthy people are not, sorry - and because any expressed concern about the effects on a broader audience of the ad hominem "arguments" that serve as red meat for scientism's primary audience will be dismissed as "tone trolling." But you do cross the line in ranting at great length about the dishonesty of a site where Cassels located the content of a leaflet on whooping cough vaccine, while not addressing the issue of what the leaflet actually says. It rather looks like you are trying to make people believe that safety in fetuses is proven and suggestions to the contrary are silly false claims by NVIC. But here's a direct link to GSK's leaflet on a DPT booster, which does, in fact, say that the safety of the vaccine has not been established in pregnant women and that they should not be given boosters while pregnant unless necessary.

http://us.gsk.com/products/assets/us_boostrix.pdf

Again, I urge you to keep in mind that many of the public, including people who are not already in full agreement with you, are quite capable of looking such things up for themselves, and may judge you as you judge Cassels, rejecting everything you say if anything you say can be proven to be false or unfair.

On Amazon, 'Seeking Sickness: Medical Screening and the Misguided Hunt for Disease', "Tags Customers Associate with This Product" = "anti-vaccine misinformation". Heh.

By Krebiozen (not verified) on 31 Aug 2012 #permalink

I am so irritated when people dismiss the possible harm of these viruses (c'mon folks, really)? Yes--really. My 4-year old nephew battling leukemia could find them to be "really" a problem.

And just yesterday Seth Mnookin pointed to this piece: http://www.cdc.gov/media/releases/2012/p0829_neurologic_flu.html

So kids who are more medically fragile have more risk from this little virus--who cares, right? Really?

Appalling misinformation.

There's ordinary ignorance, and there's willful ignorance. Nothing wrong with ordinary ignorance: nobody can be an expert on anything. But from Cassels' biography, it seems that he is willfully ignorant. Medical treatment policy is what he does for a living. He should know that most of these fears are hyped. He most definitely should know that flu is occasionally fatal and that chicken pox can sometimes be serious. (I'll give him a pass on not having a chicken pox vaccination; I didn't get one either, because it wasn't available when I was a kid.) And, per CP's comment @0921, Cassels' remarks about whooping cough suggest possible innumeracy as well.

By Eric Lund (not verified) on 31 Aug 2012 #permalink

diseases that carry a high risk of death or serious complications – which extensive human experience tells us that chickenpox and flu in healthy people are not
It's good that you can predict that you'll be healthy when encountering any of these bugs. I'm sure you can sign the complains book at the pearly gates how unfair it was to infect you with the flue just after you ate that bad salmonella burger at the church fair.

jane,

diseases that carry a high risk of death or serious complications – which extensive human experience tells us that chickenpox and flu in healthy people are not

Actually it is young and healthy people who are often at more risk of serious complications from both flu and chicken pox. Cytokine storm in young and otherwise healthy people is thought to have been responsible for many of the 1918 flu pandemic deaths, and chicken pox in otherwise healthy adults is no joke. A young and healthy colleague of mine was off work for 3 months with chicken pox which made him very unwell indeed. About 50 people die from complications of chicken pox every year in the UK, where varicella vaccination is not yet routine.

It rather looks like you are trying to make people believe that safety in fetuses is proven and suggestions to the contrary are silly false claims by NVIC.

There is no evidence that pertussis vaccine doesn't do a lot of things. Perhaps you would prefer a statement that there is no evidence that these vaccines cause any problems at all in fetuses? You are aware that package inserts for medications are, in part, put together by the legal departments of drug companies to avoid lengthy and costly litigation, aren't you?

By Krebiozen (not verified) on 31 Aug 2012 #permalink

More to fear monger about:

Jon Rappoport ( @ Natural News,today) reports that Bill Gates' 'dirty tricks' campaign will smear anti-vaccine advocates: his foundation awarded a 17 million USD grant to Seth Kalichman** to inaugerate internet based global monitoring of anti-vaccine mis-information.
The matrix is upon us. Run by a psychologist yet.

Katie Wright ( @ AoA) informs us- annoyingly- that NIH autism research grants will only apportion 5% of monies to environmental studies but 95% for genetic studies! ( I wonder why that is?) She somehow leaves out the 7% for epigenetics and 25% for gene-environmental studies.
I guess she doesn't like the G word.

** More fodder for Jake's connect-the-dots routine- Seth knows many people who aren't anti-vaccine. I fully expect diagramming with circles and arrows in his next article.

By Denice Walter (not verified) on 31 Aug 2012 #permalink

@jane

Even assuming that what you just wrote is true (though as Krebiozen already pointed out, the healthy can be at greater risk than the less-healthy wrt flu), that is not an argument to avoid vaccines for "mild" illnesses. The point of immunization is not only to protect the individual, but also to protect every other person with whom the individual comes in contact. You might get the flu and have no problems with it, but that may not be true for someone you pass it on to.

Vaccines protect the individual and the great public by preventing spread of the disease.

I generally don’t comment on your pro-vaccine posts, because I am a fervent supporter of vaccination campaigns for diseases that carry a high risk of death or serious complications-which extensive human experience tells us that chickenpox and flu in healthy people are not, sorry

hard to believe you include chicken pox on a list of diseases that does not convey a risk of serious complications--encephalitis, anencephaly, blindness, etc., in newborns whose mothers contract chicken pox aren't serious complications? Were you aware that there were over 48,000 deaths due to flu in the Untied States alone between 2003-2004,when the H3N2 strain of influenza A was circulating?

Then there's that 'in healthy people handwaving--by what rational argument should we only craft public health policies to protect healthy poeple, rather than all people? Do you have some strange idea that only healthy people contract viral illnesses? Are you blind to the fact that 'healthy' people, while at less risk of death or serious complications, if unvaccinated compromise herd immunity placing 'unhealthy' individuals, infants and the elderly at elevated risk of sufering illness, complications and death?

...diseases that carry a high risk of death or serious complications – which extensive human experience tells us that chickenpox and flu in healthy people are not, sorry...

I can tell from this that neither you or anyone you love has ever had the flu. I mean the real flu, not just a bad cold.

I was in my 30's, no health problems, and I'd get a flu shot, or not, if it was too much trouble. One year I didn't, and I caught the real flu. It hurts, and it hurts a lot. I clearly didn't die, and wasn't admitted to the hospital with serious complications, but that was a week or so I wish I hadn't experienced.

I haven't missed a year since, and never will again, even if the shots aren't covered by health insurance. I do not want to get that bug again, and I don't want anyone I love to get it.

From the blurb on his book, Cassels seems to be a man who is deeply suspicious of medicine and thinks that screening tests are worthless.

He also seems to have some odd opinions about how hypertension is just a scary-sounding made-up name.

High blood pressure ‘medicalized’ becomes ‘hypertension’, now the leading pharmaceutically treated ‘condition’ in the world.

hype the seriousness of common everyday viruses (c’mon folks, really? The flu? Chicken pox?)

Ah, one of those "I'm never sick, and anyway these illnesses are nothing serious".
As someone slightly psychosomatic, I hate these guys, they are my polar opposite.
They also seem to not remember how common childhood illnesses could be very annoying. Or they were the lucky ones with mild or no symptoms.

I had the occasion a few months ago to refresh my memory on what a "little" bout of fever looks like. Either the flu or some other virus. For a full night, uncontrollable shivers, unable to focus for the next three days, and joint pain from the exertion. For someone who hasn't been really sick for some time, the loss of my body control and the violence of my shivers was frightening. And I have no doubt what I had was minor, it could have been much worse.
Yeah, nothing serious, it was a short episode, I survived.
But I could have done without.
And if I had children, or elderly/fragile adults to take care of, I certainly wouldn't want them to catch what I had. Especially since I was out of commission and couldn't have taken care of them.
But, eh, it was just some everyday virus, nothing to worry about.

BTW, since when are flu and chicken pox "everyday" viruses? Flu is a cyclic, seasonal occurrence, and chicken pox is a childhood disease.
I suspect the brave doctor is lost to the dark side.

By Heliantus (not verified) on 31 Aug 2012 #permalink

@jane

Also, on the pertussis vaccine in pregnant women bit. It is, indeed, a bit disingenuous to advance the fear that the Tdap may cause harm to the fetus. The insert says that the safety of the vaccine in pregnant women has not been established because the manufacturer has not conducted any studies in pregnant women (though they do have a registry to track and study this). This statement does not mean that no one has studied it (they have, nor does it mean that it is dangerous to the fetus when given to pregnant women.

And for anyone that's interested, I'm trying to promote education about what these diseases can actually do through a series of wanted posters. The final one goes up at noon today. Perhaps jane and Mr. Cassels would benefit from reading these. They're short summaries based on (gasp!) facts!

@jane: do you know, almost EVERY drug on the planet will say that about pregnant women, because WE DON'T DO DRUG TESTING ON PREGNANT WOMEN!!!!! It's rather unethical, you know, to test on chlldren and pregnant women. The best they can do is test on laboratory animals, healthy adults (often male, sometimes females who are not pregnant) and then hope for the best by monitoring any new drug given to pregnant women for birth defects, etc.

The problem is, birth defects happen, so you have to eliminate the known rates before identifying if anything increases the rates.

As a midwife, I can certainly say I was a lot more concerned about my patients not coughing until they vomit, breaking ribs, possibly causing preterm labor over getting a DTaP.

And NVIC is NOT a good place for information. They don't update with new research - note that a good deal of their pertussis information is old, and has to do with the DTP over the new acellular versions. Certainly Cassels could have linked at least to the CDC, or the Canadian version of the CDC instead of NVIC unless he had an agenda.

diseases that carry a high risk of death or serious complications – which extensive human experience tells us that chickenpox and flu in healthy people are not,

Tell this to the family of Toronto who lost their (healthy) teenager boy to the H1N1 flu. His death was a harsh reality check for many people in our city: you can be healthy and die in a few days from a common disease.

I cannot tell if your sentence is a tautology (healthy people are healthy) or a no true scotman (if you get sick, then you were not truly healthy).
BTW, how do you assess if you are healthy enough not to have complications from the flu or whatever?

By Heliantus (not verified) on 31 Aug 2012 #permalink

Also: jane obviously never saw a newborn with congenital chicken pox, or a pregnant woman in the ICU with chicken pox - both of which I've seen.

And she never had to give her child narcotics for pain from the pox because said child couldn't eat, drink, sleep, sit or lie down from pain from the pox. Would I have given her a vaccine to prevent that kind of pain? HELL YES!!!

But here’s a direct link to GSK’s leaflet on a DPT booster, which does, in fact, say that the safety of the vaccine has not been established in pregnant women and that they should not be given boosters while pregnant unless necessary.

Ululating over Pregnancy Category C is an extremely superficial gambit. Indeed, given the minuscule population of Category A, it's well past time the whole scheme was revised.

And she never had to give her child narcotics for pain from the pox because said child couldn’t eat, drink, sleep, sit or lie down from pain from the pox. Would I have given her a vaccine to prevent that kind of pain? HELL YES!!!

I can't imagine that jane has any children. At least, I'd sure hope not, because anyone who could be so dismissive of kids getting the flu or chicken pox is either completely oblivious to what it is really like to have a sick child, or is a monster.

Sorry, Dawn, I don't need to have my child in so much pain that they need narcotics in order to prefer a vaccine. Just a normal run of the chicken pox is enough to make me want to avoid it. Shoot, I have argued that _I_ want a vaccine for hand/foot/mouth, because I have had to watch my kids suffer through that. Right now, the MonkeyBoy has a cold with a cough, and it was bad enough lying in bed last night listening to him cough through the night. He is such a great trooper, though, and does his albuterol nebulizer treatments so readily, but, you know, I'd rather not be doing that.

I suffer so along with my kids when they are sick. You'd have to be heartless to not want to avoid it.

By Marry Me, Mindy (not verified) on 31 Aug 2012 #permalink

NVIC is a cesspool of inaccurate and deliberately doctored information.

I saw a child die of chickenpox encephalitis when I was a paediatric SHO many moons ago. Not a nice disease at times.

By Lancelot Gobbo (not verified) on 31 Aug 2012 #permalink

To be fair, I think that it is true that many parents don't understand that vaccines AREN'T 100% effective. I'm not sure if it's the doctors' fault or the parents' fault or what but a lot of parents seem to think "If my kid got the shot, he can't get the disease".

Not a nice disease at times.

There is a long way between "not a nice disease" and "deadly." I would not consider 10 days of outrageously itchy pustules to be "nice" regardless of whether it literally killed me or not.

By Marry Me, Mindy (not verified) on 31 Aug 2012 #permalink

@ Jane: You're not current with the recommendations for vaccines given to pregnant women:

http://www.cdc.gov/vaccines/pubs/preg-guide.htm#tdap

Tetanus, Diphtheria, and Pertussis (Tdap); & Tetanus and Diphtheria (Td)

Pregnant women who have not been previously vaccinated with Tdap should get one dose of Tdap during the third trimester or late second trimester (after 20 weeks gestation). If not administered during pregnancy, Tdap should be administered immediately postpartum. 12
Available data from... studies do not suggest any elevated frequency or unusual patterns of adverse events in pregnant women who received Tdap and that the few serious adverse events reported were unlikely to have been caused by the vaccine. 12

Here are the recommendations for administering Tdap vaccine to pregnant women and to anyone (family members and caregivers), who will have close contact with an infant less than one year old:

CDC. Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months – Advisory Committee on Immunization Practices (ACIP), 2011. MMWR 2011; 60 (No. 41): 1426.

I wonder if the people embracing "We should only vacinate against diseases that are deadly when healthy individuals contract them" apply the same criteria when weighing risk versus benefit for all medical interventions? ("Surgery to repair my torn ACL? C'mon! I might limp for the rest of my life, but it's not like I need a coronary bypass . It's not going to kill me...")

palindrom: I've got your back...my post is just below yours on Cassel's article. I also invited the readers back here to have a discussion.

Also posted on his article. That pertussis insert comment really rankled me.

@MikeMa,

"4 minutes of coughing, 1 minute of message ought to be about right."

You should time radio and television spots. The correct ratio would be about 15 seconds of coughing followed by a 30 second PSA. I can tolerate about five seconds of that wet, convulsive coughing before I want mute the sound.

Four minutes of that would drive your intended audience away before the PSA airs.

@MMM: I wasn't clear, sorry. Unfortunately, both my kids got chickenpox BEFORE the vaccine was approved... ;-/ (the vaccine was March 1995, we had our little bout in January 1995)..... if the vaccine HAD been available, they would have gotten it before the pox, as soon as I knew it had hit the daycare - or before, whenever it's given in the fee schedule.

@Anj and MikeMa

Shot of Prevention has a very effective pertussis ad that I've seen a couple times, now. It's heart-rending.

Oops...you can tell I'm working and have fee schedules on the mine...I meant "immunization schedule". (Darn Posting Too Quickly Error...can't get this submitted!!!)

Jennifer Lopez did a public service spot promoting pertussis vaccine about two years ago. We were running it on the tv in the immunization clinic waiting room until the nurses asked us to stop. It was making too many moms cry.

Jane, I urge you to do some more research on seasonal flu and chicken pox. I came out of the chicken pox fully functional as did all of my six brothers and sisters. But I was a wretchedly miserable little girl while it lasted and since three of us got it at the same time, my mother was almost at the end of her tether..

I'd also recommend you take a look at the following:

http://health.mcleancountyil.gov/index.aspx?NID=209

Looks like somebody might want to splurge on a fact-checker:

In the last two years in the US, there have been nearly 2,500 awards for vaccine injury and death made under the US 1986 National Childhood Vaccine Injury Act. More than half those awards involve the whooping cough vaccine.

There have been 3037 compensated cases since inception. In 1988.

Another rebuke of Cassels can be found here, from SkepticNorth.

I am the mother of 7 children who had chicken pox before the vaccine. All of my children but one had fairly mild cases. my son had chicken pox everywhere: under his eyelids, in his mouth, on his genitals and everywhere else.
They had chicken pox in three batches, The older three the middle three an then the last three. Yes that adds up to nine. One of my daughters has had chickenpox three times.
Aside from putting a child through needless misery, it is also misery for a parent who can not take said child anywhere for 10 days.

Cassells also fails to note that the "more than half those awards involve the whooping cough vaccine" needs to be qualified, on top of the overarching error, with "whole-cell." (Numbers here.) This is straight-up shmuckery.

@Michael

Very true, mostly due to widespread innumeracy. Most people, at least in the 'States, just go their whole lives without learning how probabilities and statistics work. I remember my high school had Stats as an advanced elective, and the "normal" kids had Algebra I -> Basic Geometry -> Algebra II -> graduation. It's depressing.

By ThickSantorum (not verified) on 31 Aug 2012 #permalink

Rose, that cannot be, after all, natural diseases impart infallible life-long immunity (just ask jane).

I expected to have a bunch of insults spewed at me - Marry Me, Mindy wins the prjze for the spewiest spewing, congrats! - but sorry, anyone old enough to have actual experience of these things knows there's a difference between chickenpox and post-infancy polio, or even mumps. A century or so ago, when children routinely got whooping cough, diphtheria, rubella, etc., with overcrowding and poor nutrition as contributing factors, the vast majority survived each of these common diseases without complications. But enough did die or suffer a lasting disability that almost everyone knew of someone in their own communities or families that it had happened to. The vaccines for these diseases were not a hard sell. I have indeed had both chickenpox and flu, and nobody claims they are pleasurable. But almost every kid in my town had chickenpox, and we never heard of one dying from it. That doesn't mean it never happened anywhere, only that it's very rare.
Thus, chickenpox vaccine generally serves only to reduce net discomfort. I think it is probably a fair deal for that purpose, though I don't think it should be mandated. Since adults are much more likely to suffer serious illness (thus the lengthy illness suffered by one commenter's co-worker is not representative) and the vaccine doesn't last, vaccination creates a "need" for a lifetime of follow-up injections that may not be obtained or perhaps even obtainable by many future adults. How these short-term benefits and long-term risks are balanced requires both value judgements and some guesses about our children's economic future, and I certainly wouldn't have the arrogance to suggest that MY values and guesses should be accepted by the entire population.
While a lot of anti-vaccine idiocy is self-generated, I believe some of it represents the values promoted by the medical industry turned back on it. When it comes to natural, as opposed to iatrogenic, causes of illness and death, we are told to spend our lives in an anxious scramble to lower even risks that are already low. Of course it is silly to get all shrieky about a 1/100,000 risk that a vaccine will cause a febrile seizure. It's equally silly to suggest that a 1/100,000 risk of death if you get chickenpox and a 1/10 risk of death if you get tetanus warrant similar fear and equal levels of shrieking against anyone who doesn't scurry to get their kids vaccinated. And when our self-appointed authority figures tell us it's ethically mandatory to go to great lengths to avoid even tiny risks, some portion of the public will have the gall to apply that to tiny risks other than the ones that authority figures tell them to fear - like the tiny risks of vaccines. If our opinion molders consistently said "Cut it out with the societal OCD and stop fretting about anything that has a less than 0.01% chance of happening to you or your kid," there'd be less fear of vaccines. But there'd also be less screening and less prophylactic treatment of the worried well.

