Evidence, herd immunity, and ‘total assholes’

If there’s any one thing I’ve stressed in my talks over the past three months, it’s that parents of children who believe that their children have been vaccine injured deserve compassion and understanding. (That doesn’t mean they should be pandered to or be allowed to dictate public health policy.) I’ve also said many times that I can’t pretend to know beyond any doubt how I would react if I was in their shoes.

I do, however, know what it’s like to be a parent who feels uneasy when a doctor asks you to take off your newborn’s pants so your child can be injected with a vaccine. It’s scary. I don’t know anyone in the world who likes needles or likes watching  needles pierce their child’s skin. However, the fact that something is scary does not convey a license to blithely deny reality — which is why I find the actions of parents who have simply decided for themselves that vaccines and dangerous and at the same refuse to acknowledge the potential repercussions of not vaccinating on those around them to be morally repugnant. This is not a new position of mine; I wrote about it at length in a chapter of my book titled “Medical NIMBYism and Faith Based Metaphysics”:

The notion that people should base medical decisions on what is “right for them” is particularly problematic in a public health context, where individual choices cannot be cordoned off from each other. Consider the case of Julieanna Metcalf, a fifteen-month-old, fully-vaccinated girl who was taken to the hospital on January 23, 2008 with what her mother thought was a particularly bad case of the flu. It was only after extensive tests that doctors discovered that Julieanna had a compromised immune system that rendered the vaccine for Hib ineffective. By the time she got out of the hospital almost a month later, Julieanna had suffered multiple seizures and had a buildup of fluid in the brain so dangerous it required emergency surgery. She’d also lost all of her motor skills—including the ability to swallow—and will require multiple immune globulin injections each week for the rest of her life.

Even with her weakened immune system, Julieanna might not have caught Hib if everyone around her had had their shots, but the Minnesota community in which she lived was a place where the same ethos emanating from [Dr. Jay] Gordon’s and [Dr. Bob] Sears’s waiting rooms and [Oprah] Winfrey’s couch had taken hold. The outbreak that ensnared Julieanna also resulted in the hospitalization of four other children. One was a baby who was too young to have been vaccinated. The parents of the three others had all chosen not to vaccinate their children; one of those, a seven-month-old girl, died of the disease.

Earlier this year, I gave a talk at the American University School of Communication. At one point, Declan Fahy, the talk’s moderator and an AU assistant professor in health, science and environmental journalism, aired a clip that had originally appeared in a 2010 PBS Frontline series called “The Vaccine War.” The clip focused on Ashland, a politically liberal city in Oregon that is home to a renowned Shakespeare festival and the Ashland Independent Film Festival…and has a vaccine exemption rate of around thirty percent, which is the highest in the country. (The added emphases below are mine; a transcript of the program is available here.)

Dr. JIM SHAMES, Ashland public health officer: When you make that decision [not to vaccinate], which you have a right to do, do you think you may be affecting other children?

AUGUSTINE COLEBROOK, midwife and co-leader of the Rogue Valley Holistic Moms Network: Do I believe that I’m causing harm by not vaccinating my child? No, I don’t, because if the vaccines work, who am I putting at risk?

SHAMES: So let’s talk about that. Now, not everybody can get immunized. That child right there is probably too young to get immunized against pertussis. If your child gets pertussis by not getting the vaccine, and your child passes it onto a delicate newborn –

COLEBROOK: I really don’t believe it. I feel like — first of all, I feel like it would be responsible to then quarantine my child and not expose them to other, you know, potentially fragile populations.*

SHAMES: A lot of diseases are transmitted before you even know you’re sick.

JENNIFER MARGULIS, local parent: It’s my responsibility as a parent to keep my child safe, I think, and I don’t think it’s your responsibility to take a vaccine because I might be at the same party with you and you might cough on her. Honestly. I think your job is to protect your own health. And I mean, maybe I sound — I really don’t mean to be sounding selfish in that way.

At the end of the clip, Fahy asked me how I would communicate with parents like Margulis and Colebrook. Here’s my answer:

Ten children died of pertussis last year [in California]. Nine of them were under six months old [which means they were too young to be fully vaccinated], and to say, you know, ‘Oh this is my, this is something — keep your hands off my baby,’ is something I find so offensive, and I guess what I find most offensive is lack of honesty about the potential repercussions.

If you’re going to say, as they did — I’m clearly not giving advice for how to communicate with them because the way to communicate with them is probably not to say ‘you’re a total asshole,’ but, um, which is what I want to do — if you are going to say, ‘Well, this is my decision,’ you can’t then simultaneously say, ‘And I’m not putting anyone else at risk.’ At least be honest — at least say, ‘This is my decision, and I don’t care if I put other children at risk, and I know [children too young to be immunized are at risk] because it has happened in the last couple of years, that kids may die.’

I find that — I just find it repulsive. Her saying, ‘If you choose to vaccinate your child, that means your child is not at risk’ is also just categorically not true. There’s a child who I write about who was vaccinated against Hib and they only discovered the vaccine was not effective when she was in a coma. She lost all of her motor skills and will need therapy for the rest of her life to deal with that.

Those are harsher words than I usually use. If there’s one thing I hope I can accomplish in this debate, it’s showing parents the difference between verifiable, reliable data and anecdotal, fear-based myths — and, as I said, calling someone a total asshole is probably not the way to convince them to rely on evidence and not emotion. But I’ve spent too much time listening to the stories of people like Kelly Lacek (whose three-year-old spent four days in a medically-induced coma with Hib after her chiropractor convinced her not to vaccinate) and Danielle Romaguera (who held her seven-week old baby in her arms as she died as the result of a pertussis infection) and Toni and David McCaffery (whose four-week-old girl died of pertussis) to have much patience for parents who ignore the science supporting vaccines and also refuse to acknowledge the dangers of infectious diseases. I’ll spend all day talking with people who are willing to listen and to learn. As for the conspiracy theorists and the reality-deniers who act is if they’re living in some virus-free alternate universe…well, the might not be total assholes, but they’re definitely not worth my time.

[*] Even reading that again today makes me feel a little bit crazy. When Colebrook says the “responsible” thing to do if one of her children was infected with pertussis would be to enact a quarantine, I’m not sure where she thinks her child’s infection is going to get diagnosed other than at a pediatrician’s office…and if there’s one place vulnerable infants are pretty-much guaranteed to be, it’s a pediatrician’s office.

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145 Responses to Evidence, herd immunity, and ‘total assholes’

  1. Rene Najera says:

    Wait one minute, Seth! Is that quote of yours up there the source of the “total assholes” phrase attributed to you by the likes of Ginger Taylor, JB Handley, and others? Because, if it is, then they…

    Oh, what the hell. It’s not going to change anything. They won’t apologize. They heard what they want to hear. They have all along. It’s classic confirmation bias. I don’t even know why I waste my time trying to be rational with them.

  2. Mary says:

    Yeah, you know–I’ve come to a decision. I think that public health is a myth and I don’t want to pay for my sewage bill anymore. I think I’m going to drain my household sewage into the street. It’s my choice. \

    Funny, many of the same “warrior moms” I have seen are all about local, and community, and such–oh, and keeping E. coli out of food, which I also think is a fine idea. They #FAIL to recognize that being a responsible community member includes your responsibility to the public health of others. You don’t give out E. coli, you don’t give out Hib. I can’t fathom why they can’t understand this. They are smart enough to know better.

  3. Of all the talking heads on that Frontline episode, Jennifer Margulis is the one who got under my skin the most. I blogged about her, and her friends swarmed over to her defense (http://daisymayfattypants.blogspot.com/2010/04/jennifer-margulis-poster-parent-for-me.html). Their comments were just as smug as what you see in the Frontline interviews.

    Jennifer Margulis has been quoted as proudly identifying herself as a public health official’s nightmare. That continues to baffle me.

  4. Jay Gordon says:

    Seth–

    You are certainly correct in saying that parents and dissenting doctors must consider public health along with personal choice. I discuss this very issue with parents every day.

    The problem I have with your essay is that you cite aberrations as if they were common phenomena just as someone might try to make it sound like half the kids who get shots get autism. The emotional power of your stories is unquestionable but I could tell stories by the dozen from the other side of the issue. When I do so, I should emphasize that autism (or death) as a result of vaccination is rare. I question your journalistic integrity when you imply that death from vaccine-preventable infectious diseases is a frequent occurrence.

    Jay

    • Mary says:

      Jay: could you show me examples of you chastising Jenny, AoA, Loe Fischer, or any of the other regulars that they shouldn’t use emotional anecdotes about rare vaccination issues? I may have missed those.

      • David Gorski says:

        He can’t. He won’t.

        Dr. Jay likes to represent himself as “reasonable” and oh-so-”civil,” but his demands for civility tend to be one-way. He clutches his pearls at any criticism of his anti-vaccine buddies, but when AoA minions are comparing vaccination to shipping Jews off to Auschwitz and Buchenwald, he remains oddly silent, at least in forums where his words would make a difference.

        • Ottoschnaut says:

          What the Nazis, Japanese, and Americans did was to provide state sponsorship for medical experimentation on human subjects. The US Tuskegee Airmen syphilis experiments come to mind, as do the Japanese deliberately exposing their Chinese captives to cholera.

          Human experimentati0n without informed consent is morally repugnant.

          The current vaccine schedule has not, to my knowledge, been tested in it’s entirety on any experimental group prior to implementation. By definition, the vaccine program is an open label experiment using human children as test subjects. This is morally repugnant, and exactly on par with Jews being rounded up and delivered to Mengele. Human experimentation is human experimentation, be it on Jews, African Americans, or Chinese citizens.

          I would appreciate reading any peer reviewed studies that show full and complete testing of the entire vaccination schedule prior to the implementation.

    • Squillo says:

      While you are questioning Mr. Mnookin’s journalistic integrity, it might be instructive to examine your own statements here (and elsewhere).

      You say: “…parents and dissenting doctors must consider public health along with personal choice.”

      You conclude with the (correct) implication that death from VPDs is an uncommon occurrence.

      And yet, you seem to ignore in most of your public statements, the potential effect a significant drop in vaccine uptake would have on those VPD-related morbidity and mortality rates. I hope, in your discussions with parents, you include that in your mutual consideration of public health.

    • Mike Stanton says:

      Jay
      You claim to have stories by the dozen from the other side of the issue. The issue is the death and injury of children from vaccine preventable diseases. 10 children died from the vaccine preventable disease, Pertussis in California last year. How many children died in California as a direct result of the DPT vaccine?

      You say that vaccine induced autism is rare. Can you point to a single case in the medical literature that documents vaccine induced autism?

      You question Seth’s journalistic integrity for implying “that death from vaccine-preventable infectious diseases is a frequent occurrence.” Death from vaccine-preventable infectious diseases is a frequent occurrence in non-vaccinated populations. Vaccines save lives. I question your medical integrity for equivocating on this issue.

    • Moderation says:

      Canary in a coal mine, Dr. Gordon.

  5. Along the lines of Dr. Gordon’s comments, I too have some trouble with your lamenting of the premature deaths of these children.

    While there were 10 deaths last year from pertussis, the CDC Wonder database lists 41 deaths of children associated with pertussis vaccines? And that was one of the lowest numbers of deaths listed in years.

    42 in 2009, 76 in 2008, 82 in 2007… 126 in 1994, 148 in 1993… Do you lament the more than 1,750 children who have died following this vaccine since 1989? Where is the balance in your reporting on this, if you are the earnest journalist that you claim you seek to be?

    Do you not see that under the current vaccine policy that seeks to vaccinate all children with out screening for the known subsets that may be vulnerable to vaccine injury or death, that the cure might actually be worse than the disease at this point?

    Further, I have counted 27 premature deaths last year that came as a direct result of autism (seizures, wanderings, drowning, neglect, abuse and even being shot by police for acting strange). Where is your concern for preventing the risk to our children?

    Why to the dozen deaths you cite trump the close to 70 deaths last year that I have written about? Were their deaths some how acceptable when the others were not? Did you even know about them? Have you looked?

    Out of the abundance of the heart, the mouth speaks.

    • Reuben Gaines says:

      “While there were 10 deaths last year from pertussis, the CDC Wonder database lists 41 deaths of children associated with pertussis vaccines?” Madame Taylor, would you kindly tell us how many of those 41 were found to be because of the vaccine. Association, causation, you have played that game before.

      For example:
      “Initial report received on 30 January 2007 from a health care professional. A five-month-old female patient, who was diagnosed with an “”URI”" (upper respiratory infection) and diarrhea on 22 January 2007, and was being treated with Rondec DM, nystatin, and “”Tylenol products”", had received, on 29 January 2007 at 16:00 pm, a second, right leg dose of ActHib, lot number UF085AA (lot number Z1038-2), a second, left leg, intramuscular injection of Daptacel, lot number C2553AA, a second, left leg of IPOL, lot number Z0326-2, and a second, right leg dose of Prevnar (manufacturer reported), lot number B08672K. The route of administration was not reported for the ActHib, IPOL, and Prevnar vaccines. The patient’s pediatrician’s office was notified by the coroner that the patient had been found dead by the father sometime in the morning, on January 2007. The patient had no history of birth defects or known allergies. She weighed 4 pounds 11 ounces at birth and has a twin sister. Reportedly, the patient had no adverse events with prior vaccinations. She received her last immunizations (vaccine not provided) on 27 November 2006. No other information surrounding the death was available at the time of this report. 4/7/07 Received Autopsy Report which reveals COD as SIDS.”

