Archives For vaccines

One of the biggest issues I’ve seen again and again in the comments sections of every vaccination article is a fundamental lack of understanding of how the immune system works. Many people talk vaguely of “toxins”, “pathogens” and “immunity”, but it’s clear that they have no idea exactly how this works. So I thought that I’d invite a regular commenter, Dr. Scott Nelson, to write an explanation. I think that Dr. Nelson, who teaches this subject in university courses, has done an excellent job of making a complex topic accessible to people who are not scientists or physicians.  (Note that we have provided hyperlinked definitions of many of these terms from Wikipedia for convenience. Dr. Nelson and I have both reviewed them and agree that they’re accurate. If you would like additional information beyond what is provided here, we recommend consulting any basic major textbook).

If you are “doing your own research” on vaccines, I urge you to read all the way through the end, and then watch the video, which shows an animation of the processes that Dr. Nelson describes.  Finally, because I think it’s important to illustrate the vast differences between the scientific explanation of how the immune system works, and the “alternative medical” explanation, I’ve included the homeopathic version at the end of the post. I encourage you to share your thoughts on which you find most compelling, and why. My comments following Dr. Nelson’s are in bold

–Jennifer

A common thread through many anti-vaccine posts is fear about “all the stuff that you are jabbing into a kid”. I would like all the people who think this to perform a simple experiment. Take a piece of meat-any meat-make sure it’s fresh and smells good. Put it on the counter in a nice warm place-about body temperature-cover with a screen if you like. Let it be for three days and then look at it carefully, note all the different shapes and colors. If you know somebody with a microscope, scrape a bit of stuff off and look at it under a microscope. How many different things do you see now? Each spot, each color, each bug you see under a microscope represents something that the immune system is dealing with every second of everyday. After all-wasn’t it exposed to the exact same air that you’re breathing right now? Your body is that piece of meat-your immune system is what keeps it from rotting. Right now, our best estimates are that there are 10 microorganisms for every cell in your body. Your immune system “knows” them all and has responded in various ways, which science is currently exploring. Continue Reading…

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Last weekend I attended the Autism Trust’s Give Autism a Chance Summit. Billed as an “informative conference,” it actually felt like a Two Minutes Hate about the evils of science and medicine. Speakers harangued the audience about the evils of vaccination–including a bizarre show trial–and pushed snake oil on desperate parents. Some of the speakers touted services based on absurd, unproven theories; others lied shamelessly to the attendees. Although there were some positive messages on display, the conference focused on sowing fear and using it to move product.

Image altered from its original form. Original image credit as linked; licensed under Creative Commons BA-SY 2.0.

Parents of autistic children are reaching out for help.
What they find are people reaching for their wallet.

 

To be clear, the attendees of the conference and a number of the panelists were obviously there with the best of intentions. Some of the speakers worked hard to provide excellent, sensible advice about caring for children on the autism spectrum, such as how to help them use social media responsibly, how to make sure they’re safe at school, and how to make more severely afflicted children comfortable at dental appointments. Others, and numerous parents who came up to speak at an open-mike session, told moving and uplifting stories about their own personal experiences. The heart of the movement is certainly built around giving autistic people and their families support for their difficult journeys.

But rather than give the audience the best science or using a critical eye to weed out the opportunistic hucksters, the conference organizers emphasized the worst parts of the autism and anti-vaccine community. They made their priorities quite clear when they brought in Andrew Wakefield to take charge on stage. Wakefield is the disgraced British researcher who attempted to discredit the MMR vaccine with a fraudulent study, allegedly for his own profit. But the Summit put him on stage before an audience of parents, moderating panels that hawked products and services to them. He brought with him a veritable circus of anti-vaccine advocates and vendors eager to sell their products and services to desperate parents.

I can only summarize a small part of the summit, particularly the speakers who struck me as particularly appalling. One of them was Dr. Arthur Krigsman. Like Wakefield, Krigsman has a checkered past. Like Wakefield, he is a strong believer in an autism-MMR connection. Like Wakefield, he has failed to prove it. Like Wakefield, his failure to prove it has not prevented him pushing the theory. And like Wakefield, regulators have found reason to question his actions.