As an Alumnus of UVic (for my sins), I was interested in Cassels' training and faculty appointment. He is listed as an "associated professional" in the Faculty of Human and Social Development. His degrees are a CD which appears to be an undergraduate degree in Community Development and an MPA which is a Masters in Public Administration.
In other words, he is not "Dr" Cassels and he has no apparent education in science or medicine.

@Mu
When my daughter told her ob she had had chickenpox three times and therefore should be immune the ob replied,"No that is the opposite of immunity."
Discomfort is too mild a word for chickenpox, even in doctorspeak where discomfort means hurts like h-ll.

If our opinion molders consistently said “Cut it out with the societal OCD and stop fretting about anything that has a less than 0.01% chance of happening to you or your kid,” there’d be less fear of vaccines use of carseats.

FTFY. Anyway, I contracted chicken pox in the prevaccine era. At the age of 20. From someone who had had it before. Were it not for exquisite timing, it could have cost me an extra year of college. Anyway,

a 1/10 risk of death if you get tetanus

I don't think you really want to test out that 13.2% CFR completely unprotected.

@ Jane:

"A century or so ago, when children routinely got whooping cough, diphtheria, rubella, etc., with overcrowding and poor nutrition as contributing factors, the vast majority survived each of these common diseases without complications"

Citations desperately needed

BTW, Jane, Which of the Recommended Childhood Vaccines protect against diseases that are spread via the fecal-oral route? Which of the Recommended Childhood Vaccines protect against diseases that are spread via airborne droplets or contact with oral secretions?

" Since adults are much more likely to suffer serious illness (thus the lengthy illness suffered by one commenter’s co-worker is not representative) and the vaccine doesn’t last, vaccination creates a “need” for a lifetime of follow-up injections that may not be obtained or perhaps even obtainable by many future adults."

Any citations or proof Jane? Which vaccines require "booster shots" and which vaccines do not require "booster shots"?

@jane--
a 1/100,000 risk of a febrile seizure from a vaccine is not equivalent to a 1/100,000 risk of death from a disease. A febrile seizure is frightening but also is temporary and has no impact on future development or health. The risks from a vaccine do exist but they are small and generally minor and utterly pale in comparison to the potential suffering, morbidity, and mortality from the diseases they prevent.
Also, the varicella vaccine seems to provide lifelong protection after 2 doses for the vast majority of people. As of right now there are no booster doses recommended, nor for the similar MMR vaccine.
The risk-benefit ratio overwhelmingly favors receiving a vaccine to prevent chickenpox (or flu) as compared to contracting the disease. The fact that the ratio is even better for pertussis or tetanus doesn't make the chickenpox or flu anything to poo-poo.

By Cynical Pediatrician (not verified) on 31 Aug 2012 #permalink

MikeMa:

Dr Cassels will have much odious company there.

What is he a doctor of? Does he have a PhD? Because I have found nothing that includes his education. And he does not have a page at UVic, just a listing, and there is no "PhD" after his name.

The man cannot even give proper references, and he actually seems to believe that 2012-1988 = 2! (the two years of awards since a 1986 law)

Thank you, TBruce for rounding out his lack of qualifications.

Jane:

I generally don’t comment on your pro-vaccine posts, because I am a fervent supporter of vaccination campaigns for diseases that carry a high risk of death or serious complications – which extensive human experience tells us that chickenpox and flu in healthy people are not,

Other than the thousand who die of flu, and the pain and suffering caused by chicken pox with over a hundred dying from it each --- that is a perfectly reasonably wrong statement.

Jane:

But here’s a direct link to GSK’s leaflet on a DPT booster,

Um, yeah. Could you at least get the initials of the vaccine correct? That is the Tdap vaccine. The only place I see that consistently uses DPT, which was always wrong, Barbara Loe Fisher and her NVIC website. This gives us a hint of where you get your outdated and inaccurate information.

Jane continues (please try using actual paragraphs):

When it comes to natural, as opposed to iatrogenic, causes of illness and death, we are told to spend our lives in an anxious scramble to lower even risks that are already low. Of course it is silly to get all shrieky about a 1/100,000 risk that a vaccine will cause a febrile seizure. It’s equally silly to suggest that a 1/100,000 risk of death if you get chickenpox

First, before the vaccine there was about 90% chance of getting chicken pox. And with that there was a 100% chance of misery for both child and parent. My three kids, including my six month old daughter, got it in 1994. My daughter cried night and day, and my kindergarten kid wet the bed every night. This was not a happy fun time.

There is also a 10% chance of my kids getting shingles later in life, and it is even higher for my daughters since she had as a baby.

Only an evil and sadistic person would think that a child should not get the varicella vaccine and be allowed to suffer from having dozens of open itchy sores (pox). Especially if they get their information from NVIC.

I'm glad to win the award. Thanks, jane.

And I stand by it. Yes, the chicken pox vaccine mainly is about preventing "discomfort," but what's wrong with that? Considering that "discomfort" is fairly euphemistic for what happens with chicken pox.

Let's see, Cassell wants to know risks and benefits, so compare the chicken pox to the vaccine:

The chicken pox involves up to 2 weeks of outrageously annoying rash, generally accompanied by a couple of days of high fever. It has a mortality rate of something like 1/20 000.

The chicken pox vaccine side effects are redness and swelling at the vaccination site in maybe half, with a smaller fraction having the potential for fever. There are no deaths associated with it.

Given the comparison, why in the blazes would ANYONE choose to not vaccinate? So you can subject your child to the disease? And it's not like chicken pox are one of those rare things that no one gets, like tetanus. You don't vaccinate, your child is most likely to get it.

This is why I called you a monster, jane. You would deliberately subject your kids to suffering from the chicken pox when there is a safer, much less debilitating alternative. Why would you inflict your kids with that?

By Marry Me, Mindy (not verified) on 31 Aug 2012 #permalink

Ugh, need to proof read (or get more coffee): "my daughters"... I have only one daughter. I'm going to ignore the other typos.

BTW, jane, thinking of risk of death: do you know that the chance that someone who gets behind the wheel to drive while drunk will die in a car accident is 1/500 000? I'm guessing you are opposed to drunk driving laws, then?

By Marry Me, Mindy (not verified) on 31 Aug 2012 #permalink

Another reason for the chicken pox vaccine:

According to the Organization for Teratology Information Service (OTIS):

If chicken pox occurs within the first trimester, the risk of birth defects is 0.5-1 percent
If chicken pox occurs within the 13th and 20th week, the risk of birth defects is 2 percent
Possible birth defects may be scars, eye problems, poor growth, small head size, delayed development, and/or mental retardation.

Is it also silly to mention this, too?

A century or so ago, when children routinely got whooping cough, diphtheria, rubella, etc., with overcrowding and poor nutrition as contributing factors, the vast majority survived each of these common diseases without complications.

Oh Jane, I think you are about to get royally schooled on that claim.

From a non-specialist standpoint (mine), I see people like you show up here all the time. You making a grudging admission that some vaccines might be useful (e.g.polio), then start handwaving about others that you have deemed unnecessary (chickenpox) using an argument that amounts to "people used to get that all the time and they lived, so what's the big deal?" I find this attitude baffling. If we can prevent a disease with a simple, safe, inexpensive vaccine, why shouldn't we? Please tell me what good is served by allowing people to suffer unnecessarily.

By Edith Prickly (not verified) on 31 Aug 2012 #permalink

@jane

Your understanding of chickenpox is apparently a bit short of complete. You may want to get an introduction to what it can do here. Yes, death is rare. Less rare is meningitis or encephalitis, both of which can potentially cause permanent brain damage. Then there's the not insignificant risk of long-lasting to permanent nerve damage when it reactivates as shingles.

Generally, chickenpox and some of the other childhood diseases are mild, and the majority will recover with few lasting problems. But the risks from the diseases are orders of magnitude greater, and of a much more serious nature, than any of the risks from the vaccines which prevent them. To downplay the risks of diseases, painting them as if they are nothing to worry about leads to things like the measles outbreaks in Minnesota and Indiana in recent years, or the thought, as expressed by a coworker recently, that pertussis is nothing to worry about and "hasn't that been eliminated anyway?"

Again, the main point of vaccination isn't necessarily to help the individual, but rather to help society as a whole, including the individual.

We should also remind Jane that it is not just "risk of death." There is also risk of permanent disability. If the pox had been just a centimeter closer to my daughter's eyes, she would have lost some of her sight.

Also, when chicken pox was going through my kindergarten son's school one child was hospitalized with a very real chance of having a limb amputated due to secondary bacterial infection. When my son went back to school I helped out with a kindergarten field trip. Out of a classroom of twenty five, there were less than ten kids. The rest were home sick.

The nurse told me that one child was unable to attend school for the entire six weeks of the outbreak. He had a sibling who was being treated for cancer, and they could not afford to let him or his sibling get chicken pox.

I bet the NVIC site does not mention these issues.

Oh Jane....What did you state about febrile seizures following vaccinations? What do studies state about lasting sequelae if a child has a febrile seizure after a vaccination?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603512/

"The possibility that immunizations may cause seizures or epilepsy is another potential concern, and indeed febrile seizures have been shown to occur at an increased rate after vaccination (7). However, there is no evidence to suggest that the fever caused by vaccines predisposes a person to seizures, any more than fevers from other causes (8). This is reinforced by the fact that children with seizures after vaccination are no more likely to go on to have afebrile seizures or developmental problems than children who have febrile seizures from other causes (7). Overall, there is no evidence to suggest that vaccines cause central nervous system injury, epilepsy or infantile spasms (8)."

Where are the answers to those other questions I posed to you upthread Jane?

Jane:

A century or so ago, when children routinely got whooping cough, diphtheria, rubella, etc., with overcrowding and poor nutrition as contributing factors, the vast majority survived each of these common diseases without complications.

Funny, the parents who are speaking out about their infants dying of pertussis today do not live in crowded unclean environments. There are several stories about their children, like this one.

I am pretty sure that my grandmother's family were not living in over crowded conditions in Eau Claire, WI. They actually had a pretty nice house, and were really part of the middle class. Yet both of her brothers died before age seven (one was about ten months old).

You really should read up what rubella did just fifty years ago. There was an epidemic and tens of thousands of children permanently disabled, or not even born. It caused a surge of demand on places where disabled children were warehoused, like Willowbrook. The place that Geraldo Rivera called "Hell on Earth." There is a documentary by that name, you should watch it.

If you do have children, do read to them the story of Balto and the reason he pulled a sled in Alaska. It was the start of the Iditarod Trail Sled Dog Race.

And while I was looking up child mortality in the twentieth century I stumbled on this recent paper: The Burden of Disease and the Changing Task of Medicine. Take good look at the second bar graph. It includes the reason for the race on the Iditorod Trail. What is it?

@jane

I expected to have a bunch of insults spewed at me

I went back and read the responses to you. I saw corrections, but I didn't see insults (unless you count the "hope you don't have children" comment as an insult). Perhaps you should focus on the matters of fact, rather than the tone of the responses. Complaining about being insulted when people weren't doing so just makes you look like a tone troll.

With chickenpox there is also the lifelong scarring. I had it very badly at 15, I am now 40 and people still sometimes ask me what all the white bumps on my neck, shouldes and upper arms are, or how I got the pits in my forehead. I still find my scars embarrasing sometimes, as a teenage girl when the scars were pink and livid I just wanted to hide.

Well, Todd, to be truthful some of us have remarked that only a cruel and sadistic person would think it was okay for a child to suffer with chicken pox. I don't know if that is an insult, because Jane probably does not want children to suffer. She just not understand how much suffering the disease causes.

Now we'll see if she has an open mind, and is willing to be corrected.

A few thoughts:

* "healthy people have nothing to fear" Yeah, now. Nobody stays healthy forever. You get the vaccine when you're healthy, and then five years from now, when you get in a car accident, and your lung is punctured by your fractured clavicle, and one of the consequences of that is you develop asthma (happened to my mother-in-law), you become much more vulnerable to respiratory infections like pertussis. Or you discover a lump in your breast, get it checked, find out its cancer, and you get put on chemotherapy drugs, and then a relative visits you while you're dealing with that, but doesn't realize that little cold was actually a mild pertussis infection. Even if you don't care about the people who aren't healthy, surely you at least care about Future You, who may not be healthy enough to endure these infections.

* "healthy people have nothing to fear, part two" Actually, healthy people do have a lot to fear. After all, how do healthy people become unhealthy? Sometimes, it's by contracting a vaccine-preventable illness. Others have already mentioned how healthy people fare poorly with some strains of influenza, but healthy people can be killed by measles too. A healthy adult might get an asymptomatic case of pertussis -- or may cough so hard they break ribs, or may end up in an ICU, or may even wind up in the morgue. There is more to it than simply whether or not you are "healthy". There's luck involved too. I'll play the lottery with a dollar bill, but not my life or well-being.

By Calli Arcale (not verified) on 31 Aug 2012 #permalink

Jane -we've heard every single one of your "arguments" for years. Can't you lot come up with anything new? Ugh.

The thing is Jane, if I get flu or chickenpox I'll die. I can't be vaccinated, so I rely on the herd. Me, babies, kids with cancer, anyone with compromised immunity. So should we just shut up and die? I'm only 35. I don't want to die. I've spent the whole of the summer in my house because our tiny village is currently hosting measles and pertussis.

@MI Dawn - I'm with you 100% on helping babies get.a chance to live. Before I knew her my partner got flu, she was pregnant, 23 weeks. She got flu, which was bad enough on it's own, and then it aggravated her asthma. So she coughed, and coughed, and coughed until her amniotic sac ruptured. She blamed herself for the death of that baby for years. Flu is serious business indeed.

@Rose - I feel for your kid! I was lucky enough to catch chickenpox while I was in hospital, age six. I was sent home, and my planned corrective surgery was cancelled. I got sores on all of my mucous membranes, eyes, mouth, vagina and anus, in my nose. Awful. I just screamed and slept for three weeks. My parents had to sedate me to stop me clawing chunks out of myself. It was truly horrible.

I am getting really tired of the anti-vaccine folks and skeptics like Jane acting as though the probability of death from a disease is the only adverse effect we need worry about.

Here in the US, where there is no universal health care and where many many people have jobs that do not afford them paid sick leave, an extended illness can present real hardship, if not outright financial disaster: the school teacher wife of a co-worker caught pertussis from one of her students and was unable to work for six months. She lost her job as a result.

I wonder if it has occurred to Jane that an uninsured parent may be reluctant to take an ill child to the Dr. until the symptoms are serious, resulting in greater risk to that child. Wouldn't it be better to have prevented the illness in the first place if we could?

What happens to a single parent with no paid sick leave when they and the children all get a bad flu at the same time?

Contrary to what Jane apparently thinks, avoidance of illness is not some form of neurosis, it is a rational act.

My son was sedated the whole time he had chickenpox. It was a nightmare. Why would you subject a child to that when it can be prevented?

@ToddW: If it quacks...

What level of infant and child mortality from preventable disease is acceptable? 10%? 1%?

By Mephistopheles… (not verified) on 31 Aug 2012 #permalink

I found an interesting American child mortality. It says:

Child mortality in the United States has declined dramatically over the past century (1-5). The mortality rate for children aged 1-4 years declined from 1,418.8 deaths per 100,000 population in 1907 to 28.6 in 2007 (3, 4). The mortality rate for children aged 5-14 years declined from 307.5 in 1907 to 15.3 in 2007 (3, 4). In 1900-1902, 90.2% of U.S. children aged 1 year survived to age 15, compared to 99.7% of children in 2007 (2, 4).

So is losing 10% of all those under fifteen a good thing or a bad thing?

At least in Canada, the H1N1 influenza did a pretty good job of making women (especially pregnant women) and Native Canadians ill or dead. It did a number on me, that's for sure. I needed asthma medication, and it took months for my lungs to recover as much as they did, which wasn't completely. I got H1N1 before the vaccine was available here, and now I get flu shots every year as soon as I can.

Funnily enough, I was just listening to The Coasters:

Measles'll make you bumpy
And mumps'll make you lumpy
And chicken pox'll make you jump and twitch
A common cold'll fool you
And whooping cough can cool you
But poison ivy, Lord, will make you itch.

Get the shots, and then you'll only have to deal with the poison ivy!

By Interrobang (not verified) on 31 Aug 2012 #permalink

A century or so ago, when children routinely got whooping cough, diphtheria, rubella, etc., with overcrowding and poor nutrition as contributing factors, the vast majority survived each of these common diseases without complications.

O RLY? Do people not look things up these days? Is there a craze among the young people for making fools of themselvesf?

A century or so ago, the mortality rate from diphtheria was about 10%. 20% of children would not live to their first birthday, with diphtheria as the largest single killer.

A 90% chance of survival is not "vast majority" in my world.

By herr doktor bimler (not verified) on 31 Aug 2012 #permalink

A 90% chance of survival is not “vast majority” in my world.

It might be half-vast. 50% +1 is a majority; I suppose anything over 80.9% might be considered a vast majority by some.

By Mephistopheles… (not verified) on 31 Aug 2012 #permalink

I should replace "10% mortality rate" with "10% mortality if you caught it".

By herr doktor bimler (not verified) on 31 Aug 2012 #permalink

Oh come on, bimler, why bother looking stuff up when you can make it up instead?

By Marry Me, Mindy (not verified) on 31 Aug 2012 #permalink

Been scrolling through the co0mmentary hoping I'm the first to get to mention: Shingles! I'm 62. got my shingles shot. I remember chickenpox. It was a drag. But hey, shingles, no big deal, eh? If somebody brought it upoin an earlier post & I missed, it, my apologies. And greetings to the science-based crowd. They are generally polite, by the way, but sometimes impatient with willful, dangerous ignorance.

Forgive the typo, above. I was in a hurry. Seriously, folks, shingles is a common and serious aftermath of chickenpox. I know a few people who have been afflicted and as the years slide by I'll know a few more...