      Very sad. Very sad. However, let us look at a timeline, yes?

      1.22.07 – Diagnosed with URI and diarrhea. Treated with Rondec, nystatin, and acetaminophen.
      1.29.07- Received vaccines.
      1.30.07- Death.
      4.7.07- Autopsy, SIDS.

      You may want to believe with all your heart that it was the vaccines, since you are anti-vaccine yourself. I read your blog. Very sad. But I want to believe with all my heart that it was the nystatin and acetaminophen that killed her. After all, those two drugs were given before death and are thus associated with death, no?

      This is Seth’s blog so I will not take over by going through each one of your cases in VAERS. But one more for the road, ok?

      “Pt was found dead of unknown cause the morning after immuns were given. Child was sleeping in bed with mom. 4/20/07 Received Autopsy Report which reveals COD as asphyxia, cannot exclude parental overlay. Patient found face doen position after co-sleeping w/parents. Final dx also included dilation of left renal pelvis.”

      Tell me, Madame Taylor, did vaccine cause the parent to overlay the child?

      Always confirm the feelings of your heart in light of the evidence, my mother always said. VAERS is a good tool for initial case reporting, but the cases need to be thoroughly investigated before giving a final cause or placing final blame. Always innocent until proven guilty is a good way to live by.

    • Hyoscine says:

      “Further, I have counted 27 premature deaths last year that came as a direct result of autism (seizures, wanderings, drowning, neglect, abuse and even being shot by police for acting strange).”

      Point me to one peer reviewed study that links autism to vaccines and we can consider this relevant.

        • Mara says:

          I look forward to an actual medical professional reviewing your list, but off the top of my head, most of your “proof” here seems to either be completely unrelated to the question at hand or fall under the logical fallacy of “begging the question.”

          Yes, if you assume that vaccines cause heavy metal poisoning, then vaccines might cause autism…but I haven’t seen any evidence of vaccines causing heavy metal poisoning!

          (comment crossposted to your blog)

          • “most of your “proof” here seems to either be completely unrelated to the question at hand or fall under the logical fallacy of “begging the question.”

            And that is because you have not even stopped to learn about what the basic mechanisms of the biological processes at work in vaccine regression and autism are.

            While your group has camped in “correlation does not equal causation” land, we have gone on with out you and an entire field of medicine has sprung up on this topic that is ignored by Mr. Mnookin and those who want our children to stay sick.

            There is actual hard science here, not just epidemiology.

            Catch up with us.

    • Flavia says:

      Before the vaccine, 6,000 children died each year of pertussis. That is the number you actually need to compare to the 41.

      • Dude… that was also before the introduction of antibiotics. They both came on the market right after WWII.

        • Mike Stanton says:

          As I recall, before vaccines became la cause du jour, antibiotics were blamed for autism and still are if you read Age of Autism or The Autism Doctor, aka Dr Udell.

          Actually the antibiotic theory makes a lot more sense than blaming vaccines. Or it would if there were any data to support it. Any takers for an antibiotic versus non-antibiotic (or should that be probiotic?) study?

  6. KWombles says:

    Covered this post and quoted from you at the Autism Blogs Directory; we’ve got over 600 bloggers represented there, and maybe this will spread the word, at least lead to readers being better informed about the things AoA and its allies are writing.

  7. I see your “total assholes” comment as applying to parents who say, “Well, this is my decision.”

    But lets give you the benefit of the doubt and go with the idea that you ONLY meant that parents who want to make their own decisions, but don’t recognize that their child may transmit illnesses.

    Then two points:

    First:

    I am a parent who has decided to make my own vaccine decisions for my children. Am I a “total asshole”?

    I recognize that viruses exist and often talk about the fact that when my father was seven and his little brother was five, they and their father contracted Polio. My father had flu like symptoms at home, my uncle was hospitalized for several weeks, and my grandfather died. That death sent a shock wave through my family that was still felt. Which I why I think that we need a vaccine program.

    But I absolutely believe the current vaccine program is corrupt to the bone and likely doing more harm than good. I have been documenting it for 7 years. So, am I one of those who is not “worth your time”?

    I am having trouble telling if I fit into the category of person or non-person to you. Do I count?

    Should the fact that you won’t post my comments, while posting the comments of other critics of yours signal that I don’t count?

    Second point:

    If you think that those who deny the disease risk group then are not your comments the height of hypocracy?

    As I mentioned… 10 v. 41 deaths.

    We have TWO risk groups in play here. One that is at risk from dying or being injured by the disease, and one that is at risk from dying or being injured from the vaccine, right?

    (My grandfather was in one, my vaccine injured son is in the other… two risk groups)

    You classify people who want to protect the vaccine risk group at the expense of the disease risk group, “total assholes”, while you vociferously advocate for the disease risk group with a ‘to hell with the vaccine risk group’ attitude. You seem perfectly fine with them being sacrificed for the disease risk group.

    Does this make you a “total asshole”? Or not worth the time of readers or the public?

    When it looks that FOUR TIMES the number of children are dying from the vaccine than are from the disease in the case you cite?

    • Todd W. says:

      Ginger,

      First off, how many of those deaths associated with pertussis vaccine were actually confirmed to have caused the deaths? That’s a very important question. You’re making the common mistake made by those who rely on VAERS raw data. A search will give you what was reported, not what has actually been confirmed. If you say that the raw data is accurate, then you would also have to accept that a vaccine turned a man into the Incredible Hulk, since that, for a time, also came up in search results.

      Second, you compare the 41 vaccine-associate (not caused) deaths with the 10 pertussis deaths, yet you fail to take into account the total numbers of those who were exposed. There were, what, a few thousands who had pertussis, of which 10 died. There have been millions who have had the pertussis vaccine, of which, 41 died sometime afterward, with a causal link only suspected. Which has the greater percentage of the total?

      • Re: how many of those deaths were confirmed? That is a great question. And we want to know the answer and we think that public health is absolutely derelict in their duty NOT to properly investigate and confirm the cause of death in these cases. Of course, if those are confirmed by public health, that means that each case will cost the federal government $250,000, so there is a built in incentive to do as little as possible with these cases and every incentive to label them as SIDS so neither the vaccine program or the VICP funds take a hit.

        If your child dies from measles, you make the paper. If your child dies from the measles vaccine, you are a problem.

        As I mention, I hope you will join us in demanding that public health treat these cases seriously and give us real numbers and real data on vaccine risks.

        Re: deaths v. exposure. It is a big, clumsy question and not useful for preventing deaths. The better question is… since healthy children do not die of pertussis, what did these 10 babies have (or not have) that made pertussis deadly to them? For example, were they Vitamin D deficient? If so, would it not be a great public health investment to add a simple D test at birth to look for children who need supplementation? We have an epidemic of D less ness in this country (we don’t go outside any more) and D regulates the immune system. If our babies were good on D, it would likely protect against everything from flu to pertussis to cancer to autism if the current look at its impact on human health goes where we think it is going.

        And the same question needs to be asked of those in the vaccine risk group. What did those 41 babies have in common that put them at risk for vaccine deaths? Did they have an autoimmune process already at work in their bodies? Were they low on D or something else?

        At this point in our understanding of human health, we don’t need one big stick, we can individualize medicine. And if we can, we have that obligation to do so to minimize risk to all populations.

        • Todd W. says:

          since healthy children do not die of pertussis, what did these 10 babies have (or not have) that made pertussis deadly to them?

          Umm. I’m gonna go out on a limb here and say that pertussis made them sick enough to die from the infection. Pertussis is a deadly disease. You would do well to learn a bit more about it, before saying things like “kids don’t die from pertussis”. I’m not sure where you got that notion.

          You see, pertussis, particularly in infants and young children, causes things like hypoxia and broken ribs. These kinds of things tend to have a rather detrimental effect on health. The diseases also puts them at risk for an opportunistic pneumonia infection.

          Here is a good link to learn a little more about the disease: The CDC Pink Book chapter on Pertussis.

          That is a great question. And we want to know the answer and we think that public health is absolutely derelict in their duty NOT to properly investigate and confirm the cause of death in these cases.

          CDC does investigate reports of this nature. If you do a search in WONDER, at the bottom of your search results, there is a section of Notes. There, you will find this statement:

          Please note that VAERS staff follow-up on all serious and other selected adverse event reports to obtain additional medical, laboratory, and/or autopsy records to help understand the concern raised.

          So, if you want to find out how many deaths were actually confirmed to have been caused by the vaccine, you could ask the CDC, rather than making assumptions that the data you pull up represent reality. And you know what they say about assumptions.

    • Mike Stanton says:

      Ginger,
      regarding assholes and other terms of abuse I bow to your superior experience in their usage. I am sure you remember writing,
      “Dr. Tayloe said that in his practice that has seen 100,000 patients that he has never referred one person to the Vaccine Injury Compensation Fund. If he has never seen a serious vaccine injury, it is not because he has not come across one, it is because he has his head up his ass. Tayloe is just dangerous.”

      In the same post you mistook Dr Tayloe for his father and called him “That Asshole.” When you realized your mistake you graciously revised your judgement.

      “I think that I will retract my declaration that he is an asshole, and say that he is a dangerous, foolish man. “

      You are no slouch at dishing it out. Seth has never called you a non person or a total asshole. He did refer to “the conspiracy theorists and the reality-deniers who act is if they’re living in some virus-free alternate universe…” Well, if the cap fits.

  8. JB Handley says:

    Seth:

    If you incorporated into your writing the fact that vaccines, too, carry very real risks, you wouldn’t be as likely to have several hundred thousand parents think that you are a total asshole.

    By implying that vaccines are a perfect drug and giving any side effects lip service, you are providing some parents with a false sense of security. Children die at the hands of vaccines–this, too, is a reality.

    You’d move the debate along if you were able to strike a more realistic and honest middle ground. Given the way you currently write, you sound exactly like a CDC or AAP employee.

    I’d also be very careful talking so much about the choices you have made for your son. My understanding is that he is very young. Many of vaccines side-effects are chronic in nature, and you are most certainly not out of the woods with him, particularly if you view it as your duty to give him every vaccine on the CDC’s schedule. Why are there other first world countries that give 1/3 as many vaccines?

    JB

    • Todd W. says:

      Why are there other first world countries that give 1/3 as many vaccines?

      Because they have different disease profiles for their communities. If you’ll notice, many European and Asian countries have the BCG vaccine against tuberculosis, yet we don’t. The answer really is pretty simple if you actually take the time to think about it.

    • Mara says:

      I’m curious, sir…have you ever checked out a list of logical fallacies? Wikipedia’s list is surprisingly comprehensive and clear.

      I might recommend reading the section on “begging the question.” (“Straw man” and “correlation not causation” would sound familiar too, I think.) I’m sure if you read carefully, you’ll find at least half a dozen others that you use regularly.

      You’re welcome. I’m always glad to help!

      For the record, I am more than happy to discuss the fact that my two children are fully vaccinated. I’m proud that I’ve done everything I can to protect them from deadly and disfiguring diseases and that I’ve helped to protect the adults and children around them.

      Hey, did you know that when we vaccinate kids, the level of disease in their grandparents drops significantly? It’s awesome that I can protect my kids from the flu, and also protect their grandparents. Hooray! Win/win!

      But y’know, you are right about one thing: There are real risks from vaccines. They’re just very very rare. Even rarer than polio, measles, mumps, rubella, diptheria, pertussis, and tetanus…but those diseases will remain rare only so long as kids keep getting vaccinated.

      And so my children will continue to get their vaccines on the schedule recommended by the AAP. And we’ll all get our flu shots every year. And the children of freeloading weenies who don’t understand medicine will continue to not get those diseases because my kids got their shots. Hmmph.

  9. Jay Gordon says:

    Mary, I have done so and will continue to do so. I believe that relying on events and anecdotes at extreme ends of the bell-shaped curve doesn’t make for intelligent conversation.

    And, Seth, I don’t think you’re a “total asshole,” just a misguided fanatic who doesn’t understand his subject matter well: You have “book learning” but very little real life experience. That’s not good enough.

    Jay

    • Mary says:

      Evidence please? Your comments in comment threads at their posts and HuffPo pieces and such would be what I’m looking for.

    • David Gorski says:

      Really, Dr. Jay?

      Odd that you rely on anecdotes over epidemiology, clinical trials, and basic science to bolster your belief that vaccines cause autism.

    • Matt Carey says:

      Jay,

      “misguided fanatic” may sound more polite, but it isn’t very nice, now, is it?

      You and I certainly have more years behind us than does Mr. Mnookin, but why the putdown about “very little real life experience”. He’s been bashed for his real life experiences. He’s been to hell and back and apparently learned the lesson.

      More importantly:

      I believe that relying on events and anecdotes at extreme ends of the bell-shaped curve doesn’t make for intelligent conversation.

      If there is anything like vaccine-induced autism, it would be an event at the extreme end of the bell curve. That’s what all this discussion about “susceptibility groups missed by population studies” is all about.

    • KWombles says:

      Jay,
      To echo your comment to Seth, “I don’t think you’re a ‘total asshole,’ just a misguided fanatic who doesn’t understand his subject matter well.”

