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An epidemic of fear: The anti-vaccine movement’s war on science

We’ve often castigated the press and mainstream media for getting it so very, very wrong on the issue of vaccines and autism and its all-too-often credulous treatment of the anti-vaccine movement. That’s very important. However, it’s also equally important to recognize mainstream media outlets when they get it so very, very right. That’s why, with minimal fanfare, I’m simply going to refer you to an article in WIRED Magazine entitled An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All by Amy Wallace. I particularly like Wallace’s calling out some prominent anti-vaccine activists, such as Jenny McCarthy, Jim Carrey, Don Imus, and Robert F. Kennedy, Jr.

Bravo, Ms. Wallace. Bravo, WIRED.

Go. Read. While you’re at it, you might want to lend some tactical air support to the cause of science and reason in the comments section. As they always do, the anti-vaccine kooks have already descended.

Posted in: Vaccines

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36 thoughts on “An epidemic of fear: The anti-vaccine movement’s war on science

  1. peteswicked says:

    This was a great surprise to me when I opened my mail last week (yes, real snail-mail) and saw this article in the Wired magazine.
    I’m trying to spread the news as wide as I can, since I have to battle this problem every day as a father of a 5-year old.
    Let’s hope we’ll see more and more of this kind of articles in the mainstream media.
    Hooray!!!

  2. Harold L Doherty says:

    As you know there are many who believe that the real epidemic of fear is spread by those who spread the Swine Flu pandemic fears. As far as fear of the H1N1 vaccine is concerned to which group of fear mongers do you assign the German government body, the Federal Vaccination Agency, which has advised against the use of vaccines containing adjuvants. ?

    (Source Irish Times, October 20, 2009, “Concern in Germany as safety of swine flu vaccines questioned”.)

    http://www.irishtimes.com/newspaper/frontpage/2009/1020/1224257059631.html

    The same article states that Concerns about an adjuvant containing H1N1 vaccine’s safety and efficacy “have been raised by several German medical organisations, with warnings against using it to vaccinate high-risk groups such as pregnant women and children.” The article quotes Dr Wolfram Hartmann, president of the German association of paediatricians as stating that “The vaccine has not yet been tested on children under three, so the risk is simply too big to use on them without misgivings,”

    Are all of these German health professionals fear mongers?

  3. Chris says:

    Mr. Doherty:

    1) The Wired article is mostly about pediatric vaccines.

    2) The H1N1 vaccine in Europe is different than the USA, the American vaccine has no adjuvants. This fact has been mentioned multiple times on this blog.

    3) You are quoting a news article. Journalists are not known for their scientific accuracy.

  4. Harold – Who here is fear-mongering about the pandemic? You can call any health care warning fear-mongering. The question is – are the concerns being raised a reasonable interpretation of the evidence and the steps recommended proportionate to the risk? I think, in general the concerns about H1N! have been evidence-based and reasonable (I am not talking about the mainstream press, but rather scientific and regulatory institutions).

    The controversy in Germany is complex. Concern was raised by the fact that the government bought one brand of vaccine (without adjuvants) for the government and military and another for the citizenry (with adjuvants).

    In my opinion – raising fears about adjuvants is fear mongering because they have a long safety record.

    Hartmann, however, also pointed out that the vaccines have yet to be tested in children younger than 3. I don’t know if this is true, but if it is it seems like a reasonable point to raise, although not necessary a reason not to vaccinate. This is not an entirely new vaccine, it is just a new version of an established influenza vaccine with a new specific target. It is reasonable to extrapolate from existing evidence, while monitoring the roll out very carefully, which is being done.

    The straw man that keeps coming up is that by calling extreme anti-vaccine kooks fear mongers and conspiracy mongers (not to mention kooks) that we are somehow implying that even the most reasonable questioning or raising of concerns about vaccines is equivalent. We are not.

    Science welcomes self-criticism and the raising of questions. But the anti-vaccine movement is generally not doing this, they are engaged is an ideological battle against the science.

  5. The Blind Watchmaker says:

    “The doubters and deniers are empowered by the Internet (online, nobody knows you’re not a doctor) and helped by the mainstream media, which has an interest in pumping up bad science to create a “debate” where there should be none.”

    That’s a great line.

  6. Anthropologist Underground says:

    I’ve recently encountered a new meme among my local vaccine rejectionists: a culture of fear, beginning with GW Bush and 9/11, cultivated by the CDC, Big Pharma, etcetera, terrifies gullible parents into vaccination. Of course they neglect to mention the myriad unfounded, unsubstantiated fears that keep them from vaccinating…

    I’m so glad to see a science-based assessment of vaccine rejection in a mainstream forum like Wired. Since it has broad appeal across genders, perhaps some of the spouses who are passively going along with vaccine rejection for the sake of coital relations will awaken to the danger.