Who knows? Maybe Jane wants to see one out ten children die before reaching adulthood. Or, at least I hope, that she did not realize it was extremely common for families to lose a child.

My grandmother lost two of her four siblings. My father had one of his three siblings die, and my step-mother had one of her six siblings die during the 1918 influenza pandemic.

My mother was an only child, born after her parents were married for almost twenty years. They never spoke what happened before that time. I only found out about my grandmother's brothers when my cousin sent me our great-grandparent's Bible.

Perhaps Jane should look into her family's history.

And shingles is contagious to those who haven't had chickenpox or who have not been vaccinated. They'll get chickenpox and as time passes & perhaps the immune system sags a bit, then will come shingles.
Chickenpox is a drag and best avoided by vaccination.

@THS -- oh yeah, I had forgotten about shingles! Which I've had, fortunately a very mild case (I initially thought I had some kind of weird rash. The only lasting side effect has been an entirely unwarranted reputation in my department for stoicism). My sister in law, three years old than I am and therefore also of the pre-chicken pox vaccine generation, got a far more typical case and was in agony.

Jane: no spewing and no insults, but no one who has had chicken pox would describe the effects as "discomfort."

Given that ant-vaccination cranks are the nastiest advocacy group anywhere, as well as the most misinformed, I can't see as any degree of ridicule directed at them is excessive.

By Ivan Ilyich (not verified) on 31 Aug 2012 #permalink

Regarding the claims in the National Vaccine Injury Compensation Program related to the pertussis vaccine, here's a link to an abstract of a journal article which concisely points out the difference between the medical and the legal aspects of the NVICP:

http://jhppl.dukejournals.org/content/24/1/59.abstract

By Ivan Ilyich (not verified) on 31 Aug 2012 #permalink

A century or so ago, when children routinely got whooping cough, diphtheria, rubella, etc., with overcrowding and poor nutrition as contributing factors, the vast majority survived each of these common diseases without complications.

Oh jane, what color is the sky on your planet?

Seen in a museum in a small Gallo-Roman city in the south of France: a small box, not even 1 foot long.
Label: "Coffin of a baby. One baby out of two didn't reach one year"
On the other side, a small model of the city's baths (with slaves providing hot running water), next to a map of the locals aqueducts. The city even had rudimentary sewers - the level of sanitation of these Romans was certainly on par with many European cities of the last century, a few improvements aside. Next room, presses for olive oil, and the room after, a sunken trade galley - the small city was prosperous and the inhabitants had access to a varied diet including fish, olive oil and many vegetables.
And yet, one child out of two died.

[Chickenpox] vaccine doesn’t last, vaccination creates a “need” for a lifetime of follow-up injections

The premise, that natural infection gives on a reliable basis a lifelong immunity, is not quite true. Aside from individual to individual variation, there is some debate build on the following argument:
In pre-vaccination time, adults were constantly exposed to sick children all year long (their's, their relatives', and all the community). Including children sick with measles, mump, chickenpox... That means that the adults' immune systems were constantly challenged by the pathogens behind these illnesses; a sort of natural vaccine booster, if you like (except that these pathogens were not killed or attenuated, and quite willing to make you sick if they had a chance).
As I said before on another thread, the implication of this is that, for the adults to keep a lifelong immunity through natural infection, children have to get sick and suffer. That's not a world I very much like.

By Heliantus (not verified) on 31 Aug 2012 #permalink

Chickenpox bites and shingles blows.
Shingles, I remember shingles. I remember the rash. I remember staying home from work for a week because the pain was excruciating if I wore a shirt. I don't have to remember the post-herpatic pain.I still experience it from time to time. Chickenpox, the gift that keeps on giving
What kind of parent would wish that on a child?.

Coincidentally, our subject Alan Cassels published a piece of work this month not-so-subtly suggesting that the shingles vaccine causes shingles. He appears to have a regular column there at commonground.ca, currently headlined adjacent to an article written by an actor in defense of ‘natural health’ vendors.

By Etaoin Shrdlu (not verified) on 31 Aug 2012 #permalink

Seen in a museum in a small Gallo-Roman city in the south of France: a small box, not even 1 foot long.
Label: “Coffin of a baby. One baby out of two didn’t reach one year”

For a 3 year old, it looks like coffins are about 3 foot long.

http://www.shorpy.com/node/11595

Warning: dead child photo - measles victim.

But measles are a minor childhood disease, right?

Finally had the time to do a close reading of the blog & all comments to date & find that Chris (1:15) and Todd W (1:31) had previously mentioned shingles. So they beat me to it. OK, that gives us 3-fold coverage. As I've mentioned before on my brief time with RI, the anti-vaccine crowd baffles me. It's not that their arguments are difficult to understand. It's that they ARE easy to understand -- and outrageous in their willful and consistent error.

My, some of y'all can't read very well, e.g., those who are trying to claim I said the old standard childhood diseases weren't so bad. Well, no. You can look up historical mortality rates at the CDC website. Even before vaccinations began, there was a conspicuous decline in childhood mortality. However, it was a lot higher than ours today; as an example, in 1930 the death rate was 602.6 per 100,000 in children 1 to 4 years old. It would be simply deranged, or amazingly ignorant, to suggest that MOST people who got measles, or mumps, or whooping cough died of it; not even 10% did. But there were enough dangerous diseases out there to create, in sum, a far higher child mortality rate than we're used to. Vaccines were partly responsible for the decline, and that's great.

Then, lilady is either pretending I implied that vaccines other than the chickenpox vaccine wore off, or demanding proof that the chickenpox vaccine wears off as if she is totally ignorant of this well-publicized fact. This is a poor message from the public health standpoint, since vaccinated children will be at risk if they don't know they should get booster shots in adulthood (assuming they can). But I remember from tangling with her before that she is a retiree and has trouble with some of the nuances. Likewise, the guy who claims chickenpox has a 1/20,000 mortality rate ... "Evidence?" And there's the one who claims that because I said "DPT" it was somehow proof that I was associated with NVIC. Nope, it's proof that I'm over 40, 'cause that's what it was most often called when I was in the getting-gouged-with-needles age group. I guess that's down the memory hole? I've never read a word of NVIC's site, since I am not in fact the ignorant stupid irrational eeeevil strawperson that you would like to think I am. And I hope no undecided readers will presume that these lame attempts are the best logical, rational argument scientism can muster in favor of preventing non-lethal diseases. Believe it or not, when you lie to someone about what she believes, she's apt to assume that you're lying about what others believe too - and perhaps vice versa.

I’ve never read a word of NVIC’s site, since I am not in fact the ignorant stupid irrational eeeevil strawperson that you would like to think I am. And I hope no undecided readers will presume that these lame attempts are the best logical, rational argument scientism can muster in favor of preventing non-lethal diseases.

**Ding!** You have plenty of perfectly rational items to respond to. Instead, you choose this.

Jane:

Even before vaccinations began, there was a conspicuous decline in childhood mortality.

Which was explained in this paper that I linked to. I guess you did not bother looking at it. You want to ignore all of the social and medical advances that help keep kids healthy, that is okay. But you cannot ignore that most who survive are because of expensive medical treatment, and sometimes end up alive but with permanent disabilities (mumps used to be the most common cause of post-lingual deafness).

Jane:

It would be simply deranged, or amazingly ignorant, to suggest that MOST people who got measles, or mumps, or whooping cough died of it; not even 10% did.

So you did not look at bar graph. And you missed that 10% of children between age one and fifteen died, and that was after about 1% died before age one.

Vaccines were partly responsible for the decline, and that’s great.

It is actually a major reason. Do look at that bar graph. Because if you reduce the incidence of a disease, you reduce deaths due to that disease. It is not a coincidence that the earliest vaccines happened to be for bacterial diseases, and they were the ones that caused the most devastation. Like the one on the top of the first bar in that bar graph, the one that is the main reason for the Iditorod Sled Race.

I was hoping you would actually have an open mind and learn that there are reasons to prevent diseases. But, alas, you are not showing any thought towards the tales of suffering from zoster infections. It now seems that what we wrote about persons who would rather see children suffer from chicken pox are not really insults, but a statement of fact.

Me:

And you missed that 10% of children between age one and fifteen died, and that was after about 1% died before age one

Referencing the quote I posted on August 31, 4:48 pm:

Child mortality in the United States has declined dramatically over the past century (1-5). The mortality rate for children aged 1-4 years declined from 1,418.8 deaths per 100,000 population in 1907 to 28.6 in 2007 (3, 4). The mortality rate for children aged 5-14 years declined from 307.5 in 1907 to 15.3 in 2007 (3, 4). In 1900-1902, 90.2% of U.S. children aged 1 year survived to age 15, compared to 99.7% of children in 2007 (2, 4).

I misremembered the did not mention infant mortality. But this says:

Achievements in Public Health, 1900-1999: Healthier Mothers and Babies

At the beginning of the 20th century, for every 1000 live births, six to nine women in the United States died of pregnancy-related complications, and approximately 100 infants died before age 1 year (1,2).

Which is 10% not even having a first birthday. That means about 20% of children who were born did not grow up to be adults. Vaccines may have only a modest effect in increasing infant mortality, it has a significant effect later in life (especially since measles, mumps and rubella are only given to those over one year old).

So we'll just stick to the question being: is 10% mortality okay dokay? Or even 5%?

Jane:
Here are your quotes and here are the questions I posed to you:

lilady
August 31, 1:12 pm

@ Jane:

“A century or so ago, when children routinely got whooping cough, diphtheria, rubella, etc., with overcrowding and poor nutrition as contributing factors, the vast majority survived each of these common diseases without complications”

Citations desperately needed

BTW, Jane, Which of the Recommended Childhood Vaccines protect against diseases that are spread via the fecal-oral route? Which of the Recommended Childhood Vaccines protect against diseases that are spread via airborne droplets or contact with oral secretions?

” Since adults are much more likely to suffer serious illness (thus the lengthy illness suffered by one commenter’s co-worker is not representative) and the vaccine doesn’t last, vaccination creates a “need” for a lifetime of follow-up injections that may not be obtained or perhaps even obtainable by many future adults.”

Any citations or proof Jane? Which vaccines require “booster shots” and which vaccines do not require “booster shots”?

Why are you lying Jane? Why don't you answer my questions Jane?

jane alleges:

My, some of y’all can’t read very well

To which I must say - no, I think the people calling you out are reading just fine.

By Composer99 (not verified) on 31 Aug 2012 #permalink

I posted several at Mr. Cassels Pharmawatch blog. This is the latest one:

"The title of Mr. Cassels’ article is…

“Time to outlaw vaccine propaganda: Are we taking the easy way out by labeling vaccine questioners anti-science loonies?”

Now, just who is spreading rumors about vaccines by, using his bully pulpit to heighten parents’ fears about vaccines, by stating this?

“….I don’t think it is. Parents just want to keep potentially harmful things away from their children. And they turn to health experts for guidance, but here’s my take on things: health authorities often fail to acknowledge the risks of some vaccines, refuse to discuss uncertainty over a vaccine’s effectiveness, hype the seriousness of common everyday viruses (c’mon folks, really? The flu? Chicken pox?) and keep piling more and more vaccines onto the list of ‘recommended’ childhood shots threatening to turn our kids into pincushions. Now you’ve got a recipe for even more skepticism and fear-mongering.”

Have you ever heard of the VISs (Vaccine Information Statements) that are required to be given to patients/parents BEFORE any vaccine is administered, Mr. Cassels?

Why are you minimizing the seriousness of influenza and varicella Mr. Cassels? “C’mon” tell us, with some links to reliable websites. (Your link to the NVIC, is not a reliable website)

” Threatening to turn our kids into pin cushions”, Mr. Cassels?

Which vaccines, in your expert opinion, are necessary and which are not necessary, Mr. Cassels? Please provide links to reliable web sites that show that any vaccine is more “risky” than the actual disease that the vaccine prevents."

I had chicken pox as a kid: from reading the above comments it looks like I was "lucky" in that it was only a couple of weeks of itchy sores, a few scars on my stomach, and the possibility of shingles.

I am so very happy that I didn't suffer sores in more *ahem* uncomfortable places. (And my sympathies to those who did!)

Composer99:

To which I must say – no, I think the people calling you out are reading just fine.

Yes, she has not made the connection to the second bar graph in a paper I cited and the Iditarod Sled Race. I have found that several don't make the connection, even though it was the subject of Steven Spielberg's last Amblimation animation studio feature. I know my kids saw it when they were young. I made the connection from a tour of a local cemetery, where there were markers for whole families of kids who died within a few days of each other.

jane @August 31, 11:20 pm

because I said “DPT” it was somehow proof that I was associated with NVIC. Nope, it’s proof that I’m over 40

Well, maybe you are over 40. I know I am. However, my kids got DTaP, and I’ve had TDaP.

Your use of “DPT” does suggest that you have no children who have been immunized this century.

It's interesting how many 'skeptics' of vaccines come along and ask reasonable questions and perhaps weave in a couple of typical canards into the mix; and with a little surface-scratching, reveal themselves to be utterly full of them instead.

The fun one is "scientism".

@Lilady

Thanks but no. I just freaked myself out with pics of shingles. That's enough for one day...

My kids were vaccinated from the late 1980s to the present, I know what I saw on their vaccine records! (mostly because I have it in my hand) My daughter's vaccine record says she got "DTP" vaccines in 1994/1995 (about the time she actually got chicken pox). She got a DTaP in 1998, and a Tdap in 2006.

@ Chemmomo: Jane stated on her last post...

"And there’s the one who claims that because I said “DPT” it was somehow proof that I was associated with NVIC. Nope, it’s proof that I’m over 40, ’cause that’s what it was most often called when I was in the getting-gouged-with-needles age group. I guess that’s down the memory hole? I’ve never read a word of NVIC’s site, since I am not in fact the ignorant stupid irrational eeeevil strawperson that you would like to think I am."

Wouldn't you think that if Jane had *done* all that research, and stated that she never looked at the NVIC website, that she would *know* the difference between the whole cell DPT vaccine and the acellular DTaP vaccine?

How about the many genetic studies of kids whose parents claimed, and were awarded *damages* for DPT "vaccine injuries"?

http://leftbrainrightbrain.co.uk/2011/08/19/alleged-cases-of-vaccine-en…

Chris, there was a gradual implementation of the DTaP vaccine for the entire 5-dose childhood series. Prior to 1997, DTP was recommended for doses 1-2-3 and DTaP was recommended for doses 4-5.

http://www.cdc.gov/mmwr/PDF/rr/rr4607.pdf

My, some of y’all can’t read very well

I blame that other person who stole Jane's nom de guerre* to make ludicrous statements about the "vast majority" of children a few centuries ago surviving infectious diseases without serious complications.

* Not to be confused withnom du beurre, which is the pseudonym one adopts while spamming dairy products.

By herr doktor bimler (not verified) on 31 Aug 2012 #permalink

@ Militant Agnostic: Please, please tell me, that you linked to Cassels' blog, when you emailed Skeptically Speaking.

I'm just looking at her shot record. She was born in May of 1994. Her first four doses were between birth and November of 1995. Her fifth was in 1998, and it was a DTaP.

A nurse thought her shot record needed to be cleaned up. so she went through the records and gave us a new one where she had to change the printed "DTaP" to "DTP". But she did not specify if it was "DTP" or "DTaP" for the 1995 booster.

Last spring I had the medical clinic print out her vaccine record to comply with her university's MMR requirements. Someone had to type in the paper records to the electronic records to create the print out. So all of the 1994/1995 pertussis vaccines were recorded as DTaP.

Le sigh.

I know that is wrong. But what can you do? The persons recording the computer data are only human, and the university was only interested in the MMR.

What can you do?

She is caught up on all vaccines, including mingincoccal and the annual influenza. Oh, this is cool... her shot record now includes who gave her the vaccine! It was given 10/14/11 in her left lower arm by a person whose name I am not going to post. The manufacturer was Sanofi Pasteeur, and lot u4032aa.

Her last two flu vaccines also give the same information about the manufacturer, lot number and wielder of the needle (who knew that Nurse Tim had a last name?).

herr dokter bimler:

* Not to be confused withnom du beurre, which is the pseudonym one adopts while spamming dairy products.

Are you related to the Dutch immigrants who made their way to New Zealand? My hubby's Dutch grandparents literally cooked every thing in half a kilo of butter (yes, steak braised in butter is yummy). Googling his weird Dutch last name finds that the only other English speaking family lives in New Zealand!

Butter and cheese is a serious issue in our house. Hubby thrives on dairy products. Yet I have high cholesterol and one child has lactose intolerance. Except hubby recently was diagnosed with pre-diabetes, so he cut down on food and increased exercise and is now okay dokay.

I would hate him except that part of his regime to take walks in the neighborhood, and I get to come with him. Oh, and I have only been married to him for 32 years.

Flip - scientism is fun, but "iatrogenically induced deaths"* is the true mark of a learned woman.

I think Jane is from somebody's sock drawer. There's a distinct whiff of Grandma in the room. What say you lilady, is it your old nemesis?

*My spellcheck is not happy at all. It's almost as if it wasn't a recognised word ...

Jane *could* be my ***old nemesis...she claimed she had tangled with me before.

Might be Marsha McClelland a.k.a. Grandma Marsha...or "Laura"...or even "Lurker".

@Jane

There's a lot of us here in the 40+ club, just so you know - and some of us remember these diseases which our children are vaccinated against.

My mother remembers having the measles - two weeks in a dark room, with a high fever and vomiting relentlessly. Yes, she survived it. Her best friend did not. Both were 'healthy'.

Mom remembers rubella. Mom remembers getting a spinal tap at the age of 12 because they feared she'd contracted polio, as another child in their neighborhood was diagnosed with it.

If you want to risk your health and that of your children on some glorified, idiotic ideal of 'natural selection' - go live in a desert as a survivalist. You don't have the right to risk others who cannot be vaccinated due to your own idiocy.

@Elburto

I think there were quite a few telling phrases - I just happened to pick one.

To be honest, they all start to blur into one another, sockness or not, from the simple fact that they re-use the same old tired stuff every time.

I honestly don't know where anyone gets the patience to combat it day after day.

Are you related to the Dutch immigrants who made their way to New Zealand?

We're the Scandiwegian wave of immigrants.

By herr doktor bimler (not verified) on 31 Aug 2012 #permalink

herr dokter bimler, I know of them because I am descended from the late 19th century Norsk wave that came to North America. It seems that there are only certain people who come from Zeeland and Zealand (hubby is also part Danish) have a special affinity with dairy products.

