"Dr. Bob" Sears: Perfecting the art of the antivaccine dog whistle

Dog_whistle

Oh, no, here we go again.

In fact, before I get started, I feel obligated to show this clip, saying, just when I thought I was out, they pull me back in again:

Yes, I know I've used this clip on multiple occasions before over years. However, sometimes it's just so completely appropriate to how I'm feeling about a topic I'm about to write about that I just don't care and have to use it again. This is one of those times. I'm referring, of course, to Robert, "Dr. Bob" Sears, MD, the antivaccine-friendly (if not fully antivaccine) pediatrician from Capistrano Beach who has lately been digging himself in deeper and deeper over the rapidly expanding Disneyland measles outbreak that started over the holidays. I've been hitting the topic of the Disneyland measles outbreak fast and furious over the past, both here and at my not-so-super-secret other blog, that, quite frankly, I was getting tired of it, particularly after Dr. Bob's petulant whine the other day in which he complained about how mean skeptics have been to him over his utterly inane mutterings on his Facebook page trying to "reassure" his patients that the measles just isn't that bad a disease. (Wrong.) I was looking for a nice bit of tasty quackery to deconstruct or a good scientific study to write about, when people started sending links to this post on Facebook:

Here we go again. I figured I might as well just give in and finish out the week on this topic. I can start fresh next week.

And, yes, that's Dr. Bob, who had just written a sarcastic diatribe against "stupid people" that tried to be tongue-in-cheek but failed utterly, seriously entitling his post: WHEN WE STOP LISTENING TO EACH OTHER, WE LOSE OUR HUMANITY. One of my readers who sent it to me told he recommended vodka while reading it. Unfortunately, I have to give a talk and lead a workshop discussion tomorrow morning. Even though the groundwork and slides are done, vodka tonight is out of the question. So I settled for a nice brown ale. Very refreshing, and perfect for a cold winter night. So join me as we wade in. Because this is one of Dr. Bob's longest posts ever, I'm only going to selectively quote from it, unlike past posts, where I quoted the whole thing. Sorry, people who don't have Facebook accounts.

First off, he tries to position himself as the voice of reason telling people to "calm the F- down!", the Rodney King lamenting, "Can't we all just get a long?" Try to keep the rising tide of bile in your stomach from getting past your epiglottis as you read this opening volley:

Why does the vaccine debate have to get so ugly? Why are some people on both sides of the issue so harsh to each other? Why can't we all just get along? If the Beatles were still around, I'm sure they'd write a song. I don't know if they'd call it "We All Live in Two Separate Submarines" or "Lucy in the Sky With Red Spots All Over." Whatever it would be, the chorus would include "Everybody Calm the #$*@%!& Down."

If both sides could calm down and start listening to each other, everybody would be able to get along.

Sadly, no. No, we probably wouldn't. The reason is simple and is known as irreconcilable differences. You see, we on the pro-vaccine side have listened to the antivaccine side. We've listened to them ad nauseam. The problem is that, nearly always, they're spouting pseudoscientific quackery that is completely resistant to evidence, science, and reason. Indeed, that's why I, at least, no longer even attempt to persuade the hard core antivaccinationists. Doing so is simply an exercise in frustration, every bit as much as trying to deprogram a cult member. What I hope to do, and have had some success at times in doing, is persuading the fence sitters, parents who have heard the pseudoscience of the antivaccine movement and have become frightened enough to consider not vaccinating. The idea is to counter the pseudoscience, not to win friends and influence people among the antivaccine movement.

The most frustrating thing about Dr. Bob's little invitation to join hands and sing Kumbaya is that there are parts where he shows just glimmer of actual insight but just can't bring himself to take the next step. To be honest, it's hard for me to tell if this is just posturing on his part or if it's really what he believes. Probably a little of both, but I can't tell which is which. In fact, he states bluntly that "I firmly believe that vaccines do work" and "they do provide immunity." He even says, "I do believe that vaccination is immunization." So far so good. Then he immediately bends over backwards to emphasize how "imperfect" this immunity is:

I don't believe it's perfect immunity, and neither does anybody else on the pro-vax side. Some vaccines provide a very high level of immunity, like 99%. Some really suck, like this year's flu shot. DTaP vaccine is somewhere in between - maybe 85 to 90%, but it wanes quickly. To say that vaccines don't work at all is incorrect, in my opinion.

OK, so different vaccines have different efficacies, and this year's flu vaccine is a bit of a dud compared to past years. We know this. Dr. Bob even recognizes the reason why antivaccine activists try to downplay the efficacy of vaccines:

How do anti-vaxers attack these goals? By claiming that vaccines don't work. If vaccines don't work, then all the pro-vaxer attempts at disease prevention are fruitless, and the anti-vaxers don't pose any risk because the vaccines they didn't get wouldn't have helped anyway. This makes pro-vaxers understandably angry.

So what does Dr. Bob do? He invokes the fallacy of the Golden Mean, in which it is assumed that the correct answer to a controversy always lies somewhere between the two extreme views, although he does it by casting doubt on the efficacy of vaccines, just not as badly as antivaccinationists do:

But what's tough is that some vaccines wear off quickly, within just a few years, as is the case with the whooping cough portion of the DTaP. Many 4 to 5 year olds are susceptible before they get the booster, and many 8 to 11 year olds even more so. That doesn't mean the vaccine doesn't work well for a couple to three years after the initial series and each booster. To say that vaccines don't work doesn't accomplish anything useful, in my opinion. I've studied so much data that show vaccines work, and I am convinced. That's why I offer them in my office. If I didn't think they worked, I wouldn't bother.

He's actually fairly clever here, but he might be too clever by half. He's saying that vaccines work, in the hopes that those supporting science-based medicine will take him seriously and think that perhaps he's not an antivaccinationist after all. At the same time, he's casting doubt on the efficacy of vaccines by emphasizing the shortcomings of certain vaccines. It's basically an antivaccine dog whistle, a notice to his antivaccine patients that he's really one of them, regardless of what he said earlier in his post.

He then reinforces his identification with the antivaccine movement by saying that most of them, like him, believe vaccines work too. The real reason they are hesitant, according to him, is because they "aren't willing to risk the side effects, but they do acknowledge that they at least work." Of course, at this point, someone making an honest effort to understand both sides would point out here that the risks of vaccines are so infinitesimally tiny that it simply makes no sense not to vaccinate. He doesn't go there. Instead, he says that severe vaccine reactions are rare while implying that maybe they're not so rare after all. First up:

Now for the other side, because there are always two sides. How do the non-vaxers feel? I think that their number one issue is this: They want a choice. They don't want to be forced into a medical treatment they are not comfortable with. That's probably the number one freedom that they want preserved. IF vaccines were 100% harmless to every single person that got them, I think that we could insist on vaccination. BUT because they are not, because occasional severe and even fatal vaccine reactions do happen, it is unethical to force them on anyone. Yes, I know they are safe for MOST people, but not for all.

Of course, what is totally lacking here is any sort of risk-benefit consideration. By any conceivable stretch of the imagination, vaccines are far safer than the risk of illness. Moreover, Dr. Bob misrepresents the situation. He describes "forced vaccination," but there is no such thing as forced vaccination in this country. Really, there isn't. There are vaccine mandates that require certain vaccinations before children are allowed in school or day care, and these serve a very reasonable societal purpose, namely to prevent outbreaks in institutions where lots of children are packed together. Non-vaccinators or antivaccinationists don't have to vaccinate, but their children pay a price. They can't attend school or be in day care. Of course, these vaccine mandates are more porous than the average sponge, the rise of religious and "personal belief" exemptions having made not vaccinating and still getting your kid into school as easy as signing a form in some states, but antivaccinationists object to even these often toothless mandates. And Dr. Bob, through his use of another antivaccine dog whistle ("forced vaccination" instead of "school vaccine mandate") and painting the issue as one of personal freedom, just as many antivaccinationists do, is letting antivaccinationists know that he's really one of them.

To hammer that point home, Dr. Bob immediately starts harping on the risks of vaccination. He does it in a manner that uses another antivaccine dog whistle, in which he says these reactions are "rare, but..." This is then interspersed with claims that it is really doctors who are close-minded because they were raised not to believe that serious vaccine reactions even exist! I kid you not!

Behold:

Back in the 70s and 80s, when severe (but rare) vaccine reactions began to be reported, victims were crying out for help and no one was listening. The medical community was in complete denial that severe vaccine reactions were even possible. These victims were ignored. A generation of doctors were trained that severe vaccine reactions can't happen. So, it's taken many many years, but now almost everyone in the medical community agrees that they CAN happen. They aren't common, but they can happen. They are still some naysayers, however, who use pseudoscience to demonstrate that those who have severe vaccine reactions have genetic problems which would have eventually caused the same problems anyway, given time. The vaccine just happened to trigger the problem sooner, or triggered it coincidentally. Yet the vaccine isn't the cause. So, these naysayers continue to make victims and their families angry and up in arms. Those doctors are the minority, but they are a vocal minority, and families are worried that more and more doctors will once again believe that severe vaccine reactions can't happen. And, will that lead to forced universal vaccination? Such parents are worried it will. So, families who feel their children are victims of a vaccine reaction will continue to be very vocal, as they should be. As long as the right to choose is threatened, which it currently is in the back rooms of the legislatures in most states, vocal anti-vax parents will continue to fight back.

So many antivaccine dogwhistles, so little time. That bit about "genetic problems which would have eventually caused the same problems anyway, given time"? That's a straw man argument aimed at discussions of the Hannah Poling case and mitochondrial disorders and/or at Jasmine Renata, a young woman who died after the HPV vaccine, almost certainly due to an inherited cardiac conduction problem. Doctors who are "trained that severe vaccine reactions can't happen"? He's almost certainly referring to pro-vaccine champions like Dr. Paul Offit, caricaturing their views beyond recognition. Straw men this enormous can be seen from space when set aflame with burning stupid, and set this straw man ablaze Dr. Bob does, after which he then repeats the antivaccine dog whistle about "forced universal vaccination." His empathy with the paranoid fears of antivaccinationists that there will soon be jack booted thugs from the government coming to vaccinate their children against their will is the loudest blowing on the whistle yet, particularly when coupled with his reference to nefarious secret cabals meeting in the back rooms of state legislatures.

Dr. Bob then asks how "pro-vaxers" can respond (rhetorically, of course), and answers the question by telling them, "Acknowledge that bad vaccine reactions can happen, that's how. Stop trying to tell these parents and their children they are wrong. Have a little empathy." More dog whistling. "Pro-vaxers" do acknowledge that bad vaccine reactions can happen." The problem is that "bad vaccine reactions" do not constitute what antivaccinationists claim they do. They do not include autism. They do not include neurodevelopmental disorders. They do not include most of the evils attributed to vaccines by antivaccinationists. The vast majority of claimed cases of "vaccine injury" are not, in fact, actually due to vaccines. Certainly, as I've documented more times than I can remember, "vaccine injury" does not encompass autism, but most antivaccinationists believe that it does. Another whistle sounds when Dr. Bob dismisses the "pro-vax vocal minority" who won't "have a heart" or show empathy. He even tries to turn the pro-vaccine against each other by trying to urge the "quiet, majority pro-vaxers" to "get louder about it."

Yeah, that'll work.

At the end, while seeming "reasonable," Dr. Bob keeps those antivaccine dog whistles blowing. In fact, in the end, he goes a bit beyond that, making it very clear where his sympathies lie. He tries to accuse "vaxers" of a double standard in which they lambaste antivaccinationists for "hiding in the herd" (Dr. Bob's term is appropriate here), taking no risk but gaining the benefit of herd immunity, as though "pro-vaxers" actually claim vaccines have no risks. I have never seen such a claim. I have only seen explanations why what antivaccinationists consider to be "vaccine injury" are not. Yet, Dr. Bob twists that into a straw man and then twists it again into a straw man pretzel saying that "pro-vaxers" claim there is no such thing as a vaccine injury. It is intellectual dishonesty more naked than even most antivaccine loons.

It's also a cynical appeal to "rights" that all antivaccinationists who use it know will appeal to Americans:

A final bit of food for thought. Let's talk about rights. Which right is more important, the right to not get sick with a disease or the right to make health care decisions for yourself and your child? The way I see it, the diseases were here first. They are ubiquitous to our world. Whether created by God or by evolution, they are here. They are the status quo. Because we have invented a medical treatment to try to change the status quo, yet that treatment can cause harm to a very small percentage of people, it is my belief that we shouldn't force anyone into accepting this treatment. Life happens, death happens. It's terribly tragic when death happens before it's time. Nobody wants anyone to die. And no one wants their child to suffer a severe vaccine reaction. So, it is my opinion that ethically speaking, we must give precedence to what the status quo was or is, that diseases exist and cause some casualties, and those who decide they want to take part in the disease prevention can enter into vaccinations by their own free choice.

The stupid, it burns. It goes beyond setting a gargantuan straw man aflame with burning stupid into the realm of forming a black hole of stupid so dense that all medical knowledge threatens to be sucked in beyond its event horizon.

To call this thinking "muddled" is to be far too kind, the naturalistic fallacy at its most mind-meltingly boneheaded. Dr. Bob is seriously arguing that, because the bacteria and viruses that cause diseases were "here first" they are the status quo, and that ethically we must give precedence to the status quo? On what planet? The exact same "logic" (such as it is) could be used to justify letting parents fail to obtain medical care for their children for treatable diseases because, you know, those bacteria that caused the children's pneumonia were there before us and penicillins and some other antibiotics demonstrably cause severe allergic reactions in a small number of children. Besides, by Dr. Bob's "logic," those bacteria causing pneumonia are the status quo. Life happens. Death happens. Shit happens. No big whoop. Time is a flat circle.

Dr. Bob probably thinks this is profound. It's anything but. He is, however, as always, a master of the antivaccine dog whistle.

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I suppose NASA should invite people of the Flat Earth Society and astrologers for discussions and meet somewhere in the middle. I wonder how the earth would look like.

And why aren't airports open for flying carpets?

I suppose Dr. Bob is also against laws to force people to wear safety-belts. And that would be a bit resonable, because the person not wearing it is the one who has the damages in case of an accident.
I rather would compare it with allowing driving drunk. No-one tells you, you can't drink, but if you want to drive a car, you aren't allowed to do so intoxicated, for the safety of others. You are allowed not to vaccinate your kids, but if they go to a public place, vaccination might be mandatory, to protect others.

Dr. Sears has touched on a fascinating and novel new argument against vaccination. While the rights of the parents or the rights of the person being immunized have been brought out before, this is the first I can recall someone speaking out for the civil rights of the pathogens! And not just any minor right, like a germ's right to bear arms - vaccination directly goes after the three inalienable rights listed in the US Declaration of Independence of life, liberty, and pufuit of happinefs!

In this light, how can we see the eradication of smallpox as anything other than the crime of genocide? The Variola major held in captivity under inhumane conditions at WHO approved facilities are medicine's political prisoners, and the facilities medicine's gulags.

Can we stand by when so many of our fellow beings are being hunted down, tracked, and wiped out nearly to the point of extinction?

Free the Enterovirus C!

By Mephistopheles… (not verified) on 23 Jan 2015 #permalink

He even tries to turn the pro-vaccine against each other by trying to urge the “quiet, majority pro-vaxers” to “get louder about it.”

And they are, unfortunately for "Dr. Bob" they are lambasting his selfish, dunderhead clients for putting others at risk and ushering in outbreaks of VPDs.

By Science Mom (not verified) on 23 Jan 2015 #permalink

So, it is my opinion that ethically speaking, we must give precedence to what the status quo was or is, that diseases exist and cause some casualties, and those who decide they want to take part in the disease prevention can enter into vaccinations by their own free choice.

So, Dr. Bob, why are you practicing medicine? By practicing medicine, are you not directly interfering with the "status quo"?

"A generation of doctors were trained that severe vaccine reactions can’t happen."

Really? Lecturers, professors, and supervising physicians told medical students and residents that severe vaccine reactions can't happen? I'd love to meet these now-physicians and ask them how that discussion even came about.

Any person with a gram of scientific mindfulness in their body knows that severe vaccine reactions can and do happen. It's just that the reasonable person understands that they don't happen at the rate that antivaxxers claim, and that they're not as severe as antivaxxers claim, and that -- most often than not -- they're not the reactions antivaxxers claim they are, e.g. autism.

It seems as if Dr. Bob (who's blocked me on his Facebook page ever since I reminded him that, yes, he did talk to Seth Mnookin) is trying to justify the quack physicians out there who claim that they somehow "discovered" the truth all of a sudden and had their intellectual pendulum swung all the way to the antivax side over it.

It's not a paradigm shift to know that vaccines can and do cause reactions from mild to severe. No one has ever denied that. It's a constant accusation that is exhausting to defend when people let their perspectives and subjective opinions replace the cold, hard truth. I do not expect Barbara Loe Fisher to show up on a YouTube video and say that the risk of Guillain-Barre in the population in general is about the same as the risk from the flu vaccine. That's the truth, but, instead, we are reminded time and again of the 1976 swine flu scare as if 2015 were 1976, as if 2015's surveillance and epidemiology was the same as 1976's, and as if we had not made one single refinement to the vaccine or the recommendations for it since.

"By practicing medicine, are you not directly interfering with the “status quo”?"

Not if he gets paid for it, Todd. That there is THE status quo he seems to only be interested in. Someone mentioned that Yelp reviews of his practice have been quoting upwards of $170 per visit, cash.

As always regarding "Dr Bob" and vaccines (and shown many times previously), in answer to Seth Mnookin's question from 2012: "Bob Sears: Bald-faced liar, devious dissembler, or both?"--the screamingly loud answer is BOTH.

And now that there has been a measles case in my state of Arizona from this Disneyland outbreak, I would personally like to (sarcastically) thank Sear for his continued destruction of public health in America. Dr. Robert Sears, MD, FAAP-- YOU are the nasty, dripping urethral discharge from the fecal-covered phallus that is anti- vaccinationism.

By Chris Hickie (not verified) on 23 Jan 2015 #permalink

My bet is that the reference to genetic origin goes beyond Hannah Poling, referring to -
A. The fact that seizure claims blamed on DTP were traced to Dravet Syndrome.

B. The line of research on the genetic origins on autism.

By Dorit Reiss (not verified) on 23 Jan 2015 #permalink

One more thing: he's ignoring the fact that the right to make decision is the parent's, but the right to health is the child. Basically, the question is "which is more important, the right to choose whichever risk you want for your child, or that child's right to health?"

We respect parental freedoms and parents' rights to make decisions for their child. We do it because for many questions there is more than one answer, and with responsibility should one authority: parents are responsible for their child, ideally put a lot of work to take care of that child, have responsibilities for discipline and more. They need the authority to make decisions to do that - and the system really won't always serve the individual child as well without a parental advocate to help navigate and act.

But parental rights are not there to make the parent warm and fuzzy by letting the parent do what she or he feels like, and child's interest be damned. By phrasing it the way he does, Dr. Bob Sears is marginalizing the children - his real patients. That bothers me. I would like to see him put those children in the center.

By Dorit Reiss (not verified) on 23 Jan 2015 #permalink

@Dorit

Very possibly. It may have simply been inspired by those examples and worded vaguely enough that any time anyone suffers some sort of mishap anytime after having received a vaccine, which is then later discovered to be caused by something other than the vaccine, he and his anti-vaccine cronies (he's still an admin on that anti-vaccine FB group, right?) can crow, "See? Another example of a 'convenient' genetic cause."

"Back in the 70s and 80s, when severe (but rare) vaccine reactions began to be reported, victims were crying out for help and no one was listening. The medical community was in complete denial that severe vaccine reactions were even possible."

The smallpox eradication was pursued in the 70s in part because reactions to the smallpox vaccine could be so severe. There were very serious reactions to the early polio vaccines (the Cutter incident). The antivax claim that SSPE is caused by the measles vaccine is based on a paper from 1968 raising this as a possible risk. It is beyond stupid and well into dishonesty to make the claim that doctors were *ever* taught that vaccination had no risk.

We're interfering with the status quo?

You've gotta be kidding me.

By NH Primary Car… (not verified) on 23 Jan 2015 #permalink

His antivax pal Jay Gordon has claimed that human beings have lived for millions of years in symbiosis with measles (which diverged from rinderpest less than a thousand years ago) and that we risk who knows what disasters by trying to eliminate our symbiote.

human beings have lived for millions of years in symbiosis with measles

Hmm. Tell that to the Native Americans.

Morons.

By palindrom (not verified) on 23 Jan 2015 #permalink

So, it is my opinion that ethically speaking, we must give precedence to what the status quo was or is, that diseases exist and cause some casualties

I really hope that the CA state medical board and AAP pay attention to this bit. Dr. Bob Sears, a licensed pediatrician and fellow of the AAP, is advocating that we should give precedence to the "status quo" (i.e., the diseases), which comes with what one can assume Dr. Bob thinks are acceptable (if unfortunate) "casualties". Let's stop for a moment and consider what those "casualties" are: hundreds to thousands of deaths per year from disease, many thousands of severe injuries, including permanent harm (blindness, deafness, disfigurement, sterility, loss of sensation), lost productivity, etc.

The Native Americans and the Polynesians and everyone else who wasn't part of the Old World disease pool. We told Jay Gordon that in detail on this site. It's hard for me to search on this iPhone, but perhaps someone can find Jay Gordon's comment about the "dirty little secret" that measles improves the human race.

Actually, wasn't Measles first traced back to about the 7th Century (and first described as "worse than Smallpox")?

And since we already eradicated one of Measles' Cousins - Rinderpest, it shows that we could also do it for Measles as well.

I find his comments to be bordering on Eugenics - saying that we're better off letting diseases run rampant - with the undertone of "only the malnourished will die."

@Lawrence

This paper suggests measles emerged around the 11th or 12th century.

In the United States alone, prior to vaccination, there were about 4 million cases of chicken pox each year, resulting in 10,000 to 16,000 hospitalizations and 100 to 150 deaths.

By any rational argument that isn't a status quo to be given precedence but instead astatus quo to be oppsoed and altered.

WHEN WE STOP LISTENING TO EACH OTHER, WE LOSE OUR HUMANITY.

When a doctor stops listening to scientific evidence they should lose their license to practice medicine.

By Militant Agnostic (not verified) on 23 Jan 2015 #permalink

The gift that gives on giving. We clearly have no ethical obligation to address anything that used to represent "business as usual".

Human slavery? It used to be the status quo (it's championed in religious scripture like the bible for dog's sake) so where's the problem?

Child labor? Once the status quo, so it's all good.

Racial intolerance? Women as second class citizens? Children as property? Stop whining about individual or civil rights and give these the precedence they deserve. They used to be the status quo!

Dr Bob, in his attempt to be 'fair and balanced'- a voice of reason as it were, amidst the fray- has done exactly what our old friends, Blaxsted, did in their new book, Vaccines 2.0: they separate vaccines into good ones vs bad ones. I'm not sure if they and Dr Bob rate the same ones similarly but this strategy appears to be a way to misrepresent science in a way that isn't obvious. It boils down to saying that doctors are giving some ( not all- persish the thought!) dangerous vaccines and thus shouldn't be trusted and that adherence to the schedule that is recommended to by their professional organisation is direly problematic- a danger in fact- to children's health.

I suppose that he's a milder version of brave, maverick rebel.
Not the full Andy.

By Denice Walter (not verified) on 23 Jan 2015 #permalink

human beings have lived for millions of years in symbiosis with measles

And with lost of other illnesses, like polio, the plague and lots of others, which were responsible for lots of deaths and resulting in lots of people dieing when they were childs. Would Dr. Bob like to live in those days? Why has he studied medicine, if he considers illnesses just as a fact of life?

