Anti-Vaccination Groups: What's In a Name?

I just finished reading a piece on Slate written by Phil Plait entitled Antivaxxers Using Billboards to Promote Their Dangerous Message and I couldn't help but give a shout-out for an amazing article.

Plait speaks about the unfortunately named "National Vaccination Information Center" or NVIC, and how they are quick to point out what their perceive as "risks and failures" of vaccines, yet they never seem to mention any of the benefits.  The President of the NVIC, Barbara Loe Fischer, claims that she wants to have an honest discussion about vaccines, but the reality is she is only concerned with presenting her side of the issue and you will not find any pro-vaccine materials on her website (nor will you find peer-reviewed science detailing the effectiveness of vaccines).

I suppose I shouldn't be surprised that Plait would find fault with the NVIC, because he himself is a scientist. He understands the scientific method, he understands that we need to let the science guide our beliefs rather than opinions and anecdotes, therefore I'm not at all shocked to learn his feelings of the NVIC.  In fact, any reputable student of the sciences or even anyone with an open mind should come to the same conclusions.

If an organization wishes to be anti-vaccine that is certainly their right.  I'll even support their right to do so provided they aren't dishonest about what led them to hold those views.  However, when an organization like the NVIC pretends to want an open and honest discussion about vaccines while actually promoting an obvious bias against vaccines and while refusing to acknowledge published data surrounding the safety and efficacy of vaccines... well then they have crossed the line into quackery and thus they don't deserve a place at the table.

Clearly people like Fischer and the other members of the NVIC's leadership team aren't concerned with educating the public about the pros and cons of vaccines but rather they are only concerned with spreading their unscientific antivaxxer viewpoints.  I find that upsetting not because of the message itself, but because they go out of their way to create these false front organizations with clever names that are actually designed from the start to confuse people.  Just look at their name: "National Vaccination Information Center".  That suggests by visiting their website you might actually find unbiased information about vaccines... but that simply isn't true, and it is nothing short of a marketing tactic designed to deceive - all in the name of spreading misinformation.

This is one case where I think other nations do a better job than we do in the United States. For example in Australia they have a group very similar in scope to the NVIC that goes by the name of "Australian Vaccination Network" (AVN). Prior to that name, they called themselves "Vaccination Awareness Network".  Both of these names are extremely misleading and suggest that someone visiting them could expect unbiased information about vaccines.  However the truth is, the AVN is a well known anti-vaccination group whose sole mission is to provide information against vaccination.  They have no interest in providing both sides of the issue, they have no interest in providing peer-reviewed data surrounding the efficacy of vaccines, and they have no interest in acting as a source of reputable unbiased vaccine information.

This is why, in December 2012 the New South Wales Office of Fair Trading issued an order for the AVN to change its name as the current name was misleading the public.  They have until tomorrow (March 21st) to change their name or they may face deregistration - although as of this writing their website is still operating under the Australian Vaccination Network name.

The obvious question at play here is - why don't they simply change their name to the "Australian Anti-Vaccination Network" or even simply "Anti-Vaccination Network" so they could keep using the same acronym?  That would be a much more accurate representation of their true purpose, and updating their letterhead and business cards would be quick and easy!  Yet we know they won't willingly allow the public to be alerted to their stance because their goal is to confuse the public and mislead them into thinking they are being presented with both sides of the issue when in fact they are nothing but a front for a well funded anti-vaccination group.

Anyway, the original point is that Australia saw a name which was misleading and downright dishonest, and they did something about it.  If the US did the same, the "National Vaccination Information Center" would be forced to use a name that is more in line with their purpose as well... which would likely result in them being called something like the "National Anti-Vaccination Information Center" or "The Anti-Vaccination and Anti-Science Center of America" (or TAVASCA if you prefer).  Better yet perhaps they could use my personal favorite name of "Barbara's Anti-Vaccination Emporium".  You have to admit no matter what you think of vaccines, there is a certain ring to any name with the word 'emporium' in the title.

So this all makes us wonder - why are antivaxxers so determined to mislead the public?  Why must they purposefully choose names for their little organizations that cloud their true goals?  Why do they hide behind clever marketing rather than admitting their primary purpose is to spread anti-vaccine propaganda?  It certainly seems if they were proud of their stance against vaccines, and if they were really concerned with educating the public on their point of view, the very first thing they would do is use a name that is reflective of those viewpoints... yet antivaxxers never do.  I find that incredibly telling, and it shows us right from the start that antivaxxers have no interest in having honest discussions about vaccines.

Conspiracy Theorists and Other Enemies of Science

Journalist Will Storr recently wrote a book called The Heretics: Adventures With The Enemies Of Science which explores why so many conspiracy theorists seem to have trouble accepting facts... even when those facts are right in front of them.

This is an interesting subject and one which I've explored myself - which is why I'm certain this book would be an interesting read (the book was just published this week and I haven't had a chance to read it yet). Chris Parsons over at Yahoo! News wrote an article about the book entitled "Exploring the minds of Holocaust deniers and UFO-spotters who deny common sense".

Parsons' article begins:

"Will Storr is a man who deals in facts. As a journalist of more than 10 years, undeniable evidence and rational data are his bread and butter.

There are groups of people, however, who deny the irrefutable; who see cold, hard facts as mistruths or simply inconvenient.

Whether they are Holocaust deniers, creationists, or those who believe in UFOs - there are plenty out there whose view of the world defies centuries of scientific evidence. 

So why are there intelligent, seemingly rational people like this, who are capable of such unreasonable logic?"

Although I do agree with much of what Parsons wrote in his piece I would take issue with his statement that speaks of "intelligent, seemingly rational people", because the truth of the matter is conspiracy theorists are the farthest thing from rational. I might even debate whether most of these people are intelligent, although perhaps my personal bias is due to the lack of intelligence presented by the typical antivaccinationist. Rationality however... well there isn't much room for debate on that point. Not only do antivaxxers trample upon basic common sense, but they do so with impunity almost as if they have no desire to engage in any sort of discussion which may require it.

