Posts Tagged ‘ Vaccination ’

Anti-Vaccine Charity, No More


Last year I wrote a series of posts[1] around the Charitable organisation Immunisation Awareness Society and a complaint I had made to the Charities Commission. The Thrust of these posts and the complaint was that the Society does not fulfill the requirements of a charity and should be removed from the register. The effect of this is that they would also be stripped of their tax exempt status.

This indeed was my main goal. There are innumerable groups out there that I don’t agree with but you get that in a wide and varied world. In the case of the IAS though the speech they engage is is effectively publicly subsidised via the tax exemption, this should mean that they are constrained in what they can say. At the very least it should mean that they must present the facts undistorted by ideology.

Yesterday I found out that the Charities Commission agrees with me. In a decision handed down late last month they determined that the IAS does not qualify for charitable status and removed them from the charities register.

So, I guess you could say – I won.

It the words of one of my colleagues it also shows that one person can make a difference. Clichéd but true.

Reading through the Charities Commission decision it seems they focused on two things:

1. The biased nature of the information provided by the IAS and;

2. The political nature of their campaigning for a change in public policy.

This makes sense given the requirements that the Commission need to fulfil to determine whether an organisation meets the requirements to be a charity. Even so I’m a bit disappointed that there was no focus on the factual inaccuracy of and misrepresentation in the materials published by the IAS.

The decision does seem to skirt this line though when stating that  “Overwhelmingly, the information on the website argues that vaccination is ineffective and dangerous” the inference being that is view is incorrect as well as being biased. Even so, none of the language of the report actually states this outright (that I can see).

There was also an additional point touched on that merely providing information does not in and of itself “advance education”. In other words to be an educational charity you actually have to actively educate people, not simply act as a repository of information – otherwise every private citizen with a decent library or informational website could become a charity.

Finally, in my personal 15 minutes of fame, the Commissions decision has been reported in the Dominion Post – complete with a quote from me. Not my most eloquent moment but it’s close enough to the point I wanted to make that I’m fairly happy.

[Edit: Thanks goes to commenter Hemlock for sharing the IAS response to this news]

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1.  And here they are in all their tedious glory:
http://scepticon.wordpress.com/2011/10/11/anti-vaccine-charities-is-there-any-quality-control-on-charities/

http://scepticon.wordpress.com/2011/10/11/ias-complaint-part-1-thimerosal-in-your-vaccine-no/

http://scepticon.wordpress.com/2011/10/12/ias-complaint-part-2-gardasil-horrors-horrific-reasoning/

http://scepticon.wordpress.com/2011/10/13/ias-complaint-part-3-vaccine-ingredients-not-so-bad-really/

http://scepticon.wordpress.com/2011/10/14/ias-complaint-part-4-anti-vaccine-impact-in-new-zealand/

http://scepticon.wordpress.com/2011/10/17/defending-the-term-anti-vaccine/

http://scepticon.wordpress.com/2011/10/18/the-legitimate-risks-of-vaccines/

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Get Your Up-To-Date Vaccine News


Thanks to my recent single-minded posting I’ve stumbled across this resource that pulls together news and blog posts on vaccines and anti-vaccine topics.

It uses a cool functionality of Scoop.it to collect posts which are then “curated” by a real person (hate those obviously fully automated ones that often ping my posts).

Vaxfax monitor is a Scoop.it site, which means the curator specifies keywords and the software trawls Twitter, Google, Digg and Youtube to generate content that matches the keywords. Once this is done the output is offered to the curator to vet. The posts that are retained through this process are published to the main site while those that don’t make the cut are discarded.

The curator of this feed is a poster who goes by the handle anarchic_teapot. Regarding anarchic’s chosen Nym I took this from the about page:

“My handle was chosen entirely at random, so don’t read anything political, social or ironic into it. I have no connection with the Anarchist Teapot Collective, or the coder using the handle anarchic.teapot (with a period, not a hyphen). I’m pretty certain I used the name first, though.”

I contacted anarchic_teapot to get a bit more information about the process involved in putting this feed together and to get a feel about the person behind the page and for why this resource is important.

[Scepticon] Where abouts in the world are you based?

[anarchic_teapot] I live in France, surrounded by sunshine, wine and cheese. And lots of other stuff that’s bad for my diet.

[Scepticon] The agregator uses keywords to collect content, is there any way to get random stuff you’ve noticed into it?

[anarchic_teapot] It’s also possible to scoop stories directly off the Internet, using a browser widget. In fact, the 3 main aggregators I use: paper.li, scoop.it and newsvine now all offer this service.

[Scepticon] What’s the difference between those services?

[anarchic_teapot] Scoop.it will publish each article immediately it’s validated. You choose any tags and which sites you’re going to publish to. It’s useful for getting breaking news out the door, but does require a lot of time curating. Another drawback is that it can mean a lot of tweets going out, and I don’t like flooding the intertubes, out of respect for my long-suffering readers. I want to keep them!