And whilst I'm here:
TMR has surprised me by including *new* posts these past few days instead of re-treads.
Ms Juicy Fruit today informs us about just how hard it is to be a TM.
You have to do your research, ask hard questions and stand by your decisions even though you are targetted by the ND crowd, "vaxtremists" ( SBM), Child Protective Services and governmental agencies for your choices. You must TELL YOUR STORY. And cringe as you read another new mother's recitative about her child's descent apres vaccines.

AND all the while, the entire internet is watching you!
HOWEVER you stand "in the company of giants".

By Denice Walter (not verified) on 23 Jan 2015 #permalink

Unfortunately, she doesn't say *what type* of giants.
I'm sure the minions have educated guesses.

By Denice Walter (not verified) on 23 Jan 2015 #permalink

Jolly Green ones?

By NumberWang (not verified) on 23 Jan 2015 #permalink

Ho ho ho.

By NumberWang (not verified) on 23 Jan 2015 #permalink

In the United States alone, prior to vaccination, there were about 4 million cases of chicken pox each year, resulting in 10,000 to 16,000 hospitalizations and 100 to 150 deaths.

You are correct on the morbidity, short, very short on the mortality. That was also under-counted and was in the thousands/year.

By Science Mom (not verified) on 23 Jan 2015 #permalink

Denice @27 -- As an astronomer, I vote for red giants.

By palindrom (not verified) on 23 Jan 2015 #permalink

@ palindrom:

Right. Gaseous and dimmer than average.

By Denice Walter (not verified) on 23 Jan 2015 #permalink

This was posted in the comments under Dr.Bob's Facebook post.

Are you in the 14-year gap that was unreliable for measles vaccine?

January 21, 2015, 6:33 PM|Disneyland is offering to test its employees for measles. The move comes after an outbreak of the disease was found to have originated from its theme park. But even if you've been vaccinated before, experts say there's a troubling 14-year period where people may not have been properly vaccinated. Ben Tracy reports.

http://www.cbsnews.com/videos/are-you-in-the-14-year-gap-that-was-unrel…

Rumors are floating around the web that the Disneyland measles of 2015 is a newly mutated strain that may be vaccine resistant.Just thought I'd toss that out.

By Roger Kulp (not verified) on 23 Jan 2015 #permalink

They want to be able to go to the doctor without being read the riot act every time. Read them the riot act once, then move on. They don't want to have to call 10 different pediatricians just to find one who isn't prejudiced against their kind.

Move on? So that it becomes one discussion in the pediatrician's office versus the endless river of internet NVIC garbage to guide parents’ decisions? Bob knows how that plays out, and seems content to let it do so.

By CTGeneGuy (not verified) on 23 Jan 2015 #permalink

Oh my my my. I must add this voice to Dr. Bob's supersonic whistling:

“It’s premature to blame the increase in reports of measles on the unvaccinated when we don’t have all the facts yet,” said Barbara Loe Fisher, the president of the National Vaccine Information Center, a group raising concerns about inoculations. “I do know this: Fifty-seven cases of measles coming out of Disneyland in a country with a population of 317 million people is not a lot of cases. We should all take a deep breath and wait to see and get more information.”

Oh, sure Babs.

http://www.nytimes.com/2015/01/22/us/measles-cases-linked-to-disneyland…

There may be a tiny sliver of common ground that I can find with the likes of Dr. Bob: current vaccines could be better, more effective. Our vaccine technology has lagged behind because of lack of funding and slim profit margins for risky product development pipelines.

Of course, my vision of a better vaccine involves shooting people with DNA or injecting them with transgenic virus ... which I'm going to go out on a limb and assume most of the anti-vaxers are not going to embrace with open arms.

By c0nc0rdance (not verified) on 23 Jan 2015 #permalink

Rumors are floating around the web that the Disneyland measles of 2015 is a newly mutated strain that may be vaccine resistant.Just thought I’d toss that out.

Roger, while I haven't seen the molecular epidemiology of the strain circulating, that is not the case at all. That's just anti-vaxx defensiveness. That 14 year period encompasses the time when a killed vaccine was used and gaps in vaccination. There is also 1971~1993 where most only received one dose. Those are the "vaccinated" who are contracting measles and very few with the full two MMRII doses. Anti-vaxxers got what they wanted; they just don't want the blame for it.

By Science Mom (not verified) on 23 Jan 2015 #permalink

"When asked, even on FoxNews, Doctors consider the whole “personal liberty” argument to be a bunch of BS."

Even Fox's Keith Ablow says 'parents should get their kids vaccinated.' He also said that the 'withdrawal of study linking vaccines to autism is "the global warming, if you will, of autism".'

By Vincent Iannelli, MD (not verified) on 23 Jan 2015 #permalink

c0nc0rdance,

Of course, my vision of a better vaccine involves shooting people with DNA or injecting them with transgenic virus

I have wondered here before if it would be possible to develop a virus that inserts the appropriate DNA into memory T cells to make them recognize a wide range of pathogens. As I understand it pathogen recognition gets hard-coded into the DNA of these cells. Someone with immunity to measles must have a sequence of DNA that codes for this immunity, and I see no reason* that we couldn't engineer a retrovirus to insert that DNA into the appropriate cells.

* Apart from the enormous practical problems, of course.

By Krebiozen (not verified) on 23 Jan 2015 #permalink

'Lucy in the school, with measles...'

What real scientists (and technologists) do when the empirical facts falsify their preferred hypotheses, is to recognise their errors and express thanks that someone spotted them.

Clearly Dr. Bob is no scientist. Not even close.

Whilst we're on the subject of the status quo, someone should ask him if he 'believes in' public water supply and sewage treatment.

Lastly, 'standing in the company of giants' was likely a typo. It should have read 'standing in the company of germs.'

The morbidity/mortality figures are taken from the CDC website, which made no mention of under-reporting, and I felt it best to post them as given on their website. I'm certainly ready to believe that they represent the lower bound for average annual mortality.

Rumors are floating around the web that the Disneyland measles of 2015 is a newly mutated strain that may be vaccine resistant.Just thought I’d toss that out.

Hard then to understand both why so many more of those infected in this outbreak are not vaccinated against measles and why the numbers of those infected are not much, much larger. Measles is so contagious that in absence of vaccination we'd expect 90% of those exposed to become infected, after all.

I agree with the general substance of this article. But notwithstanding his frustration, it's unfortunate that the author chose to write in such a mean-spirited and frankly, childish tone ("The stupid, it burns. It goes beyond setting a gargantuan straw man aflame with burning stupid into the realm of forming a black hole of stupid so dense that all medical knowledge threatens to be sucked in beyond its event horizon.") State the issue, explain the science, conduct your analysis, and present your conclusion. Of course, if the purpose of the article is, in part, to show how clever you are by identifying straw man arguments and "dog whistles," then disregard. My wife and I met with Dr. Sears after our first child was born. We had legitimate concerns after an adverse reaction to his first shot. Dr. Sears explained to us that one of his sons is fully immunized and the other has received no immunizations. He didn't try to push us in either direction and we ended up opting to vaccinate our son. I think that attacking his views and opinions is legitimate. I think that attacking him as a person is just kinda dickish and serves only to ratchet up the rhetoric, not further the scientific arguments.

By Concerned Father (not verified) on 23 Jan 2015 #permalink

Dr Bob Sears (and Dr Jay Gordon, too, for that matter) should stay overnight at a hospital with a child who has measles every single night until each and every Southern California case in this Disneyland outbreak is discharged.

I think the Onion captured the spirit of the parental rights involved:
""As a mother, I put my parenting decisions above all else. Nobody knows my son better than me, and the choices I make about how to care for him are no one’s business but my own. So, when other people tell me how they think I should be raising my child, I simply can’t tolerate it. Regardless of what anyone else thinks, I fully stand behind my choices as a mom, including my choice not to vaccinate my son, because it is my fundamental right as a parent to decide which eradicated diseases come roaring back.

The decision to cause a full-blown, multi-state pandemic of a virus that was effectively eliminated from the national population generations ago is my choice alone, and regardless of your personal convictions, that right should never be taken away from a child’s parent. Never."" http://www.theonion.com/articles/i-dont-vaccinate-my-child-because-its-… ~D.

By Dorit Reiss (not verified) on 23 Jan 2015 #permalink

Concern Troll Father:

Did you notice that you're reading Respectful Insolence? And that Orac has spent years trying to get through to Dr. Bob, who clearly isn't listening.

By all means, go ahead and write and post the calm, just-the-facts version of this post on your own website.

@45
When you met with Dr. Bob to discuss vaccination, did he provide you with the necessary information and guidance for informed consent?

Do you understand that pediatrician Dr. Bob's "advice" runs contrary to the standards of care issued by the American Academy of Pediatrics?

Your son had an adverse reaction and that is unfortunate. Why would you seek out Dr. Bob's counsel on this issue? I am genuinely curious.

A great retort to fools like Dr. Sears who argue that measles isn't a big deal in a developed country, especially because of improvements in health and sanitation:

"It’s hard to argue that in 1989 we had problems with modern sanitation. Arguably, we were healthier 25 years ago than we are now, if one uses the U.S. obesity rates as one marker of health and good nutrition. We had antibiotics for secondary infections, such as pneumonia, that settle in to measles-infected lungs—and fewer antibiotic-resistant bacterial pathogens than we do in 2015. Measles-associated pneumonia isn’t easy to treat if it’s caused by a “superbug,” and we’ve not had to deal with a huge measles outbreak in the age of methicillin-resistant Staphylococcus aureus, or MRSA, and other drug-resistant bacteria.

Despite our advances and our modernity and our status as a developed country, we still saw 123 measles deaths during this epidemic—here, in the United States, where we get plenty of Vitamin A. There were also 11,000 hospitalizations—fully one-fifth of people infected with measles became sick enough to be hospitalized.

In modern-day America."

Exactly.

http://www.slate.com/articles/health_and_science/medical_examiner/2015/…

Roger Kulp @33
That “gap in efficacy” mentioned in the video suggests those born before 1971 get a second dose, just like children do today.

The same applies to those born in the 1970s who have not been in school since 1990, for the same reason – that’s the year the second dose was added (I started grad school after that, and had to get the second dose).

Rumors are floating around the web that the Disneyland measles of 2015 is a newly mutated strain that may be vaccine resistant

They’re probably being circulated by the same folks who have the vaccinated vs unvaccinated ratio for this outbreak backwards.

http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx

Patients range in age from 7 months to 70 years. Vaccination status is documented for 34 of the 59 cases. Of these 34, 28 were unvaccinated (six of whom were infants too young to be vaccinated), 1 had received one dose and 5 had received two or more doses of MMR vaccine..

There are more cases among the unvaccinated – including all 13 San Diego County cases reported to date: http://www.countynewscenter.com/news/three-probable-measles-cases-repor…

After double checking my sources:

One of the first ten San Diego cases was vaccinated, which is 12 out of 13 who were not.

I thought I had read that the vaccinated individual is an adult over 50, but I failed to save the link at the time.

Fifty-seven cases of measles coming out of Disneyland in a country with a population of 317 million people is not a lot of cases

IT IS WHEN THERE SHOULD BE ZERO CASES YOU FECKING HALFWIT!

Fifty-seven cases of measles coming out of Disneyland in a country with a population of 317 million people is not a lot of cases.

In 2013, 290,000 people were injured in accidents involving a drunk driver. Out of a population of 317 million, that's not a lot of cases--only 0.091% of the population, less than 1 1/100th ot 1 per cent..

I guess we shouldn't address the risks associated with driving under the influence, and we should all instead just take a deep breath when accidents involving a DUI occur ...

Orac wrote:

The most frustrating thing about Dr. Bob’s little invitation to sing Kumbaya is he shows just a glimmer of actual insight. It’s hard for me to tell if this is just posturing on his part or if it’s really what he believes.

I suggest we forget Robert Sears – an IRL human being who believes something, somewhere down inside – and address ourselves to 'Dr. Bob' – a constructed media persona. The question then isn't whether the pro-vax bits of his post are "posturing" but how they work rhetorically and ideologically. It doesn't matter if Robert Sears is deploying them in a Machiavellian, consciously disingenuous state of mind. It matters that they FUNCTION disingenuously in the text.

Dr. Bob is a master of blowing the anti-vax dog-whistle while pleading "Not me, I'm Mr. Compromise!" at the same time. (Y'all can decide for yourselves which orifice on either end of the alimentary canal is blowing the whistle, and which is doing the sweet talking...) Of course, he's still deeply involved with the Vax—>Autism scare movie Trace Amounts.

But I want to focus on another dog-whistle. The OC dog whistle. The 'libertarian-conservative' dog-whistle. Dr. Bob gets where Robert Sears lives. I shall venture an ideological decoding:
. . . . . . . . .
"Non-vaxers don't want to be discriminated against."
That's right. YOU are the victim here. All you want is your liberty, and those damn statists hate you for it.
"They want to be able to attend school if they want. They want their children to be able to play with the vaxer's children. They don't want it to be an issue that affects social and family life. They don't want their pro-vaxer relatives to give them such a hard time."
If YOU want. You are the absolute ruler of the kingdom that it you. Anybody who tries to lay that nonsense about 'responsibility to the community' is just a pest who wants to take from the makers and should STFU. Your un-vaxed kids are going to the big family holiday gathering, they're going to play with their cousins, and if John and Marsha don't like it they should either trust the vaccines they believe in so much, or leave THEIR kids home if they're worried. This is NOT a family issue at all.
"Non-vaxers want to be able to go to the doctor without being read the riot act every time."
Repeal Obamacare!
"They don't want to have to call 10 different pediatricians just to find one who isn't prejudiced against their kind. Instead of become more understanding, more pediatricians in my area are discriminating against these people."
Talk about Stupid with a capital 'S'; what else is snotty talking talking back from the the hired help? These pediatricians seem unable to comprehend that they work for YOU. When you had a boss while you were working your way up, did you talk back to him? No. You showed him respect. (Just like Dr. Bob shows you!) But we're beyond that here. America has so lost it's way we're letting the proles actually discriminate against those of use who build the economy and create jobs, including their jobs. Under the lab coats, they're no better than union thugs, really.
"Let's talk about rights."
[Goodie! MY rights are my favorite subject!]
"Which right is more important, the right to not get sick with a disease or the right to make health care decisions for yourself and your child?"
Duh. Obviously YOUR individual rights and parents rights. No brainer. This is not Cuba.
"We shouldn't force anyone into accepting this treatment."
Damn straight. You are NOT going to let Big Government nannies force YOU into doing anything you do not want to do. "Life happens, death happens."
The pro-vaxers think YOU owe them something. They want a free ride, on YOUR dime. Because they're soft. Dr. Bob is as nice as he can be, but he is not soft. He understand the world is a hard place, that survivial of the fittest isn't just the way things are, it's right. As the great Reverand Shuller always said, "Tough times don't last, but tough people do." YOU toughed it out. As the Rev. Shuller says, you had "the guts to get out of the ruts" struggle up the ladder of life and make yourself "something different from the average man". As he also observed, most people "don't even know there is a ladder". So if anyone wants to get up the ladder it's totally on them to get smart enough to find the first rung and tough enough to make the climb. And if they try to pull you down in the process, and get the foot in the face they deserve, that's their problem.
"Those who want to take part in disease prevention can enter into vaccinations by their own free choice."
Free choice is what makes America the greatest country on Earth, and YOU are not giving away YOUR free choice to anybody, for any reason whatsoever.
"There will always be those who don't vaccinate."
Because: Freedom. And Dr. Bob has many freedom-loving patients, so he can assure you you are not alone.
"We'd better figure out a way to get along and love each other."
And who is not showing the love? YOU are not hating. You just want to be left alone, and respected for your own free choice. For which the hate is being directed at YOU, by those uppity pediatricians, the other parents at your kids school treating you like a leper, your smart-ass liberal brother-in-law ripping into you during what's supposed to be family time, and especially those insulting so-called scientists dumping smack on Dr. Bob. THEY need to learn some love. You're fine.
. . . . . . . . .
Now, again I'm not suggesting Robert Sears thinks any of these things. I'm arguing that these are the responses that will go off in the minds of his clientele and Orange County neighbors as they read the text.

While there may be a certain liberal/conservative balance between IRL parents who have un-vaccinated kids, the ideology of anti-vax is fundamentally right-wing 'libertarian'. If we look at liberal/conservative positions on a wide scope of issues, we could reasonably define a 'liberal' as someone who has concern and empathy for other people's children, and favors enacting policies to protect and help those kids; and we could define a 'conservative" as a fundamentally selfish individual whose attitude towards other people's children is basically 3rd person: Was einen nicht umbringt, macht sie stärker.

As such, my guess is in the wake of the Disneyland outbreak and further media attention to the spread of VPDs vax rates will go up in SF and the East Bay, and stay the same or get worse in Orange County. Marin County might as well be Mars, so I have no guess about how things will go there.

[Marin's not 'conservative' by any means, but I wouldn't call it 'liberal' either. Liberals like cities. Marin has lots of big hills and tall forest. There are small towns like Mill Valley where people go for services, but to get to an awful lot of the posh residences you have to drive up long winding roads deep into the woods where the homes are tucked away hidden by the terrain and the tree canopy. From the road, mostly you just see the driveways. Few folks if any can see their neighbors. It's a different kind of 'leave me alone', in some ways more thorough than a conservative 'gated-community'.]

The morbidity/mortality figures are taken from the CDC website, which made no mention of under-reporting, and I felt it best to post them as given on their website. I’m certainly ready to believe that they represent the lower bound for average annual mortality.

@JGC, I'm sorry if I sound nitpicky; measles epi is a "hobby" of mine. I understand why you used the CDC website and maybe yours is a typo but even they have 495 annual deaths listed for pre-vaccine era: http://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html However, they also mention the estimate of 4 million cases per year with 1-3 deaths/1000 cases. This is a result of retrospective analysis of death certificates that were not attributed to measles but rather complications. Even back in the 1970's, this was known: http://archpedi.jamanetwork.com/article.aspx?articleid=505944

I harp on this particular point because it flies in the face of the anti-vaxx claim that measles is/was a harmless disease. The morbidity and mortality rates are a lot higher than they'd like to believe and mostly in children with no underlying problems. And refusing MMR is not just going to fuel measles outbreaks, mumps too and it won't be long before we start seeing congenital rubella syndrome in infants. How many cases of SSPE will we be seeing 3-7 years from now; several children and infants have been infected this year and last. This outbreak is only the beginning of the harms the anti-vaxxers are causing.

By Science Mom (not verified) on 23 Jan 2015 #permalink

"They are the status quo. Because we have invented a medical treatment to try to change the status quo, yet that treatment can cause harm to a very small percentage of people, it is my belief that we shouldn’t force anyone into accepting this treatment. Life happens, death happens."

Well sh!t. I guess we better go tell smallpox we're sorry and re-release it into the wild. Dr Sears, I suggest you start with yourself if you so strongly believe this.

"I agree with the general substance of this article. But notwithstanding his frustration, it’s unfortunate that the author chose to write in such a mean-spirited and frankly, childish tone"

Concerned father-

I get what you are saying, but must say I don't really agree. A big part of learning skepticism and science is to learn to look at the evidence alone when making decisions. Don't let any perceived tone get in the way.

Further, I think there are times what such tone is absolutely warranted. Skeptics and real scientists are people too. We get offended, we get angry, especially when someone is quite literally putting his personal profit above the well-being of children.

I post a lot on the Science Based Medicine website and a few months back we had some ignoramus who was pushing for a random trial of vaccinations where the study design would mean hundreds of kids dying unnecessarily. It was a complete clusterf^ck of an argument and about as unethical as one can get.

We pointed this out to the guy, and he was left unfazed. He then started lashing out calling us all ignorant and 'afraid of the truth' since we didn't agree with his dumb@ss ideas.

I have no issue railing on people like that.

In fact, I think that if growing up, more people were checked when they say stupid stuff, we wouldn't have a generation of adults who think that the fact their opinion exists is all the justification necessary for such a belief. If you something dangerous and stupid, it should be denigrated as such.

Ultimately, I think people have to put on their big boy pants when discussing issues such as this and not let their delicate sensibilities get so offended by snark, dark humor and disdain for the ever present stupid people among us...

I left an an otherwise good breastfeeding advice blog because of her tendency to post anti vaccine 'advice' and within minutes , post a 'why can't we all just get along and respect each other's opinions' whine minutes later. In the end, it wasn't the anti vax advice that finished me off, if was the gross hypocrisy ( she knew full well it was inflammatory) and this pervasive idea that we all have to constantly validate and support everyone's crap ideas so as not to make anyone 'feel bad'.

By Charlotte (not verified) on 23 Jan 2015 #permalink

After the 1986 National Childhood Vaccine Injury Act was passed that protected vaccine manufacturers against lawsuits, the number of vaccines for infants has been dramatically expanded:..In contrast, many of the vaccines on the USA schedule are not included on the vaccine schedules for other developed countries. A 2009 Special Report “Autism and Vaccines Around the World: Vaccine Schedules, Autism Rates, and Under 5 Mortality” demonstrates that most developed countries do not include the varicella (chicken pox), rotavirus, pneumococcal, influenza, or hepatitis A vaccines on their schedules. A slight majority of countries administer the hepatitis B vaccine to infants, but many of those countries (such as the UK, Denmark, Netherlands, Switzerland, Sweden, Norway, Finland, Ireland, Iceland, and Japan and several Canadian provinces routinely screen pregnant women for hepatitis B and only administer the hepatitis B vaccine to the infant if the mother tests positive for hepatitis B). The report points out that the USA has a higher vaccination rate and a higher mortality rate for children under the age of 5

We have many more vaccine requirements than almost all other countries, and we lead the world in autism.

AUTISM PREVALENCE in the United States has soared. In 1970, Treffert et. al. published the first known
autism prevalence study in the United States, Epidemiology of Infantile Autism, with an autism prevalence rate
of less than 1 per 10,000. In 1987, Burd et. al. published a study, A prevalence study of pervasive developmental
disorders in North Dakota, showing an autism rate of 3.3 per 10,000. In 2007, the Centers for Disease Control’s
Autism and Developmental Disabilities Monitoring Network released data showing that prevalence of
autism had grown to 66 per 10,000 or 1 in 150, an increase of more than 6,000% from the 1970 study.

I would be happy to smile and make peace if I could choose the vaccine schedule of Israel, 1/3 the vaccines, better child mortality and 1/7 the autism rate...

As far as all the snark and sarcasm goes, this site has the biggest collection of pro-vax assholes I have ever seen. rude, nasty, snarky sarcastic, in the face of one of the biggest corporate health screwings in history by big pharma. So, these are the facts, and you know how I feel about you.

By Keating Willcox (not verified) on 23 Jan 2015 #permalink

Concerned Father @45's comment could easily be used as the prototypical example of tone trolling. It's among the finest examples I've seen in the wild.

By palindrom (not verified) on 23 Jan 2015 #permalink

Mr. Willcox (added emphasis):

AUTISM PREVALENCE in the United States has soared. In 1970, Treffert et. al. published the first known autism prevalence study in the United States, Epidemiology of Infantile Autism, with an autism prevalence rate of less than 1 per 10,000. In 1987, Burd et. al. published a study, A prevalence study of pervasive developmental disorders in North Dakota, showing an autism rate of 3.3 per 10,000. In 2007, the Centers for Disease Control’s Autism and Developmental Disabilities Monitoring Network released data showing that prevalence of autism had grown to 66 per 10,000 or 1 in 150, an increase of more than 6,000% from the 1970 study.

The MMR vaccine was introduced in the USA in 1971, and was the preferred vaccine for the 1978 Measles Elimination Program. So if it caused an increase in autism that would have been noted by 1987. But your numbers do not show it.

