One of the most frequent complaints leveled at pro-science advocates who defend vaccines against antivaccine misinformation and pseudoscience is that we’re way too fast to label them as “antivaccine,” that we use the term as a convenient label to demonize their views. We’re not really antivaccine, they tell us. We’re vaccine safety advocates. Really. Now, I have no doubt that this is how most of these antivaccinationists masquerading as vaccine safety activists see themselves, to the point where sometimes I find it refreshing when I encounter an antivaccine activist who proudly labels herself antivaccine. However, it doesn’t take much poking around to show that, no matter how this variety of antivaccinationists view themselves as “not antivaccine,” they really are antivaccine to the core. One way to do that is simply to listen to them or read what they write about vaccines and take them at their word with respect to their statements about various vaccine science. Every so often, I think it’s useful to do that, in order to provide an example of how it’s done, and fortunately for me an old “friend” provided me with just such an example late last week.
I’m referring to someone whom long time readers of this blog will recognize, J.B. Handley. Most people probably don’t remember that it was J.B. Handley and his wife who founded the antivaccine protest group Generation Rescue, not Jenny McCarthy, who’s been its president and public face for something like eight years now. Generation Rescue (GR) was originally founded as a “mercury militia” antivaccine group; i.e., a group based on the idea that the mercury in the thimerosal preservative that was in several childhood vaccines until early 2002 is a major cause of an “autism epidemic.” Back in those days, Handley used to show up occasionally on this blog to try to convince me of the error of my ways. Not surprisingly, he failed. Be that as it may, over time, GR’s antivaccine stance “evolved” to embrace a more “holistic” view of autism causation. Now it’s not just mercury in vaccines. It’s vaccines and “environment” (code for vaccines interacting with other things). This evolution had the distinct advantage of broadening the class of antivaccine crank to whom GR could appeal, but more importantly it opened up the door to many more forms of “autism biomed” quackery than just chelation therapy and treatments designed to remove mercury.
So what did Handley write that provides me with a “teachable moment” about why it’s not inaccurate to call people like him “antivaccine”? Unfortunately Medium still allows Handley to spew his pseudoscience every now and then. When last we left him, he was regaling us with An Angry Father’s Guide to Vaccine-Autism Science. This time around, he’s recommending The Only Vaccine Guide a New Parent Will Ever Need. He starts out by trying to inoculate himself against charges of being antivaccine:
I am a dad. And, I write this without benefitting in anyway from what is said here. I have no book to peddle, no profits to protect, and there’s no doubt that writing this will result in some amount of hate directed in my general direction for challenging a popular narrative that vaccines are only safe and effective and should be administered the same way to all children without consideration for the unique biology of each and every child. So be it.
This is, of coure, a variant of the “special flower” narrative, so beloved of antivaccine activists. Basically, the idea goes like this. Every child is unique (who could argue with that?), which means that every child will react differently to vaccines and some of those reactions will be horrible and cause autism. Consequently—or so the “reasoning” goes—one size doesn’t fit all, and we have to consider each child’s “unique” biology in deciding which vaccines to administer and when. Not surprisingly, this “special flower” narrative always involves either not vaccinating, skipping many vaccines, or, in accordance with the ever-popular other major antivaccine trope (“too many too soon”) delaying vaccination and frequently involves “pretreating” a child to be vaccinated with various supplements and quackery to lessen the chances of a catastrophic vaccine injury (cough, cough, autism, cough, cough). Of course, vaccines are administered to many millions of children every year. We know that the frequency of serious adverse reactions is very, very low, while we also know that the protective value is very high and that it’s far safer to be vaccinated than unvaccinated. Of course, the “special flower” gambit really serves only as an excuse not to vaccinate unless medical science can come up with a test (or series of tests) that can absolutely predict with 100% accuracy that no harm will come to the parent’s special flower.
Thus, it’s not surprising that, before launching into a discussion of Ten truths about vaccines most people don’t know (what is it about cranks and appeals to “Truth” with a capital T?), Handley urges parents to “do your own research.” I, too, urge parents to do their own research, but, unlike Handley, I suggest that they do their research using legitimate scientific resources, not antivaccine crank websites and Google University knowledge. Consistent with the “special flower” narrative, Handley then urges parents to “find a healthcare provider who doesn’t believe “one size fits all” when it comes to vaccines.” Hilariously, he notes that they “might be a naturopath, a D.O., or a chiropractor, just find one!” Most DOs, of course, vaccinate just like MDs. Naturopaths, of course, are quacks (and antivaccine, to boot, which is presumably why Handley likes them), as are most chiropractors.
So here are Handley’s “Truths.” Many are repetitive and overlap.
