Andrew Wakefield wants a "live public televised debate." Oh, goody.

Living in Swansea and overhearing much bollocks about the situation in the pub, I am most definitely going to slip "Wakefield uses bollocks as ammunition" into the next friendly debate.

Public debates around issues like this serve no purpose but to give a platform for those with no evidence or proof the opportunity to BS their way through the proceedings - since they have the latitude to not engage the actual facts, but instead rely on emotional appeals, diversions and parlor tricks to attempt to sway the audience that their "side" has the answers or at least some kind of legitimacy (I mean, seriously, watch US Presidential Debates - playing fast and loose with facts is a friggin' rite of passage there).

Wakefield wants a debate because he already lost the Scientific Debate - he had his opportunity to defend the Science & instead, he turned and ran away.

This is exactly the same stunt he pulled when he filed his lawsuit in Texas - he doesn't need to win, just by "showing up" he is able to continue to burnish his image with the anti-vax crowd that he is a "martyr" to the cause.

And in this case, when his call for a debate is ignored, he plays the "martyr" card again.....it is a no lose situation for him, unfortunately. Fortunately for us, more and more people are realizing just how much of a fool and charlatan he really is - so all he has left is the small cadre of anti-vax nuts that rally around him.....

The difficulty of this silliness is that Andrew Wakefield has no credentials or qualifications to plausibly debate with anybody but some other whack-job..

He claims that years ago he did a report. The number of pages varies over the years with his retellings, but what I can reveal is that he was hired to write this report, just as he was hired to research on autism, by a firm of lawyers. I even have the legal aid certificate referring to both tasks. Ultimately, court documents show him receiving £435,643, plus expenses, which was about eight times his then reported annual salary. The payments were secret (in 2004 he denied receiving personal payments).

The purpose of the report and the research was to attack MMR for a lawsuit that failed, for lack of evidence, ten years ago. Exactly the same case failed again in US federal court in 2009, with Wakefield not even called as a witness.

At the other end of the equation, he has no qualifications in any field of medicine or science which impinges on vaccination safety.

Today, having been struck from the UK medical register on grounds of dishonesty, he is not only no longer a medical practitioner (although at no time in his career did he ever have legal care of a patient), but he is formally certified as a man who does not tell the truth.

So, why would anybody wish to debate him? Given that public concern over his allegations have passed into British history, I think one would have to look quite carefully at anybody who took the view that he should be debated. What would be in it for them? What would be in it for children's health?

If the purpose is to try to stoke the whole thing up again, then that would be Wakefield's purpose too.

I suppose there might be some point in relentlessly laying out the documents again, in public, as occurred at his GMC hearing, but that wasn't exactly a crowd-pleaser, and certainly nobody proposing a debate turned up to hear the evidence.

So I think the correct response to his latest delusion that he has anything to say on the matter that anybody wants to hear is: "Yeah, right."

You're still blaming the measles outbreak on this waste of breath? Come on...you are supposed to be a scientist. If it was Wakefield's fault, then the MMR rates should be low. They're the highest they've been in 14 years.

http://www.bbc.co.uk/news/health-20510525

Instead of looking for someone to blame, making the Wakefields and the McCarthys of the world into bogeymen to frighten children at night, instead do a little critical thinking and determine WHY the outbreak occurred and is spreading. It's obviously not vaccine refusal. So what is it? Vaccine failure? New strain? Waning immunity?

@JAT - well, could it be that the age cohort that is most effected just happens to be the one right around the time that Wakefield received all of his press?

Just because immunity levels are now higher than they were before, doesn't mean automatically that those kids are suddenly protected (because their parents didn't get them vaccinated because of the Wakefield scare).

How's that for a thought - perhaps you should do some real research before posting such drivel.

#4:

That's Orac's point, actually. Now, people are taking the vaccine again. They've wised up. But back when Wakefield first struck, vaccine rates plummeted--and those who didn't get vaccinated a decade and a half ago contribute to the outbreak now. And that link you posted even says in the second paragraph that the rate is below that needed to assure herd immunity.

Couldn't agree more with Mr Deer. Unfortunately history tells us that being proven wrong does not preclude being used as reference again, and agin.

Case in point, while almost everybody in the Bush administration has been proven wrong, if not outright deceitful (dare I say the L-word?), regarding the outlandish claims towards Iraq, you will find they nevertheless are invited to make the same nonsensical (http://www.guardian.co.uk/commentisfree/2012/nov/28/ap-iran-nuclear-bomb) claims about Iran. (http://www.guardian.co.uk/commentisfree/2013/apr/09/iran?INTCMP=SRCH, http://www.guardian.co.uk/commentisfree/2013/mar/04/resist-netanyahu-ir… )

The same can be said about any topic involving ideologues forcing their misguided views upon the world (AGW, evolution, even the financial world). For reasons that are beyond my comprehension -cue the obligatory psychiattrist- repeated incompetence never leads to lack of trust in the general population.

What do these propagandists have to do before we stop listening to them?

Just A Thought might consider thinking about how low vaccine uptake rates are in the area affected by the current measles outbreak in Wales, before trying to obfuscate the issue over how high rates are elsewhere.

The Wakefield-inspired MMR scare caused vaccine uptake to decline under 80% in some areas, even while it remained higher elsewhere in the U.K.

"We estimate that 88.6% of children born in 2000-2 had received MMR by the age of 3 and a further 2.7% had received all three of the single antigen vaccines. Although coverage is relatively high, it remains lower than the estimated level required to ensure herd immunity (over 95%), leaving a substantial proportion of children susceptible to avoidable infection susceptible to avoidable infection.

http://www.bmj.com/content/336/7647/754

Single use vaccines like the one Wakefield was trying to market? No conflict of interest there, no sir...

Just a Thought - it's not a question of whether uptake of the vaccine is at its highest NOW. It's whether there are a large number of children aged 10-18 who should have received the vaccine but didn't, thanks to Wakefield's scaremongering. You have to look at uptake levels since 1998 when the Lancet published Wakefield's paper.

Ironic accusations of lack of critical thinking FTW...

Just a Thought,

You’re still blaming the measles outbreak on this waste of breath? Come on…you are supposed to be a scientist. If it was Wakefield’s fault, then the MMR rates should be low. They’re the highest they’ve been in 14 years.

Did you even read the article you linked to? "MMR vaccine coverage has reached its highest level in 14 years in young children" (my emphasis). It's the children who didn't get the MMR 15 years ago, because of the Wakefield scare, who are the victims of these outbreaks. Twit.

Just A Thought - how about you re-read the post (or read it period, as your comment suggests you didn't bother) and pay careful attention to paragraph 6 (underneath the first set of blockquotes). The answer is there. Prat.

That orchestra of tiny violin players must be getting really worn out playing "Fakefield's Lament" over and over again.

Fakers doesn't really want to debate anybody, this is a shiny object for what's left of his deluded fan club. When no one takes him up on it, he can play the old "they're afraid of the truth!" gambit.

I think Wakefield should have a public debate - with Jake. MMR vs. thimerosal - the important question finally answered.

"Mr. Wakefield called for the suspension of the MMR vaccine in favor of single measles, mumps and rubella vaccines. He didn’t really explain why the single vaccine would be more safe in his mind"

Agree--this is something I've never understood. Even IF Wakefield's research had been legitimate, and "autistic enterocolitis" was induced by measles-vaccine virus in the gut (which--just to make crystal clear--has been thoroughly disproven)--why would anyone think measles vaccine without mumps and rubella would be any safer whatsoever? Wakefield's paper never addressed the mumps and rubella--it was always about the measles.

I'll just parrot what others have said to "critical-thinker" Just a Thought and that is MMR uptake fell below herd immunity threshold and created clusters of susceptibles after Wankfield"s bogus Lancet paper and all of his press conferences along with dodgy media reports. Uptake has been recovering in younger children, not the children who were originally unvaccinated. It's not vaccine failure; it's failure to get the vaccine you freakin tosser.

@ Mu

I think Wakefield should have a public debate – with Jake. MMR vs. thimerosal – the important question finally answered.

Good idea! In fact, they should have a tournament with enny McCarthy and Rob Schneider as the moderators/sideshow act. Bob Sears and Jay Gordon could debate "too many too soon" and the winners would go to a final debate to determine what the One True Cause of vaccine damage is.

JENNY McCarthy. But you all knew who I meant.

I actually watched the entire charade the other night.. the things I do for the cause!

AJW's presentation so fits in with our other current discussion about the AoA crowd's remarks about our most esteemed and gracious host- so much is dependent upon what the speaker looks and sounds like, not upon what is said. I've also commented about the developmental significance of this phenomenon.

Andy is master of artificiality here and as Lawrence notes, in debates, facts can be secondary to appearances.

We can all gag on AJW's feigned sincerity I suppose. He's a SALESMAN and like other woo-meisters, he has to sell himself as well as products ( in his case, probably books, lectures and services), thus each appearance is a finely honed, rehearsed performance complete with direct gazes into the camera and measured, calming, melodious tones.

Believe me, there are studies that minutely dissect exactly what a 'winning' performance entails and it's not just psychologists who are interested in this but business people and politicians as well. I could tell you stories about various businessmen in my life and their efforts to please customers and mirrors.

Listen carefully to alt media prevaricators and you'll hear the same cadences and same quiet determination as that which AJW displays: it's also quite common in television advertisement, telling you how much you really need their spectacular, unequivocably essential products.

In case you missed it the other night, I called botox and hair tinting on Andy- not that there's anything wrong with those procedures- BUT it shows to what lengths he'll go in order to make an impression on the faithful.

Putting up a good front for the superficialistas.

A debate would be fine, as long as it allocates time and representation in proportion to the weight of evidence. Wakefield would get just long enough to open his mouth before time pressure forced him to yield to the thousands of massively better qualified scientists on the other side.

But televised debates never quite work that way.

I remember headdesking over one crank who wanted public debates because "there's nowhere to hide." Don't remember if it was a Creationist or an anti-vaxxer. I had to point out the obvious: Public verbal debates allow cranks to hide behind the clock, whether they fill the time with Gish Gallops or if their opponent has to pause to look up something.

Written debates with no time limits don't have that huge hiding spot.

Who, exactly, was supposed to pay for this "live, televised debate"?

I'm inclined to believe that Mr. Wakefield was not volunteering to purchase 30 minutes or more of air time.

His idea of a "scientific" debate has morphed into a policy debate, where he wants his supporter base to believe he would attack Dr. Salisbury. It's a classic publicity stunt--he gets to in efffect create a faux debate for his readership by posing his questions while not exposing himself to the downside of an actual science discussion with a well-informed Mike Fitzpatrick. He gets to present himself as somehow on an equal footing with Dr. Salisbury,

It is so transparent. And yet it sells to his target audience. But that has always been the case.

Perhaps Wakefield could rent another "shed in a park" for his self-styled *debate*?

http://lacrossetribune.com/news/opinion/michael-winfrey-former-doctor-w…

"October 12, 2012 12:15 am • By Michael Winfrey | Arcadia"

"I chaired the Distinguished Lectures in the Life Sciences committee that brought Brian Deer to the University of Wisconsin-La Crosse earlier this month.

The purpose of this series is to bring in a scientist who has made exceptional contributions to the life sciences. For the first time, we invited an award—winning journalist rather than a scientist.

This year we invited a journalist who exposed a grievous scientific fraud by a former British doctor. The former doctor, who was found guilty of this fraud by two prestigious medical journals and the British General Medical Council, invited himself and complained that he was not invited to debate Deer.

We did this because Deer’s investigations reversed an alarming trend of decreased vaccination of children in the United States and worldwide. Deer’s exposure of fraud also provides a clear example of the consequences of fraudulent science and the challenges faced by a public increasingly inundated with alarmist studies.

It’s unfortunate that the Tribune chose to promote this as a “debate” in its Sept. 30 article, which led to the misconception that the university was hosting a debate between two opposing views.

This series does not organize debates. We invite distinguished scientists (or in this case a journalist) whose findings have not only had a significant impact on science and society but also whose work is widely accepted by the scientific community.

There are many topics worthy of debates. Whether a vaccine is the cause of autism is not among them."

There is always the "Autism Media Channel" that is owned by Wakefield and Polly Tommey, which could tape the "debate" and broadcast it.

The question still remains who will Andy debate? I suggest that the foremost experts in childhood vaccines, Dr. Jay and Dr. Bob debate Andy. "Debate" moderator could be Jake Crosby (Because of his *excellent* debating skills and his public speaking extraordinary "eloquence" .)

So when is Andy going to publish his 200 page "report" on the internet? Is he still waiting for his lawyers to approve the context?

And it was held in the appropriate forum, peer-reviewed scientific journals.

He lost.

I saw Duane Gish give a lecture (without an opponent) and I saw his colleague Henry Morris in debate with a professor from Indiana University -- both of these events in the 1980s. It's true (as I have written on RI previously) that Gish was a remarkable liar, going from one misrepresentation to another at the speed of sound. He also managed to twist some unremarkable scientific facts into superficially damning critiques of science based conclusions.

Overall, I would characterize the two performances as something akin to what a fictional lawyer does in a book about a trial -- try to raise unreasonable doubt and get away with it.

One thing that became more and more obvious about the Gish performance was that he didn't actually discuss the observations and calculations underlying evolution. Instead, he mentioned other people, implying that they were experts on one thing or another, and pointing obliquely at their arguments and conclusions.

In other words, it was a long exercise in argument from authority, rather than argument from facts and logic.

Morris, by the way, was a little more on point, probably because there was someone there to refute him, but when he trotted out an argument about the laws of thermodynamics pointing to decreasing information (ie: devolution rather than evolution), the opposition pretty much dropped the ball. There is an easy refutation to this argument that actually explains a little about how evolution works at the microbial level, is convincing, and involves the slight imperfection in the DNA replication system.

In other words, guys like Gish and Morris didn't really debate in the sense that a true debate competition would demand. You could expect the anti-vaccine side to go with the same technique of argument from authority, just as the global warming denialists do nowadays. The anti vaccines folks will trot out numerous studies and papers that bear tangentially on the topic, one or two studies (such as the Wakefield paper in Lancet) that the field now rejects but the television audience never read, and a lot of hand waving about caring about the damaged children as opposed to the cold hearted scientists who want to test their experimental poisons on an innocent population etc etc.

The technique that commenters use on RI, namely to demand that the opposition prove its own case rather than merely take pot shots at the current scientific view, is not all that applicable to a televised debate, just as it isn't always applicable when prosecuting a defendant in front of a jury. The anti-vaccine people don't need to prove that vaccines cause injuries (although they will pound on the temporary side effects seen in some children from one or two vaccines), they just need to raise doubt that vaccines are one hundred point zero zero zero percent safe for all children of all ages.

The counter argument based on truth is that vaccines are pretty good most of the time, and for some truly horrendous diseases such as diptheria, smallpox, polio, rabies, etc, they have been miraculous. That won't satisfy a few people who are convinced based on emotional need that their child is disabled due to an injection.

One way around this would be to create a panel of perhaps 4 or 5 real scientists and invite Wakefield to join them, making sure that Wakefield was speaker number 3 out of the 5. Then, Wakefield can try to play at Rumpole, but instead of getting to rig things his way, they will be set up to reveal the truth in advance of his comments, and allow for rebuttal afterwards.

lilady@22 - haha, good idea.

"Coming soon on the Autism Media Channel, a live pay-per-view (because mansions in Austin don't pay for themselves): Vax Quacks at the Gun Shack!"

@Just A Thought

Re: The Swansea Measles Outbreak

The Royal College of Paediatrics and Child Health estimate that there are currently 1 million unprotected children of secondary school age (11-18) in the UK as a result of Wakefield's self-serving antics.

The fact that the Swansea outbreak of (to date) c. 850 infections has been contained (so far) to that area is nigh on miraculous, but with the new school semester just begun, the problem could get a LOT worse.

think Wakefield should have a public debate – with Jake. MMR vs. thimerosal – the important question finally answered.

Heh, when I saw the post, my first thought was that it should be against Jay "flame retardant pajamas" Gordon. The idea stands - better that he debate someone on his own level.

When asked about the effect of his paper on vaccine uptake rates at the GMC hearing,

Do you have any observations to make about your position in relation to the apparent juxtaposition of the paper, the press conference, and a reduction in take-up rates?

Andrew Wakefield's response stated that the withdrawl of the Urabe strain MMR vaccine caused some drop in uptake and, further,

. I have no doubt that that decline was exacerbated by the publication of this paper.

Day 55 of the GMC hearing.
http://wakefieldgmctranscripts.blogspot.com/2012/02/day-55-gmc-fitness-…

But now we are to believe his paper and his statements had no effect?

By the way, I happened on that while searching to see how Mr. Wakefield approached the Urabe strain mumps component question during the GMC hearing. This response contains his only mention of Urabe. Interesting, since this is supposedly such a major defense now.

Currently I'm within two hours drive of the Swansea measles outbreak, and as an immunosuppressed individual I'm crossing my fingers and hoping like crazy that it doesn't spread. However does anyone know what you're supposed to do if you do get measles, or what the infectious period is? I haven't actually heard anyone give advice on what you're supposed to do if you get it.

Matt Carey:

This response contains his only mention of Urabe. Interesting, since this is supposedly such a major defense now.

Which is bizarre because Wakefield did not post in his Lancet article which of the three UK MMR vaccines the kids had. Plus if the issue was the Urabe mumps component, then there would not have been an American child among the twelve (the American MMR has always had Jeryl Lynn mumps strain). Nor would there have been UK children born after 1991, since both UK MMR vaccines with Urabe were removed in 1992.

It sounds like a bit of back peddling.

IIRC Wakefield et al. squandered the legal aid funds that could have been used to help the children who really were injured by the Urabe component of the MMR before it was removed in the UK.

well, could it be that the age cohort that is most effected just happens to be the one right around the time that Wakefield received all of his press?

Rather easily confirmed by comparing the uptake data with the current incidence data.

Liz,

However does anyone know what you’re supposed to do if you do get measles, or what the infectious period is? I haven’t actually heard anyone give advice on what you’re supposed to do if you get it.

IANAD but given your circumstances I suggest you look into getting an injection of normal human immmunoglobulins, that should protect you from measles - your local HPA or microbiology laboratory should have a stock, talk to your GP. Also be aware that if you lack cell-mediated immunity you may not develop the characteristic rash. here's a good article on measles and its complications.

It sickens me that there was someone commenting on the BBC website the other day, on the very story about the measles outbreak, that the whole problem was down to ineffective MMR vaccines, and that they all should have been allowed the single measles vaccine and then everything would have been fine and that incidentally Wakefield was right all along.

When pushed he insisted that the paper was pulled from the Lancet and St. Andy was struck from the medical register because they didn't like his techniques, not because he was wrong in any way. Any day now the groundbreaking research coming out of the US that proved it all was going to be published.

When pushed further a lot of shouting happened, but no links to research or names of papers or even researchers, only complaints that I wasn't a medical professional and clearly hadn't seen all the 'new evidence'.

These people are everywhere, and they are the reason all these kids are suffering and ending up in hosptial. They should be ashamed of themselves but instead they just keep on with the same old carp.

You have to register to read the page about immunoglobulins I linked to above. This might be relevant to elburto given her situation and location. Here's the relevant information (UK only):

Measles

Intravenous or subcutaneous normal immunoglobulin may be given to prevent or attenuate an attack of measles in individuals who do not have adequate immunity. Children and adults with compromised immunity who have come into contact with measles should receive intravenous or subcutaneous normal immunoglobulin as soon as possible after exposure. It is most effective if given within 72 hours but can be effective if given within 6 days.

Subcutaneous or intramuscular normal immunoglobulin should also be considered for the following individuals if they have been in contact with a confirmed case of measles or with a person associated with a local outbreak:

non-immune pregnant women;

infants under 9 months.

Further advice should be sought from the Centre for Infections, Health Protection Agency (tel. (020) 8200 6868).

Thank you Krebiozen, your first link was really useful and I hadn't realised I may not develop the characteristic rash. With regards to the immunoglobulin, to be honest I have no idea whether that would work or not - I'm immunosuppressed on the basis of having a liver transplant (well, three actually...), so I'm not sure whether injecting antibodies should be combined with immunosuppressants. It seems that one might cancel out the other, to a certain extent. (Starting to wish I had a degree in biology or medicine, since it would be really useful in analysing my own healthcare these days.) However it is definitely nice to know that there's options available if I were to contract measles; it seems that the benefit would outweigh the risk in those situations. Thanks :)

@Liz - best of luck to you. You are one of the people that the anti-vax community conveniently ignores when something like this happens - hopefully the spread of the disease can be controlled and contained.....

@Liz

Hope you remain safe and that they can get this outbreak under control. Even with the information others have provided here, I'd highly recommend getting in to talk with your GP about your situation and concerns about the outbreak.

OT : but when are candy@ssed alt media dissections of SBM, sceptics, militant atheists and rampant materialists EVER truly OT @ RI, I ask you?**

Taped inteview with Rupert Sheldrake on today's Gary Null Show, Progressive Radio Network - about 24-25 minutes in- to end; @ 39 minutes in, said supporters of SBM, sceptics, militant atheists and materialists including our own esteemed host ( as DG) are put under the microscope. It seems that now Sheldrake is investigating the investigators or suchlike. Quite an unseemly bunch, we're told.

Quake in your boots, sceptics, militant atheists and materialists!
I'm quaking in mine!***

** neatly demonstrating what those who debate alt med prevaricators are up against!
*** not really.

Also, Liz, avoid all adolescents. The best of luck to you.

@ Liz: Here's the NHS measles case surveillance guideline. It appears to me that the response to a single measles case, cluster or outbreak of measles is quite *different* from the response to measles cases here in the United States.

http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1274088429847

If you scroll down you will see a section that Krebiozen referred to, for "post exposure prophylaxis" for "at high risk" people, either in the form of an IGG shot or a measles vaccine...depending on your particular immune suppression or your immune compromising condition and, on length of time since the exposure took place.

Here's a link to guidelines from the UCSF Liver Transplant Unit on receiving vaccines (page 28), and POST LIVER TRANSPLANT PATIENTS SHOULD NOT RECEIVE ANY LIVE VACCINES (measles, mumps rubella, varicella or live intranasal influenza seasonal flu vaccines) after liver transplants.

http://www.ucsfhealth.org/pdf/liver_transplant_manual.pdf

Thanks again to Dr. Wakefield for putting Elburto, Liz and other vulnerable children and adults, whose health is in peril because of your "study" and your activities since you lost your medical license.

Corrention: I meant to state Immunoglobulin shots (not IGG shots)

If you watch the video at about 4:20, he talks about the information he got from Alistar Torres, the "whistleblower" who informed him about the Urabe strain vaccine.

At about 6:30, he states (after adding more information) along the lines that it was with that information about the practices of the joint committee on vaccination that he took the stand he took on MMR.

Except that he didn't speak with the whistleblower until after the Lancet study was published. His own book states that Dawborns (the legal firm heading up the MMR cases) was contacted in April of 1998, two months after the Lancet study was published.

As already noted, in his GMC hearing he only mentioned Urabe once. He apparently didn't consider it a major factor in his decision making process then, and now it is a primary factor.

He also misrepresnts the Hannah Poling case. The government states clearly that they did not concede that vaccines resulted in autism. Also, Hannah Poling was a thimerosal test case, not an MMR test case.

@Narad I'm having trouble interpreting the data in the pages you've cited. I'd appreciate help from Ren or others.

I read "Just a Thought" as being just as critical and disdainful of Dr. Wakefield and his findings as everyone else here is. Clearly no one else saw him/her that way.

I look forward to your interpretation of the data Narad has directed me to.

Thanks.

Jay

JAT the Pratt - the outbreak I'm slap bang in the middle of is affecting kids aged between 10 and 14, the "lost generation".

Liz - best of luck to you. My area's suffering an outbreak that's pretty much being ignored by the media, to the point that a call to the GP surgery about it got nothing but a "You wha'?" from the receptionist.

Krebiozen - That info's really helpful, thank you. Although prn was super helpful with his "Stop whining, and visit the Quack Shack. My regimen of IV vitamin C and [unknown delivery method] of B12 will do the trick". I think you might have a slight edge over him though.

a link to make you all furious: http://blogs.telegraph.co.uk/news/tomchiversscience/100211189/neals-yar…

I feel dirty for linking to the Torygraph, but it's for a good cause.

And about the outbreak up here: www.hartlepoolmail.co.uk/lifestyle/health/life-fitness/measles-jabs-for…

17% needing hospital treatment? Thanks Snakefield, you disgusting waste of DNA.

and one that has seriously upset me, as my colleagues and I helped in the drive for this little lad's transplant:

www.gazettelive.co.uk/news/teesside-news/2013/04/15/liver-transplant-bo…

I could fvcking puke blood I'm so angry, especially at the suggestion by Wankfield in this very post, that the NHS caused the problem by not offering the single measles component as recommended by him.

Anyone got any decent at-home protocols for someone coming into a house with someone immune compromised and unvaccinated, if there's a risk they may have been exposed during the day? Or, is it just a case of crossing fingers and hoping that it passes over?

Also, Liz, avoid all adolescents. The best of luck to you.

Always good advice.

[resubmitted with mangled links]

JAT the Pratt - the outbreak I'm slap bang in the middle of is affecting kids aged between 10 and 14, the "lost generation".

Liz - best of luck to you. My area's suffering an outbreak that's pretty much being ignored by the media, to the point that a call to the GP surgery about it got nothing but a "You wha'?" from the receptionist.

Krebiozen - That info's really helpful, thank you. Although prn was super helpful with his "Stop whining, and visit the Quack Shack. My regimen of IV vitamin C and [unknown delivery method] of B12 will do the trick". I think you might have a slight edge over him though.

a link to make you all furious:

blogs.telegraph.co.uk/news/tomchiversscience/100211189/neals-yard-promotes-homeopathy-for-measles-this-could-kill-real-children/

I feel dirty for linking to the Torygraph, but it's for a good cause.

And about the outbreak up here: hartlepoolmail.co.uk/lifestyle/health/life-fitness/measles-jabs-for-schools-to-stop-outbreak-1-5589060

17% needing hospital treatment? Thanks Snakefield, you disgusting waste of DNA.

and one that has seriously upset me, as my colleagues and I helped in the drive for this little lad's transplant:

gazettelive.co.uk/news/teesside-news/2013/04/15/liver-transplant-boy-lennox-nicholson-contracts-measles-84229-33175902/

I could fvcking puke blood I'm so angry, especially at the suggestion by Wankfield in this very post, that the NHS caused the problem by not offering the single measles component as recommended by him.

Anyone got any decent at-home protocols for someone coming into a house with someone immune compromised and unvaccinated, if there's a risk they may have been exposed during the day? Or, is it just a case of crossing fingers and hoping that it passes over?

@ Dr Jay:

I read JAT as disliking Wakefield but NOT attributing the current situation to him. Most of us probably see him as - at the very least- partially to blame.

Liz,

With regards to the immunoglobulin, to be honest I have no idea whether that would work or not – I’m immunosuppressed on the basis of having a liver transplant (well, three actually…), so I’m not sure whether injecting antibodies should be combined with immunosuppressants.

Again IANAD, but I can see no reason immunoglobulins would be contraindicated if you are on immunosuppressants - it's an immune reaction against the transplanted liver that is the aim of the immunosupressants, and the lack of response against measles is an unfortunate side effect that could be rectified by administering antibodies made by someone else.

BTW I worked at Addenbrookes in Cambridge throughout the 80s when Professor Roy Calne was pioneering the use of cyclosporin in liver transplants. I admit to feeling a little glow of pride at having played a tiny part their development whenever I hear of someone who has a new liver, such as yourself.

Dr. Jay:

Narad I’m having trouble interpreting the data in the pages you’ve cited. I’d appreciate help from Ren or others.

That is another reason why you should not be writing about vaccines, immunology and telling future parents "how to avoid autism." And, no, I will not help you.

Ah, avoiding adolescents is one of the things that makes being bedbound great. If I ever hear "Missus, will yer gerruz some tabs out the shop? Ere's a fiver ahll 'ave ten bennies""* again, it will be too soon.

*English translation - "Excuse me madam, would you mind (illegally) purchasing some cigarettes for me? I have five pounds of the Realm to exchange for a ten pack of Benson and Hedges"

elburto,

Anyone got any decent at-home protocols for someone coming into a house with someone immune compromised and unvaccinated, if there’s a risk they may have been exposed during the day? Or, is it just a case of crossing fingers and hoping that it passes over?

Measles is a bastard as it's contagious for a few days before it shows any distinctive symptoms - it starts with coughing and sneezing just like a cold. I would talk to your GP about prophylactic immunoglobulins, seriously. I assume the other mrs elburto is fully vaccinated, so she should be safe if she washes her hands thoroughly as soon as she walks through the door, before touching you or anything you might touch. Make any visitors wash their hands and wear a mask - I'm sure your partner could pick some disposable ones up either at work (isn't she a nurse?) or I believe chemists stock them. It might seem a bit OTT but it's not worth risking your life to avoid seeming paranoid.

I'm lost for words about the kid with the liver transplant contracting measles; all I can say is I'm glad he pulled through. With figures heading for the 1000 mark, we will almost certainly see deaths.

Wales has a population of three million people. Here is the breakdown of children ages 2-18 who are unvaccinated or who are undervaccinated for measles (November, 2012 figures)

http://www.bbc.co.uk/news/uk-wales-22156006

Dr. Jay, are you recommended MMR vaccines for the children in your practice who are traveling to the U.K. and to Europe, where measles is endemic?

Kreb - I'm gutted about Lennox. That kid has had a lifetime of pain and hospitals already. His mam is such a lovely woman, and this is just one more shovel full of guano heaped on her.

Dr Jay - surely you're up to interpreting datasets? Given that you've expounded on various theories over the years, written books, given speeches etc., about VPDs , you've surely had plenty of experience with reading and examining epidemiological data?

@lilady - I think we've seen that many anti-vaxxers believe that immunocompromised people are a detriment to the gene pool. To a lot of them measles is just a natural disinfectant.

Oh and Krebiozen - thanks for the advice. OME is fully vaccinated, and thanks to my little vomiting-when-I-smell-cigarette-smoke habit, she already goes straight upstairs, changes her clothes and washes thoroughly before coming back downstairs to where we're currently "living". She doesn't smoke herself, but her company has handily placed the new "smoke cabins" next to her parking area.

She used to use masks during a particularly bad IBD flare I had. Then one day she threw up with one on, and now refers to them as "puke traps". The woman is a saint. When I worked for the NHS she used to say "I couldn't do it, nope, tech support won't lead to me accidentally killing anyone or throwing up on them". For her to become a carer virtually overnight has been a testament to how fab she is.

Oh and as far as she's concerned, there's no such thing as "too paranoid" in disease protection! Her last cold coincided with a month-long course of prednisolone, and she's threatened to wrap sick colleagues in clingfilm in future.

Thanks for the link lilady. As we all know, the second measles vaccine is not really a "booster" dose like the repeated DTaP shots, but instead an acknowledgment that about 10% of vaccine recipients do not acquire immunity after the first MMR. Of course there's no way of knowing the titers of the group who received only one vaccine. Or, for that matter, knowing the titers of those who received both doses. That would be valuable.

Yes, lilady, I've been giving more MMR vaccines than usual.

Chris, I believe you also can't interpret the data so you were stuck with the answer you've given me. Anyone else, please?

Jay

I thought the second MMR vaccine was given due to fading immunity in older children. This led to outbreaks in the US in the early 1990's (I believe in the UK as well). These outbreaks led to the second dose of the MMR.

I.e. I think these are boosters.

I.e. I think these are boosters.

It's both actually, a booster and to capture those who didn't respond to the first (which is ~5%). The epidemiology of measles after the uptake of the second dose was sufficiently high speaks for itself.

Dr. Jay, with a high uptake of two doses of MMR, we have eliminated indigenous measles and rubella cases. A four year old with a protective titre may not necessarily have one at ten. But that's what "vaccine friendly" doctors like you and Dr. Bob omit to tell your patients, or are simply ignorant of that.

Actually, I can interpret it, Dr. Jay. I just don't respect you and think you are causing harm with your writings, especially your most recent book.

Matt Carey, I believe it was a bit of both. There may have been fading immunity in some, but also the 90% effectiveness is not good for a disease that is so contagious. The second dose gets it up to about 99% effectiveness. (sorry, Dr. Jay, nothing is perfect)

At first the second MMR was give to children leaving elementary school and entering middle school, but was later changed to those entering kindergarten. I remember because my oldest got it at age eleven, but my other two were aged about seven and four. It was shortly before the timing of the second dose happened. I brought the two younger in for a second MMR because there was a measles outbreak in a private school that was too close for comfort to our neighborhood.

Correction because of fading memory: I remember because my oldest got it at age ten or eleven, but my other two were aged about nine and five.

As we all know, the second measles vaccine is not really a “booster” dose like the repeated DTaP shots, but instead an acknowledgment that about 10% of vaccine recipients do not acquire immunity after the first MMR.

In those who did not react, it's not even odds that it will react. In those who did, it's almost certain that it will be a booster, from an immunological point of view. If I remember correctly, and you'll have to forgive me (I don't write books on the matter, nor give speeches; My thing is surveillance and epi), the reason the second dose was recommended was the acknowledgement that the "not even odds" that I mentioned was better than zero odds. So they recommended the second vaccine to make a best effort to immunize that small minority who didn't convert in order to increase the number/proportion of those immune. Again, it was a while ago. I was a 16 year-old in college who had "better" things to worry about.

Of course there’s no way of knowing the titers of the group who received only one vaccine. Or, for that matter, knowing the titers of those who received both doses. That would be valuable.

If I may inform the doctor, there are plenty of studies where seroconversion is studied after one, two, or three MMR rounds. Yes, three... Sometimes there is an outbreak in a population that has two MMR doses but hasn't seen measles or mumps (immunologically) in about 15+ years, so a third dose is given. This is a product of vaccine success, actually... Like shingles.

HERE they did it with mumps.

HERE they did it for all three viruses, with immunogenic persistence against Rubella being 100% after a long, long time. Thank God. I've seen a child with congenital Rubella. I don't wish that horror on my worst enemy.

As for interpreting data, Dr. Jay. I'll do it eventually and if I get around to it. I'm a bit busy, you see.

It’s obviously not vaccine refusal. So what is it? Vaccine failure? New strain? Waning immunity?

No, it's vaccine refusal. You need a high level of herd immunity for measles. It's infectious as I'll get out. Remember, vaccine uptake is not the same as immunity. So, if you need 90% of immunity against measles to have herd immunity, but, say 92% uptake, and 3% of those fail, then you're down to 89% immunity, which is no herd immunity.

New strain? Ha! Measles is incredibly stable when it comes to mutations. They have to really coax it in the lab to mutate.

Waning immunity? I covered that in my response to Dr. Jay.

I’m having trouble interpreting the data in the pages you’ve cited. I’d appreciate help from Ren or others.

THIS PAGE tells us vaccine uptake data. Note the age groups where uptake is lower than the ideal 90% for herd immunity. They're the "MMR" ones with red bars: 2 doses by age 5 and 2 doses by age 16. (For those of you keeping score at home, Andy's paper was published about 14 years ago.) Even the one dose MMR by age 16 is kind of low. (Read my comments above about percentages and what nots.)

THIS PAGE tells us what's going on in the Wales outbreak. Under "Notifications of measles in Wales by age," we can see what age groups make up most of the cases. Personally, I'm not surprised. It's the same age spread seen in other outbreaks. That is, the unvaccinated or under vaccinated age groups make up most of the cases.

It doesn't take a rocket scientist to see this... Which is good, because I don't think there's a rocket scientist around.

@sciencemom: Actually, the MMR vaccine probably does confer lifelong immunity when it takes. http://www.nhs.uk/Conditions/vaccinations/Pages/mmr-questions-answers.a…

@Chris: The datasets are not clear at all. If you can interpret them, please do.

Rene', what I said was there was nothing in the articles cited mentioning the titers in the different groups studied. And unlike pertactin negative B. pertussis, I'm unaware of new measles strains. Perhaps better diagnosis and more robust reporting of measles cases have created apparent increase in cases. Just as is alleged to have occurred with the huge increase in ASD diagnoses.

Jay

Ren:

Yes, three… Sometimes there is an outbreak in a population that has two MMR doses but hasn’t seen measles or mumps (immunologically) in about 15+ years, so a third dose is given.

If my daughter had been accepted to UC Berkeley, I would have had her get a third MMR due to a recent mumps outbreak there. Fortunately it was her second choice, and she gets to live at home and attend a very good university in town.

It doesn’t take a rocket scientist to see this… Which is good, because I don’t think there’s a rocket scientist around

Does it help that I used to be one? I have a Bachelor of Science in Aeronautics and Astronautics. While my last few years of work was mostly the random vibration behavior of landing gear, I did work for the MX missile program as a new hire. It was mostly how to protect them when they were in their little houses, but I did get to do sound energy profiles for some scenarios.

This means, Dr. Jay, I know lots more math than you (Euler, Fourier. Laplace and Dirac are not just random names to me!). I had to quit work to deal with a baby who had medical issues. One of those included only being given the DT vaccine, not the DTP, at a time when our county had a pertussis epidemic (thanks Vashon Island and Barbara Loe Fisher!).

So it's better reporting?

Dr. Jay:

The datasets are not clear at all. If you can interpret them, please do.

What part of "I will not help you" do you not understand. I do not respect you, and I think you are a cause of much harm, especially with your last book.

Perhaps better diagnosis and more robust reporting of measles cases have created apparent increase in cases. Just as is alleged to have occurred with the huge increase in ASD diagnoses.

With all due respect, Dr. Jay, put a sock in it.

We have objective, lab-based methods of diagnosing measles. Kids with fever and a rash are not diagnosed as having measles until blood tests or viral cultures (or PCR) are done. This is not the same with autism, AND YOU GODDAMN KNOW IT. There is no spectrum of measles. There IS a spectrum of autism. Children die from measles. Children don't die from autism.

For you to continue this mocking of something so serious is an affront to everything that medicine and public health stand for. Have you no shame?

Rene' I've looked harder at the page. 16 yr olds had one dose at a rate of 91% The drop of to 82.4% for two doses is accounted for by the fact that the second (kindergarten dose) may not have been recommended strongly back then. I really don't know. Those 16 year olds actually had higher coverage than the five year olds.

On that second page, "Wales by age" the majority of cases I don't see the strong correlation you mention above. Although it would certainly make sense that unvaccinated people would get measles more readily than vaccinated kids.