So Mr. Willcox, by presenting that information you have proved the MMR vaccine does not cause autism.

"As far as all the snark and sarcasm goes, this site has the biggest collection of pro-vax assholes I have ever seen. rude, nasty, snarky sarcastic, in the face of one of the biggest corporate health screwings in history by big pharma. So, these are the facts, and you know how I feel about you."

Only what you posted is quite bluntly, wrong. It's been belabored here plenty, but there is no link between autism and vaccines. The rise in prevalence is due to a rise in awareness and expansion of diagnostic criteria.

If you want to remain willfully ignorant to that reality, it is your choice, but understand that that is not in any way shape or form 'facts' as you have declared them.

I would be happy to smile and make peace if I could choose the vaccine schedule of Israel, 1/3 the vaccines, better child mortality and 1/7 the autism rate…

Typical anti-vaxx ignorance of epidemiology. Israel has different collection methods and less resources for minorities than the U.S.: http://www.timesofisrael.com/low-prevalence-of-autism-seen-among-israel… and more stigma attached to an ASD diagnosis. Their infant mortality rate is also lower because of differences in criteria for live births. And you're making medical decisions with this profound ignorance of basic epi?

As far as all the snark and sarcasm goes, this site has the biggest collection of pro-vax assholes I have ever seen. rude, nasty, snarky sarcastic, in the face of one of the biggest corporate health screwings in history by big pharma. So, these are the facts, and you know how I feel about you.

Yours are not facts and get used to the snark; it isn't kewl any more to leave your spawn unvaccinated and spreading VPDs. People are tired of your ignorant entitlements.

By Science Mom (not verified) on 23 Jan 2015 #permalink

The official CA state count has caught up to the media
http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx
48 Disneyland cases within CA, plus 3 in Utah, 2 in Washington, and 1 each Colorado, Oregon, Nebraska, Arizona and Mexico.

Almost half the cases without a known link to Disneyland are from Orange County.

The original 2002 Danish study by Dr Samy Suissa of McGill University in Montreal (Canada) came up with an even more astonishing result. Contrary to the original ‘no link’ finding, diagnoses of autism within two years of an MMR vaccination increased to a high of 27.3 cases per 100,000 children compared with just 1.45 cases per 100,000 in non-vaccinated children. The children who had had the MMR vaccination were 45% more likely to have developed autism than the children who had not had the MMR vaccination.

Don't forget, there is enormous profit from vaccines since they have no liability.... Ten years ago, the vaccine market sat at $5.7 billion dollars…now, that market has soared to $27 billion.” So from 2003 to 2013 the vaccine market increased nearly five-fold! This is astonishing.

By Keating Willcox (not verified) on 23 Jan 2015 #permalink

Vaccines save lives. That's more than I can say for most of the things I buy. Why are you happier that someone can make a profit selling me unnecessary electronics, jewelry, furniture than that they can make a profit saving people's lives?

(If I'm wrong and you're actually a communist, I submit there are better places to attack capitalism.)

@Science Mom...Thank you for the reference. It showed that for almost all inhabitants of Israel, most had massively fewer incidents of autism than the US. They also have better infant mortality. Al I ask for is civil debate, an Israeli vaccination schedule, and more research that is not funded by Bib pharma. We know they cheat. see Big Pharma: Exposing the Global Healthcare Agenda Paperback – February 6, 2006
by Jacky Law

As far as infant mortality, here are the facts you need....

A baby born in the U.S. is nearly three times as likely to die during her first year of life as one born in Finland or Japan. That same American baby is about twice as likely to die in her first year as a Spanish or Korean one.

Despite healthcare spending levels that are significantly higher than any other country in the world, a baby born in the U.S. is less likely to see his first birthday than one born in Hungary, Poland or Slovakia. Or in Belarus. Or in Cuba, for that matter.

You are truly ignorant.

By Keating Willcox (not verified) on 23 Jan 2015 #permalink

Mr. Willcox, an MMR vaccine has been used in USA for over forty years, the numbers you provided show it has nothing to do with autism.

@sadmar (#57):

The funny thing is that solid liberal Democrat types are often persuaded by or will parrot libertarian talking points when it comes to public health measure they don't like.

A prime example of this was the big brou-ha-ha in Portland, OR (where I spent a very happy period of my life in between college and grad school) over flouridation. (Yes, flouridation - I know, I always thought it was a fringe, John Birch Society-type concern, but...)

Portland really doesn't have a lot of conservatives to speak of, so it was basically liberals vs. liberals when it came to flouridation. (The issue got bizarrely heated. I'm generally pro-flouridation, but I'm not that invested in the issue. Plus I'm a registered Michigan voter, so I basically sat on my perch and watched it all play out without participating, in part so as not to lose any friends over the issue.)

Quite a few people I know very well, who, again, are solid Democrats in general, took a rabidly anti-flouridation stance, basically based on the naturalistic fallacy, with a little anti-corporatism thrown into the mix. ("Flouride is an evil corporate byproduct of smelting!") Thing is, when they finally argued themselves into a corner on the science and actual facts involved, they would retreat to the rather disingenous libertarian-style talking point of "Forced mass medication is unethical!" Which, I agree, it is, but that's not even what flouridation is. It's the maintenance of a naturally ocurring mineral at optimum levels in drinking water - neither too high nor too low - as a prophylactic, in the interest of public health.

We also don't count "infant mortality" the same way as some of the other countries on that list (like including any birth over 26 weeks as a "live birth").

Keating Wilcox,

Contrary to the original ‘no link’ finding, diagnoses of autism within two years of an MMR vaccination increased to a high of 27.3 cases per 100,000 children compared with just 1.45 cases per 100,000 in non-vaccinated children. The children who had had the MMR vaccination were 45% more likely to have developed autism than the children who had not had the MMR vaccination.

This particular claim never fails to amuse me. Suissa didn't correct for age, so of course there is a correlation between MMR and autism. Within the age range of the study the older the child was, the more likely it was to have had MMR, and also the more likely it was to have been diagnosed with autism. At birth none of the children had had MMR and none of them had been diagnosed with autism. By age five most of the children had had MMR and most of the autistic children had been recognized and diagnosed. If you used the same methods Suissa used you would find a correlation between height and autism.

Madsen corrected for age and the correlation vanished. Case closed.

By Krebiozen (not verified) on 23 Jan 2015 #permalink

@Kreb - I had forgotten about that particular tidbit.....so the study also showed that a child was more likely to be autistic, the taller than child was!

I knew it! Height causes autism!!!

I still maintain that the true culprit is organic foods.

Keating Wilcox,

A baby born in the U.S. is nearly three times as likely to die during her first year of life as one born in Finland or Japan. That same American baby is about twice as likely to die in her first year as a Spanish or Korean one.
Despite healthcare spending levels that are significantly higher than any other country in the world, a baby born in the U.S. is less likely to see his first birthday than one born in Hungary, Poland or Slovakia. Or in Belarus. Or in Cuba, for that matter.

As has been pointed out, most of those differences are due to differences in how infant mortality is measured; what are counted as stillbirths in some countries are counted as live births in the US. The remaining differences are very probably due to higher rates of premature birth and low birth weight babies in the US as compared to other countries.

This is in turn due to more older women in the US having babies, and I suspect because of poorer prenatal healthcare for the large poverty-stricken underclasses in the US - too little conventional medical care, not too much. It has nothing to do with vaccines.

By Krebiozen (not verified) on 23 Jan 2015 #permalink

Keating isn't interested in having a civil conversation. If he was, he wouldn't keep trying to use the same old debunked "evidence" over and over again....one cannot have an open and honest debate or even a discussion, if one side relies on the worst possible evidence and refuses to understand that the science isn't on their side.

He's been playing the same song for at least five years now (back when he was claiming the H1N1 Fu vaccine mandate for health care workers was going to cause an open revolt).

Lawrence @79 -- Well, you're obviously just a "pro-vax asshole". /snark. And sarcasm!

By palindrom (not verified) on 23 Jan 2015 #permalink

@pal - and DAMN PROUD OF IT!

@Science Mom…Thank you for the reference. It showed that for almost all inhabitants of Israel, most had massively fewer incidents of autism than the US. They also have better infant mortality.

More citation-free assertions from the arrogant ignorati who still can't grasp the differences in live-birth criteria globally as well as ASD epidemiology. Hey Wilcox, Iceland, Sweden and Korea all hit higher ASD prevalences before the U.S. and have lighter vaccine schedules.

By Science Mom (not verified) on 23 Jan 2015 #permalink

@myself:

Fluoridation, not flouridation. I don't know why that word still trips me up all the time.

I am doubting that Mr. Willcox will acknowledge he provided evidence that the MMR does not cause autism. He probably never realized that a version MMR had been used in the USA for almost two decades before there was one in the UK, and more than two decades before Wakefield was aware of it.

I didn't know there was an outbreak in San Diego County. Most of the San Diego area is as conservative as Orange County, due mainly to the military influence. It's not as affluent over-all and there are a lot of illegal immigrants living in 3rd world-type shanty towns tucked away off the beaten path. Poverty you wouldn't believe there. I don't know what the vax rates are down there...

Anyway, again, what Robert Sears thinks doesn't matter. The discourses 'Dr. Bob' channels do. It's about what whistles the dogs hear and make them come running. Thus, to continue I'll inject right-wing takes on comments from the thread:
. . . . . . . .
I suppose Dr. Bob is against laws to force people to wear safety-belts.

ON TUESDAY, I'm going to get in my car, fasten my seat belt, drive to my polling place and strike a blow for freedom, by voting to repeal the Legislature's compulsory seat belt law. It isn't a referendum on safety: It's a referendum on liberty. Repealing the seat belt mandate won't mean drivers should stop buckling up. It will mean voters are tired of buckling under. Drive without strapping yourself in and the only person you endanger is yourself. Not buckling up may be risky -- even stupid. Letting the government take away your freedom in order to protect you from yourself is riskier -- and stupider -- by far. Already the government confiscates the largest part of your income, decrees the curriculum your child must study, tells you what to do with your trash, and may throw you in prison if you enlarge your house without permission. At least let us resist the minor encroachments. – Boston Globe columnist Jeff Jacoby 1994,

Child labor? Racial intolerance? Women as second class citizens? They used to be the status quo!
Laizzez faire conservatives opposed all legislative attempts to change those things. They currently support measures to weaken child labor laws, and on women's rights...
Would Dr. Bob like to live in those days? [of common epidemics]
When Charlie Rose asked George Will what time period he would live in if he had the choice, Will replied, "the Gilded Age." Neo-Victorianism is big with conservatives.
Ethically speaking, let’s consider what [disease] “casualties” are: hundreds to thousands of deaths per year from disease, many thousands of severe injuries, including permanent harm.
None of which are my problem. It's up to individuals to take care of themselves. The nanny state on weakens America. BTW, ethically speaking, you have no right to expect me to pay for what other people need to do to care for themselves. Repeal Obamacare.
"human beings have lived for millions of years in symbiosis with measles"? Tell that to the Native Americans.
I have always thought of America as a place in the divine scheme of things that was set aside as a promised land. The means of selection was very simple as to how this land should be populated. Any person with the courage, with the desire to tear up their roots, to strive for freedom, to attempt and dare to live in a strange and foreign place, to travel halfway across the world was welcome here. - Ronald Reagan 1952 (repeated theme in his many 'City on a Hill' speeches)
The Native Americans and everyone else who wasn’t part of the Old World disease pool... saying that we’re better off letting diseases run rampant... 4 million cases of chicken pox each year, 10,000 to 16,000 hospitalizations and 100 to 150 deaths; by any rational argument a status quo to be opposed and altered.
No. It's the do-gooders who irrational. You're not going to Disneyland now, right? If the redskins encountered new diseases, they should have moved, to take themselves out of harms way. They chose not to. I also fail to see the rational argument for leaving North America in the hands of prehistoric savages who hadn't even developed the wheel, as opposed to it becoming the pinnacle of Western Civilization in terms of both scientific advancement and as opposition to tyranny. Was Hiawatha going to eradicate polio? Tecumsah invent the electric light or the telephone? Cochise create the Green Revolution? Geronimo rescue Great Britain from Hitler? Would Siittng Bull have kept the Communists from total world domination? What would be rational about reversing the outcomes of American exceptionalism? If you want to live in that sort of world, you might try the Amazon rain forest. Diseases only run rampant among individuals without the ability to protect themselves. Darwin established the rational basis of nature, the free market of the gene pool. The good survive, the flawed fail. The next generation improves. If you don't have the skill to survive the chicken pox, you most likely lack the skill to avoid other dangers. It is not ratinal to waste money taking care of someone liable to walk in front of a bus on their way out of the hospital. Repeal Obamacare.
He’s ignoring the fact that the right to make decision is the parent’s, but the right to health is the child's.
I appreciate your support for the repeal of Roe v. Wade. I shall forward your contact info to Operation Rescue. What donation level can I put you down for?
I would personally like to (sarcastically) thank Sears for his continued destruction of public health in America.
No. Thank Milton Friedman and drop the sarcasm. It has been proven beyond doubt that free market solutions and consumer choice based on rational individual self-interest lead to the best outcomes and the highest efficiencies. If you want public health, move to Cuba. Repeal Obamacare.
...and impeach the commie Kenyan muslim while you're at it.
. . . . . . . .
I have not pulled any of my fake replies out of my butt, just reworded stuff I've heard repeatedly from right-wingers (and not the Christian crazies either...) but didn't have time to dig up actual examples.

Two quotes are below. One is from The Onion with one term softened and the pronouns switched to the second person — same logic though. The other is from Dr. Bob. If you didn't have the references above, could you tell which was which?

Your decision to risk contributing to a multi-state pandemic of a virus that was effectively eliminated from the population generations ago is your choice alone, and regardless of your personal convictions, that right should never be taken away from a child’s parent.

Let’s talk about rights. Which right is more important, the right to not get sick with a disease or the right to make health care decisions for yourself and your child? We shouldn’t force anyone into accepting this treatment.

Let’s talk about rights. Which right is more important, the right to not get sick with a disease or the right to make health care decisions for yourself and your child? We shouldn’t force anyone into accepting this treatment.

When I was in school, there was a patient who came to us for new glasses that was one of the wackaloon, rabidly libertarian Ayn Rand wannabes.

He actually sent us a letter when we refused to make a pair of glasses for him based on a 5 year old prescription. We mentioned that it wouldn't be safe, and that if he has had a change in his rx, he could be driving around without proper visual acuity.

He. Went. Apesh!t. Ranting and raving in this letter about how he should be free to order whatever lenses he wanted and that is was violation of freedom that medicine is regulated, that we were just a bunch of corporate stooges feathering our own nest, etc. etc.

I'm all for less government, but there are times when it is absolutely essential.

I would have been tempted to reply, simply, that it was a violation of my freedom for him to try to force me to sell him those glasses when I didn't want to.

Let’s talk about rights. Which right is more important, the right to not get maimed or killed in a car accident or the right to make driving decisions for yourself and your passengers? The way I see it, car accidents were here first. They are ubiquitous to our world. Whether created by God or by physics, they are here. They are the status quo. Because we have invented a technology to try to change the status quo, yet that technology can cause harm to a very small percentage of people, it is my belief that we shouldn’t force anyone into accepting this technology. Life happens, death happens. It’s terribly tragic when death happens before it’s time. Nobody wants anyone to die. And no one wants their child to die in a car crash. So, it is my opinion that ethically speaking, we must give precedence to what the status quo was or is, that accidents exist and cause some casualties, and those who decide they want to take part in accident prevention can stop when the light turns red by their own free choice.

By justthestats (not verified) on 23 Jan 2015 #permalink

I mentioned this this morning but then had to go to work. Here is Jay Gordon pontificating on the benefits of measles:

... 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.

@ LW:

Right. So I guess surviving measles explains why I'm such an indomitable hard@ss.
Or else it's why I need sunglasses even when it's not too sunny outdoors.

By Denice Walter (not verified) on 23 Jan 2015 #permalink

All the talk of "rights" but no responsibilities.

If Sears does not want to interfer with the "status quo" why is he attempting to be a physician?
I can't remember the quote it might be from something KE Beth Miller PhD wrote but the practice of medicine is an attempt to oppose evolution.

As for :

By RCordes,DO (not verified) on 23 Jan 2015 #permalink

All the talk of "rights" but no responsibilities.

If Sears does not want to interfer with the "status quo" why is he attempting to be a physician?
I can't remember the quote it might be from something Kenneth Miller PhD wrote but the practice of medicine is an attempt to oppose evolution.

As for : "So, it is my opinion that ethically speaking, we must give precedence to what the status quo was or is, that diseases exist and cause some casualties, and those who decide they want to take part in the disease prevention can enter into vaccinations by their own free choice."

I once told a conservative friend that the Obama born in Africa idea was the dumbest thing I ever heard. I think Sear topped it.

By RCordes,DO (not verified) on 23 Jan 2015 #permalink

@dorit reiss - I admire your thoughtful deconstruction of the anti-vaxxers and their false arguments, but it's really not worth your time and effort.

The sad fact of the matter is that the opinion leaders of the anti-immunization movement/position/whatever are of two types--the undiagnosed or untreated mentally ill, and fucking charlatans like Bob Sears, who have a lot to gain in terms of psychic and monetary income. That's as complicated as it really is.

Providing counseling and support to parents of children with autism spectrum disorders - and to call out and impoverish the goldbrickin'-ass scrubs that profit off of them - are the only way we're ever going to lick this thing, and end the deaths and injury of kids from vaccine preventable diseases.

Orac wrote, "I forgot how Orange County is a conservative bastion in southern California." It's really easy for non-Cali's to get different parts of California mixed up.You really have to spend time some time in these places to get the lay of the land. I'm from the Midwest and didn't have a clue until I moved out here.

This might be a memory device for the Minions:
• The measles outbreaks are in Orange County (home to Disneyland) and San Diego County.
• The CA 49th Congressional district spans southern Orange County and western San Diego County.
• The 49th is represented by Darrell Issa.
• Issa chaired a highly publicized hearing on the "Federal Response to Autism" in his witch-hunting Congressional Committee on Oversight and Government Reform in 2012. Issa worked with Brian Hooker to develop the agenda for the hearing, which focused on grilling CDC and NICHHD officals about Mercury in vaccines.
• Before and after that hearing, Issa received a number of large campaign contributions from anti-vaccine activists.
• Issa defeated his Democratic opponent 70.0% to 21.5% in 2014.

Measles outbreaks <— low-vax-rate OC and SD conservative ideology Darryl Issa the anti-vax lobby

or:
Issa
SoCal
Shill
Antivaxers
. . . . . . . .
NOTE: Issa's Committee figures heavily in the internecine wrangling in anti-vax land between the Hooker/Crosby/Bolen wing and the Canary/AoA/RFKJ contingent. Apparently, after using Hooker to help set-up the 2012 Committee Hearing, Issa's staff changed what Hooker thought would be a hearing exclusively on the CDC in which he would testify to the wider 'Federal Response on Autism' rubric and removed Hooker from the witness list. Jake Crosby then called out the Canary Party for meddling, and blamed them again when Issa canceled a second autism hearing on the VICP he'd scheduled for Dec. 2013. Jakes seems not to understand politics. Issa hearings (on whatever) are political theater designed to rile up the base inside the conservabubble, in which Issa and other Congressfolk are the prosecutor/heroes and government officials are the defendants/villains. When Issa couldn't get any significant official to show up and play bad-guy on the VICP, Issa's sponsors got more play from the cancellation than they would have gotten from a weak-sauce hearing with nobody 'big' to pick on. The Canaries and AoA acted all upset and had their followers write letters to Issa urging him to re-schedule. But they didn't stop giving him money. My guess would be he consulted them before he canceled, the whole thing was scripted, he's still in their pocket, and we'll be seeing more of Issa in the future when the time is right.

@sadmar Nicely done. Only thing I'd add is that, I believe, the $40,000 tribute paid to Issa in exchange for his kangaroo hearing exceeded FEC campaign contribution rules. Can anybody here confirm or deny?

@#1-#93
"Sadly, no. No, we probably wouldn’t."
"a bunch of BS."
"And why aren’t airports open for flying carpets?"
"Free the Enterovirus C!"
"Fluoridation, not flouridation."
"Well sh!t."
"One is from The Onion with one term softened and the pronouns switched to the second person — same logic though."
"He. Went. Apesh!t."
"I would have been tempted to reply"
"I mentioned this this morning but then had to go to work."
"I’m such an indomitable hard@ss."
"I can’t remember the quote"
"I’m from the Midwest and didn’t have a clue"

Did any of you happen to receive some glitter?
I hear there is free shipping from Brooklyn.
http://shipyourenemiesglitter.com

By Toto "the Rock" (not verified) on 23 Jan 2015 #permalink

"SEATBELT LAWSUITS MORE LIKELY AFTER SUPREME COURT OF THE UNITED STATES RULING
TheresaJ | 1 AVRIL 2011
The Supreme Court of the United States (SCOTUS) has ruled that Mazda Motor Corp. must defend itself in the courtroom against a seatbelt lawsuit that once would have been an exemption under federal law, states Automotive News. Supreme Court of the United States found the lap-only rear belt of the 1993 Mazda MPV may be held liable for the internal injuries that killed Trahn Williamson in 2002 in Kane County, Utah. As a result of this Supreme Court of the United States ruling on seatbelt regulation, AUTOMAKERS CAN NOW BE SUED FOR ANY ACCIDENT, INJURY, OR DEATH that can be traced to the lack of two-point rear SEATBELTS in cars older than 2007"
http://my.teslamotors.com/fr_CA/forum/forums/seatbelt-lawsuits-more-lik…

If this happened to SEAT BELTS, then VACCINES can't be far behind!
YESSSSSSS!

By Toto "the Rock" (not verified) on 23 Jan 2015 #permalink

Here is Jay Gordon pontificating on the benefits of measles:

I find these sorts of comments from doctors extraordinary. It is almost as if they have disengaged their brains before opening their mouths.

The only benefit of getting measles is that you will most likely not get it a second time. Frankly, I don't see the advantage compared to the risks. I have not had smallpox and I don't think I am any weaker for the lack of that experience.

On a population basis there might be an argument that allowing the most susceptible in the population to die from measles will improve the resistance of the rest of the population, but even that argument is flawed. Measles has been infecting humans for a millennium and until the advent of vaccines showed no signs of being less infectious.

If Dr Jay wants to pursue such an argument, perhaps he should be suggesting that not having any medical interventions probably improves human health. It is about as senseless.

I would call Dr jay a weasel, except that would be an insult to weasels.

CELEBRATE WORLD TOILET DAY!
Flush the vaccines!

OF COURSE HEALTH IMPROVEMENT IS RELATED TO SANITATION!
Instead of spending BILLIONS on vaccines....LET'S SEND TOILETS! Safer, cheaper, more effective:

"United Nations Secretary General Ban Ki-moon said in a special message for World Toilet Day, “We have a moral imperative to end open defecation and a duty to ensure women and girls are not at risk of assault and rape simply because they lack a sanitation facility.”

Although the moniker “World Toilet Day” might sound peculiar, or laughable—or even cringe inducing—the statistics are dire: More than a third of the world population is currently without access to improved sanitation facilities (with half of them living in developing regions); over a billion people practice open defecation; every twenty seconds, A CHILD DIES as a result of POOR SANITATION. The hardest hit coverage areas remain in sub-Saharan Africa, Southern Asia, and Eastern Asia.

Access to SANITATION is proven to bestow benefits on PUBLIC HEALTH, livelihoods, and dignity-advancement—affecting not only individual households but also entire communities. Studies cutting across countries all show that the method of disposing of excreta is one of the strongest indicators of child survival: according to United Nations statistics, the transition from unimproved to improved sanitation reduces overall child mortality rates by about a third.