“Truth” #1: Handley resurrects the old antivaccine trope that the vaccination schedule includes 72 doses. Of course, like all antivaccinationists, Handley has to strain to make this number as large as he can. For instance, he includes the flu vaccine and DTaP, both of which are administered to the mother during pregnancy, not to the child, and of course the DTaP contains three vaccines (diptheria, tetanus, and pertussis). He also separates all the combination vaccines into their individual components for purposes of counting vaccine “doses.” But, as disingenuous as Handley’s “analysis” is, let’s just take it at face value for purposes of rebuttal. So what if there are now 72 “doses” of vaccine administered between the ages of 0 and 18 in 1962 and 24 in 1983? That just means there are more diseases that can be prevented by vaccines. Handley clearly means to imply that this many doses is somehow harmful, but the evidence runs counter to that. In particular, it’s been shown time and time again that vaccines do not cause autism.
”Truth” #2: Here, Handley claims, “Even today, other first world countries often give far fewer vaccines to children than the U.S., and avoid many altogether,” to which I again ask, “So what?” obviously, Handley means to imply that this schedule is harmful and that these vaccines are unnecessary. He fails.
”Truth” #3: Handley asserts: “Vaccines injure children, and the U.S. government has an entire division set up to compensate families for that injury.” Yes, there is a National Vaccine Injury Compensation Program that was set up in the 1980s in the wake of a wave of product liability lawsuits against vaccine manufacturers. I’ve written about it many times, in particular how its rules for evidence are more lax than normal courts. Basically, Handley sounds a lot like the Canary Party in his use of the existence of the Vaccine Court as a reason to believe that vaccines are unsafe. The Vaccine Court was set up to compensate families whose child might actually have suffered an actual vaccine injury, cases that are rare but do exist. In addition, the Vaccine Court pays the complainant’s reasonable court costs. The reason antivaccinationists don’t like the Vaccine Court lies more in the greed of trial lawyers who would like to go for big “jackpot” payoffs rather than accept the easier-to-obtain but smaller payouts and reasonable (and guaranteed) fees from the Vaccine Court.
”Truth” #4: Handley asserts: “In most states, you have a choice on whether or when you give your child vaccines.” Well, yes, but that’s just evidence that we don’t have “forced” vaccination in this country. We have school vaccine mandates, and states decide which vaccines must be given prior to school entry. Usually the vaccine mandates reiterate the CDC schedule, but not always. “Truth” #4 can only be interpreted as encouragement to push the limits in not vaccinating.
“Truth” #5: Handley asserts: “There will be a permanent supply of disease “outbreaks” because the vaccines for measles, mumps, and pertussis have serious efficacy issues.” Um, not exactly. As I’ve described more times than I can remember, the vast majority of outbreaks of vaccine-preventable diseases in this country are associated with areas of low vaccine uptake. In my state of Michigan, for instance, we had pertussis outbreaks that corresponded closely to areas in the state with low vaccine uptake. Yes, the pertussis vaccine is imperfect and immunity can wane, but it’s still quite protective. As for the measles vaccine, it’s quite effective. The efficacy of the flu vaccine does fluctuate from year to year, depending on the match between the types in the vaccine and what is circulating, but it’s still better to receive it than not.
“Truth” #6: Handley warns: “A public health technique, spearheaded by the CDC, is to create ‘Concern, Anxiety, and Worry’ like we saw during the Disneyland measles scare.” This is Handley straight up being deceptive by willfully misinterpreting a statement by a CDC official named Glen Nowak in 2004, who said:
The belief that you can inform and warn people, and get them to take appropriate actions or precautions with respect to a health threat or risk without actually making them anxious or concerned. This is not possible…This is like breaking up with your boyfriend without hurting his feelings. It can’t be done.
I interpret this as a recognition that it’s impossible to inform people of the dangers of vaccine-preventable disease and the benefits of vaccines without making them worry about vaccine-preventable disease, an observation so mind-numbingly obvious that it’s hard to believe that anyone would find it surprising. Indeed, in the same talk, Nowak mentioned AIDS, traffic fatalities, and DVTs as other examples. Handley misinterprets Nowak’s remarks as a manifesto.
“Truth” #7: Handley warns: “Doctors are not required to give you the actual package insert for vaccines that spells out the known adverse events.” This is nothing more than “argument by package insert,” a deceptive antivaccine trope because package inserts are legal documents designed to cover the posteriors of drug companies, not careful discussions of risks and benefits. Basically, if any adverse event is reported during clinical trials used to apply for FDA approval, it will make it onto the package insert, regardless of how likely the adverse event was due to vaccines. Read Skeptical Raptor’s explanation.
“Truth” #8: Handley claims, “Vaccines have been proven to cause auto-immunity, something now epidemic amongst U.S. children.” Apparently Mr. Handley’s definition of “proven” is a bit more expansive than mine, or that of any other scientist. For example, Handley cites an abstract presented at a meeting. (Abstracts are the easiest to get accepted, particularly if they are poster presentations.). He also cites a speculative paper. That’s hardly “proven,” particularly when weighed against the rest of the evidence.
“Truth” #9: Handley makes like the Black Knight in Monty Python and the Holy Grail: “The debate about whether or not vaccines cause Autism is far from over.” He continues:
Like tens of thousands of other parents who I have heard from, I watched my son regress from normal to Autism between the age of 12 and 20 months. His decline coincided perfectly with his vaccine schedule and he developed a myriad of physical symptoms that ultimately ended up with an Autism diagnosis. I just came across a site recently with more than 2,500 personal accounts of vaccine injury that I think is worth a look right here.