Krigsman was an expert witness in what are called the Omnibus Proceedings, in which a neutral court examined the evidence and found the evidence for an autism-vaccine link insufficient. The court discussed Krigsman’s background in one of its opinions, starting on page 138. It noted that Krigsman “left [his] hospital’s employ under questionable circumstances,” and that he had admitted that “the hospital restricted his privileges to perform endoscopies (an invasive procedure with some risks) in the belief that Dr. Krigsman was performing medically unwarranted endoscopies on children for research purposes.” He later moved to Texas and began working with Wakefield; the Texas State Board of Medical Examiners fined him “in part because of his ‘falsification’ and ‘attempted concealment’ of a prior disciplinary action by the Florida medical board.” The court further noted that Krigsman listed four “publications” on his c.v., but that only one of them was actually a publication.

Based on its website, Dr. Krigsman’s clinic is apparently still taking patients for a condition he calls autistic enterocolitis. Wakefield proposed that this condition exists; the medical community overall rejects the notion. A separate court ruling observed that “‘autistic enterocolitis” is not recognized as a distinct medical condition,” that “Dr. Krigsman’s testimony about autistic enterocolitis as a diagnostic entity was speculative and unsupported by the weight of the evidence,” and “that Dr. Krigsman’s view that autistic enterocolitis was a new bowel disorder was not recognized by the gastroenterology medical community or medical textbooks.” It found “the evidence supporting the regressive autistic enterocolitis phenotype to be scanty, and Dr. Krigsman’s problems with medical authority and his own ‘resume padding’ did not enhance his credibility.” This is not to say that autistic kids don’t have gut problems, but rather that the medical community apparently doesn’t feel there’s good evidence that a distinct condition such as autistic enterocolitis exists. Dr. Krigsman does not seem to have let these criticisms interfere with his business. The Autism Trust and Andrew Wakefield put him in front of an audience of parents looking for help and told them he was a hero.

They neglected to mention things parents might want to know before putting their kids in his care, such as the fact that a hospital “restricted his privileges to perform endoscopies (an invasive procedure with some risks) in the belief that Dr. Krigsman was performing medically unwarranted endoscopies on children for research purposes.” Instead, they gave him a platform to speak about why parents should let him perform endoscopies on their autistic children.

I’m not a doctor, and I can’t say that his advice was wrong or dangerous. (He goes into some of those reasons starting around 35:30.) Another panelist acknowledged (around 58 minutes in) that many doctors do not feel such procedures are necessary. That’s hardly surprising. Dr. Krigsman’s website includes a FAQ discussing “autistic enterocolitis” but neither poses nor answers the fundamental question: does it even exist? Outside of Wakefield and Krigsman’s coterie, the answer appears to be no.

It's never really free.

It’s never really free.

 

Krigsman obviously understands that many parents of autistic children might have trouble paying for his endoscopies. He and the other speakers explained some ways parents can work an insurance company to get coverage for his services and what to do if their carrier refuses. He also asked attendees to donate money to pay for the procedure. Given his background, I’m dubious that Dr. Krigsman’s advice was based on good, solid science. But I think it’s quite likely that he found new patients at the conference, and that the experience will enrich Dr. Krigsman.

Another panelist told parents that autism needs to be “reversed,” not “managed,” and that Western medicine is flawed because it doesn’t focus on that. Conveniently he was sitting in the same panel as Dr. Kendall Stewart, who had his very own vendor stall selling autism-themed supplements. If you missed the conference, and you have more money than you’d like, you can buy his wares online as well. Their catalog sells an “Autism Starter Kit” for nearly $200 (“$11 in savings!”).

 

Stewart isn’t as notorious as Krigsman or Wakefield, but he has made and failed to prove his own extravagant, self-serving claims. Interviewed for a 2013 article on the business of purporting to treat autism, Stewart claimed to have treated thousands of kids. But he couldn’t give any plausible explanation why he hasn’t performed evidence-based studies to demonstrate that his expensive treatments work. He suggested his methods were just too controversial to publish. I can’t find any indication that he’s ever tried. And what would be in it for him? The data might not support his claims. If he never tries to publish, he never runs that risk.

