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129 thoughts on “Anti-vaccine propaganda in The Baltimore Sun

  1. libby says:

    “Consider the old adage that everyone is entitled to his or her opinions but no one is entitled to his or her own facts.”

    To further my attempts at adopting this august principle, perhaps Mr. Gorski could explain to me which fact I should adopt as factual in the following case of grapefruit and breast cancer.

    One double blind, evidence based, peer reviewed study in the BMJ showed a link between grapefruit and breast cancer. There’s that fact. A year later, in the same journal, a new double blind, evidence based, peer reviewed study demonstrated a falsification of the link. There’s that fact. Or perhaps it’s best to wait until a further study is done that is even more factual, and if this is the case, be satisfied that this new ‘fact’, the 3rd in a series, can now be etched in stone. Maybe, though, it’s more prudent to wait a few years, or decades, or longer to make certain no other double blind, evidence based, peer reviewed study is devised that negates everything in the previous 3 studies.

    So what is your opinion on all these facts?

  2. WilliamLawrenceUtridge says:

    pD, I was right along with you until you said you liked Nickleback. Now we can’t be friends.

    And more seriously, if antivaccination nutters took your approach of saying “let’s examine” rather than “ZOMGVACCINATIONKILLSEVERYONE”, well, they wouldn’t be nutters. Examining something empirically is reasonable, and will lead to correct outcomes (with good method). The problem is, antivax nutters don’t use good methods, they aren’t reasonable, and are uninterested in actual empirical results.

    @libby:

    So what is your opinion on all these facts?

    Dr. Gorski would almost certainly say that interpreting the body of literature on the topic will be the best place to start, and further research will help. Just because we don’t know the answer right now doesn’t mean we never will.

    My opinion would be if you want to avoid cancer, don’t smoke. If you want to avoid breast cancer, breast feed, maintain a reasonable weight, drink moderately if at all, exercise and avoid hormone replacement therapy and pollution. Good advice overall from the mayo clinic.

    http://www.mayoclinic.com/health/breast-cancer-prevention/WO00091

  3. JPZ says:

    @pD

    As someone trained in immunology, I like your thoughtful approach. Thank you for sharing your point of view!

  4. passionlessDrone says:

    @WilliamLawrenceUtridge –

    And more seriously, if antivaccination nutters took your approach of saying ‘let’s examine’ rather than ‘ZOMGVACCINATIONKILLSEVERYONE’, well, they wouldn’t be nutters. Examining something empirically is reasonable, and will lead to correct outcomes (with good method). The problem is, antivax nutters don’t use good methods, they aren’t reasonable, and are uninterested in actual empirical results.

    Believe me, I find myself highly conflicted over the fact that my line of thought can be seen as complimentary to the more conspiratorial elements of the online autism community, that being said, I haven’t figured a way to rationalize my way out of what look to be glaring problems with our existing data. In fact, as I’ve thought about this, I’d go so far as to say that right now, the last thing we need is a vaccinated / unvaccinated study; I think we need to learn a lot more before attempting something like this.

    @ JPZ –

    As someone trained in immunology, I like your thoughtful approach. Thank you for sharing your point of view!

    Thank you very much! I’d be interested in your thoughts.

    - pD

  5. Th1Th2 says:

    pD,

    In fact, as I’ve thought about this, I’d go so far as to say that right now, the last thing we need is a vaccinated / unvaccinated study; I think we need to learn a lot more before attempting something like this.

    Oh yeah why don’t you give them the gun and force them to play Russian Roulette. That sounds like a good idea…not!

  6. Th1Th2 says:

    William,

    Why would we jump to ‘vaccination’, a relatively minor immunological challenge, as the reason?

    Oh really. Let’s count. An excellent immunization history would comprise of successful inoculation with 14 known infectious diseases with 36 series of exposures overall in a span of only 2 years after birth. Wherever did you hear of a child getting tortured deliberately this way?

  7. WilliamLawrenceUtridge says:

    Hear that silence? That’s the sound of Thing ignoring the thousands of antigens that are presented to the immune system within the first two years of life.