@Jane

Just about every disease we vaccinate against can be fatal. I highly recommend you peruse the CDC's Pink Book to get a better sense of just what these diseases can do, even with good medical care.

On singles, my friend's husband nearly lost sight in one eye due to the nerve damage. He was lucky, though, and recovered without permanent damage. Granted, he still had to endure the intense pain from it.

If I didn't say it above, I certainly implied it: I don't care whether a disease can kill or not, we still can want to vaccinmatye against it. Take out the 1 in 20000 chance of death by chicken pox (that is a modern #, not a century ago), and we StyIL want to vaccinate against it. Because it's so much better than the alternative (getting the disease).

Shoot, I have mentioned before, after watching my kids suffeer with hand-foot-and-mouth, I would LOVE to have a vaccine against that, too. And I don't think it is anywhere fatal. I don't care. There is a long way between a terrible disease that should be vaccinated against and deadly.

Watching my son take a drink of milk and scream in pain was enough to want me to avoid that if I can. It may have lasted only three days (with fever), but that was enough.

By Marry Me, Mindy (not verified) on 01 Sep 2012 #permalink

Heh. I don't think it's guaranteed that chickenpox boosters will be available in fifty years to the working class on account of the predicted decline of our society, and one of the symptoms (and perhaps causes) of our decline is the way in which we have broken up into groups that regard only their own ideologically pure as Good and everyone else as Bad in every possible way. In the battle between scientism and science-haters, I tend to argue with the former because they have less to get over. They are right on most facts, and only need to learn to stop hating most of their fellow Americans and rejecting inconvenient facts/research in order to be actually rational. The anti-science crowd not only has a Manichaean worldview, but believes a lot of things that just ain't so, and trying to argue about both of those issues at once is just impossible.

But because of your dualistic worldview, I can't try to make common ground by pointing out that we agree on most facts. I am guessing that most preachers of scientism have never been to a part of the world where the infant mortality rate is still above 10%. They exist. Kids mostly die of malaria, diarrhea, complications of childbirth, rather than measles or mumps. Fecal contamination is everywhere, as it was in the U.S. a hundred years ago (which is why polio was seldom a problem, ironically). In the U.S., they did of all the above causes. Did diarrhea have over a 10% mortality rate per case? Does measles? Does mumps? Does (I can't even type this without snickering) chickenpox? No. But when you add together all these causes of mortality, you end up with a lot of deaths.

My positions are clear: (1) It's better to have low child mortality rates. (2) Several of the diseases that used to commonly occur in our population killed or disabled a relatively large number of children. (3) Vaccines for life-threatening illnesses reduce child mortality, and should be made freely available by the government. (4) The dramatic declines seen from 1900-1940 in child mortality were largely due to public health measures like cleaner water and better food and working and living conditions, not due to vaccines or to modern Western medical interventions. This in no way proves that the latter are not also beneficial.

If you can agree with those points, yet persist in labeling me a cartoon untermensch who is not only stupid and ignorant but loves to watch babies suffer ... well, what can I say? Their little whimpers of pain are just music to my ears.

Well jane, when you use the term scientism (which spell-check hates) you, unintentionally perhaps, align yourself with the antiscience side. Oh and one of the suggested substitutes for scientism is omniscient. Strange.

@ Rose: And, why do you think I asked "Jane", who is fixated on fecal contamination as the "one true cause" of vaccine-preventable diseases,

- Which of the vaccine-preventable diseases are spread through aerosolized airborne droplets or exposure to oral secretions?

-Which of the vaccine-preventable diseases are spread via the fecal-oral route?

jane states,

"Did diarrhea have over a 10% mortality rate per case? Does measles? Does mumps? Does (I can’t even type this without snickering) chickenpox? No. But when you add together all these causes of mortality, you end up with a lot of deaths."

Have a good "snicker", Jane...

http://www.immunize.org/photos/chickenpox-photos2.asp

I have to second Rose. Jane, while you make some good points, your post-modernistic diatribe places you in a precarious position.

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

@lilady
I am tempted to believe that if she cudda she wudda..All she has to do is answer and my doubts about her ability will be gone.

Heh. I don’t think it’s guaranteed that chickenpox boosters will be available in fifty years to the working class on account of the predicted decline of our society, and one of the symptoms (and perhaps causes) of our decline is the way in which we have broken up into groups that regard only their own ideologically pure as Good and everyone else as Bad in every possible way.

Jane, your arguments get weaker every time you post. Now you're saying that present-day decisions about vaccination should be based on some vague predictions about a grim future brought about by people just refusing to get aloooooooong! I'll repeat what I said up the thread: vaccination is one of the most cost-effective medical interventions available. Treatment for disease would be much more expensive for your downtrodden future working class than booster shots.

And for someone who's claiming to not be allied with the antivaxers, you're using a lot of their standard tropes to argue. Trying to paint science as an ideology ("scientism")? Check. Declines in childhood mortality were a result of improvements in nutrition, sanitation and living conditions, not vaccines? Check. Complaints about getting "gouged" by too many needles? Check. What is it with antivaxers and their needle phobias anyway? That's another thing that baffles me. My annual flu shot takes seconds and my shoulder is sore for a day or two, but compared to weeks of chills, fever, joint pain so bad I can't sleep, bone-rattling coughs, and depression-inducing fatigue? (I've had classic flu twice and H1N1 once) No contest there.

By Edith Prickly (not verified) on 01 Sep 2012 #permalink

“Did diarrhea have over a 10% mortality rate per case? Does measles? Does mumps? Does (I can’t even type this without snickering) chickenpox? No. But when you add together all these causes of mortality, you end up with a lot of deaths.”

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2811%297…

Findings
Worldwide in 2008, diarrhoea attributable to rotavirus infection resulted in 453 000 deaths (95% CI 420 000—494 000) in children younger than 5 years—37% of deaths attributable to diarrhoea and 5% of all deaths in children younger than 5 years. Five countries accounted for more than half of all deaths attributable to rotavirus infection: Democratic Republic of the Congo, Ethiopia, India, Nigeria, and Pakistan; India alone accounted for 22% of deaths (98 621 deaths).

Interpretation
Introduction of effective and available rotavirus vaccines could substantially affect worldwide deaths attributable to diarrhoea. Our new estimates can be used to advocate for rotavirus vaccine introduction and to monitor the effect of vaccination on mortality once introduced.

Still snickering, Jane?

" the way in which we have broken up into groups that regard only their own ideologically pure as Good and everyone else as Bad in every possible way"

Sorry if we think Malthusian death worshipers are bad in every possible way, but too ad.

jane: "I am guessing that most preachers of scientism have never been to a part of the world where the infant mortality rate is still above 10%."

I am hoping jane is not one of those people who think that supporting immunization means ignoring other facets of improved health care. It's a common antivax trope, but dead wrong.

More info here on efforts to reduce Third World child mortality, in which vaccines are part of a multifaceted strategy:

ht_p://www.globalpost.com/dispatches/globalpost-blogs/global-pulse/rajiv-shah-…

If ignorant people were falsely ascribing dangers to oral rehydration solutions, mosquito netting and so on, I'd expect there'd be a lot more focus on that. But since ignorance and denialism heavily target vaccines, that gets more attention.

"What is it with antivaxers and their needle phobias anyway?"

I suspect it's a lot more common among antivaxers than they'd care to admit. Belonephobia by some estimates affects up to 10% of the population. Combine that with fears about government control and contamination of bodily fluids, and you've got a powerful antivax motivator.

By Dangerous Bacon (not verified) on 01 Sep 2012 #permalink

sigh, too "bad" not "ad".

Jane, why do you think it is not worthwhile to prevent children from suffering over a week with dozens of open itchy pox, than to prevent that with two simple vaccinations?

Please to not invoke any unknown future social orders or post modernism words like "scientism." Just use real science and economics. Because I am really intrigued by the notion that preventing illness is more costly than not.

Dan Olmsted's Weekly Malarkey ( oops, I mean WRAP**) @ AoA today:

informs us that MMR + Hg + SSPE = ASD
the UK government has secret documents "under lock and key" for 30 years which reveal the dangers associated the measles vaccine.
Then he rants about Mnookin.

Finally Anne Dachel wishes that the CDC would be run like the National Hurricane agency: then EVERYONE would be talking about autism..

** appropriate in which to wrap fish.

By Denice Walter (not verified) on 01 Sep 2012 #permalink

Jane.

Sigh. Please re-read yourself before posting. First you say:

[to simplify, in third-world countries] Kids mostly die of malaria, diarrhea, complications of childbirth, rather than measles or mumps. Fecal contamination is everywhere, as it was in the U.S. a hundred years ago

We can argue on details, but I would let pass most of it.
Except for measles - that's number 10 on the top ten causes of death in under-developped countries, counting adults and children. It's just next to liver cancer for the whole world, Not bad for a common illness. See the second table in this Wikipedia article.
But carry on, carry on.

And then you say:

Did diarrhea have over a 10% mortality rate per case?

The way you fram the question, I assume you expect the answer to be no.
Make up your mind. Is diarrhea a cause of child death in poor countries, or not?
(My answer: if you don't have easy access to ways to keep the patient hydrated, yes it is; a teacher of mine who worked for Doctors Without Borders told me they were using degassed coca-cola as fluid for IV perfusion - this stuff comes sterile, it has a reasonable amount of sugar and minerals, and it's cheap and everywhere)

Some other points could have come better

(which is why polio was seldom a problem, ironically)

Yeah. It's funny how being dead from diarrhea (or whatever) saves you from becoming paralyzed by polio.

Another point: we told you before, death is not the only outcome we would like to avoid by vaccination.
By example, diarrhea. Let's focus on non-fatal cases. Do you fancy cleaning the liquid poo of your children? Not to mention that your children may appreciate not to be stuck hours or days in a smelly washroom. From personal experience, I know I would have.
Actually, for someone who lists fecal contamination as a factor in illness transmission, I would have expected some consistency in not dismissing diarrhea as a mere nothing.

The reaction of my mom when I told her about rotavirus vaccines getting available: "Thanks God!". I preferred not to ask her to elaborate.

My apologies for the scatology, but it's funny how people who don't suffer from something sneer at sick people looking for a more "comfortable" life.

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

From Edith Prickly

based on some vague predictions about a grim future brought about by people just refusing to get aloooooooong!

In the dark future of the 41st millennium, there is only war no vaccines.

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

Since I'm here, why not?

When I was a child I was supposed to get the new measles vaccine but didn't because I got the measles before the appointment.

I really don't remember a great deal about the experience except that I had to stay in a darkened room and couldn't read, write or draw, which I liked to do.

Two much older cousins inform me that I probably missed around a month of school and that everyone was worried about me. I vaguely remember coughing; one cousin says that I lost weight and had been thin to begin with.

I don't know if I have any permanent damage HOWEVER I have extremely light sensitive eyes, always had many floaters and usually need sunglasses unless it is very overcast. My aunt used to take me to fashionable stores to get the latest styles so I would be envied by other kids. Think Twiggy, Mary Quant and other 1960s trend setters.
I spend a lot of money on shades.

By Denice Walter (not verified) on 01 Sep 2012 #permalink

As if way back when, people lived with overcrowding and poor nutrition, let alone the claim of sanitation. We're to believe at some point the whole world lived as a third world country and solely due to that, some may have died. The only reason why many don't die today is due to advanced medical care, which is the only thing that was lacking 'way back when'. But then we know 10 infants did die of pertussis.

My neighbor who is 50 something has cancer and is on chemo. By looking at him, you'd never know how sick he was. Exposure to chickenpox could kill him. Adults who have pertussis often don't even realize they do. I have another neighbor who has a 5 year old son which doesn't build immunity to any vaccine. Due to this, it is quite possible this child could contract childhood illnesses multiple times, and this child is a risk to that other neighbor who is on chemo. I had many childhood diseases and yes I survived, but I was miserable. Just as I wouldn't want my child to get bit by a dog, break an arm or need stitches, why would I also not want to prevent other miserable things for that child?

By Just a mom (not verified) on 01 Sep 2012 #permalink

Before embarking on one sided verbose discussion, it would have been in order for you to read a little on Professor Peter Aaby.

This would have helped you temper down your article and provide a balanced picture.

Come on, Just a Mom! Why would you bother tryinmg to prevent your child from getting a dog bite? The vast majority of dog bites are harmless. And most that aren't are due to rabies, and since we have rabies vaccines now, that's not a problem any more.

Don't you think that too many people are way too worried about dog bites? I don't bother training my dog not to bite kids. It's not like its all that big a deal if the kid gets bit.

By Marry Me, Mindy (not verified) on 01 Sep 2012 #permalink

Before I leave:
isn't there a certain legal appeal that needs to be addressed prior to 30 days after 4 weeks ago yesterday?
It was filed and dismissed in some miserably over-heated place where they wear big hats...
and.do weekends count?

By Denice Walter (not verified) on 01 Sep 2012 #permalink

Like I said, I've tangled with lilady before - under this name, as I am no more a Sockpuppet than a Shill - and have noted her limited reading comprehension. Her insistence on twisting any reasonable thing an opponent says into its opposite is so extreme that I concluded at one point it might represent actual mental illness (in which case I probably ought not to despise her). But I am amazed that anyone else would go along with it. I should perhaps not have digressed to talk about chickenpox vaccine, but I did. She used that as a reason to start ranting about fecally transmitted diseases, which I did not know chickenpox to be. This doesn't even seem to be one of her usual ad hominems - it just makes no sense at all.

There's a difference between saying "Most people used to die of infectious disease" and saying "Most people who get an infectious disease die of it", I hope y'all realize. Smallpox used to kill a third of the people who were infected. It would be ludicrous to claim that measles had a similar death rate in a non-virgin population. It would be equally ludicrous to claim that chickenpox had a death rate similar to measles. To make up some arbitrary numbers just for the purposes of MATHEMATICAL explanation, IF an average person suffered from 10 infectious diseases in childhood and each of those had a little over a 1% mortality rate, right there you would end up with a 10% childhood death rate from infectious disease, despite the incontrovertible fact that the vast majority of cases (almost 99%) of any of those diseases were not fatal. Obviously, vaccination for such diseases would be beneficial and cost-effective (as would chlorinating the water supply).

Please note also, I did say that chickenpox vaccine was probably worthwhile for the purpose of reducing discomfort. I have no problem with that; avoiding discomfort is a perfectly rational activity. I only object to its being marketed as "your kids can diieeee if they get chickenpox," especially if no long-term provision is made to give free boosters in adulthood, when chickenpox IS dangerous, to vaccinated kids who grow up to be uninsured. I recognize that one of the tenets of scientism is that our available tech will just keep getting better forever, and there's no use in my arguing over religion, but RIGHT NOW in the heartland of the American empire, children die from lack of basic dental work, and thousands of people line up when a free clinic is offered. Do you think those people, today, can and do get a lot of booster vaccines? If not, how can you be sure that their kids will twenty years from now? (A responsive answer may include the words "Jane, you ignorant slut," but must also include a rational argument referencing current economic and political conditions and known resource limitations.)

I also think that it's poor practice to argue with emotional rhetoric about discomfort only when it suits one's purposes. I've probably had more experience of diarrhea than most of you, and though it's not pleasant, I don't feel twaumatized for life by having had diarrhea (or chickenpox). In fact, I would find it less unpleasant to have diarrhea every couple of years than be stuck with a needle two or three times for every single one of the endless viruses and bacteria that cause diarrhea, IF that WERE possible [note emphasis]. Who decides? When you decree that any natural unpleasantness or suffering is unbearable, there are only financial limits on how many vaccines could be developed and promoted. Or other prophylactic treatments; why are infectious causes of suffering special? And then there is the question of, if children could actually be sheltered from any risk or discomfort, how would they turn out as adults? Someone who makes it to 20 or 25 having never been sick or suffered any pain other than from needle sticks is likely to be, perhaps permanently, unsuited to a fair number of jobs and activities.

Just a mom - You're simply wrong about advanced allopathy being the only cause of declining mortality in the past 150 years. Public health had much more to do with it. Look it up. As for the values question, you just made my last point for me. If I had a kid, of course I wouldn't WANT him to be bitten by a dog, break his arm, or (oh, the horror, the horror!) have to get stitches. But far more, I wouldn't want him to never get to play with a dog 'cause he might get bit, never get to climb a tree or own a skateboard 'cause he might fall and break his arm, never learn to use a knife or a tool 'cause he might cut himself and need stitches. I'd want him to grow up to be a confident, functional human being who was not grossly unfit, possessed practical skills, and knew that he could get an owie without falling all to pieces and running first to the ER and then to his therapist to cry about it. This is a value held by many parents also. Try Googling "free range parenting."

@Jane - I would prefer that my child have the opportunity to go outside and experience the world, than spend weeks isolated in their bedrooms with various preventable diseases.....childhood sickness was once tolerated, because parents didn't have a choice but to have their kids tough it out.

We have a choice today - a choice to prevent those diseases in the first place. It isn't being lazy, it is being a rational parent.

Jane wrote:

"Public health had much more to do with it. Look it up."

A person who makes a claim ought to be able to provide evidence, don't you think? Unless that person was just making up stuff, of course...

jane: "I did say that chickenpox vaccine was probably worthwhile for the purpose of reducing discomfort. I have no problem with that; avoiding discomfort is a perfectly rational activity. I only object to its being marketed as “your kids can diieeee if they get chickenpox”

I've never seen it marketed that way. Here's what the CDC says:

"Varicella (chickenpox) is a highly contagious disease that is very uncomfortable and sometimes serious. The chickenpox vaccine is the best protection against chickenpox."

jane seems hung up on what effect vaccines have on mortality, mostly ignoring the permanent complications, congenital abnormalities and commonplace suffering that vaccine-preventable illnesses cause.
Emphasizing mortality alone is a typical antivax tactic, since numbers of deaths appear (to them, anyway) less scary than numbers of people afflicted. Additionally, using mortality statistics alone permits construction of deceptive graphs aiming to show that vaccine introduction did not result in significant declines in disease mortality (it is much harder to jigger graphs to show a lack of decline in disease _incidence_).

"When you decree that any natural unpleasantness or suffering is unbearable"

Yet another antivax trope (not to mention strawman). I've noticed a high degree of correlation between sneering about how these diseases aren't so bad, and never having experienced them oneself.

By Dangerous Bacon (not verified) on 01 Sep 2012 #permalink

Project much, jane?