Overhauling the sanitation system is not only the right and humane thing to do, it’s also economical: as United Nations data show, every dollar the U.S. government spends on sanitation brings a return of $5.50, by keeping people healthy and productive. The Millennium Development Goal—one of eight such goals devised by the UN and agreed to by all the world’s countries as a blueprint for change—set a target of halving the percentage of people without sustainable access to basic sanitation and safe drinking water by next year. But improvement has been SLOW GOING: unless the pace of change in sanitation is increased, the MDG has stated, its target may not be reached until 2026."
http://www.theatlantic.com/sponsored/hitachi-building-tomorrow/why-toil…

The GATES TOILET COMPANY has a nice ring to it.....

By Toto "the Rock" (not verified) on 23 Jan 2015 #permalink

Sickle Cell, Tay-Sachs, and Cystic Fibrosis are all thought to be more prevalent because their genes provide resistance to some nasty diseases. Why does Gordon think that measles is incapable of doing the same kind of thing?

By justthestats (not verified) on 23 Jan 2015 #permalink

I doubt surviving rather than dying from measles selects for anything but resistance to measles; if we wipe out measles, that is very unlikely to be a relevant trait. And it may not even be that useful: we may be "selecting" for a non-heritable trait like happening to be on a different flight than the person who was spreading the virus, or living someplace with a good public health department.

sadmar @ 85 & 93
Since I don’t usually read much of your comments (due to the fact that the words-to-information ratio is orders of magnitude too high), I suppose it’s only fair that you don’t read mine (such as today: 52, 53, 54). This was made clear in your comment #85 - if you had, the measles cases in San Diego would have not have been such a revelation to you (#93). But I’m glad you finally noticed.

Back to #83: What’s with your characterization of the San Diego area? When was the last time you visited? Was during this century? Have you ever been to LaJolla or Rancho Santa Fe?

I don’t know what the vax rates are down there…

Based on the past two years of kindergarten data, San Diego County has about 92% coverage for all vaccines, and 94% for MMR (similar to statewide rates): http://www.cdph.ca.gov/programs/immunize/Documents/2014-15%20CA%20Kinde…

However, when you look up individual schools (which you can access through the state’s Measles page I and others have linked often), you’ll find the same kinds of unvaccinated pockets found in LA and Orange Counties.

It’s not the illegals in shanty towns bringing the measles here. It’s those not as affluent folks, who, evidently, have more disposable income than critical thinking skills. Evidently? Yes: they chose against vaccinating their children, and they drove the family up the road to spend at least a day at Disneyland, for cryin’ out loud!

As for #93: none of the currently reported cases reside in Issa’s district. Rancho Bernardo (last 3 cases) is in Scott Peters’ (52nd); La Mesa (the ones in the middle) is the 53d, and El Cajon (the first two) could be either the 53 d or 51st. Issa isn’t the problem. The problem is we’ve had more a decade’s worth of parents taken in by anti-vaccine propaganda, including what Dr Bob Sears sells through his book.

We don't have to worry about Darell Issa; he's no longer the Chairman of the House Oversight Committee. This session of Congress now has Congressman Jason Chaffetz as the Chairman.

Bill Posey is supposed to be Hooker's point man in Congress and the Congressman who is supposed to set up the next farcical autism hearing.

Oh, sh¡t, if I may. I've got family in two of these places:

none of the currently reported cases reside in Issa’s district.

But the Sears family wooporia are in Issa's district, as is the Bolen jerk's camper in the woods.

Rancho Bernardo (last 3 cases) is in Scott Peters’ (52nd);

A grandson, his wife and baby daughter live in RB; a granddaughter (expecting), her husband and two boys live in Escondido, just up I-15 from RB.

La Mesa (the ones in the middle) is the 53d,

None in La Mesa.

and El Cajon (the first two) could be either the 53 d or 51st.

Daughter, her husband, and three of her kids live just outside of El Cajon. One of the granddaughters there goes to Naturopathy school, as if things weren't bad enough; her father is a staunch religious-right anti-vaxer (they know of my disapproval of their anti-vax religion, although I haven't been very loud about it).

By Bill Price (not verified) on 23 Jan 2015 #permalink

This session of Congress now has Congressman Jason Chaffetz as the Chairman.

And Chaffetz represents the district I live in now, which also tells you that Orrin Hatch is one of the local senators.

No, I didn't vote for Issa, Chaffetz, or Hatch; but what's one vote among all the goofballs in these respective constituencies...

By Bill Price (not verified) on 23 Jan 2015 #permalink

As far as all the snark and sarcasm goes, this site has the biggest collection of pro-vax assholes I have ever seen. rude, nasty, snarky sarcastic

Mea culpa. But at least when I'm plagiarising cut-and-pasting someone else's words, I make some effort to acknowledge the source.

By herr doktor bimler (not verified) on 23 Jan 2015 #permalink

Well, now 5 cases of measles in Arizona, all traceable to the Disney outbreak. Just grrrrreeat....

Also, I would like to apologize for likening Dr. Robert Sears to the"nasty, dripping urethral discharge from the fecal-covered phallus that is anti- vaccinationism" (post #8). This comparison was an unfair insult to dripping phalluses everywhere.

By Chris Hickie (not verified) on 23 Jan 2015 #permalink

Toto,

The GATES TOILET COMPANY has a nice ring to it…..

Are you suggesting that the Gates Foundation should provide toilets for those in developing countries that don't have them? They already do, as well as providing vaccines, these three projects to provide sanitation in developing countries for example. I doubt you have been anywhere that open defecation is practiced, or even seen open sewers. I think sneering at a foundation that has donated over $30 billion to projects that have a real effect on people's lives is despicable.

By Krebiozen (not verified) on 24 Jan 2015 #permalink

If this happened to SEAT BELTS, then VACCINES can’t be far behind!
YESSSSSSS!

The Bruesewitz and Williamson decisions were handed down on consecutive days, dipshіt.

@justthestats, oh, Jay Gordon is pro-Sickle Cell. It seems to me that he "thinks" (for want of a better word) that that's the *right* kind of population response to disease. This is further down in the same comment section I linked to before:

Are you familiar with the connection between the sickle cell and malaria. I know, I know, not a great analogy, but an example of where a “bad” medical condition turns out to be beneficial.

Little insane doggie ignores the hundreds of millions of dollars in grant to develop and distribute personal and community sanitation devices, like dry toilets and water recyclers....

It's almost like little doggie is living in the isolation wing of an asylum....

I doubt surviving rather than dying from measles selects for anything but resistance to measles; if we wipe out measles, that is very unlikely to be a relevant trait.

More than that, Jay Gordon sees the measles as beneficial because it may kill off the "weak" for the benefit of the "strong". Puttiing aside the horrifying callousness of this attitude, weak and strong in this case are relevant *only to the measles*.

It is entirely possible that measles, like malaria, would select for traits that are harmful when considered in any context other than surviving the disease. Perhaps uncontrolled measles would select for less robust ("strong" to Jay Gordon) individuals because more bodily resources would go into fighting disease. Or perhaps it would select for an aversion to crowds, reducing the chances of contracting the disease. Or perhaps for more mucus in the lungs to impede the attack of the disease. 

Or maybe it would just select for not being gullible enough to listen to the likes of Jay Gordon and Robert Sears.

FWIW, TOTO LTD. is a major manufacturer of toilets founded in 1917. Their stock is traded on the Tokyo, Nagoya, and Fukuoka exchanges.

By Mephistopheles… (not verified) on 24 Jan 2015 #permalink

@MOB - can't ignore the obvious response....

No wonder he's full of sh@t....

@sadmar:

I'm very familiar with Rep. Issa, having written about him and his antiscoience stances many times, e.g.:

http://scienceblogs.com/insolence/2013/09/18/the-antivaccine-movement-t…

http://scienceblogs.com/insolence/2009/07/28/senator-tom-harkins-and-re…

You're behind the times, though. Issa no longer chairs the House Committee on Oversight and Government Reform. Rep. Jason Chaffetz (R-UT) does. He's in the pocket of the supplement industry; so that'll be an improvement...not:

http://scienceblogs.com/insolence/2015/01/12/the-health-freedom-legisla…

http://scienceblogs.com/insolence/2011/06/22/orrin-hatch-the-supplement…

I fully expect him to use his committee chair to drag FDA officials in front of his committee to "investigate" the FDA's "overreach" with respect to supplement regulation.

Believe it or not, someone** actually thinks that it's quite possible that what we call 'measles' in these so-called epidemics is not REALLY measles at all.

Most of those cases are not lab-confirmed so they can be nearly anything that causes red spots. Perhaps there is no real epidemic at all. Or no cases of measles at all. Maybe it's all in their vaccine-addled minds ( he doesn't say that YET).

Yes, AoA never fails us even on a weekend.

** John Stone @ AoA

By Denice Walter (not verified) on 24 Jan 2015 #permalink

"When we stop listening to each other..."

Dear Dr. Bob.

I've never started listening to you, you sanctimonious twit.

@ Darwy:

Right. He makes it sound as if it were negotiation for a divorce not science contra uban folklore.

By Denice Walter (not verified) on 24 Jan 2015 #permalink

That should be URBAN

By Denice Walter (not verified) on 24 Jan 2015 #permalink

"Jay Gordon sees the measles as beneficial because it may kill off the “weak” for the benefit of the “strong”"

Such views are, unfortunately, not unique among alties and their enablers. There is a considerable strain of sympathy for the worst aspects of eugenics, or at least an overweening sense of personal superiority that emerges repeatedly.

For example, there are the people who feel they have marvelously strong immune systems* because of their lifestyle/supplement consumption, and look down on the weaklings who think they need vaccines and drugs to prevent or control infections. They never get cancer (or readily cure themselves of it) thanks to their positive mind powers. To paraphrase F. Scott Fitzgerald, the very alternative are not like you and me.

*curiously, these fantastically revved-up altie immune systems never turn on their owners by causing autoimmune disorders.

By Dangerous Bacon (not verified) on 24 Jan 2015 #permalink

Chris Hickie

Well, now 5 cases of measles in Arizona, all traceable to the Disney outbreak. Just grrrrreeat…

Link please?
The LA Times (whose count is ahead of the state of CA) only lists AZ with one case.

Four new (unvaccinated) cases in Arizona from the Disneyland outbreak:

http://www.kpho.com/story/27927793/4-new-cases-of-measles-in-arizona-ke…

"This is a case where a family that has decided to not vaccinate their children are experiencing the consequences of that decision in a very real way" Public Health Director Tom Schryer said.

Here's the fifth Disneyland-linked measles case in AZ:

http://www.kpho.com/story/27914434/az-woman-tests-positive-for-measles-…

@ Chemmomo #83
I read your comments, which reminded me San Diego was affected, not just the OC. I was last in SD city about 5 years ago, last in La Jolla about 15 years ago. I mentioned the illegal camps because:
1) The presence of large populations of poor people with poor nutrition and poor medical service belies Sears et al.s notion that measles is no big whoop – these are innocent people likely to so suffer greatly if the outbreaks reach into their communities.
2. The appalling mistreatment and exploitation of these folks speaks to the general right-wing nature of this area.
I did not at all suggest the migrants are bringing VPDs in to infect the nice white people. I meant it the other way around. How' bout I apologize for lack of clarity if you apologize for making assumptions (that I think would have been cleared up if you'd read the posts and picked up the context.)

@ Orac #117
I had put "Darrel Issa" in the RI search box and read everything here about him. In the end, I did not link your older posts because:
1) They attributed the 2012 hearing to Dan Burton, not Issa. But as near as I can figure Issa had indeed taken the torch, it was his show, and he was being bankrolled by Gary Kompothecras, who I assume lead him to Hooker.
2) They're too kind to Issa, suggesting he's not really on the anti-vax wagon, was just conning the Canaries for the cash. When the 2013 hearing was cancelled, you called it, "the only good decision Darrell Issa has made about science" and, "There’s nothing like letting the antivaccine fringe speak out freely to reveal even to Darrell Issa that they are complete and total cranks." Issa doesn't make decisions about science, he makes decisions about politics that have consequences for science. As you have pointed out, the Canaries are anti-vax 'pragmatists', not 'true believers' such as Hooker/Jake/Bolen. Jake may have partially right in suggesting Jennifer Larson's $40K contribution to Issa was partly to keep him away from the true believers, and secure his support of the 'pragmatist' agenda. In Issa-world, the Canaries ARE a 'pragmatic interest group' not a 'crank fringe'.
3) I wanted to note Larson and Kompothecras continued to contribute to Issa's campaign chest even after the VICP hearing was cancelled.
. . . . . . . . .
The primary purpose of #94 was exactly as stated: Issa's history of associations with anti-vaxers can serve as a metonymy to remind non-Californians that:
1) That VPD outbreaks correlate to conservative political districts.
2) Anti-vax discourse is intimately tied to conservative ideology.
3) The political figures pushing the anti-vax message are overwhelmingly on the right.
. . . . . . . .
Issa is no longer chair of Oversight and Government Reform, and no longer even on the Committee because he was term limited by Congressional rules. Thus, every donation he has received was given to him in the knowledge he would be gone from that post at the end of 2014.

He's now on Foreign Affairs, replacing his OGR assignment, where he will undoubtedly shout 'Benghazi!" at every opportunity. He's continuing his assignment on Judiciary, where he's now been promoted to Chair of the Subcommittee on Courts, Intellectual Property, and the Internet. He gets big campaign contributions from Google, Microsoft and other Big Tech. I'm fairly confident he'll continue to pay back his debt to the Canaries, though that may take the form of back-room manipulations we will not see covered in the news. I had found a short video clip of his introductory remarks to the 2012 hearing posted to a CNN community page by an anonymous user I'm guessing to be Tim Bolen due the fact Bolen seems to consistently mis-spell Issa's first name 'Darrel'. My guess is further that Bolen posted this in order to be able to reference Issa's praise of Brain Hooker in those remarks as part of some screed about how the Canaries and Issa have betrayed Hooker. But what caught my ear was the last line of Issa's statement: "Our goal is to know more. Today is but a down payment on that."

They attributed the 2012 hearing to Dan Burton, not Issa

No, not really. I did, however, point out that he had re-emerged in early 2012 promoting the vaccine-autism link and that he was retiring after that term. Given his history on the topic and his relative closeness to Issa, it was not unreasonable to think that he had something to do with getting Issa to agree to that disastrous November 2012 hearing, particularly in light of his sponsorship of his sponsorship of H.R. 3489: White House Conference on Autism Act of 2011:

http://leftbrainrightbrain.co.uk/2012/04/25/congressman-dan-burton-it-i…

The dude wanted a conference. He didn't get it at the White House. He did get a congressional hearing, or, as I put it, a last antivaccine hurrah for the former chair and respected long time member of the committee.

I also stand by my conclusion that Issa is probably not antivax. Unlike Burton, before he took the Canary Party's cash and agreed to do the 2012 hearing, he had shown no antivaccine proclivities of which I was aware. More importantly, he hasn't shown any obvious antivaccine proclivities since. I do rather suspect he is sympathetic, as many right wingers are, to the antivaccine arguments about "freedom," but I stand by my assertion that he is not really antivaccine himself. Certainly you have presented no evidence to support the contention that Issa is antivaccine. That is in marked contrast to Dan Burton, about whose antivaccine views I could easily present copious amounts of evidence. Issa is really, really bad on science, particularly AGW and his desire to control politically detested science at the NIH and NSF, but I haven't found any good evidence he's antivax. And I've looked. You could change my mind if you provided evidence of Issa being antivax, but you didn't.

You also have to remember that the Canary Party has tried to position itself as being more than just about vaccines, but rather about "toxins" in the environment, big pharma, etc., hence the entire name for the group in the first place (the canary in the coal mine).

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.

Are Jay Gordon's patients aware that their doctor supports letting sick people and weaklings die for the overall benefit of the species?

By herr doktor bimler (not verified) on 24 Jan 2015 #permalink

@ Chemmomo--Brian gave some good links, but here is where I got my info from: http://www.azcentral.com/story/news/local/pinal/2015/01/23/measles-outb…

Most telling (and nicely put by the Public Health Director for Pinal County: The family had chosen to opt out of vaccinations and, according to Public Health Director Tom Schryer, they are "experiencing the consequences of that decision in a very real way."

By Chris Hickie (not verified) on 24 Jan 2015 #permalink

I would not wish measles on any child. Is there a chance that the parents got it too? One can only hope.

EBMOD wrote:

A big part of learning skepticism and science is to learn to look at the evidence alone when making decisions. Don’t let any perceived tone get in the way. I think there are times what such tone is absolutely warranted. Skeptics and real scientists are people too. We get offended, we get angry...

A few months back we had some ignoramus who was as unethical as one can get. We pointed this out to the guy, and he was left unfazed. He then started lashing out calling us all ignorant and ‘afraid of the truth.’ I have no issue railing on people like that.

I think that if growing up, more people were checked when they say stupid stuff, we wouldn’t have a generation of adults who think that the fact their opinion exists is all the justification necessary for such a belief. If you say something dangerous and stupid, it should be denigrated as such. I think people have to put on their big boy pants when discussing issues such as this and not let their delicate sensibilities get so offended by snark, dark humor and disdain for the ever present stupid people among us…

EB: I understand this as an argument directed at someone who is tone-trolling though sympathetic to the skeptic position on the science. I.e. you're asking an ally to put on the big boy pants.

However, as your own example in the 2nd paragraph shows, railing against the 'stupid' DOES NOT WORK as a check on people who "think the fact their opinion exists is all the justification necessary for such a belief."

The shouting is not 'my opinion', but the consensus of scholars who have been studying persuasion since several centuries B.C. Now the guy with the wacko vax study idea on SBM may have been a stupid and solipsistic crank. And most of the trolls who show up here appear to be lost in space, but the core group of pseudo-science true believers are neither 'stupid' in general nor lacking in things THEY think provide proper external justifications for their beliefs.

I had the misfortune of landing at the anti-vax forum mothering.com after Googling 'Disneyland measles'. Normally I avoid such sites like the plague as they're so depressing. I read through the Disneyland threads because I saw a consonance between the comments and Dr. Bob's rhetoric.

Basically, I was looking to cut-and-paste bits from this crank-forum to attempt to show just how dog-whistle Dr. Bob's posts are — especially on the whole libertarian/personal-parental-rights/freedom-of-choice/anti-goverment blah blah blah angle — by recreating his post out of the mothering snippets. I hope y'all will just believe me when I say I could have done so pretty easily, as I don't actually want to do it.

But as I read through the thread, some posters from sbm pro-vaxers showed up to 'debate' the anti-vaxers. Some observations on the 'conversation':
1) The AVs ('scuse me "transparancy advocates" :-/) are well aware of the general sbm critique of their position, to the point where they can recap it in dismissive parody:

measles is super-duper safe and not vaccinating is putting everyone at risk, you are foolish and misguided, living in a cluster, influenced by celebrities and google scholars - did I miss anything?

The PVs can't bring up anything the AVs haven't heard before, and the AVs have their defenses all lined up: counter-arguments, counter-citations, anecdotes, philosophies... They remain absolutely undented.
2) Tone matters to them. They feel they have done more than enough 'research' and put in more than enough thought that they deserve respect. Their 'mom' identities include a self-definition as both reasonable and more-or-less nice and polite, so any snark is taken is unwarranted condescension and instant delegitimation of any critical comments.
3) The PVs try to minimize or eliminate combative snark in their posts initially as the specific topics shift around, but wind up getting sarcastic in their replies at some point, and things just go downhill from there.
4) Every instance of snark produces a 'how dare you smirk at a loving mother!' response that shows the tone has the opposite effect of 'checking' any 'stupid stuff'. Rather, it reconfirms the AV's' feelings of moral superiority and higher rationality, only hardening their positions.
5) Though the AVs statements may appear 'stupid' from an sbm POV, that is simply not the AVs perspective, and from where they sit, they're the smart ones, and the criticisms are stupid.
6) The POV of this group is AVs is not so much alt-med or 'anti-science' as 'complementary', which is to say they are sort of intellectual bricoleurs who form their world-view by picking and choosing between different snippets of science, 'common sense', spirituality, yada yada yada. Some kind of 're-mix' is how most people view most things — intellectual purists or any sort are the exception in society, and generally on the margins. The is not produced by a 'golden mean' fallacy, though such fallacies will get hauled out in defense when folks are confronted with their ideological inconsistencies. For example, even one of the PVs seems to a bit granola-crunchy on stuff not related to vaccines and VPDs, and there's little if any 'crank magnetism' on display among the AVs.
7) Per (6) above, on the specific questions of a proper response to the Disneyland outbreak, a number of the AVs concede points to the PVs on the basis of sound medical practice, relevant statistics and research about measles, etc.
[Anyone masochistic enough to want to check the thread for details can find it at: http://tinyurl.com/knzz4qp]

In terms of the 'different paradigms' thing I noted above (5 & 6), I was struck by sig of PV commenter and Paul Offit fan 'teacozy';

“The good thing about science is that it's true whether or not you believe in it.” ~ Neil deGrasse Tyson

as it struck me how totally unpersuasive that is to the non-scientist, and also how philosophically unsophisticated, or even naive. Any intellectual position winds up depending on first principles it can't go outside for validation, which gives a leg up to anti-empiricists, as their first principles work better as 'just so' stories. I can toss the premise of Tyson's claim under the bus with seven letters: 'prove it'. I'm not saying there's no possible path out from under that bus, but it's a rare scientist who can do better than a tautological 'science proves that science is true' begging the question...

I shall have to addess at some other time what persuasion scholars and practitioners know about what DOES work to get people to change beliefs and attitudes, as it's a lengthy 'splainer, even by my standards...

@ Orac #126
I certainly wouldn't doubt Burton had some influence on Issa, but Issa's in it for Issa, and he wouldn't have done all the work on prepping the 2012 hearing just to act as a proxy for Burton.
"He hasn’t shown any obvious antivaccine proclivities since [2012]"... except for doing all the prep work on the VICP hearing you covered in two previous posts before cancelling it at the last minute when he realized he couldn't get a suitable scapegoat to appear.

Burton does seem like a true believer, but I reference my #57 above.

I stand by my assertion that Issa is not really antivaccine himself. Certainly you have presented no evidence to support the contention that Issa is antivaccine.

I completely reject the relevance of your first sentence. What Darrell Issa, human being, believes in his heart-of-hearts has nothing to do with it. E.g. a significant majority of historians have concluded that Joseph McCarthy was not, "himself" a rabid anti-communist, and he almost certainly did not believe there was the level of conspiracy in the State Department he claimed. He was, first and foremost, an opportunist making a power grab by calculated red-baiting. As was Richard Nixon. As was Roy Kohn. As was Robert Kennedy.

Politicians lie every time they open their mouths. What comes out is always some form of channeling larger social forces — including those represented by the people giving them money. You will never find Darrell Issa, human being, in the news. You will only find 'Darrell Issa', discursive construct. I have offered enough evidence (and there's more in your previous posts) that 'Darrell Issa' functions as an anti-vax proponent.

I just erased a bunch a couple additional paragraphs beginning responses to other assertions in #126. But the playing field is rigged. You write a sentence, I need a paragraph at minimum to present a half-adequate rebuttal, and then I'll just get grief for being verbose. So I'll just make two simple summary comments:

1) Framing politics as stemming from what any individual actor actually believes is just all kinds of 'stupid'.
2) The whole business about Issa is just nit-picking that deflects from the argument I was making, in which I referenced Issa as an illustrative metonymy. I'd take more time if anyone provided commentary pertinent to the point, but you didn't.