    Feel that breeze on your skin? That’s Thing handwaving away the immunological challenge presented by a genuinely dangerous infection.

    See that crowd at the funeral? That’s the family of the infant who died of pertussis before they could be vaccinated.

    Taste that irony? That’s Thing comparing vaccination to torture.

    Smell the napalm? That’s Thing’s stupid burning through all the papers that indicate vaccination is less risky than actually catching a disease.

  8. Th1Th2 says:

    William,

    Hear that silence? That’s the sound of Thing ignoring the thousands of antigens that are presented to the immune system within the first two years of life.

    I must have missed 60 minutes, what are you saying? That those thousands of antigens are all pathogenic, or at least were derived from known disease causing microorganisms. Could you please identify the first ten from the thousands of antigens that you know of.

    Feel that breeze on your skin? That’s Thing handwaving away the immunological challenge presented by a genuinely dangerous infection.

    Where is the infection and what is the infectious agent? Don’t just tell a story.

    See that crowd at the funeral? That’s the family of the infant who died of pertussis before they could be vaccinated.

    Myth. It’s always an iatrogenic death.

    Taste that irony? That’s Thing comparing vaccination to torture.

    And barbarism.

    Smell the napalm? That’s Thing’s stupid burning through all the papers that indicate vaccination is less risky than actually catching a disease.

    I’ll take the 0 risk any day. Do you have any problem with that?

  9. WilliamLawrenceUtridge says:

    Iatrogenic death you say? What did baby Cayla Smith die of? Unless the parents are lying, she died of pertussis, not iatrogenesis.

    As for zero risk, I would dearly love to face zero risk. However, I live in the real world where no risk can be reduced to zero, ever. The closest we’ve ever gotten with infectious diseases is smallpox. Thanks to vaccination, the only risks are the containment of the samples held in the CDC and in Russia breaking down, or someone figuring out how to synthesize a live smallpox particle from its genome. Thank science for vaccination so no parent has to face this anymore.

    Thing, you can pretend that diseases present fewer risks than vaccination but you’re simply wrong. I can’t argue with you because you dodge questions with coy non-sequiters and your starting assumptions about the immune system bear absolutely no relation to anyone whose understanding is science-based. It’s like arguing cosmology with a flat-earther astrologist. It’s like arguing about an antiretroviral treatment protocol with an AIDS denialist. It’s like arguing about cladism with a creationist. You’re a deluded moron.

  10. Scott says:

    I’d say it’s worse than any of those. The Thing goes beyond misguided into grossly delusional territory. It’s more like arguing with a computer program whose responses are randomly derived with no relation to your queries…

    One could claim that it’s like arguing with the dining room table, but that’s unnecessarily insulting to perfectly good furniture.

  11. pmoran says:

    Libby, I don’t like the name-calling either, but I do suggest that you have a great deal yet to learn about homeopathy and about medicine in general.

    For example, it appears that you did not know that a few studies have already examined individualized homeopathic remedies with negative results. That is easily done in a blinded manner.

    You also stated that homeopathic remedies may have to be individualized to work properly even after providing a list of studies of non-individualized remedies that you cherry-picked as supporting homeopathy. You cannot have it both ways.

    When I said a “vast amount of evidence from many different sources” you seemed to assume I was still talking about clinical studies. I was not. You can test the implications of some homeopathic theories in your own kitchen, and others by studying human illness in depth. You will find that homeopathic potentization cannot be shown to enhance the biological properties of any solution, in the manner typically claimed, and that principles that are critical to any therapeutic activity of homeopathic remedies, such as “like cures like” and the homeopathic “provings”, have no basis at all, when looked at alongside better established knowledge.

    Of course a few still believe in homeopathy, even after all that, but they don’t do so because “the science” has persuaded them. They sustain belief because, just like you, they think they have seen convincing clinical benefits from homeopathy. They, like you, keep looking for loopholes, rather than making what I admit is a difficult concession: that the observed benefits are due to a mixture of psychogenic responses to medical interactions and well-known illusions.

    This is where ALL the evidence best comes together.

    That is also where we “are at” with you. You have produced nothing we have not seen many times before. We have presented our position and it is up to you what you make of it.