Paper.li does quite a good job of finding keywords, and you can pick the regularity at which it’s updated. At most, you’ll have two tweets a day.
The (big) disadvantage is that you can’t remove unwanted content until after an update.

Newsvine doesn’t send out tweets, although I suppose it would be easy to send your personal RSS feed through a service like Twitterfeed for that. On the other hand, it does allow comments, so you can get a discussion going. You can also write quite a lengthy post about the article you’ve seeded, as they call it. However, you have to go find your content for yourself; it won’t go looking for you. Although you *will* be warned if Newsvine thinks someone has already seeded the same story.

[Scepticon] Once the stories are gathered what happens?

[anarchic_teapot] Every time I check the feed, I have up to 100 stories that I can either discard, block the source (porn sites, bots, or other minor noise) or decide to publish. I try to keep Scoops recent (past 2-3 days) and from reliable sources. I also try to keep repetition down.

[Scepticon] Why did you feel the need to create such a resource, what do you see as the goal of aggregating all this stuff in one place?

[anarchic_teapot] I suppose the need comes from not having enough time to check major news sources regularly, and nobody to do it for me. I’ve always been one to let the computers do the spadework. Putting it all in one place gives me the chance to spend more time sifting through the dross. There is a lot of dross. I have some absolute doozies lined up for future blogging.

At the same time, to see so much quackery being sold so hard scares me.
It keeps me motivated, and I understand why others are so implicated in the struggle for science too.

[Scepticon] What is the criteria for inclusion, do you simply include those things you already agree with?

[anarchic_teapot] Well, it’s all a bit subjective, as things have to be when you’re playing editor (I hate the word curator, that’s for museums) to any sort of publication. As a rule of thumb, I try to keep to stuff that’s informative, not too technical – I’m not the health professional in the family – and of immediate use. I had to think about announcements of potential breakthroughs (HIV and malaria are currently doing the rounds) but decided it would be quite enough to deal with currently available vaccines.

[Scepticon] What is the main focus, news stories that demonstrate harm of anti-vaccine views or information about vaccines themselves?

[anarchic_teapot] Both, really. For reasons of space, I try to avoid localised reports, unless the story is of wider relevance (e.g. a clinic offering free shots probably won’t make it, but an outbreak of mumps may). I occasionally throw in some of the nastier antivax stuff, well flagged as such, in the hope that someone better qualified than me will pick it up and pillory them.

The teapot also admitted to using the generated content prior to publishing as a means of keeping an eye on the shall-we-say “less reasoned” content out there. I believe the term used was “Stupidity detector”, turning these gems into the bases of blog posts.

One of the things that I am grateful the anarchic for is the attempt to keep the feed from turning into an agglomeration of random crap.As noted earlier, I often get pingbacks from sites that have linked to my posts (and sometimes published portions of them) that when I check are simply grabbing everything with a keyword with in filtering, even to the point that the main purpose of a page is 180o opposed to what I’ve written but presents my content as if it’s in line with the site’s philosophies.

According to the teapot:

“The nice thing about Scoop.it is that you don’t *have* to publish anything.”

Ah, how refreshing.

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Defending The Term “Anti-Vaccine”


I have spent some time recently labelling the IAS as anti-vaccine. They themselves categorically state that they are not anti-vaccine. Who am I to say that I’m right and they are wrong?

Well, nobody really. I can’t read their minds, although if I could would that change anything? All anyone can do is examine their output, and that of others, and try to make a determination as to whether it is more consistent with an impartial, or simply safety concious, approach to vaccines and vaccination or an anti-vaccine stance.

I hope that my previous posts have demonstrated that the IAS in particular produces anti-vaccine rather than balanced vaccine safety material.  The mission of the IAS is to cast doubt on the safety and efficacy of vaccines not to educate responsibly about the real concerns and limitations of vaccine use. If this was their aim they could do a much better job. Look at the articles produced on their website and you will see many that promote the “dangers” of vaccinations, try to discredit health campaigns and generally aim to undermine public confidence in vaccines.

An organisation concerned about vaccine safety and promoting responsible use of vaccines might write about reducing wide-scale vaccination in favour of targeted vaccination of at risk populations. Perhaps They would also try to work with health authorities to examine ways in which vaccine production can be improved (better production techniques might avoid allergy issues mentioned below), or ways in which the distribution of vaccines can be made more effective and thereby reducing the need to preservatives that are thought by them to be harmful.

It is important to note that someone can be concerned about the safety of vaccines while not being anti-vaccine at the same time. I alluded to this above, but there are legitimate safety issues surrounding vaccine use and vaccines should indeed be closely scrutinised prior to mass roll-out via safety and efficacy trials and post roll-out via surveillance systems and doctors reports. It is a valid complaint that procedures are not always carried out effectively.

Sometimes though they are carried out quite effectively and in a follow-up post I will look at a couple of examples of this. The trouble is that often when a “danger” of vaccines is reported more coverage is given to the sensationalistic claims than the eventual explanation. Also (perhaps because of this) these claims have a tendency to hang around and affect public sentiment long after the coast is clear from a safety standpoint.