Either way, Storr's book might help shed some light on the thought processes that so many conspiracy theorists seem to share even when faced with evidence that counters their opinions. Unfortunately, Storr didn't include antivaxxers within his book that I've seen, but the same lack of logic and unreasonable nature most certainly applies to all conspiracy theorists regardless of form.

Whether it is someone who denies the moon landings, a Sandy Hook conspiracy theorist, a 9/11 "truther", an antivaxxer, or simply someone who believes Lee Harvey Oswald was innocent they all seem to share several things in common - a blatant disregard for logic, a stubborn refusal to accept facts when presented to them, and an complete and total inability to admit when they are wrong.

I wonder what it might take to get an antivaxxer to review Storr's book? If you are interested, you can pick up a hardcover copy from Amazon, or if you are patient you can probably wait for the paperback or (hopefully) even the ebook version.

The Profit of Medicine

Bear with me here - this is a little off message as it doesn't have anything to do with vaccinations or anti-vaccinationists, but rather focuses on those who push the idea of alternative medicine, or more specifically alternative cancer cures.  Although on second thought I do find a lot of overlap between antivaxxers and those who place their faith in alternative medicine, so in essence this is probably focused on the same group of people.  Nevertheless, I found some of these numbers interesting and couldn't help but put this together to outline just how out of touch some people are about the world around them.

This post this began out of curiosity as so many antivaxxers claim that the only purpose of a vaccine is to generate profits for drug companies (aka: "Big Pharma"), or to individual doctors.  Aside from the fact there is much more money to be made by treating diseases such as polio, smallpox, or rubella than there will ever be by preventing these diseases, there is also the common sense aspect of this theory that fails to convince.  You see, to believe vaccines are merely a method to profit suggests that tens of thousands or perhaps even hundreds of thousands of clinicians, researchers, scientists, doctors, medical experts, federal regulators, and industry watchdogs are all somehow involved in some massive conspiracy and refuse to speak out because they risk missing out on their cut of that $23 vaccine given to a toddler.  To a reasonable person this line of reasoning doesn't even pass a smell test.

That aside, why is that that the proponents of alternative medicine never seem to care about the money being made by those who are so obviously anti-vaccine or pro-alternative medicine?  Why is there never a mention of how Dr. Blaylock profits from his many newsletters or his miracle brain repair pills.  Why does nobody seem to care when Andy Moulden (a man who doesn't even have a license to practice medicine) was offering his professional diagnostic service where he could tell you if a child had a neurological condition based upon a few photographs or a videotape?  Why the lack of concern when Dr. Tenpenny offers nutritional supplements that can cost more than $117 for a two month supply or when she offers a $200 "anti-flu" wellness kit which is nothing more than a collection of supplements and vitamins?

To make matters worse, why is the selective outrage non-existent when they find someone like Dr. Tenpenny offering vitamin D supplements for $14.99 when you can get a larger quantity of vitamin D elsewhere on the Internet for less than $5?  Shouldn't these people be outraged that a "doctor" would intentionally gouge people by marking up her products over 300%?  Why do they not seem to care when someone like Dr. Mercola offers a bottle 60 vitamin C capsules for $14.97 while you can head over to Walmart and get 100 tablets for under $7 or 70 vitamin C gummies for under $5?

Why don't they seem to care about antivaxxers making a living off of speaking tours and overpriced supplements?  Why don't they care about alt-med practitioners selling pamphlets or books or DVDs full of their opinions for $60 or $70 even though they don't ever seem to have peer-reviewed research to support their statements?  Doesn't it seem odd that I can download a peer-reviewed paper that involved thousands of hours of research by real scientists and doctors simply by searching Google Scholar and all of that data is available to me for free, yet antivaxxers want to charge me over $60 to watch a home movie of them giving a speech or $50 to get a copy of a PowerPoint presentation that they slapped together in a couple of hours?

The point is - if you are going to chastise someone for profiting from healthcare, why can't you apply this disdain equally?  The truth is, there is a lot of money to be made by pushing alternative viewpoints, and the benefit of doing so is that these people aren't required to provide evidence that their viewpoints are valid provided they include a nice disclaimer on their websites (which all of them do).

So should we place our trust in legitimate peer-reviewed studies written by teams of research scientists that will never directly profit from their research, or should we trust doctors who publish their own books and newsletters filled with unsubstantiated opinion, unscientific statements, and zero verifiable data?

So where does the hypocrisy end?  If we are really going to focus on the money, why can't we apply the same logic to those who seem to profit from alternative medicine?

For instance, what if we were to look at a doctor who claims he can cure cancer? For instance, what about Dr. Stanislaw Burzynski?

• Total number of clinical trials filed by the Burzynski Research Institute: 61
• Total number of Burzynski clinical trials with an unknown status and which have not had any updates in over two years (many of which were originally filed in the 90s): 50
• Total number of Burzynski clinical trials which were withdrawn: 9
• Total number of Burzynski clinical trials which have completed: 1
• Total number of Burzynski clinical trials which are not yet recruiting and yet have been open since 2010: 1
• Total number of Burzynski clinical trials with published results: 0
• Total annual cost to receive antineoplastons treatment from Burzynski: $30,000 - $60,000 or more
• Total per day cost for the Burzynski treatment program (not including other fees): $395
• Total monthly cost charged by Burzynski including all medications: $30,000 or more
• Total appraised value of Burzynski's home:  $4,351,310
• Total real estate taxes paid by Burzynski in 2012: $86,560.53
• Total number of peer-reviewed studies published worldwide showing antineoplaston treatment to be effective including all studies published by Burzynski at any point since he began his research: 0

I should probably point out the one Burzynski clinical trial that has actually been completed was originally started in 1995 and completed in February 2005, yet we still have yet to see any published data from the study.  Wouldn't you think a guy who claims he can cure cancer might be interested in actually publishing the data that might support his claims?  Guess not.  Either that or he isn't a very fast typist... because obviously eight years seems like a long time to actually release the results of the clinical trial.