  12. Chris says:

    WilliamLawrenceUtridge: you rock! I love what you have to say and how you say it.

    libby, you are still being an off topic troll. Last time I looked the article at the top of the page does not mention breast cancer, nor does it mention grapefruit.

    Also, Dr. Gorski has both a medical degree and a separate PhD. You should show more intelligence by at least being on topic if you think referring to him as “Mr. Gorski” will give you any argument points.

  13. libby says:

    @pmoran

    I wasn’t aware that there were accepted studies that have been run where patients with a specific indication were examined by a group of homeopaths and given a specialized remedy or placebo. Do you have the link for those trials? Were they double-blinded or only blinded? ;)

    The presentation of traditional trials supporting the benefits of homeopathy was more to show the flaws of the system, rather than to come to a conclusion on the actual content. If I put into a calculator 2 + 2 and it spits out “4″, and the next day put the same equation into the same calculator and it spits out “5″, it’s either that I’m not inputting the right numbers, or the calculator is flawed. That is essentially what is happening when you use the same system to test the same treatment and you get differing results – either parts of the trials were not handled properly, or the system for testing is flawed.

    Homeopaths provings, potentization, etc. do not have anything disproving them, we are merely faced with an inability to prove them. The absence of proof is not the proof of absence.

    As for “like cures like”, that is a concept already employed in certain occasions by the medical industry – one example is in acne treatment. Patients are recommended to not over-wash their faces as by removing too much oil, their bodies will start producing more to compensate. In some cases, patients are recommended to add oil to their skin to “trick” their bodies into thinking there is already too much oil being produced, thereby slowing it’s internal production: http://www.acne.org/jojoba-oil.php

    I don’t think that criticizing a clinical study based on the methods and standard operating procedures is exactly “looking for loopholes”. If that were the case, any critic of any trial in the world (including staff of the FDA and Health Canada) would fall under that category.

  14. Scott says:

    The presentation of traditional trials supporting the benefits of homeopathy was more to show the flaws of the system, rather than to come to a conclusion on the actual content. If I put into a calculator 2 + 2 and it spits out “4″, and the next day put the same equation into the same calculator and it spits out “5″, it’s either that I’m not inputting the right numbers, or the calculator is flawed. That is essentially what is happening when you use the same system to test the same treatment and you get differing results – either parts of the trials were not handled properly, or the system for testing is flawed.

    Utterly wrong. It’s in fact routine, expected, and inevitable for the results of experiments to differ. Dealing with that uncertainty is a core part of science. This is why it’s so important to consider the entire body of the literature; no single result can be trusted.

    Homeopaths provings, potentization, etc. do not have anything disproving them, we are merely faced with an inability to prove them. The absence of proof is not the proof of absence.

    So you actually admit that there’s no evidence supporting it? Yet assume that it works? I’ve got some swampland in Antarctica to sell you!

    As for “like cures like”…

    There’s a gargantuan chasm between “some treatments are in some ways vaguely similar to the conditions being treated” and “substances causing the same symptoms always cure said symptoms.”

  15. WilliamLawrenceUtridge says:

    Chris:
    Don’t encourage me. I should never be encouraged. I should always be corrected however, as I am wrong on a daily basis and welcome valid criticism.

    Libby:

    Homeopaths provings, potentization, etc. do not have anything disproving them, we are merely faced with an inability to prove them. The absence of proof is not the proof of absence.

    The burden of proof is always, always, always on the person claiming an effect. If homeopaths claim provings “work” it is up to them to demonstrate it. There are an infinite number of things that could be wrong, and it’s impossible to demonstrate things wrong in the first place. You can only demonstrate that something is right. This is basic epistemology. Are you familiar with Russell’s teapot? How about special pleading? Special pleading is used to explain away negative effects; scientific research always requires a certain amount of it during intial research on an uncertain phenomenon. But any investigation of a true effect should begin separating signal from noise in a relatively short timespan, and those results should be replicable by anyone using the same method. Further, controls should not interfere with this process, but should in fact make the signal clearer over time. Again, a failing of homeopathy is its splitting into different camps over the centuries rather than converging on an answer.