Rene', no mockery was intended. Measles doesn't always get reported any more many other childhood diseases do. With all due respect, I'm guessing that far from every case of measles had laboratory confirmation, and you damn well know that.

"However, due to the high numbers of notifications reported during an outbreak, it is possible that not all clinically-diagnosed cases will undergo subsequent laboratory testing. It is probable that not all cases notified on the basis of clinical symptoms will be due to measles infection and this maybe true especially for notifications from outside the outbreak area."

http://www.wales.nhs.uk/sitesplus/888/page/66389

http://www.wales.nhs.uk/sitesplus/888/page/66389

With all due respect, no mockery was intended. Measles and other childhood diseases are reported at a greater rate during an outbreak. You damn well know that. Lab conformation was not required.

" Usually, a notification of measles is laboratory confirmed (or not) by sending a sample for virological testing. However, due to the high numbers of notifications reported during an outbreak, it is possible that not all clinically-diagnosed cases will undergo subsequent laboratory testing. It is probable that not all cases notified on the basis of clinical symptoms will be due to measles infection and this maybe true especially for notifications from outside the outbreak area."

My comment has been wiped out three times now.

With all due respect, Rene', measles and other childhood diseases are reported at higher rates during and outbreak and you damn well know that!

" Usually, a notification of measles is laboratory confirmed (or not) by sending a sample for virological testing. However, due to the high numbers of notifications reported during an outbreak, it is possible that not all clinically-diagnosed cases will undergo subsequent laboratory testing. It is probable that not all cases notified on the basis of clinical symptoms will be due to measles infection and this maybe true especially for notifications from outside the outbreak area."

http://www.wales.nhs.uk/sitesplus/888/page/66389

With all due respect, I’m guessing that far from every case of measles had laboratory confirmation, and you damn well know that.

No need to guess, doctor. That's how outbreaks are managed. A person with a fever and a rash that is epi-linked to a confirmed case of measles is called a case until lab testing says otherwise. A person with a fever and a rash that is not epi-linked is not a case of measles, or even considered a suspect case.

I explained this to you in one of the Epi Night School lessons, the one in which you mocked the measles outbreak in Minnesotta because, as best as I can infer, you don't have a heart.

Then again, it's all "statistical porn," isn't it, doctor? In your happy, little, Brady-bunch-oriented world, you probably salivate at the idea that there is no outbreak of measles and it's all a happy accident, a "random event" as you've called so many outbreaks. Have you seen a child with SSPE in your long and distinguished career? Does it scare you that, by statistical porn alone, at least one of the kids in Wales will develop it, and that it could have been prevented?

Or do you smile at the thought?

My comment has been wiped out three times now.

With all due respect, Rene', measles and other childhood diseases are reported at higher rates during and outbreak and you damn well know that!

" Usually, a notification of measles is laboratory confirmed (or not) by sending a sample for virological testing. However, due to the high numbers of notifications reported during an outbreak, it is possible that not all clinically-diagnosed cases will undergo subsequent laboratory testing. It is probable that not all cases notified on the basis of clinical symptoms will be due to measles infection and this maybe true especially for notifications from outside the outbreak area."

http://www.wales.nhs.uk/sitesplus/888/page/66389

And, by the way, your "tetchiness" and anger about infectious diseases is only exceeded by my parallel feeling about autism spectrum disorders and their affect on millions of families.

I guess I have to be more patient with this site. Sorry for the near duplicate posts.

And, by the way, Rene', your "tetchiness" and anger about infectious diseases is only exceeded by my parallel feeling about autism spectrum disorders and their affect on millions of families.

And, by the way, Rene’, your “tetchiness” and anger about infectious diseases is only exceeded by my parallel feeling about autism spectrum disorders and their affect on millions of families.

Except that autism has killed no one directly, you know, like measles does. And I've met some great people with autism that have done great things, unlike the dead people who died from measles or the one little girl I met with SSPE who also eventually died. Oh, and measles is preventable with a safe and effective vaccine that has been shown NOT to cause autism. Unlike autism, which, at the risk of hurting your bottom line in book sales, is not preventable.

Repeat after me, Dr. Jay, "Measles is not autism and autism is not measles." Autism is also not whooping cough, chickenpox, or any of the other "marvelous" things that people you know and are very close to have openly stated are not really that bad.

So help me if you bring out the "you don't have a kid with autism" crap...

I don't believe you've seen me tetchy.

@sciencemom: Actually, the MMR vaccine probably does confer lifelong immunity when it takes. http://www.nhs.uk/Conditions/vaccinations/Pages/mmr-questions-answers.a…

You might try something a bit more academic Jay: www.ncbi.nlm.nih.gov/pubmed/2278542 and have a look at Figure 1 here: http://jid.oxfordjournals.org/content/189/Supplement_1/S54.long

A substantial proportion of vaccinated individuals will maintain lifelong immunity but not enough to interrupt transmission with only a one-dose schedule. You are old enough to have lived through many outbreaks so for you to whine about titres reflects your competence as a medical practitioner.

And, by the way, your “tetchiness” and anger about infectious diseases is only exceeded by my parallel feeling about autism spectrum disorders and their affect on millions of families.

Oh puhleese. What kind of performance art are you up to that you would co-opt a measles epidemic (in large part to that moron Wakefield whom you have professed your belief in) to pimp your sudden concern with ASD families. Please tell me you have a "make your sperm healthy" workshop to prevent the autists you "care" so deeply about.

Are you seriously-- seriously?????-- comparing a deadly, often-maiming, hugely contagious virus to an ASD?

Good thing the measles is so mild and almost never kills.

'...Wakefield's whiney wankfest...'
Thanks Orac, that is one of the funnier and better uses of alliteration that I have seen recently. I am going to use that phrase the next time I'm discussing Wakers and his current attemps of self aggrandizement through self promotion.

Sure, Mr. Schecter. It only kills one out of a thousand. Though the estimate in the 1988-1992 measles epidemic in the USA was more like more than one in five hundred cases.

It is hard to tell is Bobby Schecter actually made that comment in characteristic bad taste, or if this someone pretending to be the real estate speculator who studied fire science. It is hard to tell if it is a Poe.

[blink]

I've dealt with a lot of trolls in my day, elsewhere, and I thought I could keep my civility here despite the quacks that show up in the comments pages but...

Sid, are you just that stupid?

"Mild"?! "Almost never kills"!? One in a thousand infected people in the developed world die if infected. One in a hundred infected in third world countries die. That's not 'almost never.' Not by a long shot. Even when it doesn't kill, it can lead to complications including but not limited to encephalitis (actual brain damage), hearing loss, and eye damage. Is that desirable?

Antivaccinationists seem to like to talk only about fatality rate without ever bringing up what survivors have to go through. Spinal polio almost never killed--it 'just' crippled. But if you lot had your way decades ago, it would still be endemic to the US.

I just noticed now that I used 'infected' in a redundant manner in one sentence. Please disregard the first use of the world 'infected.'

Yes, ARD, Robert Schecter is that stupid. I refuse to address him with his 'nym, because he is not Sidney Offit, the author.

"With all due respect, Rene’, measles and other childhood diseases are reported at higher rates during and outbreak and you damn well know that!"

Did you see my post and my comment at # 41, about the investigation/case surveillance of measles in the U.K. Dr. Jay?

"@ Liz: Here’s the NHS measles case surveillance guideline. It appears to me that the response to a single measles case, cluster or outbreak of measles is quite *different* from the response to measles cases here in the United States."

http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1274088429847

You do not know diddly squat about the workings of local and State health departments when it comes to a single measles case, a cluster or outbreak of measles, Dr. Jay.

Whenever, a "suspect case of measles" is seen by a doctor or in a health care setting, in California, you are required by law to contact your local health department immediately by phone (See emergency reporting requirements-measles)

http://www.cdph.ca.gov/HealthInfo/Documents/Reportable_Diseases_Conditi…

Whenever a single "suspect case of measles" was reported by a doctor with an exposure in that doctor's office, in the County health department where I was employed, a nurse- epidemiologist would instruct that doctor to isolate the suspect case in a closed room. The doctor provided all demographic information on the suspect case, including the dates of measles immunizations. The doctor would also provide all demographic information and measles vaccine immunization records for any child or adult who had exposure to the suspect case.

The nurse epidemiologist would also instruct the doctor to draw blood for a measles IGM titer...and instruct the doctor to bring the drawn blood to the County laboratory or to a hospital laboratory for STAT testing.

We would have the results of the ELISA IGM within 1-2 hours and if the IGM titer was positive, we started case surveillance immediately...even if the surveillance was begun in the evening or on a weekend.

That is how you conduct case surveillance and containment of measles cases, clusters and outbreaks.

Chris:

Thanks. I'll keep his real name in mind for future reference. It's just...

God damn.

I've seen people who claim atomic bombs are a Jewish hoax. I've seen people deny (or even defend) the Holocaust or Generalplan Ost. I've seen all sorts of madness and nonsense across the internet. But, somehow, none have ever managed to sound as ignorant as Schecter did in comment #79.

@ Offal: Didn't I tell you the last time you posted here with yet another inane comment, to stay away? If we have need of advice about fires, we will call our local fire department...not a crank anti-vaccine, anti-science "fire science" graduate from a fourth tier college.

Trust me, ARD, you have not seen anything when it comes to science denial if you have just started with the anti-vax folks. It is amazing how they manage to warp reality when it comes to infectious diseases.

"Good thing the measles is so mild and almost never kills"

This is measles...

http://www.immunize.org/photos/measles-photos.asp

This was Natalie...

http://justthevax.blogspot.com/2011/10/so-predictable-so-sad-natalie-di…

#79 I'm sure that is of great comfort to the handful of parents whose children it does kill.

I doubt Roald Dahl missed his daughter much at all, really. After all, he had four others. What's a child or two, more or less.

#24 Well, nobody's going to say vaccines are 100% safe. They're not. (Nothing is.)

They're just much, much *much* safer than the diseases, by many, many orders of magnitude.

#45

"Anyone got any decent at-home protocols for someone coming into a house with someone immune compromised and unvaccinated, if there’s a risk they may have been exposed during the day? Or, is it just a case of crossing fingers and hoping that it passes over?"

Gosh, I don't know. Weasels or flamethrower? So many choices. Decisions, decisions...

#64 The diagnosis criteria for measles has not changed. Try again.

Wakefield’s own lawyer formally submitted to the UK General Medical Council panel that Wakefield caused the downturn in vaccination. On Day 130 of the hearing, 7 April 2009, Kieran Coonan QC submitted on Wakefield's behalf:

“Dr Wakefield was, as you know, a senior author of the Lancet paper, and publication of the paper, together with the commentary and the observations that he made at the press briefing, has led on the evidence that you have received to a downturn, or at least did turn to a downturn, in vaccination rates for the MMR vaccine. That is a fact. And it is a fact, even though Dr Wakefield may have been justified in publishing the paper; even though he held honest views about the safety of the MMR vaccine, and even though he advocated the use of a single vaccine. The fact of the linkage between the paper and the press briefing and the downturn is a fact, and it is not difficult to imagine that in some quarters he would be heavily criticised for that fact.”

So 77 kids in Wales hospitalised since November last year(so far) is nothing according to #79. As long as they don't die then who cares if they get really sick and potentially suffer lifelong eye/ear/brain damage, and as long as only a few die it's no big deal? What a gigantic, stinking arsehole you are, #79.

Rumtopf, yes, he is a " stinking arsehole." He is a real AoA jerk.

It is only me being charitable that I would think someone was pretending to be him. If someone is doing that to make him look worse: knock it off. Otherwise, it is eerily keeping with his mode of operation.

It's depressing to read the comments against that video. Logic is not one of these people's strong points.

@ Brian Deer: Here is the exact quote from Wakefield's lawyer as transcribed and recorded on on the official GMC F-T-P hearing on the 130 th day of testimony:

https://docs.google.com/viewer?pid=explorer&srcid=0B9Ek8hRNlhrbNTk4MWI5…

"Dr Wakefield was, as you know, a senior author of the Lancet paper, and publication of the paper, together with the commentary and the observations that he made at the press briefing, has led on the evidence that you have received towith a downturn, or at least did turn to a downturn, in vaccination rates for the MMR vaccine. That is a fact. And it is a fact, even though Dr Wakefield may have been justified in publishing the paper; even though he held honest views about the safety of the MMR vaccine, and even though he advocated the use of a single vaccine. The fact of the linkage between the paper and the press briefing and the downturn is a fact, and it is not difficult to imagine that in some quarters he would be heavily criticised for that fact.”

And here we are coming up with quote after quote of Wakefield associating MMR with the onset of autism, which right in the GMC hearing, Wakefield is on record disaparaging the triple jab MMR vaccine (based on his junk science) and in order to promote his own alternative single jab substitute to convince parents that MMR vaccine=bad and his substitute measles vaccine=good...just to really ream the public who he scared about MMR vaccine.

S'matter...wasn't the huge bundle of dough he collected from Richard Barr, enough for him or did he, like all charlatans, wish to wring every Pound Sterling out of his marks, buy selling them useless untested vaccines?

@lilady:

S’matter…wasn’t the huge bundle of dough he collected from Richard Barr, enough for him or did he, like all charlatans, wish to wring every Pound Sterling out of his marks, by selling them useless untested vaccines?

The latter. He was unethical enough to do the study, and I think that once he got the payout, he found he liked money and wanted more.

Julian, I think you nailed it.
Dr Jay, are you really suggesting that health professionals in Wales are too thick to diagnose measles? That somehow they just magically learned to do so? Ti'n llawn cachu.

But, somehow, none have ever managed to sound as ignorant as Schecter did in comment #79.

You should see his truly sad new ventures into trying to create "meme" images.

Dr Jay, are you really suggesting that health professionals in Wales are too thick to diagnose measles?

He's claiming that everything that is diagnosed without PCR is presumptively not wild measles. (Whether he would settle for IgM is an open question.) It's a level of ideation that I've recently seen trotted out by the wetheads at the NPPoUC group on FB.

Julian Frost,

He was unethical enough to do the study, and I think that once he got the payout, he found he liked money and wanted more.

I'm more cynical, I think he set up things up very carefully - his "safer measles vaccine" and diagnostic tests for "autistic enterocolitis" - before deliberately fueling a vaccine scare that would create a huge demand for his "vaccine" and tests. As we know, things didn't quite go the way he hoped.

It's worth repeating that the area where this outbreak has centred on is also the distribution area of one local newspaper that pushed the MMR scare particularly hard:

http://jech.bmj.com/content/54/6/473.full

"In Wales COVER statistics for the 14 trusts that provide community services are published quarterly by the Welsh Unit of the Public Health Laboratory Service Communicable Diseases Surveillance Centre. The distribution area of the SWEP (Swansea, Neath, Port Talbot and Llanelli) matches the localities served by two of these trusts. Coverage for the quarter July to September 1998 was compared with the same quarter a year previously in both the distribution area of the SWEP and the rest of Wales.

Uptake declined by 13.6% (95% confidence intervals 10.9% to 16.2%) in the distribution area of the SWEP and by 2.4% (95% confidence intervals 1.4% to 5.5%) in the rest of Wales. Before the campaign, uptake was significantly higher in the distribution area of the paper compared with the rest of Wales (difference 1.7%, 95% confidence intervals 0.1% to 3.4%). After the start of the campaign, uptake was significantly lower in the distribution area of the paper compared with the rest of Wales (difference −9.4%, 95% confidence intervals −7.1% to −11.7%) (table 1)."

It's the equivalent of a smoking gun with Andrew Wakefield's fingerprints on it.

Well, it looks as though it may have happened - a measles death in Swansea.

http://www.bbc.co.uk/news/uk-wales-22215185

(No confirmation yet)

@ Chris, ha ha, avoiding all adolescents is easier said than done - I'm at a UK university campus which happens to be quite close to the Welsh border. (Luckily for me, it's finals week, so I do get to spend a lot of time alone in my room working.)

@ lilady, thanks for the HPA guidelines. It's ok, I was aware of the whole "no live vaccines" thing, as it makes the shortlist of things you're absolutely not meant to do post-transplant: "No tattoos, no live vaccines, don't get pregnant, and no grapefruit". (Unfortunately telling me not to do things tends to make me want to do them more.) I did have the full set of childhood vaccines recommended up til the age of 3 1/2, which included an MMR and an MR, since I only became immunosuppressed after 3 1/2. But I don't really know whether that will confer much immunity given that I'm now on "industrial strength immunosuppression", to quote one of my consultants.

@ Krebiozen, I was on ciclosporin for about twelve years, and it's amazing stuff (even if it does taste foul and make you really hairy). I assume it was largely because of Roy Calne's work that it became feasible to do liver transplants in paediatric patients in the early 90's, without which I would not be alive (I was one of Birmingham Children's patients, fairly soon after their liver unit opened).

@Jay and Bobby Schlecter- I'm glad this is all so funny. I'm glad that the almost 20% rate of hospital admission in English kids with measles gets you off. I'm thrilled that you manage to mock ASDs and VPDs so cheerfully.

Dead, maimed, disabled kids... all just joke fodder, eh? I get you. It's not like "damaged" people have any worth after all. Only the ~pure~, untainted cherubs of the granola mommy set have any worth.

You're filth, both of you. Haddaway and sh¡te.

@Autismum - presumably the doctors up here and the doctors in Wales got their skills in the Medical Mines. No med school for them, no, they just p¡ssed about on the coal fields, sinking shafts until they found a rich seam of medical and surgical qualifications. Aye, that'll be right. Then, with the help of their whippets (practice patients) and pigeons (stand in examiners), they became the proud professionals they are today, conferring diagnoses of measles on every 10-14 year old with a zit.

Jay and Bobby can gan to Jarra

@Khani - imagine this in a total Beavis voice "Fire fire FIRE FIRE heheheh fire!".

Flames will always win out. OME is flame-retardant though, I checked. Her tough coat of quarry dust renders her virtually fireproof.

Liz,

@ Krebiozen, I was on ciclosporin for about twelve years, and it’s amazing stuff (even if it does taste foul and make you really hairy). I assume it was largely because of Roy Calne’s work that it became feasible to do liver transplants in paediatric patients in the early 90′s, without which I would not be alive (I was one of Birmingham Children’s patients, fairly soon after their liver unit opened).

I worked in the clinical biochemistry laboratory, and we did blood work on the transplanted pigs and dogs (sorry animal-lovers), and later on the first human patients. They used to do the liver transplants at night, and we would have two people on-call (which was fun) doing bloods continually during surgery and phoning the results to theatre ASAP. Some of my colleagues developed a method for measuring blood levels of cyclosporin A (it appears to have changed its name to "ciclosporin" recently; for reasons I don't understand).

At that time only very sick patients were operated on, because it was experimental, so success rates were low. As I'm sure you are aware, one effect of liver failure is a lack of clotting factors, so these patients bled a lot during surgery, which used to seriously upset the blood bank staff who would watch half their stock disappear in one night. I had the opportunity to observe Prof. Calne doing the exciting bits of one liver transplant (the new liver going in) which was fascinating.

You are too young to remember Ben Hardwick, who was the youngest child to get a liver transplant at Addenbrookes back in 1984. My son was in and out of Addenbrookes at the time, so I saw a lot of Ben and his mother, but sadly Ben died a few months after his transplant. They are very much more successful now - you are living proof of that.

Jay Gordon said: "My comment has been wiped out three times now."

Jay, have you ever considered learning how to use a computer?

"I’ve been giving more MMR vaccines than usual."

Usual being zero? Here's what your website says:

"Feb 23, 2010
MMR Vaccination, An Important Notice from February 2006

“I no longer give or recommend the MMR vaccine. I think that the risks exceed the benefits. Obviously, discuss this with your doctor but please know that the CDC declared rubella officially eradicated in the U.S. in 2005, measles remains a rare disease in America (30-40 cases/year) and mumps is also not very common."

If you're now giving some of your patients the MMR (no doubt with great reluctance if the parents talk you into it), isn't it time for a website update (you could throw that embarassing little announcement down the memory hole along with your effusive endorsement of Andrew Wakefield)?

And if you were practicing in Wales right now, would you be telling parents of unvaccinated kids not to worry, that measles cases are being overreported and you're far more concerned about a debunked MMR-autism link than about their kids winding up in the hospital with a preventable infectious disease? (suggestion: no doubt the BBC and the Guardian would love to hear your learned thoughts on the subject).

Baloney, Wakefield, baloney. Your original work absolutely attacks any form of measles vaccine, because your faked BS hack-fest of a paper claims that measles virus from the vaccine is what causes "autistic enterocolitis". And you were TOTALLY planning on introducing a different vaccine, so when you wrote that paper, you did not want people to go to a single measles vaccine. You only switched tactics when you realized your "vaccine" was complete junk, or more accurately when your investors did. That's when you switched to making money off of litigation. That you have subsequently tried to rewrite history by claiming you weren't opposed to measles vaccination is irrelevant..

Though hey, if measles vaccine is actually okay, I guess we can thank Wakefield for finally admitting his paper was bogus. :-P Basically, he's trying to say "it's not my fault they believed what I claimed!" What a putrescent repulsive excuse for humanity. Love to see him come back to the Twin Cities for that televised debate, because there is a contingent of Somali mothers here that are eager to give him a piece of their minds -- they also believed him, did not vaccinate their children, and then watched them get hospitalized with measles. (Somalis are at much higher risk from measles because some of them return to Africa to visit relatives, and measles is endemic there.) They want to give him a piece of their minds, and I'd love to see that.

@ Krebiozen, yup, I'm familiar with the amount of bleeding which liver transplantees usually do during surgery, having required a hundred and ten units during my third liver transplant (and probably annoying the blood-bank in the process). These days I'm very thankful that blood products are thoroughly screened for infectious diseases, but how big do you think the risk of getting hepatitis from a blood transfusion was pre-1990's? I ask because when I was in hospital for my first and second transplants, there was a young child there who had already received three liver transplants, but contracted hepatitis from a blood transfusion (in addition to their original liver disease) at some point during/after their third liver transplant. The child subsequently died from hepatitis, which I guess is both an ironic and shitty way to die from liver disease.

On a lighter note, when you transplant dogs or pigs, where do get the blood products from? I'm imagining rows of donor dogs/pigs lining up to give blood, then being given tea and biscuits afterwards.

I am too young to remember Ben Hardwick, poor kid. Do you know what his actual cause of death was (the Wiki article doesn't say) ? Although I guess it might be breaking some sort of confidentiality / general ethics if you did say, so it's ok if you don't want to.

Right, measles is so mild...

I would argue with that, having had measles in the 1960s- not that I can remember much about it. I was supposed to get a vaccine but came down with the illness before my appointment date. I guess I now have the vaunted 'natural' immunity that alt med folk rave about.

Because I have many, much older cousins, I've been able to piece together what happened: I missed 3-4 weeks of school, didn't eat much and my relatives were extremely worried about me, including those who lived very far away.
I was a good student, always reading, writing and doing art work- there was great concern that the illness might damage my vision and other abilities. Adults worried about that, I'm told.

All I remember was being confined to a darkened room with a radio and being forbidden to do anything. For a few weeks.

So I didn't die or become blind ( I just need sunglasses most of the time and prefer foggy environments to sunny ones). I did manage to get through various schools and universities and developed my abilities, working in advertising as well as in counselling and assisting non-profits.

Let's just suppose the same thing happened today to some unfortunate child:
they could suffer worse physical consequences than I did;
if their family wasn't as well off as mine was, and both parents needed to work or if it were a single parent, without assistance- who would stay with the child?
For 3 or 4 weeks.
What if other siblings were infected?

I'm over 50: I have never been ill or more than a few days at a time, except for measles. I have never had a condition that affected my abilities or faculties, except measles.

Even if you don't care a shred for what the ill child and distressed family experience, you'd have to agree that thousands ill with this condition would cost a great deal of money with medical costs and lost wages.

Liz,

These days I’m very thankful that blood products are thoroughly screened for infectious diseases, but how big do you think the risk of getting hepatitis from a blood transfusion was pre-1990′s?

About 2.8% in the UK, where donating blood is rewarded by only a cup of tea and a biscuit. Probably more in countries that pay (or paid) cash for blood, making it more likely that some high risk groups would choose to donate.

On a lighter note, when you transplant dogs or pigs, where do get the blood products from?

I don't believe that was a problem, as these were healthy dogs and pigs, having healthy organs replaced with healthy organs, mostly to practice getting surgical technique and dose of immunosuppressants right. I only ever saw the blood samples, not the animals themselves, and I assume the donors were simply euthanized.

I am too young to remember Ben Hardwick, poor kid. Do you know what his actual cause of death was (the Wiki article doesn’t say) ? Although I guess it might be breaking some sort of confidentiality / general ethics if you did say, so it’s ok if you don’t want to.

From the newspapers at the time I recall it was post-op complications, either infection or possibly rejection. I know he was pretty sick before a donor was found. I'm not sure about the ethics of revealing details about a patient who has been dead for 27 years (gulp), though his parents waived confidentiality at the time to raise the profile of transplant surgery, and the need for more donors. One of the frustrating things about working with blood (and other unsavory material) is that you rarely get to meet the patients, and quite often after watching a patient's progress with interest through their blood results, you suddenly don't see any more samples, and you don't know if they have died or recovered, except through the media if it's a high-profile case.

First death of a measles sufferer has been confirmed, although it is too early to say if measles was cause of death.

Krebiozen, we may only get a biscuit, but I gave blood about two weeks ago and it was an orange Club biscuit. Totally worth it.

This report says it was measles:
http://www.bbc.co.uk/news/uk-wales-22215185

@ Chris:

I venture that AoA will not be discussing his death any time soon. They seem to not notice things like that.

According to BBC evening news it's confirmed he had measles, but not that measles was the cause of death.

Neither do we know his vaccination status - something that the Wakefield-fellators will jump on - but that's not the point. If Wakefield hadn't scared people into not vaccinating to a level where herd immunity broke down, we wouldn't need to be having a discussion.

He's a bit old to be part of the Wakefield-induced low MMR uptake cohort. As Rebecca pointed out, he wouldn't have been exposed to measles at all if vaccination uptake had remained at pre-Wakefield levels.

@Rebecca - great point. Measles must be endemic for this to have occurred in the first place. We don't see this here in the States because we've been able to successfully eradicate domestic measles......

@#111:
On a lighter note, when you transplant dogs or pigs, where do get the blood products from?
There are dog blood banks as well, actually. Some friends of mine have been involved in greyhound rescue, and one of their dogs actually set a local record for blood donation, helping save the lives of several other dogs in the process.

Granted, blood types for dogs are actually more complex than blood types for humans, which doesn't help matters, but there are still 'universal donors' like this greyhound. Vets love them.

I remember reporting the first UK measles death, in 2006, after MMR's introduction. The story was the same with another death, in 2008. On both occasions, the usual billious voices started up, really gloating over the fact that the children who died were immunocompromised.

And, I mean gloating. These nasty, nasty people were almost saying that these kids were somehow inferior beings, or even that it was their own fault, and that therefore the campaign against MMR was not responsible.

You see a similar kind of sentiment when they gloat over vaccine failures. Because MMR is only about 90% effective, there will be kids infected with measles who have been vaccinated. And, boy, do they gloat over that.

If this young Swansea guy's measles turns out to be what caused his death, you can be pretty sure that these people will start up, as they usually do. Oh, why wasn't he vaccinated already? Why didn't the vaccine work? He was much too old.

And these voices are not of people agonising over the choice of vaccination. They are nothing to do with protecting children at all. They have absolutely no interest in the subject. They aren't even people who campaign for children with autism, or disabilities, or even want to talk about it.

It seems to me that their main need is in venting a kind of malicious hatred, the success or failure of which they bizarrely measure in uptake levels of a children's vaccine.

Nasty, nasty people.

Ren (a bit belatedly):

If I may inform the doctor, there are plenty of studies where seroconversion is studied after one, two, or three MMR rounds. Yes, three… Sometimes there is an outbreak in a population that has two MMR doses but hasn’t seen measles or mumps (immunologically) in about 15+ years, so a third dose is given.

I had it *four* times. Twice as a child, once more during a rubella outbreak when I was in high school, and again after the birth of my first child due to inadequate rubella titers. I seem not to have become autistic. ;-)

Regarding blood donation, I've signed up for a blood drive my church is doing in a few weeks. There's usually a choice of prepackaged snacks. I always try and go for the Snackwells; I love those things.

Just a reminder that even when post-vaccination measles antibody titers have waned, in most cases there will still an anamnestic response on exposure to the virus.

Just a reminder that even when post-vaccination measles antibody titers have waned, in most cases there will still be an anamnestic response on exposure to the virus.

Hiccup. Sorry.

Impact of measles in France. [Rev Infect Dis. 1983 May-Jun] -

Although measles vaccine has been licensed since 1968, immunization against measles has not met with much success in France, partly because the disease is no longer feared. The level of vaccination coverage appears to be less than 20%.

A multicenter, retrospective hospital survey revealed that 1,157 patients with measles were hospitalized during a 30-month period in five areas (total population, 4.2 million). Analysis of the preliminary results of this survey and of available national data showed an incidence of 5.6-7.5 cases per 1,000 population; a hospitalization rate of one per 10,000; a DEATH RATE of 0.56 per 1 million

Jay Gordon's new book includes includes advice on keeping sperm healthy to prevent autism.

Dr. Jay seems to have finally wavered in his "support of Wakefield," but he could still function as Wakefield's athletic supporter if Wakefield played rugby in a kilt:

http://smj.rsmjournals.com/content/58/1/e1.abstract?etoc

1-500. I don't think so.

http://www.ecdc.europa.eu/en/publications/Publications/SUR-Monthly-meas…

...10 427 cases during the last 12-month period from July 2011 to June 2012.

Although ten cases were complicated by acute measles encephalitis, over the last 12 months there have
been no measles-related deaths.

Interesting that you didn't quote the entire abstract. Particularly "The problem posed by measles is sufficiently grave to justify a national campaign urging the widespread vaccination of children."

I notice you capitalized "DEATH RATE"...

You do understand that the rates are in terms of the total population, not the fraction infected, don't you?

An incidence of 5.6 per 1000 and a death rate of 0.56 per 1,000,000 means that for those infected, they have a 1 in 10,000 chance of death.

The hospitalization rate in Wales is much higher than reported for France. And the death rate in France in recent years is much higher than 1 in 10,000 infected. I'll put that abstract below for your reference.

The full abstract from the article you cite:
http://www.ncbi.nlm.nih.gov/pubmed/6878995
Although measles vaccine has been licensed since 1968, immunization against measles has not met with much success in France, partly because the disease is no longer feared. The level of vaccination coverage appears to be less than 20%. Indeed, the present epidemiologic situation is similar to the natural situation in a developed country. A multicenter, retrospective hospital survey revealed that 1,157 patients with measles were hospitalized during a 30-month period in five areas (total population, 4.2 million). Analysis of the preliminary results of this survey and of available national data showed an incidence of 5.6-7.5 cases per 1,000 population; a hospitalization rate of one per 10,000; a death rate of 0.56 per 1 million; and a disability rate of 0.48 per 1 million. Encephalitis (the definition of which should be reappraised) occurred once in 2,850 cases, and subacute sclerosing panencephalitis was not rare (incidence, one case per 2.6 million people). The problem posed by measles is sufficiently grave to justify a national campaign urging the widespread vaccination of children.</i?

2012 report [Measles in France].
http://www.ncbi.nlm.nih.gov/pubmed/23171908
From January 2008 to May 2012, over 22,000 cases of measles were reported in France. The highest incidence rate was observed in children below one year of age. Over 50% of cases were reported in young adults. Almost 5,000 patients were hospitalised including 1,023 with severe pneumonia, 27 with encephalitis and/or myelitis : 10 died. This situation is linked to insufficient and heterogeneous vaccination coverage with pockets of susceptible people allowing virus circulation. Although the vaccine coverage in children has now improved for both doses, the issue of convincing young susceptible adults to catch up for measles vaccination remains critical, if the elimination target is to be met, and in order to protect the most vulnerable population unable to benefit from this vaccination (children below 1 year, immunodeficient people, pregnant women).

5000 hospitalizations out of 22,000 cases. about 20% hospitalization rate.

10 died. About 1 per 2,200.

Seems the best course of action is to not be infected. Best way to do that, vaccination. I don't consider hiding in a group of people who are vaccinated as the best way, but rather than criticize those of us who offer your family protection, you should be thanking us.

Matt, surely you realize cases are underreported

hospitalization data is meaningless unless we know why they occurred. Also living conditions play a big role in outcomes. So bottom line, if you're healthy you have very little to worry about

@Matt - don't worry about Sid. As long as he's not infected, he doesn't care how many people suffer and die.....

Under reported? I guess that's easier to talk about than your attempt to mislead by editing the abstract.

How about the version from the CDC about France?
http://wwwnc.cdc.gov/eid/article/19/3/12-1360_article.htm

"More than 80% of the cases during this period occurred in unvaccinated persons, reflecting heterogeneous vaccination coverage, where pockets of susceptible persons still remain. "

These come up as first page results on the google search measles france. Your article, no. I.e. you are cherry picking and editing the abstract to create an story that fits your bias.

When you indulge in black-and-white thinking patterns, dichotomous variables like 'life/ death" are the only ones considered to be meaningful.

"Nasty, nasty people" is being too kind, Mr.
I would be much harsher.

@Sid - oh yeah, conditions in France are horrible....I mean, I'm sure they lack clean water & basic sanitation, along with all of the other problems associated with a Third World Country, right.....oh wait......moron.

Lawrence,

I know that. anyone who says "Hospitalization data is meaningless" is a fool. The 5000 people in the hospital didn't find it meaningless.

"If you are healthy, you don't have anything to worry about".

Sure, if you are healthy you aren't infected with measles.

My kid is a medically fragile disabled child. You can imagine what I think of people who write off the lives of this population. Hell, I don't need to relate to my own family. People who basically consider the weak to be expendable are worthy of contempt.

Poor, Matt. Did I hurt your feelings by simply demonstrating the 1-500/1000 measles mortality number is wildly off base. Sorry. As to underreporting of cases:

Underreporting was estimated to be in excess of 50%, probably changing over time and with patient age. Local outbreak investigations found that <50% of cases had been notified, mainly because of secondary cases in households; these patients were less likely to seek medical advice once a first case had been diagnosed

@Sid - so are you now claiming that the epidemic in France was "worse" than what is reported? That doesn't sound like you...

Lawrence,

wow--he played the "living conditions" card? On France? Oh-Kay. He needs to learn the lesson that the first step in getting out a hole one has dug is to stop digging.

Living conditions do have a big affect, according to a doctor who is oft quoted by vaccine rejectionists. A doctor working in Africa reported that measles death rates are increased based on the initial exposure. Those who live in tight quarters and/or are exposed to multiple infected people were more likely to die. His belief was that the sanitary conditions were not as important.

People who play down the impact of measles are like people who claim that vaccines don't work. They are either lying or they are passing on lies they've heard and not done enough to check,

I've been at this way to long to have my feelings hurt by fools. The "hurt feelings" debate ploy is extremely transparent.

The funny thing is that when you edited the abstract, you showed that you know that you are misrepresenting the facts.

So now you will do a lot of hand waving about under reporting and try to create a smoke screen to cover your tracks. Garden variety vaccine rejectionist actions. Have a nice weekend.

"Sid" seems to think that his claim that measles is only a problem if you're unhealthy, poor or immunocompromised is an argument in his favour. After seeing "Greg's" inability to comprehend why a blinded vaccinated vs. unvaccinated study would be unethical, and, of course, Wakefield's self-perpetuated decline and fall, I have to conclude that you must be psychopathic to be an antivax activist.

Don't get your bowels in an uproar guys...you're debating Bob Schecter, the smarmy smug "fire science" expert.

Bob hates kids who are different from his child....little brown babies in California, too young to be vaccinated, who died from pertussis and black children in Africa and kids who are medically fragile, who die from measles.

How's the radio career working out for ya, Offal?

http://www.bbc.co.uk/news/magazine-15647434

"Why do parents buy chickenpox lollies?

Some parents object to what they see as the dictatorial nature of the US vaccine programme, which, they argue, leaves them little choice over what is being put into their children's bodies.

Campaigner Robert Schecter, who runs the Facebook group Proud Parents of Unvaccinated Children, claims the pharmaceutical industry is a key driving force behind the growth in childhood immunisation in the US.

By no means is it a conspiracy, but there are vested interests working together," he says.

A self-styled libertarian, who ensured his own daughter did not receive any vaccinations, he dismisses public health officials as "paternalistic do-gooders" who "get satisfaction out of what they believe to be helping people" when in fact they are doing no such thing.

Vaccination sceptics like Mr Schecter can produce reams of statistics which they claim show public health officials have exaggerated the seriousness of diseases and "covered-up" safety concerns.

They even dismiss figures from the US Centre for Disease Control and Prevention that cases of measles tripled last year, pointing to the fact that were there still only 220 cases and no deaths. The disease is also on the rise in Europe, where there were 29,000 cases and nine deaths in the first seven months of 2011..."

Offal debated Dr. William Schaffner, who whupped his sorry a$$ on a BBC late night radio program.

https://medicine.mc.vanderbilt.edu/node/451

(Offal defended parents right to chose if they wanted to immunize their kids and defended parents who share chicken pox-infected lollipops).

@elburto: You have serious anger management issues and serious social skills problems. There is nothing funny about an outbreak of measles. You're suggesting this crosses a line.

@Bacon: That seven-year-old note on my website is out of date. Thanks for calling it to my attention. I don't recommend the MMR unless travel increases the risks and parents want the vaccine. I do give the vaccine. If I were practicing in Wales right now, I would recommend the MMR vaccine.

@Ren: These outbreaks are random in some ways. There would be fewer and smaller outbreaks if 95% of people were vaccinated. I have never believed that we have proven that the MMR causes autism and also refuse to believe that it's a harmless vaccine that can't trigger ASD in genetically susceptible children. The "guilty until proven innocent" plan about any child with a rash would certainly change a small outbreak into an "epidemic."

@Brian Deer: It would be despicable to "gloat" over a death from an illness.

Within the past hour, I have given a DTaP, two polio vaccinations and an HPV vaccine--that I most definitely did not recommend. The parent requested the HPV vaccine and we discussed it and I gave the shot. Just a news update for you all from the evil "anti-vaccine" camp.

Have a nice weekend. I hope to have time to continue this interesting discussion. The perspective you offer affects the way I view the measles outbreak in Swansea and my personal practices. Thank you for that.