Handley’s love that “tens of thousands of other parents” that he’s heard from. One wonders where he finds time to write between all the phone calls and e-mails from tens of thousands of parents. In any case, this “Truth” involves Handley invoking a greatest hits compilation of discredited vaccine-autism arguments and conspiracies. Hannah Poling? Check. She’s there. Poul Thorsen? Yep, he’s there, complete with a citation of antivaccine “journalist” Sharyl Attkison. Handley’s own “Fourteen Studies”? Of course! The “CDC whistleblower” conspiracy theory? Do you even have to ask?
I’m only surprised Handley waited until #9 for this one. Maybe he was building up to his most “potent” arguments, because after trying his best to argue that vaccines are dangerous over the first 9 “Truths,” he now tries to argue that they don’t work.
“Truth” #10: Handley proclaims, “The impact of vaccines on infectious disease since the 1900s has been overstated.” Yes, he went there. He invoked the most supremely intellectually dishonest “argument” used by antivaccinationists, namely what I like to call the “vaccines didn’t save us” gambit. Basically, it notes that mortality from various vaccine-preventable diseases was declining before the introduction of vaccines for those diseases, which is true. Our ability to keep children who came down with such diseases alive was improving. Iron lungs, for instance, allowed far more children with polio to survive. What this gambit neglects to show is how incidence from these vaccine-preventable diseases plummeted after introduction of vaccines, just as one would expect if the vaccines were highly effective.
I started this post by asserting that there is a difference between being antivaccine, which is what J.B. Handley is, and being a vaccine safety advocate, which is what many, if not most, antivaccinationists, like Handley, claim to be, and that Handley’s article would help to show that difference. To see what I meant, all that’s necessary is to contemplate each of Handley’s “Truths” about vaccines. Each is designed to claim that either (1) vaccines are dangerous or (2) that they don’t work as claimed. To top it off, there’s a heapin’ helpin’ of conspiratorial thinking, in which it is implied (or outright stated) that the CDC and big pharma are conspiring to hide the dangers and ineffectiveness of vaccines from you using—of course!—fear mongering. I suppose it’s possible that a vaccine safety advocate could believe all these things and truly be advocating for better vaccines, but it strains credulity.
That credulity breaks when I look at the last section of Handley’s article, where he lists the 11 vaccines currently on the CDC’s recommended vaccination schedule and cannot recommend a single one. Instead, he divides them into two categories: “Do your homework,” which includes DTaP, PCV, Hib, and IPV, and “Highly questionable risk/benefit ratio,” which includes all the rest. In other words, he doesn’t consider a single one of the vaccines in the CDC schedule to have an acceptable risk-benefit ratio to recommend. In his treatment of each individual vaccine, Handley doesn’t list a single favorable article. His entry for every vaccine, even the ones on his “Do your homework” list, contains only negative articles that echo and reinforce common antivaccine tropes, such as claims that Hib might cause type I diabetes, claims that DTaP causes sudden infant death syndrome, and that MMR is associated with autism coupled with the fallacious claim that measles isn’t a dangerous disease anyway.
Handley’s article can only be described as antivaccine. It’s all negative claims about vaccines and those who make and promote them, and he can’t even find a single vaccine that he can recommend as having what to him is an acceptable risk-benefit ratio—the same as it ever was.
I frequently say that it doesn’t take much to identify self-proclaimed “vaccine safety advocates.” After all, a vaccine safety advocate would most likely view some vaccines as safe, some as not, and some as probably safe but not sufficiently proven for their likes. They would be unlikely to view all vaccines as dangerous. Thus, all you have to do to scratch and reveal the antivaccinationist is to ask a “vaccine safety advocate” if there is a single vaccine that he/she considers sufficiently safe and effective to recommend for most children. Alternatively, you can ask him/her if there is one vaccine she would give her baby if he/she were to have another child. If the answer is no, what you’re dealing with is an antivaccinationist, not a vaccine safety advocate.
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I have long thought that the only vaccines these people will ever think are safe are vaccines made from unicorn tears distilled by fairies and administered by winged angels.
And that's even before you get to the documented fact that most of the supposed risks and dangers are lies.
Of all the recent cases of ‘Concern, Anxiety, and Worry’ he could have chosen, he went for an outbreak which spanned from coast to coast (from California to Quebec).
Repeated for emphasis.
The accusation of emotional appeal is nothing new among AVers (well, all of Handley's other arguments are nothing new). A contrarian troll who graced us with his presence some years ago was quick to play this card.
According to him, we shouldn't talk about vaccine-preventable diseases using scary words like death, sequelae, or loss of time/revenue. Even 'sickness' was not good. That didn't leave much to talk about...
Glen Nowak's remark is so obviously true.
If people don't get concerned when you tell them about some hazard, then you failed to convey that there was a risk. And conversely, if people don't take the risk seriously, they will not take appropriate precautions against it, so you have to get them motivated.
And to have a motive is to be engaged emotionally.
"Most DOs, of course, vaccinate just like MDs."