    As for trials of individualized homeopathy, Linde & Melchart conducted a meta analysis in 1998 that concluded individualized homeopathy could be demonstrated effective only in low-quality trials. When the methodological quality of the trials increases, the effectiveness of homeopathy disappears.

    As for your comment:

    That is essentially what is happening when you use the same system to test the same treatment and you get differing results – either parts of the trials were not handled properly, or the system for testing is flawed.

    I’ve a couple things to say. In any test, you can expect to see random fluctuations; the p = 0.5 criteria that was the standard for many years meant that 1 out of 20 significant results were expected to be due to chance. That’s why replication is important, as is the us of specific statistical procedures when conducting multiple comparisons (otherwise you’re data dredging). Random variation is another reason researchers are encouraged to use the largest samples practical; it is expected that random variations and fluctuations in the subjects will balance each other out. If however, your comments are along the lines of “I know homeopathy works therefore science is wrong”, that means you’re not doing science anymore, and you’ve lost any reasonable credible justification for citing scientific research as you’re simply looking for any excuse to avoid changing your mind. May I suggest you pick up a copy of Mistakes were Made (but not by me) by Tavris & Aronson; it goes into, at length, the theory of cognitive dissonance which is the main reason people refuse to change their minds in the face of good evidence.

    The “like cures like” argument is completely wrong. In any case where “like” genuinely cures “like”, such as vaccination or face washing, there is a recognized process by which a vaccine causes an immune response (or washing one’s face make it oilier in the long run) and why it works. Homeopathy for one thing focuses on symptoms (and often practitioners deny the germ theory of disease) and for another thing, takes the “like” that symptom and then dilutes it to the point that there’s no plausible process by which it could have any effect. Quantum entanglement doesn’t work (quantum effects wash out by the time you get to the size of molecules), “memory of water” doesn’t work (any “structures” in water are destroyed by Brownian motion in picoseconds). Homeopaths assert that like cures like, it has never been demonstrated that provings achieve anything meaningful or that dilution and succussion do anything but add heat to the system.

    Again, an excellent book is Homeopathy, how it really works by Jay Shelton. If you can address the flaws Shelton cites regarding the research on homeopathy, and still successfully demonstrate that homeopathy works, you can collect $1,000,000 from Mr. James Randi.

  16. Chris says:

    Rule 14, especially for the homeopathic trolling.

  17. pmoran says:

    Libby, here is one example of authentic homeopathic individualisation. Of course it would be double-blinded. Anything less is pointless wherever end-points are subjective.

    Thorax 2003;58:317-321
    Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised
    placebo controlled trial

    A White, P Slade, C Hunt, A Hart and E Ernst

    (no benefits over placebo)

    Others have pointed out some of the reasons why in any field other than the subjective aspects of illness, wherine various illusions and psychology can have free play, homeopathic theory would not merit the least time of day.

  18. libby says:

    pmoran:

    You’re right when you said, “…here is one example…”

    I showed “one” example of grapefruit linked to breast cancer which turned out to be false, unless the subsequent study falsifying it was false. Clearly double blind studies sometimes just get it wrong.

    You do understand this is one branch of homeopathy, classical, which I don’t use. Being a solitary study of under 100 subjects is hardly conclusive, although this study is at least attempting to exhibit some integrity.

    I find it odd you would on the one hand put faith in this very limited study and when I referred to the Australian meta-analysis on 22 cancers, your first criticism was that it wasn’t comprehensive enough, that it excluded non-adult cancers.

    You can’t have it both ways.

  19. Chris says:

    Just a reminder: homeopathy and vaccines are not related subjects.

    Though the HepB and HPV vaccines do prevent cancer.

  20. pmoran says:

    Libby:
    You’re right when you said, “…here is one example…”
    I showed “one” example of grapefruit linked to breast cancer which turned out to be false, unless the subsequent study falsifying it was false. Clearly double blind studies sometimes just get it wrong.

    ————————-
    This is not the only individualized study on homeopathy, and the only claim I was making at the time was that you may not know as much as you think about the science relevant to homeopathy. You did not know that such studies have been done.