Jay

I ended up having the MMR at least 4 times. 2 as a kid, then once after my university sent a letter saying "We can't locate a record of your having been immunized against Rubella," and then another time after that when they STILL could not locate the record.

I probably shouldn't have asked for another one before a trip to the UK last year, but I did anyway. I think I ought to stop now. ;)

"On both occasions, the usual billious voices started up, really gloating over the fact that the children who died (of measles) were immunocompromised."

"And, I mean gloating. These nasty, nasty people were almost saying that these kids were somehow inferior beings, or even that it was their own fault"

Brian, the corollary to this eugenics throwback attitude is the belief that they innately (or by doing the Right Things - eating superfoods, taking supplements, purging toxins etc.) possess a superior immune system and thus do not have to be concerned with germs that afflict people inferior to them.

This attitude gets whacked in the head on occasion (as when young healthy people with vigorous immune systems are hit hard by infections which trigger deleterious hyper-immune reactions (as in the case of H1N1 influenza), but its proponents never seem to learn.

Within the past hour, I have given a DTaP, two polio vaccinations and an HPV vaccine–that I most definitely did not recommend.

Well bully for you! What do you want? A cookie?

The parent requested the HPV vaccine and we discussed it and I gave the shot. Just a news update for you all from the evil “anti-vaccine” camp.

It sounds as though the parent was a good bit better informed than her child's pediatrician.

Elburto has no anger management issues at all. She has idiot-management issues.

Jay said "@Bacon: That seven-year-old note on my website (stating that he does not give MMR shots) is out of date."

It's dated 2010, reiterating a position you apparently took in 2006. So much for a "seven-year-old note".

It'd be fun to be a fly on the wall in Jay's office, listening to parents arguing with him over the need to protect their kids via immunization (and schooling Jay on things he should have learned during his medical training).

Orac, been a long day here. A cookie sounds good.

Bacon, I learn things from the parents in my practice all the time.

Jay

Indeed. The things Dr. Jay said about the MMR were truly ignorant:

http://scienceblogs.com/insolence/2008/07/19/dr-jay-gordon-pediatrician…

Well, that goes for vaccines in general, too.

@Jay - shouldn't you be more concerned with actual medical science? You know, all of that available research that shows that your opinions are full of it?

@ Dangerous Bacon: Dr. Jay is a liar, when he posted this at you...

"@Bacon: That seven-year-old note on my website is out of date. Thanks for calling it to my attention. I don’t recommend the MMR unless travel increases the risks and parents want the vaccine. I do give the vaccine. If I were practicing in Wales right now, I would recommend the MMR vaccine."

I've quoted Dr. Jay's outrageous statements about vaccines numerous times, when he comes posting here.

Here again for the umpteenth time, Jay's opinion about Prevnar vaccine..

"The Prevnar vaccine is too new for me to recommend. The number of cases of Pneumococcal ear infections which could be prevented is very small and the number of cases of meningitis prevented is also small. I have no quarrel with doctors who recommend the shot or with parents who choose to get it. I have very strong objections to advertising this immunization to the general public on television. I don’t think enough information can be disseminated in 60 seconds."

How long does a vaccine have to be licensed, for you to "recommend it" Jay?

Prevnar 7 valent vaccine first became available 13 years ago and Prevnar 13 valent vaccine replaced Prevnar 7 in 2010.

http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-pcv.pdf

Here's something elementary that Jay has yet to absorb - from his training or his patients - the concept of preventative medicine.

This is a physician who has repeatedly promoted the idea that we don't need immunization because incidence of the diseases vaccines prevent has fallen to such low levels. Yet he blithely assures us that if he was practicing in Wales, he'd recommend the MMR vaccine.

So an epidemic has to break out to convince you of the need for vaccinate against measles? It doesn't make sense to you to maintain vigilance to avoid mass illness?

Probably if Jay had gone into internal medicine, he'd have waited until patients had myocardial infarctions and strokes before taking steps to treat their hypertension - or delayed antibiotics until they'd gone into sepsis. .

I have never believed that we have proven that the MMR causes autism and also refuse to believe that it’s a harmless vaccine that can’t trigger ASD in genetically susceptible children.

Dr. Jay, if you had an ounce of self-respect and decency, you'd stay quiet. What you write here is in many ways opposed to what you've said before:

"Vaccines, as they are presently formulated, are toxic enough to cause autism and other neuro-immune disorders, very simply."

So, in that statement at the "Green Our Vaccines" rally, did you not mean to include the MMR in "vaccines"?

Seriously, Dr. Jay, you're embarrassing yourself.

10 died. About 1 per 2,200.

Which jibes quite well with the 0.05% CFR reported for Australia, New Zealand, and Japan in Wolfson et al.'s 2009 review.

Of course, sanity-checking of assertions is not to be expected from bulletheaded jizzmops such as Schecter.

Actually Ren, Dr. Jay had a lot to say about measles vaccine at the "Green Our Vaccines" rally. He was the keynote speaker:

http://recoveringnicholas.com/2008/06/04/green-our-vaccines-rally-washi…

" Dr. Jay Gordon spoke first asking the crowd the following questions….

“Before your child got vaccinated, did your child sit down with you and explain vaccine dosages and timings and side effects?” NO!

‘When your child was diagnosed after vaccination, you doctor owed you a hug and an apology, did you get that hug?” NO!

“The Insurance Industry should have given you an even bigger hug… They should have said you know, “Thank you for paying your premiums for all of these years. Dont worry about the cost. Dont worry about the money. You take care of your child and your family. We got the cost.” Did you get a hug from your insurance company?” NO!

”The American Academy of Pediatrics, the CDC, the FDA, they all owed you hugs. Are they protecting us? ” NO! ”from a large overdose of vaccinations given too soon”

The Pharmaceutical Industry; of course all of them wanted to sit down with you and talk to you, they wanted to know how we could make things safer, they wanted your opinion, is that right?” NO! “Did they hug you?” NO!

“Vaccines as they are presently formulated are toxic enough to cause autism and other neuro-immune disorders. It’s very simple. Are we anti-vaccine? No, we’re not. Trying to label us as anti-vaccine is a trick. It allows them to try to get rid of us more easily. The doctors fear we’ll give and the parents might accept vaccines that were much safer, tested far better and given much slower.

“If we had a burning house with children in danger, we wouldnt sit outside and discuss it, we’d get the children out of the house. We have a dangerous situation right now and we have to act. The time for debate is over. We have to do something.”

“Measles..measles, there have been 65 cases of confirmed measles in the United States this year. 65 cases in a country of 300 million people. Measles has been in the NY Times and every other newspaper 20 times for the past months. If I had a press agent that good, I would have been the Beatles!”

“The Time Magazine article, I think that the Time Magazine article was a spoof of responsible journalism. If you read it, it led off by talking about the Hib vaccine and then they called Hib a virus. Hib is a bacteria, that’s a big difference. Anything after that that this writer wrote is invalid. She didn’t know what she was talking about. It’s as if you had picked up a story about cooking and they meant to talk about chocolate chip cookies and they started talking about chicken. She was irresponsible. We have to focus on the risks.”

“I’ve been a pediatrician in private practice for nearly 30 years. I take care of children and families every day of my life. I have no special expertise in Autism like the great Dr. Kartzinel. I am not an infectious disease expert either. My expertise is this…. I abandoned the routine vaccine schedule in 1980, 28 years ago. I did not stop giving vaccines. I did begin looking for a safer way to vaccinate, right now I give very few vaccines. I’ve watched children reactions over the first few minutes, over the first few hours… I’ve followed their health over weeks, months and years. I get countless… hundreds of emails, 2nd opinion consultations, phone calls about children harmed by vaccines. I get dozens of phone calls from doctors who really didn’t want to talk to me. Many of them don’t really like me, but they knew that I would listen to their stories about strange and tragic vaccine reactions that they never expected to see. The current vaccine schedule does create immunity to many diseases, this could be a good thing. But I am afraid that the way we are doing this, the way we’re vaccinating, might actually diminish a child’s overall health. On what do I base this?? on nearly 30 years of watching and then most importantly, listening to you! Listening to parents. Of all the strange things, more than any medical school class, more than any resident training, more than any book I’ve ever read, I’ve learned more from you. No one knows your child better than you do.”

“Here’s something unusual and a little bit interesting.. this is the only area of medicine, vaccines are the only area of medicine where we deny side effects. If I give you amoxicillin for a urinary tract infection, I do it sincerely. I think you need it. I apologize about the rash, the diarrhea, the cramps, and the inevitable yeast infection but I really think you need that amoxicillin, and I really think it will work. But 6 vaccines given to your 10 pound daughter. Doctors tell you before the shots that there are no side effects. And that the seizures, maybe the autism that results, are not proven and are undoubtedly coincidental. Coincidental, do you believe that?” NO!

”Your child is a real living breathing unique special beloved person. Autism is not a coincidence and your child is not a coincidence. I’ve seen children change from vibrant talking kids to silent distant children after vaccination. And then I’ve watched parents work their tails off; a gluten-free, casein free diet, supplements, hours of therapy and bring back their child’s language and their child’s smiles. I’ve watched it happen. Vaccines and the current schedule can cause autism and hard-working loving parents can help children recover.”

“Something else interesting, something else amazing. This is the only area of medicine, vaccination, where your 6 week old baby boy and I, a 180 pound man get the same dose of medication. A polio vaccine, the same dose. Does anybody believe this is the best way to vaccinate?” NO!

“When I get a dose of mercury in a flu shot, well I wouldn’t, if I were to get a dose of mercury in a flu shot, or aluminum, that’s bad enough, but does anybody believe that that same amount of aluminum or that same amount of mercury think those things are safe for a 25 pound toddler? Aluminum! There is still mercury in many common vaccines, but aluminum, there’s enough aluminum in there to cause harm. The FDA puts a ceiling, a limit, of about 50 micrograms a day. Aluminum irritates cells, it irritates brain cells. Maybe some of you are aware of aluminum because of the possible and the plausable connection to Alzheimers Disease."

@ Dangerous Bacon:

I'd go further than that- not just that they possess a superior immune system but superiority in general: I find most of the proselytisers despicable- although this manoeuvring might ultimately be self-protective of their fragile psyches and should be pitied.

I hear and read so many of the usual suspects giving medical advice, speaking derisively of professionals, etc.
You all know my fave haunts.
A tough job but someone has to do it.

For everyone's edification, Robert/ Sid maintains a website, a dreary place, but its eponymous facebook page ( The Vaccine Machine) seems to be much livlier ( 22K friends) with frequent updates and questions from his adoring fans. Yes, Robert gives advice on how to avoid vaccination- apparently to many attractive young women from AUS, US, UK, etc. .
Drop by and see what he's up to.

lilady: I still like a lot of parts of that speech. Not all of it. It was five years ago and I really don't like the tone I used. Too strident and rabble-rousing for my tastes now. By the way, I was not the "keynote speaker." As I recall, RFK Jr. was there as were politicians, Jenny McC and Jim. Read my thoughts about the Prevnar vaccine out loud. Many new medications are not found to be either dangerous or non-efficacious for a long time. Get the Prevnar 13 or don't. Just don't ask me to like a vaccine who's predecessor may have created more a more dangerous bacterial situation than previously existed. How long before we'll need a PCV 27?

Ren: Vaccine manufacturers have no product liability and no incentive to improve vaccines. The was we administer vaccines triggers neuroimmune problems in susceptible children.

Bacon: Do you take anti-malarial meds every day or only when you're in a high risk area? I would recommend vaccines for people in higher risk situations.

I'm curious, are you all so rigid and dogmatic that you really can't understand how someone could change opinions and practices? Maybe you are. Can you really do so little reading that you don't know that vaccines can cause side effects which must be take seriously and factored into the decisions we all make?

Very few of you above have actual patients you care for. I do.

Jay

Robert also has his own Facebook page. At least he has a shirt on...that nudie upper body picture was such a turnoff

Here's a list of Bob's "Favorites"

Aviva Romm, MD, Business of Baby, The Mother magazine, Armando Hasudungan, David Kirby, Writing and Media Coach, Reasonable Faith, Tania Marshall, Leslie Manookian, Vaccination News Network, Autism Advisory and Support Service, Chiropractic 4 Kids!, SafeMinds, Life Health Choices, The Vaccine Machine, CDC

Vaccine manufacturers have no product liability and no incentive to improve vaccines. The was we administer vaccines triggers neuroimmune problems in susceptible children.

A - You can thank the anti-vaccine forces themselves for that. You know, Barb Loe Fisher. Read up on her actions in creating the vaccine court and the compensation tables. They thought that it was going to be a walk in the park because all they needed was 50% and a feather of evidence. Talk about getting what you wished for.

B - "The was we administer vaccines triggers neuroimmune problems in susceptible children." Yeah, I have a response for that... What?

Very few of you above have actual patients you care for. I do.

Well, I do take care of populations. Does that count? Of course it doesn't. I'm just a miserable little insect.

I almost forgot...

Can you really do so little reading that you don’t know that vaccines can cause side effects which must be take seriously and factored into the decisions we all make?

Let me answer that in the Socratic tradition: Can you really do so little reading that you blow the risks out of proportion so much so that you even deny the benefits of immunization?

Then agan, I think we all know the answer.

Also, aluminum! *Goes to eat his metal-laced french fries.* Sodium's a metal, but we eat it as a salt. Aluminum's a metal, but we inject non-toxic doses of it as aluminum salts.

Can you really do so little reading that you don't understand chemistry and toxicology, Dr. Jay?

@Ren - both of my boys are fully vaccinated, on schedule & are well ahead of the curve - perhaps I should start a group that asserts that vaccines cause over-achievement?

Jay: It would be despicable to “gloat” over a death from an illness.

Have you taken a look at the crowd you run with lately?

Lilady: Ugh, that speech- who would *want* a hug from strangers? I wouldn't even hug my brother when we were teens.

Jay Gordon,

You wrote:

@Bacon: That seven-year-old note on my website is out of date. Thanks for calling it to my attention. I don’t recommend the MMR unless travel increases the risks and parents want the vaccine. I do give the vaccine. If I were practicing in Wales right now, I would recommend the MMR vaccine.

This doesn't read as sensible to me. Vaccines are intended to be preventative medicine, given to ensure that ideally outbreaks don’t happen or, if they do, they are limited/contained (assuming a high enough vaccination rate for the so-called ‘herd’ effects to be effective).

Suggesting that the vaccine be only be given after an outbreak has started is contrary to the point of the vaccines. (Surely.)

It’s compounded by that measles has one of the higher R0 rates of the more common illnesses.

(My apologies if this has already been addressed - I've been away from this thread too long to read it all!)

By the way, I was not the “keynote speaker.” As I recall, RFK Jr. was there as were politicians, Jenny McC and Jim.

- as they used to say in Mad Magazine: The usual gang of idiots.

@ Dr. Jay: Which parts of that speech do you like? Which parts of that speech do you not like?

"Read my thoughts about the Prevnar vaccine out loud. Many new medications are not found to be either dangerous or non-efficacious for a long time. Get the Prevnar 13 or don’t. Just don’t ask me to like a vaccine who’s predecessor may have created more a more dangerous bacterial situation than previously existed. How long before we’ll need a PCV 27?"

You really don't know anything about PIDs (S. Pneumonaie Invasive Diseases), do you? How did the introduction of Prevnar 7 valent vaccine (create) "a more dangerous bacterial situation"? You do know, don't you, that once Prevnar 7 was introduce in 2000 and provided protection against the 7 most prevalent circulating serotypes of S. Pneumoniae bacteria, that additional serotypes among the more than 90 serotypes of PID ("serotype substitution"), would come to the fore and then be diagnosed as causing PIDs?

Here, the Policy Statement And Recommendations from the AAP about 13 valent Pneumococcal Vaccine and the 23 valent S. Pneuomoniae vaccine.

http://pediatrics.aappublications.org/content/126/1/186.full

From the American Academy of Pediatrics

Policy Statement

Recommendations for the Prevention of Streptococcus pneumoniae Infections in Infants and Children: Use of 13-Valent Pneumococcal Conjugate Vaccine (PCV13) and Pneumococcal Polysaccharide Vaccine (PPSV23)

Committee on Infectious Diseases

Read the Policy Statement and Recommendations carefully Dr. Jay, to learn how "serotype substitution" after the introduction of Prevnar 7 brought forth other serotypes ("serotype substitution") that caused IPDs.

Abstract

Routine use of the 7-valent pneumococcal conjugate vaccine (PCV7), available since 2000, has resulted in a dramatic reduction in the incidence of invasive pneumococcal disease (IPD) attributable to serotypes of Streptococcus pneumoniae contained in the vaccine. However, IPD caused by nonvaccine pneumococcal serotypes has increased, and nonvaccine serotypes are now responsible for the majority of the remaining cases of IPD occurring in children. A 13-valent pneumococcal conjugate vaccine has been licensed by the US Food and Drug Administration, which, in addition to the 7 serotypes included in the original PCV7, contains the 6 pneumococcal serotypes responsible for 63% of IPD cases now occurring in children younger than 5 years. Because of the expanded coverage provided by PCV13, it will replace PCV7. This statement provides recommendations for (1) the transition from PCV7 to PCV13; (2) the routine use of PCV13 for healthy children and children with an underlying medical condition that increases the risk of IPD; (3) a supplemental dose of PCV13 for (a) healthy children 14 through 59 months of age who have completed the PCV7 series and (b) children 14 through 71 months of age with an underlying medical condition that increases the risk of IPD who have completed the PCV7 series; (4) “catch-up” immunization for children behind schedule; and (5) PCV13 for certain children at high risk from 6 through 18 years of age. In addition, recommendations for the use of pneumococcal polysaccharide vaccine for children at high risk of IPD are also updated...."

Did the introduction of vaccines to protect children against IPDs in 2000 and 2010, cause S. Pneumoniae serotypes to become penicillin-resistant, Dr. Jay...or did the over-prescribing of penicillin for otitis media by doctors, cause that penicillin resistance?

Oh Jay...

“Vaccines as they are presently formulated are toxic enough to cause autism and other neuro-immune disorders. It’s very simple. Are we anti-vaccine? No, we’re not. Trying to label us as anti-vaccine is a trick. It allows them to try to get rid of us more easily. The doctors fear we’ll give and the parents might accept vaccines that were much safer, tested far better and given much slower."

Try PubMed "MMR Vaccine Autism" for a list of 340 published studies that disprove any relationship between MMR vaccine and the onset of autism:

http://www.ncbi.nlm.nih.gov/pubmed?linkname=pubmed_pubmed&from_uid=1995…

Did you happen to read this AAP January, 2013 listing of studies about Vaccine Safety?

http://www2.aap.org/immunization/families/faq/vaccinestudies.pdf

Dr. Jay:

I don’t recommend the MMR unless travel increases the risks and parents want the vaccine.

So he insists children in his practice depend on herd immunity to protect themselves from measles, mumps and rubella. It is ironic that wealthy parents who pay him cash (he does not deal with health insurance) are required to be parasites on society by getting a free ride on the high immunity from vaccines in their community.

What a hypocrite. I respect him even less.

Dr Salisbury will not accept to challenge Dr Wakefield to a debate because he knows he can not win the argument.

Did you know there are 2 whistle-blowers suing Merck for lying to government about the safety of MMR.

Lets hear them debate!

Why doesn't Dr. Jay just give up his membership in the American Academy of Pediatrics? He doesn't follow the Standards of Care regarding immunizations and totally ignores Policy Statements about specific vaccinations and incorporating/implementing strategies in his practice for timely and complete vaccinations, according to the CDC and AAP Recommended Childhood Vaccine Schedule.

http://pediatrics.aappublications.org/content/125/6/1295.full

While Dr. Jay doesn't tell parents to "hide in the herd", like Dr. Bob Sears does...he encourages parents who get all their information about vaccines from mommy blogs to become "free riders".

both of my boys are fully vaccinated, on schedule & are well ahead of the curve – perhaps I should start a group that asserts that vaccines cause over-achievement?

Can I join you? My granddaughter is very bright and fully immunised to this point. Her mum got the letter about her next set of vaccinations the other week and was straight on the phone to book the appointment.

By the way, I posted over on AoA a satirical comment about a vaccine patent being worth 400k and not needing to bother with clinical trials (its in the bit about the tragic unnecessary Walesdeath) and it got through. I tried to post something similar about what happened to your single measles jab patent, Andy? and they didn't like that.

Dr Gordon @143:
@elburto: You have serious anger management issues and serious social skills problems. There is nothing funny about an outbreak of measles. You’re [sic] suggesting this crosses a line.

I went back and re-read Elburto's comment #107 --

@Jay and Bobby Schlecter- I’m glad this is all so funny

Now YMMD but for me the general tone here is "withering sarcasm". As for a remote diagnosis of "serious social skills problems", are you sure you want to play psychologist on the internet?

It could be that I am wrong, for my own sense of humour leaves much to be desired, and often I laugh at things that other people find un-funny, and vice versa ["laugh" used here in a broad sense to encompass "transient smile-like twitch"]. I am always looking to educate myself on this human business of "humour". With this in mind, perhaps I can ask one or two questions:

-- When you wrote two years ago that measles was "an organism [...] which has lived in relative symbiosis with hominids for millions of years", was that a joke? Or were you genuinely unaware that measles jumped species to humankind about a thousand years ago?

-- When in the course of an earlier jihad, you endorsed Gisele Bundchen's view that breastfeeding should be legally mandated, was that a joke? An ironic parody of your view the vaccination program is an unwarranted heavy-handed extension of government powers into private life? Or had you not noticed the contrast?

-- When you complained that "one can’t have a public debate of losing “weaker” humans to measles to benefit stronger humans". was that a joke? I prefer to think that you were pulling the legs of all the serious straight-faced pedants at RI, rather than espousing eugenics.

TIA.

@Chris Lipthorpe,
You seem to think that a debate between Mr. Wakefield and Dr Salisbury will have some significance. Besides determining which is the better debater, what do you expect to be discovered?

herr doktor bimler, your third link doesn't work for me. I don't want anyone to miss Dr. Gordon's eloquent defense of measles as a benefit to humanity:

http://scienceblogs.com/insolence/2011/03/24/dr-jay-and-argumentum-ad-p…

You know, it's so much easier to insult than it is to really think about what I am saying.

The fault is not completely Andy's, and blaming him for it is *giving him what he wants*! He wants this, because even bad publicity is publicity. He craves this. He can turn to his followers and the public and say, "Whoa is me! I'm St. Andy and you can see how I'm persecuted!" He's using this to build his martyr complex, and you people are giving him the tools to do so.

Ignore the tool! Hopefully, he will fade from view and only be a bad chapter in a history book some day. But blaming him for something that is not entirely his fault is what he wants.

But, instead of thinking about what I was saying, or asking clarifying questions (you know...something critical thinkers actually do), or politely discussing why you disagree, it's so much more reasonable and intelligent to call someone a twit, or a prat, or a tosser. Insulting someone always makes one look more intelligent, doesn't it?

I could return the insults, but I won't; I find myself reasonably intelligent and capable of expressing myself legibly without resorting to schoolyard taunts.

I will not be returning, however. I thought the people on this site discussed science. I see now that I am wrong. Good day.

Dr. Gordon says now, "If I were practicing in Wales right now, I would recommend the MMR vaccine."

I wonder why. After all, according to Dr. Gordon, "the measles virus and the infection it creates in strong healthy humans probably improves human health." Why would he deprive the Welsh young people of this benefit?

Moreover, according to Dr. Gordon, "An extremely very small percentage of children who get measles will get complications and a far smaller percentage of these would suffer larger complications". Why bother with vaccination when only an extremely small percentage suffer any harm? It's just like getting a cold, right?

Besides, measles has "lived in relative symbiosis with hominids for millions of years", so it can't be eradicated and it would be dangerous to try, and anyway, "The infection may have beneficial effects for humans."

@Chris Lipthorpe:

Did you know there are 2 whistle-blowers suing Merck for lying to government about the safety of MMR[?]

I've heard this before. I vaguely remeber something about it. And it turned out to be incorrect. Please give more details.

Just a Thought,

I could return the insults, but I won’t; I find myself reasonably intelligent and capable of expressing myself legibly without resorting to schoolyard taunts.

You mean schoolboy taunts like, " Come on…you are supposed to be a scientist"? Or, "do a little critical thinking"?
You came here making assertions that a few seconds thought or even just reading the article you linked to would reveal are simply foolish, such as "If it was Wakefield’s fault, then the MMR rates should be low. They’re the highest they’ve been in 14 years" when the MMR rates in those who are getting measles are low, while it is those in younger children are higher. Then you demonstrated your own ignorance and lack of critical thinking by asking us to, "determine WHY the outbreak occurred and is spreading". We know why the outbreak occurred, it clearly is clearly due to vaccine refusal that occurred during the vaccine scare that Wakefield caused, not vaccine failure, a new strain or waning immunity.

I feel quite justified in calling someone who makes such foolish statements a twit.

" blame for the measles outbreak rests squarely with the public health establishment. Separate measles, mumps and rubella were available when Andy was asked, and gave his honest view, that parents should avail themselves of that choice until more research was done. A few months later, they got rid of those shots...."
saith Dan Olmsted.

These people will say anything, won't they?

@chris lipthorpe

You do know a debate requires two valid points to an issue, right?

In this case, there is no valid point to mr wakefield's point, since there is no proof that his views are valid and it has already been established that mr wakefield had willingly committed fraud.

As for your second assertion, [citation needed].

Thanks Melissa and HDB. Jay, your reading comprehension is dire. No wonder you need to solicit help in understanding certain reports.

Measles is not funny, you're right, so why do you seem to glorify in suffering and misery? Why do you associate with ableist eugenicist scum who tout ideology suggesting that anyone who dies of a VPD was unworthy of life anyway, and laugh at our misfortune? Hmm?

Social skills... Let's see Jay, in the last 15 months I have seen my partner, my mother and father (five times) and district nurses that visit to give my B12.

I would have escaped earlier, but I got flu, and every time I have to fight a virus I get weaker, I lose function, I slip back. I'm in the middle of the virtually ignored measles outbreak in the North-East of England*, one that makes the Welsh one look minor, growing at 10% every WEEK

Scumbuckets who run in your circles have mocked me openly for being scared that I'll contract measles and die because of the huge gaps in herd immunity thanks to parents panicked over scare stories about "vaccine damage", backed up and promoted by certain doctors.

There are now two confirmed cases in my village. We had a scare on Thursday when our little nephew got a rash and a fever, luckily for me it was Fifth Disease, not measles, but unluckily for me, I'm now at risk of two viral illnesses, because I cannot force my partner into isolation that's like the situation I endure. She needs to see family and friends, even if I can't.

I'm sure you'll be terribly sad at the fact that a "normal" person is dead thanks to the efforts of your disease promoting cheersquad. Still, you can take boundless joy at the fact that a little lad not far from here, one who's immunocompromised thanks to the anti-rejection drugs that help his new liver stay put, is out of hospital after being seriously ill with measles. I'm sure Bobby Schlecter et al will be overjoyed that he's doing well.

My life is hard enough and worrisome enough without being scared that something as stupid as a preventable virus like measles might kill me, after fighting off so many other things.

That's why I think you're despicable filth, that's why you (and your monstrous acolytes) can take a flying fvck at a rolling doughnut, because I can not dredge one ounce of care from my give-a-sh¡t tank about your opinion of my language, mood or social skills.

Pretty hard to maintain an Emily Post-esque level of discourse without any social situations to practice in. My skills are a little rusty. Next time I'll just tell you to f*ck yourself with a chainsaw, then there's no ambiguity.

Fireman Bob - dead is dead. Spraying your cloacal sludge about death rates in (apparently 14th C. France) won't bring back anyone who dies of measles. Muppet.

To you and the ever-lurking cohort of chucklefvcks who are apparently revelling in the fact that "damaged" people are most at risk from VPDs, whe seem delighted at the thought of cleaning us out of the gene pool, thank you. Yes THANK YOU. Why? We've been saying that was your hidden message for years, and now you've become stupid enough to say it out loud. As Brian Deer and Matt Carey have pointed out, your loud and proud ableist rhetoric is now on show for all to see. I've had a couple of emails this week from mums who've dashed out and made sure their kids are up-to-date on their immunisations, because your "better dead than damaged" drivel finally sank into their skulls, but not in the way you intended. They realised that they loved their kids so much that actually, the risk of "vaccine damage" was nothing compared to the horror of losing a child.

So thank you very much!

Lots of love from elburto and her anger-management issues.

Cosigned by the elburtoBIL, OME,s brother, who was terrified that his 22 month old grandson had measles. The same disease that triggered the encephalitis that destroyed the optic nerves in one of his eyes and caused spinal nerve damage that still affects him 45 years later at age 47.

*We're a deprived, poor region, but actually startlingly similar to Wales. The difference is that we're way north of Watford Gap, (so further from the gaze of national news cameras) and are often treated as if we're in a different world because of that. Sadly the campaign for devolution (I'm not kidding) didn't take off, because people naively believed that Tony Bliar, being a local lad, might help bring us into the fold. Now that's funny.

I take it that Chris the disease promoter from Stockton isn't immunocompromised, and doesn't care for someone who is, and would rather gloat joyfully over third-hand long debunked rumours than worry about needless injuries and deaths.

Argh error -

luckily for him it was Fifth Disease, not measles, but unluckily for me. blah blah...

JAT - Please feel free to apply any of my schoolgirl insults to yourself. Pro-tip : your DNFTT advice about Wankfield is wrong. As a strategy DNFTT doesn't work, it's well known.

elburto:
people who can't imagine themselves in another person's position- i.e. take the role of the other- shouldn't be talking about anyone else's 'social skills'..
-btw- Dr Jay's patients are children- he should know all about how the development of social skills transpires and what its LACK illustrates.

I’ve heard this before. I vaguely remeber something about it. And it turned out to be incorrect. Please give more details.

This is the False Claims Act qui tam suit by former Merck employees Krahling and Wlochowski. It came after a two-year FDA investigation that basically found nothing, and the DOJ declined to join the case. The assertion is that serial passage of the Jeryl Lynn strain resulted in decreased efficacy and that Merck used defective testing to inflate the results. It has nothing whatever to do with safety.

I actually looked at the docket last week; IIRC, the last development was in February, and the item currently on the table is a motion to dismiss. One might note that the FCA allows the relators to personally collect something like 30% of any judgement.

Besides, measles has “lived in relative symbiosis with hominids for millions of years”, so it can’t be eradicated and it would be dangerous to try, and anyway, “The infection may have beneficial effects for humans.”

Yet more proof that Dr. Jay hasn't read up on his virology. Measles has been with us only a few thousand years. It jumped from cattle to humans somewhere in northern Africa and the rest is history. Sorry to tell you, doctor, our evolution has been more shaped by environmental (e.g. geological) forces and our own interactions with each other (e.g. extermination of the Neanderthals) than by disease. Our history is a whole other story. Millions dead, millions more crippled... And that's since we've had vaccines for things like measles, polio, chickenpox, things whose natural reservoir are humans. Things we could have eradicated in a generation or two's time.

Jay Gordon is reminding us that he takes care of patients, a responsibility some but not all the rest of us have as well.

With that in mind, here's a short CME course I picked out for Jay which would benefit his patients more than haranguing participants on RI in a vain attempt to score points.*
It's a course on immunization safety, based on a video presentation by a family physician who's a professor at the Univ. of Wisconsin School of Medicine and Public Health.

"After hearing and assimilating this program, the clinician will be better able to:

"Address concerns of parents about the immunization of children."

" Review the history of vaccine safety dating back to the 1950s."

"Discuss clinical evidence about common vaccines and risk for adverse effects, such as autism, sudden infant death syndrome, and febrile seizures."

"Explain the process of vaccine development and the safety infrastructure of the US Department of Health and Human Services."

"Provide up-to-date, honest, and evidence-based information to parents and patients who refuse vaccination.

http://www.mycme.com/immunizations-part-2-an-analysis-of-vaccine-safety…"

This CME course is only $25, and should eliminate the misconceptions and fill in the glaring gaps in Jay Gordon's knowledge about vaccine safety.

*of course, if Jay pays no more attention to facts presented in the CME course than he does to the good information passed on to him by posters in this forum, little will be accomplished. But if he's actually paying for knowledge (and getting CME credits in return) maybe he'll be more willing to listen and change his ways.

Jay: "...are you all so rigid and dogmatic that you really can’t understand how someone could change opinions and practices? Maybe you are."

Prove us wrong, Jay. Show us you can learn, and not just give lip service to the concept.

@Ren: I have tremendous respect for your care of populations and I rely on your data and opinions to help shape my own. Vaccines have too much aluminum. The typo made "way" into "was" and yes, sometimes I do over-emphasize the side effects of vaccines while placing too little emphasis on their benefits.

@politicalguineapig: I don't run with a crowd and I'm sorry to hear that you didn't hug your brother when you were teens. The "hug" comments were metaphorical. Sorry if that wasn't clear . . .

@Grant: I think the MMR vaccine has underestimated side effects. I pay very close attention to disease incidence and would change recommendations for vaccinating based on this. Most here disagree and I understand that. I also know that measles (and pertussis) have very high R0 numbers and my recommendation should probably change faster than it does. And I acknowledge that for those who don't believe as I do about vaccines' side effects those R0 numbers would lead to unwavering recommendation of universal vaccination against those specific diseases at the very least.

@lilady: I've read everything you've mentioned and much more about PID and Prevnar vaccines. There are too many serotypes for a vaccine to remain effective for a long time. It's not a bad vaccine and, as I stated pretty clearly, if you want the vaccine, get. And, yes, I read the AAP's listing. And I retain my membership because I believe in attempting to influence policies from within. I serve on committees and share most of the same beliefs as my colleagues in the AAP. My patients have a lot of information about immunizations and I don't share your disdain for the mothers who blog.

@Chris: Selling vaccines creates more profit for a pediatric practice than not selling. Much more profit.

@herr doktor bimler: Yes, I was unaware that measles jumped species that short a time ago. I get lots of gaps in my knowledge filled when I spend time at RI. Thank you. I just did the rinderpest reading that you're suggesting. Thank you. No, I don't believe that not breastfeeding should be illegal and, yes, "straight-faced pedants" legs should be pulled from time to time.

@Just a Thought: I'm sorry you might not see this. Thank you for seeing both sides of the discussion. You're correct in thinking that insults and worse often dominate the the debate her.

@LW: Most people don't want measles. The vaccine prevents it.

@elburto: I'm sorry for whatever medical condition you have that increases your susceptibility. I does not excuse your vicious responses but I'll do my best not to offend in the future. My apologies.

@Denice Walter: Lack of social skills is found in children and adults on the spectrum and certainly found in people not on the spectrum, too. Some people are just plain rude and inappropriate.

Jay

@Denice - Yep, his lack of empathy is startling. Sympathy's pretty much just a social nicety but empathy's such a vital component of human coexistence that I have a great deal of difficulty wondering how anyone can divorce themselves from the needs and fates of others.

My mother's one of the rare women that meet the diagnostic criteria for NPD. Her empathic skills are undeveloped, however her talent for exploiting the empathy of others is outstanding. She just cannot bring herself to be in anybody's shoes, never mind walking a mile in them! I always thought that was just a "grown up" thing, that I'd lose the sick lurch in my stomach when someone else was hurt or sad.

Jay & co. seem devoid of it too, and entirely unperturbed by the fact that there are real children in real hospitals, suffering and ill. He acts like he's playing 'Plague. Inc'*, not discussing the ramifications of gaps in herd immunity, and the potential for lifelong sequelae in some of the afflicted.

It's all just a game to some of them, and that's scary,.

*An Android disease simulator. Very good it is too, as it shows how the Player's choice of pathogen would spread across the world.

@Jay Gordon:

"I don’t recommend the MMR unless travel increases the risks and parents want the vaccine. I do give the vaccine. If I were practicing in Wales right now, I would recommend the MMR vaccine."

So your suggested approach is not to have a consistent and comprehensive programme, ultimately with the view to eradicating the disease, but to vaccinate until the disease is temporarily on the wane, within a certain region, then stop, wait for the inevitable resurgence, have emergency clinics with people queuing round the block, who may or may not be already infected, and may or may not be spreading it, play catch up with the disease until it's temporarily under control again, then rinse and repeat? I can see why this isn't taken seriously as a sensible vaccine strategy by the powers that be.

@Dr. Gordon, "Most people don’t want measles."

Yeah, but most people don't want lots of things that are good for them and will "probably improve human health". Why do you accede to their wishes in this case?

@Elburto

I'm still curious as to why the North East has been particularly effected, and it seems to be the same, post-Wakefield, 10-14 year age group. You suggested, on a previous thread, that it wasn't a particular hive of non-vaccination.

Bacon!!! I'm listening to this program now. Have you listened??
It leads with some of the awful complications the speaker has seen from vaccines. He is pretty strange. He then moves on to the Cutter incident and more. VAP and Rotoshield. Crazy good ammo for opponents of vaccines. Then on to how few people have actually read Wakefield's article.

I'm not hearing much I didn't know.

Email privately and I'll try to send you the link to the audio program although it's easily worth the 25 bucks you suggested I spend.

I'll print the Summary below. See if it works.

IMMUNIZATIONS: PART 2
AN ANALYSIS OF VACCINE SAFETY
From the 2011 Scientific Assembly of the American Academy of Family Physicians
Jonathan L. Temte, MD, PhD, Professor of Family Medicine,
University of Wisconsin School of Medicine and Public Health, Madison
Introduction: problem of misinformation about vaccine
safety; in United States in 1990, number of licensed vaccines,
16 (in 2009, 60); birth cohort in United States

Dr Jay said, "“I don’t recommend the MMR unless travel increases the risks and parents want the vaccine. I do give the vaccine. If I were practicing in Wales right now, I would recommend the MMR vaccine.”

Do you also not recommend condoms to folks unless they're already pregnant? It seems in line with your reasoning.

Measles is but a plane ride away - and you're actively encouraging folks to forgo immunizations because it's not an epidemic (or endemic) here in the US?

It wasn't endemic in the UK either - until immunization levels dropped. Now look what's happened - hundreds of cases, thousands exposed and already a measles related death. Is that what you want - more deaths?

I cannot believe your hubris.

@Jay: " think the MMR vaccine has underestimated side effects."

BASED ON WHAT, you lying weasel quack?