      I’m not at all certain of your book learning, though, as your knowledge about vaccines (despite your dvd) and infectious disease seems to me to be more than shaky.

    • Moderation says:

      Wow Dr. Gordon, it is funny you use the term fanatic, when that term or one like it is how I have heard many of your fellow pediatricians describe you.

  10. Todd W. says:

    Seth,

    Good article. I also share your feelings of frustration when dealing with the type of people who blatantly ignore the risks of infectious diseases. Yeah, vaccines have some risk, but the diseases pose a much greater hazard, with higher risks of complications, plus the added benefit of spreading it to other people, often before the person even knows they’re sick.

    There is a sort of arrogance that some parents exhibit, that they will somehow know the very moment their child is sick and contagious, but they don’t realize that many diseases can be spread several days before any visible symptoms appear. And then when they do appear, they may just seem like a bad cold. When they take them to the pediatrician’s office, they sit in the waiting room, spreading infection.

    It can be very hard to maintain a cool head and just talk about the facts when someone is irrationally opposed to the science behind vaccines and infectious diseases.

  11. David Gorski says:

    When it looks that FOUR TIMES the number of children are dying from the vaccine than are from the disease in the case you cite?

    Evidence for this claim? Citations from the peer-reviewed literature, please?

    • Todd W. says:

      She’s just using VAERS raw data (that 41 reported deaths following vaccines vs. the 10 confirmed deaths following pertussis).

      • As that is all we are offered by public health. So that I all I have to go on.

        I hope you will join our community in insisting that HHS give us real numbers on vaccine injury

        • Todd W. says:

          You could actually write to the CDC with your questions. I’ve done so before, and they’re usually pretty quick to answer.

          • Submitted the following message to the CDC via web site:

            “CDC wonder/the VAERS database shows that there have been 41 deaths reported to be associated with pertussis containing vaccines in 2010. I am looking for the most accurate information that I can find on how many of those deaths were investigated to either rule out or confirm that the vaccine was responsible for the death.

            Can you please either send me that information or point me toward a source that can?

            Thank you.”

            Received the following error message:

            “We’re sorry, but your request could not be processed at this time.

            Please try again later.”

      • Matt Carey says:

        Todd W.,

        I believe you might be thinking in the back of your mind this disclaimer, clearly stated for those who access VAERS:

        DISCLAIMER: Please note that VAERS staff follow-up on all serious and other selected adverse event reports to obtain additional medical, laboratory, and/or autopsy records to help understand the concern raised. However, in general coding terms in VAERS do not change based on the information received during the follow-up process. VAERS data on WONDER should be used with caution as numbers and conditions do not reflect data collected during follow-up. Note that the inclusion of events in VAERS data does not infer causality. Review cautions in the interpretation of this data:

        VAERS reports should be taken seriously. They should not be taken as a statement of causal fact.

        • Todd W. says:

          That is, indeed, the disclaimer I had in mind. I agree that all reports should be taken seriously, but they should not be represented as establishing causal fact.

          To date, none of the deaths, AFAIK, have been confirmed to have been caused by the pertussis vaccine.

          • Did my language infer “causal fact”? I am not sure why this discussion is even taking place, as I said that these were reports of associated deaths.

            Is there any alarm here on your part that these deaths are being taken lightly?

            How many deaths are ever properly investigated that are entered into VARES? VAERS is merely a place that vaccine injury reports go to die.

        • Matt,

          What does not seem to be taken into consideration by your comments is our contention that the game is rigged and public health will not find vaccine injury where they don’t want it found.

          This is a real world account of what happens to a VAERS case. Michael Belkin’s account of what happened following his daughters Hep B vaccine “associated” death from Vaccine Epidemic:

          “When my five-week-old daughter, Lyla, died hours after receiving her hepatitis B vaccine, the New York medical examiner was more concerned about examining our apartment for evidence of child abuse than about the possibility that a vaccine caused her death. The medical examiner initially told us, our pediatrician, and an investigating pathologist that Lyla’s brain was so swollen that it led to her death. After consulting with Merck (the manufacturer of Lyla’s hepatitis B vaccine), the medical examiner left me, a devastated father who just lost his precious first-born child to an avoidable vaccine-induced death, with these parting words: “We’ve changed our minds; her brain was not swollen. Vaccines do a lot of good things for people, Mr. Belkin.” Former New York Times journalist Melody Petersen, who covered the pharmaceutical industry in her book Our Daily Meds, “reports that doctors who fill out death certificates are instructed to call a ‘therapeutic misadventure’ a natural death.”

          CDC and Pharma have their narrative, and the facts will be molded to fit the story they want told.

          • Mary says:

            ↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑

            Oh–Jay! Your lucky day–here’s a chance to demonstrate your concern about people using emotional anecdotes inappropriately.

            You can thank me later for helping you to spot the problem.

        • David Gorski says:

          Indeed, VAERS is not intended to be an accurate representation of rates of vaccine injury, but rather an “early warning system.” Unfortunately, its results have been distorted by anti=vaccine litigation:

          http://oracknows.blogspot.com/2006/02/how-vaccine-litigation-distorts.html

    • Please read the comment again for the source:

      “While there were 10 deaths last year from pertussis, the CDC Wonder database lists 41 deaths of children associated with pertussis vaccine”

  12. Jay Gordon says:

    I think if I had a child with autism or if I had been subject to the repeated and deeply personal attacks that JB has to deal with, I might be far, far angrier than he is. I still don’t like ad hominem attacks, disdain, nastiness, and the tone that Dr. Gorski allows at his site.

    I really miss the RI badinage and will probably return soon.

    I actually have posted a couple times over at AoA to protest some of the wording and the personal nature of the comments. I would post everywhere if I had more time. This is such a crucial issue. I really don’t understand how scientists like yourselves can look at gigantic medicine like vaccines and turn your backs on the probable connection between the increase in shots and the increase in autism. And to vociferously protest further investigation of this is just terrible science.

    Jay

    • Mike Stanton says:

      Probable connection between vaccines and autism? How about highly improbable? No epidemiological evidence. No case studies. No scientifically plausible pathways. No evidence that there has even been an increase in autism.

    • KWombles says:

      Jay,

      That you could write that remark after the incredibly nasty things Handley has written about Seth, David, and several other people like Alison Singer, Trine Tsouderos, Amy Wallace, and Paul and Bonnie Offit is beyond me.

      I’m parent to three on the spectrum; are you suggesting that anger is an excuse, something that I’m entitled to, and therefore I could go around doing what AoA does to people with no justification and often with even fewer facts? Are you suggesting that being a parent of autistic children makes a person a victim and therefore entitled to bad behavior?

      WTF?

    • Moderation says:

      Dr. Gordon, for all the time you have spent blogging, commenting, writing and speaking on this subject, it amazes me that you still don’t have the slightest grasp of the difference between correlation and causation.

    • David Gorski says:

      Dr. Jay,

      I’ve only seen you post complaints at the AoA site once, and I do peruse it from time to time because it’s such a rich source of blogging material for Science-Based Medicine and elsewhere, although I can only take so much of it before I have to take “vacations” from it from time to time.

      In any case, let’s take a look at just one source citing a few examples of sorts of rhetoric that goes on at AoA and other anti-vaccine sites:

      http://www.google.com/cse?cx=017254414699180528062%3Auyrcvn__yd0&q=the+annals+of+I%27m+not+anti-vaccine+site%3Ahttp%3A%2F%2Fscienceblogs.com%2Finsolence%2F&sa=Search

      The latest entry includes a post from an AoA minion that says:

      When the trains left for Auschwitz and Buchenwald many of the doomed passengers took suitcases with them surely expecting to return home from this “camp”. God knows what lies the Nazis told these poor people to get them on those trains. Same with the vaccines. We are repeatedly told they are safe when they are loaded with dangerous toxins. Our children are being poisoned right in front of our eyes and we’re being told that it’s all in our heads.

      I do not recall ever having likened anti-vaccine zealots to Nazis sending Jews to concentration camps and gas chambers. Methinks your pearl clutching is aimed at the wrong side; when it comes to sheer nastiness, no one on “my” side that I’m aware of can compete with J.B. and his minions. It’s not even close.

  13. Jay Gordon says:

    Hi KWombles–

    Good to see you here, too. WTF in deed! No, I’m not excusing rudeness, nastiness and incivility because of anger. I don’t think that JB should write incredibly nasty things about Seth, Orac, Trine, Paul or anyone else. I think that the entire conversation should be conducted with respect and civility. I believe that Seth, Orac and others have on occasion responded in kind.

    I respect your wanting more proof before accepting the the idea that vaccines may cause as much harm as I think they might.

    Jay

    • Mike Stanton says:

      Jay, we do not want more proof that vaccines cause as much harm as you think they do. Any proof would be a start. What you think based on your clinical experience will not do, in part because your thinking is not consistent. Early in this discussion you argue that autism is a rare consequence of vaccinations. Later you claim that there is a link between the rising rates of autism and vaccinations.

      Now it does not matter that I think neither of these statements is true. They cannot both be true. Are vaccines a rare cause of autism or can they explain the growth in recorded cases? Which one do you really believe to be true and do you have any evidence to support your belief?

  14. Glad to see the gang’s all here. Anyway:

    If your child gets pertussis by not getting the vaccine,

    I was unaware not getting a vaccine was a way to contract pertussis. I thought it had something to do with coming into contact with the pertussis bacterium

    and your child passes it onto a delicate newborn

    People should take the responsibility to keep their delicate newborn away from situations in which they might be exposed to an infection. Additionally, those who are particularly concerned can vaccinate within the family and hire vaccinated caregivers since this is the main mode of transmission to infants. Rely on yourself, don’t force others, to protect your family.

    • René Najera says:

      Glad to see Generation Rescue’s newest contributor has joined us as well. One minor thing, Mr. Schecter…

      “People should take the responsibility to keep their delicate newborn away from situations in which they might be exposed to an infection.”

      So parents of neonates, their contacts, and the neonates themselves should live in a bubble? Because the diseases you know nothing about but continue to proclaim as being “harmless” (Rubeola showed me what you said about measles) all have an incubation time in which the person is asymptomatic (without symptoms) but still very capable of transmitting the disease without knowing. (That’s why closing down schools once kids get sick is pointless, in my opinion. The demon is out of the freezer.)

      Mr. Schecter, you keep writing about “forcing” and “freedom” and “responsibility”… I don’t think they mean what you think they mean.

  15. MinorityView says:

    So, this is the argument. Vaccinate. The facts and the science support it. A parent points out that there have been deaths following one of the vaccines in question. It is pointed out that the system for tracking deaths following vaccination doesn’t collect good data and doesn’t analyze it to determine causation. Not mentioned is that the system for tracking deaths and injuries following vaccination is purely voluntary and makes no attempt to gather a complete body of data. We can assume that many cases of injury and even some deaths following vaccination never even make it into the system.

    How in the world can a rational parent make a cost/benefit analysis with incomplete data? Depending on the clinical studies won’t do it. They are frequently small, usually exclude babies who are ill, and do not do long-term follow-up data collection.

    I’m always sort of sadly amused by the argument that bad and incomplete data in the VAERS system supports vaccination.

    One of the most effective moves that could be made to raise vaccination rates would be the implementation of a system to collect all vaccine reactions, to link this data with the lot numbers, and to follow up on all serious reactions. If vaccines are really safe, this process would pull the rug out from under the parents who don’t trust vaccines. If vaccines are not actually all that safe, having a good data set could help identify babies at risk, could help improve vaccines which aren’t so great in practice, and would help parents decide which vaccines made sense for their baby. Instead of many parents abstaining from vaccines altogether, given good data some parents might do at least partial vaccines, which I must suppose would be an end you all would approve.

    • Mike Stanton says:

      Minority Report ought to be reassured by the Rotashield experience. Rotashield was a vaccine that protected young children from rotavirus infection. In the 10 months following the introduction of Rotashield in 1998 there were 15 reports in VAERS of Intussusception in babies, most of whom were around 2 months old. Intussusception is an extremely rare but serious intestinal disorder in babies. It affects 5 in 10,000 infants, usually between the ages of 5 and 9 months. It is very unusual in children as young as 2 months old.

      As a result of VAERS reporting the CDC suspended the vaccine and spent millions of dollars investigating the problem. 3 months later, in October 1999 they had a result. In addition to the naturally occurring 5 in 10,000 cases of Intussusception, the vaccine caused an an additional 1 in 10,000 cases. Rotashield was taken off the market.

      So VAERS works as an early warning system and the CDC works as a vaccine safety monitoring organization.

    • Todd W. says:

      To add to what Mike Stanton mentioned, VAERS is entirely voluntary for physicians and average people, since FDA and CDC have no legal authority over them, insofar as the practice of medicine goes. By contrast, reporting of adverse events is mandatory for manufacturers. Manufacturers have, for reports like death or serious/permanent injuries, 15 calendar days to report the event to FDA from the time that it is first discovered by any employee of the manufacturing company.

      Also, as mentioned before, all serious AEs reported to VAERS are followed up by the CDC and investigated. If there are reports of deaths, they do get investigated. Sometimes the vaccine may be to blame, sometimes there may be some other factor responsible.