Truthfully it probably isn't fair to mention that Burzynski lives in a multi-million dollar mansion because simply living in a nice home has no bearing on whether his work is credible.  In addition to that, perhaps we should actually feel sorry for Dr. Burzynski.  After all, his home has lost around $1.5M of value since 2010.  Then again his property taxes have dropped from a high of over $114,000 down to under $87,000 so perhaps we shouldn't feel too bad for him.

The reason I point this out is because it shows you how out of touch people are when speaking about the profit in medicine.  We expect doctors to make a good living.  We expect doctors to generally be considered upper income earners or in some cases even "wealthy" due to the amount of training and education required to become a doctor.  However we don't expect that they profit at the expense of their patients.  We don't expect them to charge thousands of dollars for medications which can be purchased in pharmacies for less than $180.  We don't expect them to charge patients to be part of clinical trials when most clinical trials are done at no cost to the participants.

So why don't those who believe big pharma is simply interested in making money, or those who accuse conventional medical doctors of only caring about the bottom line ever seem to step back and ask themselves how people like Dr. Mercola or Dr. Burzynski ever became multimillionaires while the traditional GP working in a clinic and giving vaccines to children will never have an income anywhere near that level?

Rest assured patients should always come ahead of profits.  Anyone with a conscious will agree with that statement, and I'm sure the vast majority of people working in healthcare today would overwhelmingly agree.  The truth is, as human beings we have an inherent desire to help others.  People want to leave the world a better place than it was when they entered it, and when push comes to shove most people will do the right thing.  Are there exceptions to the rule?  You bet - the will always be those who put personal greed and their ambitions ahead of others, but the question we need to ask ourselves is how often does this really happen?

It simply isn't logical to believe that hundreds of thousands of people are all putting personal gain ahead of the human race.  It isn't feasible to suspect people care more about their bank accounts than they do their fellow human beings.  It doesn't make sense to claim people are knowingly suppressing cures for diseases such as cancer when there is a very high probability that every one of us will lose someone we know to cancer one day.  Perhaps even scarier is the fact that males have a 1 in 2 chance of contracting some form of cancer in their lifetime and a 1 in 4 chance of dying from cancer while females have a 1 in 3 chance of developing some form of cancer and a 1 in 5 chance of dying from cancer.

So think about that for a second.  What alternative medicine proponents would have us believe is that there are hundreds of thousands of scientists and researchers out there who are all trying to prevent cures to cancer from seeing the light of day all the while knowing they have a very strong chance of one day suffering from cancer themselves.  These alt-med types actually believe these hundreds of thousands of people would put personal profit ahead of their own health and perhaps even their own lives.

Does this make any sense whatsoever?

This is perhaps one of the many reasons why it is so difficult to take the antivaxxers or the proponents of alternative medicine seriously.  If they lack the logic to think through even the most basic of their accusations... how can they be taken seriously when discussing more complex matters such as vaccine efficacy or the peer-review process?

The Profit of Vaccinations

The New York Times recently published an article about the flu season which shows that the levels of deaths have officially crossed over into "epidemic" territory.  The full article can be found here:  Flu Season Deaths Reach Epidemic Level but May Be at Peak, C.D.C. Says

This is a well balanced article speaking about the impact of the flu as well as explaining that the flu vaccine isn't nearly as effective as some other vaccines like those for the norovirus (aka: the "stomach flu" or gastroenteritis) or pertussis (aka: whooping cough).  Part of this is obviously due to how quickly flu viruses mutate, but another aspect that could be partly responsible is the simple fact that on any given year only around a third of the population bothers to actually get a vaccine.  This means there is a much greater chance that the virus can spread among those who have no protection from the vaccine, as well as among those who the vaccine wasn't effective.

Clearly there are failures in the system and improvements must be made.  Not only do we need better vaccines, but we need to do a better job informing the public as to the benefits.  The good news is we appear to be making progress on both of these fronts, and the percentage of those who receive flu vaccines is on the rise each year.  There are also new vaccines in development that hope to address some of the problems with the current targeted vaccines although progress is slow, and funding is difficult to obtain.

This latter point is one which I wanted to speak about, because all too often we hear antivaxxers complain that vaccines are merely a profit mechanism for pharmaceutical companies and that there is no true benefit.  As the article explains it could take as much as $1 Billion to actually bring a vaccine to market, which at first glance seems like an insurmountable figure.  If a new vaccine was to be developed which either prevented the flu or even merely significantly reduced the chances of contracting a flu virus and if the usage of that vaccine was on par with vaccines for MMR or Hib, chances are we would see a vaccine acceptance rate somewhere above 90%.

So let's be conservative and use a vaccination rate of only 80% for the "one-time" flu vaccine.  We know not everyone would bother to be vaccinated the first year, but after a few years when people realized they no longer need an annual flu vaccine, they would probably be more willing to get the single vaccine, and since many other vaccines have rates well above 90%, I don't think 80% is that unbelievable.

So if we focus on the United States alone, we know there are around 312,000,000 (312M) people who could potentially be vaccinated.  80% of this is around 250,000,000 people who would likely receive a flu vaccine.  So let's assume the cost of this vaccine is $35.  The current wholesale costs of single year flu vaccines is closer to $10, but a one-time vaccine is likely to be incrementally higher due to the complexity.  For example an adult vaccine for MMR costs around $35 while the vaccine for varicella is over $60.  A childhood vaccine for Hib may be only $12 while rotavirus can be over $70, so it isn't hard to a flu vaccine could cost at least $35 wholesale - at least for the first few years after release.

Ok, so now we have 250,000,000 potential customers each of which will spend $35 for a grand total of $8,750,000,000 ($8.75B).  Even if we assume only a 50% vaccination rate (156M) and an even lower cost of $25 per vaccine, the total is still $3,900,000,000 ($3.9B).