If a doctor charges you a lot of money for it, it must be medicine, right?

If a doctor charges you a lot of money for it, it must be medicine, right?

 

Although Dr. Stewart told parents that other doctors aren’t sophisticated enough to understand the issues of autistic children, at 1:24, he demonstrated an alarmingly high threshold for nonsense. When asked for advice on helping autistic children and their parents get restful sleep at night, he suggested EM radiation from wireless routers could be keeping them awake (at 1:36). Of course he did not offer any scientific support for the absurdunfounded idea that humans can detect such low-power radiation, consciously or unconsciously. But the Summit gave him a stage to peddle this nonsense—and expensive pills, powders and potions—to parents of autistic children.

The Summit’s preaching reached a fever pitch, predictably, during the Vaccines panel. (The panel starts about 2 hours and 40 minutes into that video,and continues into the next video at that site.) Two panelists, a plaintiff and his attorney who had failed to convince the vaccine court that their case had merit, complained at length that one of the government’s experts gave conflicting expert reports. Their presentation was naturally very one-sided, relying heavily on a document leaked from a closed case file and presented out-of-context without critical evaluation or discussion. Wakefield nevertheless called for blood, demanding that the government lawyers be punished for inconveniencing the anti-vaccine movement. He conducted a straw poll of the audience asking whether two specific Department of Justice attorneys should “stand trial on charges of fraudulent misrepresentation and obstruction of justice.” When he called for the attendees to cry out their support of his bizarre demands, it revealed the heart of the anti-vaccine movement: it relies on fear and confusion, and abhors the calm deliberation of courts and scientists.

There was no panel or discussion analyzing the scientific consensus on vaccines, or discussing the problems with anti-vaccine research such as Wakefield’s. The panelists didn’t talk about how parents can educate themselves and sort good advice from expensive nonsense. I suspect such advice would be contrary to their business interests. Instead, my impression was that many people on stage were there to create a culture of fear—Fear technology! Fear Big Pharma! Fear doctors! Fear GMO foods! Fear vaccines! There was no rational discussion of whether such fear was warranted. Instead, there were speakers and vendors touting goods and services to help parents manage that fear. Supplements, endoscopy, homeopathy, naturopathy, and chiropractic: the market was booming.

Wakefield and his celebrity guests weren’t hawking merchandise. There are no Wakefield-brand tennis shoes or patent-pending MMR-shielding magnetic bracelets. Yet. But he and the other moderators were there to benefit off the backs of their audience nevertheless. The panelists harangued the crowd for hours, reinforcing the message of fear and driving home the point that the world is out to get parents, especially parents of autistic kids. Wakefield, the other moderators, and the celebrity guests presented themselves as brave rebels against the system, and reaped the crowd’s adulation. The washed-up celebrities got treated like A-listers, and Wakefield was once again–for a little while–a serious and respected health care professional. For an exposed fraud, particularly one whose malfeasance has been so dangerous to children, it must have been intoxicating to stand in front of a room full of parents primed to see him as their children’s savior. For that day, in that place, he was free from the shame that follows his name.

He’ll send us the bill.

 

All image credits to their original photographers or rights owners. Hand image altered from original and licensed under Creative Commons BY-SA 2.0. “Electric treatment“, Illustration, and Without Equal images licensed under Creative Commons BY 2.0.

 

Article and photo by Colin

 

Lies can make complex problems look simple; anti-vaxers want to keep your eyes on their distortions, rather than looking up to take in the real world.

Lies can make complex problems look simple; anti-vaxers want to keep your eyes on their distortions, rather than looking up to take in the real world.

 

Thanks to Jenny McCarthy and Megan of Living Whole for proving the point: anti-vaxers are lying to parents. Jenny McCarthy is in the news lately with an op-ed that starts with a whopper: “I am not ‘anti-vaccine.’” This is absolutely not true; McCarthy has worked hard for years to scare parents away from vaccinations. The root of her campaign is her insistence that vaccines cause autism, despite the conclusion of the community of experts that there is no evidence of such a link.