By the way, Jay is quacking about this:

h_ttp://www.audio-digest.org/pages/htmlos/summary.html?sub1=FP6006

All you need to know:

"Suggested Reading
Geier DA, Geier MR: A two-phased population epidemiological study of the safety of thimerosal-containing vaccines: a follow-up analysis. Med Sci Monit. 2005"

Quoth Dr. Gordon:

...nor do we know enough to figure out what happens when you eradicate measles from the planet. Maybe we need a low level of certain organisms to keep others in check. I don’t know and you certainly don’t know what happens when we eradicate an organism which has lived with humans for millennia. Measles is good for you? I didn’t say that. I am saying that it’s[sic] existence might be more important than we think.

On the same page, scroll down to #265, where the good doctor claims,

 Measles infection is beneficial to individual humans but creates enough morbidity and mortality to give anyone pause. I’m not going to post that link again.

Actually you should read the whole comment thread, or at least look at the good doctor's comments and the appalled responses of other commenters. It's like a compendium of Gordon's Greatest Hits, such as,

Tetanus is not “everywhere.” It’s in Africa and other parts of the globe while we in the USA have a few dozen cases/year.

Really, there's no way to do his comments justice here. Read the whole thing.

Jay - you haven't seen my vicious responses. What you've seen here is practically flirtatious, trust me on that. Yet again, I'll remind you that your opinion of me is held in such low esteem that it's well below sea level.

As far as I'm concerned anyone who directly or indirectly contributes to the death or suffering of other humans does not deserve respect. You have exploited fear and hatred of the 'other' for your own gain. You seem perpetually amused by people who react in horror to your nonsense about "vaccine damaged" children, and the alternative schedule that you pulled out of your arse.

You encourage parents to turn their children into disease vectors, but to keep it on the downlow so that they can hide in the herd.

You imply that you have the answers to producing a race of undamaged übermenschen, free of afflictions that might render them non-neurotypical, while writing off the worth and potential of people who are NNT.

Eerily enough, in the comment I posted that crossed yours, I derided sympathy. Sympathy is pointless and patronising. I'm not sorry I am who I am, or what I am. I am angry that people view me, and others like me, as less worthy of life because of our physical condition, mental health, because our brains don't conform to rigid norms, because of our sexuality, gender expression, socioeconomic status, or race.

I'm not sorry that I'm physically disabled, that I have a history of mental illness, that I'm non-NT, queer, poor, and dependent on welfare. None of that makes my life anywhere near as hard as does the existence of people who think that I'm inferior, pathetic, Leben unswörtes Leben because of any of those characteristics that I have no control over.

I'm sorry that you see people with disabilities or chronic illnesses, and who aren't neurotypical, as lesser beings. I'm sorry that children who die of VPDs don't touch your conscience or your heart. It must be hard living in such an impermeable shell of smug superiority and untroubled affect.

Sure I don't have your money, connections, power or reach but I feel so sorry for you. Sorry that you'll forever be associated with the rising bodycount from VPDs, the mockery from people who see you as the relic so blinded by his limited edition Dunning-Kruger goggles that he believes he has the power to alter the human genome by giving the recipe for "healthy sperm".

I'm sorry for your wasted potential, the lost chance to use the spotlight for good.

I go to sleep every night knowing I have not caused any deaths, directly or indirectly. I sleep soundly knowing that I am aware of any privilege I have and not using it to hurt or oppress people, intentionally or unintentionally. I wake every day determined to get what I can from the day ahead and to help at least one fellow human.

There's nothing to be sorry for Jay. I love and am loved. This morning Citylink delivered five bars of organic Green and Black's chocolate, Cornish sea salt flavour. I have a roof over my head, working thumbs, a smartphone and a sub to Netflix, and I've eliminated all of the toxic people from my "real" life. It's pretty fab being me really, apart from when gobsh¡tes try and patronise me, mock my worries about serious outbreaks in my locality, or imply that I should be sad or ashamed of who I am.

This flirtatious and friendly little riposte is in memory of:

Gareth Williams
Camron Carlton
Baby Parsons
+ the 12 other British babies dead from pertussis in the last eight months.

@Elliphile - I don't know, I just live here, I'm not an epidemiologist. It's demographically, topologically, economically and socially very much like the area of Wales suffering the same thing. It is happening here, this isn't just a case of a lone commenter claiming the region is susceptible, it's literally outside my front door.

Who the hell knows why here and why Wales? Maybe there's a god after all and she doesn't like sheep and pit villages, maybe it's the shared locat fondness for hard drugs caused by both places being plunged into ruin by Westminster, or maybe (and this is my stupidest suggestion, just for fun), some families holidayed in a resort experiencing a measles outbreak. Upon checking out of their hotel one family flew home to a welsh airport, the other to Durham Tees Valley, Newcastle, or even LBA and went back to normal life in the North-East. Perhaps the vectors were flight attendants headed home to those same airports, holiday reps coming home after the ski season, foreign uni students from the same town, studying at say... Cardiff and Teesside unis respectively, after an extended Christmas break.

Yeah, totally implausible those last scenarios, I know.

All I know is it's causing unnecessary suffering, and will cause even more if people are not aware that it's not confined to Wales. Also, that the word on the grapevine is that our Lord Draconis is losing his scales due to stress. The new hatchlings are. increasingly fractious aboard the nursery ship. They had been promised, by His Lordship, a joyous romp among the sleeping children of Terrabase
Sol Alpha (Earth, to me and you) in order to practice using their newly budding senses, but as measles causes a certain... explosive side effect in the younglings, Matron Gn'th'hraaall has forbidden excursions until further notice.

@Stu

It's not surprising that he cites the Geiers. They are the scientific equivalent of Tweedledum and Tweedledumber.

Stu -
*low whistle*

Ooh, can't argue with those titans of science. Myth BUSTED! That showed US.

@LW - Duh. Brown people don't count, slegs blankes.

I'm confused - as a doctor, how does Dr. Jay not know the history of measles? Is he really that uneducated?

@Ren, you're really wearing out your fingers for no reason in telling Dr. Gordon that measles recently evolved from rinderpest. He's been told that repeatedly, at least as far back as June 2009

Since he thinks it's important to keep measles around -- not just in a freezer like smallpox but circulating in the population -- I'm still really curious why he thinks it would be appropriate to vaccinate young people in Wales against it.

@ Dr. Jay,

Given the evidence I posted both here[1] and on my blog, do you still hold the same opinion that autism is environmental poisoning (whether it's vaccine or flame retardant pajamas)?

Alain

[1] == https://corticalchauvinism.wordpress.com/2013/04/15/ultrasound-exposure…

@elburto, "Duh. Brown people don’t count, slegs blankes."

Not quite. You might really enjoy that comment thread. The good doctor said tetanus wasn't everywhere and America has few cases per year. Appalled commenters pointed out that tetanus most certainly is everywhere and the only reason we don't have many cases is because so many of us are vaccinated. He later claimed that he knew that.

Please tell me Dr. Jay is in California & only caters to morons....please?

Jay,

Vaccines have too much aluminum.

No they don't. They are injected intramuscularly in the form of insoluble salts that very slowly dissolve into interstitial fluids at a rate (0.07–0.4 mg/kg per day) comparable to absorption from the diet (0.08–0.5 mg/kg per day) see Aluminium Toxicokinetics: An Updated MiniReview.

Even people with renal failure or premature babies with underdeveloped renal function can easily excrete this amount of aluminum, and those with normal renal function rapidly excrete thousands of times as much (after ingestion of aluminum antacids peak serum levels were 54.5 micrograms/l at 30 min, returning to the initial value of 6.8 micrograms/l at 3 h after the oral intake). In contrast the increase in serum levels of aluminum after vaccination with aluminum-adjuvanted vaccines is barely measurable.

Damn Dr. Jay - do you really jump on every single anti-vax bandwagon there is? Aluminum, really?

Lack of social skills is found in children and adults on the spectrum and certainly found in people not on the spectrum, too. Some people are just plain rude and inappropriate.

"Social skills" doesn't just mean "being nice to everyone". One sometimes-useful social skill is the ability to put one's negative opinion of another person into carefully-chosen words that will survive their passage through the abstracting, neutralising medium of electronic transmission, and convey that negative opinion to readers.

Elburto seems to be performing quite strongly on that score.

@Lawrence: he does practice in California, but his patients are just children. Their parents may be arrogantly ignorant, but they themselves are innocent and defenseless.

The kids deserve better....I know that parents freak out when their kids get a cold.....how dare they put their kids at risk of serious diseases like measles, mumps & pertussis.....

Someone who can publicly complain that, "...the vaccine remains unquestioned because one can’t have a public debate of losing 'weaker' humans to measles to benefit stronger humans" probably isn't in a good position to lecture others about their social skills. I wish I shared elburto's eloquence.

Darwy...Jay's hubris? How about Jay's colossal ego, as evidenced by this latest statements, posted at me?

"@lilady: I’ve read everything you’ve mentioned and much more about PID and Prevnar vaccines. There are too many serotypes for a vaccine to remain effective for a long time. It’s not a bad vaccine and, as I stated pretty clearly, if you want the vaccine, get."

How many children in your practice have you immunized with Prevnar -7 vaccine and immunized with Prevnar -13 vaccine?

http://www.cdc.gov/mmwr/pdf/wk/mm6043.pdf

"...In June 2011, a girl in California, aged 2 years, died of
IPD caused by serotype 19A, one of six serotypes included
in PCV13 but not in PCV7. The child had received 3 doses
of PCV7 but had not received PCV13. The California
Department of Public Health identified an additional 30
PCV13-eligible children who had developed nonfatal IPD
caused by the pneumococcal serotypes not covered by PCV7
and who became ill after PCV13 was recommended by ACIP.
In August 2011, a health advisory was sent to California health-care providers to remind them of ACIP’s recommendation for PCV13 use (2)...."

Dr. Jay also stated this...

"And, yes, I read the AAP’s listing. And I retain my membership because I believe in attempting to influence policies from within. I serve on committees and share most of the same beliefs as my colleagues in the AAP."

I'm calling bullsh!t on Dr. Jay's statement. He doesn’t follow the Standards of Care regarding immunizations and totally ignores Policy Statements about specific vaccinations and incorporating/implementing strategies in his practice for timely and complete vaccinations, according to the CDC and AAP Recommended Childhood Vaccine Schedule.

http://pediatrics.aappublications.org/content/125/6/1295.full

Dr.Jay is delusional, if he thinks the non-vaccinating mommies and daddies are attracted to his practice because of his competence. They bring their special snowflakes to him because he isn't proactive about vaccines and because he fought tooth and nail against the passage of California AB 2109 ("consulting his personal attorney"), so that he wouldn't have to give those mommies and daddies information about each vaccine and the V-P-Ds that those vaccines prevent, before those anti-vaccine parents claimed a "personal belief exemption" prior to their special snowflakes entered public school.

(continued below)

My patients have a lot of information about immunizations and I don’t share your disdain for the mothers who blog.

Dr. Jay:

@Chris: Selling vaccines creates more profit for a pediatric practice than not selling. Much more profit.

My comment just soared over your head. I meant that you are allowing your wealthy clients to be parasites on the herd immunity from the high immunity in your community. Much of that immunity is provided by the free and low cost immunizations paid for by your local and federal government public health programs, like the Vaccines for Children Program (VFC).

This is why your actions are deplorable. You are allowing the privileged to sponge off of those with lower incomes (like those using Medi-Cal), and the taxpayers.

Do you seriously think that is it cheaper to provide hospital care for the one out of ten who get measles, than to actually prevent measles with two doses of an MMR vaccine? If so, you really need to take some basic courses on economics. Along civics, immunology, virology, epidemiology, etc.

Dr. Jay stated to me...

"...My patients have a lot of information about immunizations and I don’t share your disdain for the mothers who blog..."

I have the utmost respect for the mothers (and fathers) of autistic children who blog and provide excellent analyses of studies about autism and vaccines. Have you visited the "Autismum" or the "Left Brain Right Brain" blogs, Dr. Jay?

Notice how Dr. Jay panders to the parents (John D. Stone, Angus Files, Jen, Benedetta and Linda), who piled on him, when Dan Olmsted slammed Jay for removing his tepid support of Andy Wakefield's fraudulent study. Notice Jay's vile description of Respectful Insolence commenters, as well:

http://www.ageofautism.com/2013/03/weekly-wrap-lanza-newtown-autism.html

"...I like Dr. Jay Gordon. He's definitely one of the good guys in the medical world. But he really ought to rethink his criticism of Andy Wakefield's work.

On Facebook Feb. 22, he took note of the 15th anniversary of the Lancet publication of the famous paper pointing to a pattern of novel bowel disease in 12 children with regressive ASDs, most of whose parents linked the onset to the MMR shot (that is actually what the study reported, not that MMR causes autism, etc., etc.)

Gordon writes: "Dr. Wakefield, whether his intentions were good or ill, should have written a brief letter to the editor about his findings and the need for much more study." In the event, says Gordon, the Lancet was right to retract it, and he, Gordon, bases nothing he writes about autism on it.

Well, first of all, suggesting that Wakefield might have "ill" intentions is an unpleasant and too-casual way to cast doubt not just on his work but on his motives. Second, the vindication of John Walker-Smith -- and even more, the tragic replications of Wakefield's findings not just by other researchers but by the suffering of thousands more children with regressive autism and bowel disease these past 15 years -- makes Gordon's disavowal and rejection seem downright wrong-headed.

I just don't get it, frankly.

--

Dan Olmsted is Editor of Age of Autism.

Posted by Age of Autism at March 02, 2013 at 5:46 AM in Dan Olmsted, Dan Olmsted | Permalink | Comments (83)

Oh, and before Jay starts whining about me calling him a lying weasel quack -- that's not an ad hominem, not even an insult, merely a statement of fact.

@Stu -- I'd thank you not to insult the noble weasel in that fashion.

@Dr Jay, who said:

“lived in relative symbiosis with hominids for millions of years”, so it can’t be eradicated and it would be dangerous to try, and anyway, “The infection may have beneficial effects for humans.”

and failed to respond when Ren pointed this out......
Here is some light reading for you, doctor:
http://www.virologyj.com/content/7/1/52
Evidence measles diverged from rinderpest virus less than 1000 years ago.
And guess what? Rinderpest has just been eradicated, by vaccination.
It's people like you who stop us doing just the same for humans.
Do you hate children?

@ Dr J;

Chris has already pointed out your apparent need for remedial lessons in economics, civics, immunology, virology and epidemiology, however this is surely a workload which will take even the most able individual a number of years to fulfill. Rather than attempting to remedy the knowledge deficit, why not consider a change in career? Something more peaceful perhaps, where you can really connect with people without the worry of whether you're going to accidentally kill them...

Have you ever considered that perhaps your real talents lie in the performing arts? http://www.ohiocollegeclowningarts.com/distance.html
They even do distance learning, in case you don't live in Ohio.

Wanna go a few more rounds with me Jay?

"I’m curious, are you all so rigid and dogmatic that you really can’t understand how someone could change opinions and practices? Maybe you are. Can you really do so little reading that you don’t know that vaccines can cause side effects which must be take seriously and factored into the decisions we all make?

Very few of you above have actual patients you care for. I do."

I've had "real patients that I cared for", Jay. Many of them were children who struggled to survive the devastating effects of vaccine-preventable-diseases. I've also "cared for" healthy and sick babies and children who received excellent care in public health clinics (the *kind of kids* that you have never seen, since you set up your boutique pediatric practice (Medicaid recipients and uninsured/undocumented little brown and black infants and children).

I've also investigated individual cases, clusters and outbreaks of highly communicable infectious diseases...both before vaccines were developed to prevent them...and after those vaccines were licensed. I remember each and every one of those children who "survived" those diseases and who were left with permanent neurological sequelae, major organ failure and limb amputations. I have stood at bedside in pediatric ICUs watching some of those children dying in septic shock and I've also attended memorial services (on my *own time*), because the parents of those children requested my presence.

Would you believe Jay...that many of the posters here are on "the spectrum" and some of us have beloved children and family members diagnosed with ASDs? Some of the posters here are childless and some have children who are neurotypical. We share a common bond...we are all child advocates, who really care about ALL children.

Even people with renal failure or premature babies with underdeveloped renal function can easily excrete this amount of aluminum, and those with normal renal function rapidly excrete thousands of times as much (after ingestion of aluminum antacids peak serum levels were 54.5 micrograms/l at 30 min, returning to the initial value of 6.8 micrograms/l at 3 h after the oral intake). In contrast the increase in serum levels of aluminum after vaccination with aluminum-adjuvanted vaccines is barely measurable.

"But, Krebozien, we're injecting this into babies, not giving them Tums™!!!" - Any anti-vaxxer faced with these facts.

Here's how this whole thread is looking to me right now:

1. Inane statement by Dr. Jay.
2. We refute it with facts, and maybe a choice word or two about him personally.
3. Dr. Jay writes something else, forgetting all he's ever written or said before.
4. We remind him of what he's said or written before.
5. Dr. Jay writes something else, probably with sore arms from moving those goalposts.
6. We, yet again, kick another field goal good for three points through the goalposts.
7. Dr. Jay looks over at his shovel and gloves... There's more posts to be moved.

And so on and so forth. All we're doing is proving one thing, and one thing only: Dr. Jay is not commenting here to admit that he was wrong, is wrong, or will continue to be wrong. We're not as smart. We're not as experienced in medicine. And we want to vaccinate the hell out of everybody for any reason, 100% of the time, no exceptions, no reasoning.

Dr. Jay should debate Andy Wakefield. Circular arguments are their specialty.

Jay Gordon @ 187:
No, I don’t believe that not breastfeeding should be illegal

Kudos for that, but my inquiry #172 was worded in the past tense... that is, back when your website endorsed Gisele Bundchen's call for legally mandated breastfeeding, did you *then* believe that not breastfeeding should be illegal, or were you joking?

yes, “straight-faced pedants” legs should be pulled from time to time

This sounds almost as if joking about measles is sometimes OK after all; as if the complaint that Elburto's sarcasm "crosses a line" was more of a rhetorical strategy.

Yes, I was unaware that measles jumped species that short a time ago. I get lots of gaps in my knowledge filled when I spend time at RI. Thank you. I just did the rinderpest reading that you’re suggesting.

Fortunately for all of us, omniscience is only a requirement for blogging at RI and not for commenting here. In the words of a character in Watchmen, "None of us is human".

But I urge you to see the problem here. We all go through life taking for granted things that are wrong, sometimes learning about our errors, sometimes even correcting them. In your case, you made a foundational assumption in your defense of measles that turned out to be wrong; and you were led astray by the BMJ into supporting Wakefield's anti-vax crusade.* The best we can hope for is to learn from experience that our current beliefs are provisional, and also stand a good chance of being wrong.

But anyway -- if people do not immediately sign on for the new revelation that autism is caused by fire retardants and children's pyjamas, it is not necessarily because they are bad or callous. It could be that they do not trust Jay Gordon's judgement and are waiting to hear the theory from some other source before they plough into the literature. It could be, after all, that this current etiology could itself be abandoned in another year or so.

* Let us not inquire into whatever wrong assumptions I might have made.

@Elihphile (#189) - That's what I was getting at too. It makes no sense even considered what he replied to me. (At first it sounds like he'd confused travel recommendations for vaccines for particular areas of the world with vaccination recommendations for "common" diseases that are found globally.)

@LW Doesn't JG's previous awareness of this (from your first paragraph of #200) conflict with JG's reply to herr doktor bimler in #187?

@Grant, I decline to speculate on the reasons behind Dr. Gordon's comments. However, the fact that measles is relatively recent derived from rinderpest has been pointed out in the comments on at least three posts where Dr. Gordon was also commenting. I am not giving the links to avoid moderation, but you can easily find them by title.  Below I give the post title, the commenter, the date and number of the comment for easy review.

"More anti-vaccine nonsense from an old friend on (where else?) The Huffington Post": Prometheus on June 20, 2009 (comment #259)

"Dr. Suzanne Humphries and the International Medical Council on Vaccination: Antivaccine to the core": LW on February 17, 2011 (comment #138)

"Dr. Jay and argumentum ad bradi bunchium": herr doktor bimler on March 25, 2011 (comment #86)

A general thought that has been rattling around in my head and revived on reading Jay’s comments. I’d welcome comments on it.

A general practitioner’s main job is diagnosis, then offering the treatment matching the diagnosis.

It is not to try out-do the medical scientists that develop the treatments, but to offer what they have recommended.

Specialists (i.e. with the extra training that comes with that, and that they are not infrequently also researchers) might well try riddle out specifics of treatments from the primary research literature.

But not GPs. Their goals should be seated in diagnosis and keeping up with the treatments as recommended by the medical research community.

It seems to me a few GPs try "out-do" the research community - resulting in the sort of nonsense that Jay's thinking is an exemplar of. GP's training isn't suited to this and smarter GPs would recognise that.

Thoughts? Take this as a generalisation. (There will always be exceptions and not-quite-right aspects in generalisations.)

I may later try explain to Jay why his reasoning in his reply to me is faulty, but reading others pointing at things he's said before (incl. #219) I wonder if it's worth the trouble and the more general point I've outlined above is better.

Ren,

“But, Krebozien, we’re injecting this into babies, not giving them Tums™!!!”

It's usually, "injecting it directly into babies' bloodstreams", isn't it?

@LW Are you saying that measles is good for people or did you just not read my post carefully?

@Darwy: I recommend condoms when people are having sex. Not for routine evening wear. Good one, though. Your reasoning is shaky. If there's a measles outbreak, or if you decide that the MMR is the best choice for your child, get the shot.

@Stu: Clever epithet. When one says "I think" that doesn't mean that you or anyone else has to think the same thing. You, you . . . sillyhead, you!

@elburto It is not your "history of mental illness" or anything similar that could make me feel you're "inferior." It's your incredible lack of civility, grace, compassion, wisdom and maturity that could lead me to that conclusion.

@LW: Read the data. We do not have a tetanus problem here. I have contributed my time and efforts (and money) to campaigns to get tetanus vaccines to the countries where it remains an endemic problem. Have you?

@Lawrence: As hard as it is to believe, I had forgotten the history of measles. I stand (stood) corrected.

@Krebiozen: A simple search of the medical literature will bring thousands of papers about aluminum as an irritant.

@herr doktor bimler: elburto's behavior would not be tolerated in any venue in real life and I doubt she has the desire to lose her anonymity either. One can disagree without the bile and vituperative language she uses. Her anonymity is crucial to her continuing success here.

@lilady: The PCV7 created the milieu for that fatality. My patients are attracted to my practice because I work hard and good care of their children.

@Chris: One out of ten do not get measles. The number this year is one in a couple million in the USA.

@lilady: I have visited the sites you've mentioned. AOA's complete text was critical of me. You know that.

I like Dr. Jay Gordon. He's definitely one of the good guys in the medical world. But he really ought to rethink his criticism of Andy Wakefield's work.
On Facebook Feb. 22, he took note of the 15th anniversary of the Lancet publication of the famous paper pointing to a pattern of novel bowel disease in 12 children with regressive ASDs, most of whose parents linked the onset to the MMR shot (that is actually what the study reported, not that MMR causes autism, etc., etc.)

Gordon writes: "Dr. Wakefield, whether his intentions were good or ill, should have written a brief letter to the editor about his findings and the need for much more study." In the event, says Gordon, the Lancet was right to retract it, and he, Gordon, bases nothing he writes about autism on it.

Well, first of all, suggesting that Wakefield might have "ill" intentions is an unpleasant and too-casual way to cast doubt not just on his work but on his motives. Second, the vindication of John Walker-Smith -- and even more, the tragic replications of Wakefield's findings not just by other researchers but by the suffering of thousands more children with regressive autism and bowel disease these past 15 years -- makes Gordon's disavowal and rejection seem downright wrong-headed.

I'm looking for the pandering . . .

@Stu: My apologies. I thought the "lying weasel quack" name calling was a little offensive. You merely meant it factually. Thanks for the clarification.

@dingo199: I responded. I was wrong.

@Liz: I would love to learn how to ride a unicycle. Thanks for the link.

@lilady: You don't listen. You just keep talking. No, I'll quit.

@Ren: Now that is pandering. You know that in real life I don't have any of the attributes you assign to me. You know that. Yet, life Stephen Colbert, you play this part when in real life you've never behave or speak this way.

@Orac: What happened to the view counter?? I regret having less time this weekend than I thought I'd have. I still hope to able to visit and respond, but if not please enjoy your weekend.

Jay

@Krebiozen (realizing I totally got the letter I in the wrong place),

Yes. How can I forget. Someone at AoA (where else?) recently wrote:

The most lethal toxin most humans will ever come in contact with, synthesized, combined with viruses, bacteria, and other metals, and injected into babies throughout the world without ever being tested for safety.

Mad props to anyone who can point out the three gambits used in that weird-o statement.

By the way, I propose that tetrodotoxin is far more potent than even mercury.

It seem to me that Dr. Jay never ever wanted to mess with me because I have too many evidence that autism is not a brain injury caused by vaccines (including aluminum) or his preferred alternative, flame retardant products.

Is that because of his conflict of interest in selling his book to prevent autism?

There will be autistics forever...

Alain

Vaccines have too much aluminum.

How much is "the right amount"?
If only there were people with expertise on aluminium toxicity. We could call them, I don't know, "toxicologists".

#226 We do not have a tetanus problem here.

... because people are vaccinated against it, yes.

Jay seems to love provoking people into justifiable rage at his smug lack of empathy and his insistence upon not following standard-of-care in his practice, and then to turn around and call them immature and uncivil. How dare he call ANYONE here lacking in compassion, especially elburto, who is literally one of the best people I know.

Also, how the heck does anyone find themselves thinking measles is good for the gene pool, yet autism is bad? Ableist, to the very core.

@Dr. Gordon: "@LW Are you saying that measles is good for people or did you just not read my post carefully?"

I've read your comments *very* carefully over the years.

Measles is a dangerous disease and I am utterly appalled that someone holds himself out as caring for children and deliberately and willfully urges parents to leave their children unprotected from it.  A friend of my family is a pediatrician. She did her best to undo the damage that people like you have done, but she wasn't always successful in convincing parents to vaccinate. So -- no surprise -- there was a measles outbreak and one of the children that she wasn't allowed to vaccinate got the disease.  He developed encephalitis, Dr. Gordon, and suffered severe brain damage from which he will never recover.

I am utterly appalled that someone who holds himself out as a doctor deliberately and intentionally urges that girls be left unprotected against rubella as they grow to adulthood and consider having children.  I have urged you to read about the devastating effects of congenital rubella; I assume you didn't. 

I am utterly appalled by someone who holds himself as caring about children and deliberately and willfully urges that children be left unprotected against tetanus. Did you read about the little boy left unprotected against tetanus in Australia?  He's out of the ICU, and I understand that after a year or so of therapy he may well be able to walk again. 

I have been quoting *you*, Dr. Gordon. I have been quoting *your* claims that measles is not merely harmless but beneficial, to individuals and to the species as it wipes out the weak (I restrained myself from using an apt German term here).

Yes, I've read your comments *very* carefully over the years.

Um, Jay? Is it possible you listened to Dr. Temte's presentation on immunization safety and missed this (from the program's written summary)?:

"Summary: vaccines one of most successful medical interventions; highly effective; good record of safety; patients and clinicians concerned about vaccine safety; multiple layers and mechanisms exist to ensure safety"

That Jay only heard the part of Dr. Temte's talk that mentioned past problems with vaccines (i.e. the 1955 Cutter incident) is further evidence that Jay hears only what he wants to (things he can stuff into his mental box of preconceived notions).

@ Dr. Jay: What the hell are you blathering on about with this statement?

@lilady: The PCV7 created the milieu for that fatality. My patients are attracted to my practice because I work hard and good care of their children.

Really Jay? Care to explain to us how serotype substitution (not antibiotic-resistance from the overprescribing of antibiotics) after the development/availability of the PCV-7 valent vaccine "created the mileau for "that fatality".

Here...to get you started, the PubMed line listing of 142 articles published for S. Pneumoniae 13-Valent PCV vaccine:

http://www.ncbi.nlm.nih.gov/pubmed/?term=s.+pneumoniae+invasive+disease…

Adv Ther. 2013 Feb;30(2):127-51. doi: 10.1007/s12325-013-0007-6. Epub 2013 Feb 7.
The impact of 7-valent pneumococcal conjugate vaccine on invasive pneumococcal disease: a literature review.
Myint TT, Madhava H, Balmer P, Christopoulou D, Attal S, Menegas D, Sprenger R, Bonnet E.
Source

Pfizer ESAT Vaccines, 23-25 Avenue du Docteur Lannelongue, 75014, Paris, France. Myint.TinTinHtar@pfizer.com
Abstract
INTRODUCTION:

Streptococcus pneumoniae can cause invasive pneumococcal diseases (IPD), such as bacteremic pneumonia, bacteremia, meningitis, and sepsis, and non-IPDs, such as otitis media, nonbacteremic pneumonia, and upper respiratory tract infections. It was estimated in 2000 that, worldwide, S. pneumoniae was responsible for 826,000 deaths annually in children aged between 1 month and 5 years. A 7-valent pneumococcal conjugate vaccine (PCV7) was licensed in 2000 in the USA and in 2001 in Europe.
METHODS:

A literature search was performed in PubMed to identify studies assessing the impact of routine childhood PCV7 vaccination on pneumococcal morbidity and mortality. Here, the impact on IPD is reported.
RESULTS:

A total of 37 articles reporting impact data on IPD were included in this review: four from Australia, 17 from western Europe, and 16 from North America. In vaccine-eligible children in the postvaccination period, a reduction ranging from 39.9% in Spain to 99.1% in the USA in vaccine-type (VT) IPD incidence, compared with the prevaccination period, was reported in 18 studies. All but one of the 30 studies assessing the impact of PCV7 on all-type IPD reported a reduction ranging from 1.7% in Spain to 76.3% in Australia. In addition, the majority of studies reported reductions in VT and all-type IPD incidence in age groups that were not vaccine eligible.
CONCLUSIONS:

The results from this review illustrate that PCV7 has had a significant impact on IPD across all ages through its use in pediatric immunization programs. With the introduction of 13-valent pneumococcal conjugate vaccine (PCV13) further reductions in the incidence of IPD due to the six additional serotypes included, as well as continued protection against IPD due to PCV7 serotypes may be expected. Robust surveillance systems are essential for the evaluation of the impact of PCV13 on all-type IPD and for monitoring the evolution of non-VT IPD.

Dr. Jay:

@LW: Read the data. We do not have a tetanus problem here.

Why didn't you provide it? The reason is that we vaccinate for tetanus. When was your last booster? Read this paper: Philosophic objection to vaccination as a risk for tetanus among children younger than 15 years, and then provide a similar citation telling us that we don't have tetanus spores in the entire USA.

@Chris: One out of ten do not get measles. The number this year is one in a couple million in the USA

Because most people vaccinate there children with the MMR vaccine. Which still means your wealthy clients are getting a free ride on the community that does vaccinate, often at taxpayer expense. That still makes you are horrible.

If we all stopped vaccinating, then 95% of those children would get measles with one in ten going into the hospital. Seriously, how does providing each child two MMR doses compare to providing hospital care to one of ten cases of measles?

Now just provide the title, journal and dates of the PubMed indexed paper that show the MMR vaccine is worse than measles? Then provide those PubMed indexed papers from before 1990 that showed an increase in autism from the 1971 introduction of MMR in the USA.

If there was a spike in autism from the MMR in the UK in less than a decade, then there had to be a much bigger one in the USA over almost twenty years and a much larger population. Where are those paper?

Jay, in a snit because his interview with the producers of "The Vaccine Wars" ended up on the film editor's floor...

http://www.huffingtonpost.com/jay-gordon/pbs-frontline-show-about_b_554…

What an odd coincidence. I viewed that documentary on PBS and the excellent interview of Brian Deer. That documentary propelled me over to Deer's website to see how he took on *big pharma* interests...before he ever started investigating Andrew Wakefield's fraudulent study..

To add to Chris' statement about measles cases in the United States. The population of Wales is 3 million-versus-the population of the United States of 314 million.

If we were to extrapolate the number of confirmed measles cases (more than 800 cases 2013 YTD in Wales, we would be look at more than 8,000 cases of measles 2013 YTD in the United States.

Could the fact that we have mandatory (not compulsory), vaccine requirements for day care and school entry in the United States, have an impact on measles disease prevalence?

Could the fact that we have a well-funded, well-staffed public health system in the United States which prevents large measles outbreaks and contains smaller outbreaks, have an impact on the low prevalence of measles here in the United States?

Measles was declared "non-endemic" in the United States in 2000 and remains non-endemic. ***The U.K. was declared non-endemic for measles, yet lost that designation after 14 years, when it was declared once again as "endemic for measles in 2008".

** Great work Dr. Wakefield. The U.K. went from from a first world country for measles endemicity...to a third world country for measles endemicity with 14 years. Now the CDC recommends that babies as young as six months should receive an MMR vaccine to provide some protection when visiting the U.K. (Babies still require the regular 2-dose series of MMR vaccine given after one year of age and spaced a minimum of 4 weeks apart, to protect them from measles, mumps and rubella).

@elburto It is not your “history of mental illness” or anything similar that could make me feel you’re “inferior.” It’s your incredible lack of civility, grace, compassion, wisdom and maturity that could lead me to that conclusion.

If someone persisted in being an activist and a self-styled authority for a cause that directly threatened my life and well-being, I might tend to get a little testy myself. In fact, I might even be a little uncivil, and more - who knows?

You also mention compassion. Glad to see that you've got a sense of humour.

Jay,

@Krebiozen: A simple search of the medical literature will bring thousands of papers about aluminum as an irritant.

As a local irritant, yes. If you have been injecting vaccines directly into the brain, you have definitely been doing it wrong.

Read the data. We do not have a tetanus problem here.

People in road traffic collisions hardly ever hurtle through the windshield any more. Is that a good reason to dispense with seat-belts and airbags?

Only "local" should have been in bold, hopefully I haven't embolded the rest of the thread.

@lilady, "If we were to extrapolate the number of confirmed measles cases (more than 800 cases 2013 YTD in Wales, we would be look at more than 8,000 cases of measles 2013 YTD in the United States."

I'm afraid you dropped a zero. We'd be looking at over 80,000 cases.

Dr Jay, my reasoning is absolutely not shaky.

You are recommending that people don't take precautions to protect themselves until AFTER there's a risk of exposure to measles (ie: a measles epidemic).

Not only is your reasoning faulty, it's downright DEADLY.

"By the way, I propose that tetrodotoxin is far more potent than even mercury."

Thimerosal is toxic, but at level 2 on those hazard pi us materials diamonds, 2 out of 4. Ironically so is one of the chelators often used by people who claim they or their child has been poisoned by the mercury in vaccines. The difference is that people expose themselves to a lot more chelator. A lot more given some people go on chelators for years.

Thanks LW for the correction....We'd be looking at 80,000 cases of measles YTD in the United States, by extrapolating the number of cases of measles in Wales (population 3 million) to the United States (population 314 million).

BBC London TV got a good item:

http://www.bbc.co.uk/news/uk-england-london-22230875

@Dr. Gordon:

@LW: Read the data. We do not have a tetanus problem here. I have contributed my time and efforts (and money) to campaigns to get tetanus vaccines to the countries where it remains an endemic problem.

It's endemic here! Don't you get that? The spores are everywhere. Tetanus is not a contagious disease and will never be eradicated by vaccination.

As Krebiozen implied, the risk of getting tetanus is like the risk of going through a windshield in a car accident: you have to protect each person and you have to keep protecting them or they will be injured or killed because the risk remains in the environment forever.

lilady:

We’d be looking at 80,000 cases of measles YTD in the United States,

Isn't that close to how many cases were in the USA during the 1990 measles epidemic? Too bad Dr. Jay doesn't remember that. Most of the deaths were in California among low income, which prompted more federal and local public health fund to get those with low income vaccinated. The same people whose immunity Dr. Jay has his wealthy clients leach from:

Pediatric hospital admissions for measles. Lessons from the 1990 epidemic.

Oh, Mr. Deer, you know that the AoA crowd will just say that the little boy with leukemia and that the young man who died had asthma. That means that they don't deserve to live because they are not perfect. Just like they did with the kids died in the UK almost a decade ago.

@ Brian Deer: My medically fragile child who was born with panyctopenia including leukopenia, only survived because he was immunized against measles, mumps, rubella. I was very fearful of him contracting varicella because they was no vaccine available to protect him.

He did contract varicella just before the vaccine became available, and at the first sign of lesions, he was put on acyclovir to prevent the proliferation of the virus in his body and to shorten the course of the illness.

Some doctors think we should let "nature take its course" (culling of the herd), and forget their commitment to protect the vulnerable members of society. These doctors will administer vaccines to their young patients "if their parents request them". These doctors place great emphasis on "mommy and daddy intuition" and the information mommies and daddies garner on the internet.

Sorry, you have to keep protecting them or they may be injured or killed. I didn't mean to imply a certainty of harm.

By the way:

@Jay: ” think the MMR vaccine has underestimated side effects.”

Back this up with research or admit you are a quack.

@ Chris: The extrapolated number of 80,000 measles cases YTD in the United States, far exceeds the number of cases (and deaths) that were reported during the last major outbreaks of measles in the United States:

http://www.historyofvaccines.org/content/timelines/measles

@ Dr. Jay: What Stu stated above...and put up or shut up.

Thanks, lilady. That epidemic hit only 50000, and "only" killed a bit over 120. I can't imagine how many deaths would occur if it happened if it repeated here again.

That epidemic is why Rosalynn Carter and Betty Bumpers started Every Child By Two. They actually care about the health of children.

Dr. Jay,

When you write, "I pay very close attention to disease incidence and would change recommendations for vaccinating based on this. " I see a "closing the barn door after the horse has left".

For example, your colleague Dr. Sears was unable to prevent an outbreak started by one of his own patients.

Also, how does changing a recommendation help past generations of your patients? How would a 15 year old who rarely comes to your office any more (or has moved out of the area entirely) get protection if a major outbreak were to occur?

"Vaccine manufacturers have no product liability and no incentive to improve vaccines. "

We hear this a lot and both parts of the statement are untrue. First, people must sue the government before they can go to civil court. But they can go to civil court. All those discclaimer statements on vaccine inserts are there to protect the manufacturers in case of such a suit. Second, vaccine manufacturers most certainly have liability in case of manufacturing defect. Should they put out a lot of vaccines, for example, which had, say, botulism growing inside, they would be liable.

When people point out that the manufacturers do not have liability for adverse events, they should point out that we as a people have accepted liability for this in the form of the vaccine court. I.e. liability has been shifted, not eliminated.