Of course the $1B it takes to bring a vaccine to market does not include the costs to produce, distribute, and market the vaccine, so it isn't as if there will be billions in profit the first year, but the flip side of this equation is that we are only factoring in the population of the US.  Chances are once the vaccine was available it could be submitted for approval in numerous other nations with the potential to sell hundreds of millions of doses to those nations.

The moral of this story is, there would be a lot of money to be made from a one-time flu vaccine, yet to date we haven't seen anything available.  Since antivaxxers seem to feel vaccine manufacturers are only interested in profits, how can they explain that not a single manufacturer has unleashed such a vaccine on the public?  It shouldn't matter if the vaccine is effective or not, because as any good antivaxxer will tell you vaccines don't actually work (and yes I'm being sarcastic).  Antivaxxers are even willing to claim publicly that the polio vaccine and the smallpox vaccine did nothing to prevent those diseases (suggesting the diseases just magically disappeared on their own apparently), and they feel that vaccines are generally ineffective.

These same antivaxxers will tell you that the MMR vaccine does far more harm that good and that there is no evidence that viruses like the Measles have been controlled by the vaccine in any way.  They will also claim that the HPV vaccines don't work at all and that it is merely a method for the manufacturers to collect millions upon millions from insurance companies and the unsuspecting public.

You see this is one of those situations where antivaxxers want to have it both ways.  One one hand they claim vaccine manufacturers are simply in it for the money and that the vaccines themselves don't actually work.  On the other hand, they can't explain why the market hasn't delivered something like a one-time flu vaccine which would quite obviously be a gigantic windfall for the pharmaceutical companies.

So which is it antivaxxers?

It would seem to be the fact we don't have a one-time vaccine for the flu only proves that the system works.  We have clinical trials and data which shows us the effectiveness of vaccines, and if a vaccine is found to be ineffective it wouldn't be approved.  We have a system of checks and balances in place to ensure the public is protected and that vaccines are not only effective but that they are safe.  We have a system which rewards responsibility, and one which puts the safety and health of the public as the priority far head of profit.

We aren't talking about a nutritional supplement or a vitamin that can be sold by anyone trying to make a buck.  Vaccines are subjected to rigorous safety and effectiveness testing which can take years to complete and which requires verifiable proof of efficacy before that vaccine is ever approved for use.  Can we say the same thing about the various supplements and pills sold on antivaxxer websites?

Sort of makes you wonder what type of clinical trial or testing was done on something like the miracle "brain repair" pills sold by a well known anti-vaxxer.  I think we all know the answer, and it rhymes with none.

If vaccines were really all about profit and if the health of the public was an afterthought as so many antivaxxers have suggested, I have no doubt we would have a half dozen one-time flu vaccines on the market this very moment.  Yet we don't - and I've yet to see an antivaxxer who can explain this without contradicting themselves.

The True Anti-Vaccine Warriors

We have known for quite some time that extremist terrorist groups like the Taliban have a hatred for vaccinations, but now it seems these terrorists are going so far as to actually kill people responsible for providing life saving vaccines for diseases such as polio.

Yes you read that correctly - terrorists are actually killing people who are providing vaccines.  The latest attack in Pakistan resulted in the deaths of five teachers and two healthcare workers who were involved in providing polio vaccines.  In the month prior, nine others were killed due to their affiliation with vaccinations.

So aside from senseless deaths, the effect of these killings is fewer people receiving their life saving vaccines. It means more children being infected with diseases which could have been prevented, and needless suffering and death.  That may seem like an overreaction, but we need only look at the latest numbers of children dying from the measles in Pakistan to witness the impact.

Measles deaths have surged due in no small part to the lack of vaccines.  According to the World Health Organization (WHO), 306 children died of measles in 2012 up from only 64 the year before.  Yet if you are to ask an anti-vaccinationist they will claim vaccines are harmful and that they don't even prevent disease.  They will claim the only people pushing vaccines are those who stand to profit from them, and they will claim that people are better off if they never receive any vaccines at all.

Tell it to the families who have suffered from the loss of one of their own.  Tell it to the healthcare workers who are putting their own lives on the line only to see ignorance and fear result in hundreds of senseless deaths.  Tell it to the grieving mothers who have had to bury those 306 children.

The truth is, anti-vaxxers have a lot in common with terrorists.  They both fear education.  They both fear legitimate science.  They both prey upon fear, and they both take drastic steps to prevent people from receiving vaccines.  Thankfully the anti-vaccinationists in the US have yet to resort to murder in order to push their viewpoints, but when you deliberately mislead people about matters of life and death, perhaps they aren't that far off after all.

One thing you won't see from the anti-vaxxers is any talk about the violence against those who are working in areas like Pakistsan, India, or Afghanistan.  You won't hear about the murders, and you won't hear about the growing numbers of children dying from preventable diseases.  Once again, anti-vaxxers will do their best to avoid the difficult conversations as they continue on their mission to mislead the uninformed and as they refuse to accept responsibility for the true impacts of remaining ignorant.

It would seem anti-vaxxers have a lot more in common with terrorists than they would like to admit.  They may claim they are warriors, but in the end they are still responsible for the deaths of children... and that is nothing to brag about.

Old Habits Die Hard

We have discussed the conspiracy theorist repository known as whale.to a few times in the past namely here and here, and you might think after showing how that particular website included such riveting fiction as flying dolphins, holocaust denials, and how the government invented the AIDS virus and is secretly infecting the population, you might have thought anti-vaccinationists would try to distance themselves from the site.

You may have thought the popularity of Scopie's Law would have some antivaxxers second guessing whether they wanted their names associated with whale.to due to the obvious implications to their credibility. You may have even thought that rather than siting the website directly, that antivaxxers would instead just copy and paste the data into other less familiar websites.

Well... you would be wrong.

As it turns out, antivaxxers still flock to whale.to on a regular basis, and just today I was directed to a comment thread where none other than anti-vaccination extraordinaire Lowell Hubbs is once again citing whale.to as a reputable source.  The following screen cap was taken from a Huffington Post article found here (and one which I recently discussed in a previous blog post).