    Yes, double blind studies can give false results, but usually as false positives. Nearly always there are active homeopaths involved in the design and performance of the studies. Seeking vindication for their field they naturally choose to study those areas where they believe they are getting their best results.

    So it is not at all unreasonable to expect the studies to be consistently positive if homeopathy worked as claimed, and if homeopaths (and persons like yourself ) were actually able to detect a clear therapeutic signal amidst all the noise and clutter of day-to-day medical activity.

    Clinical studies merely attempt to eliminate all the noise, so that the signal is clearer, and the statistical yardsticks commonly applied are not that hard to reach. So why all the negative studies?

    Homeopaths and other CAM practitio
    ners instinctively understand this, which is why they then often turn around and try to find reasons why “scientific studies cannot test what we do”.

    You do understand this is one branch of homeopathy, classical, which I don’t use.
    ——————————–
    Yes, I know that homeopathy has no consistent conceptual basis, so that homeopaths can always claim that “you are not doing it right” when results are negative.

    Being a solitary study of under 100 subjects is hardly conclusive, although this study is at least attempting to exhibit some integrity.
    ————————
    That is offensive, especially when many homeopaths and ex-homeopaths are now prepared to admit that homeopathy “works” via placebo and other non-specific effects.

    I find it odd you would on the one hand put faith in this very limited study and when I referred to the Australian meta-analysis on 22 cancers, your first criticism was that it wasn’t comprehensive enough, that it excluded non-adult cancers.
    —————————-
    We were not talking then about an either/or situation. It was being widely alleged that chemotherapy improves cancer survival by only 2%. I was pointing out that that figure was an average that included many common cancers where improved survival is not expected, but where, if used, chemotherapy may provide useful palliation, and that that figure does not apply to either childhood cancers or leukemias.

    You can’t have it both ways.

    I am not biased against homeopathy, only certain claims it makes. On these very pages I have defended the availability of homeopathic remedies, at least in those countries with strong traditions of its use.. We should limit the claims it is allowed to make, although most of the Western public does , I think, already have some idea of its limitations.

  21. David Gorski says:

    Limitations? As in: Homeopathy is nothing more than water or sugar pills with water mixed in? :-)

  22. libby says:

    pmoran:

    “…the only claim I was making at the time was that you may not know as much as you think about the science relevant to homeopathy. You did not know that such studies have been done.”

    You seemed unaware that a JAMA study demonstrated that gifting by drug companies resulted in non-rational prescribing. Does that compromise your knowledge of medicine?

    “Yes, double blind studies can give false results, but usually as false positives. “

    A good point I hadn’t considered.

    “Nearly always there are active homeopaths involved in the design and performance of the studies. Seeking vindication for their field they naturally choose to study those areas where they believe they are getting their best results.”

    If true, the question remains, why would homeopaths who are knowingly scamming the public submit themselves to a study by their competitor?

    Further to the study you submitted (White et al), the homeopaths were so disgusted by the lack of objectivity and the cherry picking of data that they withdrew their names as authors.

    “So it is not at all unreasonable to expect the studies to be consistently positive if homeopathy worked as claimed, and if homeopaths (and persons like yourself ) were actually able to detect a clear therapeutic signal amidst all the noise and clutter of day-to-day medical activity.”

    My therapeutic signal is that every year my hayfever is gone. The placebo effect, typically lasting for short durations, is a poor explanation.

    “…many homeopaths and ex-homeopaths are now prepared to admit that homeopathy “works” via placebo and other non-specific effects.”

    Who are the homeopaths that are saying these things?

    “On these very pages I have defended the availability of homeopathic remedies, at least in those countries with strong traditions of its use.”

    Actually in my country the battle is being won to limit the availability of many items. That means that more and more options that I find effective are being closed out.

    In Canada natural health products are now classified as drugs because they make medical claims. On the other hand, General Mills is allowed to place medical claims on their boxes of Honey Nut Cheerios (can help lower cholesterol & reduce the risk of heart disease) without suffering regulatory issues of any kind.