If one believes that the profits from vaccines are very important to the manufacturers, one must then accept that the manufacturers have a financial incentive to create a product which can be licensed and maintain licensure. An unsafe product will be delicensed. A product which can be proved to be safer will replace another vaccine--even if that vaccine is already deemed safe. Such a new product would have patent protection and would make much higher profits for the manufacturer.

The real issue is that vaccines are very safe. It is very difficult to demonstrate that a new vaccine is safer than an existing vaccine. Such clinical trials would have to be huge. Difficult and expensive.

Dr. Jay,

I've just read through this entire comment thread and I am wondering about your overall impressions of this discussion compared to similar discussions on AoA.

While there are some strongly held views here, and some insulting words (many of them fully justified, IMO), the level of discourse is very high - intelligent and logical, and well cited with scientific references. Now let's look at AoA, where the discussion is not intelligent, not logical, with citations to "childhealthsafety" and "whale.to" and often highly insulting besides. And that's only the messages that have gotten through their "approval" process.

When you compare the two, does it not ever start to occur to you that there is a substantial difference between the two sites, and it's not just their point-of-view? Or do you think that you are so smart and so polite and reasonable, that your word is law, and that you can say whatever you want?

@Matt Carey: "If one believes that the profits from vaccines are very important to the manufacturers," one must also then wonder why so many manufacturers have dropped the manufacture of vaccines, so that shortages have occurred because the one or two remaining manufacturers can't keep up with the demand.

I just stood back and thought to myself- here we have a medically trained professional who writes advice about children's health who doesn't appear to have practical knowledge about infectious disease and vaccines.

J-sus Chr-st! I'm a frigging psychologist and I know the basics and did even before I ever worked with people who had compromised immunity in the 90s.

It's worse than this because Dr Jay and other altie influenced medical professionals could stand between the REAL woo-artists and the general public and point out how alt med/ natural health/ ANH style ideas can be wrong-headed and ultimately dangerous to children's health. This could be done responsibly by encouraging the 'naturalistic' leanings potential clients might fancy as a LIFE STYLE but peppering them with SBM on issues where health concerns are paramount.

But NO! He caters to the tastes of affluent, young white people who romantically affect styled nostalgia based on unrealistic ideas about a past golden age prior to the advent of science in medicine that never existed.

Their set of beliefs trickles down and we can survey it in places like AoA and TMR: the latter has produced volumes of choice idiocy ( see the past few days' output- especially the video- re "Sh*t " conventional mothers say). The followers spread this propaganda around via facebook like ripe manure. Tacit approval from experts fuels their inability to self- criticise or be realistic. Recent entries ( AoA comments) seem to write off a death due to measles as nothing for THEM to worry about.

Of course, Dr Jay doesn't go as far anywhere as many of the outright woo-meisters we write about do BUT he doesn't say this loudly enough and occasionally uses similar ploys ( e.g. above- stress on negative effects of vaccines without mention of their positive effects). I hear that on PRN and read that on Natural News.

At risk of sounding rude or reverting to coarser speech, I just expect better of him.. he's smart.. and probably cares about children.

I don't know, I'll go outside and view nature from the cliffs - that usually calms me down.

Matt Carey:

If one believes that the profits from vaccines are very important to the manufacturers, one must then accept that the manufacturers have a financial incentive to create a product which can be licensed and maintain licensure.

This is what drives me nuts. A couple of years ago I stumbled upon a document that I think was for information to guide business decisions on research spending and investments in pharmaceuticals. I saves its URL because it has a lovely table showing the US Market for various pharmaceutical categories on its page 30 (31 for pdf).

I dare Dr. Jay to argue the profit of vaccines after looking at Appendix 1 of Use of Medicines in the United States: Review of 2010. Dr. Jay, what is the number to the left of the word "Vaccines", and what does it mean?

Denice Walter:

But NO! He caters to the tastes of affluent, young white people who romantically affect styled nostalgia based on unrealistic ideas about a past golden age prior to the advent of science in medicine that never existed.

If you read the article about the hospitalizations and cost to Medi-Cal (California's health insurance for those with low income) from the 1990 measles epidemic I posted in comment #248, you will learn the most highly impacted were low income non-white children. Because of this measures were taken to make sure that vaccines were available to as many children as possible. I mentioned the federal program, but the is also LA County's List of No to Low Cost Immunization Clinics.

It is those who are provided vaccines at public cost that Gordon's clients are using for protection from measles. They are getting a free ride on those with low income, and the taxpayers. He, and they, should be ashamed of themselves.

BrokenLink, you just gave me the laugh of the century! You characterize this thread as having some "strongly held views and *some* insulting words!" You just unwittingly summed up the problem for many (though not all) who participate on this blog. I'm pretty sure that saying things like "fuck yourself with a chainsaw" by Elburto etc.- even encouraging adults on the spectrum to swear and vent (yes, by lack of censoring some comments or admonishing for them) and claiming self righteously that some of you (lilady or Chris) are the only ones who could be feeling vulnerable as to their children. Get over yourselves, ladies. There is not strong enough science yet (physiological) to back vaccine safety and no vaccinated VS unvaccinated study and so you think you can just trounce merrily on any who know their loved ones (children or adults alike) suffered from a vaccine side- effect. Hopefully we are coming close to a better standard of safety so that risk/benefit will be improved.
Oh and "Elburto" you really need to read this article on ranting- it apparently just makes one angrier. I really fear for some of you.
www.health24.com/Lifestyle/Man/News/Ranting-on-website-just-makes-you-a…

@Broken Link: I don't like nor enjoy uncivil discussions in real life, at RI or at AOA. Unlike you, I would aver that there is no justification for insults in a scientific discussion. Say what you have to say, disagree, present facts, but be civil and respectful. The scientific level rises extremely high at RI and the insults and nastiness reaches levels that are unacceptable.

Don't assign ill intent or nefarious motives when you have no proof and when it certainly doesn't add to the discussion.

Both sites presents points of view and they are inextricably linked, as you imply. My word is not "law." It is my point of view. I'm not sure how many times I have to explain that observation of events is a very valuable part of the scientific process. Data get manipulated. My confirmation bias is well-known, commented upon and I have never denied it.

And, yes, you and I can say whatever we want. I think we're both obligated to be civil and respectful. That word is half the name of this site.

@lilady: The varicella vaccine was available in the mid-seventies. If your son is over forty, I'm sorry it was not available to him. It is a good vaccine for higher risk children. For heaven's sakes, no one believes in "culling of the herd"--your posts are becoming more and more problematic.

@Chris: You linked to an article which says, "In1990,the peak of the epidemic, 27,786 cases of measles were reported (11.2cases per 100,000population.)"
Also ECBT was started and funded by vaccine manufacturers, not by Rosalynn Carter, Betty Bumpers and Eleanor Roosevelt. It's not a bad group but pretty naive to assume that private citizens do these things without financial assistance.
@Stu: Back up your concept that the MMR vaccine does not had underestimated side effects or admit you are a quack! See how silly that sounds?

@matt Carey: Liability was not shifted it was eliminated. Read Bruesewitz http://www.supremecourt.gov/opinions/10pdf/09-152.pdf

@Denice Walter: Your racist comments about me have no place in this discussion. You don't know what you're talking about. Stop it. Please.

@Chris: Vaccines are very profitable both for the manufacturers and for us docs. I see that there is a statement about it only being a $5,000,000,000 business, but, firstly, that's a lot and secondly, it's wrong.

Dr Jay - you don't understand the first thing about epidemiology, yet you think you can interpret legalese now?

The plaintiff's premise of a 'design defect' - was rejected. They must bring suit to the NVICP - because they are trying to claim that the vaccine was inherently flawed, and that flaw is what injured their child.

The decision specifically addresses that claim as, "Section 300aa–22(b)(1)’s text suggests that a vaccine’s design is not open to question in a tort action. If a manufacturer could be held liable for failure to use a different design, the “even though” clause would do no work. A vaccine side effect could always have been avoidable by use of a different vaccine not containing the harmful element. The language of the provision thus suggests the design is not subject to question in a tort action. What the statute establishes as a complete defense must be unavoidability (given safe manufacture and warning) with respect to the particular design. This conclusion is supported by the fact that, although products-liability law es
tablishes three grounds for liability—defective manufacture,
inadequate directions or warnings, and defective design—the Act mentions only manufacture and warnings. It thus seems that the Act’s failure to mention design-defect liability is “by deliberate choice, not inadvertence.” Barnhart v. Peabody Coal Co., 537 U. S. 149, 168. Pp. 7–8.

Parents are still able to directly sue a vaccine manufacturer in civil court on the basis of a manufacturing defect or labeling defect.

So, you're still wrong in saying that the vaccine manufacturers have zero liability.

@Jay: "The scientific level rises extremely high at RI and the insults and nastiness reaches levels that are unacceptable."

Tone trolling. Sad, predictable, pathetic.

"Back up your concept that the MMR vaccine does not had underestimated side effects or admit you are a quack! See how silly that sounds?"

Yes, that sounds silly, because

A) YOU made an assertion that
B) YOU are not backing up that causes
C) YOU to endanger children making
D) YOU a quack.

Not only did you not address my question, you are deflecting my questioning your assertion by demanding I prove a negative. Pathetic, evasive, predictable tripe.

This is what makes you a weasel.

By not backing up your assertion of underestimated side effects, you have tacitly admitted you are a lying, incompetent quack. You spit on the Hippocratic oath and are a fecal stain on your profession.

By the way, Jay: you aren't NEARLY as smart as you think you are.

Ooh, I missed these.

@Jay: "My word is not “law.” It is my point of view.""

You've already admitted you don't quite put it that way to parents of your patients when you lie your ignorant behind off about vaccines, chelation and Bob knows what else. You being a lying douchecanoe ceases to be funny when you start endangering others, Jay.

@Jay: "I see that there is a statement about it only being a $5,000,000,000 business, but, firstly, that’s a lot and secondly, it’s wrong."

Why do you think we will take the word of a weasel? Citations or shut up, Jay.

Quoth Dr. Gordon:

The debate was heated and the vaccine remains unquestioned because one can’t have a public debate of losing “weaker” humans to measles to benefit stronger humans.

Nope, "no one believes in 'culling of the herd'”.

@Jen: "here is not strong enough science yet (physiological) to back vaccine safety and no vaccinated VS unvaccinated study "

Only a monster would suggest such a study. What the hell is wrong with you?

@Stu, please don't impugn weasels. They are beautiful, intelligent little carnivores who make their own way in a very tough world. They don't deserve to be compared to Dr. Gordon.

@LW: How about eel?

@Stu: eel, hagfish, lamprey, slime mold ...

even encouraging adults on the spectrum to swear and vent (yes, by lack of censoring some comments or admonishing for them)

Heavens!! Lack of censorship, lack of moral guidance! Will no-one think of the AS adults?!

I feel a swoon coming on. I take myself to the Fainting Couch.

I will post this as it was without the link as it is taking so long.
Broken Link, you just gave me the laugh of the century! You characterize this thread as having some"strongly held views and *some* insulting words!" You just unwittingly summed up the problem for many (though not all) who participate on this blog. I'm pretty sure that saying things like "fuck yourself with a chainsaw" by Elburto is well beyond insulting. Even encouraging adults on the spectrum to swear and vent (yes, by lack of censoring comments or admonishing for them) doesn't seem right, especially when a few of these individuals have said they do suffer from mental health problems and or substance abuse. Chris and lilady claim self- righteously that they re the only ones in a position to feel vulnerable as to their children. Get over yourselves, ladies. There is not strong enough science yet (physiological) to back vaccine safety and no vacc VS unvacced study so you think you are entitled to trounce merrily on any who know their loved ones (children or adults alike) suffered from a vaccine side-effect. They are just as worthy of anyone's sympathy, though you will never acknowledge this. Hopefully we are coming close to a better standard of safety so that risk/benefit will be improved for all. Oh and "Elburto" -you really need to read this article on ranting. It apparently just makes one angrier- rantingonwebsitejustmakesyouangrier.

@ Dr. Jay:

"@lilady: The varicella vaccine was available in the mid-seventies. If your son is over forty, I’m sorry it was not available to him. It is a good vaccine for higher risk children. For heaven’s sakes, no one believes in “culling of the herd”–your posts are becoming more and more problematic."

My son was born in 1976 and you're a "bit off" (20 years), about the availability of the varicella vaccine in the United States:

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

Odd...that you didn't know that Dr. Jay.

Now about my post ( # 234 ), about the PCV 7 and the two links I provided...you haven't replied. I'm still waiting Jay.

Don’t assign ill intent or nefarious motives when you have no proof

Yes, as Asimov (I believe) once remarked, never attribute to malice what is actually the result of stupidity.

Oh come on, Dr Jay!

What you label as my "racism" is simply an observation about a self-selected group of affluent, usually well- educated, young(ish) parents who adopt a belief system based on a back-to-nature vibe, including organic products, less use of pharmaceuticals ad infinitum: you can't deny that this group is predominantly white.

The anti-vax contingent we know about through sites like AoA and TMR ( the Canary Party, Safeminds) is also predominantly white- both US and UK- and overlaps ( but is not identical) with the aforementioned group and shares similar beliefs about "naturalism" and frequently scoffs at SBM.

I never said that you PREFER white people but that you may market to this group because of shared beliefs, shared background and shared philosophy - to some degree.

Would you prefer that I call them "crunchies", "earth mothers", "naturalistas", hippies, bohemian bourgeosie'rs?

I am -btw- affluent, educated,liberal and as white as the proverbial sheet. I fit the same demographic and do not actively campaign against white people - which would be rather difficult as they're everywhere I look and I am related to many of them.

@ Jen: How so-totally-out-of character for you to come here dissing Elburto Chris and me.

Our prose is a little too colorful for you...the exemplar of propriety? Why don't you stuff your sock puppet in your mouth and haul your ass outta here?

#260 "@Stu: Back up your concept that the MMR vaccine does not had underestimated side effects or admit you are a quack! See how silly that sounds?"

Except that as you know, the burden of proof is on the person making the assertion. In this case, the assertion is "MMR vaccine has underestimated side effects," which wasn't Stu's assertion. It was yours; thus, you need to back it up.

"For heaven’s sakes, no one believes in 'culling of the herd.'"

Your exact words were "The debate was heated and the vaccine remains unquestioned because one can’t have a public debate of losing 'weaker' humans to measles to benefit stronger humans."

And you're correct, this doesn't actually mean you would approve of such a thing, but for clarity's sake, where would you stand in a public debate of losing "weaker" humans to measles, in order to benefit "stronger" humans?

Also... what would it take to change your mind, Dr. Jay? If the scientific evidence *and* the anecdotes from real people don't do it, what would?

I'm still new here and I'd love to convince you, and haven't quite given up hope that we might. I'm positive you went into pediatrics to help kids, and though vaccines aren't perfect (as the medical literature and studies do show) they are much, much better and safer than getting the diseases.

Plus, longterm vaccination means that some diseases can be stamped out entirely, and then we need not ever vaccinate again. So a good way to end vaccination is actually... vaccinating! (Note: Tetanus is not one of those, unfortunately.)

@Khani:

Your exact words were “The debate was heated and the vaccine remains unquestioned because one can’t have a public debate of losing ‘weaker’ humans to measles to benefit stronger humans.”

And you’re correct, this doesn’t actually mean you would approve of such a thing, but for clarity’s sake, where would you stand in a public debate of losing “weaker” humans to measles, in order to benefit “stronger” humans?

Here's the context of Dr. Gordon's comment:

These debates have pretty much disappeared, but here’s more red meat for you, the measles virus and the infection it creates in strong healthy humans probably improves human health. The debate was heated and the vaccine remains unquestioned because one can’t have a public debate of losing “weaker” humans to measles to benefit stronger humans.

Does that sound like he's against it?

I hope we're all punting this, as it seems to be going somewhat viral:

http://tallguywrites.livejournal.com/148012.html

Oh, and while Dr. Gordon is lecturing us that " I don’t like nor enjoy uncivil discussions in real life, at RI or at AOA. Unlike you, I would aver that there is no justification for insults in a scientific discussion", we can't forget this tidbit, which is in the same comment with his "red meat":

Orac, spending hours and hours and tens of thousands of words writing about ten cases of measles while millions of children die from lack of breastfeeding is truly cold-hearted and your lack of concern for these children is shameful.

Emphasis added since we all need to be educated by our betters on how one has a civil scientific discussion.

@lilady: The vaccine became available in the mid-1970s and was used in special circumstances in the USA and elsewhere all throughout the seventies and eighties. The manufacturer supplied it upon request during that time. http://www.ncbi.nlm.nih.gov/pubmed/73844
By the way, if I cited wikipedia . . .

@Denice Walter: Your comments are racist, imply racism on my part and have no place here. You know nothing of my practice. It's none of your business, but a significant proportion of care in my office is done pro bono and a very, very small proportion of the families are as you've described them. Keep your racist elitist comments away from me, please.

@Khani: I continue to read and listen and learn. My opinions and my practices change as I learn.

There is a public debate about varicella and the vaccine in Europe right now just as there was a heated debate in the USA quite a while ago. My statement is easy to interpret: Measles is a much more dangerous disease and no one--including me--would ever suggest "culling" as a criterion for the debate. I think that risks and benefits of the MMR vaccine are appropriate topics and there remains insufficient proof of the vaccine's dangers.

I defy anyone to sit and talk with 100 families who are certain that vaccines greatly harmed their children and come away feeling the same as many of you do. Yes, the parallel of sitting with parents whose children contracted diseases and were harmed is equally effective anecdotal evidence. I've done both.

#276 I would prefer to hear a clarification straight from the horse's mouth. He may wish to walk back his statement, after all--people do change their minds, or speak clumsily, on occasion.

I'd rather give him a friendly chance to clarify than assume the very worst. I'm still new and naive and hopeful, remember? :)

@Khani, I'll let you form your own opinion of Dr. Gordon. I've had four years to form my opinion of him.

#279 If the anecdotal evidence is equal on both sides, why not let the science be the determining factor in what you recommend? The preponderance of the evidence is for vaccination.

If that is not enough to change your mind, what would change your mind?

As off-putting as Orac may be to you, he has very clearly given criteria that would make him change his mind (scientific studies, well-constructed, published in journals of excellence).

Please, for the sake of argument, tell us what would change your mind, if equal anecdotes and the preponderance of scientific evidence will not?

@Jay - sitting with the families of children with autism, who have been brainwashed by the folks at Generation Rescue and AoA that vaccines are to blame - for something that is almost certainly a genetic condition......Sorry, I'll continue to rely on Science and not the word of quacks.

Dr. Gordon:

@Chris: Vaccines are very profitable both for the manufacturers and for us docs. I see that there is a statement about it only being a $5,000,000,000 business, but, firstly, that’s a lot and secondly, it’s wrong.

So you don't know how scroll through a pdf file to page 31 and look at a table? Try again: tell what is to the left of the word "Vaccines" on the table in Appendix 1 of this document, explain what it means:
http://www.imshealth.com/imshealth/Global/Content/IMS%20Institute/Docum…

@Khani: As an example of the quality and tone of discourse, I have to cite the last few comments above. I wish more basic science vaccine studies had been done. I not favor leaving children unvaccinated to thin a herd or as an experiment.

Above, LW, and others twist words to make it sound like I've suggested that. As you've said, I'm in pediatrics to care for children as best I can. My points of view are not shared by the majority of my colleagues and those points of view are shaped and even changed by the words of some of the more knowledgable denizens of Orac's world.

I happen to like Orac. As I mentioned, like Stephen Colbert, he plays a role on this site. Curmudgeon and more. In real life, he a dog-loving, family-loving, Apple-loving fine surgeon and researcher. No one else here seems to understand that like Bill O', Colbert and others, he does what he does for educational and entertainment value.

The chickenpox vaccine was scorned as a universal vaccine for a long time.

Letter to the Editor
Varicella Vaccine: The Crossroads Is Where We Are Not!
Philip A. Brunell
+ Author Affiliations

Department of Pediatrics, The University of Texas Health Science Center, San Antonio, Texas
ABSTRACT

The commentary on the Japanese varicella vaccine (Pediatrics 60:930, December 1977) implies that there is some urgency in proceeding with testing at this particular time. I do not feel that we are at the "crossroads" any more than we were three years ago when one of the authors of the commentary wrote eloquently in Lancet expressing concern about the same vaccine. One would hope that we could all adopt an attitude that would permit us to make decisions based on the continuing evaluation of information which addresses the concerns we have all expressed about the vaccine.

Copyright © 1978 by the American Academy of Pediatrics

Also, Dr. Gordon, I did mistype the numbers from the 1989-1991 measles epidemic from the History of Vaccines timeline. Since you cannot directly link to it, I shall post the entire paragraph:

Over the period from 1989-1991, measles outbreaks sickened 55,000 Americans, killing 123. Of all of the cities that suffered from the outbreaks, Philadelphia was hit hardest: 1,500 children fell ill and nine, most of whom had not been vaccinated, died. Many outbreaks were centered in areas where immunization levels were low.

Yes, 1990 was the peak of the epidemic. Are you going to dismiss the 120 that died as just collateral damage of children who did not deserve to live. Just like you dismiss adoptive children because their mothers did not give birth to them, and therefore cannot breastfeed?

And are you going to ignore the cost to California taxpayers that the 1989-91 measles epidemic caused? From that paper:

Hospital costs amounted to $18 million, two thirds of which was paid for by Medi-Cal.

Are you proud that your rich special little snowflake clients are leeches on the community immunity provided in part by the taxpayers?

So, really, do read that table on that document, and tell us what number is to the left of the word "Vaccines."

Dr. Gordon, a vaccine that is created and used in Japan does not mean is approved for use in the USA. The varicella vaccine was not approved nor available in the USA until 1995.

From the CDC Pink Book Chapter on varicella:

Subsequent laboratory studies of the virus led to the development of a live attenuated varicella vaccine in Japan in the 1970s. The vaccine was licensed for use in the United States in March 1995.

You are really showing a lack of education, Dr. Gordon. Perhaps you should get some relevant CME credits, or at least familiarize yourself with the CDC Pink Book. Though the next thing you will do is tell us it is sponsored by "Big Pharma."

So, again, what is that number to the left of the word "Vaccines" in the table of Appendix 1 of that document I linked to, twice?

@Chris: We used the vaccine in 1977 and beyond. I used that vaccine during those years for non-immune adults and children who were immunocompromised. It became increasingly difficult to get it from the manufacturer in the eighties. Ask an old pediatrician.

Notice the silence when one of you says something really wrong.

#285 I'm pretty familiar with the "tone" of discourse here--I have read significant portions of the archives. I don't think it's as bad as what I've seen elsewhere and had directed at me personally in my professional capacities.

But really, discussion of tone, or of loving dogs, or of ethnicity, gender or personal appearance, has no place here.

My educational background is in philosophy; I'm only interested in the arguments, not in who is or is not a nice person.

I don't see you taking into account the rare cases of complications of illnesses, is the problem. While they are rare, they are no less real, and having a great many cases of garden-variety, mostly-harmless illnesses means an inevitable tiny number of deadly or permanent side-effect-causing illnesses.

Chicken pox, for example, is horrible and generally unfun. It's rare to have permanent complications, but because it is rare, that means *it really does happen*. Let a million ordinary people get chickenpox; a fraction of them will be adults. A small fraction of them will be female adults of childbearing age. Are you aware that chickenpox can result in a number of horrible consequences for a fetus? Permanent ones?

And that's without even talking about the horrors of shingles, generally suffered by older people, many of whom already have other medical problems. One in 20 people who've had chickenpox get shingles. That can go into your eye and blind you.

The reason people vaccinate isn't to prevent the garden-variety cases, which, mind you, do cause significant suffering and pain in their victims and their victims' families.

The reason people vaccinate is to prevent blindness, birth defects and deaths, which are numerically inevitable if enough cases occur. Fewer cases = fewer complications.

There are legitimate side-effects of vaccines (rashes and fevers, as well as others), but your chances are much, much greater for side-effects and complications with the illnesses themselves than with the vaccines. That's simple math.

@ Jen

Jen cited those “who know their loved ones (children or adults alike) suffered from a vaccine side-effect.”

Jen, can you understand the difference between those who believe or think or suspect that their loved ones suffered from a vaccine side effect and those who actually know that?

Well, it certainly seems that you don't, so let’s try this: According to a 2005 Gallup poll, about 25% of the American adult population believes in astrology; can you understand that there is a difference between those who believe or think or suspect that their lives are guided by the stars and those who knowthat to be true? How about this: according to the same poll, about one in ten Americans believe that a person’s body can be taken over by a spirit—is there a difference between those who believe or think or suspect that their bodies can be taken over by a spirit, and those who knowthat’s true?

Much of the anti-vaccine nonsense is based on the difference between belief and knowledge. Evidence matters.

For example, you might want to review the studies that clearly show that the subtle early signs of ASD can be discerned by trained researchers long before parents might ascribe the later, more obvious signs of ASD that happen to emerge in proximity to vaccinations given long after the initial signs could be detected.

@Khani: There are more than a few comments about my personal life. It's well worth knowing that the site's proprietor is a pretty good guy.

There are numerous European studies showing the consequences of universal varicella vaccination. The scientists there have decided that the morbidity and mortality to adults outweighs the benefits to pediatric population. I agree. Higher risk children should receive the vaccine.

#291 That's a shame, especially for all the children who will be born with birth defects because of chickenpox.

I for one dearly wish I'd had the opportunity to have the chickenpox vaccine. Now I'm at risk for shingles, which strikes when you're most vulnerable in your later life, and for which the vaccine is not as effective.

@ Dr. Jay: You will never, ever admit that your are wrong.

My son did not have acute leukemia or other malignancy to "qualify" for the varicella vaccine....

http://www.ncbi.nlm.nih.gov/pubmed/202915

Dr. Jay, did you read my post about my child's pancytopenia and leukopenia? My son's RBC morphology tests revealed that he had megaloblastic anemia along with poikilocytosis http://en.wikipedia.org/wiki/Poikilocytosis and anisocytosis http://en.wikipedia.org/wiki/Anisocytosis which caused episodic internal bleeds.

My son also had ITP along with platelet aggregation and adhesion disorders.

Trust me on this, Jay. You don't want to engage me in a pediatric hematology p!ssing contest...I'll wipe the floor with you.

I *trust* that you and your staff followed the CDC and AAP recommendations to have yourselves tested for presence of antibodies against varicella, once the vaccine became available in 1995...and have had the varicella vaccine, if your blood tests showed you had no immunity.

I *trust* that you and your staff have followed the CDC and the AAP recommendations to have the booster Tdap vaccine, as well.

Long comment (with too many links), addressed to Dr. Jay...stuck in moderation.

Jay Gordon (#260, #279, #285)

You appeared to have walked past (or avoided?) my earlier point (#224), where I stepped back to look at a larger picture. (I generally find it's a trait of those who go astray to squabble about in details whilst overlooking larger issues, hence my drawing back.)

It is not the job of a GP to try "out-do" medical research.

Instead you say here that you offer what you have as personal opinion from anecdotal observations and reading. You can do that to treat yourself that way, perhaps, but I doubt you are right (or even, have the right) to impose your personal beliefs on your patients.

The sitemeter link is likely gone because sitemeter has been erratic for months. I've noticed it on my own blog.

By the way - you wrote:

“Don’t assign ill intent or nefarious motives when you have no proof and when it certainly doesn’t add to the discussion.”

Usually that start leads to a different expression: “don't ascribe to malice what can be explained by incompetence”.

I think you should think about what you are doing in light of that honestly.

You also wrote:

“@Stu: Back up your concept that the MMR vaccine does not had underestimated side effects or admit you are a quack! See how silly that sounds?”

Your inversion looks silly because you’re asking someone to prove a negative. (Note the double negative you've introduced.)

You wrote: “No one else here seems to understand that like Bill O’, Colbert and others, he does what he does for educational and entertainment value.”

Oh, I see. Only you know. Rrrright. (You might want to observe that a good number of people writing here write blogs themselves and so are quite familiar with how things go.)

herr doktor bimler #269 -- :-)

@lilady: "Odd…that you didn’t know that Dr. Jay."

Yes, let's put Jay's delusions of grandeur and general whining aside and talk about his rank incompetence and ignorance for a while.

Or, maybe not.

@Jen, since you repeated yourself for no reason and ignored my comment: “here is not strong enough science yet (physiological) to back vaccine safety and no vaccinated VS unvaccinated study ”

Only a monster would suggest such a study. What the hell is wrong with you?

@Jay: "Your comments are racist, imply racism on my part and have no place here."

A) No, they were not.
B) No, they did not. They implied narcissism-infused star-farking. And that, Jay, you have proven over and over to be accurate.
C) You do not decide what has a place here, you arrogant, WATB douchecanoe. Start your own blog.

"You know nothing of my practice."

Oh yes we do, Jay. We know it is Very Important. We know it is Very Busy. We know you lie to your patients. Jay, the first link on your site under Vaccinations is that disgusting piece of tripe "Deadly Vaccinations" by RFK Jr. for crying out loud.

I know you're trying to re-invent yourself as being rational and reasonable, but you're not. You're not fooling anybody. You're a liar, and you're a quack. Again, you are a fecal stain on the medical profession, and you should be ashamed of yourself.

"a significant proportion of care in my office is done pro bono"

I call bullsh*t. You're a proven liar. Sorry if we don't take your word for it, sweetheart.

"a very, very small proportion of the families are as you’ve described them."

You mean rich? Yeah, um, sorry, Jay, again, sorry if we don't take your word for it.

"Keep your racist elitist comments away from me, please."

This coming from someone endorsing letting the poor and weak die off from preventable diseases so his special snowflake patients don't have to deal with them.

Ah... the milk of human kindness.

"I continue to read and listen and learn. My opinions and my practices change as I learn."

Obvious and stupid lie. You're just trying to repackage your tripe, Jay. You're still as anti-vaccine as ever. This takes ten seconds of Googling, doofus. Who do you think you are fooling?

"no one–including me–would ever suggest “culling” as a criterion for the debate"

Of course not! You just say very reasonable things, like that the side-effects of the vaccine are underestimated. Now, you don't have any proof of that whatsoever. You don't give a crap that communicating this stance can and will cause irreparable harm to children. You care about how knowledgeable this makes you sound to all your anti-vaccine (pro-bono, natch) patient's parents. You want more TV stints as the voice of reason, when you are not.

"I think that risks and benefits of the MMR vaccine are appropriate topics and there remains insufficient proof of the vaccine’s dangers."

FREUDIAN SLIP OF THE DAY ALERT

No really, read that again, and you'll know exactly where Jay is coming from here.

Man, was I right about calling him stupid.

"I defy anyone to sit and talk with 100 families who are certain that vaccines greatly harmed their children and come away feeling the same as many of you do."

Jay. You're a goddamned moron. Your medical license should be set on fire forthwith. Allow me to illustrate:

I defy anyone to sit and talk with 100 families who are certain that seat belts greatly harmed their children and come away feeling the same as many of you do.

"Yes, the parallel of sitting with parents whose children contracted diseases and were harmed is equally effective anecdotal evidence. I’ve done both."

You don't get to have this middle ground, you herd immunity parasite. If nobody vaccinated, you'd have to have the latter "sitting" orders of magnitude more often. YOU'RE NOT FOOLING ANYONE, YOU CLOWN.

"As an example of the quality and tone of discourse, I have to cite the last few comments above."

Stop your tone trolling. It's tired, it's old, it's pathetic. Nobody would call you names if you just addressed the damned issues, Jay. Try that instead of whining.

"I wish more basic science vaccine studies had been done. I not favor leaving children unvaccinated to thin a herd or as an experiment."

Hi! I'm Jay. I cannot form two sentences without directly contradicting myself. It's ok, nobody will notice, right?

"I’m in pediatrics to care for children as best I can."

That is either a lie or an open admission of rank incompetence.

"My points of view are not shared by the majority of my colleagues"

Why? No, seriously Jay, why do you think that is?

"those points of view are shaped and even changed by the words of some of the more knowledgable denizens of Orac’s world."

Liar. As long as you have "Deadly Immunity" up as your first link under Vaccinations, that is a filthy, scum-sucking lie of the first order. Have you no shame?

"I happen to like Orac."

Ah yes. Let me guess. You are so dense and delusional that you think this is all in good fun, right?

"As I mentioned, like Stephen Colbert, he plays a role on this site."

Jay. Sooner or later, someone is going to die or be maimed for life because you lied to them. How do you live with yourself? This is not funny, jackwagon.

"like Bill O’, Colbert and others"

Just by comparing those two, you have proven yourself denser than several packs of hammers. Sweet tap-dancing Jeebus you're stupid.

"he does what he does for educational and entertainment value."

I'm sorry, I... I don't even... what the hell is wrong with you.

"Notice the silence when one of you says something really wrong."

You hypocritical tone-trolling bucket of lamprey slime. You can say these things AFTER you back up your assertions about underestimations of vaccine side effects, not before.

* That's "Deadly Immunity" by RFK Jr., of course.

@Khani:

The reason people vaccinate is to prevent blindness, birth defects and deaths, which are numerically inevitable if enough cases occur. Fewer cases = fewer complications.

Another reason for vaccinating is that with certain diseases, if you vaccinate enough people at the right time, you can eradicate the disease and then nobody has to be vaccinated for that disease anymore. Smallpox was eradicated that way. Measles could be eradicated that way. There aren't a lot of diseases that fall into that category: tetanus doesn't, for example, but measles does.

@Dr. Gordon:

There are numerous European studies showing the consequences of universal varicella vaccination. The scientists there have decided that the morbidity and mortality to adults outweighs the benefits to pediatric population.

Hmm, what would cause morbidity and mortality in adults? Exposure to the disease? Seems less likely if you have a high level of immunity among children and adults can get vaccinated too. That doesn't seem like the right explanation.

Could it be ... shingles? Could it be that allowing the disease to circulate freely among children means that adults are re-exposed so their immune system stays prepped and they don't develop shingles?

My understanding is that it is thought that less frequent exposure to poxy children is the cause of higher rates of shingles in older people these days, so that makes sense as an explanation.

Of course, it means that the children who were allowed to suffer the misery of chickenpox for the benefit of their elders are set up to get shingles themselves some day, which means that other little children must also suffer the misery of chickenpox and the risk of shingles, and so on forever...

Or we could, you know, beef up the adults' immune systems through vaccines instead of exposure to poxy children, and then over time the risk of shingles will afflict fewer and fewer people and overall human suffering would be greatly diminished.

@LW: "Could it be … shingles?"

Obligatory: h_ttp://www.youtube.com/watch?v=62Qfbrc1jdo

You hypocritical tone-trolling bucket of lamprey slime

Lampreys don't slime; you're thinking of hagfish. I am now VERY VERY OFFENDED.

*Yawn*

I've been stuck in the lab all day. How's everyone doing?

*Looks up at comment number*

Holy crap, you guys! 300?!

Jay:

We used the vaccine in 1977 and beyond.

Before it was licensed for the general pediatric population it does not count. It is like saying RSV vaccine is commonly used. Also asking older pediatricians is just asking for anecdote. You need to provide the evidence that it was approved for use in the USA before 1995. Otherwise we will think you are just making stuff up.

And since I had to suffer with three kids with chicken pox, including a six month old baby in 1994, I would be very mad that the vaccine was available!

Stop back tracking.

Now, again, for the third time: go to the first appendix of the following document and tell us what is the number to the left of the word "Vaccines", and tell us what it means:
http://www.imshealth.com/imshealth/Global/Content/IMS%20Institute/Docum…

It does not look good when you cannot open a pdf document, got to a certain page and read a very simple table.

@ Stu:

Well, thanks for saying some things that I couldn't myself.

At any rate, I was not talking specifically about his patients' families only but also about his larger audience: Dr Jay speaks publicly and WRITES BOOKS. Like any writer, he appeals to a certain demographic, which I believe fits into a particular mould that would eschew modernity and opt for a more 'natural' alternative which often goes against SBM. Anti-vaccination/ suspicion of vaccination is one aspect amongst many others- more 'natural' child-rearing, organic food etc. This audience overlaps with the more radical groups who advocate totally against vaccines.

Perhaps I shouldn't have used the W- word: "affluent" and "back-to-nature" might suffice but let's be honest, those groups also over-represent whites.

AFAIK, there's only one race anyway. Right?

@herr doktor bimler: "I am now VERY VERY OFFENDED."

We need to come up with insults that don't unfairly stigmatize critters. I like to use "orc" because they don't actually exist.

*giggles* Apologies for the inaccuracies, guys. I forgot where I was for a second. Even smack-talk needs rigorous research.

Of course, this is TOTALLY comparable with AoA.

Apart from the undeniable fact that antivaxxers like Mr BS can't do basic maths (0.5 deaths per million - if you include everyone who didn't get the disease? MORON!), I'd love to know what they consider an acceptable death rate for a preventable childhood disease? One child in 10,000? 2000?

Especially if it were applied to a hypothetical entirely-unprotected population numbering hundreds of millions?

We can wipe diseases out with vaccination. Or we can let them roam unchecked and watch thousands of children die every year.

Still, it would only kill the weak kids, hey? Perhaps we should bring back smallpox and polio for the same reason. And have lions roaming school playgrounds too - sure, some will die but just imagine how fit the survivors will be!

Dr Jay - some of your statements to (and presence at) that conference were truly outrageous. Care to elaborate which you still stand by, and which you do not?

@Chris: Jay has already stated that he does not believe the numbers in that document. The real question is why?

***IRONY METER WARNING***

From the linked video, @1:22: "I was appalled with the quality of that science" (talking about MMR safety research)

#298

As I said in #275. :) It would be great to (mostly) eliminate vaccines, through eliminating the diseases, wouldn't it? We're so darn close with polio.

Polio? Polio-shmolio. I mean, most people get over it, right?

h_ttp://upload.wikimedia.org/wikipedia/en/thumb/2/20/Iron_lungs.JPG/1280px-Iron_lungs.JPG

WTH is with pediatricians who don't desire to wipe out as many infectious diseases as possible? A few generations of 90-plus percent measles vaccine coverage, and we'd never have to give it again!!! You'd think this would DELIGHT the antivaxxers! We had come SO CLOSE to wiping out polio completely... and then antivaxxers in Africa caused the uptake to drop and the disease to resurge.

It is so frustrating, because it seems the most logical path to go ahead and get rid of these diseases, then NO MORE VACCINE needed for that disease!

Hah-- hi5, Khani!

AND Stu! ... Yeah, me go bed now; my observational skills are tanking.

Stu:

@Chris: Jay has already stated that he does not believe the numbers in that document. The real question is why?