Mr. Hubbs' comment shows everything that is wrong with the anti-vaccination movement today.  No, I'm not talking about his usage of ellipsis which make it appear that he has to take... a... breath... between...each... word.  Rather I'm speaking about how when antivaxxers are presented with facts they simply choose to ignore them.  When their sources are shown to be lacking, laughable, or just simply absurd they don't seek out more reputable sources but instead they latch on to their nonsense and go into defense mode.

We've seen this same pattern of behavior when it comes to Andy Wakefield.  Even though the Wakefield "study" was retracted and Wakefield himself stripped of his medical license, and even though he was found guilty of fraud and manipulation of data, and even though he was shown to have conflicts of interest due to financial connections to competing/alternative vaccines to those which he was attacking - the anti-vaccine movement refuses to distance themselves from this failed relationship even though it is clear to everyone else that it only serves to harm their credibility.

Thus is it really any surprise to not only see Lowell Hubbs citing whale.to in his comments, but even going so far as to claim it is a "great site" containing "real history"?  Sadly, anti-vaccinationists don't appear to grasp the concept that a untrustworthy source harms their credibility so they just continue to spew the same nonsense day after day.  The fact is, for someone who is on the fence and unsure of vaccinations, these types of tactics only serve to harm the anti-vaccine movement because a person of even moderate intelligence is going to take a look at a website that features flying dolphins, extensive data pertaining to UFOs, and information about government mind-control, and they will be either consumed with laughter, or they will simply assume the anti-vaccine movement is akin to every other group of conspiracy theorists out there such as Bigfoot hunters, 9/11 "truthers", or those idiotic moon-landing conspiracy theorists.

Come to think of it, whale.to might actually be helping to show people how out of touch these anti-vaxxers really are.  In that case I can only hope people like Lowell Hubbs continue to reference the website as often as possible - because it seems to be doing a fantastic job of showing the anti-vaccinationists for what they really are... simple conspiracy theorists who have a propensity to believe anything they read on the Internet.

HuffPo: Anti-Vaccine Vitriol: Seeking Reason

Dr. David Katz recently published a piece on The Huffington Post in response to some of the anti-vaccination nonsense that gets posted on the HuffPo website on a regular basis.  The amazing thing is HuffPo is known to  be somewhat of a safe haven for antivaxxers, so to witness them being called out for their tactics and lunacy is nothing short of amazing.

I'd love to cite some specific passages from his article, but the truth is if I cited only the parts of the article which make sense and which make very valid points, I'd end up posting the entire piece.  Therefore I encourage you to read the entire article in its entirety over at the HuffPo website.  You can find the article at this link:  Anti-Vaccine Vitriol: Seeking Reason.

Well ok, I do have to list one of my personal favorite quotes that Dr. Katz wrote: "In other words, if you want to offer advice against vaccination that reasonable people can take seriously, try being reasonable".

I dare say the phrase "reasonable antivaxxer" is an oxymoron, but perhaps one day I'll actually come across one.  It is difficult to imagine a world where a reasonable person tosses aside all logic and common sense while ignoring mountains of scientific evidence and historical records, but perhaps there are varying levels of reason.

Of course even after reading the article, the antivaxxers once again come out in full force in the comments section.  Sadly it seems most of them were unable to complete the entire article before posting because many of their comments are using the very tactics discussed in the article itself almost as if they antivaxxers were so enraged after the first paragraph or two they skipped the remainder to cut and paste more anti-vaccine nonsense.

One comment that caught my eye was from an antivaxxer who complained of a lack of "[d]ouble-blind, randomized controlled studies" showing the efficacy of flu vaccinations.  Not only did this particular antivaxxer clearly not read or understand Dr. Katz's article, but she also appears to be very confused about ethically questionable studies.

We of course have discussed this issue in the past, and frankly anyone of average intelligence should understand the moral issues with trying to perform such a study, but even more troubling is how these antivaxxers presume it is possible to prove a negative in the first place.  I just have to wonder if someone did perform a double-blind randomized controlled study on a flu vaccine and those individuals who did not receive the vaccine were six times more likely to contract the flu - would antivaxxers actually suggest the vaccine was functioning as designed?  I think we all know the answer, and that answer is "no", because they would simply claim there was bias, or they would challenge the funding source for the study, or they would make claims about how correlation does not equal causation (even though they are guilty of confusing the two on a continual basis).

The truth is, even if the results did come out as expected it wouldn't change perceptions or the minds of the anti-vaccination crowd, so what benefit would such an unethical study provide, and at what costs?  What if one of the test subjects contracted the flu and died as a result of complications?  What if those study participants who didn't receive the vaccine contracted the flu and spread it to dozens or possibly even hundreds of others?

You see when someone doesn't receive a vaccine, it isn't only them who is impacted.  Potentially it is everyone around them.  It is anyone and everyone who comes into contact with that person which is precisely why I have no problem with calling someone who willfully skips their vaccinations out of ignorance to be nothing short of selfish.  If you want to kill yourself I have zero problem with it, but when you put the lives of others in danger due to your selfishness, then I have a problem with your actions.

We have seen the ramifications of scientific ignorance when antivaxxers refuse to allow their children to receive vaccines, and in some cases it has lead to outbreaks of vaccine preventable diseases such as the measles or pertussis... with the end result being hospitalizations, prolonged illness, and in a few select cases even death.

Therefore antivaxxers can continue to protest that no double-blind randomized and controlled studies on the efficacy of the flu vaccine have been performed, but it won't change anything and is merely a distraction.  As much as we might love to see such a study, it won't be happening anytime soon not only because of the ethical issues, but because anytime a study is performed and the treatment has such profound effects, the study will be interrupted.  It is simply inhumane to continue a study when a sample group shows such a significant benefit over the control group, and any long-term study of a vaccine is most certainly going to show this disparity thus we must look elsewhere for the necessary data.

Granted it isn't like we can't look at actual historical data to know if something works.... say for instance the fact that the CDC reported the incidence of invasive Hib disease dropped from 40-100 per 100,000 children down to 1.3 per 100,000 due to routine usage of the Hib vaccine from 1980 to 1990. Surely that is merely a coincidence.

