ThinkTwice and Polio: An Idiot's Guide to Critical Thinking

As he seems to do several times a week, Mr. Hubbs attempted to leave a comment on one of the blog posts here with a lot of nonsense mixed in with links to numerous anti-vaccine websites (including his own personal website several times).  One of his latest comments included the following quote:

"See if you can do your next blog page as to an analysis on this document? There sure are allot of references in it! But I won't add confusion to your personal issues and use the word "fully" again, you can just judge for yourself. Do a comparison against your figures? Like I said, the information is and has been all controlled. The polio vaccine: a critical assessment of its arcane history, efficacy, and long-term health-related consequence.  http://www.thinktwice.com/Polio.pdf"  ~Lowell Hubbs

This is yet another example of how Mr. Hubbs doesn't understand the difference between peer-reviewed science and an editorial.  Thus, I'll try to walk him through the process one more time although I'm fairly certain he won't be swayed since antivaxers rarely, if ever, rely upon logic or fact when they argue their points.

First of all notice that the article Mr. Hubbs cites here is hosted on the thinktwice website.  So the first thing we need to know is what that particular website is associated with.  Mr. Hubbs may feel this isn't important, but the point is you wouldn't want to read a "study" or "article" that claims smoking is actually healthy and that it doesn't cause cancer as has been proven in the past only to find that article was written by tobacco researchers who work for Altria nor would you give it credibility when you found it was hosted on the Altria website.

For that reason I examined the thinktwice website and tried to determine who was associated with it.  Unfortunately the "about us" page doesn't list any names or any doctors who are affiliated with the website, so I have no way to know who runs or manages the website nor do I know their qualifications.  They do however list a nice disclaimer that includes such phrases as:

• "Some of the information presented on the Thinktwice Global Vaccine Institute website may conflict with data presented elsewhere. Therefore, readers are encouraged to remain circumspect and use discretion when interpreting contradictory, complex or confusing concepts."
• "Vaccine recommendations change rapidly. Immunization schedules are periodically revised. Therefore, the FDA and CDC -- not the Thinktwice Global Vaccine Institute -- should be consulted for the most up-to-date information regarding who should or should not receive vaccines, at what ages, and the number of doses."
• "For official information about vaccines, contact vaccine manufacturers, the FDA, CDC or World Health Organization"
• "The Thinktwice Global Vaccine Institute does not recommend for or against vaccines. Parents and other concerned people must make this decision on their own. Because the data on this website tends to implicate vaccines (find fault with them), readers are advised to balance the data presented here with data presented by "official" sources of vaccine information, including pharmaceutical companies, the FDA, CDC and World Health Organization."

So aside from the fact that it is glaringly obvious Mr. Hubbs has failed to read the disclaimer, it seems apparent that those behind thinktwice are at least being honest about the fact that they have no credentials and shouldn't be trusted to offer objective advice.  Yet Mr. Hubbs still believes this is a trusted unbiased source worthy of citing?  When will the man learn.
 
So since we can't determine who is behind the website, what else do they have to offer?  Well as is the case with every single antivaxer website I have found thus far, they have an online store which can sell you books and various supplements.  In this  case they are pitching a colon cleansing product called "Herbal Fiberblend" for only $40, or a product called "HumiKleanse" for Heavy Metal Chelation for only $25.  Don't ask for any science to prove either of these products actually work however, because there isn't any.  They are marketed as nutritional supplements and therefore are not required to prove they do anything other than drain your wallet.

Looking further on the website, there are also the obligatory "homeopathy kits" ranging in price from $29.95 all the way up to $99, as well as random pamphlets and books an even PowerPoint presentations ranging from $49 to $99... but hey at least the $99 presentation includes a whopping 32 slides about vaccinations, so that must be a bargain.
 
Let me stop right here and ask if you went to the CDC or FDA website and they had a store where they would sell you books and pro-vaccine pamphlets and slideshows... would you believe for a second that those websites were as reputable and other websites which offer their information for free in an effort to simply educate the public?  If you visited the website of a major pharmaceutical manufacturer and they were selling books for $19.95 that show how their pills can solve all of your ailments and that there are no known side effects... would you actually believe that book is in any way unbiased?  Could you trust the information shown to you was impartial and fair if you knew their goal was to have you pack your online shopping cart with various remedies and books and emergency supplies?  No you wouldn't - because real unbiased science doesn't rely upon pushing the reader towards an online store.  Real science and real unbiased information is only interested in sharing that information, which is why you will never see a reputable website or medical journal offer to sell you some random supplement as a promotional tie-in to the information being disseminated.

So we have clearly established this website is an antivaxer joke with a sole purpose of selling goods to ignorant masses who don't understand science.  Now it is time to move on to the real purpose of this post and that is to review the article Mr. Hubbs feels is so worthy to be cited time and time again.