Hmmm, I just don't recall any interaction with jane on this blog...or any other blog. Perhaps jane had a hold on reality back then...before she became so delusional.

Why don't you point us to the blog and the dialogue we had?

@Jane - wait, I thought Public Health also had to do with Preventative Medical Care & more advanced treatments for disease?

It became a heck of a lot easier to keep kids from dying of these diseases, since we could start treating the more severe side-effects, like pneumonia - but it wasn't until the advent of vaccines that we were actually able to reduce the incidence of these diseases (to almost zero in many cases).

Oops, jane has begun referring to "allopathy".

Add that to use of the term "scientism" and it's clear jane is deep in the woo.

By Dangerous Bacon (not verified) on 01 Sep 2012 #permalink

"advanced allopathy"? ding ding ding! I think we've got an altie glibertarian here. Yes Jane, I'm calling you a name and dismissing you. Glibertarians just love that "not suffering turns everyone into wimps!" gambit. Yes, children do face a lot of risks we can't control. My son just got a cast taken off this week after he broke his arm playing at camp. All the more reason to reduce the risks we can control.

By Edith Prickly (not verified) on 01 Sep 2012 #permalink

You’re simply wrong about advanced allopathy being the only cause of declining mortality in the past 150 years. Public health had much more to do with it. Look it up

Prove it, jane.

I have 'looked it up' and found no credible evidence for that position. Why should we believe your assertions without evidence?

@ Dangerous Bacon:

"jane seems hung up on what effect vaccines have on mortality, mostly ignoring the permanent complications, congenital abnormalities and commonplace suffering that vaccine-preventable illnesses cause.
Emphasizing mortality alone is a typical antivax tactic, since numbers of deaths appear (to them, anyway) less scary than numbers of people afflicted. Additionally, using mortality statistics alone permits construction of deceptive graphs aiming to show that vaccine introduction did not result in significant declines in disease mortality (it is much harder to jigger graphs to show a lack of decline in disease _incidence_)."

How about necrotizing fasciitis?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3211661/

And, other complications such as congenital varicella syndrome, hemorrhagic varicella, etc.?

http://emedicine.medscape.com/article/1131785-clinical

I love religious fanatics, I really do. Here, from the readily available CDC website, are mortality rates per 100,000 children ages 1 through 4 at 5-year intervals from 1900 through 1935:

1983.8; 1498.9; 1397.3; 924.2; 987.2; 641.0; 563.6; 440.9.

Now, was this trend, undeniable even to lilady, the result of the adoption of the MMR and *DPT* vaccines? No, because the first diptheria vaccine was (according to Wikipedia) manufactured in 1921, the first pertussis vaccine in 1926; the first polio vaccine and all the MMR vaccines were first marketed after 1950. Was it all due to the availability of advanced medical care for every childhood illness? Nope, modern antibiotics didn't even exist yet and the vast majority of kids with the now-vaccinated-against diseases were cared for at home. Some mortality benefit surely accrued from allopaths' ceasing to treat illnesses by feeding mercury compounds by the spoonful as had been a common practice in 19th-century conventional medicine.

One or two of you plainly don't have a clue that in 1900, huge numbers of Americans in rural areas and in the tenements of industrial cities lived in the kind of squalid poverty that you would acknowledge to exist in "developing" countries today. It simply can't be true that lack of sewage disposal, clean water, adequate nutrition or food safety, sanitary conditions for childbirth, etc. are bad for the health of the non-white Them of today, but weren't bad for your ancestors. Of course they were.

Pretending that the glories of Western medicine (in an era before antibiotics or randomized controlled trials) were responsible for all declines in mortality has a great risk of misleading us as to what developing countries with low life expectancies today most need. Is a country better off with one more doctor, or a thousand more sanitary village latrines? One shipment of foreign drugs, or a hundred wells? One fully stocked operating room in the big city to perform C-sections, or a training program to teach sanitation to 10,000 rural midwives? The foreign medicine that is by far most cost-effective is in fact vaccinations, and America has gone out of its way to hinder vaccination programs not just by the usual shut-up-and-obey arrogance, but by letting the world find out that that guy sticking a needle in their kid's arm might actually be a CIA operative.

It simply can’t be true that lack of sewage disposal, clean water, adequate nutrition or food safety, sanitary conditions for childbirth, etc. are bad for the health of the non-white Them of today, but weren’t bad for your ancestors. Of course they were.

Beg the question much, jane? Everything you wrote isn't evidence but mere speculation.

Jane,

You make a number of good points in your post at 2:29pm but I am not sure what your argument really is. You acknowledge that vaccines work. You acknowledge that medicine works. You add that hygiene, sewers and clean water work. I'd be shocked if anyone disagrees. You use loaded language like scientism and allopathy and emphasized in your first post that vaccines aren't tested on pregnant women, but to what end?

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

"Blah, blah, blah 'Now, was this trend, undeniable even to lilady, the result of the adoption of the MMR and *DPT* vaccines?', yadda, yadda, yadda.

Linky, linky, linky?

Is a country better off with one more doctor, or a thousand more sanitary village latrines? One shipment of foreign drugs, or a hundred wells? One fully stocked operating room in the big city to perform C-sections, or a training program to teach sanitation to 10,000 rural midwives?

We have to choose? Cannot we try all of the options?
What about a hundred doctors (not just a paltry one) AND a thousand latrines?
What about shipping drugs AND training the locals on how to administer them?

In the real world, we have the Red Cross (and all similar groups) for short-term relief, AND long-term programs from UNICEF and other humanitarian organisations, who do things like building wells, latrines, field hospitals, and training the locals...
Sometimes with mixed results, but that's another debate. Not really the fault of the locals, more an issue of conflicting priorities and limited resources. And politics getting involved (like your CIA stuff).

One or two of you [...] for the health of the non-white

Or in other words, two of us are racists. Name them.

Pretending that the glories of Western medicine (in an era before antibiotics or randomized controlled trials)

You forget anesthesia. And germ theory of disease, which was followed by the discovery of pasteurization and the need for washing hands (come on, bring forth Ignaz Semmelweis). And assisted ventilation (handy for people suffering from diseases affecting the lungs). And real schools for teaching medicine and surgery (post French revolution, we had a hiatus in France in teaching doctors - with disastrous results during the Napoleonic wars). And nurses with a real knowledge of medicine (before Florence Nightingale, hospital nurses in London were barely literate poor women offered the job of assisting sick people). All of these post-1830 and pre-1920.
There is more, but I'm just an amateur historian.

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

Canadians and fans of Heritage Minutes will also remember aviation pioneer and hero Wop May, who helped prevent a diphtheria epidemic in Little Red River, Alberta, in 1928.

A friend of mine was born in 1950. She was one of a set of triplets, but the other two didn't survive. Less than a year later, her three older brothers caught the 1951 pandemic influenza and died, all within weeks of each other. That's right -- her parents had to bury five children in the space of a year. In 1951. That was doubtless due to the poor sanitation and overcrowding they had in their spotlessly clean farm home.

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

More on this:

One fully stocked operating room in the big city to perform C-sections, or a training program to teach sanitation to 10,000 rural midwives

As I said before, we can have both, and we do.
A program I read about some years ago (sorry, no handy reference) was about mothers in central Africa who were victim of a nasty side effect of their pregnancy - as I remember it (not a doctor), their uterus and their urinary tract merged during the delivery.
Which results in them becoming pariahs of their societies, between not being able to be a mother anymore, and, to put it bluntly, the smell.
In our countries, thanks to our glorious Western medicine, putting back things in the correct places is just a matter of a surgical operation (well, for a given value of "just"). But over there, they don't have many surgeons trained in this operation, or the appropriate operating room. Not to mention the cultural taboos to overcome.
Hence this program. First propose these women the surgical operation (with the nice side effect of getting them together and out of their isolation). And then, hey, ladies, since you are all here with your life back in your hands, and we have a teacher in the next room, what about learning a new job?
I believe it was actually part of a HIV prevention program, these women were to become health councilors/teachers in STDs and spread some education back to their countries.
I should have keep tab on this program, I wonder how it panned out.

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

Heliantus - obstetric fistula is, indeed, a devastating condition. Tragically these girls and women rarely even get to be mothers to their babies, who usually die during birth.

If you go to the topdocumentaryfilms website and look for "A Walk to Beautiful" you can see a documentary about it. Also, the website rhrealitycheck has info on current efforts to prevent and treat OF. The Gates Foundation is doing a lot of that work.

Welcome to Just a Mom!

Jane, the munterwench - guess what? We're not all in America, all white, or all anything.

I'm working-class, and always will be. We're not going anywhere. However, immune-compromised people are at risk from VPDs, and you still haven't given your thoughts on that. Although, given your obvious ableism and Randroid tendencies, I suspect you don't give a fu<k.

Thanks elburto :-)

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

Please note also, I did say that chickenpox vaccine was probably worthwhile for the purpose of reducing discomfort. I have no problem with that; avoiding discomfort is a perfectly rational activity. I only object to its being marketed as “your kids can diieeee if they get chickenpox,” especially if no long-term provision is made to give free boosters in adulthood, when chickenpox IS dangerous, to vaccinated kids who grow up to be uninsured. I recognize that one of the tenets of scientism is that our available tech will just keep getting better forever, and there’s no use in my arguing over religion, but RIGHT NOW in the heartland of the American empire,...

See now, you made a good point about how some argue in favour of the varicella vaccine but then go off the rails. I tried to help you out but instead you double-down on the post-modernism, glibertarian (thanks Edith I love that term) wankery.

I also think that it’s poor practice to argue with emotional rhetoric about discomfort only when it suits one’s purposes. I’ve probably had more experience of diarrhea than most of you, and though it’s not pleasant, I don’t feel twaumatized for life by having had diarrhea (or chickenpox).

Yet here you are using emotional rhetoric with religious fervor and implying that YOUR personal experience should and does trump all others and even dictate public health policy. My personal experience with chicken pox sucked and my personal experience with diahhroeal diseases have been pretty awful too along with rotavirus that one of my children (unvaccinated for it) was something that he would rather have avoided too, even though he survived.

I don't expect others to use my experience to guide their decisions and I certainly don't expect public health agencies to dictate public health policy based on them. And I don't even agree with why the varicella vaccine was added to the schedule or rather why it was mandated for school entry.

Just a mom – You’re simply wrong about advanced allopathy being the only cause of declining mortality in the past 150 years. Public health had much more to do with it. Look it up. As for the values question, you just made my last point for me. If I had a kid, of course I wouldn’t WANT him to be bitten by a dog, break his arm, or (oh, the horror, the horror!) have to get stitches. But far more, I wouldn’t want him to never get to play with a dog ’cause he might get bit, never get to climb a tree or own a skateboard ’cause he might fall and break his arm, never learn to use a knife or a tool ’cause he might cut himself and need stitches. I’d want him to grow up to be a confident, functional human being who was not grossly unfit, possessed practical skills, and knew that he could get an owie without falling all to pieces and running first to the ER and then to his therapist to cry about it. This is a value held by many parents also. Try Googling “free range parenting.”

Not only a massive strawman and erroneous but clearly a bid for top place in the Mompetition. Public health or public sanitation Jane? You may want to make the distinction there since vaccination falls under the auspices of public health. Who said that wanting to prevent your child from being bitten by a dog equates to never allowing them around dogs along with the rest of your strawman comparisons. Does your "free-range" parenting include never instructing your child not to approach strange dogs? Does your "free range" parenting including giving your child a knife or a skateboard and letting them just have at it? Do I need to go on to demonstrate how utterly stupid your argument is?

I love religious fanatics, I really do. Here, from the readily available CDC website, are mortality rates per 100,000 children ages 1 through 4 at 5-year intervals from 1900 through 1935:

Yet here you are doing just that. Going back to your worship of sanitation, first (as others have pointed out) this is not mutually exclusive of other interventions like vaccines, medical care and measures to improve quality of life. We will never even come close to producing vaccines for all of the pathogens that we are exposed and potentially exposed to although that is also a common anti-vaccine trope. But that doesn't mean we can't reduce morbidity and mortality; it's not all or nothing.

Did you know that improvements in sanitation actually increased some disease prevalence? Polio and rubella are prime examples. What is your solution other than to keep a population living in squalid conditions?

Let's go back to the good point you made about chickenpox. Instead of going off the rails, why don't you try facts when you encounter over-stated claims? Or don't and continue to use goofy anti-vaxx, post-modernism terms to shoot yourself in the foot.

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

Iqbal:

Before embarking on one sided verbose discussion, it would have been in order for you to read a little on Professor Peter Aaby.

Perhaps you should have used the search box to see where we have already discussed Dr. Aaby's work. Even India does not have the same dire conditions as Guinea Bissau. Using his work to make judgements on the vaccine programs of the Americas and Europe is an apple versus tuna comparison.

I can't help but observe that child (age 1-4) mortality was appalling in 1900 at 1983.8 per 100,000, dreadful at 440.9 per 100,000 in 1930 and not too bad really at only 26.1 per 100,000 in 2009. In another 80 years hopefully people will think of current child mortality as being just as unacceptable as we now consider child mortality was in 1930 in the US (and still is in some developing countries, several of which I have spent time in BTW Jane).

Personally I think the 94% reduction in child mortality from 1930 to 2009, which has a great deal to do with vaccination is just as important as the 78% reduction from 1900 to 1930, even if it did have more to do with public health measures.

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

I recognize that one of the tenets of scientism is that our available tech will just keep getting better forever, and there’s no use in my arguing over religion

I know exactly where Jane is coming from. I too have noticed that when people disagree with me and ridicule my arguments, it is for religious rather than rational reasons.
It is just surprising how many adherents there are to the Church of Ridiculing HDB.

By herr doktor bimler (not verified) on 01 Sep 2012 #permalink

without falling all to pieces and running first to the ER and then to his therapist to cry about it

Ah, I see. Man up, you sissy.

I heard this one before. Doesn't work.

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

When Jane does get around to having children, I hope she remembers all this stiff-upper-lip talk and refuses the epidural.

jane:

If I had a kid,

I see. I love it when people who are not parents tell me how to treat my children. Especially the "helpful" advice I got around the time my oldest was being diagnosed and I was desperately looking for information on seizures and severe speech disorders. (Yes, the librarian was one of those who said "my uncle's third wife's second cousin had a kid who did not speak until age three/four/twenty and is just fine now. Ugh)

I guess I'll regard her opinions as seriously as I would any of "those helpful people." Which is a bit less than I regard those who use words like "allopathy" and "scientism."

Someone who makes it to 20 or 25 having never been sick or suffered any pain other than from needle sticks is likely to be, perhaps permanently, unsuited to a fair number of jobs and activities.

When your argument against a particular medical intervention is that "kids should suffer a bit because it's character-building and looks good on the CV", you know you're scraping the bottom of the Rationalisation Barrel.

Jane's central concern seems to be that the kids today are too soft, and it's the fault of today's over-involved Helicopter Parents who won't listen to Jane's advice. Also, in my day we didn't have padding under the playground equipment and when we fell off the jungle-gym and broke our arms, we just laughed about it.

By herr doktor bimler (not verified) on 01 Sep 2012 #permalink

The U.K. has only just started to recommend the flu jab being given to all kids, it was only to vulnerable groups before. The reason why they're doing it now is not solely because the flu is a risk to kids, but that they catch everything at school and then it spreads to everyone else, including both vulnerable groups and the work force in general. It seems to me some of these anti-vaccine types lack a social conscience and don't think of the effects of not vaccinating on others.

By kath withcats (not verified) on 01 Sep 2012 #permalink

isn’t there a certain legal appeal that needs to be addressed prior to 30 days after 4 weeks ago yesterday?

Yup. The order dismissing was signed on August 3, so he's got until Tuesday to file a notice of appeal with the Travis County district court. Why this triviality hasn't been dealt with already is anybody's guess.

If I had a kid....
If I had a pet unicorn I would know just how to take care of it but I don't.
And everyone can clear their bingo cards. Allopathy and scientism. Bingos for all
BTW scientists practice science, not scientism.

"If I had a kid"

The point of being a parent isn't to 'toughen up' your kid so they'll be 'suited' for job "X" or activity "Y".

It's to love, educate and protect them until they're old enough to protect and provide for themselves.

JFC that has to be one of the most moronic reasons to not vaccinate against vaccine preventable diseases.

Why don't you just sign your kid (if you had one) up for the Peace Corps when they're 6, so they can go work in India, Nigeria or the Sudan. That'll toughen the little guy up!

/facepalm

If I had a pet unicorn I would know just how to take care of it but I don’t.

No, Rose, if you don't have a pet unicorn then you are uniquely qualified to tell actual pet-unicorn owners how to feed them, and train them, and treat their ailments, and how their pampering is turning their unicorns into disrespectful hooligans, and how much better you could do the job than they are. That's the law!

By herr doktor bimler (not verified) on 01 Sep 2012 #permalink

Rose - I've crossed out my scientism, allopathy, iatrogenic death, and hygiene fallacy squares, but Sheeple! and the toxin gambit are not yet filled.

I hear tonight's prize is an MMS enema and some apricot shells. I'll never be ill again!

Yeah, before I had kids I thought it was a shame that the childhood ritual of illness like measles and mumps were gone, and all we had left was chicken pox. Then I had kids and dealt with illness, including a few that put one kid in the hospital (croup).

Then my kids got chicken pox. I never wish that on anyone. It does not toughen kids up, because they are too miserable. It also caused a month of not having a full night of sleep.

I have also realized that when I had mumps, chicken pox, influenza and dengue fever ... I don't remember much about them. Usually I ended up in bed with pain, and the rest was a blur. I mostly heard about it from my family members. Like the fact that my parents were really worried when I had influenza. My brother does like telling how much blood he had to clean from the car when I almost bled to death after a tonsillectomy. Again, I don't remember that because I was unconscious (I remember waking up in the hospital).

Re jane @ 1:42 pm (my emphasis)

If I had a kid

This may explain jane’s complete lack of sympathy for the suffering of others.

I’m also very amused that she followed up that statement by providing parenting advice.

I would like to thank Edith Prickly @ 1:56 pm (like ScienceMom, I love your word glibertarian; I may borrow it from you) and Rose @6:08 pm for their astute assessment of jane’s writings these past two days.

"If I had a kid"

I'd rather birth a baby goat, than a unicorn. That horn must be a b*tch to birth.

And everyone can clear their bingo cards. Allopathy and scientism. Bingos for all
BTW scientists practice science, not scientism.