  7. SF Mom and Scientist says:

    Excellent article. I especially like how she points out that people who are true experts are viewed as suspect, so the general public prefers to believe non-experts.

    However, this my favorite part was about Curt Linderman Sr. who, besides being an anti-vaccine “advocate” has said that it would be nice if Paul Offit was dead.

    “I’d met Linderman at Autism One. He’d given his card to me as we stood outside the Westin O’Hare talking about his autistic son. “We live in a very toxic world,” he’d told me, puffing on a cigarette.”

    Classic.

  8. wales says:

    SBM was so quick to tout the Wired article, which does not offer anything newsworthy and is basically a duplicate of Offit biographies published elsewhere. There are also a few questionable pieces of information, such as Wallace’s statement that the prevaccine measles mortality rate was 3,000 annually, when the CDC’s Pink Book and other authoritative sources state it was 150 annually.

    Still no SBM mention/critique/review of the recent Atlantic article which is timely, well-written and raises intelligent questions about flu vaccine efficacy. The article also discusses the importance of placing science before doctrine, another SMB mantra. The silence is deafening and puzzling……….

    http://www.theatlantic.com/doc/200911/brownlee-h1n1#

  9. wales says:

    PS on the Wired article: How about the irony of Paul Offit’s fear of receiving an anthrax-laced letter? I guess he doesn’t want to roll up his sleeve for an anthrax vaccination.

  10. urology-resident says:

    With more and more people being unvaccinated, has anyone looked at the incidence of autism in the unvaccinated population and compared it to the rest of the population? Wouldn’t this, if it shows that the unvaccinated kids still get autism shut up the antivaccers?

  11. David Gorski says:

    Still no SBM mention/critique/review of the recent Atlantic article which is timely, well-written and raises intelligent questions about flu vaccine efficacy. The article also discusses the importance of placing science before doctrine, another SMB mantra. The silence is deafening and puzzling……….

    Be very careful what you ask for. You might just get it. Perhaps even sooner than you expected.

    As has been mentioned before in multiple places in the comments, Mark Crislip, although not explicitly addressing this article, did address much of the claims in it about flu vaccine efficacy:

    http://www.sciencebasedmedicine.org/?p=2040

    As for Tom Jefferson, he might have revealed his true colors when he agreed to speak for the NVIC. That tells me that he’s either leaning towards the anti-vaccine end of the spectrum or totally oblivious. He did redeem himself partially because he withdrew, but he only did it because he found out that he would be sharing the stage with Andrew Wakefield.

  12. Peter Lipson says:

    Jefferson’s original editorial in BMJ was very effectively eviscerated by actual experts.

  13. wales says:

    Another “true colors” opinion from Gorski. No matter how many times it is repeated, it is still opinion based rather than science based. I assume Dr. Lipson’s evisceration comment is referring to T. Jefferson’s October, 2006 commentary.

    http://www.bmj.com/cgi/content/full/333/7574/912

    Choosing to characterize the commentary’s Rapid Responses as an “evisceration by experts” is interesting. After reading all of the responses I am left with the opposite opinion. Over 20 responses were generated, a handful of which criticize Jefferson’s conclusions (some of which are generated by individuals with competing interests, such as Fedson).

    In his response to these critiques Jefferson notes “No one so far has challenged my key conclusion that the optimistic WHO statement that vaccination of the elderly reduces the risk of serious complications or of death by 70%-85% is not based on evidence.” Jefferson goes on to say “I note with worry their statement [Fedson and Nichol] that decisions should be made on three of the most notoriously biased sources of information: non- randomised studies, expert opinion and economic evaluations.”

    Of note among the comments is an articulate summary of the difference between vaccine efficacy and effectiveness by Jochen Mau, Director of the Institute of Statistics in Medicine, Dusseldorf. The last sentence is particularly incisive.

    “Much of the debate is around the insights (or epistemiological merits) that can be expected from (the results of) randomized controlled trials (RCT). It should be clear that Karl Popper’s falsification paradigm for empirical research provides the rationale, and RCT is only a technique for its implementation: Causal inference must exclude all other possible causes that could explain the observed treatment effect, and the RCT is a convincing design, then. However, a RCT cannot accomplish more than a test of the concept (efficacy), and it can never replace a study of effectiveness, on any logical grounds. As with car racing, in which a care maker gives evidence of knowing how to make cars (the proof of concept) while the real-life (market) setting is every-day car driving in the streets, RCT efficacy may be considered sufficient empirical evidence that the test compound works in the test stand; a positive efficacy trial may also justify regulatory approval and market entry, but by no logical means would the RCT give re-assurance of success in the target population, as long as a logical basis for extrapolating from the test setting is lacking.