Then again, Australia found the same thing... which results in this chart showing how the Hib vaccine resulted in over a 90% drop in reported cases in 12 years and actually eliminated all fatalities within 7 years.

It still must just be a coincidence right?  I mean we can't use this type of data because it isn't part of a double-blind randomized and controlled study... so it must be garbage.

Then again, there have never been double-blind randomized and controlled studies proving the efficacy of parachutes either, and there won't be anytime soon.  Does that mean we shouldn't trust the efficacy of parachutes?  Of course not, because we already know they save lives.  We already have more than enough evidence to know that parachutes are a great idea, and we know what the alternative is.  To suggest we need a double-blind study to determine whether parachutes work or not would be unethical (and obviously idiotic), but when you think about it, vaccines are no different.


So the next time an antivaxxer asks for a double-blind study aka: a "vax vs. unvaxxed" study showing the efficacy of vaccines, just ask them if they are willing to participate in a double-blind study for parachutes.  Sure that seems incredibly stupid, but so does the idea of passing on a vaccine because of scientific ignorance or fear.

Now if you need an example that is more in tune with vaccine, simply look no further than shoulder-mounted three point safety belts in automobiles.  We know the usage of such devices has resulted in many lives saved, and we know what the statistics are prior to their usage much in the way we know what the rates of disease were prior to vaccines being developed.  So should automobile manufacturers be required to perform double-blind studies on seat belts prior to installing them in vehicles?  Should they be required to report any findings of shoulder injury or broken arms due to the seat belts even though those same people may have died without the seat belt?

Our world isn't always so black and white, and sometimes the data is impossible to obtain via a perfectly controlled scientific study.  In some cases we need to look at the other sources of evidence such as infection rates or historical data.  It may not always be as clean and concise as a chart listing infection rates of X vs. Y, but unless you are willing to jump out of a plane without a parachute you really have no business complaining about a lack of double-blind studies.

Need Another Reason to Get a Flu Shot?

If reducing the risk of suffering from the flu this winter isn't quite enough to convince you to get a flu shot, consider this:  according to two studies presented at the Canadian Cardiovascular Congress, it turns out getting a flu shot can actually decrease the risk of a heart attack by as much as 50%!

So not only can you avoid the flu, you might actually save your life.  Sort of makes you wonder how antivaxxers will spin this to make it look like a bad thing... because saving lives isn't exactly the type of side effect they like to talk about.

Is this the kind of thing that should be reported to VAERS?

Read more here:  The Shot That Prevents Heart Attacks (via Yahoo Health)

Move the Goalposts... It's Time to Talk Aluminum

Spend more than five minutes on an anti-vaccination website and you will soon realize that most antivaxxers aren't exactly fans of aluminum.  No we aren't talking about aluminum cans or cookware, but rather we are talking about aluminum in a salt form which is commonly used in vaccines to act as an adjuvant.  In simple terms, the aluminum increases the effectiveness of a vaccine due to how it triggers a reaction within the immune system.

Aluminum has been used within vaccines for over 80 years, so you might ask yourself why are antivaxxers suddenly so focused upon aluminum when it isn't exactly a new ingredient?

Well to answer that, you first need to realize where we have been.  Antivaxxers have previously attempted to single out other ingredients such as thimerosal as they blamed it for various conditions up to and including autism in children.  They used scare tactics to associate thimerosal with mercury poisoning due to a misunderstanding of the differences between ethylmercury and methylmercury.

However, even prior to these cries of mercury poisoning from the antivaxxer community, the Food and Drug Administration (FDA) was already in the process of reviewing the use of thimerosal in vaccines.  Under the FDA Modernization Act (FDAMA) of 1997, the FDA carried out a comprehensive review of the use of thimerosal in vaccines.  The review found no evidence of harm from the use of thimerosal other than local hypersensitivity reactions near the injection site.

In the early 2000's, the Immunization Safety Review Committee of the Institute of Medicine (IOM) performed a review of all available research including studies in the United States, the United Kingdom, Sweden, and Denmark and they specifically focused upon the hypothesis that thimerosal was a contributing factor to childhood diseases such as autism.  The committee concluded that the available data and studies rejected the casual relationship between thimerosal (or vaccines containing thimerosal) and autism.

This is probably a good time to mention the fact that the IOM is part of the National Academy of Sciences and is a non-governmental institution. That may not seem particularly relevant, but since antivaxxers have a severe distrust for the federal government or any three letter agency (CDC, FDA, EPA et al), it should be clarified that the IOM is an independent organization and therefore would not share the same perceived bias(es) as a government agency.

Even though the IOM rejected the relationship between thimerosal and autism the FDA, as a preventative measure which had begun years earlier, was already in the process of removing thimerosal from vaccines.  As of 2001 thimerosal was removed from all childhood vaccines recommended for children six years of age or younger (keep in mind autism generally presents itself between ages two and four), and the only exception to this were some versions of the inactivated flu vaccine (although thimerosal-free versions are available).  In addition to this, all new non-influenza vaccines licensed since 1999 contain no thimerosal.

So what was the end result of removing thimerosal from childhood vaccines? Did we see a significant drop in the rates of autism? Nope. In fact, since 2001 the rates have actually gone up, and thus the theory that thimerosal was responsible for the "autism epidemic" was quite obviously no longer popular to rally behind. Children who had never received even trace amounts of thimerosal were still being diagnosed with autism and therefore antivaxxers realized they could no longer place blame upon thimerosal. It soon became obvious it was time to try something new.

Move the goalposts - we have another new theory!

When antivaxxers realized that pinning their hopes upon thimerosal might not exactly pan out, they shifted gears a bit and started focusing on one specific vaccine (the MMR vaccine) which they claimed was directly responsible for autism in children.  It was around this time that they started professing that Andrew Wakefield was a genius and seemed to have the secret to unlocking the root cause of autism due to a study he published in 1998 which attempted to link the MMR vaccine with autism.