  16. This might post twice. If it does, I’m sorry. I don’t know if these comments are held for approval.

    Glad to see the gang’s all here. Anyway:

    If your child gets pertussis by not getting the vaccine,

    I was unaware not getting a vaccine was a way to contract pertussis. I thought it had something to do with coming into contact with the pertussis bacterium

    and your child passes it onto a delicate newborn

    People should take the responsibility to keep their delicate newborn away from situations in which they might be exposed to an infection. Additionally, those who are particularly concerned can vaccinate within the family and hire vaccinated caregivers since this is the main mode of transmission to infants. Rely on yourself, don’t force others, to protect your family. Which is not to say there’s no responsibility to remain away from babies if sick; of course their is. But that’s where the obligation ends. Additionally, one can voluntarily decide to get vaccinated to assure an illness won’t be caught and then spread; the problem arises when that decision becomes a forced one.

  17. Toad says:

    “If you incorporated into your writing the fact that vaccines, too, carry very real risks, you wouldn’t be as likely to have several hundred thousand parents think that you are a total asshole.”

    Yeah, and JB Handley is going to incorporate the fact that vaccine-preventable diseases carry very real risks. While it’s probably not productive to overstate those disease risks, it’s also not necessary. Most rational people understand the relative safety of vaccines compared to the actual diseases.

    “By implying that vaccines are a perfect drug and giving any side effects lip service, you are providing some parents with a false sense of security. Children die at the hands of vaccines–this, too, is a reality.”

    Vaccines are a measurably excellent alternative to actual diseases. Show us your freshman logic and mastery of basic statistical skills Mr. Handley, and acknowledge that.

    “You’d move the debate along if you were able to strike a more realistic and honest middle ground. Given the way you currently write, you sound exactly like a CDC or AAP employee.”

    Ah, the good old fallacy of the middle ground and a weak attempt at ad hominem!

    “I’d also be very careful talking so much about the choices you have made for your son. My understanding is that he is very young. Many of vaccines side-effects are chronic in nature, and you are most certainly not out of the woods with him, particularly if you view it as your duty to give him every vaccine on the CDC’s schedule. Why are there other first world countries that give 1/3 as many vaccines?”

    Spoken by a true infectious disease/vaccine expert. Let’s probe a little deeper into Mr. Handley’s internet education and expertise on the subject, shall we?

    http://www.youtube.com/watch?v=e7Hhgaf3Co0

  18. “How in the world can a rational parent make a cost/benefit analysis with incomplete data?”

    And if the information was provided, how could a rational parent make a correct cost/benefit analysis using such information alone? There would be equally critical information that would be absent. And that is precisely were the studies become necessarily. Also, if there is a fundamental lack of trust, the best data set in the world will not resolve the problem. The data will be seen as rigged from the start.

    I remember the autism discussion forums in the very early 2000s. There was great excitement for the CDC studies and praise for the CDC. They were magicked into the bad guys when they found the wrong answers. One day I will go on a hunt and find all those old posts.

    “I’m always sort of sadly amused by the argument that bad and incomplete data in the VAERS system supports vaccination.”

    How can an adverse event reporting system support vaccination? It is not its purpose. Honestly, who uses it this way? I would like to see quotes please.

    “If vaccines are really safe, this process would pull the rug out from under the parents who don’t trust vaccines.”

    Unless, the fundamental mistrust negates any answer other than the previously chosen one.

    “Instead of many parents abstaining from vaccines altogether, given good data some parents might do at least partial vaccines”

    The next town over from where I live is currently experiencing a Whooping Cough outbreak in its school system. I have no doubt we will see it in our town next autumn. I know several people who have had it now. It has a funny name, but it sure isn’t very funny. An extended fever and coughing every night till you vomit for a few weeks gets old quick. To be honest, at this point I would strongly support beefed up legal requirements in our area.

    “which I must suppose would be an end you all would approve.”

    You are assuming. Perhaps you should not.

  19. Mike Stanton says:

    Jay Gordon suggested earlier that JB Handley is an angry man, made angrier by personal attacks. He also reminded us of his own disquiet for ad hominem attacks. So thank you everybody for not responding to Handley’s remark that “several hundred thousand parents think that you are a total asshole.” It does you credit.

    • David Gorski says:

      It could also be that people have become so inured to JB’s nastiness that it takes him rising to a particularly nasty level, like a shock jock being forced continually to “best” his last bit of shock radio, for him to get a reaction again.

  20. Tom says:

    CDC follows all deaths reported in VAERS and publishes the data. In the paper below , they investigated 206 deaths repoprted during 1990-91. Only ONE of the reported 206 deaths was actually thought to be associated with vaccination.

    Also, if you read the prescribing sheets for vaccines, they give adverse event rates. Serious adverse events are so rare as to make it difficult to determine whether a causal association exists . Bottom line, vaccines are safe and prevent the morbidity and mortality that ARE causally associated with infectious diseases.

    From: http://www.cdc.gov/mmwr/Preview/Mmwrhtml/ss5201a1.htm

    Serious Adverse Events

    Overall, 14.2% of all reports received in VAERS during 1991–2001 described serious adverse events (10) (Table 9). During 1991–2001, reports of deaths ranged from 1.4%–2.3%, and reports of life-threatening illness ranged from 1.4%–2.8% of all adverse event reports. During the previous 3 years when distribution of vaccines reached the highest level, the annual percentage of reports of death was stable, approximately 1.5% of all adverse event reports. The reports of life-threatening illness were also stable throughout the years except for a peak of 2.8% in 1999, which reflected RRV-TV and intussusception incident that occurred in that year.

    A clinical research team follows up on all deaths reported to VAERS. The majority of these deaths were ultimately classified as sudden infant death syndrome (SIDS). Analysis of the age distribution and seasonality of infant deaths reported to VAERS indicated that they matched the age distribution and seasonality of SIDS; both peaked at aged 2–4 months and during the winter (15). The decrease in deaths reported to VAERS since 1992–1993 parallels the overall decrease in SIDS in the U.S. population since the implementation of the Back to Sleep campaign (15). Carefully controlled epidemiologic studies consistently have not found any association between SIDS and vaccines (16–19). FDA and the Institute of Medicine (IOM) reviewed 206 deaths reported to VAERS during 1990–1991. Only one death was believed to have resulted from a vaccine. The patient was a woman aged 28 years who died from Guillain-Barré syndrome after tetanus vaccination (20). IOM concluded that the majority of deaths reported to VAERS are temporally but not causally related to vaccination (20). A similar conclusion was reached regarding neonatal deaths temporally reported to VAERS in association with hepatitis B vaccination (21).

  21. Lara says:

    Parents who fail to understand that they and their children are part of the society they live in are never willing to make choices that are anything but selfish. Having had two of those sorts of parents I think it is completely fair to call them assholes. Other people’s children are your children’s peers. Even those who try to live in bubbles do not; having been pulled out of school to live in a bubble as a teenager I can attest to the fact that the only true bubble is the one people erect in their minds to prevent themselves from having to change their strongly felt beliefs.

  22. Dear Seth,

    I just ordered a copy of your book and I am eager to read it, to better understand your point of view and benefit from the hard work and research you have done.

    As you’ve had a tremendous amount of experience with the media, you know that comments and quotes are often taken out of context.

    I was identified in that Frontline PBS show as a parent who does not vaccinate. That was not true. My children are vaccinated. I consider myself pro-vaccine. I had to have a lawyer contact PBS to change the script, which they did, but I do not know which version you saw.

    That small clip of our conversation that you object to was a few seconds in a much longer conversation. For what it’s worth, I think I come across as a total jerk there too. And I am sorry for that. If you knew me in real life (which perhaps you will one day), you will know that I am not a selfish or uncaring person. The stories that you tell above are heartbreaking, and I care as much about those babies as you do.

    I fear you have unfairly lumped me in the category of “…parents who ignore the science supporting vaccines and also refuse to acknowledge the dangers of infectious diseases.”

    I am more than open to the science supporting vaccines. I have seen firsthand the devastating effects of infectious diseases. I’ve lived in Niger, one of the poorest countries in the world in West Africa, and seen people who were terribly paralyzed by polio. I’ve seen this in America too–our across the street neighbor in Cabbagetown (Atlanta) was a polio survivor, as was my friend Jenna’s father.

    But, sadly, our current vaccination schedule is NOT taking much of that same science into account. That we vaccinate every newborn for a sexually transmitted disease (Hep B) is simply wrong. So wrong that many mainstream doctors privately advise their patients not to get the vaccine. (And unless my baby shares body fluids with your baby, I in no way put any child or immune compromised person at risk for declining the Hep B vaccine.)

    That we vaccinate babies who are too small to crawl or walk (and hence have no risk factor) against tetanus also makes no scientific sense. Yes, there is a “scientific” reason for the early tetanus vaccine but it is not one that has anything to do with tetanus (and since tetanus cannot be “caught” from another person, as far as I know–please correct me if I’m wrong–my decision, if I were to make it that way, not to vaccinate against tetanus also puts no one but my child at risk.)

    You know this, of course, and it is probably in your book, but for 8 years in America there were 0 cases of wild polio (reported, that is), yet 8 children a year were paralyzed as a result of the vaccine (when it was a live virus, which I’ve taken myself orally in my twenties when I was first on my way to Niger.)

    I do not object to vaccines. But despite the media’s love of a “war,” you actually can be pro-vaccine and against the current schedule. I’m writing a book that includes a chapter on vaccines and I have been interviewing medical doctors and some of America’s leading immunologists who are also deeply concerned about the current schedule. Sadly, they often say one thing in public to their medical peers (the All Vaccines Are Good line) and another thing in private to their patients (yes, you should delay some vaccines and simply not accept others.)

    I am sorry your first thought is that I’m an asshole. If you were to take the time to talk to me, Augustine Colebrook, and others (like Vicky DeBold, a pediatric nurse with a Ph.D. in public health who has seen children die of Hib but who is against the current schedule, or Dr Bernardine Healy, health editor of U.S. News & World Report and former director of the National Institutes of Health, who has publicly acknowledged that the safety studies–which usually do not examine what happens when a child is given multiple vaccines, and which do not include statistically significant control groups–are inadequate, or Dr Larry Palevsky who called his medical school mentor to talk about how crazy Hep B at birth was, and whose mentor agreed wholeheartedly off the record but still teaches his students it is mandatory, you would find that we are not assholes, selfish, thoughtless, or denialists. I’m sorry that the level of discourse often gets so vitriolic. I truly believe we all care about the same thing–keeping every child in America safe and healthy. If our current vaccine schedule were actually doing that, we wouldn’t be having this conversation.

    • René Najera says:

      Ms. Margulis, I read your comment and locked on to one thing that I need to clarify immediately. Hepatitis B is not exclusively a sexually-transmitted disease. It is a disease that is transmitted parenterally (through the skin, mucous membranes, veins, etc. http://www.cdc.gov/oralHealth/infectioncontrol/glossary.htm#P) The reason why it is important for newborns to begin the series of Hepatitis B vaccinations is because from day 1 (and even before), they and their parents (and people around them) will be at risk for exposure to Hepatitis B. No, I’m not calling their parents “whores”, as I have been accused of doing in the past for suggesting that parents are exposed to Hep B. That is one HUGE misconception about the disease that, frankly, has only helped it spread.
      The ways parents of children and the children themselves may be exposed include accidental needle sticks (at the hospital, on the playground, through the uncle’s diabetes kit, etc.), IV drug use, exposure to another person’s blood (think paramedics, housekeepers), and, of course, unsafe sexual practices.
      To perpetuate the idea that Hep B is only sexually transmitted doesn’t help. I hope you can see this.
      While there is zero evidence that Hep B vaccine is harmful, we’ll leave that discussion for other commenters. I just wanted to clarify the origin and nature of Hep B infection.

    • Dicty says:

      Ms. Margulis,

      Why in the world do you think babies can’t get tetanus?

    • There is no evidence supporting a need to change the current vaccine schedule, and in contrast to what Dr. Jay asserts below, there are piles and piles of studies showing that vaccines are among the safest medical interventions known. There is no physiological mechanism and there are no data to support the idea that somehow, having five antigens instead of one to produce immune memory is inherently dangerous. It’s a drop in the bucket to the daily exposure to immune triggers infants experience. That idea of “vaccine schedule” as the bugbear du jour is just a fallback notion that reared its head when at least some reasonable people who had been anti-vaccine because of mercury concerns had to acknowledge that mercury is not, in fact, a concern. Those who couldn’t let go of their “vaccines are evil” conceptions had to turn to “the schedule” or to “green our vaccines.” Sorry, but viruses and bacteria that harm and kill people–infants included, and that includes tetanus *and* HBV–don’t care what the vax schedule is or how green a vaccine is.

      I’ve read much of what you’ve written about vaccines and watched the Frontline video of your comments, Ms. Margulis, and there are no scientific mechanisms to support the hypothetical dangers you propose and the data conflict overwhelmingly with your epidemiological assertions. The main driver in your carefully constructed defenses seems to be fear. I get that. My own fears for my children and a strong feeling of a social responsibility to children and adults who cannot receive vaccines and need a blanket of protection from the community drive my decision to vaccinate my children.