It’s absurd for her to claim now that she only wants “safe” vaccinations, since the dangers she complains about are primarily in her head. Vaccines, like any medicine, can’t ever be 100% safe, but they’re “among the most safe and effective public health interventions to prevent serious disease and death.” Science can’t make a vaccine “safer” if the problems she wants fixed don’t exist. It’s as if she was telling parents not to fly until Boeing finds a way to keep gremlins off their planes. They can’t do it because gremlins, like a vaccine-autism connection, don’t exist. Nevertheless McCarthy uses those false fears to drive a wedge between parents and their doctors, depressing vaccination rates while still shamelessly claiming she’s not “anti-vaccine.”

McCarthy has been lying for years about the dangers of vaccines. If the effect of those lies is to stop parents from vaccinating, then yes, she is an anti-vaxer. But she’s not stupid; she knows that people give more credibility to voices that claim to be “in the middle” or “just asking questions.” So she lies. She claims that she’s not an anti-vaxer, even though her goal and effect is to reduce childhood vaccinations, because she’s a more credible and effective anti-vaxer if she can persuade parents she’s just asking questions about the safety of the vaccination schedule. Since those questions have long since been answered, the only reason she’s still asking them is to spread fear, uncertainty and doubt about some of the safest medical products available, her pretense at a balanced stance is false and misleading.

It’s common for anti-vaxers to lie to enhance their credibility. It’s one of the only ways the movement can make progress, since the community of experts disagrees with their conclusions so fervently. One way is to claim false equivalence, as McCarthy does. But we recently saw a good example of an even bolder lie, courtesy of Megan at Living Whole.

Continue Reading…

My most recent post (“Dear parents, you are being lied to”) has sparked a very lively discussion. I encourage you to continue to share your thoughts on it, but I also want to follow up by asking for your reactions to one comment that I found particularly interesting. (I’ve edited it a bit for brevity)

As a pediatrician who’s spent extensive time working in the US and overseas and has seen children die from EVERY disease (except small pox) for which there is a vaccine I am appalled at the lack of education by the general public on the vaccine issue. This is my rant: I had two unvaccinated children in the US die from whooping cough, one from tetanus, and 2 from meningitis in the past few years. Perhaps this reflects our country’s generally poor understanding of math and science in general. A recent large study in the US showed that no matter how scientists try to educate US parents about disease and disease prevention, whether it is vaccines or hand washing, parents simply cannot follow the logic.

It’s devastating to see children die from preventable disease and despicable that it is happening here. I would like to know why those whose children end up in the PICU with tetanus or whooping cough now trust us to save the life of their child? Why do you run to a doctor when you are terrified your child has tetanus after refusing to vaccinate? Why am I now competent to save your child’s life when they have meningitis or epiglottis, but I wasn’t competent enough to keep them from getting sick? If there was no medical help for your unvaccinated child if they acquired a vaccine preventable illness would you think about vaccinating? If you’re not willing to run to your anti-vaccine friend, treat your child with advice from non-scientific sites on the internet, go to your chiropractor, or your holistic healer with your dying child perhaps you shouldn’t be taking their advice about vaccines. –Anonymous

To those of you who simply don’t trust the medical community’s use of vaccines, I am curious what you make of this physician’s point. Given your reservations about vaccines, do you trust an MD to treat yourself or your children for any medical issues at all? If so, why do you trust his/her education and experience on some points but not others?

I invite anyone, pro- or anti-vax, to share your thoughts on this. Please respect each other by following the commenting policies (and feel free to alert me if I miss a comment in violation of them).

 

Standard of care.

In light of recent outbreaks of measles and other vaccine preventable illnesses, and the refusal of anti-vaccination advocates to acknowledge the problem, I thought it was past time for this post.

Dear parents,

You are being lied to. The people who claim to be acting in the best interests of your children are putting their health and even lives at risk.