In the USA, sure, but elsewhere? I wonder. Here in France, the osteopaths don't have a complete medical education and the way they practice is close to that of chiropractors, including the hostility to conventional medicine.
One has to wonder about the irony of accusing CDC about spreading "Concern, Anxiety and Worry" while in business of fear mongering about "autism epidemy" and "vaccine holocaust".
Smith@5: That's just garden-variety projection on the part of Handley et al. Accuse your opponents of doing exactly the thing you do.
A. I always love the fact that having the ability to protect against more diseases, and the U.S.' s choice to protect against more disease, is a bad thing in anti-vaccine world.
B. I suspect counting combination vaccines separately by components also helps them with the toxins gambit. They can ignore the fact that combination vaccines - to my understanding, someone correct me if I'm wrong - - are the same 0.5 ml as other vaccines, and end up decreasing the volume of what's injected aside from the active ingredient (and the number of needles going into a child, yay.
c. I suspect the hostility to NVICP is not just lawyer greed. First, any adversarial process can be unpleasant, especially if you're already dealing with the stress of a disabled child. Second, if you bring a case on something that is not supported by the evidence, you will lose. If, as appears to happen often, your lawyer did not get the case together well, the process will be fraught.
And the process is not perfect. There are things to improve. I expect the unhappiness with it is real enough - especially by lay people who don't appreciate how hard it will be to win in a court.
I get angry every time I read the "vaccines didn't save us" argument. It's so easy to point out mortality vs. morbidity, but they just ignore it. Has there every been a blog post or a discussion from an anti-vaxxer addressing this?
Look around. Compare now to 1900. It's just so obvious that vaccines work. You must have to work really hard to convince yourself otherwise. (Maybe I'm giving anti-vaxxers too much credit.)
I left a comment on JB's post. Wonder how many people will slam it? :)
My only argument with that poster is that it’s wrong. In 1962, you got more than 8 doses….because the DPT and OPV were given at 2,4, and 6 months of age. Then DPT, smallpox and a TB test were done at age 5. So, if you count *doses* you got 17 doses by age 5, NOT 8. But there were a LOT more antigens in the vaccines, too. Yes, that’s still less than the current dosage. BUT, on the other hand, kids have to deal with far fewer illnesses.
Autism existed then, too, JB. I had a kid in my class from K-6 who would now be diagnosed with autism. And that’s not counting the kids in the “retard room” who no one ever got to know and you rarely saw. My brother is probably Asperger’s. I had a 2nd cousin in the 1930s who more than likely was autistic (and the only vaccine was smallpox!)
Of course, I don’t expect you’ll change your tune. You haven’t in the 15 years I’ve heard of you.
I may be being particularly dense today, but the sentence below which starts the fourth from last para doesn't make sense to me ...
"I started this post by asserting that there is a difference between being antivaccine, which is what J.B. Handley is, and being a vaccine safety advocate, which is what many, if not most, antivaccinationists like Handley, are and that Handley’s article would help to show that difference."
The "autism is vaccine injury" crowd was not particularly hostile to NIVCP until they had their day in court and lost.. Not just lost, but suffered repeated crushing defeats.
I also like that the "pro-vaccine safety" language implies that the rest of us aren't pro-vaccine safety. Because those of us that vaccinate our children on schedule or get vaccines ourselves don't care about them being safe?
There is a lot of pro-vaccine-safety work being done, but Handley and his group aren't the ones doing it. Real scientists and public health officials do that.
I'm still baffled by why they think they'll win in civil court when they lost in NVICP.
@Jazzlet: I think it's missing a word (at least, that's how I read it).
“I started this post by asserting that there is a difference between being antivaccine, which is what J.B. Handley is, and being a vaccine safety advocate, which is what many, if not most, antivaccinationists like Handley, claim to beare and that Handley’s article would help to show that difference.
Well, botched THOSE tags...hope it's understandable.
Orac's minions are in for a treat:
AoA feature TWO- not one!- articles by Kent** Heckenwhatever, who announces that he has a new book coming out soon. He even provides an outline of its contents.
Aren't we lucky !
-btw- I wish everyone a happy solstice.
** I always associate him and Handley for some reason.
Look around. Compare now to 1900. It’s just so obvious that vaccines work
True and you don't even have to go back to 1900. Measles still strikes about 20M people per year, the majority in LDCs, and kills about 300 of its victims per day. The numbers are declining, though. Thanks, measles vaccine! :)
Handley is right that docs don't give patients the packet inserts as is Dr Gorski in that they contain information more for legal reasons that to inform such as the rarest of events that might, just might, be linked to a vaccine mainly by post hoc ergo prompter hoc. What Handley fails to acknowledge is that since 1986 it is mandated by law that doctors give a Vaccine Information Sheet to parents for each and every vaccine given and that these sheets include description of the disease being vaccinated against, a list of mild side-effects, rare but serious side-effects, and instructions, if they believe associated with a vaccine, to notify their doctor, submit a report to VAERS (with instructions how to do so), and information about the Vaccine Court. All in easy to read language on two pages. So, if parents choose not to read these, what does Handley suggest? Does he really believe they would read the more difficult, less reader friendly packet inserts. The Vaccine Information Sheets contain all the relevant info and in easy-to-read form. Check them out yourself at: http://www.cdc.gov/vaccines/hcp/vis/index.html
Note that if the doctor or nurse did not give you a Vaccine Information Sheet, ask for it, if not given, report them.