As I mentioned there are real risks associated with vaccine use, there are known side effects that can have implications for the health of a small number of vaccine recipients. One of the more obvious being allergic reactions to the vaccine ingredients. Those with egg allergies are urged to use vaccines cultured via chicken embryos with caution and may be unable to receive the vaccine at all. There can be other serious and not so serious or transitory side effects for specific vaccines and effects that are general to vaccines (such as redness, soreness, syncope etc).

As such there are a variety of non-histrionic ways that vaccine safety can be discussed, without impugning the general safety of vaccines. Likewise reasonable conversations may be had regarding relative efficacy of vaccine preparations against the myriad of infectious agents that we are exposed to as well as discussions about cost effectiveness of mass vaccination for low incidence infections.

Serotype replacement (or replacement disease) is another issue that can be raised. As infectious strains are targeted by vaccines there is the possibility that other strains that were less important in the pathology of disease become more prominent once the “Top Dog” has been removed.

Encouraging the production and research into more effective vaccines that give better or more long lasting protection could also be a fruitful line of approach. Perhaps we could focus on immunogenicity, better adjuvants would give a vaccine the ability to provoke a stronger immune response, possibly with fewer antigens – as has already been achieved with modern vaccines. If vaccines are improved in this way then there will likely be more local reactions with the inclusion better adjuvants. This again is a reasonable discussion to have.

The lack of large RCTs on all vaccines and the challenges of working around this (for example ethics prohibit withdrawing a measles vaccines then trying a new one against a placebo). The types of studies required or currently used to give us the appropriate information to act upon is something that we can all try to resolve together.

All these things are such that reasonable people may disagree and we should be able to marshal evidence based (rather than emotive) arguments to discover the optimal us of vaccines in society. To my reading of the IAS, their output appears limited to vitriolic and divisive attacks on health authorities and other informational agencies, vilification of pharmaceutical companies, fearmongering over the alleged dangers of vaccination and downplaying the risks of infectious diseases.

Where we start treading into anti-vaccination territory is when we start to become entrenched in a view that sees vaccination as an evil unto itself, perpetrated in the name of profits by immoral pharmaceutical companies and carried out by unethical doctors who are either ignorant dups or willing accomplices. Those who take this stance may make all of the reasonable arguments that I outline above but also be resistant to evidence that contradicts their views and committed to a general non-vaccine outlook.

In discussing this it is very difficult to convey the range of views that may be represented. Obviously we all exist on a spectrum – from fully pro-vaccine to recalcitrant anti-vaccine. It can also be very difficult to determine the views of people in conversation. I prefer to err on the side of caution and assume people are generally well intentioned and open to evidence until proven otherwise.

One of the defining characteristics of the anti-vaccination crowd, it seems to me, is the hyping of dangers far beyond what the evidence supports. As can be seen in some of the attacks on vaccine ingredients, lists of ingredients are given and scary information accompanies them with the toxicological effects of these compounds on living organisms. In these cases  though the dose is often ignored. Dose response is one of the corner stones of medicine and the dose makes the poison. Drink large quantities of formaldehyde and you’re in trouble, but in the tiny doses found in vaccines your body can easily handle it. as noted in a previous post our bodies actually make formaldehyde as part of normal metabolism and the amount found in vaccines is far smaller than that made by the normal process of living.

When it comes down to the bottom line – Vaccines work, and they actually perform that holy grail of CAM, “boosting” the immune system and allowing the body to heal itself. Not in some vague, feel good alternative medicine way but in real objectively measurable and observable ways. Your immune system is primed to react to infectious agents in such a way as to reduce the amount of time that it takes for an effective immune response to be mounted against the pathogen.

With this priming your body can fight off infections much more efficiently and this translates into keeping us healthy, or reducing the severity of diseases. While we can debate the finer points of vaccine safety and efficacy in the end we have a system that works and has saved many lives. I see that as a win.

[for more on this topic see this post from David Gorski of Science-Based Medicine published last year]

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Vaccines and Autism – Media Report Card


Just got sent this link by the irrepressible Aimee, a “Not great” article about the Vaccines vs Autism “Debate”.

Here’s my Media Score Card for this article:

Much rubbish, a few good points. I give her a C-.

‘vaccinate at any cost’ = Strawman
Court decisions =/= Science
Incomplete knowledge = No knowledge = Fail
Anecdote =/= Good Evidence
“acceptable risk” argument simplifies risk/benefit assessment = Fail
“Teh Toxins” = Fail
Injection = Unnatural = Fail
“canaries in the coalmine” = Fail.   Can someone say “Mommy instinct”?

Respectful discussion = Win
Pro-information = Win
Complex topic = Win.

All-in-all a reasonable person sucked into the Vaccine -> Autism perspective.

Pity.

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Vaccination Awareness Week Round-Up


There’s still officially one more day of Anti-Vaccine Awareness Week (two really, as it’s an American idea) but here’s a round up of the posts anyway. While I know there are lots of great in-depth posts around the blogosphere on this the following list has been restricted to NZ posts to keep the local flavour. The posts are in roughly chronological order.