@LW:

His antivax pal Jay Gordon has claimed that human beings have lived for millions of years in symbiosis with measles (which diverged from rinderpest less than a thousand years ago)

The problem with the 11th/12th century dating by Furuse et al. is that it conflicts with al-Judari wa al-Hasbah, which was written in 910 C.E.

I would be happy to smile and make peace if I could choose the vaccine schedule of Israel, 1/3 the vaccines, better child mortality and 1/7 the autism rate…

Typical anti-vaxx ignorance of epidemiology.

You left out "and how to count."

The problem with the 11th/12th century dating by Furuse et al. is that it conflicts with al-Judari wa al-Hasbah, which was written in 910 C.E.

I stand corrected. I am reasonably certain, though open to correction, that Jay Gordon is off by at least two orders of magnitude in claiming that measles has been around for "millions of years". My excuse for this statement is that I would interpret the plural as indicating at least two million years and, to the best of my understanding, though of course I am no expert in any field whatsoever, the existing evidence suggests that measles has been around for less than 20,000 years, hence less than 1/100 of the time stated by Jay Gordon. But, again, I have no expertise in this matter so I will leave correcting Jay Gordon's fantasies to you in the future.  

But, again, I have no expertise in this matter so I will leave correcting Jay Gordon’s fantasies to you in the future.

Please, no. The only issue was "less than a thousand years ago." These guys tweaked the calculation and found a divergence time that was even further off from what appears to be a solid reckoning point in the historical timeline.

And, as they note,

"Humans had to live in close proximity to RPV, which became commonplace only after the domestication of cattle over the last 10,000 years (Perkins 1969, Loftus et al. 1994, Beja-Pereira et al. 2006) and 2) humans needed societies with a population size above 250,000–500,000 to sustain the epidemic, which did not exist until about 5,000 years ago (Black 1966)."

sadmar @125

How’ bout I apologize for lack of clarity if you apologize for making assumptions (that I think would have been cleared up if you’d read the posts and picked up the context.)

Your apology is accepted. However, I’m not offering one. You did not make a case for being concerned about the San Diego homeless (illegal or otherwise) in comment #85 (or anywhere else). You simply, by your own admission, reworded stuff I’ve heard repeatedly from right-wingers. And why would I want to read that?

Your comment #93 is just a rant about Darrell Issa, who is pretty much irrelevant to the discussion at this point. But while we’re on politics, would you be surprised to learn that in this area as conservative as Orange County, due mainly to the military influence, the 52nd Congressional District which includes Miramar MCAS – and yeah, some Marines do live near the base – just re-elected (OK, it was a very close race) a Democrat? Talk about making assumptions.

Again, I skim most of what you type out here because of your inability to make a point clearly.

Please let that be the take home message from our exchange.

Again, I skim most of what you type out here because of your inability to make a point clearly.

Not to mention, succinctly.

By palindrom (not verified) on 25 Jan 2015 #permalink

@ chemommo #137
Got it. You skim. You have no clue what I'm saying. You can't connect #94 to previous posts you skimmed or didn't read. Your have no reading comprehension skills. You are blind to your own logical fallacies. Take that home. You and I are done.

@ everyone else
I know there are Dems in SoCal, including Loretta Sanchez (46th) and Alan Lowenthal (47th) in the OC. I also know Sanchez is a 'Blue Dog' who succeeded Bob Dornan. If you've never heard of Dornan, use the Google. And I just checked the 52nd. UCSD, USD and two other colleges are in the 52nd. In 2014, incumbent Scott Peters (D), endorsed by the CoC and voting with John Boehner 56% of the time squeaked past challenger Carl DiMaio (R) who is openly gay and faced with no less than 3 separate charges of sexual harassment by separate accusers.

Obviously, I never claimed everyone in Orange and San Diego Counties are conservative Republicans. I observed that the area in which Bob Sears practices is overwhelmingly conservative, and not in a Christian Conservative way, but a Barry Goldwater-ish old-school conservative way that is majorly congruent with right-wing libertarianism. Anyone who doubts that that ideology holds a significant voting majority in that region can seek valid refutation if they like. They won't find it.

#94 IS about 'Dr Bob'. In #58, Orac wrote "I forgot how Orange County is a conservative bastion in southern California; but it’s true." You cannot understand the 'Dr. Bob' phenomenon apart from conservative waters in which Robert Sears swims. People who, like Orac, have not spent time out here, tend not to associate Cali South of LA with conservative ideology. They don't know where Disneyland is on the map. It's in the 46th, which was represented for 13 years by Bob Dornan. How then are RI readers in Maine or Iowa or wherever supposed to remember that 'Dr. Bob' is in the middle of a sea of conservatism, where the Democrats vote with John F-ing Boehner? They've heard Sears practices in Orange County, but that means nothing to them. They don't know Orange from Marin from Alameda from Contra Costa. But almost everyone in the U.S. who pays politics any mind has heard of Darrel Issa, because he's been the Right's designated pit bull on The Hill for years, and is a grandstanding publicity hound. Robert Sears lives where Darrell wins elections by over 48% points. That's where the vax rates are low. That's where the VPD outbreaks are happening: Darrell Issa land. Got it? Good. There will not be a formal test.

It was just frosting on the point about Dr. Bob that Issa happened to have been bought by Gary Kompothecras before staging a Congressional anti-vax witch-hunt co-scripted by Brain Hooker, and received a big bonus afterward from Jennifer Larson (and as a retainer for future services.)

If the anti-vaxers had given him nothing, and if Dan Burton had still been the OGR grilling the public health officials with Issa just nodding along, he's still a right-wing icon and his district still straddles San Diego and Orange counties putting him right in the middle of the VPD outbreak central. The anti-vax thing made for a funny business-seminar type acronym: ABC, EDIP, GIGO, IMCIS, LSMFT... ISSA.

Fer cryin' out loud... Uff da!

Got it. You skim. You have no clue what I'm saying

If people only skim your comments, maybe you should look at the writer, not the reader, for the reason why. As I like to say, when people don't understand or can't be bothered to read you, look first within before blaming without.

I can very much understand why people skim your comments. They are long, rambling, and on occasion near incoherent. Even if there is an idea worth hearing in there, it's usually buried in self-referential verbiage and "gee, look how smart I am!" smugness. Figuring out just what you're getting at is, quite frankly, rarely worth the effort. It's why I didn't bother to respond to your last one from last night about Darrell Issa. I thought about it for a moment, and then said to myself, "Oh, screw it. It's just not worth the time and effort it would take to respond to this windbag." Then I turned on the TV.

One other thing. If the Dr. Bob phenomenon depends on the conservative politics of OC, then how do you explain Dr. Jay, who is at least as well known as Dr. Bob as far as antivaccine-friendly pediatricians go, and whose practice is ensconced nicely in Santa Monica? Or any number of antivax docs in California I could name who are not in what would be considered conservative areas of the state? As I've said many times before, antivax is the quackery that transcends political boundaries.

Unfortunately.

Right now, Hooker and his group of anti-vaxxers are pinning their hopes on Congressman Bill Posey who supposedly is assisting them to gather up "100,000 pages of documents" from various government agencies.

Posey, who is not the sharpest tool in the shed, tried to stop the re-authorization of the Autism Cares Act, which included funding for the IACC...he was unsuccessful. He also posted a commentary on The Hill which gave some of us the opportunity to describe his connections to the anti-vaccine groups:

http://thehill.com/blogs/congress-blog/healthcare/209310-fix-the-combat…

Orac, as a fellow surgical oncology-trained guy (I'm from Hopkins), let me point you to this "questionable" data source, the CDC, which shows that the number of vaccines a baby gets at 2 months went from 3 in 1995 to 6 in 2013. I have long frowned upon alarmist who say that there is something in ONE vaccine. So easy to disprove. But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician's office.

As for rambling, this entire pro vax/anti vax subject is rambling. I sure do miss Ebola.

@Steve - six vaccines, with so few antigens compared to what a baby would face on a minute by minute basis? You consider that to be a problem?

What evidence can you provide to support it?

Lawrence, try not to redirect my comment. You do see a difference between vaccination and environmental exposure, don't you? Minute by minute basis of...what? Injected live virus? Mass numbers of oral virus? Ummm...no. The reason a vaccine works is because of the immune response...or are you that much of a head in the sand type of guy? You tell me the extent of immune response to the "minute by minute exposure to antigens" that a baby has...oh yeah, not much at all compared to a vaccination...again, the whole point of the vax.

Don't be a hack. What evidence do you want me to provide? A multi-vaccinated baby developing a fever of 105 is a coincidence? It was hayfever? OK...have a great Sunday.

Steve,

the number of vaccine antigens we given babies has dropped dramatically. We are immunizing for more disease with fewer antigens. For example small pox vaccine had approx 200 antigens, whole cell pertussis had approx 3000. The current schedule will give a baby approx 150 antigens over the first year. It varies with the brand of vaccines.
Please see: https://www2.aap.org/immunization/families/overwhelm.pdf

A strep throat infection exposes the person to 25-50 antigens. Babies rarely get strep throat but I think it is a good example of vaccine antigen exposure vs everyday exposure.

While training as a pediatric resident we routinely gave acetaminophen 15-20mg q4 the day of the vaccine. Since then the CDC has recommended not giving routine antipyretics with vaccine based on evidence it may decrease the response to the vaccine. My concern with this was I would get a lot of calls about fever (which is not dangerous to the baby anyway) but I do not get them. So either fever post vaccine is rare or it is not upsetting to the parents.

By RCordes, DO, FAAP (not verified) on 25 Jan 2015 #permalink

"Injected live virus?"

So no one ever gets an insect bite or scraped by anything?

"Mass numbers of oral virus?"

So you never drank a beverage? Nor swallowed water while swimming? No child has ever picked something from the ground and put it into their mouth?

And no baby ever breathes the air around themselves?

Is this another manifestation of of Thingy?

Here is a study: Increasing exposure to antibody-stimulating proteins and polysaccharides in vaccines is not associated with risk of autism.

postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office.

Is there any epidemiological evidence that a signficant number of babies react this way? Especially in view of the fact that a high fever might be due to any of a number of causes?

By palindrom (not verified) on 25 Jan 2015 #permalink

This reminds me of an anecdote about my two sons. Many years ago when we were down in our newly remodeled basement the non-verbal toddler came to me and signed "baby spider."

So I went to his little brother who was just learning to crawl and swept his mouth with my finger, and out came a large and very much alive beetle!

When that child got older he had a tendency to pull chewing gum off the sidewalk to chew on himself. He did have a pretty good immune system, but that did not save him from chicken pox which was miserable on his four year old body. Also as an adult he does have seasonal allergies.

And a few months before the younger one was born his older brother had a seizure from a virus before its vaccine was available. As an adult he still has a severe speech disorder.

Yeah, I'll take the vaccines over the diseases any day. And I am hoping for a good dengue vaccine so that I can visit the place where a mosquito injected that virus into me. Getting bone break fever a second time is both quite possible, and much more likely to cause death.

Steve:

"Is postulated" by whom?

And do you have evidence that the vaccines cause a significantly different reaction from the actual live virus or bacterium other than that they are much less likely to actually cause illness? ("Other than" to save someone taking us off on a byway about my not having had smallpox symptoms.)

Steve,

But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office.

Firstly, far more children endured repeated high fevers in the pre-vaccine era. A single bout of measles, that more than 90% of children suffered, caused a far more extreme immune reaction than the vaccines given on any given day, and was far more likely to cause a fever of greater than 105 degrees.

Secondly, do you have any evidence that a high fever causes "destruction of brain cells"? I don't believe that is true. Even if it were true, vaccination would be a good way of preventing it.

By Krebiozen (not verified) on 25 Jan 2015 #permalink

God, it's like a cult. Sorry for stirring things up. I've now read everything from utilitarianism arguments to denial that elevated temps cause brain damage...all because you believe I threaten the pro vax. I was talking about what can happen, not "should we vaccinate." Keep an open mind...oh sorry, the cult.

I mean, really? Do I have to go the whole "fever, anorexia causes dehydration...can cause hypoglycemia in toddlers..." or do i have to go to the cellular level? Nothing will satisfy you cultist close minded freaks, so keep pasting in your non-definitive and inapplicable links. You win.

Sorry Steve...you made several statements that appear to be lifted from the anti-vaccine playbook...without any citations to back up those statements.

Are you certain you're an oncology-surgical trained guy?

Why do you explain to us how fevers (which overwhelmingly are low grade fevers), associated with a vaccine are worse than the fevers associated with actually contracting a vaccine-preventable-disease?

Do go to the cellular level, Steve.

"Are you certain you’re an oncology-surgical trained guy?"

Why would you doubt that? Isn't Russell Blaylock a "neurosurgery trained guy"?

I would however like to see evidence regarding the risk of two month old children and toddlers getting brain damage from fevers induced by routine immunizations. Sorry, we "cultist close minded freaks" prefer facts to non-definitive and inapplicable claims.

Even from the allegedly Hopkins-trained.

By Dangerous Bacon (not verified) on 25 Jan 2015 #permalink

@Steve

So your saying you'd rather your child get any or all of the 6 (or more) diseases the vaccines prevented against rather than having one fever? Or are you saying you'd rather get the shots one at a time and take the chance of developing a fever (or other, rarer, side effects) 6 times rather than once? The odds of any given side effect occurring after getting 6 shots at once is not 6 times that of getting one shot because, as Lawrence said, the number of antigens is a drop in the bucket compared to what you're exposed to every day. Of course vaccines are designed to provoke an immune response - but its not, at least initially, the antigens themselves that the immune system reacts to. That's why subunit vaccines need adjuvants: to get the immune system to sit up and take notice of the antigens (killed or live-attenuated vaccines are self-adjuvating b/c whole pathogens have pathogen-associated molecular patterns that the immune system recognizes.) That initial response (its called the "innate" response) is what causes the fever, and its not affected by the number of antigens delivered - that's the point of Lawrence's comment, not that vaccines don't provoke an immune response at all.

Contrary to anti-vax propaganda, the CDC does study the effects of giving multiple shots together. If you're interested in how the CDC determines the vaccine schedule every year, I suggest you visit the Advisory Committee on Immunization Practices website.

Orac, as a fellow surgical oncology-trained guy (I’m from Hopkins), let me point you to this “questionable” data source, the CDC, which shows that the number of vaccines a baby gets at 2 months went from 3 in 1995 to 6 in 2013. I have long frowned upon alarmist who say that there is something in ONE vaccine. So easy to disprove. But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office.

If you really are surgical oncology-trained at Hopkins, then it would appear that Hopkins, whatever institution you did your general surgery residency at, and your medical school have all failed you when it comes to teaching you science and critical thinking skills. Do you actually still practice as a surgical oncologist? I hope not.

Do go to the cellular level, Steve.

Yes, I'm in the mood for some yucks. This ought to be entertaining, albeit embarrassing to me as a fellow surgical oncologist if Steve really is a surgical oncologist like myself.

Not to pile onto Steve, but either he's a new parent with a morbid fear of febrile seizures or just unaware. Yes, Steve, we do know that *extremely* high fevers can cause brain damage. We are also quite aware that those are very rare in infants, and even rarer after immunizations. Certainly, any child who develops a high fever after an immunization needs to see their doctor, and have future immunizations carefully discussed - delayed or not given. But really. Brain Damage? Fearmongering much?

I'm reminded of the Simpson's character Lionel Hutz, who at one point describes himself as a "law-talking guy".

By palindrom (not verified) on 25 Jan 2015 #permalink

Steve: "God, it’s like a cult."

Sure, it's a cult, one where the main rule is if you make a claim you need to provide the evidence to support your claim. So I responded with two papers, and several questions.

All of which you ignored.

"Nothing will satisfy you cultist close minded freaks, "

Except that is exactly what you provided us: absolutely nothing. What will satisfy us is actual verifiable data. Just provide the PubMed indexed studies by reputable qualified researchers that a child is in more danger of high fever from any vaccine on the present American pediatric schedule, versus getting a disease.

Re: dr johnson's #135 link to MAM having a sad. The article links to a petition(at https://www.change.org/p/u-s-house-of-representatives-stop-allowing-the…) for dog's sake. When I looked, I saw just over 2K signatures, many with comments, mostly in the "freedumbz" category.

Anyone inclined to do so may flag the petition as inappropriate, and may leave a (unfortunately non-public) comment explaining why.

But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells

"Postulated"? Me, I prefer to postulate leprechauns and unicorns, they're more fun.

By herr doktor bimler (not verified) on 25 Jan 2015 #permalink

I stopped reading after I finally found one person saying that "although rare, extremely high fevers...." so thank God someone on here has rational thought. The rest of you, who challenge my medical background, training under Cameron...you remind me of the legions of Lance Armstrong supporters. "He's the most tested athlete in history...no way you are correct that he doped."

Be happy in your smugness...but why the spittle-flying attacks on me? Why the anger. All I said is that occasionally a kid gets messed up in a temporal relationship to a bunch of vaccines. You all have it figured out...I mean, it never happens. And if it does, it's better for that kid than if he suffered from "real" measles...and if not, then hey, it's better for society. No really, I get it, all of you who took my comments out of context, angrily challenged my credentials while apparently yours are authentic.

And Chris, my burden is not to do a PubMed search for your contortion of what I said. You want me to search for "reputable" and "qualified" researchers (and I'm sure that doesn't mean peer-reviewed to you, it just is your subjective determination of those adjectives, of showing a "child is in danger of high fever from a vaccine....versus getting a disease."

Who ever said that? Me? No, I did not. I never made the comparison...YOU all did. All I said was "it does suck that the occasional kid goes down in flames after getting six vaccines are given in one visit to the pediatrician." I find no PubMed articles that state that it does NOT suck, do you all?

I'm not a new father...my child (fully vaccinated)...is 21 years old. Why not move on from the personal attacks and get back to the mutual admiration club that is the commentary section to this site? You all have it figured out. Oh, and I didn't train at Hopkins, I'm really just a local barber who gets on a website like this and plays surgeon with an overreactive and vindictively smug bunch of "real scientists." Damn you all are the best and you got me!

Oh, and Orac, I don't really care if I'm an embarrassment to your "field" of surg-onc...hiding out in breast cancer at [redacted], after crapping on Greenfield with your smug MD/PhD apologist analysis...we just know how your breast specialty has bullet proof research over the years, now don't we?

I leave your site now and apologize for disturbing the nest of chicks that feed off of the musings of Dr. Napoleon Complex and his bankrupt third-tier academia (hat tip to [redacted]).

Oh, but since "Chris" has been the loudest guy in the room...one last tip: if you are going to cite papers that show I am "wrong," try not to cite to the Pediatrics paper that is not about what I said (in some kids, immune response is over the top) but is about parental worries that the immune system is not strong enough/overwhelmed. One of your articles (Pediatrics) even summarizes...

"Current studies do not support the hypothesis that
multiple vaccines overwhelm, weaken, or “use up”
the immune system. On the contrary, young infants
have an enormous capacity to respond to multiple
vaccines, as well as to the many other challenges
present in the environment."

Yes indeed, an enormous capacity. Thanks.

If you are going to block my comments responding to the personal attacks on me (including from you), then I would expect you will move on and block further such attacks on me. I don't really know why this cite of yours is so emotional. not really "scientific" or professional to be calling me out as a fake, Dr. G.

Of course, I've made no personal attacks, simply expressed dismay at the rather ignorant things you've been saying about vaccines. Actually, it was the bit about the "cult" that made me decide not to give you the benefit of the doubt.

I am, however, glad to know from your remark about Dr. Greenfield that you've read my stuff before. If you have read my stuff before, you'd also know that I admire Dr. Greenfield and was profoundly disappointed at what he wrote.

http://scienceblogs.com/insolence/2011/04/19/cluelessness-and-sexism-in…
http://scienceblogs.com/insolence/2011/04/25/dr-greenfield-digs-himself…

@Chris Thanks, I hadn't seen the post yet. On FB, there's also https://www.facebook.com/ModernMainstreamMama?fref=ts attempting direct counter-education toward the MAM audience.

Am I alone in thinking our friend from Hopkins is likely to be a drive-by? Although I'm also looking forward to the yucks. Based on commentary at Medscape articles on the flu and measles, I'm also prepared to be surprised, though disappointed, if Steve's backstory turns out to be in the least bit credible. Gives me a sinking feeling in the pit of my tum to see not only the number of comments, but the uprates. . .

In other news, an exchange with a liberal vaccine refuser on dKos recently resulted in a public change of mind on her part. I'm stunned, but delighted.

I am fascinated by, and struggling with my own reactions/responses when I encounter what I regard as counterfactual anti-science online, especially in context of something so near my heart: public health. It's all too easy to rip out bon mots, thinking that ridicule is earned, but what does that do, really, save to provide temporary personal relief*? This article http://www.medicaldaily.com/node/318334 , which I think I stubled onto via a link at VoicesForVaccines or ShotOfPrevention, gave me a lot to digest on the topic.

*An argument may also be made that snark is necessary to preserve sanity, mine at least. Not to mention that tone is completely irrelevant to evidence, although difficult to extract from rhetoric.

I leave your site now

Shortest flounce ever.

By herr doktor bimler (not verified) on 25 Jan 2015 #permalink

He'll be back. Surgeons, even, I suspect, surgeons who've become lawyers, love to have the last word.

Of course, when you come barreling into a new comment thread spouting talking points from antivaccine websites and bragging about being a Hopkins-trained surgical oncologist, you shouldn't be surprised if people don't...react well.

But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells

When you postulate something, you make a post out of you and... no, wait, this isn't going to work.

By herr doktor bimler (not verified) on 25 Jan 2015 #permalink

@hdb Beat me to it. Flounce would've been my 2nd hypothesis.

I should clarify, perhaps, the nature of the commentary at Medscape is wootastic, largely but not completely from "other healthcare provider."

And lest we hope for a sea change in crunchy-granola land, it's worth pointing out that even among the pro-immunization commenters at dKos, the amount of misinformation was mind numbing. Within the same time period, there was also an anti-fluoridation article posted & withdrawn, leaving a useful and informative comments section. Zombie lies really live forever.

Orac: "A lawyer now, eh?"

Funny, I would think a lawyer would know better than to argue with unsupported postulations. Though he seems to have skipped to blatant assertion and random insults.

Never a winning combination.

Steve: Take a look at your comments which were lacking in substance, insulting and accusatory. You presented absolutely no proof for your postulate (lifted straight out of the anti-vaccine playbook) about the Recommended Childhood Vaccine Schedule being "too many and/or too soon" and you have presented no citations from PubMed which prove that vaccines "kill off brain cells".

You also need to tell us why you believe the very occasional high fever experienced by a child following vaccination(s) is worse than the high fevers experienced by every youngster who contracts a vaccine-preventable-disease.

BTW Steve, while frightening for parents to watch, a febrile fever does not "kill off brain cells" and does not cause lasting neurological deficits.

I've got the 1995 childhood vaccine schedule and the current childhood vaccine schedule for you to compare and for you to tell us which vaccines you deem unnecessary to be given at two months of age:

http://www.cdc.gov/mmwr/preview/mmwrhtml/00035471.htm

http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-schedule…

My last word, guys: if you pride yourselves on "flouncing" by turning a rather benign comment about the occasional kid going bad around a series of vaccines into a personal attack on me, complete with changing my first name into a full name and providing links to my law firm, hey, that's a flouncing. Not really an "exchange of ideas."...so why would I keep coming back for more, "Herr Docktor?" I'm embarassed for the immaturity...you all are supposed to be our best and brightest scientists?

And as for the "oh, he's a LAWYER." Give me a call when you need some advice. No charge. And for the record, not one lawsuit from our firm has ever been, or will ever be, about an alleged vaccine related incident. That's not why I showed up here. I actually came to the site to read about the flu vaccine...I liked that write up...then I hit here and honestly had no idea that this site was founded on crushing anti-vax people.