Because he likes the ones that agree with his beliefs, or that he just makes up out of thin air!

Chris, now you're being a meanie poopoohead again. I'm sure Jay will tell us all about it once he is done clutching his binkie.

#311 I personally would love to need fewer vaccines. I hate and fear shots; I get them anyway.

Like many other people, I primarily get the vaccines to protect old people or small children I come into contact with, along with folks who are on chemo or are otherwise immunosuppressed. My own immune system is pretty tough, and I'm not an oldster yet myself.

It's a public service that costs me nothing (thank you insurance) except for a few minutes of anxiety and (thank you pertussis-diphtheria-tetanus) sometimes a very sore arm.

I’d love to know what they consider an acceptable death rate for a preventable childhood disease? One child in 10,000? 2000?

With Sid? "Acceptable" to him is "anyone but my family getting it."

Let's back up.

My first comment about my son's pancytopenia and leukopenia was directed at Brian Deer:

"@ Brian Deer: My medically fragile child who was born with panyctopenia including leukopenia, only survived because he was immunized against measles, mumps, rubella. I was very fearful of him contracting varicella because they was no vaccine available to protect him.

He did contract varicella just before the vaccine became available, and at the first sign of lesions, he was put on acyclovir to prevent the proliferation of the virus in his body and to shorten the course of the illness."

Dr. Jay misinterpreted my comment; ("pancytopenia and leukopenia" are NOT leukemia or solid tumors). Dr. Jay did not pick up the clue about Acyclovir being prescribed for my son, which was NOT approved for treatment of varicella until 1992 http://news.stanford.edu/pr/91/911125Arc1046.html

Jay then posts a snide comment back at me...

"@lilady: The varicella vaccine was available in the mid-seventies. If your son is over forty, I’m sorry it was not available to him. It is a good vaccine for higher risk children. For heaven’s sakes, no one believes in “culling of the herd”–your posts are becoming more and more problematic.."

I then posted back at Dr. Jay...

"My son was born in 1976 and you’re a “bit off” (20 years), about the availability of the varicella vaccine in the United States" (and linked to the Wikipedia entry that provided information about the licensing of Varicella vaccine in the United States in 1995).

Dr. Jay, because he will never admit he is wrong, then posts back at me...

"@lilady: The vaccine became available in the mid-1970s and was used in special circumstances in the USA and elsewhere all throughout the seventies and eighties. The manufacturer supplied it upon request during that time" (with a link to the vaccine's use in JAPAN for children with acute leukemia and solid tumors)

I really doubt you ever administered Japanese varicella vaccine "all throughout the seventies and eighties", when the recommendations from the CDC and the ACIP was to secure ZIG (Zoster Immune Globulin) and/or VZIG (Varicella Zoster Immune Globulin), when it became available:

From the MMWR, February 24, 1984 Issue.

http://www.cdc.gov/mmwr/preview/mmwrhtml/00022690.htm

Recommendations of the Immunization Practices Advisory Committee (ACIP) Varicella-Zoster Immune Globulin for the Prevention of Chickenpox

"...In 1969, zoster immune globulin (ZIG), prepared from patients convalescing from herpes zoster, was shown to prevent clinical varicella in susceptible, normal children if administered within 72 hours after exposure. Subsequent uncontrolled studies of immunocompromised patients who received ZIG after exposure to V-Z virus showed that they also tended to have lower- than-expected clinical attack rates and higher-than-expected rates of subclinical infection when ZIG was administered no later than 96 hours after exposure. Patients who became ill tended to have modified illnesses with a low complication rate. The efficacy of ZIG in immunocompromised persons was further demonstrated by a study comparing the use of low-titer versus high- titer lots; patients who received the high-titer ZIG had significantly lower risks of complications.

ln 1978, VZIG became available. Both serologic and clinical evaluations have demonstrated that the product is equivalent to ZIG in preventing or modifying clinical illness in susceptible, immunocompromised patients exposed to varicella. VZIG has been licensed by FDA's Office of Biologics. VZIG is prepared from plasma found in routine screening of normal, volunteer blood donors to contain high antibody titers to V-Z. VZIG (Human) is a sterile, 10%-18% solution of the globulin fraction of human plasma, primarily immunoglobulin G (IgG) in 0.3M glycine as a stabilizer and 1:10,000 thimerosol as a preservative. It is prepared by Cohn cold ethanol precipitation.

ZIG was in short supply because of the continuous need to find new donors convalescing from herpes zoster. Because of the method of routinely screening plasma from regular blood donors for high titers of V-Z antibody and using those units to prepare VZIG, supplies became substantially greater..."

Did you forget Jay, that I worked as a public health nurse clinician-epidemiologist in a County health department, before the varicella vaccine was licensed in 1995. The staff at the Health Department controlled the supply of VZIG and secured the VZIG from the Red Cross, for post exposure prophylaxis administration to pregnant women, newborn children and those undergoing immune suppressing treatments for cancers:

"Supply

VZIG is produced by the Massachusetts Public Health Biologic Laboratories. Outside Massachusetts, distribution is arranged by the American Red Cross Blood Services--Northeast Region, through other centers (Table 4). VZIG is distributed within Massachusetts by the Massachusetts Public Health Biologic Laboratories."

I'm still waiting for you to reply/supply citations to back up your statements about PCV-7 and PCV-13 vaccines, Jay.

I'm not impressed with your diversionary tactics about varicella vaccine...which are blatant mistruths. Really Jay, did you think you were going to roll over on us, by just making sh!t up?

Japan gives another example of a country with low vaccine uptake, measles outbreaks and deaths.

In Steps toward Measles Eradication in Japan— A report from Okinawa Prefecture we can read

"In 1998–1999, Okinawa Prefecture recorded 2,304 cases of measles, including 8 infant deaths. In 2001, measles affected 1,565 persons and killed 1 infant, as shown in Fig. 1. This figure highlights the remarkably high occurrence of measles in Okinawa in comparison with the national average. During this period, there were many measles patients whose condition was severe enough to require admission to ICUs. There also were many cases of gestational and perinatal measles and infant measles"

An additional sad note: the paper also discusses measles related spontaneous abortions. I suspect these are not counted in many death rates.

Another publication (a comment in The Lancet) discusses measles in mainland Japan.

http://www.thelancet.com/journals/lancet/article/PIIS0140673604167159/f…

"Japan has been confronting the problems of uncontrolled measles for more than a decade now, and WHO has taken the initiative to eliminate measles worldwide. Despite these global efforts, however, measles is still endemic in Japan: there were an estimated 200 000 cases and 88 deaths (mainly in children) in 2000"

That works out to about 1 in 2,200 cases die. Mostly children.

Japan and France in recent history. I guess they have a lot of "weak" or "unhealthy" people? Or is it the sanitary conditions? Under reporting? What excuse will we hear to ignore these facts?

BTW Jay...

Do you get the seasonal flu vaccine and provide it free-of-charge to your staff?

Were you and your staff tested for the presence of IGG antibodies against varicella, once the vaccine was licensed in the United States in 1995? Did you provide the vaccine free-of-charge to staff who were found to susceptible?

Have you and your staff all received the Tdap vaccine?

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6007a1.htm

There is a point that the doctor may have been trying to make, but failed to make clear, namely that we might not be here at all had it not been for various pieces of viral and perhaps bacterial DNA that we modern humans contain. The more recent discovery goes to the ability of mammals to connect the placenta to the mother's circulation, as the result of a long-ago incorporation of viral information:

http://blogs.discovermagazine.com/loom/2012/02/14/mammals-made-by-virus…

Whether this was an absolutely essential part of the evolution of humans can be questioned, but it's obvious that the way we actually are, and our ability to develop in utero as modern homo sapiens, is dependent on a viral gene product that our long-ago ancestors incorporated into their genomes.

The older argument goes to the origin of mitochondrial DNA as the result of a very early combination of what we now think of nuclear DNA with an endosymbiont that gave us what is now our mtDNA. Certainly the mitochondrial genome is structured very differently from most of the nuclear genome and is kept in a completely separate compartment of the cell.

None of this has anything to do with whether or not vaccines have side effects or that mass immunization is one of the major triumphs of modern medicine and pharmacology. It's just a part of natural history. Still, the interactions between viruses and our long-ago ancestors were an integral part of our evolutionary heritage. I don't think that this history means that we need to suffer continual infectious diseases in order to be healthy. I suspect that we need to be challenged with foreign antigens in order to maintain the ability to fight off diseases, but that is common to our lives anyway. Babies taste anything and everything that is at hand, including dirt, so they get a lot of stuff, including lots of minerals that the anti-vaccination people are so horrified about. Just take a look at the substances in sea water, and then listen to some of the woo-folk brag about sea salt. The vaccines are just a little extra bit of information that we supply the immune system to charge it up in advance of a challenge by something that will maim or kill us.

Regarding the discussion about abusive language here: I find it tedious and not terribly useful, but perhaps it's just a bit of predictable venting. I'm not shocked or frightened by words that are apparently supposed to be shocking and frightening. I do find it strange that when I pointed out the trollish behavior by one (apparently rare) commenter, I was called names by another commenter, presumably because I'm not an expert on the history of comments here. This is not tone trolling on my part, just an observation that there is a Gresham's law regarding internet blogs, and at some point, extremely abusive commenters can end up driving away the majority of regular readers.

More about Japan's Vaccines Problems...

http://pediatrics.about.com/b/2011/03/08/japans-vaccine-problem.htm

"...It is kind of ironic that the first varicella vaccine was developed in Japan in the 1970's and was licensed in Japan in 1988, but still isn't on their routine immunization schedule.

Why is all of this important? Although anti-vaccine proponents will likely applaud Japan's immunization schedule, it is important to note that vaccine-preventable infections are still a big problem in Japan. In early 2000, there were 20,000 to 30,000 reported cases of measles a year in Japan, with actual numbers of cases 5 to 10 times higher due to under reporting. Although rates are trending down, as recently as 2008, Japan had 11,015 reported cases of measles, compared to 140 in the US.

Also of note is that there were 104,568 cases of mumps in Japan in 2009, along with 148 cases of rubella, 2 cases of congenital rubella syndrome, and 113 cases of tetanus.

Routine pertussis vaccinations were halted in Japan in 1975 following the deaths of two children. That eventually lead to epidemic cases of whooping cough in the country and at least 41 deaths in children before the vaccine was restarted. Did halting the pertussis vaccine lead to their seemingly fear of vaccines over a fear of vaccine-preventable diseases? Will halting vaccines again cause further fear of vaccines and increased rates of vaccine-preventable diseases?

As we continue to see these kinds of vaccine-preventable infections, like measles, being imported by travelers from Japan, Europe, and other areas, these vaccine questions are important to think about...."

Liability was not shifted it was eliminated. Read Bruesewitz

Jay, I've read Bruesewitz more times than I can remember. Design-defect claims are preempted from state law into the federal no-fault system, but manufacturers pay the excise tax into the NVICP trust. It assumes liability from the outset, bills for it in advance, and transfers administration to the Court of Federal Claims. It would be utterly senseless to have 50 separate sets of product-liability controlling an issue of national public-health policy.

Do you similarly object to the Locomotive Inspection Act? Price-Anderson? What, really, do you propose? Different vaccine formulations for each state? What design-defect theory do you think could survive in the modern day? Keep in mind that lots of things are intrinsically dangerous, such as kitchen knives. The only theory you would seem to be left with is that a safer design existed at the time of manufacture. How easy do you think this would be to prove? Do you really think the exact same thing needs be litigated over and over again?

Matt Carey:

Japan gives another example of a country with low vaccine uptake, measles outbreaks and deaths.

Thank you for those examples that were not in my file. Unfortunately there was an error in your comment, it seems that this is the actual link (doi:10.1016/S0140-6736(04)16715-9):
http://www.thelancet.com/journals/lancet/article/PIIS0140673604167159/f…

Another take on this is: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1177963/

The "Background" of the paper says:

Due to low vaccine coverage, Japan has not only experienced outbreaks of measles but has also been exporting it overseas. This study aims to survey measles vaccine coverage and the factors uncompleted vaccination among community-living children.

Further down the paper says:

In Japan, measles vaccine coverage has remained low, and either small or moderate outbreaks have occurred repeatedly in communities. According to an infectious disease surveillance (2000), total measles cases were estimated to be from 180,000 to 210,000, and total deaths were estimated to be 88 [11,12]. Measles cases are most frequently observed among non-immunized children, particularly between 12 to 24 months.

So, Dr. Gordon, how many babies need to die in this country for you to actually get some pertinent CME credits on vaccines and infectious diseases?

@Denice Walter: Your comments are racist, imply racism on my part and have no place here. You know nothing of my practice. It’s none of your business, but a significant proportion of care in my office is done pro bono and a very, very small proportion of the families are as you’ve described them. Keep your racist elitist comments away from me, please.

Oh for FSMs' sake Jay - Don't let that mean SHH* upset you. Cowboy Up and get back on your high horse.

*Self Hating Honky

#321 Regarding the tone thing: People can get a bit carried away.

However, given that in some cases their lives are actually being threatened by the results of anti-vaccine rhetoric, I can see why they do.

Japan was an interesting example for my investigation of Wakefield. He and a woman called Carol Stott, the "try me shithead" hatemailer, who has so far pocketed almost as much money as he has from this thing, claimed in 2005 that the famous Honda et al study of what happened In Japan to autism data (it went on up) after the withdrawal of MMR was "the strongest evidence yet for a link between MMR and autism".

Incredible, but true.

In recent days, there has been much talk of the 1998 Lancet paper, but people overlook the fact that the Wakefield campaign against MMR was relentless, over more than a decade, with innumerable highly-promoted attacks, including their critique of this paper.

In 2005, Wakefield and Stott argued that MMR continued to be administered in Japan, only separately, and that because this wasn't 12 months apart (as the grand doctor "recommended"), children were still effectively getting MMR. You will, of course, understand that Wakefield and Stott were writing to parents - targeting parents - posing as experts, and in receipt of their money.

In fact, readily available WHO data (two minutes on Google) showed that the three vaccines were not being administered separately at all. Not least because mumps vaccine was not part of the core schedule of vaccines in Japan.

At times like that I was always confronted by questions. Were these individuals just fools? Were they too lazy even to perform basic responsible research in return for all the money they were pocketing and all the lives they were distorting? Did they not have access to specialists who they could phone for advice? Or was the misinformation wanton? In short, as libel lawyers would express it, was it reckless, or was it malicious?

There was so much work in the queue ahead of this stuff that I never got round to writing it up.

In any event, they've had plenty of time since to recognise their wrongdoing, come forward and sincerely apologise for the misinformation. Perhaps the Moonie Blogger would like to take this up with them.

Dr Jay - I wish I could say I'm ashamed at how poorly you research, but I have to say I'm not surprised.

"The vaccine became available in the mid-1970s and was used in special circumstances in the USA and elsewhere all throughout the seventies and eighties. The manufacturer supplied it upon request during that time.

(For folks who want to see the actual study it's here;

http://dx.doi.org.globalproxy.cvt.dk/10.1016/S0140-6736(76)92397-7

Oh wait. that's not a study - it's a letter to the editor!)

"Varicella infection is often severe or even fatal in children with leukaemia or other malignancies. In a nationwide survey of leukaemic children in Japan we found that symptoms were severe in 56 out of 106 varicella-infected leukaemic children; 32 died. The risk of varicella has been increasing with the longer survival-times of these children and with the more intensive chemotherapy these children are given. Live varicella vaccine has proved safe and effective for children with chronic diseases such as nephrosis who had been receiving steroid therapy. We have tried this vaccine in children with acute leukaemia or other malignancies.

...Considering the increasing risk of exposure and the potentially fatal nature of varicella in leukaemic children, live varicella vaccine would be a potent measure for prevention."

-Akihiko Hattori, Toshiaki Ihara, Toshiaki Iwasa, Hitoshi Kamiya, Minoru Sakurai, Tadasu Izawa. Department of Pediatrics, Mie University School of Medicine, Tsu-City, Mie, Japan.

So tell me, Dr. Jay - what part of that letter to the Editor supports your claim that it was used in the United States in the 70's, and was available?

Because it was in use in Japan?

It was DEVELOPED in Japan in 1974. The 'Oka' in the 'Oka strain' is the child's LAST NAME, Dr. Jay. (Much like the Jeryl Lynn strain for mumps is named after the child).

The first clinical trial of the vaccine occurred in an 18 month period (between '74 and '75) in a pediatric outpatient clinic in Chukyo Hospital

Asano, Y., Nakayama, H., Yazaki, T., Kato, R., Hirose, S., Tsuzuki, K., & ... Takahashi, M. (1977). Protection Against Varicella in Family Contacts by Immediate Inoculation With Live Varicella Vaccine. Pediatrics, 59(1), 3.

So in other words, Dr. Jay. You're full of it. There is no way your claim is true. When the FIRST clinical trial was held IN Japan in 1974-1975, it was most certainly NOT available in the US for use in 'special circumstances'.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2573284/

"The Oka-V strain was first supplied in 1976 under license from the Biken Institute in Japan. Several manufacturers (SmithKline RIT, Merck Sharp & Dohme, and Pasteur Mérieux) subsequently used the Oka-V strain in the development of proprietary vaccines. A product license was obtained for Varilrix (frozen formulation) in 1984 by SmithKline RIT for use in groups at high risk for severe varicella and their healthy close contacts. SmithKline RIT—now GlaxoSmithKline (GSK) Biologicals—subsequently developed a refrigerator-stable formulation of this varicella vaccine. Varilrix is indicated in many countries for use in healthy and immunocompromised subjects from 9 months of age. GSK Biologicals' varicella vaccine production is based on the seed lot system (6, 14) using classical cell culture methods (Fig. (Fig.1).1). A manufacturer's working cell bank of human diploid cells, MRC-5, was prepared and tested according to World Health Organization requirements.

The Biken vaccine was licensed in Japan and Korea, in 1986 and 1988, respectively, for use in healthy subjects, and a license for Varivax with the same indication was granted in the United States in 1995 (1). In 1993, the vaccine manufactured by Pasteur Mérieux was licensed in France for use in potentially immunocompromised subjects."

So, it was AFTER 1984 when any 'high risk individual' or their 'close family contact' could have POSSIBLY been given a varicella vaccine, and it was ONLY licensed for that use - NOT for giving to the general public.

Varilix was reformulated in 1989 and the new vaccine finalized in 1991, with its first licensure granted in 1994.

http://link.springer.com/article/10.2165/0063030-200822060-00005

Really Dr. Jay - if you're going to make up stories (and I really wish you wouldn't) you should do it in a place like AoA, where folks wouldn't know how to research even if they lived in a library.

@ Bob G. I don't wish to pile on you...but you did refer to autistic individuals as "brain damaged"...whereupon I defended you.

Many of the posters here are on the "Spectrum" and many of the posters here have children who are autistic. We, unfortunately have been told by some of the trolls that our children are "vaccine-injured". We therefore, are quite sensitive to that pejorative (and incorrect) terminology.

"Brain damaged" or the more accurate TBI (traumatic brain injury) occurs after birth and after someone was involved in a serious accident or was assaulted. Our children and ourselves who have been diagnosed with as ASD were born "that way".

You are a relative newbie here and therefore are unaware of the *history* of Dr. Gordon's promotion of anti-vaccine and anti-science theories...as well as his history of posting on this blog (about 7-8 years, IIRC).

Dr. Gordon never posts anything that is backed up by citations or links to studies. In short...he posts his *opinions* that are not based in science and the anecdotal stories related to him by his elite select group of parents.

While posting those many comments he displays his passive-aggressive tactics, his constant goal post moving maneuvers, his tone trolling and his concern trolling..and every so often his truly snide remarks are interspersed in those comments of his.

Is it any wonder then, why Orac refers to him as "pediatrician to the stars", when he latches on to D-list celebrity parents?

He's oh so disappointed when his interviews either end up on the cutting room floor or his statements and interviews meet with the derision he so richly deserves?

Dr. Jay has a boutique pediatrics practice and no...he isn't prejudiced. As long as his mommies and daddies have the dough or the credit cards available to pay his fees...money is money for Dr. Jay (he doesn't accept health insurance payments).

Poor Jay, the only places where he gets some respect are those crank anti-vaccine blogs and organizations. He keeps coming back here, with oh so proper posts, to try to ingratiate himself with us and to try to convince us that he is a caring knowledgeable physician.

He violates every standard of care and every recommendation about immunizations put forth by the AAP, all because he'd rather have the respect of those know-nothing celebrity mommies and daddies...to the detriment of the children who are his patients.

The "RI Regulars" see through his phony veneer and call him on his behaviors.

Sigh; I have a comment hung up in moderation. I have to remember to use less than 3 links when I post, I really do.

Lilady:

Here's what one of the regulars said to me and about me:

"My last words to Blathering Bob, defender of bigots – DFTT doesn’t work.

"It’s actually better to address their piles of vomit, all the better to show [WARNING! BAD WORD ALERT!] lurkers that trolling is pointless, as there are innumerable counterarguments to quash their positively faecal assertions.

"Now as we know, Rhandi isn’t a troll, she’s just a hateful bigot. As you can’t be arsed to evaluate your RI debut as a white knight for homophobes, instead preferring to unleash herds of teal deer that deposit endless piles of no1curr about your internet adventures and curriculum vitae, I can only assume that you are the troll.

"Still, accepting that is the hardest part, and first step on your road to recovery."

Now I suppose we could interpret those words as brilliant sarcasm, pythonesque in its wit, and go on to other things, but I will offer one or two comments. First, it represents a real stretch -- I mean you really, really have to work at misinterpreting my words so remarkably. The plain text meaning of what I said was pretty obvious, but because I did not react in a shrill and angry manner to some remarks about bis-phenol A (about which I know something, and therefore made a comment), I was attacked. The attack was not on point, but simply ripped me because I had not bought 100 percent into an earlier ad hominem comment by the same person who then turns around and calls me a troll.

You know, everybody has to be new sometime. The question is whether people stick around after being new, and if they do, whether it's to exchange thoughtful comments or just to vent. And from my standpoint, it makes a difference whether I've just crashed a clubby little in-group or a group of commenters who are actually interested in science. I have to tell you that the review is mixed, with some interesting material and a lot that is just anger finding an outlet. Some of that anger is misdirected.

As to the comment that I referred to the "brain damaged," this is one part where I could legitimately type "citation please," because I sort of remember an exchange that was different, and also misinterpreted. If we are talking about the same event, I was referring to some incidents that made the local television news, and showed footage of a 31 year old man who lacked the ability to talk, who showed repetitive motions, was described by the newscasters as autistic, and was somebody who had been placed in a care facility to give him a chance to live the best life he could. I believe I referred to the fact that somewhere in his early development, something went wrong. I think that his life is damaged, and I fail to see how any rational person could see it differently. The fact was that his caretakers were beating him up and threatening him, and he had no way to defend himself or to communicate to his own mother that something bad was happening. She only figured it out because he was bruised all the time. If you want to complain when I say that this man has been damaged by life and his unfortunate circumstances, I think we simply have a stylistic disagreement. And of course I recognize the difference between traumatic brain injury and developmental difficulty.

We can quibble about the semantics of whether the developmental pathway for neuron growth and interconnection is atypical, or non-typical, or just plain damaged. Whatever the wording, the point is that something happened beginning in utero or shortly after birth, that it affects some people more severely than others (hence the term "the spectrum"), that many children eventually do quite well, that some don't (like the man shown on television), and that it has nothing to do with a few environmental insults such as the kind of pajamas the baby wears, whether it is breast fed, or whether it is vaccinated.

Two last comments: First, I was born in Hollywood, California and have lived in the southern California area more than half of my life. I don't pretend to be a member of the movie colony (an unlikely term anyway, nowadays) but I had never seen a reference to Jay Gordon as the pediatrician to the stars until I started reading this column. If you look on Wikipedia, you will find 3 names, and none of them is Jay Gordon. Curiously, one was Heidi Fleiss's father, who apparently had a following among actors and actresses at one time.

And by the way, I've known about Burzynski for many years because a local newspaper writer brags about writing the book The Burzynski Breakthrough (editions 1 and 2).

Finally -- I think the anti-vaccine crusade is a serious danger, I've spoken at length (not in this forum) about the notorious RFK Jr article, and I've written at length about the serious deficiencies in science and medical reporting in the mainstream media. This column by Orac is a force in that fight, but I'm beginning to believe that the comments section is becoming something of a hindrance, because it is such a turnoff. Yes, a lot of it is well done (you and DW and the reptilian life form, in particular), and some is just unbelievably repetitive comments which add little by the time we've seen them seven or eight times in the same setting.

Bob G,

I generally agree - the endogenous viruses (and their remnants) have little to do with present-day infections. ERV, on this forum, has written some posts on this topic (ERV = endogenous retrovirus). Their history and the involvement of the derived gene regulatory elements in human development, etc., is fascinating.

Bah, the first link gets caught up in a proxy server login.

http://dx.doi.org/

Use 10.1016/S0140-6736(76)92397-7 or the following link:

http://www.sciencedirect.com/science/article/pii/S0140673676923977

@ Bob G. Rhandi Paige is not a "RI Regular". A day or two before Rhandi posted here at # 50 http://scienceblogs.com/insolence/2013/04/05/who-can-quack-the-loudest/ I went after the troll Rhandi for a nasty comment posted at Orac. Here's the vile remark Rhandi made about gay people.

"Rhandi Paige
April 5, 2013

I don’t know about vaccines making you gay, but BPA can cause abnormal hormonal changes and excess estrogen in males. It does make sense that since the increase in BPA useage, an increase in male feminism has also occured in the USA. Countries that prohibit BPA have more manly men and less homosexuality. Could be a potential link. That is the “scientific” approach to it. There were rumors that USA and Russia both had bioweapons that could make people gay back in the 1980s. Of course if there were such a thing, we would have used it in Iraq. The jist of gayism is that it is a satanic inspired event that happens over time. porn abuse, childhood abuse, single family homes where the mother is dominant source of guidance, and other factors contribute to gayism, but ultimately it is a sin no matter the cause."

Follow the comments, where you attempt to teach us about the proper use of the terminology "Citation please" and your misunderstanding of "lurker".

I recall the young man you wrote about whom you referred to a "as brain damaged"...and I also recall you referring to other autistics as "brain damaged". At that time I commented that many of the posters here are autistic and many of the posters here have children who are on the "Spectrum" and we all take great offense at the phrase "brain damaged".

BTW, if you find some of the remarks obscene, you don't have to post here. I, OTH, find many of the remarks posted on AoA as being far worse than obscene.

I went after the troll for a snide remark about Orac.

Disregard my last sentence above....I need another cup of coffee.

"Pediatrician to the Stars" is Orac's unique (and clever) description for Dr. Jay...because Dr. Jay is the pediatrician caring for the children of every whacky ignorant celeb crackpot who publicizes their opposition to vaccines.

I too, have posted about RFK, Jrs. scurrilous paper, on many science blogs, but I didn't bring it up on this thread...because Dr. Jay cannot, or will not, reply to my questions about Prevnar vaccines. (And, I don't want to give Jay yet another opportunity to go O/T)

Jay: I don’t run with a crowd.

Suuure, you don't. It's just a coincidence that you have hordes of slavering fangirls in the bored, whiny, yuppie mummy crowd.

@Bob G: It is for notes like yours that I come to RI. We certainly disagree but I really appreciate your information. I too agree that Gresham's Law will eventually turn RI into a lot less than it could be.

@Khani: Try not to join the hyperbolic rhetoric. If you must, you'll just be like so many others here: Talking to yourselves over and over again.

@Darwy: I'm sorry to be repetitive, but the vaccine was available and used in pediatric oncology patients in the USA in the 1970s and for non-immune adults in the seventies and eighties. The manufacturer supplied it. Again, I was there, I administered that vaccine many times.

@lilady: You are wrong. It's like people who pull the pharma-shill gambit on ORAC. I do not do what I do because of the money. There are far more profitable ways to practice medicine or to use the Internet. You are wrong, mean, and not much fun to read.

@Bob G: You are correct. I work in Los Angeles and therefore many of my clients are in the entertainment industry. It's the neighborhood. Very few of the pediatricians in my area can contract with insurance carriers because they have dropped reimbursement below our cost of doing business. No, I have no Wiki, no best-selling books, and my media appearances are limited by my ineptitude on TV and my busy schedule in the office.

Extremists in the anti-vaccine movement can get just as unpleasant as the perseverating posters here. I do not "run with a crowd." I have spoken for the Robert Wood Johnson Foundation, for WIC many times, for the AAP and for Jenny McCarthy. (The only one who paid for my speech was RWJ)

I keep vowing never to come back here but I do for two reasons: I learn a lot when I take the time to sort through the junk posts and find the gems and I feel the ridiculous need to defend myself.

@lilady: Prevnar?? I give the vaccine occasionally. I sincerely feel that we're going to see, as we did with the Prevnar 7, complete replacement of those serotypes with new more dangerous serotypes. Vaccines are not the answer to S. pneumo. The Prevnar 13 has been in wide use for about three years. No where near long enough to really assess safety of efficacy. Nonetheless, to copy and paste from your previous post:

Here again for the umpteenth time, Jay’s opinion about Prevnar vaccine..

“The Prevnar vaccine is too new for me to recommend. The number of cases of Pneumococcal ear infections which could be prevented is very small and the number of cases of meningitis prevented is also small. I have no quarrel with doctors who recommend the shot or with parents who choose to get it. I have very strong objections to advertising this immunization to the general public on television. I don’t think enough information can be disseminated in 60 seconds.” (Emphasis added)

The above is a really sensible and moderate statement and you still choose to unleash your venom. Bob G, I hope you stay.

Have a great week, all!

Jay

@Khani:

It’s a public service that costs me nothing

You're a nicer person than I am. I get vaccinated because I don't like getting sick.

Dr. Gordon:

@Darwy: I’m sorry to be repetitive, but the vaccine was available and used in pediatric oncology patients in the USA in the 1970s and for non-immune adults in the seventies and eighties. The manufacturer supplied it. Again, I was there, I administered that vaccine many times.

Prove it. And tell us why this is relevant to the general population of children during the two decades between the 1970s and 1990s.

By the way, are you still having trouble opening up a pdf document, going to the first appendix and reading a table. For the fourth time, go to page 30/31 of the following document, read the table of Appendix 1 and tell us what number is to the left of the word "Vaccines", and explain what it means:
http://www.imshealth.com/imshealth/Global/Content/IMS%20Institute/Docum…

I don't care if you believe them or not. Just prove you can read a table.

@ Militant Agnostic:

I'll put that epithet in my files.
You know, at first I couldn't tell if he thought I was being disrespectul to whites or non-whites.

At any rate, I do feel that anti-vacciniana targets a particular audience that is privileged and largely white. Sites like AoA or Natural News brag that their position ( anti-vax) is shown in surveys to over-represent people with better educational status and higher income. If you scan websites' owners/ contributors ( e.g. AoA. TMR, SafeMInds, Canary Party) or photos of their conventions, you'll see mostly white faces.

@ Bob G:

Well, thanks. I try very hard to bring in material from my own studies/ work and my surveying of alt media, including anti-vax. There's so much awful fearmongering around the net. I try to read and listen and imagine how I might react if I were not immunised against it.
I like being a stranger in a strange land.

@Denice

I still can't figure out what he found "elitist" in your comment.

#338 I have one of those healthy immune systems the antivaxxers seem to like. I'm susceptible to low-level sinus problems but not much else. Now if there were a vaccine for that...

#337 I did notice that you didn't answer my question, which I feel is a fair one. Still, there's been a lot of posts so maybe you missed it. If anecdotes and the *preponderance* of scientific evidence don't change your mind, precisely what will?

Orac has laid out his requirements for changing his mind; I would like to see yours, please.

@Chris: I looked at that table, stared at that table, saw the number "17" and can't figure out why you keep repeating the same thing over and over again. Yes, we spend more on other drugs than vaccines. OK?

I honestly have no idea how to prove that the vaccine was given at major pediatric oncology centers in the USA in the 1970s and also no idea how to do the research or find the industry documents about compassionate use for non-immune adults for the 15-20 years prior to USA licensure. It was a small answer to one of the posters above. But 100% true.

@Denice Walter: I do not target any particular race or socioeconomic demographic when I discuss vaccines. I offer my admittedly minority point of view about giving six or seven different vaccines to a two-month-old and following other aspects of what I regard as a very unscientific approach to administering immunizations. I speak for free, I consult for pay and for free, too. I believe you must be projecting when you accuse me of racism and would ask you, once more, to stop.

So what you're saying, Dr. Jay - is that you used a vaccine in the US before it actually existed.

Remember; the first clinical trial of it was held in Japan in 1974-1975.

It is IMPOSSIBLE that you were using that vaccine at that time in the United States.

The Oka-V strain wasn't even available from Japan until 1976, and the first US license was granted in 1984.

So, your claim that it was available 'throughout the 70's and 80's is demonstrably a load of bulshite.

@Khani: I'm guessing you're asking me to answer the question about what it would take to change my mind.

I have changed my mind. I give more vaccines than I used to. I try harder to contain the absolutism of my rhetoric because the concepts presented by many people above. I still think that the current schedule is very wrong and endangers too many children. We must consider that family history when we vaccinate and parents must retain the right to participate fully in vaccine discussions. But, to directly answer, I have changed my opinions and the way I care for children and families. The practice of medicine evolves and if I rigidly adhere to what I thought I knew five or ten years ago I wouldn't be much of a doctor.

(Can you hear, can you feel, lilady or Chris grabbing that last sentence and running with it? I feel like I've just given them a straight line from heaven. I can live with that.)

Gordon:

Yes, we spend more on other drugs than vaccines. OK?</blockquote.

Exactly. And one of those drugs has to do with respiratory issues, like asthma, etc. You still don't get that vaccines are an inexpensive safe preventative form of medicine and actually save money.

You still don't understand how much the measles epidemic cost the California taxpayers a bit over twenty years ago. And you still don't understand that your patients are being protected by herd immunity from others, many of whom are low income and get vaccinated at taxpayer expense.

You really need to stop whining about how much pharmaceutical companies get paid for actually preventing illnesses that cost lots more to take care of in the end. It is a completely idiotic argument. Perhaps you make those claims to drive sales of your books, especially the last very horrible one where parents get blamed if their baby grows into an autistic preschooler.

Here are some other papers for you to actually read:

Arch Pediatr Adolesc Med. 2005;159:1136-1144.
Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001

J Infect Dis. 2004 May 1;189 Suppl 1:S210-5.
Measles hospitalizations, United States, 1985-2002.

J Infect Dis. 2004 May 1;189 Suppl 1:S69-77.
Acute measles mortality in the United States, 1987-2002.

JAMA. 2000 Dec 27;284(24):3145-50.
Individual and community risks of measles and pertussis associated with personal exemptions to immunization.

@Jay: "I feel the ridiculous need to defend myself."

Liar. Back up your statement about underestimated side effects of the MMR vaccine, then maybe you can start saying that.

And no, you don't have a Wiki. You wouldn't make money off of that. You have books that *boohoo* are not best-sellers, and you have a webinar you charge $9 for.

Pro bono my foot. You're a money-grabbing narcissist, Jay. Again, not an insult -- just a statement of fact.

It genuinely blows my mind when anyone calls the comments HERE uncivil. They wouldn't last an hour on Pharyngula, I'm guessing. Heck, the commenters on many of the "Mommy" forums will verbally eviscerate one for the slightest disagreement.

I would recommend toning it down a bit.

In one exchange I've had with Dr. Jay, I've found him to be polite and willing to admit a statement was not appropriate.

There is enough in the way of facts and well supported opinions to discuss without going to personality. In my opinion.

@Matt: we're not talking "not appropriate". We're talking "not true".

Oh, and by the way:

@Jay: "I still think that the current schedule is very wrong and endangers too many children."

Again, based on what?

To Lilady among others:

On March 23, in comment number 69, I was doing a little speculating about the fact that humans show a lot of variance that are collectively referred to as birth defects. Here's what i said:

"The parents of disabled children want to ask why, and some of them want to have some tangible thing to blame. It might be more correct (to speculate) that the fully developed human brain is the consequence of many genes, developmental effects, and even prenatal nutrition, and that every fertilized egg (except identical twins) is a random mixture of genes from both parents. Thus we should expect that most of the time (say nine out of ten), the offspring is essentially normal in brain development and anatomy, but when enough unlucky alleles are present, say one time out of ten, the combination results in some degree of abnormality due to the interaction of this unidentified set of unlucky genes.

"This seems offhand to be a very high level of disability, when we think about standard models of Darwinian selection. But the answer is actually fairly simple: Human intelligence is the most important selective advantage on the planet at the moment, and this selective advantage for the whole species can tolerate a fairly high level of damaged people. The correlate speculative hypothesis goes something along these lines: Since the development of the human brain is so complicated and requires so many gene actions, most required in a developmentally regulated fashion (ie: they have to come on and go off at the right time), there is simply no way to breed the damage out of the species in a limited number of generations. Partly this is because a gene activity that results in abnormality in some genetic background may be positively selected under some other genetic background."

The next commenter, Melissa G, remarks:

"BobG, I wish you wouldn’t refer to the autistic brain as “damaged.” Many of us get along fine, thank you."

I then tried to give an explanation in comment number 75 of March 24, 2013.

I was careful to use the phrase "damaged people" in a broad sense. Once again, I would ask whether anybody here will dispute that the 31 year old abuse victim who was the subject of widespread television coverage is "damaged" in some form? Certainly his whole life has been damaged by his inability to use language or to defend himself against cruelty and abuse. That was my clear meaning. I pointed out that this unfortunate man has a developmental disorder, and I think it's obvious that it's not the result of a car accident, lack of oxygen at birth, or parental abuse.

Given the totality of those remarks, does anyone want to argue that cerebral palsy is not some form of damage, that schizophrenics are exactly like the other 98 percent of the population, or that Parkinson's disease is just an eccentricity?

I can understand that some of us are especially sensitive to particular word usages because the phrases in question have been used maliciously by some people in some venues. To read those kinds of intent or thought into my remarks is to misread me, and as I said before, it requires trying very hard to do so.

One thing that struck me as a little odd is the accusation that I refer to autistics as "brain damaged." I found that a little strange, and I still can't find any place where I wrote that. I do, however, view a lot of behavioral and temperamental issues as being due to developmental differences between people, both the more typical and the less typical.