The University of Auckland Library at Tamaki Library blog Misinformation spread about HPV vaccine

Me Anti-Vaccination in NZ

Scott at Imperatorfish They Can’t Vaccinate Against Tin-Foil Hat Syndrome

Michelle at Skeptics In The Pub Vaccines: The actual facts (well, the links to some anyway…)

Alison Campbell at Bioblog on polio

Michelle at Skeptics In The Pub More facts about vaccines….

Me A Side Benefit of the ‘Flu Vaccine – Reduction in Heart Attacks

Michael Edmondsat Sciblogs Guest Work “I’m not a Scientist but …”; Dissection of an antivaxxer’s argument

Alison Campbell at Bioblog chelation quackery around vaccination

Grant Jacobs at Code for Life Immunisation, then and now

Alison Campbell at Bioblog homeopathic vaccinations – fail

The next couple are not specifically about vaccination but I think are worth a mention:

Grant Jacobs at Code for Life If presenting a claim on a popular issue

Megan Leask at Southern Genes This Week in Science History: 1-11-10

If anyone knows of a post I’ve missed then please feel free to add it in the comments.

[Edit] One more – Alison @ Bioblog vaccination & smallpox

For those of you interested in the international posts, blogger Liz Ditz has done an awesome job collating all of the posts here:

The Big List of Reality-Based Vaccine & Infectious Disease Blogging

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A Side Benefit of the ‘Flu Vaccine – Reduction in Heart Attacks


ResearchBlogging.orgIt’s a bold claim, that being vaccinated for Influenza will protect you against having a heart attack or Myocardial Infarction (MI). Well according to a study published last month in the Canadian Medical Association Journal that could well be the case.

The study, “Influenza vaccination, pneumococcal vaccination and risk
of acute myocardial infarction: matched case–control study
“, included 78,706 individuals over the age of 40 in an attempt to determine whether and how much of an effect the vaccine had on MI. The results showed that the vaccine was associated with an almost 20% reduction in risk of MI compared to the unvaccinated population.

My first thought when I read this was that those individuals who get vaccinated might engage in other activities that would lend themselves to reducing risk of MI, healthy eating habits, regular exercise etc. The so called “healthy user” effect. This study attempted to control for this sort of confounding factor by using matched controls with similar risk factors. In particular they performed two further analyses that I think comfortably undermine this interpretation of the results.

First they compared the timing of the receipt of the vaccine, ie early or late in the ‘flu season. Second they looked at subjects who had been vaccinated with the pneumococcal vaccine as a comparison. In the first case there was a greater reduction in risk for those who had received the vaccine early in the season, 21% compared to only 12%. In the second case they found no protective effect for those who had received the pneumococcal vaccine. It seems unlikely that the subjects of the study would vary their healthy habits in precisely the ways they would have to in order to see these results as being independent of the vaccine itself.

An interesting aspect of this kind of epidemiology though is that simply looking at the raw numbers there is a greater incidence of MI in the vaccinated group compared to the unvaccinated group. This is an artefact of how the vaccines are administered clinically. Those patients who have greater cardiovascular risk are also the patients who are more likely to be recommended for vaccination. It’s like noticing that people who buy antiperspirant tend to have sweatier armpits than those who don’t*. Those who are prone to sweaty armpits will likely tend to be those who will buy and use antiperspirant, to accurately gauge effectiveness you would have to control for this factor.

Tying this into the anti-vax focus of this week, one of the claims I’ve seen is that the flu vaccine is useless as it is based on strains that were around the previous season (Here via IAS). This is distressingly simplistic thinking. This paper shows that the vaccine is far from useless, in fact the most benefit was found within ‘flu seasons. If there was no effect of the vaccine on the current ‘flu season strains then the study would not have shown the protective effect that it did. Once again the anti-vax crowd (and by extension the altmed crowd as there tends to be overlap) has shown their inability to grasp the nuance of the situation.

There is a gradation of effect when a vaccine does not exactly match the wild strain, the interaction of antigens and antibodies is more complicated than you might suppose. Changes in the antigen (mutation of the virus over the ‘flu season) mean that antibodies may bind less tightly and therefore have a reduced effect but that is not the same as no effect.

To sum up, health is a complicated thing. Many factors are inter-related and in order to get the whole picture we sometimes have look at things from an unusual perspective. Vaccinating for the ‘flu can reduce your risk of heart attack, who knew? But, we should also be wary that we are keeping things within the realm of plausibility. Infection does cause inflammation which can plausibly effect heart function**. This does not mean it’s valid to blame the Wi-fi at your local school for your vague aches and pains.***

Footnotes:

*To make up an example.