      The danger of someone like you, Ms. Margulis, is that you come across as well educated, articulate, calm, and plausible, even as what you say lacks foundation. That doesn’t make you an asshole. But it does make you a danger to public health. As you have been quoted as describing yourself as a public health official’s nightmare, I can only conclude that that is your intention. That doesn’t sound…kind.

      It’s easy to pick and choose things that support one’s confirmation bias. As for wild polio, etc., there’s a reason they are not present in the U.S. right now. It’s called vaccination. These diseases remain a mere plane ride away, from places such as Pakistan, Nigeria, Congo, and many other parts of the world where wild polio appears to be alive and well. These squabblings and babblings about “too many too soon” and pickings and choosings of vaccines and parsing their long-standing ingredients represent the presumptuousness and entitlement that often accompanies these first-world conflicts. You know why we have the luxury to sit here and even argue about these specifics in our comfortable, entitled, first-world way? Vaccines. And we’re not really “first world.” We’re a global society, and those deadly diseases *are* a plane ride away. Sometimes, they’re just right here in Minnesota.

    • I have here irrefutable evidence, with pictures even, that babies too young to crawl can and do get tetanus: http://www.aap.org/pressroom/aappr-photos.htm#tetanus

      Thank you. And good night.

  23. Pingback: New on PLoS: Evidence, herd immunity, and “total assholes”

  24. Jay Gordon says:

    Jennifer, really excellent post expressing the thoughts of many of us who keep being pushed into the “anti-vaccine” box when we’re not. Vaccines are not manufactured nor administered as safely as they could be and the science behind the current schedule is very, very shaky.

    René, hepatitis B’s “vertical” transmission from an unknowing mother to her baby is extremely rare and quite oreventable. The “horizontal” possibilities you suggest are statistically, incredibly unlikely for children. Nearly impossible. The side effects of the newborn hepatitis vaccination are known and real. Postulating “uncle’s diabetes kit” accidents and playground accidents with exposure to large enough amounts of blood-to-blood contact isn’t your forté and almost makes you sound less like a scientist. I completely agree with your thoughts about paramedics, nursing students, med students and other high risk blood-exposed people being current on hepatitis B vaccination.

    Jay

    • René Najera says:

      Dr. Jay, my comment was mostly about classifying Hep B as a disease exclusively of (and for) those who practice unsafe sex. (We in Public Health learned a hard lesson on that with HIV, didn’t we?) But, since I’m on my coffee break, and I didn’t have a single hypergraphic episode all weekend, I’ll take the bait…

      Please cite the source for the “known and real” side effects of newborn hepatitis vaccination. I can’t for the life of me find anything in any non-anti-vax source whereby Hep B vaccine in newborns is worse and in a higher proportion than the disease itself at any point in life. I’d like to tell the new cases of Hep B I investigate something along the lines of, “Hey, I know you’re going through a rough time with this hepatitis thing, but at least we didn’t put you in a known and real danger at birth by giving you the goddamn vaccine.” (No, I don’t.)

  25. Jay Gordon says:

    René, do you really see children with newly diagnosed hepatitis B with HBV negative mothers? I doubt it.

    You see, taking the conversation in this direction is pointless. You do not see kids with mysterious hepatitis B cases. You see adults who should have protected themselves because they either engage in high risk behavior or have professions which expose them to possible transmission.

    Your specious reasoning about vaccine side effects and “higher proportion” is not great either. I will give you citations about HBV vaccine complications, if you’d like, but a simple look at Medline or similar will take you to those same articles from very reputable journals like “Neurology”

    http://www.neurology.org/content/63/5/838.short

    and many others. I also know that for every article I cite, you can cite others which disagree. Most of these opposing studies were funded by the people who make the vaccines.

    If the hepatitis B vaccine given at birth benefited the baby, I’d give it.

    Jay

    • René Najera says:

      Dr. Jay, I have a game that I play when I read comments from you and others lately. I try to identify how many “gambits” and biases you present in your arguments. In that last comment, you managed to squeeze in the big pharma gambit, confirmation bias, and recall/surveillance bias as well.

      I will now declare a 12th rule to being an anti-vaxer:

      If Dr. Jay Gordon does not see it, doubts it, or has never heard of it, then it absolutely never happens.

      (Don’t say that I didn’t make it clear that I wasn’t going to go this route and ONLY wanted to note that Hep B is present in people other than the sexually unsafe. We can stop this right here and now and move on, or we can go back and forth with our own biases muddying the discussion all day long… With breaks for work, of course.)

    • Flavia says:

      So, you’ve never seen or known of a baby needing an emergency blood transfusion? There would certainly be potential for Hep B transmission there.

  26. Roxanne says:

    You know what’s interesting to me … as a bit of an outsider to this issue … is that many of these same discussions happen in veterinary medicine as well. The idea of vaccinating dogs and cats every year for pretty much everything is changing. Many people don’t vaccinate ever again, after the initial series of puppy vaccines, for example. Others (like me) do some every 3 years and others every year … based on both our dogs’ relative risk for certain bacterial or viral diseases and on the efficacy timeline of certain vaccines.

    I too am not “anti-vaccination,” but I am in the camp that says, “Let’s make specific decisions for specific pets.”

    One of my dogs has no problem getting all vaccines we give all at once, but the other gets quite sick for several days if we give too many together. So, my veterinarian and I work together to find the right balance of what to give and when … and how to pre-treat my youngest dog to mitigate the vaccine “reactions” she does have.

    Because rabies is the primary disease with human public health implications, it’s heavily mandated by states. I certainly know people who still choose not to vaccinate for rabies after the initial puppy series of vaccines, but the truth is that if that dog bites someone down the road … officials can kill the dog … no questions asked … if the family cannot come up with proof of a recent vaccination.

    Both of my current dogs nearly died from Parvovirus as pups … because they were exposed before they were too young to be vaccinated or were not properly vaccinated early on (before we adopted them), so I can see that side of things too.

    I like to think I make decisions that are best for my dogs and my community (human and canine alike), including keeping the pups quarantined at home for many months because even after recovery, they continue to shed the parvovirus … and I didn’t want to put other pups at risk.

  27. carykoh says:

    Hepatitis B transmission is not purely sexual, nor purely due to ‘high risk behavior’. The transmission is in fact a bit of a mystery. As many as 30% of Hep B patients have no risk factor. In fact, it’s well documented that household contacts can spread the disease. The reason, Dr. Gordon, for the early inoculation is that the risk of chronic Hep B, and therefore liver disease and hepatocellular carcinoma, is far higher in a child that is infected than in an adult. As to the tetanus vaccine, again the transmission is not as clear as Jennifer makes it out to be. The toxin can also be transmitted food items, esp raw honey, just look up neonatal tetanus.

  28. Jay Gordon says:

    René, I’d like to go back and forth with our biases muddying the discussion for another few hours, then I’ll stoop to veiled name-calling, play the pharmashill gambit one more time (a gambit that I actually will then dispute is a gambit at all!!) and eventually stomp off angry.

    Just one point, I will easily acknowledge the public health benefits of vaccinating every newborn (benefit to population as a whole probably outweighs risk to baby) but I’d like you to acknowledge that you don’t see hepatitis B in low risk babies and children.

    OK?

    Jay

    • René Najera says:

      I cannot fully acknowledge that, Dr. Jay, because I was once (in a previous life) involved in assisting in an investigation of an outbreak of Hep B precisely in low risk neonates. I don’t do such investigations now as an Epi. I was a Med Tech back then.

      However, I will acknowledge that such events are rare. Thing is, they are rare because of… you know… Hep B vaccine use in healthcare workers, expecting parents, daycare workers, and the population in general.

      (Biases used by me: Recall and Confirmation, maybe.)

      • Mara says:

        Hooray for pointing out to Dr. Jay that the reason these things are rare is because of the vaccine :)

        When I hear anti-vaccine people (yeah, dude, I’m telling it like it is) say “X is rare”, it makes my head want to explode because have they ever considered the possibility that THE VACCINES ARE WHY IT’S RARE!

        ::coughs:: Sorry, I get a bit worked up.

        • Twyla says:

          Mara, they did not even start giving the hep B vaccine to all babies at birth until about 1991. I lived for several decades before that, and I have never ever known anyone whose baby was sick with hepatitis B. How common could it have been?

          Go ahead, I’m expecting comments about how stupid it is to base anything on experience.

          Hep B vax at birth for all infants is one of the most insane decisions ever made by those in charge of our vaccine program. The only newborn babies at risk for Hep B are those whose mothers are carriers. By the time a baby is old enough to engage in risky behaviors such as sex and IV drug use, the immunizing effects of that vax will have worn off.

          • I have it on good authority that refusing to immunize is a far more “insane” decision.

          • Mara says:

            Well, if you don’t believe babies are at risk, then let’s take the other side of the question…if the Hep B vaccine is so awful and dangerous, then there should be a sharp difference between kids born in 1990 and those born in 1991. Heck, I’d even take a statistically significant uptick between those two years as a reason to do further research. (Not proof, but certainly a reason to look into it.)

            What happened to babies born in 1991? Did a larger percentage die? Did a larger percentage develop autism or eczema or anything?

            If not…then I’m comfortable taking the risk. And in fact, I did. Both of my children received their Hep B shots while in the NICU as premature babies. And I do not regret that decision in the least.

  29. Jay Gordon says:

    Almost there: What were the findings in that outbreak? Can I read about it somewhere? (Please don’t read sarcasm into that; There’s none.)

    Jay

    • René Najera says:

      I’ve been googling for it for a while now and can’t seem to come up with something. Let me see if I can find it. It was in 1996 or 1997, when I was a med tech in a far-off place. They couldn’t rule out contaminated medical equipment in the NICU. (The lawyers had a field day. I remember that much.) I’ll write it up or direct-message you anything I find on it.

  30. Jay Gordon says:

    Hepatitis B is rare because of blood bank safety, maternal screening, condoms and vaccination of higher risk people. The vaccine’s benefit to babies is pretty much zero.

    I believe that the statement “As many as 30% of Hep B patients have no risk factor” is incorrect and, while botulism spores can be found in honey, I’m pretty sure that tetanus transmission from honey does not occur.

    Jay

  31. Here’s my problem, Seth. See, in my state (New York) children are required to have 16 shots to enter kindergarten.

    http://www.health.state.ny.us/publications/2370.pdf

    However, doctors don’t give parents that information. They just give them the “suggested” immunization schedule which pumps about 35 vaccines into a child.

    http://www.cdc.gov/vaccines/spec-grps/infants/downloads/parent-ver-sch-0-6yrs.pdf

    How is that right or fair? I have a feeling we’re going to find out some day soon that all those toxins and chemicals — suggested, not mandated — are part of the reason we’ve got such an increase in ADD, ADHD, allergies, autism, and all of the other autoimmune diseases that are plaguing our young kids.

    People like me, who are not anti-vaccine but anti-over kill vaccines, might trust doctors more if money (and let’s be real — the reason doctors over-vaccinate is all about money) didn’t dictate public policy.

    –KB

    • Chris says:

      — are part of the reason we’ve got such an increase in ADD, ADHD, allergies, autism, and all of the other autoimmune diseases that are plaguing our young kids.

      Citation that any of these are from vaccines, please.

  32. Carykoh says:

    Neonatal tetanus is a real disease, but as is classically taught, raw honey is connected with botulism, I stand corrected. That doesn’t change the point, the point being that neonates do get tetanus. This is to just correct Jennifer’s point that there is no way for a neonate to get tetanus. The 30% figure is directly from Wikipedia, but I checked the source and it seems legit, you can easily check it if you wish. If you have other information, by all means share. Also, I think you can concede that Hep B is spread though household contact. This is well established, and I don’t consider household contact high risk. Point is, anybody can become infected with Hep B, not just those who engage in high risk behavior, it’s far more transmittable than say Hep C or HIV.

  33. Jay Gordon says:

    Carykoh, to continue the amiable tone of this conversation, I disagree with the 30% figure and checked this out with an ID contact. (Some of them still talk to me . . .) The transmission of hepatitis B from toothbrushes or very unusual incidents like needle sticks at the beach is rare enough to be considered zero. Some would argue that it is actually zero.

    The circular issue is simple: the reason I have the luxury of discussing alternatives to the current vaccine schedule is because of . . . vaccines. I do not agree with people who say that polio went away because of reclassification or that better hygiene led to a decrease in measles. Vaccines work. I just can’t stand the way we do it and the manufacturing and testing standards we allow.

    Jay

    • Todd W. says:

      Jay,

      Some would argue that it [transmission of HepB via toothbrushes/accidental needle sticks] is actually zero.

      Then some would be idiots, quite frankly. Accidental needle sticks do occur, and some result in Hep B transmission. And needles don’t just turn up at the beach. They may be dropped anywhere: playgrounds, gardens (found an insulin needle in my own garden once), etc. Bites from other kids at daycare can transmit it, not to mention open wounds (cuts, scrapes, etc.).

      Now, the tactic of focusing on only at-risk populations for vaccination. Well, we tried that. It didn’t work. There was virtually no impact on the rate of new infections reported. Then the decision was made to recommend vaccinating all infants at birth, not just the ones at risk. Know what? New infection rates dropped.

      Jay, I would recommend that you read the CDC Pink Book chapter on Hepatitis B. From the way you talk about it, it seems you have not read it. It may help you get a better grasp of the disease and why infant immunization is important.