I am flattered that I had to be "outed" b/c generally that just reveals that I was pissing someone off. But honestly, Herr Doktor, do you expect me to stand in a circle of ad hominem's and keep taking it?

If you cannot figure out that my initial comment was not anti-vax, then just go ahead and pour on the science and ignite. But "flouncing" someone personal attack and providing information that no other commenter has posted (full name etc.)...not so much. Bush league and reveals vindictiveness. I hope your patients don't trust you to keep their information off the web.

Steve (added emphasis): "Pediatrics paper that is not about what I said (in some kids, immune response is over the top) but is about parental worries that the immune system is not strong enough/overwhelmed."

That tactic is called "moving the goalposts." What you originally said was the very inelegant: " the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines."

First you never gave what percentage of babies experience this after vaccines, plus you never provided the source of this unknown statistic. Also missing was the comparative risk of a baby getting the vaccine versus actually getting Hib, measles, rotavirus, influenza, pertussis, etc.

Steve,

I did not change your first name to your full name. Seriously. I did not. Here's the way things work here, functionally. If a new commenter posts, his first comment goes to automatic moderation. Once I approve it, that commenter can post freely, subject to some minor filters, such as for profanity or too many links. That happened with you. I approved your first post, and, I trust, you had no problem posting after that.

Then something happened.

After your first few posts, I noticed a post by you with your full name stuck in moderation. (Yes, that change was enough to trigger the "first time poster" automatic moderation filter.) So I approved it, figuring that's the way you wanted things now. You must have done it, because I did not. Moreover, you did it for more than one post. So don't blame me. Once YOU had posted using your first and last name, and I had let it out of moderation, I did a quick search with your name, surgical oncology, and Hopkins, and it became obvious who you were.

I rather suspect you must have some sort of autofill thing going on in your browser.

I did not "out" you. You "outed" yourself by posting your full name. As regulars around here know, I'm rather sensitive about "outing" anyone using a pseudonym or just a first name and would never have done so if you hadn't posted your full name.

If you like, I could go back and remove your last name from those three or so posts and then delete my comment.

Steve needs to check the definition of the world "flounce," as he doesn't seem to know what it means.

Chris:
I moved the goalposts? You came out swinging with your "crushing" literature and all I did was point out that 1 of your 2 "crushers" merely asuaged fears of "overwhelming" THE CHILD's immune response which had nothing to do with my statement that "isn't it harder to disprove a child's OVERWHELMING IMMUNE RESPONSE as the source of the rare messed up kid when you give six in one day?

Not "right out of the playbook" just a question. Reread my first post: I said it is easy to quell the ALARMISTs about a single vaccine but it is "more difficult to disprove...." to me? Nah, I'm fine. To others? Show them the data...and you failed. Maybe others here did not, but you did.

Why do I need to do a comparative risk? I never argued that kids should not get vaccines. Show me one time? All I ever said was "how do you disprove that the occasional kid gets cooked?" That's a question that ALL OF YOU should be working on: it needs a simple answer and not a "who cares, she'll be cooked if she doesn't get vaccinated" or a "who cares, other kids will die" utilitarian argument.

Way more power to you if you just disproved that the occasional kid getting cooked can ever be associated with multi vax. I'd be your biggest fan: I'm surrounded by plenty of laypeople calling me for...yes...either med or legal advice...that I would love to swat down since it's a loser discussion to say "we don't know, but it doesn't matter."

is that "inelegant" enough for you?

As for fever...yawn. Go to CDC, what I would call the base level of information since not all fevers by far are reported to the pediatrician or the ped to the gubment, but even the CDC has 105 as a known reaction in 1/16,000 for e.g. DTaP. I don't know how one could separate out the 105's in a multi-vax visit into one vax, but there's one.

No, I do not think that we should stop vaccinating. I do think that if a parent is gonzo anxious over vaccines, it wouldn't be the worst thing in the world to spread out the early schedule's 6 in one day deal...is that so wrong? Adapting to your patient? Can I have my ped friends forward the 2 am calls from frantic parents b/c dammit we MUST give 6 in one day.

All of you have mistaken me for an antivax guy. I'm really a guy who wants to have definitive data on a question that may never be answered: what are the date re: immune response in the rare kid who goes down temporally related to multivax? You tell me so I can tell others.

Don't bait and switch with the Horrible of Horribles argument: bbbbbut if we don't vaccinate, hellfire missiles will strike. Try convincing an irrational patient with that.

Surgical Oncology-Trained Guy: " Nothing will satisfy you cultist close minded freaks"

Surgical Oncology-Trained Guy: "why the spittle-flying attacks on me? Why the anger...Why not move on from the personal attacks"

Shades of Jay Gordon and you're-a-bunch-of-pharma-shills-and-why-can't-we-all-just-get-along. ;)

By Dangerous Bacon (not verified) on 25 Jan 2015 #permalink

Lawrence: you've been away for a bit. Sorry, but to me the "flounce" here was all the anger and personal attacks directed at me for apparently stirring up a hornet's nest regarding vaccines. It was this crowd that became annoyed and irritated with me. Sorry if I don't follow Urban Dictionary and sorry if I am not wise to the coolio online slang [hides head in shame that he's still on the computer talking to the very pale].

That all came later, Bacon, after I was told that I was fake.

Surgery guy makes comment about disproving fringe science theories.
Surgery guy gets attacked.
Surgery guy fires back.
Surgery guy is accused of not being a surgeon; other personal attacks
Surgery guy outted as also being a "lawyer" by site owner, and full name published by same.
Surgery guy says "why all the personal attacks"

Bacon says "ha ha ha, Surgery guy attacked first."

Not.

Surgery guy outted as also being a “lawyer” by site owner, and full name published by same.

More like surgery guy outed himself by posting under his full name, which the site owner approved.

Once again, no one outed you except you.

I did go back and change all instances of your real name back to just "Steve" and deleted my post with the link to you.

No, Chris, that's your...what did you say before...moving the goalposts again. Fail. Like your off-point citation.

Surgery guy provides amusement on a lazy Sunday afternoon to Orac and his minions.

Chris, I must return to the Illuminati. Good day to you, sir.

Sure, Orac. that's why every other post is my first name only.
That's OK though, since your links were not in any post of mine.
Keep up the Google stalking.
Lazy Sunday afternoon? Don't you all have critical research and patient care to do? Off with thee! Save lives!

It's not my fault if you can't seem to decide whether you want to post just under your first name or under your full name. I did what I could to make amends. If that's not enough, flounce away. I no longer care.

As for research, well, you've been a nice diversion from my working on my R01 today. All good things must come to an end, though.

hahahaha. Finally.

Steve, I want to comment about your concerns about "outing", by Orac.

Every one of the commenters who post on Respectful Insolence frequently, has seen some nasty trolls (and one pediatrician), who have attempted to "out" someone on this blog. Orac quickly removes their comments and posts a warning about "outing"...he does not tolerate that behavior on his blog; it is one of the very few instances where he will ban a commenter.

Gee...Steve liked my comment about fevers. Too bad he didn't continue to comment about it, and the point I made.

Steve - I'm glad your child(ren) are fully vaccinated. Thank you for making sure your children, and those around them are protected. Now, if you would kindly give us the pubmed reference to those high fevers, I'd be grateful.

And gee...I missed all the Steve's Full Name posts. Not that I really care. I don't google people anyway. Especially not those who have a habit of being nasty.

Steve (sorry, saying Surgery Guy gets tiresome) attempts to rewrite forum history, but fails.

Steve did not like his opinions being challenged (quite civilly and to the point, as the record shows) and instead of calm and factual rejoinders made comments like "are you that much of a head in the sand type of guy", "Don't be a hack", "God, it’s like a cult." and "you cultist close minded freaks".

And that was _before_ anyone questioned his stated credentials (it seemed reasonable to wonder, given such standards of behavior and reasoning).

It's disappointing to see typical tactics of the woo crowd (along with don't-you-have-better-things-to-do-with-your-time and the immortal "hahahaha"*) used by someone who should know better.

*usually we get only two or three "ha"s to a post here, but I supposed you're entitled to more, given your intellectual attainments.

By Dangerous Bacon (not verified) on 25 Jan 2015 #permalink

MI Dawn, I am making a delicious roasted chicken for Sunday dinner so I'm not going to get things stirred up again, but my cursory PubMed search for brain damage only showed pediatricians who cannot let things go. I never "liked" your comment about fevers. Someone else wanted a reference to 105 and vaccines and I gave one -- the vaunted CDC that you all worship no less.

But as to brain damage, yeah, errr, the CDC lists that as a rare reaction as well. http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#jeixiaro

I find that using "CTRL + F" and searching for "brain damage" will give you 3 entries on that page alone. Now admittedly the CDC says this is so rare that they cannot be sure it's the vaccine, but you are sure, aren't you? So all I've been doing in playing catchup with the overreaction to my initial comment is this: YOU give me the PubMed that backs up your being certain that brain damage is never caused by vaccines. When you find it, get the CDC to change their website, and I will also shove it in the face of the people who ask me for that level of certainty (and don't hide behind "statistical insignificance" some of your patients want a guarantee...give me that to share with them).

So that leaves, what? Temperature as a causative source of brain damage? Did I say that...hmmm...let's look:

Initial post: "But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines...."

Nope, I see "some think that the immune response to 6 vaccines in one day causes brain damage" and "among other things, the temp hits 105" but nothing on "the temp causes the brain damage." Let's look again, "the immune response...causes brain damage...."

And it's postulated. By whom? Did I say "the scientific community accepts..."? No. I want answers for those who postulate this every day: AT MINIMUM, SOME OF YOUR PATIENTS' PARENTS, at an intermediate level, by some scientists who may well have dubious credentials.

So do your own PubMed, and then let it go if you don't "really care." And since you "missed all the Steve's Full Name posts" (including links to me) then I suggest you keep the snarky commentary about that to yourself on that one. You don't have a foundation to comment.

Bacon, I love you like a brother, but really? The responses to my first post were "quite civil and to the point?" To what point?

Oh, Steve, what about antigens these kids get exposed to every second?

Oh Steve, these kids will have a far worse outcome with the actual disease.

Oh Steve, the needs of the many outweigh the needs of the few.

Those were thrown up as contortions of my simple inquiry about immune response...and sorry, but the tone was hardly civil. And yes, I felt it was a cult response because...the responses were NOT on point, but were all in alignment of attack: seemed like a mantra of everything but my point
...how do we disprove the "immune response over the top" thing?

How do we disprove immune response:

NO "well, the kid gets exposed to antigens all the time"
NO "well, the kid will suffer far less if he gets the real thing"
NO "well, 1 million sick kids with the real thing outweigh that risk"

I got as frustrated as I am now with your need to tack on the shot on my hahaha ratio and responses to...what should I call it...the typical cheerleader crowd who taunt the new girl but when she tries to leave says "oh yeah, run off now new girl"

But you keep on coming with that superiority.

OT ** but is good news in print - which I hadn't seen as yet- EVER truly OT @ RI?

From BD.com:
re Wakefield's lawsuit

QUOTE Case closed 18 December 2014 UNQUOTE

Woo hoo..

** well, maybe not entirely because it involves anti-vaccination, Texas and lawyers

By Denice Walter (not verified) on 25 Jan 2015 #permalink

Actually Steve, you were the one who came in here & made a bunch of vague pronouncements, without a single citation or even context....given the venom that the anti-vax crowd normally throws out, what else were we supposed to think?

And truly, the antigen challenge experienced by a baby who experiences even the common cold, is far and away more challenging than all of the vaccines combined that they would otherwise receive.

My son got the flu when he was three months old - so trust me, I know what high fevers can do - disease is much, much worse than the vaccines we use to prevent them.

And "flounce" isn't a word of the urban dictionary - Websters will do just fine:

http://www.merriam-webster.com/dictionary/flounce

@Steve:

All I ever said was “how do you disprove that the occasional kid gets cooked?” That’s a question that ALL OF YOU should be working on: it needs a simple answer and not a “who cares, she’ll be cooked if she doesn’t get vaccinated” or a “who cares, other kids will die” utilitarian argument.

Well, first of all, nobody can prove a negative. The onus is on you to prove that the occasional kid does get "cooked," i.e., does suffer lasting neurological harm as a result of a vaccine-induced fever.

Second, what ethical system would you suggest in lieu of utilitarianism when it comes to vaccination? Fewer deaths and permanent disabilities of children from VPD, especially with such vanishingly small risks involved, is a good thing. Which ethical system are you going by in which its not?

Actually, I agree that there are times when utiltarianism is at best insufficient for making moral choices. The choice to hide a Jew (or Jews) in your home in Nazi-occupied Poland, for instance, when getting caught would mean the deaths of you, your family, and probably everybody on your street, clearly can't be made on the basis of a risk/benefit analysis. The human experience isn't always or entirely reducible to numbers.

But when it comes to public health, utiltarianism makes a lot of sense. Less suffering, death, and permanent disability is a Very Good Thing. I'm curious as to your ethical argument against that statement.

Lawrence, here's what I got from my dictionaries:

"go or move in an exaggeratedly impatient or angry manner."
"an exaggerated action, typically intended to express one's annoyance or impatience."

Flounce isn't always connected with leaving. It is always connected with being exaggerated. As in, I still think the initial reactions to me were exaggerated, although now I know why. It's just not worth the ongoing effort trying to make me sound like a dumbass regarding verbiage.

But look, I obviously was the gadfly that landed in the wrong place today. Looking around the site, I see the same people posting on multiple entries, so yeah, sorry I'm the ugly new kid.

I think I've cleared up the substance of what I was trying to say. Apparently Bacon thinks he needs to rehash the form rather than the substance and get in the last word. So I am mocked for wanting to get in the last word by "the community" who want the last word. But see, I always lose that fight because hey, I'm the new ugly guy in the room.

The truth is that a stranger (me) blundered in here and got some people moved to the point of a biblical stoning, and yes, I fired back at "the community" and was dealt with via utter contempt and even links to me. Then it de-escalated, and now it seems to be re-escalating. It's your place...your virtual place away from home, not mine. You are regulars, not me. Now...make fun of me for your version of "flouncing"...or a simple "hahahahahaha I just want to get the $%@! out of here, so let me go"

Ugh, really, JP, are we starting all over again at 2 pm or so CST? All I said was "disprove immune caused brain damage."

I never said "don't vaccinate." NOT ONCE. While I do love a good utilitarian analysis, I never once said "don't vaccinate."

I mean, I can see the frustration if I did...but you all created that frustration by reading into what I said. Now, before a smart boy like Bacon makes fun of that ("oh, sure you backtracker"), remember, I came to this site for the first time today about a flu vaccine article that I liked. I then clicked over here...I had no idea that you all get anti-vax hacks on here all the time.

So I understand how I was misinterpreted, but you all need to acknowledge that I did not say what you claim I said.

@steve - or, you can talk the virtual ribbing for what it is, an education that was learnt by dealing with the worst anti-vaxxers in the world, and settle in and be prepared to have a lively discussion based on science and evidence.

We really aren't that harsh, if you give us a chance.

@Steve:

Well, here's your first comment, or the salient part, anyway:

I have long frowned upon alarmist who say that there is something in ONE vaccine. So easy to disprove. But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office.

So what are you saying? That all vaccines should be offered a la carte and parents should choose there own vaccination schedules? I mean, sure, that might work okay for a well-off stay-at-home mom who has the time and money to go to 6 Dr.'s appointments instead of one. But five extra afternoons off of work and five extra co-pays (or out-of-pocket visits) is not trivial for a whole lot of families. You might not have encountered poor people before, so I guess I can give you the benefit of the doubt that that just didn't occur to you.

It's much the same as people who engage in extreme fear-mongering about food - the GMOs, the pesticides, yadda yadda! I get that it's mostly directed at an affluent audience who probably isn't actually being hurt by it, but it trickles down (forgive the economic metaphor) to the less affluent among us, who then either end up shelling out money they don't have for organic, GMO-free food, or feel like they're not doing right by their children. It puts an extra burden on poor and/or working-class Americans, and it's based on falsehood. That bothers me.

Your original comment on vaccines is based on just as little evidence as the Food Babe's fearmongering. Show us that 6 vaccines at once is more dangerous than 6 separate vaccines over a longer time period. Please.

@Steve

YOU give me the PubMed that backs up your being certain that brain damage is never caused by vaccines.

If you are going to complain about people misrepresenting your comments, it would be helpful if you do not misrepresent theirs. Please point to anywhere in the comments that anyone has claimed that "brain damage is never caused by vaccines". Thanks.

Also, complaining about the insults? Please go back and re-read the comments. The first person to start throwing out insults was you, Steve. Up until that point, people questioned your premise, as you were a bit vague and your phrasing implied that you shared the belief that 6 vaccines at 2 months was too much. Perhaps you weren't aware of the history people have here of dealing with anti-vaxers who make similar pronouncements, so your ignorance on that matter can be forgiven (note, this is meant seriously, not as derision, since you seem particularly sensitive to snark).

Getting back to your original post:

Orac, as a fellow surgical oncology-trained guy (I’m from Hopkins), let me point you to this “questionable” data source, the CDC, which shows that the number of vaccines a baby gets at 2 months went from 3 in 1995 to 6 in 2013. I have long frowned upon alarmist who say that there is something in ONE vaccine. So easy to disprove. But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office.

There are some basic assumptions/premises in the "postulation":

1. The immune response to 6 vaccines at 2 months in 2013 is greater than the response to 3 vaccines at 2 months in 1995.
2. This immune response is greater than the immune response to daily antigen exposure.
3. Such a strong response is bad because it can damage the brain through 105+F fever.
4. The risk of such a fever following vaccination is greater than the risk of such a fever following natural infection with one or more of the diseases prevented by the 2-month vaccinations.

Lawrence's initial reply to you (and some of the similar responses) was not off-topic, as it covers premises 1 and 2. The total antigen load in 2013 is less than it was in 1995 and is less than the total antigen load from daily exposure.

Premise 3 is true insofar as extremely high fever carries the potential (though not the certainty) of causing brain damage. However, such a strong immune response can occur after natural infection, as well (and, indeed, natural infection can produce a much stronger immune response than vaccines). So then the question is, which is a greater risk: vaccine or natural infection? Which leads us to premise 4.

Natural infection produces a much stronger immune response than vaccination. We know this because of the symptoms/signs produced following infection that do not occur following vaccination, as well as from the fact that for some vaccines, immunity following infection is slightly longer-lasting than immunity following vaccination. The risk of getting an extremely high fever is therefore greater following infection than it is after immunization.

So to those who are afraid of extremely high fever following immunization and therefore want to space things out, I would say that the risks are greater from the diseases prevented, and spacing out the vaccines means that the child will be left vulnerable to those diseases for a longer period of time. Furthermore, whether they space the vaccines out or put them all together in the same visit, the risk of suffering an extremely high fever from the vaccines remains roughly the same, except that spacing things out means more doctor visits. There is a net increase in risk with no commensurate increase in benefit.

BTW, if you want people to start being nice to you, why not make the first move and tend to your own tone. Take a breather.

parents should choose there own vaccination schedules

Their, not there, obviously.

Steve, let me remind you; this is your comment:

".... But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office...."

Is this the type of comment one would expect from a physician?

I've provided you with references to answer your concerns and you have yet to prove to any of us that the febrile seizures associated with vaccination(s) lead to last neurological sequelae.

I replied to your comment about "too many, too soon" and you have yet to answer my question about the two month old scheduled vaccines in place, currently:

http://scienceblogs.com/insolence/2015/01/23/dr-bob-sears-perfecting-th…

You don't trust the CDC and the "gubment", yet you refer to the CDC for what you believe to be ammunition for your cause. Big fail there, Steve.

You failed to make a cogent argument for your point of view...as a physician...and as a lawyer.

Those were thrown up as contortions of my simple inquiry about immune response

Oh puh-leeze, no one's impressed with your JAQing off (unlike the word "flounce," that one is internet slang, so you might want to look it up before you try to use it in a sentence and potentialy hurt yourself.) You didn't "simply inquire" anything; your original comment was:

But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office.

You were clearly implying that receiving 6 vaccines at a time is inherently more dangerous than getting those vaccines separately, which is false for all of the reasons explained in the multiple comments you claim aren't "to the point." (oh and, pro tip: if you object to angry, "spittle-flying attacks" you might want to refrain from calling people "cultist close minded freaks.") You invoke the "irrational parents" who supposedly won't be satisfied with those explanations, but what makes them irrational? Fear stoked by people like you making unsubstantiated insinuations that vaccines are dangerous.

How do we disprove the "immune response over the top" thing?

Why would we want to disprove it? We know that it happens, its a well-quantified risk associated with vaccines and, no matter how much you pummel that straw man, no one has ever denied that.

Why do I need to do a comparative risk? I never argued that kids should not get vaccines.

You don't need to post anything at all, but if you want to start talking about the risks of vaccinating, than the rest of the commenters are entitled to point out that the risks of not vaccinating, or even of spreading out the schedule, are far greater.

As for your pathetic whining about all the snark: sarcasm is the body's natural defense against stupid.

Sarah A: "... your JAQing off (unlike the word “flounce,” that one is internet slang, so you might want to look it up before you try to use it in a sentence and potentialy hurt yourself.)"

Hence the link in my Comment #189.

@Chris - Thanks, I knew someone put it up, but I didn't want to look for it again; every time I post a comment it ends up 10 comments below the one I was responding to.

Dr. Sears has unwittingly given the perfect defense of vaccinations. Because they prevent infection from happening rather than killing an already established infection, vaccines are respectful of the lives of germs. Far from damaging these ancient and resilient beings, vaccines foster the harmonious co-existence of germs with humans. We should embrace them out of reverence for microscopic life.

By animalcule lover (not verified) on 25 Jan 2015 #permalink

Just out of curiosity...
Steve's firm's website ( which was linked earlier) notes that he , as " an 'insider' in the world of medicine gives the firm an advantage when crafting innovative claims and litigation strategies"
Lots more there.

So I wonder, Steve, why the sudden interest in vaccines?

By Denice Walter (not verified) on 25 Jan 2015 #permalink

All I said is that occasionally a kid gets messed up in a temporal relationship to a bunch of vaccines.

How very medical. And Steve wonders why he's being mocked.

By Science Mom (not verified) on 25 Jan 2015 #permalink

So I wonder, Steve, why the sudden interest in vaccines?

If his medical prowess is any indication of his legal skills then the sudden interest may be hearing about the easy payouts for legal fees in vaccine court to less-than-stellar lawyers.

By Science Mom (not verified) on 25 Jan 2015 #permalink

"Oh Steve, the needs of the many outweigh the needs of the few."

Steve, if you can show me where anyone in this thread said that to you, I will give you a kewpie doll.

It is generally considered good form in any discussion not to make up stuff and pretend your opponents said it (another example is claiming someone here said that brain damage can never occur as a vaccine reaction).

As to form triumphing over substance, it is also a classic tactical fail to ignore many substantive posts and the excellent questions they raise in order to focus on a few instances of snark.

"Show us that 6 vaccines at once is more dangerous than 6 separate vaccines over a longer time period. Please."

Yes, that'd be nice. Or will your response again fall along the lines of "Prove to me it isn't so"?*

*Any lawyer should be well acquainted with the concept of burden of proof (and the fallacy of wrongly assigning it to an opposing party), but if a refresher is needed:

http://www.nizkor.org/features/fallacies/burden-of-proof.html

By Dangerous Bacon (not verified) on 25 Jan 2015 #permalink

Sarah A:
" sarcasm is the body's natural defense against stupid"

And strange as it ay seem, those who utilise sarcasm frequently have an area of the brain that's enlarged.