Oh but it's advanced allopathy and we also have American Empire.

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

As I was sitting in the pediatrician's waiting room with my 15-year-old son waiting to be called in for his final HPV and seasonal flu shots, I was noting aloud to him a couple of chicken pox scars near his ear. He got the pox before he turned a year old. The shot was relatively new then so there were lots of kids around with the disease. Yes, he's a little annoyed that he got it while his sisters avoided it by getting the vaccine. He recovered fully, albeit with some scars, but he suffered for a week with a fever, even longer with the itching and the marks did not completely fade for about 5-6 months. It's definitely not a walk in the park.

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

I remember this quote on the intro page of a book about raising boys:

“Before I got married I had six theories about raising children; now, I have six children and no theories.”
― John Wilmot

That horn must be a b*tch to birth.

Exactly why Naomi Wildman was born by being beamed out on Star Trek Voyager.

and yes my DVR is recording BBCA now

:-p ... we don't get that channel. You should enjoy Dr. Who folks bowling.

gpmtrixie, I had thought my eighteen year old daughter was one of the youngest of her generation to have had chicken pox. Now that dubious "honor" goes to your son.

Jane, there's a particular claim you've made at least twice now that you're going to need to address. I have no illusions that you'll even acknowledge this, because you'd much rather talk about "scientism", play the victim game, and quietly ignore your fast and loose treatment of reality, but it's worth bringing it up anyway.

At least twice now you've implied that receiving the chickenpox vaccine would commit the vaccinated individual to relying upon multiple boosters later in life to maintain the immunity, implying that good old fashioned natural disease would provide permanent immunity in one go.

This matters to me because I've had childhood chickenpox. It wasn't too bad for me, I emerged relatively unscathed. I was not immunized against it because it wasn't available yet. And now I know that I get to look forward to the possibility of shingles later in life. BECAUSE THE IMMUNITY IS NOT PERMANENT. I will still be best served being "boosted" by a shingles vaccine later in life. From what I've read, the worst that can be said is that if I'd been vaccinated instead I'd still be at risk for shingles and would need the shingles vaccine anyway, but I'd be likely to get a less severe form of it.

So yes Jane, you are ignorant. I have no desire to call you a slut, but you're out of your league here. The best I have to say is that you're employment of argumentum ad apocalypse was very amusing. The whole "society will be ruined in the future and medical intervention X won't be available, so we might as well just give up now" thing. Perhaps diabetic kids should simply be allowed to die when they're young since they won't be able to acquire their much needed medical supplies in our inevitable dystopian future? Or does that argument only work if it''s being used to support other facts you pulled out of your own nether regions?

Ahem, my "non-kid" son contracted varicella when he was ~ 18-19 years old, just before the vaccine was licensed in the USA in 1995.

I called his pediatrician immediately and he was on acyclovir within two hours. His "roomie" at his group home, surprisingly, never contracted the disease and I cared for him 24/7 in the facility, sleeping on his play mat, in strict isolation in an unused playroom. Great stuff, that acyclovir, it prevented a lot of the poxes and they crusted over within four days.

@ Jane- I did look it up. A contractible disease is just that and 150 years ago or today, the outbreaks would be the same except for the use of vaccines. Advanced medical care has very much to do with the death rate. Prior to the use of vaccines, those who contracted measles, pertussis or polio were not living in 3rd world conditions, but quite modern. The only thing living conditions can be blamed on is the Plague. One seems to not realize why small children are so affected where as adults are not. Children do not have fully developed respiratory systems so no matter their living conditions or good or bad immunity, young children simply can not handle a respiratory illness. And young children are mainly those who spread the illnesses, since few at a young age cover their noses and mouths when then cough and sneeze or wash their hands.

Back in the 1050's parents were pleading with scientists to prevent their children from needlessly dying and physical maiming. They did not live in horrible conditions. Germs were spread and healthy children died. Don't want to vaccinate, who cares, but if one choose that they had better keep their germs to themselves since most childhood preventable disease are air-borne.

By Just a mom (not verified) on 01 Sep 2012 #permalink

Just a mom, did you mean to write "1950's" in the last paragraph? It was certainly true then regarding polio, which terrorized the population. I was among the first children vaccinated in the mid-1950s when the Salk vaccine became generally available. My mother was one of the RNs administering it. People were lined up outside the clinic awaiting their turn. I find it incomprehensible that today anyone questions polio vaccination, yet some do.

By Ivan Ilyich (not verified) on 01 Sep 2012 #permalink

lilady - you know who else Jane reminds me of? Whatsername, who insisted that vaccines were causing kids to have IDDM and asthma.

This was shown in her "Where were all these asthmatics when I was a kid? HUH?" rant, implying that coddling children made them ill.

She'd missed the point that dead children tend to not be around to be observed. I'm only 35 and had friends with dead or brain damaged siblings, and my mum witnessed the death of her best friend from an attack.

Add that to Jane's "free-range parenting" and Th*ngy's "Toddlers instinctively avoid germs" clanger, and we can see that these fools are a few adjuvants short of an inoculation.

So now in addition to ranting about "scientism" and "allopathy" and ignoring suffering and permanent complications from infectious disease in favor of mortality statistics alone, jane has descended further into woo tactics by labeling opponents as religious fanatics. It always puzzles me that woo-sters who commonly flaunt their own religious beliefs, think that calling their opponents religious is a devastating insult.

If having had mumps, measles, rubella and chickenpox in childhood is such a character-builder, I should be a tower of strength - though not quite as strong as my siblings, who also suffered through bouts of whooping cough.

I am sorry that today's kids don't get the chance to build fortitude by scratching itchy pustules, but even sorrier for parents like the mom who complained that because of vaccines, she has less chance to "bond" with her children during sickness.

We need some new diseases, really.

By Dangerous Bacon (not verified) on 01 Sep 2012 #permalink

D. Bacon -

"but even sorrier for parents like the mom who complained that because of vaccines, she has less chance to “bond” with her children during sickness"

Did someone actually say that?! Good God, how incredibly self-centered! When my son was sick with the chicken pox, I did spend a lot of time rocking him to try to soothe him, but it was heart-wrenching to see such an active baby laid low with illness. I know we'd both have been happier if he could have spent that time on the floor practicing sitting up instead of being itchy, feverish and miserable.

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

@ Ivan Ilyich- thanks for correcting that error. The darn 9 had to be next to that 0... I meant the 1950's. I find it incomprehensible as well.

By Just a mom (not verified) on 01 Sep 2012 #permalink

@Jane

predicted decline of our society

Lack of evidence for assertion. Check.
Typical anti-science use of "fall of man" idea. Check.

scientism and science-haters

Use of scientism. Check.
Use of false dichotomy. Check.

They are right on most facts, and only need to learn to stop hating most of their fellow Americans and rejecting inconvenient facts/research in order to be actually rational.

Assumption all scientists, commenters, etc are American. Check.
Calling out people for ignoring some sort of vague evidence without actually supplying it. Check.

The anti-science crowd not only has a Manichaean worldview, but believes a lot of things that just ain’t so, and trying to argue about both of those issues at once is just impossible.

But because of your dualistic worldview, I can’t try to make common ground by pointing out that we agree on most facts.

Use of sophistry. Check.

I am guessing that most preachers of scientism have never been to a part of the world where the infant mortality rate is still above 10%.

Etc etc more sophistry. Check.
Assuming that if one hasn't seen it, one can't understand it. Check.

My positions are clear: (1) It’s better to have low child mortality rates. (2) Several of the diseases that used to commonly occur in our population killed or disabled a relatively large number of children. (3) Vaccines for life-threatening illnesses reduce child mortality, and should be made freely available by the government. (4) The dramatic declines seen from 1900-1940 in child mortality were largely due to public health measures like cleaner water and better food and working and living conditions, not due to vaccines or to modern Western medical interventions. This in no way proves that the latter are not also beneficial.

Then why in the world are you here arguing with people?
Ah, the "I agree with you, but" tactic. Check.
And the "but it was the changes in hygiene" argument. Check.

Their little whimpers of pain are just music to my ears.

Reductio ad absurdum. Check.

Hmmm... let's count the tally. Turns out, I was right: scratch the surface and a whole lot of typical canards come flying out.

(Er, darn Edith got there first)

But because of your dualistic worldview....

Say, Jane, could you elaborate on what this is supposed to mean as a critique? Was it just a word choice to liven things up after already playing "Manichean"?

I know many have covered this but I thought it was worth posting anyway as I covered some of Jane's comments a little differently.

@Jane

actual mental illness

Ah yes, the "you're crazy" gambit. Otherwise known as the ad homenim. Check.

She used that as a reason to start ranting about fecally transmitted diseases, which I did not know chickenpox to be.

Completely missing the point and creating a strawman. Check.

To make up some arbitrary numbers just for the purposes of MATHEMATICAL explanation

Invention of statistics instead of citation of real ones. Check.
Ignorance of history. Check.

I only object to its being marketed as “your kids can diieeee if they get chickenpox,” especially if no long-term provision is made to give free boosters in adulthood, when chickenpox IS dangerous, to vaccinated kids who grow up to be uninsured.

Another assumption that your US standards of health care apply elsewhere. Or that such provisions don't exist in many places in the US. Or that policy on vaccines should be predicated on possible financial crises.

(PS. If all you're objecting to is the unfairness that vaccines cost money, maybe you'd have a legitimate point and many people agreeing with you. However you couple it with that "I'm not complaining but I am" attitude that comes from so many anti-vaxxers and yeah, you won't get much agreement)

I recognize that one of the tenets of scientism is that our available tech will just keep getting better forever, and there’s no use in my arguing over religion

Ah the religion gambit.... Check.
Strawman about tech getting better. Check.

but RIGHT NOW in the heartland of the American empire, children die from lack of basic dental work, and thousands of people line up when a free clinic is offered.

Then your problem is not with vaccines, but with the way in which health care is provided. They're not one and the same.
Conflation of separate issues. Check.

A responsive answer may include the words “Jane, you ignorant slut,” but must also include a rational argument referencing current economic and political conditions and known resource limitations.

Strawman. Again.
Request to supply data but provides none of her own. Check.

In fact, I would find it less unpleasant to have diarrhea every couple of years than be stuck with a needle two or three times for every single one of the endless viruses and bacteria that cause diarrhea

And another strawman. And seriously, you'd rather be constantly sick than put up with a couple of needles? I mean I hate needles, but I love them in comparison to whooping cough.

When you decree that any natural unpleasantness or suffering is unbearable, there are only financial limits on how many vaccines could be developed and promoted

Again, your issue is cost. Fine, cost/benefit analysis is good: but why are you just jumping to a conclusion about one side of the argument? (Check) You need to not just compare cost/benefit of the vaccines, but also compare *that* to cost/benefit of the illness and resulting treatment.
Typical lack of using all sides of the equation. Check.

And then there is the question of, if children could actually be sheltered from any risk or discomfort, how would they turn out as adults?

Healthy?
"Won't someone think of the children" gambit. Check.

Someone who makes it to 20 or 25 having never been sick or suffered any pain other than from needle sticks is likely to be, perhaps permanently, unsuited to a fair number of jobs and activities.

Er, yeah. FSM forbid that someone is capable of using their lungs when at work. (Whooping cough) Or simply being unable to go to work because you're contagious. Or take on a labour-intensive job where you actually need to be able to stand up without retching for five minutes. Those jobs?

Oh, let's not forget the retail jobs, where having an employee cough every two seconds at the checkout does wonders for customer interest in your store.

Yep, a needle in the arm is just *so* coddling the average person.

allopathy

Yep, that one's a check.

But far more, I wouldn’t want him to never get to play.. [etc]

Strawman. Again.
And false dichotomy again.

I’d want him to grow up to be a confident, functional human being who was not grossly unfit, possessed practical skills, and knew that he could get an owie without falling all to pieces and running first to the ER and then to his therapist to cry about it. This is a value held by many parents also. Try Googling “free range parenting.”

Oh seriously. And if he dies from a childhood disease? Oh right, you haven't looked at history have you?

I love religious fanatics, I really do.

Oh, you mean the ones that ask for evidence before believing what you assert? Yeah, I love them too. (Check)

As for the rest of that comment, instead of linking to CDC numbers what would really support your assertion of hygiene helping and not vaccines.... studies showing causation. You know, instead of just asserting causation and hoping nobody'd notice you haven't supported it in any way.

feeding mercury compounds

Ding ding ding. We have the anti-vaxxer code-word.

Can we call bingo yet? No, let's continue...

One or two of you plainly don’t have a clue that in 1900, huge numbers of Americans in rural areas and in the tenements of industrial cities lived in the kind of squalid poverty that you would acknowledge to exist in “developing” countries today. It simply can’t be true that lack of sewage disposal, clean water, adequate nutrition or food safety, sanitary conditions for childbirth, etc. are bad for the health of the non-white Them of today, but weren’t bad for your ancestors. Of course they were.

Yeah, I think you've hit another strawman. I think Burning Man statues have been made smaller than yours.
Add in a little hint to racism and we have another 'check'.

Pretending that the glories of Western medicine

Thinking 'Eastern' vs 'Western' medicine is somehow a valid point. Check.

Is a country better off with one more doctor, or a thousand more sanitary village latrines? One shipment of foreign drugs, or a hundred wells? One fully stocked operating room in the big city to perform C-sections, or a training program to teach sanitation to 10,000 rural midwives? The foreign medicine that is by far most cost-effective is in fact vaccinations, and America has gone out of its way to hinder vaccination programs not just by the usual shut-up-and-obey arrogance, but by letting the world find out that that guy sticking a needle in their kid’s arm might actually be a CIA operative.

Let's see: strawmen galore, false dichotomies galore, a confusion (are you for or against vaccines?), and oh, one very large government conspiracy.

You're doing great! A few more of these and we could fill a bingo hall full of cards. And it's nice to know you're for vaccines: except when you're not.

I think perhaps I need to submit myself for the JREF Challenge. Apparently I'm psychic.

Slightly off/on topic:
Recently drove past a sign advertising a local university. They were hinting at their science courses by stating that they were vaccinating mosquitoes to prevent (I forget what) in third world countries.

Re: the oregano... one wonders if any illness would exist at all if we all just ate lots of heavily spiced Italian food.

@Rose

And everyone can clear their bingo cards. Allopathy and scientism. Bingos for all

See my above comment.

@Heliantus

Ah, I see. Man up, you sissy.

I heard this one before. Doesn’t work.

Of course it does - you're just doing it wrong, that's all. ;)

@Elburto

and the toxin gambit are not yet filled.

Incorrect: she mentioned mercury. That's good enough for me.

Jane's lofty ignorance sure rankles with me. We had an adult friend suffering leukaemia die from complications he suffered after catching chickenpox, and because to my regret, we hadn't vaccinated our own kids against it, (it's not on the schedule here) we exposed their 4 year old cousin who was undergoing chemotherapy, also for leukaemia. Luckily he didn't catch it - and we learned from the experience. Nowadays I do my best to raise awareness. Someone like Jane could merrily entertain chickenpox in their own child (when they get it in their mouths and genitals it's especially fun), blissfully, selfishly, unaware that the virus had been passed to a susceptible child with a compromised immune system.

By nz sceptic (not verified) on 01 Sep 2012 #permalink

One shipment of foreign drugs, or a hundred wells?

I recall that the option of drilling 100 wells has already been considered: Not a good idea in arsenic-rich geology.

By herr doktor bimler (not verified) on 02 Sep 2012 #permalink

It's early Sunday morning, and I have some time to deal with jane.

1. Don't you DARE bring Free-Range Kids into this conversation the way you did. FRK is very PRO-vaccine; the movement is towards letting your child grow and make mistakes on their own. Also, getting a vaccine and being able to be out and about, playing on their own, is what FRK is all about. NOT being stuck in bed sick, cared for by mommy and daddy.

2. Re: the "squalor" of the 1900's - jane, go research the history of public health nursing, and the Henry Street Nurses, then come back and talk about it. Sure, people lived in lousy conditions - people still do, today, thank you very much. And a lot more people DIED in those conditions than do today, because of the lack of modern medicine and vaccines. Do you really think for one moment that if you had the same conditions, and added the protective vaccines, fewer people - especially children - wouldn't have died? Clean water, modern plumbing (which isn't so modern, btw), good diet help prevent transmissions/deaths from oral-fecal diseases. They don't help against the air-bourne ones. (and gee, MOST vaccines are against the air-bourne ones - the ones that FRK are more likely to get because they aren't kept at home in a protective sterile bubble).

Maybe YOU don't find diarrheal illnesses to be an issue. I recently had a bout with one (probably not rotavirus but I'm not sure). I ended up napping on the bathroom floor, because I was too afraid to walk too far from the toilet, I was curled up, crying in pain from the cramping, taking some left-over narcotics hoping they would help the pain and stop the diarrhea (opioids are constipating). I was vomiting, so I had trouble keeping myself hydrated. I can't imagine not wanting to help a baby avoid going through that by a simple oral vaccine.

I still have scars from chicken pox. My mother was stuck in the house for almost a month as first I had it, then my brother, then my baby sister (who, as she had a light case then, thanks to left-over maternal antibodies) got it very severely at 15 and nearly ended up hospitalized). She would have leapt at a vaccine to prevent us from having that misery.

I had the measles, I've had the MMR twice. I'm a non-responder to measles and don't develop antibodies. At 50+, I really don't want to catch measles again, so hope where I live the herd immunity stays high. But you don't care about people like me, obviously, since I probably wouldn't DIE of them. I might be miserable, and, since I live alone, might find it very hard to keep myself fed and hydrated. I might end up in the hospital for care. But I have insurance, so that's not important, right? Just the financial stress of lost work days pay, the deductible and co-insurance for any hospital stay, the risk of other financial issues. Those don't count in your world, obviously, since I probably won't die, the only metric YOU are interested in.

Ugh. Making myself really cranky. Time to go get some coffee, clean up the place and enjoy the rest of the long weekend.

Flip seems to have a full card bingo.
As for recent cases of chickenpox, my grandchildren who were two and three at the time had chickenpox between their two immunizations, thanks to poor herd immunity..That was about 2 years ago. The cases were fairly mild but being cooped up at home was no fun for my daughter and even with a mild case the kids were miserable.
The pediatrician called everyone in to see them because nobody there had seen a case of chickenpox before.
This may seem trivial, but what if my grandson's friend who has leukemia had caught the chickenpox? (She had chemo and so far so good)

@MI Dawn

(I'm sorry, I'm really really sorry, but I have to do this)

Is Air-Bourne the next movie/book in the series?