    • carykoh says:

      I don’t really dispute that the 30% number seems high. I haven’t done a thorough search of the literature, but found a source and used it. It’s an older source and could easily be off. Anybody with better more recent data, I’d appreciate it. The point isn’t really the absolute number, it’s that you seem to be claiming you can only get Hep B from high risk behavior, and this is just false. A very significant number of low risk people will acquire the infection. On top of that, an infant that acquires the infection is at a far higher rate to go on to be a chronic carrier and suffer serious sequelae than an adult, something I’m sure your ID contact would agree with. So, I guess I can see your point. If you have a Hep B- mother, and live in a community with low Hep B prevalence, you can tell your patient that their child has a very low risk of contracting the disease, but not zero. But you should also inform them that if they do get infected, they have a much higher risk of becoming chronic carriers, and therefore higher risk for cirrhosis and hepatocellular CA. On top of this, they will have to inform any potential sexual partners of their status if they become chronic carriers, if they want to be honest. If you have that discussion, and they still don’t want the vaccine, I guess I wouldn’t argue the point too much more.

  34. Twyla says:

    JB Handley lists some of the studies showing reasons for concern about the Hep B vaccine here:
    http://www.ageofautism.com/2009/10/hepatitis-b-vaccine-an-unmitigated-disaster-.html
    And, yes, go ahead with a round of bashing JB and AoA, but these studies were not done by JB nor by AoA. They are from journals such as Neurology and the Annals of Epidemiology.

    • Todd W. says:

      Let’s take a look at that list, which was provided without any links to the actual studies.

      1) “Delayed Acquisition of Neonatal Reflexes in Newborn Primates Receiving a Thimerosal-containing Hepatitis B Vaccine: Influence of Gestational Age and Birth Weight” (PMID: 19800915) – Withdrawn by the publisher. Also, performed in monkeys, not in humans, so we cannot extrapolate results to humans. If memory serves, this was the study that had 13 monkeys in the experimental group and only 2 in the control group?

      2) “Hepatitis B Vaccination of Male Neonates and Autism” (PMID: 21058170) – The study had a number of problems. These have been discussed at Left Brain/Right Brain.

      3) “Hepatitis B vaccine and the risk of CNS inflammatory demyelination in childhood” (PMID: 18843097) – The study authors did say that one brand of Hep B vaccine (Engerix) appeared to have an increased risk of CNS inflammatory demyelination. However, Handley left out the important bit: “Our results require confirmation in future studies.” There were also some important letters that followed this, pointing out that the Engerix link was not confirmed.

      4) “Hepatitis B triple series vaccine and developmental disability in US children aged 1-9 years” (PMID: not found) – This is by the same authors as #2. The only place I could find this was on anti-vaccine sites, not on any science/journal sites. Unfortunately, I can’t find the full paper, so I can’t offer a reliable critique of it.

      5) “Immunization Safety Review: Hepatitis B Vaccine and Demyelinating Neurological Disorders” – The IOM found that there was no evidence linking the vaccine to MS in adults, and that for other demyelinating conditions, there was not enough evidence to make a conclusion one way or the other. To a sane person, this means exactly what it says: we can’t make any conclusions because the evidence isn’t there. To Handley, this means: Hep B causes demyelinating conditions!

      6) Not a published study, but rather Handley and Gen. Rescue’s own mental meanderings trying to compare the U.S. schedule to other countries. I already pointed out why different countries may have different schedules. Not every country has the same disease burden or goals for handling those diseases. The example I gave was the BCG vaccine against tuberculosis. Lots of other countries require it; the U.S. doesn’t. Using Handley’s logic, since lots of other countries require it, then we should, too.

  35. Twyla says:

    These discussions often go something like this:

    Person A: “My typically developing child received several vaccines and soon developed a high fever, screamed inconsolably for hours, had a seizure, and after that was never the same again.”

    Person B: “It’s irresponsible to not vaccinate! Diseases are dangerous! Your children are a danger to the community if you don’t vaccinate them!”

    First of all, this is a nonsequitur. The parent did vaccinate his/her child, and is describing the adverse results.

    Second of all, does modern medicine have nothing to offer besides all-or-nothing, the entire vaccine schedule exactly as is or no vaccines, either total fidelity to the CDC and AAP or you are a traitor?

    The only solution to vaccine problems is to not talk about them? It’s irresponsible to talk about any problems? The only approach is totalitarian suppression of discussion?

    Isn’t it good science and good medicine to start with whatever evidence we have and investigate it? Vaccine injured children are not studied by our government agencies and medical associations for the purpose of better understanding vaccine injury. What are the causes? Who is susceptible? Can these injuries be prevented? How can they best be treated?

    And, how can these injuries be identified? Vaccine injuries are constantly called “coincidence”. It is said that there is no evidence — because we don’t even have defined what evidence should be looked for.

  36. Twyla says:

    Mike Stanton said (on 5/7 @ 8:35 a.m.), “Early in this discussion you argue that autism is a rare consequence of vaccinations. Later you claim that there is a link between the rising rates of autism and vaccinations. Now it does not matter that I think neither of these statements is true. They cannot both be true. Are vaccines a rare cause of autism or can they explain the growth in recorded cases?”

    You are confused. To say that “autism is a rare consequence of vaccinations” is not the same as saying that “vaccines [are] a rare cause of autism”.

    If 1 in 100 children have autism, and most of the children are vaccinated, even if vaccines cause most of the autism, it is a rare reaction to vaccines, because something like 99% of the children who received vaccines did not become autistic.

    However, vaccines could still be the primary cause of “the growth in recorded cases”. The question is, what caused the autism in that 1% of children with autism? If 80% percent of them had vaccine-induced autism that would be a significant cause, even though most children did not become autistic and so autism would still be a relatively rare reaction to vaccines.

    • Mike Stanton says:

      I am confused … by advocates of vaccine induced autism who argue that the growth in prevalence can only be explained by environmental factors and then cite vaccines as the most likely candidate. When it is pointed out that an adverse reaction affecting nearly 1% of all vaccinated children would have been detected by now we are told that the vaccine induced autism only affects a susceptible minority that is too small to be detected by our present vaccine surveillance methods. But, in the case of Rotashield, vaccine induced Intussusception was detected at a rate of 1 in 10,000 and the vaccine was pulled by the CDC.

      Hence my question to Dr Gordon. What does he believe? Are vaccines a significant cause of the increase in figures for autism prevalence or not? You believe they are. Do you have any citations to back your suggestion that 0.8% of children have an adverse reaction to vaccination that results in autism?

  37. Hi Ren, glad to see you’ve been over to my Generation Rescue blog.

    So parents of neonates, their contacts, and the neonates themselves should live in a bubble?

    Bubble is a strawman. But keeping infants out of public places has been common practice since the beginning of time. Parents can decide how worried they are and act appropriately.

    Because the diseases you know nothing about but continue to proclaim as being “harmless” (Rubeola showed me what you said about measles)

    Can’t respond if there’s no actual quote

    all have an incubation time in which the person is asymptomatic (without symptoms) but still very capable of transmitting the disease without knowing.

    True. What’s the point?

    • Todd W. says:

      @Robert

      But keeping infants out of public places has been common practice since the beginning of time.

      Let’s see. There are a few problems with this. First, most doctors don’t make house calls, so there’s taking the kid for his/her regular checkups, not to mention when the child needs medical care for an illness. So, there’s chance for exposure in a doctor’s office.

      Second, not everyone can afford to stay home with the baby, missing out of work for weeks or months beyond whatever maternity/paternity leave the employer offers (if any), so you have exposure at daycare or from a nanny.

      Speaking of caring for the child, what happens when the parent(s) need to run an errand, but can’t afford to hire someone to watch the child while they do so? Do they leave the infant home alone?

      Then you have family and friends who come to visit. They may be carrying an illness, but not be symptomatic yet and not even realize they’re infected.

      Of course, there are also immediate family: parents, siblings and so forth. What happens when they get sick and are contagious before showing symptoms? By the time they show signs, it’s too late to quarantine the little one from them.

      What about when the child is old enough for school? Again, not everyone can afford home schooling. What happens when the child goes off to school?

      So, yes. In essence, you are arguing that people should basically live in a bubble. At the very least, you don’t appear to have taken the time to really, truly think through the possibilities and various consequences.

    • René Najera says:

      The google alerts on your name + vaccine misinformation are part of my morning routine, Mr. Schecter. Don’t want to get caught off guard by the latest nonsense, so I try to keep up. Have you guys thought of all getting together and launching the Anti-Vaccine Times or some such? A collaborative effort. Like a Gawker.com-type media project, all about scaring people away from vaccines?

      But enough with the ad hominems.

      Social distancing does not work for those diseases where you are asymptomatic and infectious. Many vaccine-preventable diseases are like that. Influenza is the most common one. That yearly outbreak is not because sick people don’t stay at home. It’s because they were at work, school, out in the public before they were symptomatic, thus spreading the infection.

      Social distancing works in diseases where you are not infectious before your symptoms, or those where you are not infectious at all (tetanus)… And, of course, in those diseases that kill you before you can walk to the next town over.

      That’s what I was getting at with the incubation thing. Why?

      Because it leads right through the argument to distance newborns/susceptible kids from the rest of society. As Todd pointed out, it’s just not going to happen in today’s world.

      Finally, I think you may want to rephrase your statement about whooping cough not being a big deal for adults. It’s a big deal when said adults pass it on to kids.

  38. Todd W, maybe people will give up on the well baby visits (where healthy kids are brought to sick people.) Do you have any evidence they do any good?

    So it’s my responsibility that they can’t stay home with THEIR child or have to send them to daycare? I don’t think so. As to the nanny, they can stipulate that he or she is vaccinated as a condition of employment. Additionally, they can send their kids to a daycare that has high rates of vaccination.

    Immediate family? If you’re worried build that vaccine cocoon.

    By the time they’re ready for school, they can be vaccinated – and even if they’re not, whooping cough is far less serious after one year of age.

    • Todd W. says:

      @Robert

      So it’s my responsibility that they can’t stay home with THEIR child or have to send them to daycare?

      No, but if you are sick and pass your infection on to them, you bear at least some responsibility for them getting sick, and the consequences that may follow.

      Let me ask you, what precautions do you take to prevent yourself from passing on an infectious disease when you are contagious but asymptomatic? Do you wear a mask anytime you go out in public?

      Additionally, they can send their kids to a daycare that has high rates of vaccination.

      High rates does not equal 100% vaccination of all kids and workers there. And even with 100% vaccination, there is always the chance that some may not be immune, for the same reason that they may not be immune following natural infection.

      I notice you didn’t address what happens when they parent needs to run an errand but cannot, for whatever reason, have someone stay home with the child while they’re out. What happens then? Suppose a single mother needs to go to the store and has no choice but to bring her child with her. While there, she is in line behind you while you are infected with pertussis, but before you show any symptoms.

      Are you willing to take responsibility if you infect that child? Are you prepared to take responsibility should the child suffer any serious complications?

  39. Todd, you seem to think you can force people to do whatever you like to prevent pertussis. That’s not the case. People have the right not to be medicated against their will. If pertussis remains endemic as a result then pertussis will remain endemic. If people are concerned whether or not they can run errands is not my concern. They need to take what is called personal responsibility. Since I don’t share your communitarian worldview, this may be hard for you to accept.

    you bear at least some responsibility for them getting sick

    If I go out, with measles/flu/pertussis etc, while asymptomatic or with some mild, nondescript symptoms (not red spots) you could say “responsible” in the sense someone caught flu/pertussis from me. But since I was under no obligation to act differently, there was no responsibility (as defined by obligation to act) to stay home or vaccinate.

    Let me ask you, what precautions do you take to prevent yourself from passing on an infectious disease when you are contagious but asymptomatic?

    I take no precautions because it is unreasonable to do so

    Yes asymtomatic can pass along illness – you seem to think that excuses unwanted medication. It doesn’t; people pass germs from one to another as a function of life in civilization. If that doesn’t work for you can act [not force other to act] and leave civilization, stay home, promote your immune system etc. But ultimately, the “problem” can only be addressed by voluntary action.

    • René Najera says:

      Alright, Mr. Schecter, one last thing. I know it’s not going to change your mind, since you appear to be very set in your ways. This is a link to an article on my now defunct examiner.com page: http://exm.nr/mmCZ3X

      It’s my synthesis of a speech by Dr. Paul Offit. I know. I know. Nothing he says will ever be right by you. Just look at the decisions by the US Supreme Court, as should everyone else who thinks that freedom is closer to anarchy than it is to democracy. The Supreme Court, in several cases, did not find sufficient basis in the US Constitution to allow people to be freed from restrictions placed on them by public health authorities, including compulsory vaccination.

      Again, not trying to change your mind, but trying to set the record straight as to what our collective “freedoms” and “responsibilities” are. Good day, sir.

    • Todd W. says:

      you seem to think you can force people to do whatever you like to prevent pertussis.

      Actually, that’s not what I’m saying at all, but feel free to build up straw men all you like. You certainly have the right to refuse vaccination, just as I have the right to try to convince you that you’re being an ass who shows zero thought for contributing to the well-being of the society of which you are a part.

      They need to take what is called personal responsibility.

      Interesting how you say others need to take personal responsibility, but then eschew taking it yourself.