At least that's what the MRI person told me.
( I'm joking! I read it in a journal. Probably true as well)

By Denice Walter (not verified) on 25 Jan 2015 #permalink

Oh look, the group raises their collective voice "get out! get out! get out!" Quite a pubescent response for a bunch of hard core scientists.

Nice to know that someone saw links to me on a site that claims an absolute ban on such behavior.

And you know, there is no "sudden interest in vaccines" and certainly as an "insider" I know enough NOT to include vaccines in some quest for $. You know nothing of the patients (and doctors) that I represent, so try to avoid defamatory stuff.

And speaking of that, there's enough recent shrill harpy activity here to make me alarmed at the ability for some of you to control emotions. Glad to give you your proverbial punching bag. Is this where I quote Dr. Greenfield about the vindictiveness, Dr. G?

Oh look, the group raises their collective voice “get out! get out! get out!” Quite a pubescent response for a bunch of hard core scientists.

You're imagining things, I'm afraid. Nobody's crying "get out" - just about everybody who's replied to you has simply posed questions. Which you have failed to answer, I'll add.

BTW, I'm not a "hard core scientist" at all. I study literature. I'm also not pubescent, though I am younger than most of the folks around here, I'd wager.

And speaking of that, there’s enough recent shrill harpy activity here to make me alarmed at the ability for some of you to control emotions.

Projection much?

Your problem as a group is the inability to recognize that I don't do your research until you do mine. WAAAHHHHH, the MD, JD isn't searching for what we say he said.

Burden of proof? On a friggin web page comment section. How weak can you be at making excuses for your smugness amongst friends. The crowd chants...outsider! Is he like we? Not stud? We cast out! And then there's s you, .smug boy, who knows details about me that I don't know about you because your fearless leader posted links and comment now taken down.
Even though, you know Steve, we NEVER out anyone on this site.

Sigh. You came here with the (implausible) hypothesis that six vaccines at once is bad and dangerous, and the implication that they should be spaced out instead, or something. You get to provide the evidence to back up your hypothesis if you want it to be taken seriously.

I'm not being mean, that's just how science works. I mean, cripes, you, a surgeon, apparently need to be informed of this by a lowly literature PhD candidate. I'd be embarrassed, myself.

That wasn't my hypothesis. You, a literature guy, should learn to read.

Actually, I know it's your hypothesis because I can bloody well read. Or what's this?

But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office.

But please, do enlighten us as to what your hypothesis, in fact, is.

Incidentally, I'm not a guy, though you could hardly call me a lady.

Mass numbers of oral virus?

Yes, attenuation can do that. Let's work the numbers for the hell of it:

From PMID 9015109, one finds ≳10¹² rotavirus VPs per gram of stool, with Dennehy (Pubmed links out to a paywall) citing PMID 6411227 for 10¹¹.

Thus endeth the tracking down of the Medscape references.

Taking these fellows (PDF) at their word, that becomes about 2 to 20 million infectious units (IU) per gram, with an infectious dose of... 10–100 IU.

Taking Rotarix for simplicity, one has no less than 10 median CCID50 per milliliter of RIX4414, which could be half-assedly* taken to represent 7 × 10 PFU = monovalent IU.** Only the Phase III trials reported both FFU (which, at this point, might as well be monovalent IU) and CCID50.

And that, folks, is the human infectious dose.

* Poisson, ln 0.5 multiplier.
** Cochrane reports Rotarix as "10[^6.5] PFU CCID50" in PMIDs 20464766 and 22336845 for "RV1 Steele 2010b-ZAF," which is PMID 20684724 and [http://www].gsk-clinicalstudyregister.com/files2/d2396f6d-7322-432b-974… (PDF). They also helpfully provide a URL in the references that is invalid HTML. The combination is apparently meaningless.
*** It turns out that the Unicode brain trust forgot a superscript period.

Anyone here claim that was my hypothesis?

"...is postulated..." makes it my own? Literature my arse.

Incidentally, I’m not a guy, though you could hardly call me a lady.

Love it.

This whole exchange is getting rather tiresome, no? It increasily appears that Dr. law-talking guy resides under a bridge.

By palindrom (not verified) on 25 Jan 2015 #permalink

^ The third footnote was left over from an earlier revision; it still applies to the first footnote.

Actually, "is postulated" is an incredibly vague and tortured passive construction. People use wording like that all the time to avoid taking responsibility for the statements they make.

But again, what is your hypothesis? Or your point?

As I am a guy, I'm going to watch a movie with my wife...I suppose you can now mock that and giggle amongst yourselves some more. Good night, oh coral reef community.

@palidrom:

I think you may be right. It might be prudent to disengage, but I do find it diverting at the moment. :)

As I am a guy, I’m going to watch a movie with my wife.

And I'm going to finish the laundry. BTW, some women have wives, and some guys don't, but most people like to watch movies. :)

You know, it's rather depressing to see which way Steve's decided to go. I had thought that perhaps I had been to hard on him, but after seeing him in action the last few hours...whoo boy.

I hate to see a fellow surgeon turn troll.

^^ Having reviewed the record, it appears that Steve might need a "tl;dr" version:

The reason that there are "mass[ive] numbers of oral virus" in Rotarix is that the wild-type virus is about 10,000 times as infectious as the attenuated* one. I've leave Rotateq as an exercise for the reader.

* That being 33 passages of wild-type 89-12 in Vero cells.

“…is postulated…” makes it my own? Literature my arse.

Postulated by whom? And why would you repeat it? Also what JP @ 232 said.

By Science Mom (not verified) on 25 Jan 2015 #permalink

@Steve

I realize my comment was a bit long, but I do hope you go back and read it. At any rate, glad that you are taking some time away from the computer to watch a movie. It may give you some time to sit and reflect on your experience here. Maybe you'll come to realize that if you want to be treated nice and with respect, you may try giving that to others. Perhaps apologize for being the first one to fling insults and admit that you were wrong to do so.

At any rate, enjoy the movie.

JP@232 -- My favorite passive construction: "Mistakes were made". Matt Groening has a wonderful cartoon with that title.

By palindrom (not verified) on 25 Jan 2015 #permalink

At least he's a topically appropriate troll. If you think about it, this interlude with Steve has essentially been a reprise of the original post: like Dr. Bob, Steve doesn't have to balls to come out and say what he thinks, so he just "passes along" antivax misinformation that "some people" think/postulate/have concerns about (not that I'm saying that - wink, wink; nudge, nudge) and then tries to play the innocent, misunderstood victim when people aren't fooled and demand he defend what he's obviously implying. And he does it all in the name of "reassuring" the poor, frightened, irrational parents, who wouldn't be frightened and irrational if it weren't for him and his ilk "just passing along" frightening misinformation in the first place.

Haha, I love that cartoon! I have a copy of it in The Big Book of Hell which is in fact sitting atop the bookshelf nearest to where I'm sitting. :) (Groening and I share an alma mater, by the way.)

Good night, oh coral reef community.

OK, if you insist. G-d help us if somebody tries to outpace evolution by developing a highly competitive yet relatively benign strain.

JP @241: "Grad School: Some People Never Learn".

By palindrom (not verified) on 25 Jan 2015 #permalink

@palindrom:

OH GOD YES. :D It's hanging on the inside of my office door.

Your problem as a group is the inability to recognize that I don’t do your research until you do mine.

That's a keeper.

Steve: 22% of the comments on this thread since lunchtime PST today. For future reference: it was about 8 hours, and just over one hundred comments.

I think he beats MJD back in 2011, and that's without having a book to plug.

Your problem as a group is the inability to recognize that I don’t do your research until you do mine.

I've already done my homework. Why don't you do your own?

I am happy to be compared to a coral reef community, personally: symbiotic organisms providing a habitat for a variety of other species, and a bit more sensitive than I would like to hot weather.

Since I'm human, all the symbiotes I have living on and in my body are smaller than I am, and I suspect none are as colorful as some of the tropical fish found in a coral reef. But if that's someone's idea of an insult, I will wear it with slightly confused pleasure.

@Denice:

Steve’s firm’s website ( which was linked earlier) notes that he , as ” an ‘insider’ in the world of medicine gives the firm an advantage when crafting innovative claims and litigation strategies”

Given what I've seen so far, Daubert doesn't seem to have sunk in too deeply. Then again, it's a "a friggin web page comment section," "smug boy."

Then again, it’s a “a friggin web page comment section,” “smug boy.”

It turns out that everyone on the Internet is male, especially if they're interested in science-y things. Even if they're named Denice.

Sarah A @ 241: Great, super great, post about Steve's sterling comments.

Steve really should e-mail Orac's blog and his own comments to his medicine colleagues and his law colleagues, so that they might critique his style and his content-free posts.

You all still postgaming it? Smug boy wasn't directed at Denise. Narad, you know dick all about Daubert from a practical and applicable manner, but think it's really about reliability (since you read that online somewhere or read the case but nothing since) and not judges as amateur scientists, and sarah...crawl back into your shinebox, don't tell me what I do re discussing vax, or chime in after I'm out to say I don't have balls. Since you engaged in the imagery, I will say that I've been waving my balls in your faces all day. Your group even compromised its no outing rule because of mere words from a guy passingly interested in vax who blundered in here. Again, go back to your group hugs and high fives, but it's a hollow victory when all you can say is your friends are still on your side.

Goodnight and more giggles to you, little ones.

BTW, did not expect The Interview to be funny, but it was.

Oh --------, super duper awesome post...slurp slurp. Pathetic.
And providing these posts to colleagues? Don't worry, it's not my credibility shot here...I entered with none and exit with none in your group. But the alleged integrity of what was here is a joke and will be addressed "with my colleagues."

Nope. "Pathetic" is just an accurate description of your behavior here.

Maybe I'll see you at the SSO.

Yeah, pathetic indeed.

Since you engaged in the imagery, I will say that I’ve been waving my balls in your faces all day.

This from a man who accuses others of behaving in a pubescent manner...

Narad, you know dіck all about Daubert from a practical and applicable manner

Leaving aside the abuse of the Mother Tongue here, Counselor, I'd be fascinated to know how you arrived at that conclusion.

Hell, what would be even better would be a list of cases in which you've been at bar and this was relevant. PACER IDs will suffice.

You all still postgaming it?

"It"? You're now invoking Been Down So Long?

Smug boy wasn’t directed at Denise.

I know, Smug Boy, but I think the coinage is a fertile one.

it’s not my credibility shot here…I entered with none and exit with none in your group

That's the first honest statement you've made since you started commenting here. As far as "chiming in after I'm out" goes, no one is taking your revolving-door flounces seriously at this point - I knew perfectly well that you were still reading the comments and that you'd be back. But since you're so eager to prove your testicular fortitude, perhaps you could answer the question I asked you way back at comment #157, when I was still acting on the assumption that you were arguing in good faith (I started writing it before you made the "cultist close minded freaks" comment, though it ended up posting after it.) Since you seem to have a hard time remembering your own words, let me remind you. You said:

But the immune reaction to 6 vaccines in and of itself is postulated to cause destruction of brain cells in, say, the percentage of babies who among other things hit 105 degrees reacting to a boatload of vaccines that just have to be shoved into them in one day at the pediatrician’s office.

Whereupon I asked:

So your saying you’d rather your child get any or all of the 6 (or more) diseases the vaccines prevented against rather than having one fever? Or are you saying you’d rather get the shots one at a time and take the chance of developing a fever (or other, rarer, side effects) 6 times rather than once?

So which is it? Or are you willing to acknowledge that the balance of the evidence is that getting multiple shots at once (at least, the ones that have been approved by the CDC to be given together) is less risky than either a) the diseases the vaccines prevent or b) getting the shots separately.

But the alleged integrity of what was here is a joke and will be addressed “with my colleagues.”

If nothing else, I've learned that Cecilia Chicken was well preceded by Garfield Goose.

palindrom: "This whole exchange is getting rather tiresome, no? It increasily appears that Dr. law-talking guy resides under a bridge"

Where the only comments he finds challenging that he then assumes are from someone who possesses a Y-chromosome. Truly pathetic.

And truly quite amusing. The question in: will he really stick the flounce this time, because Orac's minions are just toooo meeaan, and former surgeon lawyer guy can't take the evil questions!

Ooooh, they killed him with questions! Questions are the worst thing ever!!!

Good grief, how does he handle himself in front of a judge?

(Sorry, Narad, your references are getting too elusive, try to dial it back to reality... most of the folks who read this were born after the 1970s)

Sorry, Narad, your references are getting too elusive, try to dial it back to reality… most of the folks who read this were born after the 1970s

It's not my fault that there are no <appendix> tags. I'd be perfectly satisfied with an answer to the first entry.

^ And I don't expect that nobody's going to understand the comments, and they're brief, so perhaps you could skip the "tone trolling."

Steve, how can we miss you if you won't go away?
What an odd, angry person you turned out to be. So desperately invested in . . . something.

By Pareidolius (not verified) on 25 Jan 2015 #permalink

Someone who doesn't know the definition has once again proven it, by not sticking to his original "flounce."

There is a certain mentality which believes that the person who can say, and get others to believe, "THEY started it!!!" has won the argument forever and is thereafter justified in behaving as crudely and aggressively as they can.

This mentality is actually rather rare after high school. The majority of people, whether they ever think it out consciously or not, realize that someone who enthusiastically PERPETUATES a state of hostility is just as responsible for that state, if not more, than whoever originated it.

Steve has had plenty of calm, wholly non-insulting comments to reply to. Todd W.'s at 209 is only one notable example. From what I can see, Steve has ignored all of them, choosing instead to reply to a construction mostly of his own imagination, a "cult" that cries "Get out!" because it can't deal with his questions ... a "cult" that would never have produced those calm responses to his questions, those responses which he appears to have entirely overlooked.

On the issue of the purported "outing", which as far as I can see the only complaint of Steve's which is founded on objective basis... a perfectly reasonable explanation has already been offered, namely, that his computer misbehaved and filled in the name field with his full name. Since it's been less than half a year since we experienced a bug here that resulted in many people seeing the name field filled in with other people's names (I cannot link the example I looked up, for reasons of my computer misbehaving ironically enough, but it's rather easy to find with a Google search on "name field") that explanation seems quite plausible.

The idea that the alternative explanation, "Orac found the comments of a first-time commenter, saying pretty much nothing that hasn't been said before, so utterly threatening that he used information available only to him as the moderator to do detective work and ascertain that first-time commenter's identity, then tamper with that commenter's comments to make it cleverly look like he'd revealed himself, only to willingly remove all that information again at the commenter's request", is more plausible, you basically need to be coming at the issue with a massive bias: "Deliberate, deceptive and malicious behavior on Side A is far more probable than that the computer or its user on Side B could have made a simple mistake."

I would advise Steve to look up "principle of charity" and contemplate how it applies to his decisions of what to respond to here, and how. Of course, if he declines to believe that that principle applies to a discussion, when that discussion takes place in a "web page comment section" - as he seems to have previously asserted about the burden of proof - then I'm afraid it will be very obvious why Steve's participation is not receiving a good reception. One doesn't get much respect by swaggering onto a soccer field and declaring "All right, I'm better than all of you, and I'm gonna prove it, but I'm not gonna follow that sissy rule about not touching the ball with your hands", after all.

By Antaeus Feldspar (not verified) on 26 Jan 2015 #permalink

And yet you now anonymously swagger in to your group of friends and say "I know what did not happen?" You missed links to me posted by the site moderator, now deleted. And yes, he can change the name appearing...he did so.

This only exemplifies that the minions are sure, without foundation, of their own narrative. Yet I'm guilty of the same and must be ridiculed?

@Steve

If you bothered to take the time to do a bit of research, you'd find that "outing" people is something that Orac takes very seriously. He's even censured some of the regulars and removed their comments when they have outed people in the past, even though he disagreed with the person who was being outed.

Apparently, taking time away didn't help you cool down and reassess this comment exchange from a calmer, more rational point of view. I'm sorry you are having such difficulty with this.

Never be hasty to attribute to stupidity what can be adequately explained by someone knowing something you don't.

Double-check your own work, if you can. If you're going to be calling someone else wrong, it's a good idea to triple-check to make sure that you are in fact right. If you have the bad judgement to be snotty about calling someone else wrong, have the good judgement to quadruple-check.

If you have the basic desire to act ethically in the first place, then you have to take second place in line to a whole lot of other people out there who can do a lot better of a job twisting your good intentions into bad deeds than you can. To be hoist by one's own petard is not necessarily the easiest or most common way to go, only the one with the most irony.

Beware of approaching a problem by trying to find its identifying characteristics. What is truly needed, and what should be the goal of your search, is distinguishing characteristics.

@Steve

I think you got Hanlon's Razor a bit mixed up. I believe it goes:

Never attribute to malice that which is adequately explained by stupidity.

Todd, first off, the hits keep coming "in the time off," yet you ignore that...I mean friendlies right?

Second, the fact that Orac takes outing seriously blah blah doesn't make me a liar any more than "I never raped anyone before" makes one innocent of rape. In this case, these vaunted rules were broken...apparently for the first time...and I don't think my comments came close to the screed I've read elsewhere from any "opponent" of this gruopthink.

So rather than "lessons learned on all accounts" the drum beats on...against me.

But right, I'm the bad guy.

Todd, yet I'm quoting Antaeus Feldspar, by literal cut and paste, which was the point, not what AF has "not quite got right" himself, which includes yesterday's history

The first place I see the word "stupidity" is in your comment, so it seems you're working with a different definition of "cut and paste" than I'm used to.

Now, do you care to respond to my comment at #209? It may help clarify this whole back-and-forth that's been going on.

It would be nice if Steve, in plain language, would explain what his original intent was, other than just coming in & clutching at pearls....

What an odd, angry person you turned out to be. So desperately invested in . . . something.

Indeed. It's just that he won't tell us what it is.

In any case, if he's this easily provoked in the comments of a blog, which most of this blog's readers don't read intensively, if at all, and concludes we're all "cultish" from just some criticism, the dude has a seriously thin skin.

Also, on the topic of "outing", what evidence do you have, Steve, that Orac was responsible and that it was not simply a mistake on your part? Furthermore, what motive would Orac have to out you, considering you haven't said anything particularly compelling or threatening to Orac.

But please answer that after you've addressed my comment at #209.

And yet you now anonymously swagger in to your group of friends and say “I know what did not happen?” You missed links to me posted by the site moderator, now deleted. And yes, he can change the name appearing…he did so.

Yes, to correct your mistake. There were three comments you made that included your full name. After it became clear that you hadn't intended to post under your full name, I changed them back to just "Steve." The server logs will show this to be true, if you still won't believe me. Contrary to your insinuation, I did not (and do not lie) about this.

One of two things happened. Either you have some sort of autofill going on that automatically put your full name in and you didn't catch it (which is quite possible), or you yourself put your full name in. I don't know which happened, but I fixed it.

Alright, I DO have an idea about what type of clients Steve's firm represents because the ( now forbidden but highlighted on my computer) website discusses them. In truth, it says NOTHING about "vaccine injury'- which is, -btw- a frequent topic at anti-vaccine sites, and it does discuss several types of very serious problems that patients may develop.

HOWEVER Steve ( @ 142) himself brings up ( in the same sentence) " immune reaction to 6 vaccines" and " destruction of brain cells".

We know that many anti-vaccine parents attempt legal suits because they believe that their children have been injured by vaccines which affects their brains- often citing Blaylock.

Is it any great leap of my imagination to think that there may be possibility that Steve and/ or his colleagues COULD represent/ have represented people who believe in vaccine injury?

Later on, he says he doesn't if I read him correctly.

By Denice Walter (not verified) on 26 Jan 2015 #permalink

which AFFECT their brains

By Denice Walter (not verified) on 26 Jan 2015 #permalink

Orac, you ignore the links that you put in previous and now deleted posts. We can go the autofill route with full name if that matters, but putting in links and an "aha!" that was all you. There are a great many Stephen B____ [full name] out there, but the links were direct to THIS Stephen B, and I appreciated that you pulled them. But for others to come on here now and rewrite history is just a silly waste of time.

Said differently: I don't know how many Dr G's there are out there, but a Google shows you (and I know this from your own internal link...you aren't hiding a thing), an OB doc, a researcher at UT in Austin, and others. But I do know that a link to any of those person's bio sites removes the remaining anonymity...what do we call that to be semantically correct for all here? The "Final Outing?"

I've moved past this except for the reconstructionists coming in late. I appreciated what you did and still are doing. Let me respond below to Lawrence and get to work.

Todd W., what Steve is doing is going back to my long-ago unused Wikipedia user page and copying-and-pasting what he finds there.

If I apply the principle of charity to that action, the most reasonable explanation I can find for what that has to do with anything is that Steve is essentially protesting "Even if I have provided you with enough information about myself that you can easily find more about me from elsewhere on the web, it is unfair for you to do so." This would be more reasonable than what previously seemed to be his position, in which he seemed to be insisting that it could only be through unjust means that his full name was revealed to us.

Contrary to his assertion, I did not miss the fact that his full name appeared yesterday, or that additional information about him was turned up by those who thought he had voluntarily revealed that full name, and combined that with what he DEFINITELY volunteered of his own free will about his training.

I simply didn't think there was anything improper about it. Of course, part of why I have that view is because of previous experiences here, where doing a modicum of research of someone who shows up to comment often turns up information which they should clearly have disclosed themselves, if they were participating in good faith. The most notorious example that comes to mind is "Emily", who wrote of the obvious merits of the Natural Hygiene philosophy saying that it was just something she'd come to appreciate as the mother of a variable number of children; it was detective work which revealed that "she" was in fact Dr. Greg Fitzgerald, who purveys "Natural Hygiene" as part of his alternative medicine practice. Similarly, I recall a few people who came in insisting that their opinions on whether vaccines could cause shaken baby syndrome or whether Brian Deer would be found to have defamed Andrew Wakefield were particularly trustworthy opinions because they were complete newcomers to the debate ... and detective work demonstrated that they had in fact chosen their sides long ago.

I'm not sure what Steve thinks he's demonstrating by showing that I once edited Wikipedia. He wouldn't be the first person to invoke my Involvement with Wikipedia here; he wouldn't even be the first person to do so assuming that "participated on Wikipedia" would be taken as "sign of something bad", if that was his intent.

----

Upon reviewing, I find that I was mistaken in what I wrote above. Steve is clearly NOT asserting merely that it's unjust to do detective work on facts that have already been revealed; he IS asserting positively that Orac deliberately, deceptively and maliciously ascertained his last name and altered Steve's comments to include it. "yes, he can change the name appearing…he did so." Inherent in concluding this to be the case is the presumption that neither Steve, nor his computer, could possibly have made a mistake.

Even if I knew neither of the parties in this incident, I think that I would tend to look skeptically upon "I could not POSSIBLY have made a mistake, and therefore it must be him not only doing something vicious and sneaky but doing so in the most dishonest manner possible, because he perceives me as just that much of a threat!!"

By Antaeus Feldspar (not verified) on 26 Jan 2015 #permalink

Lawrence, Denice, and really all:

Lawrence, your comment that maybe I should reveal my intent struck me as an excellent one. Then I read Denice's comment akin to "you can see why we would think you, lawyer, would..." and it's like a "oh, so that's the snowball effect." I have posted before about my side of what happened. That was ridiculed, particularly by Sarah, as "oh yeah right, you are as passive voice dangerous as [insert "Dr." Antivax Loudmouth here]...you really are another [insert "Dr." Antivax Dickhead" here. So let me give you some backstory in addition to what I already posted re: what went down yesterday.