    When it is commonly understood that efficacy is a research goal, and effectiveness is the health service objective, when it is accepted that proof of concept (efficacy) is necessary, but must not be substituted for proper effectiveness studies, then no dissent about the value of currently available evidence will remain: it does not seem compelling, as Thomas Jefferson pointed out. “

  14. Danio says:

    Be very careful what you ask for. You might just get it. Perhaps even sooner than you expected.

    Squee!
    *happy dance*

  15. Dr Benway says:

    shorter wales: “OMG WE DON NOES ENUF!!!”

  16. SF Mom and Scientist says:

    I apologize for going slightly off-topic, but since we are talking about the mainstream media finally starting to get it on vaccines, I thought I’d mention this.

    For the parents out there, here is a summary describing this coming Monday’s episode of Sid the Science Kid (a great kid’s show on PBS produced by the Jim Henson Company).

    “Getting a Shot: You Can Do It!
    Sid’s grandmother visits his school and administers flu shots, prompting Sid to learn about how vaccinations work.”

    I am so delighted they are doing this. When I was a kid I saw anti-smoking campaigns and convinced my parents to quit smoking. Here’s hoping this kind of show can have a similar effect on today’s parents!

  17. Lawrence C. says:

    I think the Wired Magazine piece is pretty good overall. I hope some of the people that regularly read Wired who also believe in “holistic” health will note that vaccines in general do work astonishingly well. Many diseases that used to maim or kill are under control.

    Until now, it seems, when a weird anti-vaccine movement seems to have blossomed out of…what? It seems to be an odd ideology crafted and cherry-picked from a wide range of unrelated subjects.

    What is most troubling is the apparent extreme selfishness of parents and people who choose not to be vaccinated. As if they exist in a bubble, not interacting with anyone, incapable (as they are too smart, too good, too full of supplements to get a germ much less infect anyone else) of passing anything but goodness and light along.

    These folks seem to like looking things up on the internet. Good! Google this: Typhoid Mary.

  18. pdeluca says:

    I’m trying to understand the issues surrounding the latest H1N1 vaccine and have been doing research (gasp!) on the Internet and have been reading the package inserts that accompany the Influenza A vaccines manufactured by CLS, Novartis, and sonofi pasteur that are published on the Institute for Vaccine Safety website. It’s safe to say that the three inserts contain identical language in many sections of the documents and, being in the business of making money and being wary of litigation, the pharm companies have covered their bases to protect against legal action by inserting the proper disclaimers as any prudent person would expect. The CLS insert, however, contained something that was not in the other two. In the indications and usage section was the following:

    “Influenza A (H1N1) 2009 Monovalent Vaccine is an inactivated influenza virus vaccine indicated for active immunization of persons ages 18 years of age and older against influenza disease caused by pandemic (H1N1) 2009 virus.
    This indication is based on the immune response elicited by the seasonal trivalent Influenza Virus Vaccine manufactured by CSL (AFLURIA®). CSL’s Influenza A (H1N1) 2009 Monovalent Vaccine and AFLURIA are manufactured by the same process. There have been no controlled clinical studies demonstrating a decrease in influenza disease after vaccination with AFLURIA”

    The part of the statement that caught my attention is, of course, “There have been no controlled clinical studies demonstrating a decrease in influenza disease after vaccination with AFLURIA”.

    I take this to mean that the spread of the disease is not affected by vaccination with the CLS drug. If this is true, why get vaccinated? (Just to be clear, I am not anti-vaccine; I’ve gotten them my whole life, as have my children, although I’ve never gotten a flu shot and have never gotten Influenza, I’m just trying to make an informed decision.)

    If the drug maker is not prepared to support the effectiveness of its own drug, what should consumers infer from this?

  19. jofspammo says:

    No articles on? An Epidemic of Establishing Bad Habits: How Parents Taking Kids for Fast Food Endangers Future Health Care Costs !!!

  20. Rob Tarzwell says:

    @pdeluca, a statement like that simply means that the manufacturer has not taken vaccine recipients and then tested their response vs placebo recipients when exposed to the wild virus.

    I should hope they have done no such study, as it would be egregiously unethical. I can’t imagine it getting past my local ERB (ethics review board).

    Consumers should infer from that statement that CLS has idiotic package-insert writers, little else.