      Since I don’t share your communitarian worldview, this may be hard for you to accept.

      Yes, it is tough for me to understand. I try to do what I can to, if always help outright, at least take action to prevent harming others.

      If I go out, with measles/flu/pertussis etc, while asymptomatic or with some mild, nondescript symptoms (not red spots) you could say “responsible” in the sense someone caught flu/pertussis from me. But since I was under no obligation to act differently, there was no responsibility (as defined by obligation to act) to stay home or vaccinate.

      Actually, you do have a responsibility to take reasonable action to minimize the risk that you pose to others. Vaccination is such a reasonable action. Let’s try another scenario: You have chosen not to get any vaccines for yourself or your children. You get infected and pass that infection along to your kid. By your logic, you bear no responsibility for your child getting sick. After all, the kid should’ve just stayed away from you, right?

      I take no precautions because it is unreasonable to do so

      Ah, yet you expect others to take unreasonable precautions to avoid getting/spreading an infection. Bit of a double standard, there, no?

      If that doesn’t work for you can act [not force other to act] and leave civilization, stay home, promote your immune system etc.

      Whether you like it or not, you live in a society with other individuals, which brings with it certain responsibilities (ethically, if not always by law) in addition to the freedoms. If that does not work for you, you can always leave the society, stay home, etc.

  40. The google alerts on your name + vaccine misinformation are part of my morning routine, Mr. Schecter. Don’t want to get caught off guard by the latest nonsense, so I try to keep up.

    I appreciate your interest in my work.

    Have you guys thought of all getting together and launching the Anti-Vaccine Times or some such? A collaborative effort. Like a Gawker.com-type media project, all about scaring people away from vaccines?

    I think I’ll just focus on The Vaccine Machine blog along with some guest appearances here and there.

    Social distancing does not work for those diseases where you are asymptomatic and infectious.

    If the baby is kept away from people, it doesn’t matter if those people are asymptomatic or not.

    Finally, as I told Todd, the chance of a symptomatic infection does not excuse unwanted medication.

    PS
    Thanks Rene, I’ll have a look. But a court decision (Jacobson?) does not define morality for me.

    • moderation says:

      I just finished reading your comments and wanted to address acouple of comments you made.

      1. “… maybe people will give up on the well baby visits (where healthy kids are brought to sick people.) Do you have any evidence they do any good?” Wow, I don’t think you could have made a more uniformed statement if you were trying. Do you have a child? Have you ever been to a pediatric check-up? The visit involves a full physical exam, developmental screening (expressive and receptive speech, fine and gross motor skills), growth screening, counseling parents and answering their questions (especilly for 1st time parents) on topics from breast feeding to safety issues. Actual vaccination education and administration are only a small part of a check up and even if all vaccine preventable disease was eliminated, there would still be a need for pediatric infant check ups.

      2. It is quite clear from your comments that you take an extreme libertarian point of view on most subjects (favoring individual rights over the common good), so I’ll bite: lets go with your theory. I assume then that you are OK with me as an ER physician refusing to treat you for your injuries if you have not been vaccinated against Hep B, Hep A and other transmittable diseases as I would be assuming the risk of transmission when I treat your wounds or intubate you. I, of course, would treat everyone as is my ethical obligation, but it would seem you would view this differently.

  41. Garbosmed says:

    Just curious to know, is Dr. James Cherry an asshole too? Or the doctors who saw the sick infants and misdiagnosed and improperly treated them, leading to their deaths? Or the California Health Department for blaming the deaths on misdiagnosis instead of selfish non-vaccinators? Or maybe it’s those asshole pertussis germs that drifted and have the unmitigated gall to no longer match the vaccine strain?

    “Eight infants in California died during the state’s current pertussis epidemic. A state review now reveals that the infants had been seen by doctors several times before they were accurately diagnosed with pertussis, also known as whooping cough. According to experts, the pertussis deaths stemmed from misdiagnosis.

    Dr. John Talarico of the California Department of Public Health reported that some of the infants were treated for mild upper respiratory infection or nasal congestion. By the time an accurate diagnosis was made, the infants were in severe respiratory distress and it was too late to prevent their deaths.

    University of California Los Angeles professor and pertussis expert Dr. James D. Cherry reviewed all eight cases and concluded that the doctors did not consider pertussis until it was too late. Although he noted that diagnosis of pertussis is difficult, he stated that these cases should have been diagnosed earlier. Further, he accused some healthcare providers of not taking the disease seriously enough after the correct diagnosis. Dr. Cherry asserted that, in his opinion, the deaths stemmed from delayed hospitalization.

    All eight infants who died were under three months old.

    California doctors have been urged by health officials to test for pertussis in any infant under the age of six months who is experiencing troubles breathing. An early diagnosis combined with antibiotic treatment can keep the infection from becoming serious and leading to death. “

    • Twyla says:

      Thanks, Garbosmed.

    • moderation says:

      The problem with your theory is that pertussis is extremely difficult to identify in the 1st two weeks of illness (the catarrhal stage) as it looks exactly like a common cold. And yet this is the time that you need to initiate antibiotics for them to have any effect at all. Initiating testing and antibiotics on every child who presents with a cough (the average child has 5-6 viral upper respiratory illnesses per year) would be cost prohibitive and impractical (cultures come back in 2 weeks and PCR requires half a week). By the time pertussis reaches the paroxysmal stage with the classic “whooping” cough, antibiotics are only effective in decreasing transmission, not disease severity. What this is all to say is that it appears obvious and logical from your statement that you must therefore be highly supportive of universal pertussis vaccination for those eligible, to provide herd immunity to those who are too young or unable to be vaccinated. Cost effective and practical.

      • Garbosmed says:

        I think it depends on whether your goal is the elimination of pertussis (an epidemiologic pipe dream) or the elimination of pertussis deaths. The California statistics are quite interesting in this regard because after the <6mo. olds (majority of cases) the highest numbers were in the highest vaccinated populations. The CDC's 2009 stats for vax rates show over 93% compliance for pertussis vax among school age kids. Rates are much lower for adults (53-55%), with many longer years since last vaccination, yet there were very few adult cases. A more interesting question is why is it that the younger generation seems to have less robust immune response despite quite high vaccination coverage? Is this due to primary vaccine failure, and if so will boostering with ineffective vaccines do anything to help the problem?

        Of the infants that died, several had household contact siblings who had coughing illness but were fully vaccinated. The vaccine is not a teflon condom; even if rates were 100% and effectiveness were 100% it does not prevent one from catching or transmitting pertussis. An effective vaccine lessens the severity of the disease in those who catch it. The downside of that is that they may then be unaware that they have an illness that might be serious to household infants whose immune systems are too immature to mount a response. In short, "cocooning" is, IMO, a load of malarkey that may ultimately do more harm than good.

        Pertussis comes around every 3-5 years or so, regardless of how many people are vaccinated. The answer if you want to prevent infant deaths from pertussis is to develop faster testing and find other ways to boost the immature infant immune system. 9 of 10 infants who died were latino, and many of these affected infants seem to have been gestated/born during the winter months; perhaps boosting vitamin D levels in mothers and infants would help. Delayed or incompetent medical care cannot be entirely ruled out either. It doesn't say the doctors in question ordered tests but the tests took too long, it says they failed to even explore the possibility and even once pertussis was diagnosed they failed to properly treat it. And it's disingenous to moan about the expense of testing if you care so much about these babies — the costs of testing infants <1 with respiratory illness would be exponentially less than the costs of vaccinating every middle school entrant with a booster.

        If one really cares about pertussis vax coverage, and the pertussis portion of the vaccine only has an efficacy of 5-6 years, why keep bundling it with tetanus vaccines that are needed only once every 10 years? And why not demand a more effective and longer-lasting vaccine so that repeat boosters are unnecessary? Why not demand — or compile independently — more honest vaccine efficacy data, because surely the efficacy of these vaccines has been overstated or else something has gone terribly wrong in manufacturing/transport/storage.

        Given the fact that antigenic drift of pertussis has been documented for years in other countries, (and in this country with the pneumococcal vaccine), it would seem more nimble from a public health point of view to stop bundling vaccines together so that antigenic drift can be more rapidly and effectively addressed without adding unnecessary risk to vaccine recipients by loading them up on antigens they don't need.

        So no, I am not for more comprehensive vaccines for everyone, especially if they are ineffective and ill-matched to the disease and confer both risk and a false sense of security rather than genuine protection. I am for better testing and more competent and educated health care for infants.

        • Moderation says:

          Very few diagnosed adult cases. First keep in mind that the symptoms of pertussis are much less severe in adults, so it is underdiagnosed. Additionally as with other illneses, school age kids are at greater risk because they are school age kids … congregating in large groups, more frequently than adults.

          Review the lit on the CA outbreak and you will find the investigators belive the most likely cause of transmission was unvaxed adults in the household, NOT other vaxed sibs or kids. Had the adults been up to date then perhaps “cocooning” would have been possible. By definition if a vax is 100% effective and everyone is vaxed the no one would get the disesase and it would cease to exist outside of labs … like smallpox.

          You question the effectiveness of vaxes and then bring up Vit D and winter born infants which has a very small amount of preliminary research behind it, and only shows slight corellation.

          Here is the easy stats to look up … Check the rates of infant death from pertussis, HIB, pneumococcus, diptheria, etc. before and after the introduction of the vaccines. Scoreboard.

          • Sarah says:

            “Here is the easy stats to look up … Check the rates of infant death from pertussis, HIB, pneumococcus, diptheria, etc. before and after the introduction of the vaccines. Scoreboard.”

            Gotta love how the mantra against a vaccine/autism link is “correlation doesn’t imply causation” but correlation is almost always used to “prove” that vaccines are responsible for lower death rates. Go ahead an look at those charts. In most cases, the rate of disease and death was already on the decline before the vaccine was introduced. And if we’re looking at correlation here, go ahead and compare those rates with the rates of autoimmune disease, diabetes, asthma, allergies, cancer, etc. You can also toss in a life expectancy graph for good measure. If the general health of our country were improving we could talk about that, but as we vaccinate more and more and shift our focus to pharmaceutical intervention, we get sicker and sicker. Our children, with the most aggressive vaccine schedule ever, are sicker than ever. Our health care costs are through the roof.
            So is correlation still something you want to use on your scoreboard?

          • Garbosmed says:

            Yes, so the CA DPH response is to add a mandate for middle school entry boosters, failing utterly to address the possibility that the vaccines are dangerously substandard in their ability to induce immunity while possibly over-vaccinating a population that demonstrably isn’t the the problem in the first place. It’s an entirely asinine repsonse, but they have to be perceived as doing SOMETHING and they know that if they instituted a motor-vaxxer law that required adults to get vaccinated to get a drivers license or a plane ticket, there would be a disastrous public mutiny. Not to mention that Vaccine Injury Compensation Program payouts are exponentially higher for adults than for children. Maybe the older adults have less symptoms because they have naturally primed immunity from having pertussis as children, and the younger adults because they had the more dangerous but effective DTP vaccines as children as opposed to the acellular version. Perhaps it’s high time to know the real world effectiveness rate of the various mfr.’s DTaP as compared to currently circulating strains and demand more effective single-antigen vaccines to address outbreaks, rather than relying on demonstrably ineffective multi-antigen vaccines. Perhaps it’s time for pediatricians to tell their patients not to give fever reducers after vaxxing as it reduces immune response and vax effectiveness. There are numerous reports ofDTaP vaccine failure in VAERS, which represents only a 10% sliver of probable events. Has CDC bothered to see which manufacturers’ vaxxes are the least effective, and instituted a preference against them? NO. Have the bothered to look for commonalities in vaccine failure cases, to see which children don’t respond and find out why and how that problem might be solved? NO. If they cared about public health, they would do these things. All they care about is protecting the status quo, which is unacceptable.

  42. @Moderation

    … maybe people will give up on the well baby visits (where healthy kids are brought to sick people.) Do you have any evidence they do any good?”

    Wow, I don’t think you could have made a more uniformed statement if you were trying

    Where’s the uniformed statement? The first sentence is just a speculation, then I point out the simple fact that well baby visits allow healthy children to be exposed to sick one. And the second sentence is a question(which you failed to answer)

    Do you have a child? Have you ever been to a pediatric check up?

    Yes and yes, one or two until we decided they were of little value.

    I assume then that you are OK with me as an ER physician refusing to treat you for your injuries if you have not been vaccinated against Hep B, Hep A and other transmittable diseases as I would be assuming the risk of transmission when I treat your wounds or intubate you. I, of course, would treat everyone as is my ethical obligation

    The problem with the above is you’d have me live in a half-free world and a half-statist one. Medicine as it exists today could not exist without the government’s support (medicare/medicaid, student loans, medical licensing, university and hospital funding). Since the government is “owned” by all the people, it’s problematic to assume a creation of that government – medicine – could deny treatment to a citizen. In a world without such overlap between government and medicine, I’d not have a problem with denial of treatment due to a lack of vaccination, yet imagine that in reality such a problem would not manifest.

    • moderation says:

      I at first typed up a response to this post and then it occured to me … Mr. Schecter, your answer reveals your true character and I should let it speak for itself.