I am a senior citizen and every time I get a vaccine, whether flu, pneumococcus, shingles, TDaP, I was given one. Not once as far as I can remember going back over 20 years have I not received one.
Vaccine Didn't Save Us??? WRONG
Prior to the WHO program started in 1967 to eliminate smallpox from the world, just in the 20th Century an estimated 500 million people in the Third World died from smallpox and many others were permanently disabled, e.g. blind, or left seriously disfigured. We in the US had high smallpox vaccination rates so if a case entered the US he/she could be quarantined without risk of spread because of herd immunity.
In the early part of the 20th Century up to 15,000 in a much smaller US population died from measles. The main cause of measles deaths was secondary opportunistic bacterial pneumonia. With the advent of antibiotics almost all of these cases could be saved. However, even with antibiotics and good nutrition, prior to the introduction of the measles vaccine in 1963, each year approximately 400 - 500 kids died, up to 2,000 suffered permanent disabilities, e.g. seizure disorders, mental retardation, deafness, and blindness, 50,000 were hospitalized, and a million or more suffered a week or more of high fevers, intense itching, malaise, and anorexia. Missing school. Nowadays with both parents working to make ends meet and single parent families, someone would have to stay home to take care of the sick kid with potential economic consequences.
Today our population is twice what it was in the 1950s. Measles is just as contagious, so, without the vaccine one could logically expect around a doubling of the above numbers. And with the rise of antibiotic resistance, perhaps more deaths from opportunistic bacterial pneumonias.
I could go on with all the other vaccine preventable diseases; but I think I've made my point, if anything, many experts consider vaccines to have made either the principal or one of the main contributions to the increase in life-expectancy over the past 100 years. The other contributions include clean water, availability of safe food, and safer work environments; but vaccines are numero uno.
Oh, come now, Dr Harrison, you *know* they've just renamed smallpox "chicken pox". It never went away. The same thing with polio. And measles. They all just got renamed. Vaccines didn't get rid of them. It's not like we can tell the difference between different bacteria and viruses, or anything...( /snark)
Now my brain hurts...I can't think like an AVer for long.
@ The Smith of Lie / Eric Lund
It's not just projection, as Eric said.
To start with, blaming your opponent for emotional appeal is just the logical following step of dismissing/minimizing the risks your opponent is talking about. Accusations about mountains and molehills, or about crying wolf, are generally part of the debate at this point.
IOW, the side having facts to buttress their risk assessment are morally right to raise “Concern, Anxiety and Worry” in relation to these risks, while the other side is the fear-mongering one. Since both sides present themselves as the one having supporting facts, the issue is figuring out which is which.
tl;dr: it's a normal state in a debate, with each side accusing the other of exaggerating.
But there is more. Two other aspects of throwing accusations of appeal to emotion are the following:
- notably with the troll I mentioned earlier, it's an accusation of not sticking to our supposed role: we scientists are supposed to be cold and matter-of-fact, à la Dr Spock. Being emotional is supposedly showing that we don't have the hard data, or that we are not real scientists.
Of course, if we don't display emotions, then we will be accused of being egghead elitist Vulcan in their ivory tower. Accusations of 'library smart' vs 'street smart' may occur.
Either way, it's an attempt to box your opponent in a defensive role.
Same thing as calling a woman either hysterical or non-feminine, really.
- it's also a covert/subconscious attempt to monopolize the displays of emotion for themselves, so they can secure the status of victim to their side of the debate.
"Don't talk about all the bad things which could happen to other children, it's not that bad and who cares anyway, but oh woe! pity me, for I have an autistic child."
IOW, there is a mix of savvy debating skills and of narcissism cropping in here.
It would be a mistake to overlook the good debating skills part. If the AVer movement has some traction, it is because its leaders do have some skills at attracting and keeping followers.
Ugh, seriously? Right out the gate, Handley starts with something so mind-numbingly dumb as the "72 doses" claim (or is it 69? or 74? or something in between? I've heard them all, even claiming it's 69 doses by age 6!)
On the U.S. schedule of recommended childhood vaccines, there is a maximum of 53 doses, if a child gets every single recommended vaccine, including all flu shots. That number goes down with combination vaccines, like the DTaP-Hib-IPV vaccine.
And, yes, as Dorit notes, each vaccine is a 0.5mL dose. So, you get a Hib shot? One 0.5mL shot. You get a DTaP-Hib-IPV shot? One 0.5mL shot. So anti-vaccine activists calling for single-antigen shots instead of combos are asking for more needle sticks and more of all those "other things" in the vaccine that they think are so horrible.