Continue Reading…

by Colin McRoberts

A while back a friend asked me to help with a difficult conversation. Someone she cared about was expecting her first child, and had decided not to vaccinate her baby. My friend desperately wanted to change the mother’s mind to protect that child. But she wasn’t sure how to proceed. She had the facts on vaccines, and knew that refusing immunizations was a dangerous and irresponsible decision. But she wasn’t sure how to convince her friend of that without jeopardizing their relationship. There are some excellent resources for health care providers having this conversation with patients. But there wasn’t much that applied to her particular situation. So she asked me whether my experience as a negotiator gave me any insights that might help her plan for what was sure to be a difficult conversation.

As it happens, I had been thinking about the same thing. I’m particularly interested in how laypeople should approach a conversation like this, since laypeople can be much more persuasive than the family physician. In the real world, our family and trusted friends very often carry more weight than experts. The giant but useless homeopathy industry would collapse otherwise. So when you hear that one of your friends or relatives doesn’t plan to vaccinate, you have the opportunity for a conversation that could potentially change their mind and save that child from terrible harm.

Unfortunately, too many people approach that conversation timidly, without a solid strategy for persuading their friend. That makes it hard to respond when things take an unexpected twist, such as your friend spouting off antivaxer talking points you hadn’t considered. Other people are too aggressive, treating the conversation like the comments section of a blog post. That kind of combative and confrontational dialog can feel good, but it doesn’t accomplish much in the real world.

So what does a strategy for an effective, persuasive conversation look like? There is a world of advice we could give about that conversation. We’ve distilled it into four basic points: be sincere, ask questions, be sympathetic, and provide information.

Picture1

After the fold, we’ll go into some specific thoughts about each one. We want to stress, though, that this is just a framework. The conversation itself will be different every time. We want to know more about your conversations. If you’ve tried to talk someone into getting a child (or themself) immunized, please share your story in the comments section.
Continue Reading…

This afternoon Ms. Couric’s show “Katie” featured the “HPV Vaccine Controversy” as part of its “Big Conversation”. The segment focused mainly on the vaccine Gardasil, which is administered to girls and boys around the age of 11, in an effort to immunize them against HPV before they become sexually active and likely to contract the virus.

Although Couric herself claims that she is personally “not anti-vaccine”, her show was extremely biased against the scientific consensus. She kept referring to the vaccine as “controversial” when there are no legitimate scientific studies showing it to be dangerous. I’m used to getting upset at journalists who give false equivalency between the scientific consensus on an issue on the one hand and a fringe belief on the other. But this was beyond the pale; Couric’s program didn’t even aspire to that “balance”.

Continue Reading…

Orac is reporting that a planned Congressional hearing into the National Vaccine Injury Compensation Program has been canceled. This is unambiguously good news; the hearing was probably a political favor being done for anti-vaccine cranks who despise the NVICP. Their hatred for the Program can be confusing, given how much better it is for their position than the alternative.

Continue Reading…

Today I took care of myself and my community by getting a flu vaccine.

Getting the jab!

I get one every year. I do it not just to protect myself (although that’s an important consideration–I don’t have time to get sick!), but also to protect my community from a serious health hazard. Continue Reading…

Given ongoing interest in this post: http://violentmetaphors.com/2013/08/14/the-truth-about-vaccinations-your-physician-knows-more-than-the-university-of-google/, and based on several people’s suggestions to me, I’m going to put together a FAQ on the subject of vaccine myths/misconceptions. I will be pulling questions from the comment section of the University of Google post (and other places), but I would like to ask for your participation.  What questions do you or your friends have about vaccines? What are some vaccine myths have you heard that you’d like to have addressed? What kinds of information would you find helpful for sharing with family members when talking about vaccine issues? Parents, I’m *especially* interested in questions that come up repeatedly on parenting forums and messageboards.

Please leave me any questions/suggestions/links in the comments below, or email me privately at jenniferraff (at) utexas (dot) edu

Thanks, as always, to everyone for reading, commenting, and sharing.