** See http://www.sciencebasedmedicine.org/?p=6926

*** http://theness.com/neurologicablog/?p=2215

—-

Siriwardena AN, Gwini SM, & Coupland CA (2010). Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case-control study. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 182 (15), 1617-23 PMID: 20855479

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Anti-Vaccination In NZ


As promised here’s my first entry for “Vaccine Awareness Week”, I thought I would take a little look at Anti-vaccination in New Zealand. In particular the  Immunisation Awareness Society. This organisation has set itself up as pro-choice on the subject of vaccination but this is essentially a thin smokescreen for their anti-vaccination views. Here, rather than pick apart a certain piece of writing from their website (of which there is much to choose from) I’ll focus on the points they have put forward as their basic philosophies and see how they stand up. Without further ado, once more into the breach…

1. That natural immunity is far superior to artificial immunity.

This is true, but only for a given value of “Better”. If you are concerned with antibody production and response to infection over your life time then yes, often immunity acquired via infection by a pathogen can last longer than that stimulated by vaccination.  One reason for this is that if you live in an area where vaccine uptake is relatively low (because, you know, they are so harmful) then you will be periodically re-exposed to the pathogen which naturally boosts your immune response. Vaccine induced immunity does tend to wane over the years and if your only contact with antigens (those parts of the pathogen that promote antibody production) is via the Vaccine then the only way to combat this is a booster shot.

Therefore, to benefit from this longer lasting immunity you must actually contract the disease. You must then also suffer through the consequences and complications of that disease. Then you must be periodically re-exposed to the disease to keep antibody production high. Those that survive will have superior immunity to those who don’t, I believe it’s called “thinning the herd”.

I also notice some weaselling in the reference to artificial immunity.  It is not the immunity that is artificial but the method of inducing immunity. This may seem like splitting hairs but how we use words affects how those words are understood, by implying that the immunity gained by vaccines is itself artificial this group is subtly undermining how vaccines are perceived. Then again the rest of the website is as subtle as a sledgehammer to the face so…

2. That breast milk is the best immune stimulator for the baby during the first year of life and that a great deal of immunological protection is provided to the child for as long as breastfeeding continues.

That’s fine, I agree that breast feeding has undeniable benefits, but unless you intend to breast feed your child for life, making for the creepiest business lunch ever*, your child will eventually need to acquire immunity in some other fashion. In this instance, see above.

3. That good health, which starts with a balanced diet that includes important vitamins and minerals, is safer, and more effective at preventing many diseases than artificial immunity.

I can’t argue that a balanced diet isn’t good for you, there is good evidence that ensuring your body has the vitamins it needs does improve your immune response to infection. Beyond this diet is not a replacement for acquired immunity, once again vaccination is the best method of acquiring immunity without actually having to contract and suffer the disease itself.

4. That appropriate allopathic (conventional) and homoeopathic/naturopathic treatment in the event of illness is safer and more effective than trying to prevent illness through artificial immunity.

Homeopathy is not a treatment for anything besides thirst. Apart from that , treating the disease is safer than not contracting the disease in the first place? Are you kidding me? So not only do you have to contract the disease and chance any side effect of the disease itself but also any complications from treating the disease. Seems to me it’s better to just sidestep the whole issue and not get sick.

5. That most diseases contracted by a healthy child, at an appropriate age in childhood, provide important challenges to the immune system enabling it to mature and strengthen, and almost always provide lifelong immunity to the disease.

I’m so glad that the potentially life threatening  diseases contracted by children are actually good for you. Whatever doesn’t kill you makes you stronger right? How about Measles, that’s one of the dreaded vaccinations our children now receive, what does the WHO have to say about it’s safety?:

Complications: Up to 75% children may develop complications which include diarrhoea, otitis media,
pneumonia, laryngo-tracheal bronchitis (croup) and encephalitis. Measles also depletes Vitamin A status that
results in severe eye complications and blindness. Measles can lead to longer term brain damage and deafness.

Death: Case–fatality ratios for children under one in emergency settings: 3–30%. The three major causes of
high case–fatality rates are pneumonia, diarrhoea and croup. Children may also die from measles infection or
its sequelae including encephalitis and malnutrition. Measles infection often leads to a prolonged suppression
of the immune system, increasing susceptibility to secondary bacterial and viral infections.

But at least we get life long immunity. Surely the purpose of immunity is to prevent us from getting the disease, in that case a wide vaccination policy will do the same thing and also gives us a chance to wipe out the disease altogether.

Then there is the “important challenges” bit, the number of antigens children are exposed to as part of the vaccine schedule is minuscule compared to the number that they are exposed to every day just interacting with their environment. Our normal body flora, those bacteria that call our skin and gut home, outnumber the cells that we would normally think of as “us” by a factor of 10 or more.

This represents hundreds of different species of organisms, add to that the numbers of bacteria we might come into contact with due to food, dirt, household and public surfaces etc. and the number of antigens represented by the organisms prevented by the vaccine schedule can be seen in their proper context – insignificant. Not just insignificant but not even worth mentioning.

6. That the vast majority of childhood infections are benign and self limiting in a healthy, well-nourished, well cared for child with a healthy immune system.