Of course after Wakefield was discredited and stripped of his medical license, and after his "study" was retracted, and after he was found guilty of fraud and manipulation of data.... well he didn't exactly seem like the great savior afterall and he soon found himself the laughing stock of the scientific community.  It was around this time that many antivaxxers decided to back-peddle a bit and distance themselves from Wakefield (although in some extreme antivaxxer circles, Wakefield continues to be considered a favorite son).

So at that point the antivaxxers decided that instead of focusing on the MMR vaccine specifically, they should simply talk about vaccines or vaccine ingredients in more general terms because scaring people by talking about mercury poisoning or "toxicity" is generally more effective than trying to convince people that a discredited doctor was right all along.

You guessed it - time to pick up those goal posts and slide them back just a bit further!

A few years ago around the time many antivaxxers decided to stop talking about thimerosal or the MMR vaccine, they decided to start talking about other vaccine ingredients such as formaldehyde.  Why the focus on formaldehyde?  Well it surely had nothing to do with science, but rather it was about perception.  It seems most people associate formaldehyde with high school Biology class where a fetal pig or a frog was stored in it prior to dissection.  They recall the strong odor and the fact there were warning labels which stated severe over-exposure to the liquid could result in death.  They also associate formaldehyde with embalming fluid and dead bodies... so surely this isn't something that should be in a vaccine should it?

Well the truth is there is very, very little formaldehyde in vaccines, and it just so happens that we already have far greater quantities of formaldehyde in our bodies at any given point than we ever receive from any vaccine.  It turns out we have around about 2.5 ug of formaldehyde per ml of blood.

Per the Children's Hospital of Philadelphia's (CHOP) Vaccine Education Center: "Assuming an average weight of a 2-month-old of 5 kg and an average blood volume of 85 ml per kg, the total quantity of formaldehyde found in an infant's circulation would be about 1.1 mg, a value at least five-fold greater than that to which an infant would be exposed in vaccines".

In fact, we as humans actually NEED formaldehyde to survive since it is required for the synthesis of DNA and amino acids, thus suggesting the amount in vaccines would somehow be harmful was at best ignorant, and most likely simply dishonest.  Thus after antivaxxers realized the amount of formaldehyde found in vaccines was insignificant, they actually went so far as to suggest there is a difference between "natural" formaldehyde, and "synthetic" formaldehyde... once again showing that antivaxxers seem to ignore even the most basic tenets of chemistry.

The formaldehyde argument didn't seem to gain much traction however - most likely since anyone who has ever taken a basic chemistry course understands what formaldehyde really is - so the antivaxxers soon decided it was time for something new.

Get the shovel out... those goalposts need to be moved yet again!

This brings us to present day - when many antivaxxers have decided the one ingredient within vaccines which is REALLY, REALLY harmful (for reals this time), and the one ingredient that has the potential to cause the most damage is none other than aluminum.  Per the Centers for Disease Control (CDC), "[a]luminum salts, such as aluminum hydroxide, aluminum phosphate, and aluminum potassium sulfate have been used in vaccines for more than 70 years" so you might think the antivaxxers are a bit late to the game... but hey - better late that never right?

I suppose to the layman, telling them you are going to inject them with aluminum sounds about as appealing as telling them you are going to inject them with mercury.  Saying these things scares people... and isn't that the point?  We can't expect people to realize that the aluminum is the most common metal on the entire planet can we?  Can we expect them to know that there is a vast difference between a chemical compound containing aluminum and an actual piece of aluminum that may be used to form a soda can?

The truth is, aluminum is actually all around us, and even in us.  Aluminum is found in our water, it is found in our the soil, it is found in the air, it is commonly used in antacids, aspirin, and yes it is even found in our food including fresh fruits, vegetables, and meat.

So what is an antivaxxer to do when they soon realize that aluminum is all around us? What can they do when they find out the average human contains between 50 and 150 mg of aluminum at any given time?  What do they do when the find out the average daily intake of aluminum may range from 10-110 mg?   Well... they simply decide to focus on the amount of aluminum in vaccines rather than the amount of aluminum anywhere else in our body or our environment. Seems legit.

The problem is, vaccines really don't contain very much aluminum.  A typical vaccine contains no more 0.85 mg of aluminum per dose.  To put this in perspective, aluminum is also found in soy-based infant formula (0.46–0.93 mg/L) and milk-based infant formula (0.058–0.15 mg/L) which means an infant will consume more aluminum in a few days of drinking formula than it would receive from a typical vaccine.

Per CHOP, "During the first 6 months of life, infants could receive about 4 milligrams of aluminum from vaccines. That’s not very much: a milligram is one-thousandth of a gram and a gram is the weight of one-fifth of a teaspoon of water. During the same period, babies will also receive about 10 milligrams of aluminum in breast milk, about 40 milligrams in infant formula, or about 120 milligrams in soy-based formula.

Even more shocking, a common over the counter antacid has around 300-600 mg of aluminum hydroxide (approximately 104–208 mg of aluminum) per tablet, capsule, or 5 milliliter (mL) liquid dose! That means if you take a single tablet of a commonly available antacid, you are consuming as much as 245 times more aluminum than you would get out of a typical vaccine.

So why aren't antivaxxers out there protesting against antacids?  If you consider how much aluminum a typical adult human might consume in a 24 hour period as a result of some heartburn, it would seem to be the equivalent of hundreds and hundreds of vaccinations, yet antivaxxers fail to even mention it.  Why are these same antivaxxers not signing petitions to have soy-based infant formula removed from store shelves when it exposes infants to 30 times as much aluminum as vaccines within the child's first six months of life?  Could it be the antivaxxers are just slightly biased due to all of their previously failed attempts at pinning the root cause of autism on the vaccine industry?