1. At brother-in-laws for breakfast. BIL is coughing like a cat with multiple hairballs and feeling like crap. I asked if he and the kids got the flu shot. He said no.
2. Me being me, I launched in about him being an idiot, now the kids will get sick, WTF?
3. BIL says "in your face, the flu shot doesn't work this year, and I saved my kids the exposure and risk"
4. I ask "what risk other than at most feeling a little off for a few days"
5. BIL says "immune response...kids got over 6 shots in one day as far back as first few months of age...it's BS."
6. Me being me, I think "that is horse___ it's at most three in one day"...but more importantly drive home at 90 mph and get on the internet to search for "flu vaccine did not work this year" [i'm actually better at Google than typing in that]
7. I read a few articles and then one from this site. I liked the article...said that yesterday.
8. I blundered over to this Dr. Bob Sears entry as it was new. I read it and was like "holy crap" and then, and this is important...
9. Identified myself as a fellow surg onc guy to Orac and thought I was asking him a question: WHAT DO I STUFF IN THE PIEHOLE OF MY BIL ABOUT VACCINES AND IMMUNE RESPONSE, because when I look up the schedules I will be damned it is 6 in one day now as opposed to when my son was vaccinated. I want to be thorough in putting this shite to bed.
10. A bunch of pseudonyms respond...I have no idea that they are credentialed to address the question...and I asked Orac...but in any event the pseudo's respond with "show us the research about 6 in one day" and "utilitarianism" and "kids will be sicker if not vaccinated."
11. I feel attacked by what I believe are a non-credentialed cult -groupthink response -- don't give me a good answer to stuff in BIL's face about immune response/brain damage/cooked babies/105 etc....whatever he was ranting about and I re-ranted for him... just deflect onto other tangents like "the other babies will be at risk." Trust me, BIL gives two shites about other kids.
12. Me being me, I have to be obnoxious in swatting what I perceive are flies away from my prize answer: "Orac, you are the anti-anti-vax lecturer...let me know about this immune response argument." So I say "away, cult!" WTF is with that answer, groupie. Admittedly callous (as an understatement).
13. When I'm asked "show me the studies backing up YOUR hypothesis" I react internally as such: "MY hypothesis, Jesus H. C., I came on here for help in crushing that hypothesis...YOU GUYS SHOW ME."
14. I'm outted as a "lawyer" who "may be sniffing around to sue vax companies" which really pisses me off as that "lawyer" card is thrown in my face a lot to NEGATE ANY SCIENTIFIC INQUIRY I ever have..."what, you need to know for a LAWSUIT?" Uh, no. I need to know because before Harvard Law School (they apparently let anyone in), I went to Duke, U of Michigan Med School, and Johns Hopkins for my residency and fellowship. Yeah, believe it or not, in addition to suing the occasional drug-addled doc, or the nurses who left a first time mom alone in a room for over two hours, at 25 weeks GA, with twins, "intermittent abdominal pain" (i.e. preterm labor), and vaginal discharge, until she bled and now we have two premies --- in addition to suing that sort of thing, and suing over "insider" based novel claims (such a claim is not "vax causes brain damage" a claim is still negligence or product liability...a novel claim is "negligence per se for violating the nurse practices act and injecting Lovenox into a post spinal tap patient while admitting under oath that you have no idea it's a blood thinner...patient now paralzyed due to epidural hematoma as you then waited 12 hours to call the doctor..." whew but I digress.
15. A feeding frenzy ensues, and me being me, and as Orac says, a surgeon who has to have the last word, I keep plugging along, and I get more and more callous and base (but so do you guys).
16. My least favorite entry was my balls in your face, but you know that was after being told I had no balls.
17. I did start sensing, and participating in, a downward spiral of insults that I found oddly enjoyable (and don't tell me that you all were angrily typing and not laughing, too).

So my intent, Lawrence? My intent was to ask the Big Guy how to stuff my BIL. Looking back, I should have said "how do I stuff my BIL" and I guess risk Sarah saying "waiiiiiit a minute, you are the cloaked ANTIVAX SATAN" but I nevertheless wish I had been more clear. And more clear that I was not antivax...but I tried.

As best as a fellow arrogant science guy/gal can try.

Now, lest you jump me for some internet maneuver I have not heard of called "the Big MISUNDERSTANDING" let me end with this: now that you all know the backstory, regardless of your experiences with true quacks I am not one, and perhaps the feeling of misunderstanding can be mutual.

Enjoy your Mondays. I never do but will try.

Steve

Antaeus...just let it go, it's not worth it. No need to justify things.

@Antaeus Feldspar

Even if I knew neither of the parties in this incident, I think that I would tend to look skeptically upon “I could not POSSIBLY have made a mistake, and therefore it must be him not only doing something vicious and sneaky but doing so in the most dishonest manner possible, because he perceives me as just that much of a threat!!”

If your assessment of him is correct, then it also speaks to an inflated sense of self-worth.

@Todd W and Antaeus Feldspar:

Yeah, I was just going to say the incident smacks of megalomania.

I really don't care what type of client Steve represents. I care that he came on here with major issues and looking for a fight. That, and the phrasing of his fact-free comments, his massive distrust of "gubment" and the CDC, led me to believe that Steve was not a physician.

I still don't know how a physician could be so ignorant about any topic in the medical field...even if he doesn't represent clients before the United States Court of Federal Claims (Vaccine Court).

His directive to other commenters to do his research for him is preposterous.

Nothing that Steve has posted since then is impressive.

Orac, you ignore the links that you put in previous and now deleted posts. We can go the autofill route with full name if that matters, but putting in links and an "aha!" that was all you. There are a great many Stephen B____ [full name] out there, but the links were direct to THIS Stephen B, and I appreciated that you pulled them. But for others to come on here now and rewrite history is just a silly waste of time.

Said differently: I don't know how many Dr. Gorski's there are out there, but a Google shows you (and I know this from your own internal link...you aren't hiding a thing), an OB doc, a researcher at UT in Austin, and others. But I do know that a link to any of those person's bio sites removes the remaining anonymity...what do we call that to be semantically correct for all here? The "Final Outing?"

I've moved past this except for the reconstructionists coming in late. I appreciated what you did and still are doing. Let me respond below to Lawrence and get to work.

Dr. G, I don't really care about the links ongoing discussion...it's counterproductive. I did send in a rather large missive describing yesterday in an effort to get this all put to rest.

A rather large and non-confrontational missive is apparently awaiting moderation, lilady. I don't mistrust the CDC and government...I quoted the CDC as a basis for my comments more than anyone. That's because I have to deal with a brother in law who reads into the CDS website (e.g. brain damage); and no, I came here looking for a way to stuff him, not advocate for him, which is why i was doing the asking in the first place.

You know, I find it rather ironic that Steve was chastising me for spending time on my blog on a "lazy Sunday afternoon," dismissing me by asking if I had some patients to save or some important research work to do, but here it is a Monday morning and he seems to have boatloads of time to write 1000+ word comments. Good thing Monday isn't one of my OR days...

Oh rats...lilady, please see 286 above. And I'm sorry for getting caught up in my own misunderstanding of who is actually commenting on here (all of you are very smart).

I know...law is a lot slower than medicine.

@Steve

Thank you for providing the backstory at #286. There is information there that you finally provided that, had you included it from the beginning, may have saved a lot of the heated rhetoric flying back and forth. Certainly, if you had provided some of that information when people made reasonable, insult-free comments responding to you, rather than breaking out the "hack", "cult" and "freak" comments, things would have gone differently.

I think my comment to you at #209 addresses the situation, as do a few of the other comments here.

Note that I just removed Steve's last name from two posts again because I don't know whether his posting under his full name was intentional or not.

Certainly, if you had provided some of that information when people made reasonable, insult-free comments responding to you, rather than breaking out the “hack”, “cult” and “freak” comments, things would have gone differently.

Indeed, it started with Steve's first response to anyone, which he dismissively concluded with, "Don't be a hack." The very next comment by him included the "cult" comment. And Steve wonders why it took so little time for regular commenters to react very badly to him.

Well, at least he thinks we're smart.

By Denice Walter (not verified) on 26 Jan 2015 #permalink

@Orac - either you missed 292 and 293, or that's another Steve...(I did refresh the screen before saying this to make sure!)

awrence :"It would be nice if Steve, in plain language, would explain what his original intent was"

I don't think I've ever seen so many flounces in one thread before .... three and still counting...and still he comes back firing popcorn from all barrels.

Steve: "Your problem as a group is the inability to recognize that I don’t do your research until you do mine."
I just wonder if, despite his protestations, whether he's got an interest in some related litigation, and he's just hoping to shake out a reference he can use.

By Peter Dugdale (not verified) on 26 Jan 2015 #permalink

@Peter Dugdale

I'm willing to give him the benefit of the doubt with post #286. And even if he were involved in litigation, I doubt he'd get any reference that would benefit an anti-vaccine case from this group, seeing as how legitimate science doesn't support any anti-vaccine claims.

A bunch of pseudonyms respond…I have no idea that they are credentialed to address the question…

And you presume that before you posted with your full name, the credentials that random "Steve" claimed were supposed to have been taken on faith?

^ Argh, blockquote fail.

Peter, I don't know who you are, but asking for a reference to "six shots in one day is not anything worse than spreading them out...or no shots at all" hardly would assist me in any litigation regarding vaccinations. In fact, it would do the opposite.

Again, I'm just looking for a counter "in your face" to a BIL who thinks he knows better.

I already have the CDC saying this:
"A number of studies have been conducted to examine the effects of giving various combinations of vaccines simultaneously. These studies have shown that the recommended vaccines are as effective in combination as they are individually, and that such combinations carry no greater risk for adverse side effects. "

But of course, I get the "show me the studies" response.

I haven't found those studies readily available. I'm obviously not a vaccine expert, and you all know that when I search for "multiple vaccines are safe" the first X hits are all conspiracy theorists. Looking for "multiple vaccines safe study" I got this:

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

which is a great summary that I air dropped in multiple leaflet form over my BIL's house.

But I was just being obsessive...imagine that. All I was asking was "hey, you all know this stuff, can you tell me to what the CDC is referring re: studies ?

When I've looked to the CDC before for, say, how long does a broken hip put you at risk for earlier death, a simple Google "CDC hip fracture" takes you, first result link to a CDC page with this:

One out of five hip fracture patients dies within a year of their injury. [footnote 9]. Footnote 9 is a Swedish study that actually shows the risk of earlier death after a hip fracture may last up to 6 years in some.

But references for multiple vaccines are not on the CDC page.

There's nothing shady going on. And it's OK...I'm mindful that I pushed my research onto strangers and came off like the haughty "you don't even comprehend what I am thinking, you fools!" which was wrong.

Do you need a solemn pledge that I have never, am not, and will never, represent a vax case, and that I am not an anti-vax stooge? That's an easy "I swear" to make.

Your own Angst-producing Nonsensical Guffaws

Narad, your comment about my last name being needed (and links to my web page) to identify me first before accepting my credentials is odd to me seeing how I have accepted all of the posters on this comment board without more than vague references to specialty or "lot in life."

But I can see how it is not odd to all of you to question newbies because you are apparently used to posers coming in here and doing dirty work.

I already have the CDC saying this:
“A number of studies have been conducted to examine the effects of giving various combinations of vaccines simultaneously...."

I haven’t found those studies readily available

If the question is combining vaccines, the first G—le result I get for "safety of combinations of vaccines" is this JID paper.

Click on the plus sign by "PubMed," click on "Pubmed citation," and look at the "Related citations." There's a reason the phrase "a number of studies" was used.

Now that you're there, try searching for, say, concurrent administration of vaccines, and examine "Titles with your search terms."

Once again, the advice of Mr. Natural is apropos.

Thanks Chris and Narad. The "good link" DeStefano article that Chris sent works and the paper is excellent. Narad's JID paper...I'm holding back from BIL as it has buzzwords he will key in on, even in the abstract. But the related citations are great.

In any event, I'm sorry for being lazy about finding citations...I thought I'd get a quick answer before I drove off the cliff. Then I became obstinate in not doing it...wasted all of our time (and a huge part of Sunday) when I should have just searched on my own.

As for Mr. Natural's advice: he says a lot of good and/or funny stuff. I hope you weren't thinking of one that isn't "idiot" oriented.

Thanks again.

"weren't thinking of one that IS [not isn't]“idiot” oriented"

@Steve - glad to have you back from the brink (who knew you could drive off the cliff & still find a way to recover? Kudos!!!)

You can also try "concomitant" in the search terms, which will pull in this sort of stuff, etc.

The Mr. Natural was one I mentioned recently, "At home or at work, get the right tool for the job." It's been a while since I've used Lexis or Westlaw, but Pubmed is a far less nightmarish interface than I recall from those two.

It becomes more useful if you sign up for a free account, which adds the ability to save custom filters and create sharable collections of papers.

Ah, but when you cite the JPeds or the Oxford articles, what you get back is "Tainted! The authors work for the CDC and/or the FDA!"

Other than taping all of these papers into a very large club, weighting it with a bag or so of lead shot, and using it to whack anti-vaxxers over the head with, I'm not sure what impact they have on the debate.

To make matters worse, deStafano et al thanked Dr Offit for his help.

All good. And Narad, Westlaw is a huge pain. We get it free here since I and the senior partner edit the Texas caselaw update book every year (published by Westlaw). But even with the relatively new "natural language" search method, Westlaw is a pain.

I admittedly lost my PubMed expertise a while back since, as hard as it may be to master, Westlaw just has a ton of fun stuff (if "fun" is "reading how judges threaded a needle on what was thought to be a done deal in law").

But PubMed and medical research...thanks, Mr. Natural!

Love the club idea. I won't tell him that the some say "tainted, authors work for the CDC or FDA" he's not smart enough to figure that out on his own. And after his idiocy and my personality disorder combined to ruin a Sunday, I'll just stick with papers without disclosing author employment. That would be UGH.

I, for one, am glad that Steve has clarified his position. I think Steve will find that the RI Regulars who post here are very knowledgeable about vaccines, and all the other topics that Orac tackles.

*Yawn*

What did I miss?

Ren@321:

Six diseases vaccinated against with one injection are not appreciably different than the one worst shot, or getting six separately. It may be hard to convince some people of this.

Steve - I'm mildly surprised that you're so concerned about my opinion, but since you are then I will state for the record that I'm perfectly willing to take your word for it that you're not asserting that getting 6 vaccines at once carries a greater risk than getting them separately, or getting the diseases they prevent instead. After all, it would have been a waste of time for me to ask you (twice) to answer that very question if I wasn't going to believe your answer. I'm not going to apologize for comparing you to Dr. Bob Sears, because it was justified based on your behavior at the time. I do, however, apologize for using the phrase "he doesn't have the balls" instead of "he doesn't have the guts/courage of his convictions," since it seems (again, to my mild surprise) that you found this particular phrase uniquely offensive compared to all of the other comments making more or less the same point. I'm not always good at judging the level of vernacular appropriate to a given situation: a result of lack of socialization and positive reinforcement (IRL I'm a short, rather baby-faced young woman, so people typically just laugh when I use bad language.) I'm glad the conversation is back on track; I don't think I have much to add to what others have already posted other than my original comment at #157, except to recommend that you let go of the idea of using studies to "shove in [your BIL's] piehole" or "in his face." At this point I don't think you need me or anyone else to tell you that that isn't likely to change anyone's mind.

Well, glad things have been cleared up.

I'm keeping "smug boy," though.

@Sarah A:

As another baby faced young woman, I can relate. I'm also sort of burly, though, and I shave my head and wear combat boots and usually all black. So mostly I just confuse people.

IRL I actually tend to swear more around people who are offended by it, I guess because I find the attitude parochial and stupid. (Also, people who actually find swearing "immoral" typically have pi$$-poor moral compasses when it comes to things that actually matter, I've found.)

Well, I should have known better about the initial response from BIL. So I email him the DeStefano article and a few more. And I get this (exact quote but caps are my emphasis):

"Well, as a LAWYER I'm sure you just picked out the papers supporting your position."

So I said I'm "give him more" and thought of the club made of dozens of articles suggested by Shay #317. Here is a pic of my office staff working on it (OK, not really but it's all I could find):

https://www.google.com/search?q=paper+club&espv=2&biw=2133&bih=1205&sou…

Bob's missive today on Facebook

DR. BOB'S DAILY:
THE STORY THAT WON'T GO AWAY, BUT AT LEAST IT'S NOW ACCURATE
I know, I know. You're all tired of hearing about measles. But I wanted to throw out this story since it came out where I live in the OC Register. Many bloggers, tweeters, and reporters have been misrepresenting my ideas on this, and I was at first leery about communicating with the Register too. But this reporter nailed it. Sure, this story doesn't cover ALL my thoughts on the matter, and it doesn't discuss all the possible pros and cons of the vaccine, but it's the first story that I've seen that at least presents part of both sides and accurately reports my statements and ideas on the matter. So, I won't expand on it. Enjoy! And send her some love on the Register's page on the story.

On a related note, Cheryl is planning to hit Disneyland on Friday with Joshua, since he doesn't have school and we have two free passes. So, she asks me, "Do you think it's now safe to go?" Ya, she did ask me that. I was like, "You're one of THOSE people?" But then she looked at me squarely and said, "Don't just give me your quick answer like you always do when I ask you a medical question about a family member. Stop and think seriously - do you think any of the employees there could be part of the next wave and possibly spread it?" She's the best mom, and wife, and she's so right - I usually blow off medical questions about my own kids and don't consider them seriously. I deserved that. So, I stopped and thought. Yes, that could happen. But you should go anyway. Respect the disease, but don't fear it, right? They are SO going. And the place is probably still deserted. Or is it? Does anybody know? Anyone been there in the last week?

Dr. Bob

In other news, somewhere around 30 children younger than 12 months are quarantined. Putting aside the risk to the babies' health, imagine the economic consequences. It is unlikely that all the families have stay-at-home parents or dedicated caregivers -- can you imagine what that is going to do the families' finances?

Sears was referring to this article in the Orange County Register, which quoted him:

Sears said he advises his patients to weigh the complications of vaccines, but ultimately leaves the choice to them.

Five percent to 10 percent of those who get the vaccine develop a low fever and a mild rash, according to the CDC. Severe side effects are so rare that public health officials say it’s difficult to tell whether they were caused by the vaccine. They include deafness, permanent brain damage and serious allergic reaction.

On his Facebook page, Sears posted recently that more pediatricians in his area have begun discriminating against parents who don’t vaccinate.

“The answer won’t be to make everyone vaccinate; neither should the answer be to allow diseases to run rampant and kill people left and right,” he posted. “The answer needs to be somewhere in the middle, and it needs to include love, understanding, and calm-headed people who will actually stop and listen to each other.”

Respecting the disease would mean take your precautions, in other words: "Vaccinate".

Steve, you probably need to be aware that as a retired Marine, my initial response to any situation is blunt force.

That doesn't mean it's the correct response.

CONSERVATIVES AND NOT CONSERVATIVES
Orac #140 asked:

If the Dr. Bob phenomenon depends on the conservative politics of OC, then how do you explain Dr. Jay, who is at least as well known as Dr. Bob as far as antivaccine-friendly pediatricians go, and whose practice is ensconced nicely in Santa Monica? Or any number of antivax docs in California I could name who are not in what would be considered conservative areas of the state? As I’ve said many times before, antivax is the quackery that transcends political boundaries.

Anti-vax practice absolutely transcends ideological boundaries, being especially high in non-conservative granola-crunchy Marin and Sonoma counties in NoCal (though I wouldn't call the folks there liberals — long story...). And I can only make a fairly wild guess about that area to the effect that a different kind of 'leave me alone" attitude seems to prevail there, along with a sort of magnet for the new-agey. I think it's about the isolation and 'nature vibe' of hills and forests. Other places with similar topography I've been have similar 'alternative' cultures.

As for 'Dr. Jay'. I've never been in Santa Monica long enough to get a feel for the place, but my impression is he's a Hollywood guy, and the central piece of the 'Dr. Jay phenomenon' would be a kind of media-image-related narcissism that is pretty apolitical. As Steely Dan put it:

Show biz kids making movies of themselves
You know they don't give a ƒvck about anybody else
While the poor people sleepin' with the shade on the light
While the poor people sleepin' all the stars come out at night

So 'Dr. Bob', 'Dr. Jay' and the NoCals are all different cultural phenomena, but leading to similar material outcomes of unvaccinated kids.

My argument is that the most political powerful, most obstinate, and most dangerous of these phenomena — and thus the greatest public health concern — is the OC/SD conservative version. I take no real issue with you, Orac, as you have repeatedly said anti-vax is a cross-ideological thing and you have noted it's underpinnings in libertarian ideology. However the notion that 'anti-vax=granola crunchers' still seems to remain the dominant trope on the web in general, and shows up often in the comments here.

The VPD outbreaks are in Orange and San Diego counties. This is a historically overwhelmingly conservative area, but many people unfamiliar with California don't know that. The big-time anti-vax supporters in Congress have been Dan Burton, Bill Posey, and Darrell Issa, arch-conservatives all. The science hating and AltMed business loving pols are all Republicans. What little ability the Florida authorities might have had to go after HHI was scuttled by new legislation pushed by Jeb Bush...

[I'll put further comment on the 'Dr. Bob' thing at my off-RI page at some point, and drop a link back here.]
.............
RAMBLING WIND
"When people can’t be bothered to read you, look first within before blaming without." is a fair point. Taken. I'm glad you turned on the TV instead of responding to the Issa comments. That would have been a waste of your time. However when people flame w/o making any effort at comprehension, yes, I have a problem with that. If folks can't find the point through the verbiage, expend the effort to try to figure out what I'm getting at, I can hardly complain just at that. Everyone has only so much time and energy, and how they chose to make best of that is certainly not for me to say. So skip or skim-and-ignore as you will. NP here. But if you chose to engage, and think you might not be getting it, just ask for clarification or elaboration as Orac did #140 (I'm assuming the 'Dr. Jay' question wasn't entirely rhetorical...). I can do that, and it takes less bandwidth than a flame war.

Steve:

Is it worth pointing out in so many words that your BIL has just said that you are inherently dishonest and that he will ignore any possible evidence you present?

For what it's worth, when someone jumps that fast to that sort of accusation, without previous evidence of behavior, I suspect projection.

Vicki, not sure but I think you are saying that he is projecting...not clear since you said "jumps that fast to that sort of accusation" and I never accused him of anything. Did you mean that BIL jumps that fast to my evidence? I agree!

As for me, my only "jump" to the lawyer label thrown in my face is the dread that I'm lumped in with the majority of lawyers. That's from my own inherent distrust of...lawyers...knowing that I'm not one that was farm raised as one in my 20's but instead taught to be honest by my parents and science. I think it was too late for me when I graduated from law school at age 42 to become yet another shady lawyer.

Apparently not too late to become bellicose, though. Ugh.

Yes, I was suggesting that he is projecting: that someone who is so quick to accuse you of being dishonest on this subject may be intellectually dishonest himself.

In which science writer Tara Haelle takes Gordon and Sears to pieces -- at Forbes Sears and Gordon: Should misleading vaccine advice have professional consequences?

Perhaps one could argue that Sears himself, and Gordon, cannot fairly be labeled truly “anti-vaccine” if they give vaccinations in their practices. But here’s the thing: I met and interviewed Sears several years ago, when I first started reporting on vaccines and wanted to explore every avenue, including that of the anti-vaccine side. And so I met Sears at the Dallas Film Festival screening of the anti-vaccine movie The Greater Good. He was serving on a panel there with anti-vaccine doctor Lawrence Pavlevsky, anti-vaccine Texas advocate Dawn Richardson, and anti-vaccine NVIC founder Barbara Loe Fisher. And Gordon has regularly spoken publicly with Jenny McCarthy, anti-vaccine celebrity extraordinaire. From my perspective, the company you keep says a lot about you and your beliefs. Perhaps that’s what fellow AAP members are so concerned about.

I wonder what is going to happen next?