This must mean that the organisation supports vaccination for those diseases that are life threatening (I couldn’t find any evidence on the website that this is the case though). Say pertussis, or Whooping cough as it is more commonly known (from Wikipedea):

Pertussis is fatal in an estimated one in 100 infants under 6 months, and fatal in one in 200 infants aged 2 to 12 months. Infants under one are also more likely to develop complications (eg pneumonia (20%), encephalopathy, seizures (1%), failure to thrive, and death (0.2%)). Pertussis can cause severe paroxysm-induced cerebral hypoxia and apnea.

Well it’s only 0.5-1% of children who die. Tell that to the parents. The best way to prevent this disease is vaccination, not just of the individual child but of all who come into contact with her. Herd immunity is the barrier between potentially fatal diseases and those who are too young to have received the vaccine and those whose immune system is compromised and the vaccine is not as effective.

Ok, that’s just one disease vaccinated against, the rest must be very safe. the vaccination schedule can help us here. The list of diseases vaccinated against and the complications for each is:

DiphtheriaThe bacterial toxin can lead to nerve paralysis and heart failure. Between 2–10 infected people in 100 die.
TetanusThe bacteria produce toxins which cause painful muscle    spasms and lockjaw. Hospital intensive care treatment is needed. About one in 10 patients dies. The risk is greatest for the very young or old.
Whooping CoughCovered above.
PolioAbout one in 20 hospitalised patients dies and 0.1–2 in 100 patients who survive is permanently paralysed. The overall risk of paralysis is about one in 100. This increases with age, ie, one in 75 adults. There are 2–10 fatalities in 100 cases from paralytic poliomyelitis. Post-polio syndrome may occur 30–40 years after poliomyelitis (ie, muscle pain and worsening of existing muscle weakness).
Hepatitis BThe virus causes liver infection and acute illness. Severe illness is rare in children. Fatalities are rare and are more likely in adults. Some people become carriers of the virus, especially children (six in 100). Liver cirrhosis occurs in one in 20 carriers (half of these will die). Liver cancer occurs in one in 10 male carriers and one in 20 female carriers and usually leads to death.
Haemophilus influenzae type bAbout one in 20 patients with meningitis dies and one in three survivors has permanent brain or nerve damage.About one in 100 patients with epiglottitis dies
PneumococcalAbout one in 10 children with pneumococcal meningitis die and one in six survivors will have permanent brain damage. About one in three children will be left with a hearing impairment after pneumococcal meningitis. Pneumonia and septicaemia (blood poisoning) leads to hospitalisation. Less severe illness, such as ear infections, may lead to deafness. Children with medical conditions such as congenital heart disease, some chronic lung diseases, kidney diseases, HIV infection, and children whose immune system is lowered through chemotherapy, radiation therapy, or organ transplant are at higher risk of pneumococcal disease. Children with spinal fluid shunts and with cochlear implants are also at higher risk of pneumococcal disease.
MeaslesCovered above.
MumpsIn about one in ten people it causes meningitis, but it is usually relatively mild. It causes encephalitis (inflammation of the brain) in about one in 6000 people, of whom one in 100 will die, and nerve deafness in one in 15,000 people. If infected after puberty, one in 5 males gets testicle inflammation and one in 20 females gets ovary inflammation. In rare cases this leads to infertility.
RubellaFor women in early pregnancy, 85% of babies infected during the first eight weeks after conception will have a major congenital abnormality such as deafness, blindness, brain damage, or a heart defect. This declines to about 10–20% by 16 weeks of the pregnancy. About one in 3000 patients gets thrombocytopaenia (low platelets causing bruising or bleeding). One in 6000 develops encephalitis (inflammation of the brain). This usually occurs in young adults. This may result in death.

Well, they all sound like a barrel of laughs, and perfectly safe. Seriously, the complications from these diseases are serious while the vaccines are relatively safe**.

That’s it for the IAS “philosophies”, while there are good recommendations mixed in (healthy diet, breast feeding) mostly it’s a collection of misinformation, misunderstanding and distortions. I am of two minds about this organisation as a whole, on the one hand I’m a proponent of free speech and that includes topics that I don’t agree with. On the other hand organisations like these have the potential to do great harm, both to individuals and greater society. Balancing these two things can be tricky and where to draw the line between them is not always clear.

On a related note, the Australian based anti-vaccination group the Australian Vaccination Network – has had it’s charitable status revoked. Part of this decision was based on the group’s failure to place a disclaimer on their website stating that it’s purpose was anti-vaccination and that it’s information should not be considered medical advice.

IAS also has charitable status. Under New Zealand law Charities must serve a charitable purpose, as specified by the Charities Act 2005:

Section 5(1) of the Charities Act 2005:
“In this Act, unless the context otherwise requires, charitable purpose includes every charitable purpose, whether it relates to the relief of poverty, the advancement of education or religion, or any other matter beneficial to the community.”

Given that the information distributed is often incorrect or presented in such a way as to misrepresent the facts I consider this organisation to fail both the “educational” and “beneficial” aspects of this definition. As such I would question the validity of it’s charitable status, but that’s for the law to decide not an irritable blogger***.