Lots of people are damaged in lots of different ways due to the way we are constructed and the way our anatomy develops. Our upright posture is a fairly new evolutionary development compared to our 4 legged ancestors, and lots of people pay the price in the form of back pain as a result. Are sufferers of sciatica going to argue that they are suffering from damage? I think the answer is obvious, and I think that the remarks attacking my own remarks should be directed to those who have used the term "brain damaged" as a slighting remark, ie: to imply some form of mental inferiority. I see remarks like that routinely in the rantings of right wing radio hosts, one of whom wrote the book with the title Liberalism is a Mental Illness. The usage and intent are obvious in this example, and if the author had used the term brain damaged, I would also have reacted angrily to that usage.

One other comment: Rhandi Paige was not the regular commenter I was referring to. Paige was not the one who called me a troll or a defender of homophobes etc etc. It was, in fact, a regular commenter. I'm simply avoiding typing the screen name of that person in capital letters because I'm not interested in getting into flame wars.

There is another large subject which I may wish to write about on another site. This is the tension between the idea of vaccine as personal preventive medicine and the idea of vaccine as a social duty in the sense of participating in herd immunity. I think for most of us (and most parents), the basic idea was to get your kid (ie: me) immunized against polio so that the kid wouldn't end up wearing leg braces. I know several people who had polio before there was a Salk vaccine, and some of them still suffer from its effects. I don't think that when parents were putting their children in line to get a polio shot, that they were thinking about herd immunity or the eventual eradication of the disease. They were thinking about the paperboy down on the corner who had to use crutches. I would suspect that the concept of herd immunity is mostly foreign to most people even now, and that may be because the concept has not been explained very well to the public. There is a little bit of mathematics involved when you start to calculate whether an infection flare will grow or will damp down, so I can see how the typical news reporter will avoid that part of the story.

I second Matt Carey's call to tone things down a bit. Not to spare Jay's feelings, but because it only gives him something to complain about and reason to ignore or sidestep the meat of the conversation.

Jay, if you really want to show us that you are willing to learn and that you change, perhaps you could start by removing or correcting the misinformation on your web site. You know, all those things that you "feel" but which is not actually supported by good science, and which good science says is incorrect. For instance, you might want to get rid of that RFK Jr. link. You might also start following AAP/CDC recommendations regarding immunizations, since they are supported by science and evidence of the current state of VPDs in the U.S.

One more thing that you may consider trying: don't promote whatever latest "ZOMG, The vaccines!!! Danger! Danger" headline that tickles your vaccine-hesitant tendencies. Rather than promoting scares about this vaccine or that vaccine, take a breather, wait for more evidence (especially where you're relying primarily on anecdotes or a single study) and see what develops. In short, don't take the CNN- or FoxNews-approach of wanting to be the first to get something out when more than likely, it's going to be wrong.

Jay said: "I have changed my mind. I give more vaccines than I used to...I have changed my opinions and the way I care for children and families."

So...how has your practice changed, apart from your statement that you give some MMRs? Which vaccines do you prescribe that you didn't before, and how often? Do you space them out or just not give complete series? Are they given as part of good medical practice or because parents browbeat you into doing it? As you consider the current recommended vaccine schedule "very wrong" and that it "endangers" children, what is your evidence that the Jay Gordon Schedule is very correct and does not endanger children ("it's my opinion" doesn't count)?

Jay does alter his pitch over time - for instance he's apparently dropped his formaldehyde-in-vaccines rant, though now he's riffing on Aluminum Toxicity. It's not so much that he's changed his tune, but that he's presenting variations on the same theme, hoping to get a pat on the back from advocates of evidence-based medicine while retaining his aura among antivaxers. It must be one hell of a difficult balancing act. :)

@Todd - I was going to second that as well. Dr. Jay. for what it's worth, isn't vitriolic or bad tempered (like some of our trolls) - and we should engage him with facts.

@DB - we certainly never want doctors to ignore their "gut" but use that "gut" with good scientific evidence to be a better advocate for their patients......Dr. Jay, just using his "gut" without good scientific evidence, isn't practicing good medicine - that kind of medicine went out the window over 100 years ago....and for good reason.

BobG, I don't think anyone's arguing that everyone's brain is just alike, but many of us do think you are being tone-deaf to our objections. Do you really not understand why "damaged" might have negative connotations to the non-neurotypical, regardless of your intent? We and our children confront stigmatization and marginalization every day, so using a marginalizing word like "damaged," no matter how neutrally-intended, just hurts.

I'd rather you just call me a #%$&. ;)

@ Jay Gordon:

Your last two remarks directed at me are lacking in *civility*.

"@lilady: You are wrong. It’s like people who pull the pharma-shill gambit on ORAC. I do not do what I do because of the money. There are far more profitable ways to practice medicine or to use the Internet. You are wrong, mean, and not much fun to read."

and,

"@lilady: Prevnar?? I give the vaccine occasionally. I sincerely feel that we’re going to see, as we did with the Prevnar 7, complete replacement of those serotypes with new more dangerous serotypes. Vaccines are not the answer to S. pneumo. The Prevnar 13 has been in wide use for about three years. No where near long enough to really assess safety of efficacy. Nonetheless, to copy and paste from your previous post:

Here again for the umpteenth time, Jay’s opinion about Prevnar vaccine..

“The Prevnar vaccine is too new for me to recommend. The number of cases of Pneumococcal ear infections which could be prevented is very small and the number of cases of meningitis prevented is also small. I have no quarrel with doctors who recommend the shot or with parents who choose to get it. I have very strong objections to advertising this immunization to the general public on television. I don’t think enough information can be disseminated in 60 seconds.” (Emphasis added)

The above is a really sensible and moderate statement and you still choose to unleash your venom...."

Why don't you answer my questions about the PCV 7 and PCV 13 vaccines? I provided you with a line listing of studies from PubMed http://www.ncbi.nlm.nih.gov/pubmed/?term=s.+pneumoniae+invasive+disease… that disproves your theory (excuses) for not recommended S. Pneumoniae vaccines, since the first 7 valent vaccine was licensed 13 years ago (because) the vaccine "is too new for me to recommend". Show us where the licensing of the 7 valent Prevnar vaccine has set the stage for IPDs caused by "new more dangerous serotypes", not contained in the Prevnar -7 vaccine.

Try to be truthful Dr. Jay, by copying and pasting abstracts from recent "Pediatrics" journal that are behind pay walls or copying and pasting paragraphs from the S. Pneumoniae section from the current online edition of AAA "Red Book"...to prove your theories.

BTW Jay, your *assumption* that my son had leukemia or a solid tumor is wrong...even if he had undergone treatment for these cancers before 1995 he would have received VZIG following exposure to a varicella case as post-exposure prophylaxis

Jay,

I see you haven't replied despite my drawing my question to your attention (#295) and you having replied extensively to (to my reading) almost everyone else (#337, #344, #345). I take from this that you are avoiding my point.

It is not a GP's job to try "out-do" medical research science.

(Others might express the same concept less charitably.)

@Brian (lilady and Chris, too) -look at this child (Saba) and it's quite obvious that this healthy child suffered some severe effects (perhaps brain damage) from her fluvax shot (presumably the Australian docs and surveillance groups agree). It was mentioned that all subjects were healthy prior to immunisation. They noted that clinical trials were not even completed to get it to market quicker. Such a shame.
http://www.perthnow.com.au/news/western-australia/kids-get-banned-fluva…

I am thoroughly confused. Will me being more polite make Jay answer my questions? No. Will it make Jay stop lying? No. Will it make Jay take down "Deadly Immunity" as his lead information on vaccines from his website? No. Will it stop Jay being incompetent about immunology? No. Will it stop Jay selling a $9 Webinar full of lies about vaccines? No. Will it stop Jay selling his tripe-filled books? No.

All of your arguments for civility make a lot of sense if we were dealing with someone who is arguing in good faith. Jay is not. He lies, misrepresents, deflects, throws every fallacy in the book into the conversation and runs away as soon as he is called out on anything.

It is not me who is violating the rules of civil conversation, thank you very much. Please keep that in mind.

@Stu

You raise some good points, but you forgot one thing. Will changing tone stop him whinging about people being mean, leading him with only the near of the arguments to focus on? Yes. Well, more likely, anyway. The goal is to take away his excuses for not answering the questions poised to him. You

Tragic case, Jen, from 2 years ago.
Tell us, how did the court case for the claim against the company manufacturing the vaccine go?

How is one anecdote supposed to topple all of the years of safety data?

@Todd: *snirk*

Okay, I promise to be civil. Now all we are waiting for is Jay backing up his assertions, for starters, that the side effects of the MMR vaccine are underestimated.

@jen, I see your useless anecdote and raise you another:

look at this woman and it’s quite obvious that this healthy woman suffered some severe effects (like death) from drinking water (as all doctors and pathologists agree). It was mentioned that she was healthy prior to drinking water. They noted that clinical trials were not even completed to get water to market quicker. Such a shame.

h_ttp://www.nbcnews.com/id/16614865/ns/us_news-life/t/woman-dies-after-water-dr…

Patients sometimes die from anesthesia. Should all surgeons say, "There is a possibility that the patient will die on the table. Therefore I will not do surgery no matter how unlikely death is nor how beneficial surgery can be?"

http://tallguywrites.livejournal.com/148012.html
this says it all

@LW: that all depends whether those surgeons sell books and webinars on how evil anesthesia is.

Stu, your link didn't work and I think there's a different burden of safety for someone when they are given a medical intervention (and they are healthy). Water? I notice Chris and lilady have not commented on Saba yet...

Jen, I did comment. I asked how one anecdote trumps years of vaccine safety testing. This year influenza killed at least a hundred children. So how many deaths were caused by any influenza vaccine this year? Provide a good citation.

Also, do provide the title, journal and dates of the PubMed indexed studies that show the MMR vaccine is worse than actually getting measles. From the recent outbreak in Wales, you would have to show it hospitalizes one in ten, and kills about one in a thousand.

@ Brian, this looks to be one of the more recent links.
http://www.westaustralianmedicalnegligence.com/tags/saba-button/

@Jen: I imagine Chris and lilady will comment, unless, like I normally do, they are ignoring you.

ALL medical interventions have risk. No one here denies it. Life has risk. Yes, it really sucks when something happens and it's your child. It's very sad what happened to Saba. But the article doesn't say exactly what happened. Was it the fever? What caused her problems? Many, many children have fevers, and febrile seizures - my daughter included - but they are not harmed.

And you can go on living safely protected by the others who DO get the vaccines and are less likely to infect you. Bye, Jen.

dingo199, you are kidding me?!!!! You refer to the fact that this case is from 2 years ago to just write it off?! Pathetic. MI Dawn and Chris, save your mock sympathy. You view this poor kid as an "anecdote." I"ve heard enough.
http://sababutton.org/sabas-story

@jen: "your link didn’t work and I think there’s a different burden of safety for someone when they are given a medical intervention (and they are healthy)."

Hogwash. You are intentionally ignoring the entire concept of preventative medicine.

Here's another example. Two weeks ago an adolescent near here was almost decapitated by her seatbelt when her car was T-boned. By your logic, we now, by virtue of that single anecdote, all have to stop wearing seatbelts. Or at least until a lot more research is done. Right?

By the way, are you still advocating a full, double-blind clinical trial of vaccinated vs. un-vaccinated?

@jen: Oh hai, monster, I have a few anecdotes for you.

http://www.usatoday.com/story/news/nation/2013/03/22/flu-toll-children/…

@jen

[citation needed]

I actually bought Jay Gordon's "Preventing Autism" book to see what random untested theories-as-fact concepts may next be spoken of in my exam rooms by fully gulled parents. The idea of having buffed up sperm, in and of itself seems interesting. But after reading that chapter (ch 8) of his book, I looked back to his "References" section, and THERE ARE NO REFERENCES FOR HOW TO BUFF UP YOUR SPERM!!!!. FYI all the other chapters have references but this one. Oh, please tell me you didn't make this all up, Dr. Gordon. I was so psyched about all that was advocated for spermatopia, but now I see no references. Egads (so much for proofreading, something that is much more likely to happen with PEER REVIEW), now I'll just be left with my usual Homer-Simpsonesque two-headed swimmers. :(

Chris Hickie, MD, PhD

I just read the story of Saba, Very sad. Stu's comments are beyond insensitive.

You are all very correct when you say that neither I nor anyone else should minimize even one death from a preventable disease. To discuss this case the way Stu does embarrasses and diminishes us all.

@Grant: I'm not a GP, I'm specialist, a pediatrician with the extra training you've described. I have no desire to "outdo research." I interpret recommendations and implement the best possible care. I try not to use antibiotics when they're not indicated and I also individualize my use of vaccines.

Melissa:

OK. No offense intended.

Dr. Gordon, Stu linked to a news article that over a hundred kids have died from influenza, the actual disease, this year in the USA. How is it insensitive?

Jen (and Dr. Gordon), can you tell us how the MMR vaccine caused enough autism in the UK that it was noticed in less than a decade (1988-1998), but that effect was not noticed in over twenty years of use in the USA, a much larger country, after it was introduced there in 1971? Why would it happen only after 1988, and not after 1978 when the MMR vaccine was the preferred vaccine for the American Measles Elimination Program?

@Jay: "To discuss this case the way Stu does embarrasses and diminishes us all."

Why? Jen provides one anecdote of an adverse vaccine reaction, I provide documentation of what the disease that vaccine prevents against does.

This is innuendo transparently intended to impugn my character. You do not get to do this while accusing others of being uncivil.

Also, in the course of a civil conversation, if one makes an assertion, it is expected that said assertion is backed up. I am still waiting for evidence for your assertion of underestimated side effects of the MMR vaccine.

#345 Yes, but what would it take to change your mind and go ahead with the ordinary vaccine schedule, like most other pediatricians do? I'd like to change your mind the rest of the way, if possible. :)

@ all the various posts about tone. My educational background is in philosophy, so I generally ignore tone in favor of solid argumentation. Otherwise Kant would have been impossible to get through without hurling the text through a window.

Plus, politeness might help with the fence-sitters, as other people are not quite as able to divorce tone from content as I am. (It did take a few years of training.)

#360 @jen I am sorry, but simply looking at a person's picture does not determine causation. You may be right, and you may be wrong -- but that is impossible to determine from any picture, regardless of how sad it is. From the story accompanying the picture, it sounds like there was a specific problem with a specific set of vaccines, and when they were recalled/halted, not everyone did as they were told and stopped using them.

That said--the position of people here is not that vaccines are 100 percent safe. They are not. (Nothing is.) It is simply that vaccination is statistically safer than the illnesses we vaccinate against.

#370 Yes. Water. Water is a poison and it has killed. It just takes a *lot* of water. Dose makes the poison.

Out of curiosity, in your opinion, what should the burden of safety be for a medical intervention? Would 90% safety be enough? 99%? 99.99%? What is the exact percentage you would like to see for a medical intervention on an otherwise apparently healthy person?

@jay

Clutch your pearls somewhere else and stop tone trolling.

And why won't you answer Chris' question? Try answering it in three posts, or we can all assume that you do not know anything about vaccines.

Jay,

Aside from that a pediatrician is a generalist to me*, you’re using labels to side-step the point.

Sorry, but I’m seeing weasel words.

"I interpret recommendations and implement the best possible care." - but you've shown here, by your own words, that you offer your opinion, not medical science's recommendations -- two very different things.

"I also individualize my use of vaccines" - what do you mean by "individualize" - per person, per vaccine, per environment? This sounds like a word to shuffle your opinion under when it differs from medicinal advice.

---
* My distinction was by type of disease or organ; pediatrician is general practice over an age group.

@Grant: oh my, "weasel words"? We'd best get a fainting couch ready...

novalox:

And why won’t you answer Chris’ question?

Dr. Gordon did answer my first question after I asked it four times. He did not understand why vaccines being 17th in list of 20 was significant to him continuing to use the "Big Pharma" ploy.

I really do not like the "companies who make product actually get paid for it" complaint, when that product actually saves money. It is kind of like complaining that paint companies make money by selling paint, when in truth the paint does protect the exterior of a house more than just leaving the wood unfinished.

He has not posted since I posted the second question.

Jen,

I wish that every vaccine was perfectly safe—but I don’t recall that I—or anyone—has ever indicated that vaccines are perfectly safe.

Life is imperfect. Let me elaborate, based on my personal history: Some years ago my father died of a particular disease, and so I dedicated much of my life to find a cure. I doubt that you can understand how pleased I am that I helped to find a way to cure patients who now need not die as my father did. The good news for you is that you or your loved ones need not succumb, as my father did; the bad news is that, if you need the drug, you may suffer side effects that are, I think, on the whole are rather better than dying—I’d ask my dad if he’d rather be dead or risk the adverse events, but he’s gone.

I’m sorry that that child suffers. I’m sorry that her family suffers. I think that, in the absence of vaccination, a great many more children and families would suffer. What do you think?

@Khani: "Like many other people, I primarily get the vaccines to protect old people or small children I come into contact with"

You're a generous person. I get them to protect myself, but I'm happy that they also protect others. Well, except for tetanus. That one I get exclusively to protect myself.

@brian: "I doubt that you can understand how pleased I am that I helped to find a way to cure patients who now need not die as my father did."

Without even knowing the disease, I do thank you for helping reduce the suffering of the world.

#390 I like being able to cuddle babies without worrying about making them sick, too.

Brian-- that rocks!!! Well done, you!

BobG, thank you for listening. I appreciate your apology and accept.

One of the things that seems to said about diseases like influenza, measles, and the like is that "healthy people don't have to worry about them." Now, I suppose there may be some truth to that. After all, only about 1 in 1000 children who catch measles have serious complications. That number varies for other diseases, naturally. Additionally, not everyone who is presumed to be exposed to the disease develops it. When asked why some people don't get sick, some get sick but recover, some have serious complications, and some die (which is considered a serious complication by some), it would appear there are two explanations:

1. The people who got less sick did something right that prevented them from getting sick.

2. The course of the disease is subject to a variety of factors, some of which are understood, some of which are predictable, and some of which are neither.

Hindsight being what it is, if you believe explanation 1 then it's quite easy to tell who was truly healthy - if you were healthy, you didn't get serious complications or die.

MESSAGE BEGINS----------------------------

Shills, Minions, and Assorted Rabble:

Perhaps you can help your old Overlord with a little insight into what makes some of your fellow monkeys tick. Now, I've been subjugating and bribing your kind for the better part of a terran century, and while I spend most of my time on "administrative" duties, I am a decent observer of behaviour under duress.

Well, I just don't understand this Gordon character that keeps popping up here. He always seems so . . . unhappy. What exactly does he want here? Why does he return? For instance, I really rather hate cheese. It's an absolute horror. I would rather eat the droppings of a Haavk'cht Rift Lumberer than be in the same room with a plate of gelatinous, disgusting Cannon Bear, or whatever it's called. Now, mind you, the Rothschilds simply live on it, so you can imagine how many nasal filters I go through during one of the Baron's endless marathons of whist. In any case, I dislike it and I avoid it's offensiveness.

There is a point to this . . . oh yes, the Gordon creature. He seems to hate being in the midst of our happy, little band of species traitors, reptilians and the like and yet he seems unable to resist, showing up with the dreadful inevitability of an unloved season.
Oh, it usually starts out well enough, but surely he knows where things will go. He knows that eventually he shall be pressed for facts, and that the language will become increasingly colorful (commendations to Cadre Leader Class XV Elburto), and that all of his slightly-too-sincere, mawkish overtures will be for naught. And yet he comes back. Again, and again, and again. What was it the great Glaxxon philosoraptor Ech'pnäak said? "Schv'aat chuk m'veet Glaxxon'vah sssvanx ott, v'maat hokk chuk vhallkra chuk beeth." This translates somewhat less elegantly as, "It's a sad Glaxxon who does that which fails/sinks repeatedly only to expect differing outcomes."
Honestly, if he were Glaxxon, I'd swear he was flirting with you . . .

Well, do drop some kernels of wisdom on this subject, I've got some homeopaths to dissec . . . I mean, gently question.

Lord Draconis Zeneca, VH7ihL
Foreward Mavoon of the Great Fleet, Pharmaca Magna of Terra, Played a Doctor on TV

Glaxxon PharmaCOM Pediatric Division
0001111010111010110110101010101

--------------------------------MESSAGE ENDS

Jen: I was offline for several hours. I don't know anything about the Fluvax vaccine that is used in Australia or the case of Saba Button.

According to the AVN which is using Saba Button as their "poster child" http://nocompulsoryvaccination.com/2011/04/09/the-story-too-important-n… the child had a high fever and accompanying seizures, within a short period of time after she received Fluvax vaccine.

Have the parents instituted a lawsuit for what they claim are vaccine-injuries? It seems to me that if no other for her high fever (such as a viral or bacterial illness), that the future costs for her care will be paid for by that lawsuit.

How about the MenAfriVac fiasco post vaccine paralyses rumors that were started by Christina England and were headlined on Age of Autism. You couldn't wait to post that crappy rumor on the Ho-Po and I requested that you not indulge in spreading that story? I also asked you if you would apologize for spreading that manure and you never replied.

How many parents in Africa avoided the vaccine for their children because of the activities of you and your ilk. How many African children and young adults died from bacterial meningitis, because of your activities.

AoA never retracted their headlined story and you never apologized, jen.

http://lizditz.typepad.com/i_speak_of_dreams/2013/01/meningitis-vaccine…

Jay, at the risk of being called "mean" by you, when are you going to explain why "Prevnar vaccine is too new for (you) to recommend"?

I provided you with a slew of studies about the vaccine's safety and all you have are your unsubstantiated-by-science opinion (and sincere "feelings") about the vaccine and your lame excuses for only administering it rarely...

"I sincerely feel that we’re going to see, as we did with the Prevnar 7, complete replacement of those serotypes with new more dangerous serotypes. Vaccines are not the answer to S. pneumo. The Prevnar 13 has been in wide use for about three years. No where near long enough to really assess safety of efficacy."

I'm still waiting Dr. Jay.

Have the parents instituted a lawsuit for what they claim are vaccine-injuries?

They had an attorney in 2011, at least. As of last week, they had yet to file.

lilady:

Jay, at the risk of being called “mean” by you, when are you going to explain why “Prevnar vaccine is too new for (you) to recommend”?

With him claiming to use the varicella vaccine before it was approved for all children, I wonder about his use of the MMR in the 1970s. It was approved in 1971. Did he use it then? Is it still too new? What evidence shows that it is more dangerous than measles?

I think Dr. Jay has flitted away...again. Poor Jay, he keeps lurking here, posts a *civil* comment or two...then *wonders* why we treat him as the fact-free, citation-less drive-by poster he has become. Lord Draconis wonders why Dr. Jay keeps coming back. (Dare I venture an opinion about possible masochism being his motivation?)

There's another video up at AoA with Andy talking about peanut allergies as a not-too-effective seque into anaphylaxis caused by measles-containing vaccines. He's really desperate to have a debate about the measles outbreak in Wales. Jay should be viewing it right about now, to get some *pointers* to explain his view on the *under reported dangers of MMR vaccine" and his "selective vaccination policies".

http://www.ageofautism.com/2013/04/andrew-wakefield-questions-for-salis…

Prevnar: Not a dangerous vaccine, I give it when asked. I'd like to see a few more years of data and would not combine with other vaccines. This is s personal impression, no proof.

MMR: Enough anecdotal evidence to convince me that 1-2% of children are severely adversely affected by this vaccine. I think it's safer for five year olds than for one year olds. Again, no proof claimed, just evidence and my confirmation bias.

Citations for the pre-licensure of chicken pox vaccine as soon as I can get them.

Jay

@Jay:

MMR: Enough anecdotal evidence to convince me that 1-2% of children are severely adversely affected by this vaccine. I think it’s safer for five year olds than for one year olds.

As you well know, the plural of anecdote is not data. Also, so you're happy to have children from the ages of 2-5 at risk for measles and later complications like SSPE?
Even if we accept your 1-2% of children at risk (I don't), not vaccinating and delaying vaccines are not risk free options either.

#401 Any ideas as to why the sample you've seen is so out of whack with the larger studies of many more children? Do you think it may be possible that your patients may be wrong about the cause at all, and that it might be, as you say yourself, confirmation bias?

Do you see that it is possible that people who believe (wrongly, as it happens) that vaccines caused their children illness are much more likely to seek you out because you have stated you do not believe in the vaccine schedule? And that this may have tainted your numbers by a factor of, likely, more than 10?

I'm not seeing any reason to believe what you believe, unfortunately, in what you say. Given that you yourself said the anecdotes were equal, and that it's clear that the vast majority of data supports MMR early... I'm not sure what reason you would have to differ from the schedule.

@lilady - That new Wakefield video's quite something... I've scribbled a few thoughts down...

http://jabsloonies.blogspot.co.uk/2013/04/andrew-wakefield-moves-goalpo…

@Jay

So, a "gut feeling" based on unsubstantiated anecdotes that MMR causes severe adverse effects in 1%-2% of recipients is worse than a 15%-40% hospitalization rate? Or 1.3% risk of post-infection encephalomyelitis? Or around 20% risk of pneumonia? SSPE is, thankfully, very rare. Then again, it is universally fatal.

To be honest, I'm not sure why Dr. Jay insists on continuing to show up here. In a way, I'm glad he does, because I keep thinking that eventually reason and science might get through to him. On the other hand, it is painful to watch, because he gets his posterior handed to him time and time again every time he shows up. I do tend to agree that it's probably best to tone it down, if only to eliminate an excuse for Dr. Jay to clutch his pearls and complain about the "incivility" of it all, while every so often demonstrating that he is quite capable of being as "uncivil" as the the people he views as the worst offenders on that score.

Interestingly, since the first time Dr. Jay showed up in the comments here, back at the Blogger precursor to this blog back in 2005, this appears to be one of his longer-lasting appearances (several days now). Usually he shows up for a day or two and then, having taken a rhetorical beating, retreats for a while. I'd be curious why he's sticking around this time.

Enough anecdotal evidence to convince me that 1-2% of children are severely adversely affected by this vaccine.

If I were in Dr Gordon's situation and shared his conviction, I would be doing my best to bring my amassed data to everyone's attention via the NEMJ or such as.

MMR: Enough anecdotal evidence to convince me that 1-2% of children are severely adversely affected by this vaccine. I think it’s safer for five year olds than for one year olds. Again, no proof claimed, just evidence and my confirmation bias.

That would be approximately 40,000-80,000 children "severely adversely affected". Care to qualify this Dr. Jay?

I’d be curious why he’s sticking around this time.

My guess is that since he is no longer the darling of the Wakefield worshippers, he's trying to cosy up to the sceptics by feigning some ability to learn whilst maintaining his dearly-held anti-vaxx dogma.

Jay,

You wrote (my emphasis added):

Prevnar: Not a dangerous vaccine, I give it when asked. I’d like to see a few more years of data and would not combine with other vaccines. This is [i]s personal impression, no proof.

MMR: Enough anecdotal evidence to convince me that 1-2% of children are severely adversely affected by this vaccine. I think it’s safer for five year olds than for one year olds. Again, no proof claimed, just evidence and my confirmation bias.

You seem to think your personal opinion, based on anecdote, trumps recommendations from whatever organisation presents these in the USA.

Unlikely at very best and you must know the anecdote is a very weak form of evidence to hold up against formal studies (to be polite).

Jay: "I also individualize my use of vaccines.
Jay: "I give (Prevnar) when asked."

Anyone else having a hard time reconciling these two statements? Jay seems to have no coherent rationale for his (relatively rare) usage of vaccines, no organized schedule, nothing but his intuition and confirmation biases - but he's willing to override even those to please parents.

He announced on his website that he doesn't give the MMR vaccine, and remains convinced that it has horrific effects in 1-2% of recipients, yet has lately been giving it to some of his patients even though he doesn't see a need for it unless an epidemic breaks out.

This strikes me as a very confused and contradictory element of Jay's pediatrics practice.

Isn't it high time for Jay to put together coherent guidelines on immunization and update his practice (and website) accordingly?

Dr. Gordon says he listens to the parents who seek him out -- but he won't listen to the researchers who've devoted their lives to trying to find causes of conditions like autism.

And Dr. Gordon says his clinical experience trumps all research -- but he won't consider the clinical experience of thousands of pediatricians and other doctors around the world who don't see what he claims to have seen.

And Dr. Gordon says, "I’ve witnessed firsthand temporal relationship between vaccination and regression" -- but somehow such slam-dunk cases just don't seem to make their way to the vaccine court.

What I want to know is since Jay doesn't give the MMR vaccine until the parents twist his arm, how he comes by sufficient anecdotes to put a hard percentage on side effects.

As Orac notes (#406), why Dr. Gordon keeps taking a shellacking here is puzzling (almost like a toddler who engages in bad behavior simply to seek attention). Dr. Gordon emailed me last week to to tell me "Many pediatricians I know do not give all six or seven vaccines to their own children at two months of age and are flexible in scheduling vaccines for their patients too. They are quiet about the way they practice and sometimes it may seem that I'm the only one who does what I do." Well, I don't know where this secret society of pediatricians is (not here in Tucson, BTW). In fact, most practices here in Tucson now will not even see your child if you aren't vaccinating according to schedule, in order to prevent an unvaccinated older patient from infecting newborns too young to be vaccinated with a vaccine-preventable infections (such as happened in the 2008 San Diego County measles outbreak where an 8 year-old unvaccinated child of Dr. Bob Sears went into another pediatricians's office with measles and infected all 11 unvaccinated children in that waiting room, including infants)

Dr. Gordon completely ignores all scientific research (both benchtop and clinical) regarding how well vaccines work, how safe vaccines are and how dangerous diseases like polio, measles and pneumococcal infection can be. It greatly grieves me as a pediatrician that he sells his books and webinars to parents proclaiming his dangerously wrong advice and that he remains uncriticized by the AAP (along with Sears) for views that are so antithetical to the AAP's on vaccines that it boggles the mind. He and Sears live and thrive on the mommy blogs/social media, and as a recent AAP abstract has shown, (http://pediatrics.aappublications.org/content/early/2013/04/10/peds.201…) “the variable most predictive of parents’ vaccination decisions was the percent of parents’ people networks recommending nonconformity.”

If you are a physician I have an online petition you can sign at http://www.ipetitions.com/petition/request-for-the-aap-to-publicly-oppo… asking the AAP to be more vocal against Gordon and Sears. If you are not a physician but would also like to let the AAP know you don't think they are doing enough to counter the public health disaster being created by two of their own members, you can sign the online petition at http://www.ipetitions.com/petition/request-by-non-pediatricians-for-the… . As an FYI, I'm footing this effort out of my own pocket and am doing this because I can't stand by and watch vaccine rates drop (and disease outbreaks occur) and not try to do something to fix it.

We can keep thumping Gordon and Sears here, but a larger group like the AAP has to decide to publicly call out these two if there is to be a larger impact on parents perceptions of these two "vaccine friendly" (read: infectious disease friendly) pediatricians.

Chris Hickie, MD, PhD
Tucson, AZ

Does anyone else find Dr. Gordon's continual "I run a breastfeeding practice" assertion a bit creepy?

Dr Gordon appears to confuse a patient's (or parents') desires with needs. A good doctor addresses the latter primarily.

We are taught at medical school the importance of the patient's history in making a diagnosis. However, a crucial distinction needs to made between using the history to make a diagnosis and drawing inferences about causality from the parents' theorizing. Unfortunately, it seems, Dr. Gordon has virtually fetishized "listening to the parents". Sadly, doctors like Dr. Gordon will always be popular amongst deluded people.

Dr. Jay: Make certain that you provide use of the varicella vaccine during the 1970s and 1980s in the United States for individuals being treating for leukemia and solid tumors...not children with pancytopenia.

To be honest, I’m not sure why Dr. Jay insists on continuing to show up here.

This is purely my uncharitable opinion, but I suspect that
A) he's trying to get in front of any criticism of his latest collection of autism nonsense that may come from these quarters and
B) wants to distance himself from the flop sweat currently pouring off his former ally, Saint Andy Fakefield.

Dr. Jay has certainly put himself in a difficult position, hasn't he? He can't come right out and say Fakers was wrong because Jay's based his own career on the claim that vaccines cause autism, and he'll lose his fan club if he admits he's been wrong all this time. It looks to me like he's decided to play both sides - he shows up here trying to score points by saying he gives more MMR shots now (but only if the parents insist) but knowing full well he's going to get raked over the coals. Then that allows him to run back to the true believers, point to this thread and say, "I tried to reason with those people, and look how they treated me. "

There are "Compassionate Use" or "Treatment Use" exemptions, whereby a clinician can administer an unapproved drug, but it must be under the auspices of a clinical trial. So, if Jay was giving the vaccine before 1995, those patients should have been enrolled in clinical trials. He would have had to obtain a treatment IND exemption. Even then, a treatment IND must meet certain requirements:

There are four requirements that must be met before a treatment IND can be issued: 1) the drug is intended to treat a serious or immediately life-threatening disease; 2) there is no satisfactory alternative treatment available; 3) the drug is already under investigation, or trials have been completed; and 4) the trial sponsor is actively pursuing marketing approval.

We'll wait and see how Jay managed to give an unapproved drug to patients.

Addendum to the previous bit. All that said, the Treatment IND regulations weren't created until 1987, before which such an option for getting promising life-saving drugs to patients before approval was a bit, shall we say, trickier.

While we're mentioning Jay Gordon's inconsistencies and incoherent medical policies, here's another: Jay thinks physicians and the news media exaggerate the need for pertussis vaccination, and while he thinks it can be a nasty illness, he confidently states that it is treatable with antibiotics like azithromycin.

http://drjaygordon.com/vaccinations/pertussis-tylenol-recall-and-more.h…

While Jay is strident on the subject of vaccines doing harm, it seems to have escaped him that azithromycin has been in the news recently over its potential for severe side effects (there's a long list, including but not limited to cardiac arrhythmias, kidney disease and potentially fatal liver failure):

h_tp://voices.yahoo.com/zithromax-side-effects-concerns-taking-azithromycin-6357828.html

This is a drug Jay gives infants and young children with pertussis, instead of protecting them from getting sick in the first place via vaccination? Something isn't right here.

MESSAGE BEGINS--------------------

Shills and Minions:

It is as I suspected. He loves us and wants to join our "club."

Well, we shall just "play it cool," until he's ready to defect to the winning side. Oh, the camaraderie, PharmaLucre™, and nearly god-like powers that awaits you, Dr. Gorgon! What? Oh, yes, Gordon. My bad. Anyway, I can't wait to see the smile on your face when you are issued your first hand thranzor, or buzz your dreaded in-law's house from a cloaked Obsidian Unit. Oh, the fun you'll have shopping for bespoke luxuries. It never gets old. I do hope your jab hand isn't too out of practice . . . you're going to need it.

Until then,
Lord Draconis Zeneca, VH7ihL
Forward Mavoon of the Great Fleet, Monkey Master of Mars, The Candylizard

Glaxxon PharmaCOM Pediatric Division
1111010101001000010101010010101

------------------------MESSAGE ENDS

I dunno. I kind of enjoy watching lilady use him as her own personal Kong.

OK...dog toy joke aside...as a layperson, I am profoundly disturbed by the "my opinion" "my belief" "I think that" leitmotif that runs through all of this man's responses. It scares me, really.

In my former line of work, we used to accuse those who tossed established tactics and doctrine out of the window in order to wing it of "John Wayne-ing." As in engaging in self-aggrandizing, arrogant theatrics. Perhaps that is the case here.

Dr Hickie - all I can say is, Bravo! And if my daughter who lives in Tucson ever has children, I know a good pediatrician to recommend she use.

(oh, and petition signed)

So Dr, Jay...you've now made this statement about Prevnar vaccines:

"Prevnar: Not a dangerous vaccine, I give it when asked. I’d like to see a few more years of data and would not combine with other vaccines. This is s personal impression, no proof."

- Prevnar 7 was licensed 13 years ago and Prevnar 13 was licensed 13 years ago. How many more years of data do you need to take a proactive stance on Prevnar 13 valent vaccine (not *waiting* for a parent to ask for the vaccine), before you explain to a parent the dangers of not providing the vaccine?

- Your "personal impression" (without) "proof" are not valid.

I'm still waiting for documentation (citations) that the varicella vaccine was given to individuals with leukemia and solid cancer tumors (not for pancytopenia, megaloblastic anemia, ITP and platelet adhesions/aggregation disorders), in the United States during the 1970s and 1980s.

@ Becky: That's a great post on your website. I too, was unable to locate any study about increased risk of anaphylaxis with the administration of a second MMR in New York...or anywhere. :-)

^ Prevnar 7 was licensed 13 years ago (2000) and Prevnar 13 was licensed 3 years ago (2010).

While we’re mentioning Jay Gordon’s inconsistencies and incoherent medical policies, here’s another: Jay thinks physicians and the news media exaggerate the need for pertussis vaccination, and while he thinks it can be a nasty illness, he confidently states that it is treatable with antibiotics like azithromycin.

@ Dangerous Bacon, not to mention that antibiotics do not appear to shorten the duration of illness or ameliorate pertussis symptoms. But then again, that is according to Cochrane and why would Jay bother with evidence when he has his anecdotes. On top of all that; he doesn't test for pertussis, just throws antibiotics at his patients during a pertussis outbreak. Brilliant.

In my former line of work, we used to accuse those who tossed established tactics and doctrine out of the window in order to wing it of “John Wayne-ing.”

"You know what the definition of a hero is? Someone who gets other people killed." Zoe, in Serneity

'Zackly.

Dangerous Bacon:

This strikes me as a very confused and contradictory element of Jay’s pediatrics practice.

There's nothing confused or contradictory about it. It only *seems* that way because of a presumption of ethics and professional integrity. It's quite simple: Jay does what his clients hire him to do. If they wish him to provide that service, he does. If they do not, he doesn't. It's business.

And yeah, that's as depressing it sounds, since what it *should* be is medicine. Medicine is not about always making your clients happy. It is about caring for their wellbeing. But Dr Jay is not alone in being more interested in the desires of his clients than the needs of his patients (who are the same people, of course, but approached in a different way). There are doctors who pander to people with body dysmorphic disorder, conducting increasingly bizarre cosmetic procedures on them just becuase the person wants them. And of course there's the gynecologist responsible for Octomom. Satisfying his client's request was more important than his professional integrity. It is not really much of a slippery slope between those, once you decide that what your patient wants is more important than what's actually in their best interests. And of course it's very easy to justify bowing to patient requests, and we've seen Dr Jay go through the contortions many times.

lilady, I didn't notice any comment on Saba's situation by yourself. I suppose you will just write her off (as with all the others who have suffered a serious vaccine side effect) as 'anedotes.' You linked to Liz Ditz's blog about the Menafrivac situation. I have heard reports (by C. England) that many of the parents were paid off and government officials were replaced. I honestly don't know what the truth is but I still do not feel I know. I am certainly not convinced that everything was just fine by Ditz's article. I don't need to apologize for anything.