    1. Harriet Hall says:

      @libby,

      “My therapeutic signal is that every year my hayfever is gone. The placebo effect, typically lasting for short durations, is a poor explanation.”

      We have tried to explain to you that there are other possible explanations. The fact that improvement follows taking a homeopathic remedy doesn’t prove that the improvement was caused by the remedy. That’s a logical fallacy: post hoc ergo propter hoc.

  23. WilliamLawrenceUtridge says:

    Libby, you may benefit from a thorough review of SBM’s postings in the vaccines and homeopathy categories. Most of your talking points are addressed there. You’re not really presenting much that is new, which is why your reception isn’t exactly rosy. We’ve seen arguments like these before; in fact, we’ve dealt with most of them. And again, you should read Jay Shelton’s book, Homeopathy: How it Really Works.

    If true, the question remains, why would homeopaths who are knowingly scamming the public submit themselves to a study by their competitor?

    Most homeopaths probably do not think they are scamming people, any more than doctors who applied bloodletting and purgatives during the days of prescientific medicine thought they were scamming people. There are a myriad ways the human mind can fool itself, it doesn’t matter if you’re a doctor or a homeopath. We just hope that people will listen to the evidence and discard that which does not work. Doctors do, over years and decades if not over months; it depends on the evidence. Homeopaths may sincerely think they are helping people but that doesn’t mean they actually are.

    My therapeutic signal is that every year my hayfever is gone. The placebo effect, typically lasting for short durations, is a poor explanation.

    Placebo is only one reason your allergies would go away. Allergies also drift, appear and disappear over the span of years. Without a specific test protocol, you simply don’t know. Correlation isn’t causation, but people often fool themselves into believing this is so.

    Actually in my country the battle is being won to limit the availability of many items. That means that more and more options that I find effective are being closed out.

    Ah, health freedom, which is really the freedom to pay money out of pocket for unproven interventions. Although with a public health care system, it becomes the option to spend someone else’s tax dollars. It’s funny that so many people decry drug companies and support “health freedom” for “Big Herbal”, “Big Needle” and “Big Sugar” (homeopathy). Don’t homeopaths, acupuncturists and herbalists make a profit? What about the companies that supply them? Why do you advocate for “health freedom” for CAM interventions, but not prescription drugs, or surgery? Why is it unacceptable that drug companies promote their products when herbalists, acupuncturists and homeopaths do exactly the same thing, except with less evidence, zero mandatory quality control and far, far less oversight in general? That’s a double standard, which is hypocritical.

    In Canada natural health products are now classified as drugs because they make medical claims. On the other hand, General Mills is allowed to place medical claims on their boxes of Honey Nut Cheerios (can help lower cholesterol & reduce the risk of heart disease) without suffering regulatory issues of any kind.

    Honey Nut Cheerios has a medial claim on the box because there is evidence to support soluble fiber lowering cholesterol and reducing the risk of heart disease, the very specific claim made by the manufacturer. Most regulatory schemes are quite reasonable – you must have good quality evidence to claim a treatment effect. I would suggest they do not go far enough though – there should be restrictions on vague claims like “boost the immune system” and “support organ function”, which are made without evidence, are not defined objectively and don’t actually mean anything. There is evidence that Honey Nut Cheerios will do something– lower cholesterol and reduce the risk of heart disease because of the presence of soluble fiber. Wouldn’t you say that statement is more precise and therefore more valuable than “supports organ function” or “boosts the immune system”? Seriously, what’s the issue here, that a processed food is marketed as having health benefits when there is evidence to support it? Why should herb and supplement manufacturers get to make similar, or even broader claims, when they do not have any evidence to support it? That it’s “not natural” therefore it must be inherently bad? Have you fallen prey to the naturalistic fallacy?

  24. libby says:

    HH:

    “We have tried to explain to you that there are other possible explanations.”

    Placebo is the only one that stands out. The rest were a vague collection of mental delusions.

  25. WilliamLawrenceUtridge says:

    The fact that hay fever can naturally fade with time is another possible explanation, and one that the NIH doesn’t appear to consider a mental delusion.

    http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001816/

    By the way, all delusions are mental.

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