  21. pdeluca says:

    @Rob Tarzwell, I have a hard time believing that idiot package insert writers are to blame. I’ve been involved in product development in Fortune 500 companies and the amount of legal scrutiny that goes into every aspect of communication is mind-numbing. I’m sure a legal team either required that that statement be included or did not object to its inclusion. Concerning ehtics, couldn’t a study be done with informed consent?

    That aside, how, then, is the effectiveness of a vaccine measured? It seems to me that there are several assumptions here: 1.) The intent of the vaccine is to prevent the spread of infectious disease by bolstering the immune systems of vaccine recipients to reduce their risk of contracting the disease; 2.) The science behind the process of vaccine manufacture, usage, and the resultant changes in individual biology is well documented, proven science (i.e. the vaccine creates the anticipated antibodies); and 3.) Based on 1 and 2, we should logically deduce that the number of cases reported for the vaccinated disease should decline. (It occurs to me that we really aren’t eradicating a disease, we are merely preventing people from contracting it. Some viruses survive in nature, do they not?) The third assumption does not sound like science to me. If JiffyLube tells me that I should change my oil every 3,000 miles because it will extend my engine life and I do it, that doesn’t mean my car is going to last 100,000 miles. Unless they can prove it, it’s just marketing.

    People that get vaccinated and people that don’t get vaccinated are likely to be exposed to the wild virus in question at the same rate. Some in both groups will get sick, but not all. Those with severe cases will be reported and treated. Those with mild cases will ride it out. In theory, the number of severe, i.e. reported cases, will drop. But that doesn’t mean that fewer people are getting sick nor does it mean that the disease is spreading any more slowly. It therefore seems my first assumption is incorrect. Perhaps the goal is to reduce the severity of reported cases. Either way, I’m still puzzled why a vaccine manufacturer would include such language in their package insert if there were good scientific reasons for omitting it.

  22. Dr Benway says:

    “There have been no controlled clinical studies demonstrating a decrease in influenza disease after vaccination with AFLURIA”.

    It’s my understanding that the method for producing flu vaccine is fixed and the government contracts with various companies to make it each year using this method. Each company may brand its own product (e.g., “Afluria”) but in the case of the injectable vaccine, the stuff in the vial should be the same regardless of who manufactures it. So it may be true that “Afluria” was not tested prior to release while vaccine by the other two manufacturers was tested.

    Kinda like with generic drugs. The original branded product manufacturer does the testing, then the generic manufactuer just has to show that his product is the same as the original.

    This explanation is just a guess on my part.

  23. Dr Benway says:

    Oh and Rob’s point about a prospective study where researchers intentionally expose people to the flu virus makes sense. People do die from the flu, so it’s hard to imagine how that type of study would be approved.

  24. Rob Tarzwell says:

    @Pdeluca, your third paragraph is correct, that there will be exposure to the immunized and non-immunized by wild virus. That sort of uncontrolled, naturalistic study can be and is done when controlled studies are not feasible or are unethical. It can’t strictly speaking prove causation, but it can point toward it.

    It’s the sort of study done to determine, for instance, the differential cancer rates between those who are or who are not exposed to second hand smoke.

  25. skepsis says:

    Hmpf, not getting vaccine shots will not cause much higher mortality, but higher morbidity (and a minor increase in secondary effects).

    E.g. all cause mortality for children aged 0-7 was down to about 50/100000 by WW2 in Sweden. Antibiotics began to be used after WW2 and the childhood vaccination program began at the end of the 60ties. By which mortality was even lower.

    What lowered the rates from about 1250/100000 on average in the 18th century to the post-WW2 levels? Hygiene, clean water and a steady food supply. Variola vaccination eradicated variola and caused a shortlived decrease in mortality, but that soon turned to an increase as other diseases (notably cholera and dysentery took its place).

    Amy Wallaces article is just plain unscientific scaremongering. Not a piece of good journalism. (This is more reminiscing of the tobacco industries tactics to cause confusion as to keep their sales up.)

  26. Harriet Hall says:

    skepsis,
    Hygiene was important: it decreased the risk of infection but could not eliminate it. Vaccines were able to lower the risk still further and to eliminate it entirely in the case of many diseases. Your own argument that cholera and dysentery increased to take the place of smallpox demonstrates that improved hygiene was not so effective.

    If not getting flu shots mainly decreased morbidity and had only a small effect on mortality, wouldn’t that still be a good argument for getting the shots?

  27. herbprof says:

    The Quack Vaccine Industry
    There have been no placebo-controlled studies on flu vaccines because the vaccine pushers say such clinical trials would be “unethical.” Thus, there is actually no hard scientific evidence that they work at all.