In all fairness to Jane:

Water and sewage treatment have dramatically reduced the incidence of some diseases. So have the expanded use of soap, food inspection, pasteurization, window screens, and the change from horses and oxen to motor vehicles. I don't believe anyone argues otherwise.

I also believe people can reasonably differ about whether the benefit of reducing the chance of getting a particular disease and possibly helping spread it to people with compromised immune systems is worth the cost of the vaccine.

I don't buy the "being sick builds character" argument,

By Mephistopheles… (not verified) on 02 Sep 2012 #permalink

@MOB

I don't think anyone is disagreeing with Jane on the issue of improved sanitation. Where the disagreement lies is that it's a strawman to say that people discount it completely.

And I also pointed out in one of my long-long comments that if she'd stuck with the more reasonable stance of arguing cost/benefit, she'd have much more of a leg to stand on.

Here's a concise summary of the effects of improvements in public health and medicine, including vaccination, in the US between 1900 and 1999 that I found interesting. BTW, I have been watching the BBC America series 'Copper', which is set in New York in 1864, at the end of the Civil War. Those who like that sort of thing will probably like it a lot, it reminds me of 'Deadwood' (without the swearing, unfortunately). The conditions back then in terms of hygiene, sewerage etc., assuming BBCA have done their research properly, seem to have been considerably better than the conditions I saw in parts of Egypt and India 20 years ago.

By Krebiozen (not verified) on 02 Sep 2012 #permalink

M O'B, cost/benefit? I don't agree that there is any reasonable difference here. The cost of vaccination is a pittance compared to the cost of treating disease. And as someone with a compromised immune system, I object to allowing children to avoid vaccination for anything other than bona fide medical reasons.

By Ivan Ilyich (not verified) on 02 Sep 2012 #permalink

flip:

Recently drove past a sign advertising a local university. They were hinting at their science courses by stating that they were vaccinating mosquitoes to prevent (I forget what) in third world countries.

Sounds like the research being done at the University of Melbourne. I usually notice news about dengue fever. If you look at one of my comments above, you will see I can personally vouch for the accuracy of its nickname: bone break fever.

The "lovely" thing about dengue fever is there really is no natural immunity due to its multiple strains. And if you get it again, you have a very high chance of internal bleeding and death (dengue hemorrhagic fever).

Ivan ilyich - To clarify, cost has more than a monetary aspect in this case. When someone takes a vaccine, they take a personal risk of some adverse effect, and that is included in the cost calculation. For all vaccines on the current childhood schedule, this risk is extremely small, particularly compared to the the risk of adverse effects from not taking the vaccine. However, the cost/benefit (or risk/benefit, if you prefer) ratio is not the same for all vaccines.

As an extreme example, there is a plague vaccine. As it happens, I have had the plague vaccine because of a trip I took some years ago. However, I wouldn't encourage its use in many parts of the world because the risk of getting plague is vanishingly small in those areas - so much so that side effects that happen in .00001% of vaccinations would be more common than the disease that's being prevented.

I believe it's reasonable to make this assessment on a disease by disease (and vaccine by vaccine) basis. The case for diseases like polio, diphtheria, mumps, rubella, pertussis, and measles is clear, at least in my view (not an exhaustive list). There are other diseases where the case may not be so clear.

By Mephistopheles… (not verified) on 02 Sep 2012 #permalink

About the statement that the 2-shot series of varicella vaccine does NOT confer lifelong immunity...that is being monitored closely. No one has any secret knowledge about the vaccine's ability to confer lifelong immunity...or not.

I had a friendly discussion with another member of the science community on another science blog. We provided each other with published research...which is after all...one of the purposes of science blogs.

You would have to know the length of time it took to study other similarly manufactured vaccines, such as rubella, to determine whether or not a vaccine against a virus confers, lifelong immunity.

You would have to determine when the point arrived that there was universal acceptance of a vaccine, uniform reporting requirements of individual cases/outbreaks and breakthroughs of a disease in a fully immunized population and the history of enhanced surveillance, since a vaccine was placed on the Recommended Childhood Vaccine Schedule.

We fully discussed the theory that constant "boosting" of immunity after a person, by exposure to others with the disease, is responsible for the "seemingly" lifelong immunity that the wild-type disease infection confers.

The rubella vaccine first became widely available in the USA in 1970 and was immediately accepted by the general public. Babies who received that vaccine are at least 40 years old and few of them had exposure to the natural disease...most haven't. Pre-employment testing of doctors, nurses, allied medical professionals and ancillary staff (clerical, housekeeping) is a requirement for employment in every hospital, every nursing and group home, every clinic, etc. and shows lifelong immunity conferred by the rubella vaccine...without any constant "boosting" by exposure to the virus.

http://www.chop.edu/service/parents-possessing-accessing-communicating-…

"Natural immunity

Q. I would rather my child develop natural immunity to chickenpox, so that he is at less risk of developing chickenpox as an adult.

A. The good news is that regardless of whether we become immune to chickenpox from getting a vaccine or having the disease, our immune memory will protect us as adults. While there used to be a concern that the chickenpox vaccine would not provide lifelong immunity, data has not supported this concern. Immunity lasts at least 20 years and based on experience with the rubella vaccine, which is made the same way, is expected to be lifelong. Because the chickenpox vaccine affords immunity without the possibility of complications typically associated with natural infection, the vaccine offers immunity without the risk of disease."

Is the debate over? No, but "experts" are making some early assumptions, about the varicella vaccine's immunity. So for a layperson, like Jane to make this statement in an earlier rant and then to repeatedly make that statement, with increasing vehemence in more rants, is just ludicrous:

"Thus, chickenpox vaccine generally serves only to reduce net discomfort. I think it is probably a fair deal for that purpose, though I don’t think it should be mandated. Since adults are much more likely to suffer serious illness (thus the lengthy illness suffered by one commenter’s co-worker is not representative) and the vaccine doesn’t last, vaccination creates a “need” for a lifetime of follow-up injections that may not be obtained or perhaps even obtainable by many future adults. How these short-term benefits and long-term risks are balanced requires both value judgements and some guesses about our children’s economic future, and I certainly wouldn’t have the arrogance to suggest that MY values and guesses should be accepted by the entire population."

@ Herr doctor bimler.

I recall that the option of drilling 100 wells has already been considered: Not a good idea in arsenic-rich geology.

OT, but oh yes, there is this too. I remember a National Geographic magazine with a picture of the arsenic-burned hands of an African villager. It gave me a better view on how privileged we are in our developed countries to have tap water: clean, safe water at will.

To be fair, there are also perfectly justified projects to upgrade wells: bringing in the materials and a skilled team to add a masonry wall around an existing well (which was just a hole in the ground) does wonders to reduce drinking water contamination. With a wall surrounding the well, surface waters (like rain) don't wash up directly into the well.

@ Mephistopheles O'Brien

Water and sewage treatment have dramatically reduced the incidence of some diseases. So have the expanded use of soap, food inspection, pasteurization, window screens, and the change from horses and oxen to motor vehicles.

Speaking for myself, I agree on this but I have troubles with considering improvements in sanitation or food safety as separate from improvements in medicine.
I think I consider all of them advancement of medical science. Or maybe I should say derived from health sciences.
I'm not saying I'm right, rather that it seems to be a bias I have.
Or maybe it's just a reaction to the alt-meds poo-pooing some of our modern technology like vaccines while completely accepting other technologies without question. Or berating us for not living "the natural way" while cooking their food, wearing clothes and using a computer.

To give a dramatic example on the impact of improved sanitation in the 1900's time: tuberculosis. Having milk pasteurized cut one of the ways of transmission of this illness, from cow to human, via contaminated milk.

@ lilady

We fully discussed the theory that constant “boosting” of immunity after a person, by exposure to others with the disease, is responsible for the “seemingly” lifelong immunity that the wild-type disease infection confers.

I like to throw this debate in the wheels of anyone arguing that natural infection is lifelong, but I have to admit I approach this topic as an amateur - or more bluntly, I could do with some reading to strengthen my position. Would you have some article to recommend?

By Heliantus (not verified) on 02 Sep 2012 #permalink

Relevant news - the pertussis situation in the UK is now so critical, that the Joint Committee on Vaccination and Immunisation at the Department of Health are now seriously debating the vaccination of newborns.

I could cry, and rip apart with my bare hands, every selfish, free-riding, science-denying lackwit that has contributed to this situation.

Of course you know, you just know, that those same Muppets will be out screaming about "EBIL BIG PHARMA!!!11eleventy" if one of the infants has an adverse reaction. Either way, they win.

Just thought some of you may be interested in how it's going here, in Wakefield's wake. Curse his existence.

Last season's flu shot will probably be my last. My reaction was just enough to scare even me, an asthmatic who strongly believes in vaccination. I will rely on herd immunity and hand washing and wish that those who can get jabbed will.

@flip: OK. My bad. Air-bourne or airborne or whatever - it's bad anyway you look at it (so is the "miracle cure of the same name). And without my coffee, as that comment was, my spelling is worse than otherwise...

@elburto: that is HORRIBLE! If I had a newborn, not only would I get them vaccinated, I wouldn't let anyone NEAR my baby without proof of recent vaccine and clean bill of health. No vaccine, grandma? Sorry, you can't come in. Period. (yeah, I'm a very mean, protective mom when it comes to illnesses that can be prevented.) If you can't be vaccinated due to your own health issues, you're either not coming over until the baby has had enough immunizations to protect him/her, (I'll gladly skype, send pictures, video chat) or you are wearing a mask the entire time you are in my house. (And yes, I actually made my family do that when my children were babies if they came over and were ill.)

Rose,

Last season’s flu shot will probably be my last.

Just to balance your comment, lest it discourage others, I didn't even feel the flu shot last year, and had no reaction at all, not even a sore arm. If I hadn't watched the needle going in I might have thought the nurse was just pretending.

By Krebiozen (not verified) on 02 Sep 2012 #permalink

And yes, I actually made my family do that when my children were babies if they came over and were ill.

Is that actually effective? I seem to recall that masks mainly protect the wearer.

@Krebiozen
I know severe reactions are rare and I have had a flu shot every year with no trouble but last year was bad.

Narad @4:17 pm - Actually, you’ve got it backwards. The masks protect everyone else by making you keep your droplets of germs to yourself. That’s why surgeons wear them in the OR, and why my kid was supposed to wear one at the pediatrician’s office during the H1N1 outbreak (yeah, you try getting a 3.5-yo to wear a mask – even if it does have Mickey Mouse and Donald Duck on it).

@Chris

Dengue fever: that's the one.

I think it's probably a very interesting idea and one I intend to look up when I have more time. I'm curious as to how they know which ones they have vaccinated and which ones they haven't. Thanks for posting the link.

@MI Dawn

It's ok, I was only joking. It was just the first thing that popped into my head when I saw the spelling
:)

Actually, you’ve got it backwards. The masks protect everyone else by making you keep your droplets of germs to yourself.

No, I understand the idea, but the question is how effective they are. If you sneeze, there are two possibilities: you need a new mask, or you create a turbulent flow that vents around the borders of the mask and disperses. On the other hand, a mask certainly offers protection to the wearer by filtering the air supply almost directly at the point of inhalation.

@ Heliantus: I was offline for several hours...visiting my "other son" at his group home.

You asked about some further studies about effectiveness (the ability of a a vaccine regimen to prevent varicella disease in a completely immunized population).

The varicella vaccine was first licensed in the USA 1995, with recommendations for 1 dose. Varicella vaccine was licensed in Japan and Korea ~ 10 priors to that. The 2-dose recommendation was made by the ACIP and the CDC in 2006.

Here is a rather old (2007), MMWR article that describes post licensing studies for a 1-dose and 2-dose varicella vaccine regimen:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5604a1.htm

Scroll down to see results of the post licensing studies, under

"Postlicensure Efficacy and Effectiveness" and,

"Two Dose Regimen"

Here's a newer (2010) report from the Public Health Agency of Canada, which also compares the efficacy and effectiveness of a 1-dose varicella vaccine regimen-versus-a 2-dose varicella vaccine regimen.

http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/10vol36/acs-8/index-eng.p…

I'll look for more recent American post-licensing studies and I'll try to locate recent MMWR varicella outbreak reports for details of the effectiveness of 2-doses of varicella vaccine.

Rose,
No criticism implied - I'm very happy to pay for my shot to protect those like you who react badly or can't get the shot for whatever reason. I consider it my social duty.

By Krebiozen (not verified) on 02 Sep 2012 #permalink

The idea that having chicken pox as a child confers life-long immunity is about as wrong as it is possible to be and still get away with the telling. Of course the facts are a little more complicated, in the sense that the virus remains in the body but is usually kept in check until later in life, at which time it directly irritates the pain nerves, creates a rash with little blobs containing active virus, and often enough makes the victim absolutely miserable. It's obviously different from the original disease, but it can be even more damaging, since it is working directly on nerves and can leave them damaged. For this reason, people who have had chicken pox are strongly advised to get the shingles vaccine, which is designed to boost the body's immune responsiveness to that same virus that you were exposed to half a century ago. In other words, you should be getting the vaccine (one form or the other) at some point in life, but the option involves having the original disease, the original disease plus the shingles, or neither.

As to needle phobia, I don't think we should be entirely insensitive to this, especially in the older population. At one time, hypodermic needles were reused repeatedly; if your doctor was competent, they were cleaned and autoclaved; if not, you could get hepatitis from a previous patient.

Nowadays (and for quite a few years now), needles and syringes are one-use disposables. What this means for the patient is that we get a shot using a thinner needle with a very sharp end, so pain is minimized. I've had quite a few shots in recent years, and I honestly cannot remember feeling pain from the actual needle insertion, at least enough to be bothersome. This is a lot different from getting a penicillin shot as a kid, delivered through a needle that may have been used dozens of times. Might as well have had a roofing nail hammered in. I once mentioned this to a doctor who was a research collaborator. He stared at the ceiling for a moment and reminisced that when he started as an intern, he was provided 3 needles. I think that there were procedures for resharpening needles and that the intern was responsible for maintaining the needles, but this is in the way of urban myth for me. I suspect that every nurse and physician who was trained in the post-AIDS era missed out on these experiences due to the rapid introduction and enforcement of what they called Universal Precautions at the time.

Our health department gives flu shots for free. There are no income requirements. Just show up and get a shot.

Our health department gives flu shots for free.

Unfortunately since I am in the UK and don't fall into one of the high risk categories that get free flu shots, I had to pay for £20 for mine last year. Since I recently scared my GP by having a rather impressive asthma attack in his office despite not being asthmatic (it seems I have developed salicylate sensitivity), I may be able to blag a free shot this year.

By Krebiozen (not verified) on 02 Sep 2012 #permalink

Bob G:

As to needle phobia, I don’t think we should be entirely insensitive to this, especially in the older population.

And then there is this bizarre suggestion from a comment on Alan Cassels' article:

Why must all children repeatedly receive the full booster regimen when a simple titer test can easily demonstrate immunity? The majority of children gain immunity without the full booster schedule. If the child already had adequate titers, further boosters provide no benefit yet they still entail risk as an invasive medical procedure.

So the needle of a vaccine is bad, but the larger gauge needle to draw blood is better? How is that less invasive?

@ Bob G. Of course, the issue of lifelong immunity against chicken pox is somewhat more complicated. Immunity derived from having had a case of chicken (wild strain) or derived the varicella vaccine will still leave a person prone to shingles (known as herpes zoster)...due to the latency phase of chicken pox.

A vaccine (Herpes Zoster) has been developed and recommended by the ACIP and the CDC for older people, to prevent reactivation of the herpes zoster virus in the form of "shingles".

Here's the clinical trial results of the Herpes Zoster vaccine:

http://www.cdc.gov/vaccines/vpd-vac/shingles/hcp-vaccination.htm

Vaccine Efficacy

In a clinical trial involving more than 38,000 adults 60 years of age or older, the vaccine reduced the overall incidence of shingles by 51% and the incidence of PHN by 67%. The efficacy of the vaccine in preventing shingles was higher in the younger age group (60-69 years; vaccine efficacy was 64%) than in the older age group (older than 70 years; vaccine efficacy was 38%).

Studies are ongoing to assess the duration of protection from one dose of zoster vaccine and the need, if any, for booster doses.

There are no comprehensive data on the effectiveness of zoster vaccine in treating shingles once it occurs, and the vaccine is not licensed for this indication.

That first paragraph didn't even make sense to me...let me try again:

Of course, the issue of lifelong immunity against chicken pox is somewhat more complicated. Immunity derived from having had a case of chicken pox (wild strain) or immunity derived from the varicella vaccine will still leave a person prone to shingles (known as herpes zoster)…due to the latency phase of chicken pox.

(I miss the old platform...where I could edit my comments before submitting a comment)

Krebiozen - that salicylate sensitivity just saved you twenty quid! I think Tesco and Asda are planning some flu season stuff too. I need the jab, but I'm allergic to the culture medium.

I'm asthmatic and salicylates are my absolute worst trigger. I was once given Feldene gel for a knee injury, and ended up with green knees and hands (it stains) and a blue face! (a fashion faux pas) I can't take the necessary drug for my IBD either, as it's got a salicylate base. They're everywhere.

MI Dawn - I believe July had half as many cases as the first six months combined. Mumps has quadrupled in my part of the country, and tripled everywhere. else. Measles is raging. I'm so angry that one stupid man has sparked a public health crisis. Thanks to socialised medicine parents won't have to pay for their kids' treatments if they become ill, but we've had deaths from pertussis, babies too young to be vaccinated.

And yeah, I'd vaccinate any theoretical baby of mine too.

I located a 2011 case control study of 71 cases of chicken pox, in children four years of age and older diagnosed 2006-2010, which analyzed immune status of the cases...comparing 1-dose versus 2-doses of the varicella vaccine administered

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071110/

Abstract

Background. Because of ongoing outbreaks of varicella, a second dose of varicella vaccine was added to the routine immunization schedule for children in June 2006 by the Centers for Disease Control and Prevention.

Methods. We assessed the effectiveness of 2 doses of varicella vaccine in a case-control study by identifying children ≥4 years of age with varicella confirmed by polymerase chain reaction assay and up to 2 controls matched by age and pediatric practice. Effectiveness was calculated using exact conditional logistic regression.