And, as Dr. Harrison points out, doctors are required, by law, to provide a VIS, which lists info about the disease(s), the vaccine, risks and benefits, and what to do if an adverse reaction is suspected, including info on VAERS and NVICP. They're written in easy-to-understand language and, more importantly, are short enough that a parent might actually take the time to read it, unlike the many pages of tiny font package inserts written at a college level.
The link to the VIS was borked. Here's what I meant to include.
...ask him/her if there is one vaccine she would give her baby if he/she were to have another child. If the answer is no, what you’re dealing with is an antivaccinationist, not a vaccine safety advocate.
As the biological father of two children with an autism spectrum disorder, I'd answer the question with a "No Comment".
Personally, a third child experiment wherein all vaccines are avoided would violate moral and ethical standards of treatment for such an individual.
In continuation, it may be immoral and/or unethical for a medical professional to ask or suggest that someone else ask this question to help assign a label of "antivaccinationist" or "vaccine safety advocate".
Outstanding piece of work which caused me to introspect too much. You'll get the next billing invoice from my therapist in the mail if you could please provide the address.
In my opinion, J. B. Handley is a staunch "vaccine safety advocate".
I had four great aunts and uncles die from diphtheria in the late 1800's and early 1900's.
The following is from Outbreak News Today.
A 15 year old boy from Kerala’s Malappuram district in southern India has died from diphtheria, according to multiple local media reports. All account say the teen was unvaccinated against diphtheria.
He developed fever on June 2 and was admitted to the Medical College Hospital, Kozhikode, on June 6. His condition worsened even though he was administered the anti-diphtheria serum and other drugs. The boy died at the MCH on Saturday following multi-organ failure, according to a report in The Hindu.
Two other children were found to show clinical symptoms of the disease, are being treated and doing well.
Malappuram district is a Muslim community known to be reluctant to immunization, reports note.
Honestly, if doctors did simply hand parents a vaccine insert they'd probably just complain that they weren't properly informed because the relevant info was buried in the fine print and legalese (and in that case, they'd actually have a point.)
I've noticed that many parents seem start down the antivax path precisely because they weren't paying enough attention when the doctor explained the side effects they were actually likely to see after vaccination - fussiness, fever, and/or general malaise - and then freaked out when they happened and concluded that they's been deceived somehow. So many antivax stories start with something like "I never questioned vaccines because I trusted my doctor" followed by a melodramatic description of the common side effects I just mentioned. Then when their kid is diagnosed with autism (or whatever), they think back to that reaction and assume that it meant that something was wrong with the shots.
I've often wondered if it would help if the VIS sheet (or the doctor him/herself) briefly explained how vaccines work and why they can cause mild flu-like symptoms before giving the shots - but I'm guessing that's hard to do in the context of a short well-baby visit. Maybe insurance companies or whoever pays for these things could arrange to have a longer "first shots" visit where the parents can be educated about vaccines before they turn antivax, instead of trying to do damage control after the parents have already decided that vaccine are evil and closed their minds to any info that contradicts that.
That should have great grand aunts and uncles; I'm not quite that old.
Of the last five vaccines I've received, only twice have I been given a VIS (flu, from my pharmacist).
@Joel,Narad: As I mentioned on a previous thread, I got a DTaP booster when I visited my PCP last week. Not only did they hand me a VIS, they made me sign a piece of paper saying that I had read and understood the VIS.
With annual flu vaccines, I recall reading something like a VIS, but my memory is hazier and I am not certain I got the form every time I got the flu shot. Other than the DTaP, the last non-flu vaccinations I got were 11 years ago, which is long enough that I don't trust my memory on the subject. That set included yellow fever (I was about to travel to Brazil) and a combination hepatitis A/B vaccine called Twinrix, which was new at the time.
As for why the number of vaccine doses would increase, I can think of two reasons. One, vaccines have been developed for certain diseases that did not previously have vaccines. I never got the chicken pox or HPV vaccines because they did not exist when I was growing up (I got chicken pox instead, and I think I would have rather gotten the vaccine). I'm not sure if I got a hepatitis vaccine back in the day (one reason why I got it in 2005). The other reason is that doctors may not have realized that with some vaccines immunity fades with time. That's why I needed the DTaP last week: IIRC you are supposed to get a booster for that one every ten years. I would also need another yellow fever vaccination if I were planning another trip to a tropical country, since countries with a yellow fever vaccination requirement specify that it has to have been in the last ten years. The office that administered the Twinrix vaccine to me mentioned that they thought it would be a lifetime immunity, but at the time they could only guarantee 20 years.
We've gotten a VIS every single time I or my husband or one of our children has been vaccinated. If I'd kept them all, it would be a pretty big stack by now.
Not only do I give out a vaccine information sheet to every patient I administer a vaccine to, I have to enter information on that vaccine dose into a log that is maintained by the state health department, and includes:
1. Name of the patient
2. Medical record number of the patient
3. Vaccine being given, and dose
4. Maker of the vaccine
5. Lot number of the vaccine dose
6. Expiration date of the vaccine dose
When I taught OB, the newborn nursery was often the first encounter the students had with vaccine administration (Hep B). They learned about the importance of documenting this information, and giving these sheets along with doing the teaching. When I would have them again later in the capstone course, and they were routinely giving pneumonia and flu shots to adults, I seldom had to remind my students to do these things. They understood what had to be done and why.