Finally, for accurate information on vaccines you should head on over to the Immunisation Advisory Centre, which also has a handy list of websites for both Parents and Health professionals.

Footnotes:

*Although This can’t be far behind.

**No active intervention is 100% safe, no-one is claiming that.

***Similar to irritable bowel only more annoying.

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Vaccine Awareness Week


Thanks to the incomparable Orac over at Respectful Insolence we here at Sciblogs have been made aware of an effort by Anti-Vax proponents to have their own consciousness raising week. The haven of anti science that is Mercola.com is promoting November 1st-6th as “Vaccine Awareness Week”.

Like the “World Homeopathy Awareness Week” earlier this year I think this is a great idea, we can use the opportunity to raise awareness of anti-vax misinformation. Like Homeopaths Anti-vaxxers are generally less than forthcoming about the cherry-picking and distortions that underpin the “information” they spout. To be fair, I have no doubt that most are sincere and want nothing more than to help people. I would venture that most don’t really realise that they are perpetuating myths (like vaccines containing anti-freeze, they don’t).

Still, you know what they say about good intentions – they give you excitations, or it that vibrations I forget. Anyway, I’m working on a couple of posts to publish during this time, those of a similar mindset may wish to do the same. I intend to give the week a NZ flavour but I’m aware there are readers of Mercola in our midst so I might throw in a bit of that stuff too if I have time. The more the merrier. It’s at this point I wish I had a flock of monkeybirds at my disposal, fly my pretties and spread the word.

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Gardasil Post-licensure Study


Last month the Post-licensure safety study for Gardasil (the HPV vaccine) was released. The study focused on the reports of adverse events as reported to the VAERS database by the manufacturer, doctors and patients or caregivers. Much has been made by detractors of the vaccine about the serious alleged side effects that have struck young women given the course of injections. These allegations have been supported by referring to the VAERS database itself so if they are valid they should be upheld by this study.

Of the 12,424 reports that VAERS received in the 2.5 year period following implementation of the vaccine, 772 (6.2%) were classified as “serious”, the total number of vaccine doses distributed in this period was 23 million. The category of “serious” was defined according to the FDA regulatory definition of an adverse event that “is life threatening; results in death, permanent disability, congenital anomaly, hospitalization, or prolonged hospitalization; or necessitates medical or surgical intervention to preclude one of these outcomes”.

It must be noted at this point that the VAERS database cannot determine causality, the events reported merely have to occur after vaccination takes place. Therefore anything that happens to a patient in this time frame that someone thinks might be related to the vaccine may be entered. I point this out only to remind that while we may be looking at vaccine safety life does go on, accidents happen and co-incidences occur. The point of a study such as this is to determine if these events are occuring at a frequency higher than what we would expect in the normal population. In other words, is there really a correlation between these events and the vaccine or is is simply a statistical fluke.

The study looked into each type of adverse report in detail and attempted to answer the above question, does the rate of reporting exceed that which would be expected in the general population? In almost all cases the answer appears to be “No”, the exceptions to this were reports of syncope (fainting) and venous thromboembolic events (blood clots), this finding will certainly be followed up in future studies. Curiously one of he more prominent adverse effects that has been concerning many on both sides of the debate, Guillain-Barre´ Syndrome was not found to occur more than expected.

Guillain-Barre´ Syndrome is an auto-immune condition that can be brought on by vaccines but also by normal infections. The syndrome is caused when the immune system is stimulated by an antigen but then starts to target the body’s own nervous system, it usually exhibits as an ascending paralysis noted by weakness in the legs that spreads to the upper limbs and the face along with complete loss of deep tendon reflexes. As vaccines are made to induce an immune reaction the link between vaccines and the syndrome is biologically plausible and not controversial in the medical community.

The study concludes favourably but cautiously, as scientific studies are wont to do:

Vaccination with qHPV has the potential to decrease the global morbidity and
mortality of HPV-associated diseases, including cervical cancer. After hepatitis B vaccine, which can prevent liver cancer, qHPV is only the second vaccine licensed with an indication to prevent cancer. The postlicensure safety profile presented here is broadly consistent with safety data from prelicensure trials. Because VAERS data must be interpreted cautiously and cannot generally be used to infer causal associations between vaccines and AEFIs, postlicensure monitoring will continue, and identified signals may be
evaluated using epidemiologic observational studies.

The full study can be found here, a summary of the study here and a comprehensive discussion of the study here.

Measles Outbreak


There was a story in the NZ Herald this week regarding a Measles outbreak in Auckland and the response to this event by the Powers That Be. Whether or not the action taken (keeping unvaccinated children at home following possible contact with carriers)  is correct, either practically or ethically is a question that will be endlessly discussed by others. I would like to focus on a point made in the article about vaccination coverage in New Zealand children. It was implied that approximately 25% of NZ children are unvaccinated, at the moment data is collected at childhood “milestones” 6,12,18 and 24 months of age. At 24 months the coverage is 77%, after this age no information (currently available) is collected but it is reasonable to expect that the numbers do not climb appreciably after this age.