@jen

And you still didn't apologize for your use of a sock-puppet.

Hypocrite much?

(oh, and petition signed)

ditto :)

Alain

@jen: "I suppose you will just write her off (as with all the others who have suffered a serious vaccine side effect) as ‘anedotes.’"

Did you get a chance to look at the article I linked in response? You know, the one about 105 children dying of the flu in a single season?

Any thoughts?

I too, was unable to locate any study about increased risk of anaphylaxis with the administration of a second MMR in New York…or anywhere.

Somebody needs to get "John Fryer, Chemist" on the blower.

@ORAC: If I spend all my time talking with people who agree with me I don't learn much. (Frightening to think how ignorant I might be if I didn't stop in at RI from time to time. The anger and fierce feelings displayed here remind me that I have to keep an open mind.

I could never say, as lilady does: "- Your “personal impression[s]” (without) “proof” are not valid."

Yes, they are, lilady.

Dr. Hickie, I've noticed that you've resigned from the AAP. Not really a great idea if you want to make changes. The AAP's "confiding" in you that they don't try to stop me because they're afraid of being sued is just plain wrong. The AAP tolerates differences of opinion. It's a large tent.

@DrBollocks: Yes, I am very much compelled to keep listening to parents.

Prior to licensure there were IRB approved protocols for using chicken pox vaccine and at the same time the manufacturer provided the vaccine for non-immune parents and health care practitioners. http://www.unc.edu/depts/spice/dis/ICHE-1996-Oct-p694.pdf
Look at references 51-58.
But . . . this is apparently not relevant to the child described above.

Antibiotics do not change the course of pertussis except to eliminate or diminish contagion.

A few of you appear actually practice medicine. In real life it's a lot more complex than it is on a blog site like this one.

Jay

Don't ask Jen for an answer because she doesn't have one. She prefers the comfort of her knowledge that teh ebil baccines are responsible for all modern ills. I will continue to say that my autistic daughter was affected by mangoes.

@ jen: I made a simple honest statement about Saba Button and the type of Fluvax vaccine used in Australia two years ago. I also questioned if her parents have instituted a lawsuit for "vaccine damages".

You now commented again about the MenAfriVac meningitis vaccine, using *impeccable sources* (Christina England and AoA)...

"You linked to Liz Ditz’s blog about the Menafrivac situation. I have heard reports (by C. England) that many of the parents were paid off and government officials were replaced. I honestly don’t know what the truth is but I still do not feel I know. I am certainly not convinced that everything was just fine by Ditz’s article. I don’t need to apologize for anything."

Here are real impeccable sources..

http://www.meningvax.org/files/MVPstatement_10Jan2013_EN.pdf

http://www.meningvax.org/files/2ndstatementMoHChad_21Jan2013.pdf

Read the second statement carefully jen. If you need any explanation about mass hysteria and conversion disorders, I'll be happy to explain those disorders. (Similar to the mass hysteria and conversion disorders experienced by the Leroy New York school children after receiving HPV vaccines...and the BFD crappy epidemiology study conducted by the *science journalists* at AoA).

@ novalox:

"@jen

And you still didn’t apologize for your use of a sock-puppet.

Hypocrite much?"

Correction novalox: "jen" has used at least two sock puppets to post on RI; Dr. Dent and Sick Sauce.

Hypocrite extraordinaire!

I didn't comment on saba's story either, Jen, so I will. High fevers occurring within hours of immunization are a known but rare side effect of immunization, and febrile seizures are a knownbut rare event associated with high fevers. Typically they last several seconds to a few minutes, and very rarely have long term complications.

There does, hoever, appear to be an increased risk of high fever associated with the specific vaccine Fluvax Saba received, as a result this vaccine is no longer approved for administration to children under 5 years of age.

From http://www.health.gov.au/internet/immunise/publishing.nsf/Content/immun… :

In 2010, increased rates of high fever and febrile convulsions were reported in children under 5 years of age after they were vaccinated with the CSL Fluvax® vaccine. CSL Fluvax® has not been registered for use in this age group since late 2010 and therefore should not be given to children under 5 years of age.

So, Fluvax was associated with an increased risk of high fever and febrile seizure, and that although febrile seizures very rarely have long term consequence, and Saba may be one of those who has experienced such a long term sequelae. I would consider this a reasonable argument that Fluvax should no longer be administered to children under 5 years of age--and in fact, the Australian Government Department of Health and Aging embraced this argument and no longer approves its use.

I don't se, however, how this could be considered a reasonable argument against immunzation in general or with flu vaccines other than Fluvax, or that risk versus safety considerations oppose being vaccinated against influenza and in favor of remaining vulnerable to infection.

I could never say, as lilady does: “- Your “personal impression[s]” (without) “proof” are not valid.”

Yes, they are, lilady.

What exactly makes your personal impressions valid, Dr. Jay? Or perhaps more to the point what makes them more valid than the body of evidence arguing against their supposed validity?

Yes, they are, lilady.

Keep in mind, bloodletting to balance the humors was supported JUST as well by the "personal impressions" of its practitioners. More so, arguably, because the bulk of practitioners had the same impression... unlike here.

When personal impressions conflict with careful science, the science wins. It's not even a contest. Doctors who fail to appreciate this, and arrogantly insist on their own personal infallibility in the face of high-quality, directly on-point evidence saying they're wrong, are doing a grave disservice to their patients. Ethically, if not legally, it's malpractice.

You linked to Liz Ditz’s blog about the Menafrivac situation. I have heard reports (by C. England) that many of the parents were paid off and government officials were replaced. I honestly don’t know what the truth is but I still do not feel I know. I am certainly not convinced that everything was just fine by Ditz’s article.

So, basically, you're willing to resort to England's conspiracy theory to try to pretend this sparkly antivax toy didn't break shortly after being taken from its wrappings? Obviously, she has to, since she provided it in the first place and simply does not admit to being wrong under any circumstances (unless she's corrected her claim that there is a "government of Africa"), but that doesn't mean you have to insist that maybe the tricycle wasn't supposed to have wheels in the first place.

@Beamup:

Not to mention that whole dead-cat-in-the-cemetery-at-midnight thingie for warts.

Would Sam Clemens lie to us? I think not.

@Jay: "I could never say, as lilady does: “- Your “personal impression[s]” (without) “proof” are not valid.”

Yes, they are, lilady."

So let me get this straight, Jay. You are admitting your views are unscientific. They are anecdotal, and when it comes to vaccine side effects not even first-hand. You are committed to taking a parent's word over that of established research.

If I were a car salesman, and was walking down the street. If I saw a car crash where someone was injured by their seat belt (e.g. wearing it wrong, defective seat belt, wearing a 3-pointer over a pregnant belly), in your world, I would be more than justified in removing all seatbelts from all the cars I sell forever more -- unless, of course, the customer specifically requests them.

Simple question, Jay. Would you find that acceptable for me to do, yes or no?

Actually, amend that to read "if I were a car salesman and HEARD of a car crash..."

Jay: "Antibiotics do not change the course of pertussis except to eliminate or diminish contagion."

Not so.

"If treatment for pertussis is started early in the course of illness, during the first 1 to 2 weeks before coughing paroxysms occur, symptoms may be lessened...If the patient is diagnosed late, antibiotics will not alter the course of the illness and, even without antibiotics, the patient should no longer be spreading pertussis."

http://www.cdc.gov/pertussis/clinical/treatment.html

Even if you'd been correct, Jay, it would still leave open the question of why you'd use macrolide antibiotics in pertussis solely to lessen contagion, seeing that they cause distressing and sometimes serious (or even fatal) side effects. How is it that you hype vaccine side effects (real and imagined) but appear uninterested in or unaware of the impact of antibiotic side effects? From the above link:

"On March 12, 2013, the Food and Drug Administration (FDA) issued a warning that azithromycin can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm in some patients."

Jay" "The anger and fierce feelings displayed here remind me that I have to keep an open mind"

The evidence presented here that contradicts your feelings and misapprehensions about the practice of pediatrics should be a further reminder.

jen @430:
lilady, I didn’t notice any comment on Saba’s situation by yourself.

jen appears to be living in a solipsistic world in which events such as lilady's comment #415 do not exist if they clash with her narrative... they simply do not penetrate her Contrary Evidence Exclusion Bubble.

I seem to recall an earlier thread containing one of jen's patented "I'm never coming back!" flounces, in which she complained about lilady 'stalking' her. Now she is complaining about not enough attention from lilady in response to her latest finger-painting.

NPD? BPD? Inquiring minds want to know.

@ Dr. Gordon:

How *uncivil* of you Dr. Jay, to post this at Orac...

@ORAC: If I spend all my time talking with people who agree with me I don’t learn much. (Frightening to think how ignorant I might be if I didn’t stop in at RI from time to time. The anger and fierce feelings displayed here remind me that I have to keep an open mind.

I could never say, as lilady does: “- Your “personal impression[s]” (without) “proof” are not valid.”

(Cue to Orac now, for his statement about "keeping an open mind")

You replied to Dr. Bullocks, instead of me, with this statement:

"Prior to licensure there were IRB approved protocols for using chicken pox vaccine and at the same time the manufacturer provided the vaccine for non-immune parents and health care practitioners. http://www.unc.edu/depts/spice/dis/ICHE-1996-Oct-p694.pdf
Look at references 51-58.
But . . . this is apparently not relevant to the child described above.

Antibiotics do not change the course of pertussis except to eliminate or diminish contagion.

A few of you appear actually practice medicine. In real life it’s a lot more complex than it is on a blog site like this one."

Gee Dr. Jay, thanks for that link, and the reference to 51-58. Did you happen to *miss* that the vaccine was only provided to individuals who were healthy during clinical trials"

Doesn't this citation disprove all the statements in your comments upthread about the varicella vaccine being available during the 1970s-1980s for leukemia and solid tumor patients?

Jay at # 260:

"@lilady: The varicella vaccine was available in the mid-seventies. If your son is over forty, I’m sorry it was not available to him. It is a good vaccine for higher risk children. For heaven’s sakes, no one believes in “culling of the herd”–your posts are becoming more and more problematic"

Jay @ # 279

"@lilady: The vaccine became available in the mid-1970s and was used in special circumstances in the USA and elsewhere all throughout the seventies and eighties. The manufacturer supplied it upon request during that time. http://www.ncbi.nlm.nih.gov/pubmed/73844"

Jay @ # 288:

"@Chris: We used the vaccine in 1977 and beyond. I used that vaccine during those years for non-immune adults and children who were immunocompromised. It became increasingly difficult to get it from the manufacturer in the eighties. Ask an old pediatrician.

Notice the silence when one of you says something really wrong."

Jay @ # 337

"@Darwy: I’m sorry to be repetitive, but the vaccine was available and used in pediatric oncology patients in the USA in the 1970s and for non-immune adults in the seventies and eighties. The manufacturer supplied it. Again, I was there, I administered that vaccine many times."

Jay @ # 344

"I honestly have no idea how to prove that the vaccine was given at major pediatric oncology centers in the USA in the 1970s and also no idea how to do the research or find the industry documents about compassionate use for non-immune adults for the 15-20 years prior to USA licensure. It was a small answer to one of the posters above. But 100% true."

Jay @ # 401

"Citations for the pre-licensure of chicken pox vaccine as soon as I can get them."

So Dr. Jay...still no admission from you that you were *mistaken* about the "compassionate use" of the varicella vaccine during the 1970s-1980s for patients diagnosed with leukemia or solid cancerous tumors?

I'm beginning to wonder about your memory when you emphatically stated that you gave varicella vaccines to immune suppressed individuals during the 1970s-1980s.

@ORAC: OK, I'm exhausted. Gresham's Law (Bad information drives out the good.) is kicking in big time here at RI. Intolerance and nastiness dominate the word count over actual information exchange.

@JGC: My impressions are not more valid than yours. But they're just as valid.

@Beamup. No infallibility has ever been mentioned.

@Stu: Great seat belt analogy. Hard to present anything to counter that.

@Bacon: Pertussis rarely gets diagnosed early enough for macrolides to change the course of a person's illness. It does however often get diagnosed early enough to prevent spread. I give the vaccine and Zithromax in my office. Macrolides should not be prescribed for higher risk patients but no one is recommending that we stop using them. You knew that, Bacon.

The scheduling of six vaccines at a time is not evidence based. I don't have my own schedule. Dr. Sears might, but I don't.

lilady: Who are you??

Jay Gordon @436:
I could never say, as lilady does: “- Your “personal impression[s]” (without) “proof” are not valid.”

Here from an earlier thread is Dr Gordon telling a mother that her personal impressions are not valid:

Kristen, what you’re describing is not medically possible [...] Your child did not experience a 23% weight loss.

@ Dr. Jay:

"lilady: Who are you??"

As you well know, I am not a medical doctor....just a retired public health nurse clinician-epidemiologist.

Too bad, you, who is a practicing pediatrician, lost the debate with me about about Prevnar 7/Prevnar 13 vaccines and the licensing/use of varicella vaccine in the United States.

Thanks for playing immunology/epidemiology bingo with me, Dr. Jay.

A few of you appear actually practice medicine. In real life it’s a lot more complex than it is on a blog site like this one.

What about scientists? we drive very complicated issues for which you don't seem to be aware. Furthermore, I have been accepted to write reviews for the Cochrane collaboration; you know, finding efficient treatments for major illnesses. I guess I'll have a really good look on how complicated medicine is.

Alain

"Gresham’s Law (Bad information drives out the good.) is kicking in big time here at RI."

Wait. Did the guy who has been lying, misrepresenting and who has openly admitted to being unscientific and driven by second-hand anecdotes just bring up Gresham's law?

Jay, you are so spectacularly lacking in self-awareness it is amazing you don't run into the walls continuously. Also, you owe me a new irony meter. Sheesh.

"My impressions are not more valid than yours. But they’re just as valid."

If you think impressions trump research, you are an embarrassment to your profession.

"Great seat belt analogy. Hard to present anything to counter that."

Must be why you don't. I sense you are working up to another flounce, but unless you actually address the analogy I will keep bringing it up, because it seems pretty darned valid to me. Of course, from your biting (SNIRK) sarcasm you are implying you could tear it down easily. I'll be waiting with bated breath.

"The scheduling of six vaccines at a time is not evidence based."

I'm sorry, but you cannot possibly be serious. When has anyone, here or elsewhere, argued that there is a benefit to giving vaccines together?

Have you ever considered that there is an actual cost to the child and parent for a doctor's visit? Financially, emotionally, logistically? Have you considered the outlandish possibility that vaccines are given together because it saves doctor's visits, time, money, stress and because there is not a single evidence-based reason not to? Have you considered that not every patient is a parent of a special snowflake where driving/bussing in on six separate occasions, paying six co-pays, taking six days off of work, for no good reason other than our magical snowflake pediatrician having an unsubstantiated hunch about vaccines (which for $8.99 you can hear all about online), might be an actual burden?

I thought you did a lot of pro bono work, Jay. Do you still wonder why I don't believe a word you say?

@herr doktor bimmler:

What we have to understand is that Jay's personal impressions count, whereas those of others only count when they agree with Jay. He is a special snowflake that way.

But...herr doktor bimler...Dr. Jay must have been having a bad day. Dr. Jay, who lectures us on *civility*, would never, ever, stoop so low to accuse a parent of "fibbing".

@Jay #436 (I've skipped everything earlier from last night - no time):

You wrote “A few of you appear actually practice medicine. In real life it’s a lot more complex than it is on a blog site like this one.”

A few of us here are practicing research scientists and, to be extremely polite about it, would disagree with (& rather firmly) at some of what you write.

I’d also caution that the reality of science is a lot harder the neat summaries you get in various sources on-line.

@Stu #444:

I'm wondering if you can extend your analogy to regulations, e.g. would it be morally or legally proper for a salesperson to recommend or remove seat belts because of his anecdotally-derived views? (by the argument you offer)

@Jay #449:

“@JGC: My impressions are not more valid than yours. But they’re just as valid.”

Not necessarily. As I pointed out earlier anecdotes are a (very) weak form of evidence compared to more formal approaches. (Regards your remark to Orac, don’t forget you’re considered to be presenting bad information of your own.)

@Alain #452 - my remarks earlier in this comment crossed over yours.

My dearest Lord Draconis,

While I suspect that you are indeed correct ( you're always correct: you pay the bills around here), I've never ever experienced 'flirtation' quite like that.
Live and learn, I say.

Most sincerely yours,
in grateful servitude,
DW

@ Chris Hickie:
In addition to your current project, you might want to take a peek at a few websites/ facebook pages wherein the faithful play doctor with each others' children ( treatments for "recovering" kids with ASDs) and publicise doctors who
tolerate anti-vax and/ or provide non-SBM treatments. See Thinking Moms' Revolution and The Vaccine Machine ( esp facebook). The latter is run by Sid/ Robert/ Whoever.

@ Politicalguineapig:
Agreed.

@ Dr Bollocks:
What you say is not bollocks.

@ Stu:
Careful there, Mr. You are getting awfully close to the Forbidden Zone. And you don't want to go there.

Denice, you just reminded me of an unpleasant experience I had a few years ago, that I don't remember mentioning here before. For reasons that now escape me I joined a Yahoo group run by a woman who had some odd ideas about autism, its causes and its effective treatment. IIRC she claimed that it was all about vitamin D, calcium metabolism and acidosis.

What I do remember is that she encouraged her acolytes to get their children's blood and urine tested and post the results, so she could play amateur doctor (she was taking evening classes in some medical related subject) and make suggestions for treatment. Since this is something I know a bit about, I was horrified by what I saw.

For example she told one parent that their child had impaired renal function on the basis of perfectly normal results (a low serum creatinine and normal urea led to a low GFR).

My favorite was her interpreting calcium and alkaline phosphatase results based on adult reference ranges, and telling parents their children had bone metabolism disorders and hypercalcemia - children have higher serum calcium and much higher alkaline phosphatase results because their bones are growing - and required a low calcium diet (I kid you not).

She also did a nice line in telling people that results were high or low when they were within the reference range. She was a great example of a little knowledge being a dangerous thing.

I did point this out to her in no uncertain terms, but she censored my posts, and it didn't seem to do much good. When I saw her recommending OSR#1 I gave up on her as beyond help and quit. I sometimes think I should have done more, like report her to someone, but its a bit late now I guess.

@ORAC: OK, I’m exhausted. Gresham’s Law (Bad information drives out the good.) is kicking in big time here at RI. Intolerance and nastiness dominate the word count over actual information exchange.

When you are done clutching your pearls and the vapours have passed could you please answer my question @ 408?

I would also like to know why you would eschew prevention for pertussis as opposed to antibiotics which you are unlikely to be able to give in time.

@Science Mom: The DTaP vaccine doesn't work as well as we thought, doesn't last as long as we thought and has put pressure on the bacterium and we're going to need a new vaccine soon. I give kids that vaccine pretty much every day. As I've said before I just don't think we give vaccines as safely as we could and I'd like to see that change.

@lilady, I read some reports on Prevnar 7 but they weren't totally clear to me.

I gathered that after Prevnar 7 was recommended for young children, cases of the disease went down, even plunged in some countries like America. It even went down among older cohorts who were not vaccinated, indicating that the disease had been mostly spread among the younger cohorts. The remaining disease for obvious reasons tended to be caused by non-vaccine strains so their percentage of cases went up even though their absolute numbers did not.

Some years thereafter, the non-vaccine strains became somewhat more common in absolute numbers than they had previously been but -- this is where the papers were somewhat confusing -- the overall rate of disease is still well below the pre-vaccine rate. Is that correct?

Furthermore, the surviving strains are developing antibiotic resistance, probably due to antibiotic abuse, so we'd better have a vaccine for them (Prevnar 13) because they soon won't be curable. Is that also correct?

@ Krebiozen:

Amongst those I survey, it is common for non-doctors to provide 'protocols' for illness while simultaneously scoffing at SBM ( see Mike Adams/ Talkback @ PRN): I'd guess that that encourages the faithful to 'strike out on their own' , using remedies suggested by an herbalist, nutritionist, ND or via personal experimentation- like in the olden days, where folk wisdom provided cures and every Wise Woman could take care of her own problems and her children's un-assisted.

The stress on natural cures and on cherished archaicism - (and let's not forget ,"Let food be your medicine"):- are the foundation: alt med mavens then select quasi- medical providers to assist them in their vision quest of "recovering" their child/ curing their illness. Some of the sites I list 'hook-up' client and provider and/ or self-practitioner and literature/ supplies.

On a lighter note:
I've been searching high and low for my own ancient book of wisdom - "The Golden Bough"- can't fnd it anywhere.

Jay,

I believe this: “and has put pressure on the bacterium”, is presumption on your part.

http://www.ncbi.nlm.nih.gov/pubmed/20823436

@LW: We ended up with more 19A because of the PCV7. It's possible that nothing like this will occur because of the PCV13 but it might.

@Grant: No, it's a paraphrase from this CDC report.

http://wwwnc.cdc.gov/eid/article/19/3/12-1475_article.htm

We have analyzed the evolution of the bacterial population under vaccine pressure, using pulsed-field gel electrophoresis, genotyping, microarrays, and tests for virulence factor expression (5–9). Immunity induced by the whole-cell pertussis vaccine controlled the circulation of vaccine-type isolates but not all types of isolates (5,6). The isolates remaining in circulation are as virulent as those circulating during the prevaccine era (7–9). Since the introduction of acellular pertussis vaccines, the number of B. pertussis and B. parapertussis isolates collected that do not express pertactin (PRN), which is used as a vaccine antigen (7–11), has steadily increased.

I’ve been searching high and low for my own ancient book of wisdom – “The Golden Bough”- can’t fnd it anywhere.

Gutenberg.org has various editions if you want a searchable version. Alternatively, the Internet Archive has a scanned edition.

@Science Mom: The DTaP vaccine doesn’t work as well as we thought, doesn’t last as long as we thought and has put pressure on the bacterium and we’re going to need a new vaccine soon. I give kids that vaccine pretty much every day. As I’ve said before I just don’t think we give vaccines as safely as we could and I’d like to see that change.

The Nirvana Fallacy at work. There is no denying that the vaccine, as flawed as it is is still more beneficial than your protocol. Need I lecture you on antibiotic abuse and the superbugs reckless use is producing? Yes we need a better pertussis vaccine and we had one but the crowd you pander to created hysteria with that.

Now what about qualifying your claim that MMR causes severe adverse reactions in 1-2% of children receiving it.

Denice,

Amongst those I survey, it is common for non-doctors to provide ‘protocols’ for illness while simultaneously scoffing at SBM

This seemed a bit different, a sort of cargo cult medical science, using legitimate diagnostic tools but grossly misinterpreting them.

I hope your sacred tome turns up.

adverse reactions in 1-2% of children

Perhaps someone can work out the details of Poisson Distribution and calculate how many cases are required to estimate this frequency with +/- 1/2% accuracy.

#440

I learned in various philosophy classes that personal experiences are not arguments. So I suppose I wouldn't bother denying them or confirming them; they're simply not relevant to the issue of what Dr. Gordon believes. We need his arguments, not his experiences.

I still haven't seen any of those, given that he clearly and explicitly states the anecdotes are equal on each side.

I don't really believe that, but if he *does*, that means he should be suspended in the middle, and is clearly allowing some other argument to be his reason for retaining his current view.

I would like to know what that other argument--which is not anecdote and is not any science--is.

@ herr doktor bimler:

Thanks for that: I traditionally utilise the abridged but I can look up what I want via the complete- although it's unwieldy.

@ Krebiozen:

Thanks. It's around somewhere. Who would take it?

Thanks. It’s around somewhere. Who would take it?

Its seven-year reign was over. It has been displaced by some younger, more virile book.

Thank you for the link, Dr. Gordon. The paper still didn't clarify the point on which I was confused, which was whether the total rate of disease had gone down even though the rate of certain serotypes had gone up.

However, that 2010 paper which was about a study in the Netherlands was cited by a 2012 paper, also about the results in the Netherlands: "Invasive Pneumococcal Disease and 7-Valent Pneumococcal Conjugate Vaccine, the Netherlands", here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559145/

The Abstract in that paper was very clear and answered my question:

In the Netherlands, the national immunization program includes 7-valent pneumococcal conjugate vaccine (PCV7) for all newborns born after April 1, 2006. We compared the incidence of invasive pneumococcal disease (IPD) and patient and disease characteristics before PCV7 introduction (June 2004–June 2006) with those after PCV7 introduction (June 2008–June 2010). Culture-confirmed IPD cases were identified by 9 sentinel laboratories covering ≈25% of the Dutch population. Significant declines in overall IPD incidence were observed in children [less than] 2 (60%) and in persons [greater than] 65 (13%) years of age. A trend toward gradual increases in non–PCV7 serotype IPD infections was observed in all age groups; the largest increases were among persons 50–64 (37%) and [greater than] 65 (25%) years of age. In adults, the proportion of immunocompromised persons increased among IPD patients. Overall, deaths from IPD decreased from 16% to 12% because of a lower case-fatality rate for persons with non–PCV7 serotype IPD.

The paper also commented that

For all age groups, the overall reduction in IPD incidence is greater in the United States than in European countries; the great reduction in the United States is a result of a decrease in PCV7-serotype IPD in adults and less replacement of PCV7-serotype by non–PCV7 serotype IPD in children and older adults

Now I understand the situation better. Prevnar-7 has saved and continues to save a lot of lives despite serotype replacement, especially in America.

"...showing up with the dreadful inevitability of an unloved season."

Did... did our beloved Reptilian Pharma Overlord just say, "WINTER IS COMING"??? I think I am in Pharma-Shill love! :D

Jay,

Distinguish between observing and increase and your offering a reason for the increase. You’ll note the article you cite doesn’t give a reason for the increase observed, nor investigate that. If you think you’re paraphrasing that particular article, then I’d suggest you’re doing a bit more than that.

@ herr doktor bimler:

re " seven year reign was over"
Oddly, I've rarely said that to books. Men, sure.

observing an increase - no 'd' - sorry.

@Dr. Gordon, thank you also for the link to the pertussis paper.

I noticed some interesting things in that paper:

As early as 1959, whole-cell pertussis vaccine was used intensively in France for primary vaccination of infants at 3–5 months of age and for the first booster at 24 months (1). This vaccine program resulted in a dramatic decrease in the incidence of pertussis among young children. Acellular pertussis vaccines (2- and 3–component vaccines) were introduced in 1998 as boosters for vaccinated adolescents and were rapidly adopted for primary vaccination of infants. These vaccines replaced whole-cell pertussis vaccines in 2005, changing herd immunity by specifically targeting the virulence of the bacteria (2,3).

Since the introduction of acellular pertussis vaccines, the number of B. pertussis and B. parapertussis isolates collected that do not express pertactin (PRN), which is used as a vaccine antigen (7–11), has steadily increased. The proportion of PRN-negative (PRN–) isolates to the total number of isolates collected each year increased from 2% in 2005 to 14% in 2012 (8), indicating that PRN– isolates are transmissible.

Has there been a dramatic increase in pertussis among the vaccinated, so as to wipe out the dramatic decrease described above? I don't think so. Also it appears that one could always go back to the whole-cell vaccine or target a different antigen to control the PRN- isolates. Moreover,

Vaccination was associated with less severe clinical symptoms (Table 2): the proportion of hospitalizations in intensive care units was significantly lower in the vaccinated group (p = 0.001). Clinical symptoms, such as apnea, syncope, cyanosis, and deterioration of general condition, were also less frequent in the vaccinated group (Table 2). This confirms previous findings (12) indicating that infants who receive 1 or 2 doses of pertussis vaccine are protected to some extent.

So infants are still better off if they've been vaccinated.

And ... wait ... since when has Dr. Gordon been concerned about shaping his personal vaccine schedule with any consideration for the benefit of society?

Here, Dr. Jay...knock yourself out by looking at the CDC's ABCs (Active Bacterial Core Surveillance) website:

http://www.cdc.gov/abcs/overview/index.html

"Background

Active Bacterial Core surveillance (ABCs) is a core component of CDC’s Emerging Infections Programs network (EIP), a collaboration between CDC, state health departments, and universities. ABCs is an active laboratory- and population-based surveillance system for invasive bacterial pathogens of public health importance. For each case of invasive disease in the surveillance population, a case report with basic demographic information is completed and bacterial isolates are sent to CDC and other reference laboratories for additional laboratory evaluation. ABCs also provides an infrastructure for further public health research, including special studies aiming at identifying risk factors for disease, post-licensure evaluation of vaccine efficacy and monitoring effectiveness of prevention policies.

ABCs was initially established in four states in 1995. It currently operates among 10 EIP sites across the United States, representing a population of approximately 41 million persons. At this time, ABCs conducts surveillance for six pathogens: group A and group B Streptococcus (GAS, GBS), Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, and methicillin-resistant Staphylococcus aureus (MRSA).

ABCs data have been used to track disease trends, including the decline in pneumococcal disease following the introduction of the pediatric pneumococcal conjugate vaccine and the emergence of serogroup Y meningococcal disease. ABCs has also contributed to public health policy by providing information which formed the basis of revised CDC guidelines recommending the use of universal screening of pregnant women to prevent early onset GBS infections and the prevention of GAS infections among household contacts of persons with invasive disease and among postpartum and post-surgical patients. A program to assist state and local health departments with surveillance for MRSA and drug-resistant Streptococcus pneumoniae has been developed, based primarily on lessons learned from ABCs."

Have you read any of the studies of S. Pneumoniae vaccines generated by the ABCs component of the CDC?

http://www.cdc.gov/abcs/reports-findings/pubs-strep-pneumo.html

Of course, if you can locate any of the Pediatric journal's articles that are behind pay walls...or if you are willing to copy and paste the current online AAP Red Book chapter on S. Pneumoniae that prove your "opinion" that Prevnar vaccine "is too new for (you) to recommend", we would appreciate your input.

What is the decrease in prevalence of invasive S. Pneumoniae infections for children < 5 years of age who have been fully immunized with the Prevnar 7 valent and Prevnar 13 valent vaccines, Dr. Jay?

@ LW: Ask Dr. Jay if he and his staff have received the Tdap vaccine, which is recommended for all HCWs and others who have contact with infants under one year of age. :-)

I don't recall Jay ever answering my question as to whether he gets the flu vaccine in order to protect vulnerable patients (and visitors) he encounters on hospital rounds (making the assumption that he has staff privileges at at least one hospital), whether or not said hospital(s) mandate flu vaccination for physicians on staff. If he ever did answer, perhaps he or someone else could let me know what his response was.

Note: I get annual flu vaccinations, though only one hospital at which I work requires them.

@ Dangerous Bacon: See my post at # 156 and the text of Dr. Jay's speech at the 2008 "Green Our Vaccines" rally...

"“When I get a dose of mercury in a flu shot, well I wouldn’t, if I were to get a dose of mercury in a flu shot, or aluminum, that’s bad enough, but does anybody believe that that same amount of aluminum or that same amount of mercury think those things are safe for a 25 pound toddler? Aluminum! There is still mercury in many common vaccines, but aluminum, there’s enough aluminum in there to cause harm. The FDA puts a ceiling, a limit, of about 50 micrograms a day. Aluminum irritates cells, it irritates brain cells. Maybe some of you are aware of aluminum because of the possible and the plausable connection to Alzheimers Disease.”

- Has Jay changed his mind about seasonal influenza vaccine for himself...and for his patients?

- Did Dr. Jay have himself and his staff tested for immunity against varicella...once the varicella vaccine was licensed in the United States in 1995? Did he pay for the vaccine for anyone who works for him who was not immune to the virus?

- Have Dr. Jay and his staff received Tdap vaccines?

Inquiring minds want to know.

The DTaP vaccine doesn’t work as well as we thought, doesn’t last as long as we thought and has put pressure on the bacterium and we’re going to need a new vaccine soon.

You perhaps overstate the case regarding aP-based selection pressure per se.

Dr Jay said, "See refs 51-58"

That's nice Dr. Jay - I happen to have those papers. I had them before you went looking for them.

The Arbeter paper was a clinical trial of 90 healthy children - this was first performed to test for safety and efficacy before moving on to clinical trials in leukaemia patients. Clinical reactions were monitored up until day 22 and lymphocyte proliferation responses were monitored up to 6 weeks post vaccination.

The other studies reflect ~500 pediatric leukaemia patients who were enrolled in clinical trials between 1980-1985.

As Todd W. has pointed out - the chances of you being able to 'request' a varicella vaccine from the manufacturer outside of the clinical trial group... is very, very small. I expect the KC Chiefs will win the World Series before that occurs.

Since folk seem determined to make this a record-busting thread, I wish to complain to the management that it has egregiously failed in its duty not only to post, but to embed upon this page, my highlights from the Andrew Wakefield threatening a whistleblower video, which has a seriously spooky opening, more than suitable for the ferocity of debate:

http://briandeer.com/solved/whistleblower-betrayed.htm

@ Jay Gordon, #449:

I call bull on "not having your own schedule"

You don't publish your own schedule, but you have repeatedly said that you don't think infants should be vaccinated before 6 months of age, which IS your own schedule (it is sure not the CDC/AAP schedule or that of any pediatrician who has seen neonates and infants seriously ill/die from pertussis and meningitis)

I would have thought, given your age, that you would have seen and remembered and learned from such illnesses and deaths from pertussis and meningitis during your younger years as a resident and newly-minted pediatrician. I've seen one toddler during my residency (an unvaccinated 2 year-old) die from Hib meningitis/sepsis, and that was good enough to re-remind me of why we need to vaccinate. The more senior pediatric attending physicians told me it was a lot worse in the days before there were vaccines for these diseases

I shudder to think of seeing a return to the "days of old" if every parent took your advice not to vaccinate until their infant was 6 months old.

You do understand that we don't see vaccine-preventable diseases because we vaccinate against them? And you do realize that if we stop vaccinating, we will (and are) starting to see these diseases return?

And yet you rail on about vaccine safety/efficacy, Dr. Gordon, as though vaccines are some sort of snake oil, when they are, undeniably, one of if not the most important health advances of the 20th century. You live in a bizarro world, and I wish to h*ll you'd stop trying to drag all my families into it with your lies and deceits.

Chris Hickie, MD, PhD

It seems that "progressive" governor Jerry Brown shot down mandatory flu shots for California hospital workers:

"The California Hospital Association (and California Pharmacists Association) supported SB 1318, which required mandatory vaccination of all healthcare workers."

"Gov. Jerry Brown vetoed it last year."

“The job of a health care worker, be it physician, nurse or anyone else, is to make sure they’re caring for patients in a safe and effective manner,” spokesperson Jan Emerson-Shea said. “If a person has an issue with taking a vaccine, then they should really question whether they’re appropriate for the job.”

http://www.kcra.com/news/local-news/news-sacramento/Should-hospital-wor…

The lack of a state law doesn't prevent individual California health care facilities from mandating or urging vaccination.

"Sherlyn Ocampo, a nurse who works on the medical/surgical unit at the hospital, said she gets the vaccine every year because her patients are elderly, fragile and ill."

"I don't want to get sick," she said. "I don't want to get my patients sick."

"Emergency room doctor Naveed Natanzi got the vaccine after being "nudged" by the hospital administrators. "I did it for the sake of our patients," he said."

h_tp://articles.latimes.com/2013/jan/18/local/la-me-flu-vaccine-20130119

Does Jay Gordon share these sentiments?

@ Brian Deer:

"ferocity of debate"? Here?

@Grant: "I’m wondering if you can extend your analogy to regulations, e.g. would it be morally or legally proper for a salesperson to recommend or remove seat belts because of his anecdotally-derived views? (by the argument you offer)"

I couldn't possibly speculate. Unless of course you are talking about the salesperson encouraging buyers to claim religious objections against seat belts to get around regulations, and encouraging lawmakers to allow for such loopholes.

What is the record for most comments? Because we're about to hit 500.

I do hope that it doesn't go over 9,000!!!

DW: I should note that while I find breast-feeding admirable, I dislike the way it's marketed and that most of the La Leche Leaguers seem to resemble the cast of Mean Girls all grown up.

@Dr. Jay, @lilady: who are you? She is a bully who engages in tracking (cyber-stalking). She tried to have Kent Heckenlively in trouble with his job due to his beliefs. She has mentioned your staff and their actions. Her name is known to those at his schoolboard, presumably.
@Brian Deer- be a real reporter.

My impressions are not more valid than yours. But they’re just as valid.

Valid. You keep using that word. I do not think it means what you think it means.

As I’ve said before I just don’t think we give vaccines as safely as we could and I’d like to see that change.

And again I'm moved to ask why you don't think we give vaccines as safely as we could and change is needed? Surely you have some actual, evidentiary basis for your conclusion (i.e., something other than anecdotal accounts)?

Jen, why do you keep posting here if you claim lilady is stalking you?

Alain

I do hope that it doesn’t go over 9,000!!!

495 / 6 * (365 / 4) == 7528 and 1/8, range 6023 -- 9033 :)

Alain

@Beamup. No infallibility has ever been mentioned.

Not explicitly. But your continued insistence that your personal experience is more accurate than both (a) the collective personal experience of the pediatric profession and (b) careful science cannot be interpreted any other way.

If I were a pediatrician, and my clinical experience were sufficient to "convince me that 1-2% of children are severely adversely affected by this vaccine", I do believe that I would regard it as my duty to document that experience and publish it in the scientific literature. Indeed, I would view every day that I failed in that duty to be allowing a hundred or more children to suffer through my neglect.

Dr. Gordon does not feel that way.

@LW

Exactly. If he's seeing such a level of adverse effects, he should be documenting each and every one of them to VAERS as well as building a case report upon them. That way, other researchers can also look into it.

But, he'd rather make grandiose claims and point fingers rather than actually stepping up and being part of the solution, rather than part of the problem.

@LW and Darwy

He is too busy to run a clinical trial. I mean, he has patients to see, books to write and sell. Where will he find the time?

@Jay

I notice you never address my question to you re: said adverse reactions. Namely:

So, a “gut feeling” based on unsubstantiated anecdotes that MMR causes severe adverse effects in 1%-2% of recipients is worse than a 15%-40% hospitalization rate? Or 1.3% risk of post-infection encephalomyelitis? Or around 20% risk of pneumonia? SSPE is, thankfully, very rare. Then again, it is universally fatal.