It's like this everywhere I've ever worked (10 states now and counting) and has been for at least 20 years.
Now is a good time to remind our commentariat and inform new ones that Handley has changed this story too many times to count. At one point (if memory serves correctly) he claimed his sentence-speaking nine month-old son lost his speech suddenly. His other accounts include different ages at "regression". Revisionist history as so many of the "vaccine causation" parents engage in.
It's also worth noting that Handley has abused his son with every form of biomed quackery you can think of including bleach enemas ala Kerri Rivera. Each time proclaiming great results.
I've gone through JB's post and pointed out some stuff to his audience. Medium is really good about highlighting a part of the post and adding your own comment to it. I'm sure he'll delete or hide my comments. I also asked him why he didn't name Dr. Offit this time.
@Ren #33 he hasn't blocked you from his medium yet?
Guy, your vaccine is definitely NOT safe. Unicorn tears contain unicorn DNA, a most potent auto-immune agent. Fairies are notorious for not wearing gloves in processing the tears, and the winged angels trigger feather allergies.
He's really not very honest, is he?
Um, that's an article from inquisitr-dot-com. Once one follows things down, the payload turns out to be an N = 1 http://www.jacionline.org/article/S0091-6749(15)02364-7/pdf">conference abstract (PDF).
#12 You have touched upon a core insult.
One of my lines is election security. The single most common outcome to popular allegations of fraud is the finding someone who does not like the outcome has seized upon some or other oddity in a process that he does not understand, so as to demand that the entire process be invalidated.
When I try to explain that this is a well understood field and we actually do understand what to look for - we are neither blind nor simple, as some would have you believe - the first response is to sweet talk while the second response is to scream WHY DO YOU HATE DEMOCRACY?????
Truly, crackpots are all the same in every field.
I'm sure that the nurse that recently gave me an MMR booster at my current FQHC did this, because I asked if I could keep the vial as a souvenir and she said no, I have to write down the lot number, etc. No VIS, though.*
But Twinrix, pneumococcal, Tdap? No VIS. these were all cases where I was shunted off to an erratically staffed (judging by my wait times and, in some cases, number of other people waiting). These three were at a large university medical center.
There is only one lifetime adult Tdap booster currently recommended, unless you're pregnant. The rest are just Td.
* I was waiting for the phlebotomist. The nurse called me back. "Mr. Narad, you're getting a shot?"
"Yup, but I'm in line here now."
"Come on back, they'll call you on the overhead."
Regarding the whole "unique biology of each and every child" - if you wanted to take that to its illogical extreme, you could substitute pretty much anything for "vaccines": air, water, breast milk, you name it.
Because children can and do have reactions to all those things (although usually it's things *in* the air rather than air itself).
To paraphrase Mark Twain: Curing autism is easy; I've done it a hundred times. I've also noticed how Handley's story seems to have changed from "my perfect, healthy son got the MMR and instantly became autistic" to "my delicate, fragile son had progressively worse health problems each time he got a vaccine." That may jive better with the new "too many, too soon" and "sensitive subset" narratives the antivaxers adopted to justify their continued existence after thimiserol was removed from childhood vaccines and completely failed to affect the rising rate of autism diagnosis, but it begs the question: if your son had a progressively worse reaction every time they got a shot, why did you keep bringing him in for more shots? You can only stretch the "I foolishly trusted my doctor and he/she betrayed me!" excuse so far.
How do you figure that is either unethical or immoral? No one is forced either to ask or to answer, and it is a reasonable question.
If someone is not just against all vaccines qua vaccines, then there should be some risk/benefit analysis that they accept (e.g., rabies vaccine after a bat bite where the bat escaped and could not be examined). What is immoral or unethical about trying to pin down the risk/benefit ratio that they would accept?
Since you, MJD, are effectively accusing Orac of immoral or unethical actions, I think it is incumbent on you to explain exactly why his actions can be so described.
Oh, and this is the question that MJD thinks it's immoral or unethical to ask:
Note that this isn't asking what vaccines you have given, or plan to give to, an existing baby, which I suppose MJD might consider a disclosure of patient information; it's a purely hypothetical question about a purely hypothetical baby. How it can be unethical or immoral to ask a purely hypothetical question which the other person is under no obligation to answer, is beyond me. I suppose MJD thinks it's unethical or immoral to ask a question that shows the other person to be a liar.
" I have no book to peddle, no profits to protect, "
No. Just defend his reputation. Which to Handley is more than money.
He just has to justify years of his life, a lot of his money, and avoid accepting that he's been taken in by some of the most famous charlatans of the modern era.
He not only got taken by people like Rachid Buttar, he built an organization with his own money to promote them.
The guy who promoted Wakefield as "Jesus Christ and Nelson Mandella all rolled into one" (or some such nonsense).
Here's a guy who desperately can not face his failures. And he's made doozies. Recently he was indicating that he got caught up in the MMS scam. People who understand that they've been taken are cautious about making more mistakes. Not Handley. In a few years he will be promoting the next big autism scam.