I found it interesting that the article did not mention that compared with other developed countries this coverage is practically dismal. The coverage in the USA is >95%, though school attendance is predicated upon receiving vaccinations exemptions are available. In the UK where recently there have been concerns over vaccination rates dropping encouraging outbreaks over there, the coverage is still >80%. Even Australia has 82% coverage at age 5. The target coverage for NZ is >95%. Why do we lag behind?

According to the National Childhood Immunisation Survey conducted in 2005, 25% of those whose children do not receive the vaccinations have made this choice due to fears of vaccine safety (another 5% had concerns over a particular vaccine). 3% of respondents reported that they did not believe vaccines work at all. More mundane reasons were also quite prominent: child was on a different schedule or immunisation was done overseas – 19%, medical reasons – 11%, thought the child was vaccinated/not sure if vaccinated ~10%. A laundry list of other reasons each had <3%. Compared with the US where the reasons mostly cited were “Philosophical or Religious beliefs against vaccination” ~66%. Considering that in many states exemption due to religious reasons are about the only ones the law will accept (barring medical reasons) this is likely to cover a wider array of actual reasons.

How should NZ tackle the vaccination issue?

See also:

Evidence Based Thought: What’s wrong with catching the Measles?

VAERS Data: A Comparison


My two regular readers are probably sick to death from hearing about a certain HPV vaccine by now but I thought I’d put up a quick comparison of VAERS data for those that are interested.

The raw VAERS data is quite popular among those who wish to cast aspersions on the safety of the vaccine so I thought I would query the database myself to see what the results would be and compare the Gardasil figures against less controversial vaccines. I decided to compare the data for all reported adverse events between the time 2006-2009 for not only the HPV quadrivalent vaccine but also the flu vaccine and the MMR vaccine. If Gardasil is so dangerous the figures should be significantly higher for this vaccine than the others shouldn’t they?

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Gardasil Follow-up: The Evil Toxins


My last post on Gardasil has garnered quite a bit of interest so I thought I would follow it up with a look at some of the other claims about this vaccine that are also geared towards warning women away from it. The focus of this entry is, as the title implies, the ingredients of the vaccine and their alleged toxicity. Now I would first like to make clear that I am not trying to argue that these compounds are not at all toxic, that would be an untenable position almost anything is toxic at the right (or wrong) dose. This brings up the heart of the issue though, the dose is key here, the claims by detractors of the vaccine imply that the amounts of the chemicals in the vaccine are above the toxic threshold. I, along with the medical community so I feel I’m in good company, consider this to be an incorrect conclusion.

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Gardasil


(Edit: For those interested in the toxic components of the vaccine please look here.)

Recently I  read a letter in a New Zealand paper decrying the widespread acceptance of the new HPV vaccine Gardasil. The letter contained references to suitably scary statistics from a impressive sounding report, in it it was claimed that Gardasil had contributed to the deaths of 18 people and had over 8000 reports of harm due to the administering of the vaccine. The letter ended with the sentence “This vaccine is essentially a large-scale, public health experiment. With doubt about its safety and efficacy, my daughters will not be getting it.”  I thought it might be useful to provide some information that casts a little more light on the situation, the statistics used in the letter and information on efficacy.

Read more

Vaccines


Parents have a tough job. That’s a fact. However this job is made tougher by two things, 1. Fear for their children’s safety, 2. False information in the media. The first is completely natural and even necessary. The second unfortunately is also natural and is something that arises because of peoples fear.

Part of the reason is that when you are talking about someone’s child then any risk is too much. That is understood and absolutely forgivable, this leads to trouble though when that fear is misinformed and the public does not have the knowledge to decipher the facts for themselves. An inability to rationally weigh the risks also leads to making decisions that can be detrimental to health long term.

The trouble with the current concern over vaccines causing autism is that this is primarily a case of parents being overwhelmed by media coverage that is intended to produce ratings not provide accurate information. It is a recurring theme that the controversial stories are hyped and the factual follow ups are down played or overlooked altogether.

Multiple studies have shown that the putative link between the MMR vaccine and autism does not hold up, some of these are listed below. In addition the rise in autism diagnoses that anti-vaccination groups point to is widely regarded by the scientific community to be an artifact of the inclusion of a wider variety of disorders under the umbrella term of “Autism” in recent decades. Autism is defined by a certain constellation of symptoms being present and their severity. In recent years less severe examples of these symptoms have been added to the diagnosis of the autism spectrum. This allows for a greater number of diagnoses than in the past.

This is a very complex and emotional debate and I have only touched on it briefly here, I recommend reading up on the subject through the resources listed below.

Resources

http://www.cdc.gov/od/science/iso/mmr_autism.htm

http://www.theness.com/articles.asp?id=74

http://www.theness.com/neurologicablog/?p=37http://www.immunize.org/mmrautism/

http://www.immunize.org/catg.d/p2065.htm

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=26561

http://www.bmj.com/cgi/content/full/330/7483/112-d

http://www.bmj.com/cgi/content/full/324/7334/393

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