Results. From July 2006 to January 2010, of the 71 case subjects and 140 matched controls enrolled, no cases (0%) vs 22 controls (15.7%) had received 2 doses of varicella vaccine, 66 cases (93.0%) vs 117 controls (83.6%) had received 1 dose, and 5 cases (7.0%) vs 1 control (0.7%) did not receive varicella vaccine (P < .001). The effectiveness of 2 doses of the vaccine was 98.3% (95% confidence level [CI]: 83.5%–100%; P < .001). The matched odds ratio for 2 doses vs 1 dose of the vaccine was 0.053 (95% CI: 0.002–0.320; P < .001).

Conclusion. The effectiveness of 2 doses of varicella vaccine in the first 2.5 years after recommendation of a routine second dose of the vaccine for children is excellent. Odds of developing varicella were 95% lower for children who received 2 doses compared with 1 dose of varicella vaccine.

The full article is available by clicking my link. Note the USA was the first country to put varicella vaccine (1 dose) on the Recommended Vaccine Schedule and the first country to add the 2nd dose to that schedule. According to this article, no other country had, as yet (2011), added the 2nd dose to their Recommended Childhood Vaccines Schedule.

Enough about the stupid chickenpox. It's not even worth agonizing about. Of course it's not a life-threatening disease and shouldn't be a mandated shot. Yes, and they did go all hysterical about it a few years back blabbing on about the possibility of flesh eating disease and such. My kids both had it, swam in toxic lakes and were just fine- don't do anti-bactial soaps, those are a problem. Why isn't "Science"blogs tackling the new Trinity College Dublin/Pittsburgh School of Medicine study (AGP) that basically says autism is not genetically caused? Oh I'm sure you'll find some rationale for the Anney study to be fifty shades of hogwash while all the other studies that say there are so many genes involved in autism, dandy. So predictable you people.

Oh, Jen, we really didn't your carrying on. But, anyway, how about a full citation from the study you want us to look at? Journal, date, etc? Somehow, I really doubt the study says what you are saying it does...and I also think that if it DID say what you are saying it does, you would have given the full citation...

And, tell my patient who lost her baby at term from congenital chicken pox that it's not a life-threatening disease, you heartless woman.

@jen

The CDC would beg to differ with you about chickenpox not being life threatening. Just up today, the impact of varicella vaccine, noting >95% reduction in mortality.

Individual Common Variants Exert Weak Effect on the Risk for Autism Spectrum Disorderspi, Human Molecular Genetics, 2012 doi:10.1093/hmm/dds301. HMG Advance Access published July 26, 2012. R. Anney et al.
MI Dawn, now your going all "Chris" on me- a disaster at every corner, every second of the day.

@ Jen

now your going all “Chris” on me- a disaster at every corner, every second of the day.

Well, it's reality-based: during the time I used to write this answer, 3 people died on earth, and 4 more were born.
So yes, maybe not every second, but quite often, you have disasters every day at every corner.
Unless you don't count an human death as a disaster.

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

Jen:

Enough about the stupid chickenpox. It’s not even worth agonizing about. Of course it’s not a life-threatening disease and shouldn’t be a mandated shot.

And if you have read the comments about the effects of chicken pox, you are a disgusting human being. And it is not "mandated", it is just required to attend public school and some private schools. All the more reason why we should not let you tell us what to discuss.

Jen, I noticed that you did not really read that paper because it does not say what you think it says. Which is probably why you did not include the link to the full paper (which I did), and just cut and pasted from some anti-vaccine website.

At this point I would never think all of the genetic variations that cause neurological issues, especially with all type of autism, would be found. If we went by "Jen logic" my son would not have HCM because they did not find one of eighteen known genetic sequences known to cause it.

I see that Autism Speaks provided lots of the paper's funding. This is why I anyone who wishes to do the "vax/unvax" mythical ethics study should write a grant to them (after getting the study design past an IRB).

@Jen: I worked as a OB nurse for 15 years, as a midwife for 5. Yes, I saw a hell of a lot of disasters. The preventable ones are the ones that really make me mad. The non-preventable ones just make me really sad - but those are the luck of the draw. Having a newborn die of congenital chicken pox was not the luck of the draw for my patient. We actually had 2 patients with chicken pox that year - the one who lost her baby and the other who spend 2 weeks in the ICU but was lucky enough to not have her baby die or get congenital chicken pox (yay for acyclovir!)

doi:10.1093/hmm/dds301

Wrong DOI. Anyway, the notion that the conclusion here is that "autism is not genetically caused" suggests that you somehow failed to actually read the paper, which is looking only at common SNPs. Shall we skip to the end?

Thus, while the existence of common variants affecting the risk of ASD is almost assured, their individual effects are modest and their collective effects could be smaller than that for rare variation.

Dandy work, Jen. What do you do for an encore, slip on a banana peel?

Narad, she was relying on the word of webpage where she read about. Probably someone who does not have the requisite education to understand it. Here is the html version of the paper.

And it includes something I mentioned:

Given these challenges, it is reasonable to conjecture that even if all of the samples analysed here were also sequenced at the whole genome level, it would still be impossible to discern how much risk accrues from common versus rare variation, at least from current knowledge. Thus a precise estimate of the relative contribution of rare and common variation to risk will require further studies.

In other words, they are just scratching the surface, and more work needs to be done.

All this talk of chicken pox not being a real problem leads me to think about a doctor working at a refugee camp. She sees a patient with severe diarrhea. It turns out to be dysentery, and she says, "Thank God!!" Why? because she was very worried it was cholera (quite contagious, over 50% mortality if untreated, and the doctor doesn't have the supplies to treat very many people). Compared to that, dysentery (mortality rate up to 15%) seems like downright good news. It is not good news in itself of course -- better no diseases at all!

In the same way, in the past, people would get chicken pox and just sigh and say "at least it's not polio". Having really worrisome diseases to think about fosters a blase attitude. But it makes no sense to have that attitude carry over to the present. Now that we're not being given a false sense of perspective by looking at all the worse things it is not, chicken pox can be evaluated on its own terms, and it does not look good at all. I wouldn't want to go back to the old way of thinking, for sure.

You hear a lot about people 60+,but do they suggest shingles vaccines for younger adults who are immune compromised?I suppose they do,but you don't hear much about it.I had shingles,not once,but twice in my thirties.

By Roger Kulp (not verified) on 03 Sep 2012 #permalink

Tsk, tsk, MI Dawn - caring about unnecessary death of babies... you'll never get the admiration of antivaxxers that way.

Quite a discussion here

Children with neurologic disorders at high risk of death from flu.

I was surprised you hadn't blogged on this yet.

By Roger Kulp (not verified) on 03 Sep 2012 #permalink

@ Roger Kulp: Shingles (herpes zoster) vaccine information and recommendations are covered in the CDC Pink Book, under "varicella". Scroll down the link to see topics, including vaccination for younger individuals who have chronic diseases and who are taking immune-suppressing drugs.

http://www.cdc.gov/vaccines/pubs/pinkbook/varicella.html

Enough about the stupid chickenpox. It’s not even worth agonizing about. Of course it’s not a life-threatening disease and shouldn’t be a mandated shot.

Why do you hate children so much, Jen?

Individual Common Variants Exert Weak Effect on the Risk for Autism Spectrum Disorders

Jen, you've completely mischaracterized this paper when you claim it "basically says autism is not genetically caused." It's clear to me you didn't even bother to read that excellent paper, which argues that autism is likely not caused by common genetic variants, but rather rare and de novo events, often CNV's. I'd be happy to discuss this further as this happens to be my particular area of expertise.

I note in the link lilady provides that there is no non-human reservoir for chicken pox. It would be nice if we could make this (and mumps) go the way of smallpox, and then we wouldn't need to worry about these any more.

Of course, the anti-vaxers probably don't want these diseases extinct (in the wild, at least). They would have less to complain about.

@Thomas: sorry, it's just the way I am...(hangs head in shame). Guess I'll never make it into the anti-vaxxer inner circle.

Adam G:

It’s clear to me you didn’t even bother to read that excellent paper,

No, she does not read the references. She only parrots the dreck she reads on certain website, because she cannot think for herself. I have asked her multiple times to post a critique of the Danish paper she keeps bringing up, but she has not. The reason is there is only one scathing "review" of that paper. It is on the SafeMinds website and is written by Mark “Not a Doctor, Not a Scientist” Blaxill (funny that link is the first in a google search!).

elburto,
Your clashing colour-scheme made me chuckle on and off all day, thanks.

Et al.
I have lost count of the number of times Jen has come here, made some ludicrous claim based on a paper that she or someone else has grossly misinterpreted and accused us all of being idiots. When her error is pointed out and explained she disappears, but comes back a month or two later making the exact same erroneous claim, and claiming we are idiots again. It's painful to watch.

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

So Chris" the paper does not say what I think it says" AND you note that AS provided lots of the paper's funding. Hmmm, seems a little contradictory of you. I'm pretty sure it means genetic heritability is modest at best where autism is concerned. Adam I'll look at the paper, have been out. They should study vaccines and their effect on children in a more thorough way.

Wow, per Bryan's paper, "it is well established that ASD's have a genetic component." The first line would seem to be a stretch. The largest, most recent twin study (Hallmeyer) shows less heritability than previously thought. I admit I am not an expert in genetics (far from it) but it's obvious that something else environmental is going on. What hasn't been studied thoroughly and with integrity? Oh ya, vaccines!

Adam I’ll look at the paper
Imagine how much shorter these threads would be if people did this *before* broadcasting their opinions about papers.

By herr doktor bimler (not verified) on 03 Sep 2012 #permalink

@ Jen

What hasn’t been studied thoroughly and with integrity? Oh ya, vaccines!

Vaccines, I don't know. I was under the impression that there were a few studies here and there.

But I'm sure we have not studied thoroughly and with integrity:
rocks
troll's with sticks
All sorts of dragons
Mrs Cake
Huje green things with teeth
Any kinds of black dogs with orange eyebrows
Rains of spaniel's
fog.
Mrs Cake

Maybe we should.

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

I’m pretty sure it means genetic heritability is modest at best where autism is concerned.

That's not my reading, which is that there is no magic combination of common SNPs that turns the key.

But I’m sure we have not studied thoroughly and with integrity:
Environmental causes belonging to the Emperor
Those that are embalmed
those that are tame
pigs
sirens
imaginary animals
wild dogs
those included in this classification
those that are crazy-acting
those that are uncountable
those painted with the finest brush made of camel hair
miscellaneous
those which have just broken a vase, and
those which, from a distance, look like flies.

By herr doktor bimler (not verified) on 03 Sep 2012 #permalink

Enough with the stupid chickenpox, Jen? Oh I forgot, you've never had a child with a moderate to severe case of chickenpox. or did you say that not to move the debate along but just to cause a stir?

Environmental causes belonging to the Emperor

Oh, very well played.

Liladay, you definitely display stalker tendencies and Rose, yes my kids were both very severely affected. My daughter had more pox in her head than some kids have on their whole bodies. Some fever and of course itching. For the vast majority of children, chicken pox is a relatively benign illness.

Jen
A severe case of chickenpox is life threatening. If you can prevent that with a relatively benign inoculation, why would you not?

For the vast majority of children, chicken pox is a relatively benign illness.

And for the vast majority of soldiers, war is a relatively benign affair.
Eh, most of them are going back home alive, don't they? They may be missing a few bits, but who is counting?
So what's all the fuss about providing them with an helmet and some body armor?

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

Liladay, you definitely display stalker tendencies

How so? Lilady is here all the time. You're the one stewing around until it's time to pop out from behind the dumpster yet again.

Jen, when you accuse a regular of being a stalker when she is appearing just as much in this thread as all of the ones without you in them, you are revealing rather more than you think about your own sense of self-importance.

By Calli Arcale (not verified) on 03 Sep 2012 #permalink

Wrong DOI. Anyway, the notion that the conclusion here is that “autism is not genetically caused” suggests that you somehow failed to actually read understand the paper, which is looking only at common SNPs.

Fixed that for you Narad. :D

Jen, don't dig any deeper, you really don't have a clue what the paper actually says and it isn't what you think. And doesn't it just chap your friend's arses at AoA that Autism Speaks is pouring so much money into genetic ASD research?

By Science Mom (not verified) on 03 Sep 2012 #permalink

Aww, why doesn't strikethrough work here? And why no damn preview?

By Science Mom (not verified) on 03 Sep 2012 #permalink

Lilady just seems to go above and beyond in tracing people- say like Jake Crosby. Calli, you are welcome to 'read' what you want into my post about that but even one of your own commented on her style at one point (and no I'm not obsessed with trying to link to that comment). Rose, you asked if my kids had "severe" chicken pox (I'm not even really sure as to what that medically means but they were absolutely covered from head to toe- I answered you and no, I am very happy I didn't subject them to that vaccine. They will have lifelong immunity- though shingles is a possibility. You can do what you want with respect to your children.

Aww, why doesn’t strikethrough work here?

Use <strike> rather than <s>.

And why no damn preview?

Not included in the off-the-shelf product.

They will have lifelong immunity- though shingles is a possibility.

As I've mentioned above, I contracted chicken pox at age 20 from someone who had had it before.

@ Jen with a capital "J"

"Lilady just seems to go above and beyond in tracing people- say like Jake Crosby."

It's called "two can play" Jake's game of Six, Sixty, Six Hundred Degrees of Separation, Jen.

Why don't you run along now. Better yet, why don't you call out the troops at AoA...we'd just love to have Jake and his sycophants posting at RI.

Jen, catching chickenpox does not guarantee lifelong immunity. My mother caught it a second time after I brought it home from school aged 6. She was very sick and it caused damage to her lungs. Had the vaccine been available at that time, it is likely she would not have had chickenpox a second time around and I would not have had shingles in my 40s.

That old anti-vax canard that catching the disease is better than being vaccinated against it. I have checked this one off on two threads today - I am doing well.

Thanks Narad.

Jen, varicella doesn't confer lifelong immunity.

By Science Mom (not verified) on 03 Sep 2012 #permalink

Jen,
Do you remember showing up for elementary (K – 5) school when a third of the class was out sick? And wondering if you were going to join the absentees? Do you? You don’t? My husband is just that much younger than me that he doesn’t remember that, either.

Sorry, I just don’t get how being sick – as a child or as an adult - is a good thing. Could you clarify that for me?

As for lifelong immunity to the chickenpox – marriage relates me to two different outliers.

By the way, Jen, you’ve been commenting here longer than I have. Even lilady (whom you called a stalker because she comments on more than one website) figured out how to post links. Why haven’t you? Doesn’t reading AoA teach you how to google? Maybe googling things like “html tags”?

" Even lilady (whom you called a stalker because she comments on more than one website) figured out how to post links."

Chemmomo...It took me a long time to learn how to post links :-)

For any newbies here, I never ever, post on AoA. I go "slumming" there, and at other notorious anti-vaccine blogs for my daily doses of rank pseudoscience.

Narad:

How so? Lilady is here all the time. You’re the one stewing around until it’s time to pop out from behind the dumpster yet again.

So is Jen channeling "Medicien Man"?

Chemmomo:Do you remember showing up for elementary (K – 5) school when a third of the class was out sick?

I saw this as I mentioned on my comment of "August 31, 1:37 pm." Obviously, Jen is not very observant.

Doesn’t reading AoA teach you how to google?

Jen does not know how to think for herself. She does not know how to seek information, she only knows how to parrot stuff from AoA.

Ugh... I left off an "e" on:
Chemmomo:

Do you remember showing up for elementary (K – 5) school when a third of the class was out sick?

You've a strong stomach, Lilady.

Shay, when one has a kid who is not part of the norm, you get a strong stomach and a thick skin. I was told by a member of a baby/mom support club to stop talking about the issues I had with my newly diagnosed son who could not speak. This was a bit over twenty years ago. I finally found a group who understood the issues on the Internets. But I had to leave it when the Mercury Militia Moms started to dominate the discussion (one was actually being paid by DAN! doctor to drum up business).

I am sure that lilady faced similar, it not more onerous, persons when dealing with her son. She was involved in the issues around Willowbrook. For this, she has more respect than Jen will ever comprehend.

(Blushing) Chris and Shay: I actually knew many of the "key players" (plaintiffs' and State lawyers, mental retardation experts and a few of the named plaintiffs), involved in the Willowbrook Class Action lawsuit.

Many of these same professionals were involved in another Federal Court class action lawsuit to deinstitutionalize a large "developmental center". My husband and my close friend testified in that lawsuit, to represent children and adults cared for at home...and who were in need of support services, provided by the State.

When I write the definitive book about this Federal Class Action lawsuit :-) perhaps I will *mention* how a parent/advocate interrupted the judge during the public hearing to discuss his Consent Decree And Order, to address the unmet needs of developmentally disabled children and adults cared for at home, by their parents.

Jen - I thought you were insisting that paracetamol/acetaminophen caused ASDs, what changed your mind?

If you're Jen McA from a state with a five-letter name then you were clearly heavily invested in that theory, as you spread it all over the internet.

What happened, did the wind change, and blow that lonely brain cell back over to the vaccine camp?

@ elburto: Have no fear, I've been *slumming* again at AoA and Jen has definitely left our arena.

Remember that study that she couldn't linked to? She went running back to her keepers at AoA to post this comment, sans link:

"Funny that Orac/"Science"blogs isn't speaking about the newest genetics study (R. Anney- Trinity College Dublin and Pittsburg School of Medicine) which shows that basically there is nothing much genetic about autism.

Posted by: Jen | September 02, 2012 at 11:29 PM"

Give Jen credit. When she pops up to spread the word about this new paper that proves we're Wrong about Everything, one can be confident that it is indeed worth reading.

By herr doktor bimler (not verified) on 03 Sep 2012 #permalink

elburto--

JenInTx (or a reasonable alternate spelling of that handle), while indeed fixated on Tylenol, is light-years ahead of plain 'ol parroting AoA Jen in terms of being able to carry on a reasonable conversation.

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

Jen
Having chickenpox does not confer life long immunity. My daughter had it 3 times.
More spots on the face than other kids had on their whole bodies is terrible. I would not want my child to endure that if it was preventable by a vaccine. But have you considered that chickenpox can also effect every mucous membrane making urination extremely painful for a girl, or the optic nerves causing blindness... and the list goes on.

Late addition to the above mention of obstetric fistula:

Tara Smith from Aetiology had a recent post about it.

Jane, still thinking that one surgical room for c-section is not that important compared to teaching hygiene? (for the lurkers, again, my position is ideally to get both)
We Westerners have some time no idea how privileged we are with our access to modern medicine. Or running water.

By Heliantus (not verified) on 08 Sep 2012 #permalink