    The “50 percent reduction in mortality” statistic that’s tossed around by vaccine pushers is a total fabrication based on “rubbish” studies (“cohort” studies).

    Scrutinizing the existing studies that claim to support vaccines reveals that flu vaccines simply don’t work. And when vaccines aren’t available or the formulation is wrong 1968 and 1997, there’s no spike in death rates, indicating quite conclusively that these vaccines offer no reduction in mortality.

    Flu vaccines only produce antibodies in people who don’t need vaccines (your immune system must be strong enough to react to the vaccine for it to work). At the same time, they fail to produce antibodies in people who are most vulnerable to flu. Thus, vaccines only work in people who don’t need them.

    The entire flu vaccine industry is run like a cult, with dogma ruling over science. Anyone who asks tough, scientific questions is immediately branded a heretic. No one is allowed to question the status quo. (So much for “evidence-based medicine,” huh?)

    As you can see from all this, the flu vaccine is pure quackery. Those who administer vaccines are, by inference, QUACKS. They claim to have scientific minds, and yet they are the most gullible of all: They will believe almost anything if it’s published in a medical journal, even if it’s complete quackery.

    Today, countless doctors, nurses and pharmacists across North America and around the world are pushing a medically worthless, scientifically-fabricated chemical injection that offers absolutely no benefit to public health… and yet they’re convinced it’s highly effective! It just goes to show you how easy it is to brainwash people in the field of conventional medicine.

    They’ve abandoned real science long ago, you know. Now the whole industry is just run on the momentum of dogmatic arrogance and the illusion of authority. From the CDC and FDA on down to the local pharmacist at the corner store, the American medical system is run by some seemingly smart people who have been brainwashed into become full-fledged members of the Cult of Pharmacology where vaccine mythology overrules real science.

    The vaccine industry is perhaps the greatest medical scam ever pulled off in the history of the world. Don’t fall for it. Hyla Green Earth Journey

    See full article in The Atlantic by Shannon Brownlee and Jeanne Lenzer: http://www.theatlantic.com/doc/2009

  28. pmoran says:

    To take just one of the assertions that herbprof has presumably read somewhere —

    “There have been no placebo-controlled studies on flu vaccines because the vaccine pushers say such clinical trials would be “unethical.” Thus, there is actually no hard scientific evidence that they work at all.”

    Here is part of the abstract of one of some dozens of of systematic reviews on the effects of flu vaccines in differing populations. It is a very small fraction of decades of research.

    It should, incidentally, not be necessary for studies on vaccines to be double-blinded and placebo-controlled unless they are looking for more detailed information on side effects and immune responses, as some of these studies were.

    This gives some idea of the intensity with which vaccine questions are examined and also of the appalling mendacity of common antivax allegations. Why do they feel compelled to feed on each others lies without bothering to check?

    Quote–

    “Fifty-one studies with 294,159 observations were included. Sixteen RCTs and 18 cohort studies were included in the analysis of vaccine efficacy and effectiveness. From RCTs, live vaccines showed an efficacy of 82% (95% confidence interval (CI) 71% to 89%) and an effectiveness of 33%(95% CI 28% to 38%) in children older than two *compared with placebo* or no intervention.
    Inactivated vaccines had a lower efficacy of 59% (95% CI 41% to 71%) than live vaccines but similar effectiveness: 36% (95% CI 24% to 46%). In children under two, the efficacy of inactivated vaccine was similar to placebo.”

  29. weing says:

    This herbalprof has been smoking too much herb. The Atlantic is a medical journal? I’ve read better stuff in the National Enquirer.

  30. Dr Benway says:

    No one is allowed to question the status quo. (So much for “evidence-based medicine,” huh?)

    You must summarize the current consensus opinion regarding flu vaccination and the evidence upon which it is based prior to challenging that opinion.

    When you don’t lay out the “status quo” that you are questioning, readers are left to guess whether
    1) you understand the consensus and didn’t want to waste time reviewing it prior to offering legitimate criticism
    2) you hope readers won’t notice that your criticisms are illegitimate.

    Most anti-vaxers offer illegitimate criticisms based upon a false or incomplete understanding of physiology, immunology, toxicology, chemistry, etc. That’s why vaccine critics must offer a cogent summary of the consensus opinion prior to questioning that opinion.

  31. Dr Benway says:

    The Brownlee article in the Atlantic conflated seasonal flu and pandemic flu vaccination strategies.

    The fact that elderly people exhibit a weaker antibody response to seasonal flu vaccines is not an argument against pandemic flu vaccination. Pandemic flu hits younger people hardest.

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