  43. Sarah says:

    I’m just a parent, trying to make good decisions for my children, but articles like this really do leave me with more questions than answers. On one hand, I do understand that we have a responsibility to each other, and should try to prevent the spread of illness if we can. On the other hand, I don’t understand two things in particular about this article. First, why is vaccination assumed to be the easiest or most accurate path to good health, and second, why would pertussis be used as the example here?

    As far as pertussis goes, it’s my understanding that not only does vaccination not always prevent infection, it doesn’t even USUALLY prevent infection. I agree that vaccination causes a lessening of symptoms in most cases, but doesn’t prevent asymptomatic infection. Around 35% of coughs that last longer than a week are pertussis. Even WebMD states that “Hundreds of thousands of people do catch pertussis each year, but they don’t usually realize it. The pertussis vaccine reduces the severity of whooping cough, so most vaccinated teens and adults experience relatively mild symptoms.” Sounds to me like the vaccine may be effective at keeping the vaccinated person from experiencing severe disease, but generally does little to stop transmission. So what’s the point in asserting that vaccination would have saved those 10 babies? They were too young to be vaccinated, and whoever transmitted it to them would have been fully capable of doing so with or without the vaccine. That doesn’t make their deaths any less a tragedy, but I do question the need use guilt in a situation where it doesn’t apply.

    Now, to circle back to my earlier point about general good health, if I had to choose between having my baby exposed to a fully vaccinated child whom I knew nothing else about, or a child of unknown vaccination status who was not ill, I think the choice would be obvious. I know it’s impossible to know for sure that a child is not ill, but my point is this- our goal should be for our children to have the most robust immune systems possible so that they are not passing around any infections, not just to have them potentially immune to a list of 12 or 15 diseases. How is a person who gets their child the recommended vaccines and then props them in front of the tv with a bag of Cheetos a hero, while the mom who provides whole foods, sunshine, exercise, probiotics, a full night’s sleep (every night), and prompt medical care an “asshole”? Isn’t the child with shiny hair, clear skin, bright, healthy eyes, strong intestinal flora, and the immune system that’s able to withstand most onslaughts less of a “risk” than the just vaccinated child who’s slightly feverish with allergic shiners and a runny nose? Now I know that’s not all vaccinated children, and I also know that some who vaccinate also care for the health of their children in other ways. But the above article seems to imply that vaccination is all one must do to fulfill this obligation to not get others sick. Even vaccine inserts warn that after a live vaccine the vaccinated should avoid close contact with at-risk individuals (babies, immunocompromised, etc) for 6 weeks. So are parents who fail to keep their children home for 6 weeks after a live vaccine also “assholes”?

    Most parents I know who unquestioningly vaccinate also unquestioningly serve fast food, entertain with video games, and drive the two blocks to school each day, while the non-vaccinating parents take active, assertive roles in supporting their children’s immune systems. That’s a generalization, and I realize that, but I’m attempting to make the point that checking the box next to “fully vaccinated” does not mean you have done everything you can to keep your child from being a risk to others.

    • Chris says:

      A child is not fully protected from pertussis until they had a series of at least four, which is completed when they are about a year old. The vaccine is 80% effective, which is better than none.

      Plus, the protection does wear off between five to fifteen years. Though the immunity to actually getting the bacterial infection also wears off somewhere between five and twenty years. It is asking a bit too much to suggest a vaccine confer better immunity than the disease.

      This is why herd immunity is so important, and why it is important to get the Tdap for older children and adults.

      You say “How is a person who gets their child the recommended vaccines and then props them in front of the tv with a bag of Cheetos a hero, while the mom who provides whole foods, sunshine, exercise, probiotics, a full night’s sleep (every night), and prompt medical care an “asshole”?” Hmmm, very interesting. Reminds me of what Christine Maggiore said after the death of her daughter: “Why our child — so appreciated, so held, so carefully nurtured — and not one ignored, abused or abandoned?” she wrote. “How come what we offered was not enough to keep her here when children with far less — impatient distracted parents, a small apartment on a busy street, extended day care, Oscar Mayer Lunchables — will happily stay?”.

      You see, the problem was that she did everything right, except some pesky conventional medicine preventative care for her daughter.

      • Sarah says:

        I think you and others are wrong when you assume that “80% effective” means that 80% are totally immune and will not be contagious with pertussis. According to a DTaP insert (in this case, INFANRIX) the approximately 80% rate you guys keep quoting only applies to “WHO defined pertussis” which is a cough lasting grater than or equal to 21 days plus a lab confirmed infection. They go on to say that the efficacy rate drops to 67% when “definition of pertussis was expanded to include clinically milder disease” which in that case was a cough grater than or equal to 7 days AND a lab confirmed infection. So, the 80% actually INCLUDES lab confirmed infections as long as the cough didn’t last 21 days. We can assume then that the 67% would include any cases with a cough that lasts fewer than 7 days. So let’s be clear- we know that the vaccination causes milder cases most of the time. Its ability to prevent transmission is unknown, as is the way it works. The vaccine manufactures freely admit this. “The role of the different components produced by B. pertussis in either the pathogenesis of, or the immunity to, pertussis is not well understood. There is no well established serological correlate of protection for pertussis.”

        The fact that people on this board do not seem to understand that (and in my personal experience even the doctors prescribing these vaccines don’t know this and haven’t read the inserts for themselves) is alarming and makes your argument for that particular vaccine irrelevant.

        http://us.gsk.com/products/assets/us_infanrix.pdf

  44. Tanqueray and Tab says:

    “morally repugnant” – that’s rich coming from you Seth!

  45. Jay Gordon says:

    I loved the possible misinterpretation:

    “Do you have a child? Have you ever been to a pediatric check up?”
    “Yes and yes, one or two until we decided they were of little value.”

    Thinking, yes, it might take one or two kids before you realize they are of little value and your whole house gets gets sticky cuz of them . . . :-)

    Sarah, your post is a thing of beauty. It will be incredibly easy for people to attack it, but the central thesis is great! Overall great health is a more important goal than universal vaccination.

    The day is young here, but I’ve already given a few shots, counseled a couple traveling families about when the Hep A or typhoid vaccine are useful and talked at length about a very prolonged vaccine schedule with another family. The topic is nuanced, complicated, and cannot be broken into “pro” and “anti” vaccine unless you turn your brain off and just want to shout at people who don’t agree with you.

    I “retweet” a lot of Rene’s posts, Seth’s too because I think that they have solid facts to support what they say and that my wider audience benefits from hearing all points of view. I disagree with them most of the time.

    Have a wonderful day!

    Jay

  46. Flavia says:

    “I’m not sure where she thinks her child’s infection is going to get diagnosed other than at a pediatrician’s office”
    Since pediatricians are part of the conspiracy, she’s actually more likely to take the child to a naturopath or chiroprator. After all, she sees her self as so much smarter than pediatricians in regards to vaccines. I’m guessing her midwife certification is CPM and CNM.

  47. @Flavia

    Before the vaccine, 6,000 children died each year of pertussis. That is the number you actually need to compare to the 41

    You’re off by thousands. Additionally since the pertussis mortality rate was in a free fall well before the vaccine, the majority of those 2,700 deaths per year would have disappeared on their own.

    http://www.encyclopedia.com/topic/Pertussis.aspx#2
    Between 1940 and 1945 in the United States, an average of 175,000 cases and 2,700 deaths occurred from pertussis each year

    • Mike Stanton says:

      Why not give us the full quote:

      “Between 1940 and 1945 in the United States, an average of 175,000 cases and 2,700 deaths occurred from pertussis each year. A vaccination program has been in place in the United States since 1948; in the 1990s, an average of 6,000 pertussis cases and 12 deaths are reported each year.”

      There was a historic decline in mortality. This was subject to analysis in 1979 by Mortimer and Jones. Their conclusion is instructive.

      “Because most deaths from pertussis occur in the young, death rates were determined for consecutive five-year periods from 1900 through 1974 among children younger than one year of age (infants) and among those from one to four years of age. there was an accelerated decline in mortality beginning in 1940, especially among infants (P < 0.01 vs. mortality in 1930-1939). On the basis of the rate of decline before 1940, 4,000-8,000 deaths from pertussis would be expected to hve occurred in 1970-1974; however, only 52 such deaths occurred. It is unlikely that factors other than pertussis vaccine caused this decline in mortality. Therefore, the vaccine's benefit-risk ratio probably is high."

  48. Mike Stanton says:

    I sometimes wonder what would happen if Dr Offit invented a vaccine for autism.

  49. @Mike

    I’ll take real numbers over Mortimer’s wild speculations. Besides, how do you explain the paucity of pertussis deaths occurring in Sweden when the vaccine was abandoned for seventeen years?

    http://whqlibdoc.who.int/publications/2004/9241592303_chap2.pdf

  50. Mike Stanton says:

    Real numbers from your source.

    In Sweden, where routine immunization against pertussis was
    stopped in 1979, three deaths were reported among 2282 hospitalized
    patients in 1981–1982, yielding a CFR of 0.13 per cent

    That was before the first major outbreak of pertussis that occurred in the unvaccinated population in 1983. I find it interesting that the chapter you ite as supporting your views begins thus.


    “The severity of whooping cough…is much underrated, both in the direct and the indirect damage it causes to the health, growth and resistance of young children…. Deaths are inordinately frequent among infants aged less than one year. As a world problem of preschool children, whooping cough is in the front rank of acute infections…. Despite all this, the disease continues to be lightly regarded by the public, and also by many physicians.”

    This situation analysis was reported by Gordon & Hood in 1951, but it remains for the most part true today. Over the past three decades, immunization programmes have been implemented successfully in most countries of the world, and morbidity and mortality attributable to pertussis have declined dramatically (Galazka 1992). Since the 1970s, however, six developed countries (Germany, Italy, Japan, Sweden, United Kingdom, and United States of America) have grappled with low levels of pertussis vaccination, leading to substantial problems with this disease in places where it had previously been well controlled. The underlying causes of this situation include apathy and complacency on the part of physicians and parents, negative attitudes toward immunization spread by anti-immunization pressure groups, and litigation over liability for alleged vaccine related injuries (Galazka 1992, Mortimer 1988)

    You cite a source that is pro-vaccine and deprecates your point of view, namely the “negative attitudes towards immunization spread by anti-immunization pressure groups” in your own support? Either you are suffering from severe cognitive dissonance or you are a “Liar, liar pants on fire!” Whatever the case, rational discourse with you is clearly not on agenda. Goodbye.

  51. Despite all the cutting and pasting, you still fail to address the issue of low mortality.

    Anyway the source from which I learned about the 3 deaths seems to misrepresent the original source of the number which states:

    The seriousness of pertussis was evaluated by studying the 2282 pertussis patients hospitalized from 1981 to the end of 1983. …Fatal outcomes were reported in 3 children (0.1%), 2 of whom had severe congenital disabilities.

    This puts the study right in the middle of the 83 outbreak.

  52. Terri says:

    A very important point that hasn’t had enough attention: Live virus vaccines shed live virus, and those who receive them shouldn’t be around people who have weak immune systems.

    In reality, no one follows this practice.

    Anyone who gets the FluMist vaccine, for example, puts my children at greater risk for the flu than they would otherwise be.

    How could we even begin to track how many people are harmed by second-hand vaccination? That is, how many people get sick because of picking up virus from a person (or multiple people) who just got vaccinated?

    • Rene Najera says:

      Be honest. Though alive, the virus is what we in the scientific community call “attenuated”, weakened. Your immune system should really be incredibly damaged for it to let an attenuated virus through, and, if it does that, then NO ONE should be coming near you for potential infection with any of the MILLIONS of viruses and bacteria humans carry around.

      Please, more honesty in the discussion, less sleight of hand.

      • Matt Carey says:

        Simple gedanken experiment:

        How many people come down with Measles in the U.S.? This is an infection that is closely tracked. Very, very low still (though rising). Almost all of the cases can be traced to exposures of infected people, usually from people who traveled abroad.

        Same goes for mumps and rubella. All attenuated viruses in the vaccine. How many doses of MMR are given each year? Millions?

        Pretty clearly, there isn’t much in the way of infection through shedding for those viruses.

        • Rene Najera says:

          But, Matt, why don’t we waste spend millions of dollars in researching exactly how many people get diseases from this biologically improbable, rarer than rare, anti-vaccine notion of Terri’s?

        • Andrew says:

          And weirdly, outbreaks of measles always seem to be traceable back to other cases of actual measles, not to one of those shedding vaccinated folks.

  53. Terri Lewis says:

    Yes.

    His immune system was incredibly damaged, as appears to be the case with so many children these days: life-threatening food allergies, Type 1 diabetes, asthma, cancer. . .all are on the rise in children today. These issues were not all present in my own child, of course, and it was too soon to know that he would show many symptoms of a weak immune system later.

    With asthma, for example, the live virus flu vaccine (FluMist) is contraindicated.

    How many newborns, 2-month, and 4-month babies are vaccinated without any consideration of family history of autoimmune disease or other factors that might indicate a weak immune system?

    Pretty much all of them.

    Children should be screened thoroughly before receiving any vaccination, to the best of our ability.

    Instead, most doctors will repeat boosters without even checking for titers first. Why take even a small risk and re-immunize if the child is already showing immunity? The potential benefit in these cases is zero, compared to all of the myriad risks of vaccination–no matter how common or rare–including death.

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