The truth is, even if someone does ingest 2000 mg of aluminum in a single day, it will quickly leave their body via their feces and urine, which results in over half being flushed out of the body within 24 hours and over 70% of the aluminum being flushed out of the body within five days.  There have been some reports of long term complications surrounding high levels of aluminum exposure which I am certain many antivaxxers have latched on to, but unfortunately for them there have been long term complications from exposure to every element and chemical compound known to man.  As it turns out, the number one cause of drowning in humans is a result of too much exposure to H₂O (commonly called "water"), yet I don't hear many people asking for the government to investigate Evian or Aquafina to see if they are killing people.  Go figure.

Sort of makes you wonder where the goalpost will move next doesn't it?

Will Antivaxxers Embrace the HIV Vaccine?

I was reading the latest news about one of the many HIV vaccines in development, and even though the results of the initial phase of testing appear to be very positive, I couldn't help but wonder to myself... how will the antivaxxers spin this to make something as beneficial as a HIV vaccine to be a bad thing?

I understand full well we are a long way away from an actual usable and functional HIV vaccine, but the initial clinical trials suggest that such a vaccine could be right around the corner.  So if we assume a HIV vaccine is within our grasp, and we already know over 33,000 people a year are diagnosed with HIV / AIDS and over 9,000 die from the disease annually, will there be a major push from the antivaxxer community to proclaim the vaccine is more harmful than HIV itself?

Perhaps it is too early to tell.  We don't yet know of any potential side effects of the HIV vaccine so we can't say what harm it may cause.  However if we look to other vaccines as examples of what we might expect it seems highly unlikely that antivaxxers will support such a vaccine even if it is shown to save thousands of lives.

How do we know this?  Simple... just look at something like the HPV vaccine (Gardasil). We know the lifetime risk of developing cervical cancer in the US is 1 in 147 for those women who are unvaccinated while it is only 1 in 400 for those women who are vaccinated.  Knowing the fatality rate of cervical cancer is around 35%, we can use simple math to determine that the HPV vaccine could potentially save approximately 2,500 lives per year in the US alone.  Now antivaxxers are quick to point out that within one year of receiving a Gardasil vaccine there have been at least 68 reported deaths.  Some sources cite slightly higher numbers, some cite lower numbers, but the 68 number is accurate as of June 2011 and came directly from the Vaccine Adverse Event Reporting System (VAERS).  What they fail to tell you however, is that that total includes all deaths... even those which were a result of suicide, car accidents, or unrelated medical conditions.

Now in case you are curious, even if we use the full 68 deaths, and we consider that at that point in time over 35,000,000 doses of the Gardasil vaccine were given it would mean that 68 works out to be 0.0004%.  It is probably also a good time to mention that 0 of those deaths (0.0000000000%) have actually been attributed to Gardasil... and that number doesn't change no matter who has reviewed the data.

However, I'm in generous mood and I'm trying to make a point, so for the sake of discussion, let's just go ahead and assume out of those 68 deaths that the vast majority were a direct result of the vaccine.  For the sake of argument, we will ignore all common sense and logic and simply assume that 50 of those 68 deaths were a direct result of Gardasil.  Now let's also assume that VAERS only captures about 10% of the actual adverse events tied to vaccines, and therefore we need to now extrapolate that 50 deaths to be a total of 500.  So out of 35,000,000 doses of the vaccine given, we are making a wild assumption of 500 deaths.  In case you are curious that works out to be an effective rate of 0.00142%

Do you have any idea how small a number 0.00142 really is? That is roughly one out of 70,000.  That means  if you injected one person each day with Gardasil, you could continue to do so for 192 years before someone might actually die as a result - and that is under the huge assumption that all of these deaths can be directly linked to the vaccine (which we know they cannot).

Great - so the chances of dropping dead within one year of receiving a Gardasil vaccine are 0.00142%.  Fine... I know it is a huge stretch, and we know the numbers are nowhere near that level, but even if we use worse case scenario logic coupled with idiotic assumptions, we still come up with a value which is incredibly small.

So how many lives have been saved by the vaccine during that same period of time?  The Gardasil vaccine was approved by the FDA in June of 2006, so five years later in June 2011 by the time those 35,000,000 doses were distributed, we could have potentially saved 12,500 lives from the vaccine.

So let's be clear - if the vaccine saves 2,500 lives a year (12,500 lives over five years) and if the vaccines results in 500 deaths during that same period, that tells us the end result is a net increase in lives saved.  This means the Gardasil vaccine actually saved at least 12,000 lives.  Yes you can argue the number is larger or smaller, but in the theme of keeping things simple, this is a fairly conservative figure.

So what do antivaxxers say when presented with these numbers?  Do they admit that the net effect of the vaccine is that lives are saved?  No.  Do they admit that even if the vaccine isn't perfect that it is still better than nothing?  Nope.  Instead of looking at the net impact, antivaxxers do what antivaxxers always do when the numbers don't help their cause.  They deny the numbers and claim the math doesn't add up.... or better yet they simply refuse to talk about it.

Now we know it is impossible for even the most diehard antivaxxer to deny basic arithmetic, so instead they simply flatly deny that the vaccine saves any lives.  They even go so far as to claim there is no connection between HPV and cervical cancer.  Yes seriously.  (In case you are wondering, the claim about HPV not causing cervical cancer is flatly untrue and stems from a misunderstanding of the virus.  It is true that not all strains of HPV cause cancer and it is also true that many HPV infections are short-lived and don't result in cervical cancer, but it is widely know that some strains of HPV (namely HPV 16 and HPV 18) do in fact cause more than 99% of all cervical cancers).

So we can see with our own eyes that antivaxxers with do anything and say anything rather than admit a vaccination is actually beneficial.  They will misinterpret data, they will misreport the facts, they will misrepresent scientific studies and even cherry-pick statements out of context.  Even worse, when all else fails... they will just flat out lie.

So if one day we are presented with a HIV vaccine that could potentially save tens of thousands of lives each year, is it possible that antivaxxers would actually embrace the vaccine and admit that it benefits the health of the human race?

Considering many antivaxxers don't even believe that the HIV virus causes AIDS... not bloody likely.