He's loud and acts the bully--as many who lack backbones do. The guy couldn't even bring himself to directly contact Paul Offit. Much less even acknowledge that he owes Bonnie Offit an apology.
He's the perfect example to parents facing a new diagnosis of autism: careful, you could become JB Handley.
@matt Carey: don't forget acknowledge that he wronged his son by subjecting him to probably painful and scary treatments with real risk and no scientific benefits. That's a hard truth to admit to oneself, let alone others. It's a string motive to cling to the myth.
"I also asked him why he didn’t name Dr. Offit this time."
Perhaps because he promised he wouldn't?
Oh, yeah. He broke that promise long ago. His word is worth about as much as his advice.
"Now is a good time to remind our commentariat and inform new ones that Handley has changed this story too many times to count."
Here's one comparison.
To put it another way, the purported steady decline in Handley fils's condition coincides perfectly with Handley pere's use of him as a guinea-pig.
Wait. Are you saying that Mr. Handley is not a man of his word?
Yes Matt, like that. And people listen to this man and don't ever point out his glaring inconsistencies.
@HDB, pretty much sadly. I recall reading that he had his wife chelated, but not himself of course.
Congratulations. You've just admitted you're antivaxx.
careful, you could become JB Handley.
The carefulness, I did carry it to an extreme. My role models are models, not to become . Taking the higher road so to speak. Another reason why I learn so much from those 6 sigma from the masses like handley.
"biological"? If they were adopted children, would you just bring them back to the shop and ask for a refund?
While I don't post much here, I have been a long time reader.
Yesterday my son and his girlfriend took me to dinner for Father's day. Now this is a very lovely lady, but she has shown some anti-vaccine tendencies due to the fact that her sister has an autistic child. My son has been dating her for a couple of years now and it's a serious relationship as they are getting married in a few short months.
Early on he got me to promise to not bring up vaccines as a talking point. Ok. <sigh> The stuff you'll do for your kids.
Now, while it hasn't been a major subject of conversation, it has occasionally come up. And I've used what I've learned on this and other blogs to gently steer her to a more realistic view of vaccines.
And yesterday at dinner, she told me she had gotten her first vaccine since she was 10 years old.
So Thank You Orac and all the great commenters here! You really are doing good!
Somewhat off-topic. However . . .
Couple who treated ill son with maple syrup--not medicine--blame ambulance workers for boy's death.
These two malignant nematodes were interviewed by Del Bigtree. They claim there is a government conspiracy to silence anti-vaxxers and alt-med believers*.
Methinks Mr. Bigtree has found the subjects for his next faux-umentary.
*If there is such a conspiracy, yay for Canada!
EmJay -- That case really, really infuriates me. For instance, Bigtree of course leaves out something rather significant: although Mr Stephan "didn't specify which devices could have prevented the child from going eight minutes without oxygen", he also neglected to point out that it would be eight *additional* minutes -- they did not even call 911 until the boy had already stopped breathing. Presumably they were conducting CPR, which the ambulance crew continued during the ride. This should not have been necessary in the first place, as he should have seen emergency medical care weeks earlier.
JimB @53: Yay! It's great to read stories like yours and remember that people do change their minds. Good on you for being so persuasive.
Calli-- It infuriates me, also. And it infuriates the people commenting on that story. A few think the Stephans should be shown leniency. The rest want to curb-stomp them into oblivion.
As far as the lack of equipment is concerned: It was pointed out that even if the EMTs didn't have the equipment to intubate Ezekiel, they would have used other methods to get oxygen to him. (Bag and mask? I'm totally ignorant about these things.) (OK, lots of things.)
If what the Stephan's say is true, the EMTs screwed up by not properly checking their equipment (you do it every morning no matter what guys...). That said, I probably wouldn't have tubed the kid regardless. In most places, consistent with the best evidence, intubation is not the first line choice for airway management in full arrests.
Intubating anyone in a moving ambulance sucks. Pulling over to do it delays definitive care at the hospital. Intubating a kid makes it all more difficult. It would make more sense if it was clearly a respiratory related arrest but Ezekiel was septic, he needed antibiotics and vasopressors.
If you watch a code team work an arrest in hospital, they will generally bag the patient (you were correct) until after they get the patient back. The really good ones will remember to put an oro/nasopharyngeal airway in but often that is lost in the shuffle.
I hate how the discussion has moved onto the EMTs and their supposed role in it. It is an obvious attempt to try and shift the public eye away from the fact that he should've gotten proper medical care days, if not weeks, before they even called the ambulance.The only equipment they could've brought that could've saved him would've been a time machine.
The following news article is quoting one of the ambulance's paramedic; there is another article available with more details from the paramedic.
The short version: they checked and asked for a refill in masks, but the masks never came.
It seems the ambulance crew did the best they could under the circumstances.
It also seems that Ezekiel's brain was already oxygen-deprived by the time the ambulance reached the Stephans.
The Stephans may as well ask themselves why they didn't have a resuscitation unit in their home.