The first thing you notice about this article is that it is not a research study nor is it peer-reviewed.  That should be red flag number one that you aren't getting the whole picture.  Red flag number two is that there is only one author listed and that author (Neil Miller) is not a doctor, research scientist, or medical researcher.  In fact Mr. Miller's education was an undergrad degree in Psychology and as far as we can tell he has never participated in or added his name to any peer-reviewed science published in a reputable medical journal.

Red flag number three is that this article is "published" not in a true reputable and/or respected medical journal, but rather in Medical Veritas which as we have discussed in the past is not a real medical journal but rather a journal created by the anti-vaccine and anti-mainstream medicine community so they could pack it full of their unsupported and non peer-reviewed opinion pieces and then claim those pieces were "published".

As you actually begin reading the article that Mr. Miller has drafted, you soon realize that he makes numerous accusations but with very little supporting evidence, and the evidence he does use is manipulated to make suggestions or correlations which are unproved.  Case in point, Mr. Miller claims that "Polio cases skyrocketed after diphtheria and pertussis vaccines were introduced" and he shows a chart which lists the number of cases of polio and how from a period in the 1930s to a period in the 1950s the number of cases seemed to be rising exponentially. 

As any good antivaxer would do, Mr. Miller automatically picks a vaccine to arbitrarily blame for this rise, and he doesn't bother to consider any other alternatives.  Unfortunately for Mr. Miller, polio was already on the rise long before the diphtheria and pertussis vaccines were introduced and continued to rise after their introduction even in the portion of the population which wasn't receiving normal vaccinations.  Also, even though vaccinations for diphtheria and pertussis continued to be given throughout the next several decades (and are still given today) polio has not increased as a result.  Miller is guilty of the assumption that correlation equals causation, and either out of ignorance or intellectual dishonesty he fails to recognize or report the glaring holes in his theory.

Miller then goes on to postulate that polio is caused by an "excessive use of sugars and starches" and he uses quotes from the 1940s that suggested nations that used the most amount of sugar also had the highest rates of polio.  He also suggests polio outbreaks were always more severe in the summer months and that was due to children drinking soft drinks, eating ice cream, or ingesting other products which are artificially sweetened.  Mr. Hubbs and other antivaxers have made these claims in the past and as always they are proven to be entirely without merit.

Notice that Miller drills down on one particular state (North Carolina) and shows how their rates of polio dropped after they were warned to decrease the amount of sugar intake.  However Miller offers no data on surrounding states to determine if these numbers were witnessed elsewhere, nor does he provide any evidence beyond personal opinion that sugar intake in North Carolina actually decreased.  He does mention that one ice cream manufacturer shipped one million pounds less in a single week after the sugar-causes-polio claim was first reported, but Miller fails to mention the reason for that drop in shipments nor does he provide any evidence beyond that one week.

The problem is, this was the 1940s and it wasn't like companies had automated shipping lines or replenishment on demand ordering systems.  Besides the fact it wouldn't be feasible for a manufacturer to even be notified that they shouldn't ship massive amounts of ice cream during a single week, there is no background data to support the theory that sugar consumption in general actually decreased.  For all we know this one particular manufacturer (which Miller conveniently fails to mention by name) could have had a plant malfunction or a union strike, or a problem obtaining milk supplies or any other issue which was the root cause for them being unable to produce the same amount of ice cream.

It is quite possible that other manufacturers shipped even more ice cream to North Carolina during this same period, but we aren't given that data.  We are only given the select pieces of data that Miller wishes us to read in order for him to make his scientifically unsupported position.  A true study would not have relied upon such assumption and rather would have examined numerous states, their rates of polio, the amount of sugar consumed per capita from all known sources, and any other underlying factors which could have been to blame for a reduction in the number of cases (such as a unusually wet or humid summer resulting in less human to human contact, improved sanitation resulting in less fecal-oral contamination, more awareness of the disease resulting in less human transmission, or countless other factors).

A true study would have at least examined other potential causes or other factors, but Miller isn't concerned with digging deep, he is only concerned with cherry-picking numbers and statements to support his anti-vaccine viewpoint.  Case in point out of the 50 US states, Miller selects five states that reported more cases of polio after the development and usage of the polio vaccine than they did previously.  Although he cannot directly connect the rise in polio to the vaccine (as he cites no supporting studies which show those that were vaccinated were the same people diagnosed with polio) he does attempt to make a correlation between the two.  I would have loved to examine the figures for the 45 remaining states to determine if they too saw an increase in the number of polio cases after the vaccine was used, but unfortunately Miller doesn't tell us where he obtained his numbers... merely that they were sourced from "U.S. Government statistics".

Does it strike Miller as odd that the five states he has represented (Vermont, Rhode Island, New Hampshire, Connecticut , and Massachusetts) are all in New England and all border one another?  Does it strike Miller as strange that although the vaccine was in widespread use nationwide that he was unable to find any other areas that saw this sudden spike in the number of cases of polio?  Did Miller consider other possibilities for these increases such as an outbreak in New England?  Obviously not.  This is why such an article would never be taken seriously in a true medical journal and why Miller had to resort to publishing this idiocy in Medical Veritas and on his own website.

The fact is, across the entire US there were close to 58,000 cases of polio in 1952, whereas after a massive vaccination campaign we witnessed a massive decrease in cases to around 15,000 in 1956, to just over 3000 in 1960, and in 1965 there only 72.  A few years after that in 1969 there were less than 20 total across the entire US, and by by mid 70s there were only around 8 cases per year.  Does Miller believe this is all due to the US vastly decreasing the amount of sugar intake? 

If that is Miller's suggestion, then he is being incredibly dishonest because sugar consumption in the US has actually increased during that same period from 6,846,000 tons in 1948 to 9,884,000 tons in 1969.  Unlike Miller I would like to disclose that those figures are total across the US and are not broken down per capita nor did I cherry pick just a few select states to make a point.  However it should be noted that per capita sugar consumption rose during this same period.  I know this because I am capable of doing basic math, and according to the US Census Bureau the US population was 146,631,302 in 1948 and 202,676,946 in 1969.  That tells us that American consumption of sugar in 1948 was 93.4lbs of sugar per person, while it was 97.5lbs of sugar per person in 1969.

Note to Mr. Hubbs:  There are 2,000lbs of sugar in a ton, thus 6,846,000 tons of sugar equates to 13,692,000,000 pounds.  If you divide that figure by the total population of 146,631,302 your end result is 93.37706079, or roughly 93.4 pounds of sugar per capita.  Math doesn't lie.

In fact actual consumption per capita continued to rise until the development of High Fructose Corn Syrup (HFCS) which started to supplant sugar in many of the foods and drinks Americans consume beginning in the 1970s.  With all of this being said, one might think if Miller's hypothesis is correct we would have seen a massive increase in the cases of polio as sugar consumption rose, but sadly for Miller that wasn't the case and in fact the opposite was true.  That isn't to say more sugar consumption is good for people by any means, but it obviously doesn't relate to the number of nationwide cases of polio either.

Miller then goes on to suggest the vaccine isn't actually helpful and rather it is responsible for causing polio.  He also suggests polio was on a decline on its own before the vaccine was introduced, but there is some clever word play used here.  Miller's actual quote is "from 1923 to 1953, before the Salk killed-virus vaccine was introduced, the polio death rate in the United States and England had already declined on its own". 

Notice the clever diversionary terms "death rate".  Miller isn't saying the cases of polio decreased which is what so many antivaxers don't understand.  The numbers I have shown earlier clearly show the number of cases of polio was still increasing at a rapid pace until after mass vaccination programs took effect.  Miller attempts to confuse people by focusing on the death rate as if that is significant, but once again he is cherry picking figures to support his viewpoint.  Notice that at no time does Miller suggest actual cases of polio were on the decrease before the vaccine, merely that the death rate was on the decrease.  This begs the question on why Miller would think polio by itself was perfectly fine provided it doesn't kill people.  I'm sure all of the paralyzed polio victims who have suffered for decades due to this disease would be happy to hear that Mr. Miller doesn't feel their disease is all that significant since it didn't kill them.

Back to reality, the reason that fewer people (as a percentage of polio cases) were actually dying from polio from the 1920s to the 1950s was not because polio had magically transformed from a deadly disease to merely a harmful disease.  Instead, the decrease in deaths was due in no small part to advancements in treatment of polio such as massage for muscle relaxation, confining patients to bed, increased usage of iron lungs, and perhaps most importantly usage of antibiotics to prevent infections.

As you can see, a little objective analysis of Miller's work easily shows gaping flaws in logic, blatant intellectual dishonestly, misleading conclusions, and even factual errors.  I could easily spend several days identifying the countless significant errors throughout the entire article, but at the end of the day no amount of facts or figures is about to sway a devoted antivaxer.  In their minds Miller is a hero for trying to suggest a vaccine causes more harm that good no matter how much evidence exists to the contrary.

Obviously antivaxers like Mr. Hubbs aren't intelligent enough to examine such a document and identify the gaping flaws and therefore they just accept it at face value.  The most comical aspect of this is the fact that Miller actually makes a reference to the concept of herd immunity (second page of the document under item 5) which is the total inverse of what Mr. Hubbs believes, but it is pretty clear that Mr. Hubbs never actually bothers to read the sources he cites and instead is lucky to make it beyond the title and the abstract.

Is it any wonder why nobody will ever take the antivaxer movement seriously?  I think not.