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Since when did an apologist for the antivaccination movement, Dr. Jay Gordon, become an “expert” in vaccine law?

I am an alumnus of the University of Michigan twice over. I completed a B.S. in Chemistry with Honors there in 1984 and then I stayed on to do obtain my M.D. in 1988. I look back very fondly on those eight years spent in Ann Arbor, as several of my longtime friendships were forged or solidified during those years. Consequently, I still care about the place. Indeed, I even once tried to see if I could get a position in the Department of Surgery there a few years back, but unfortunately the “fit” just wasn’t there at the time. That’s why it distresses me when I see my alma mater suffer from a self-inflicted wound, almost as much as the plight of the Michigan Wolverines bothers me, given that never before in my life (at least not since I was old enough to pay attention), have the Wolverines sucked so badly and so hard. Given that level of football futility, though, I consider it even more important that my alma mater not provide any more ammunition to those who would enjoy making fun of it. It doesn’t matter to me that I never went to law school at Michigan; it’s all part of the same campus to me.

This time, the embarrassment comes in the form of an article in the Michigan Law Review by a person who has previously been a subject of posts by both Dr. Novella and me. I’m referring to Dr. Jay Gordon, whom we have both–correctly, I believe–labeled as being, if not fully anti-vaccine, at least a prominent and major apologist for the anti-vaccine movement. Unfortunately, because he is the pediatrician taking care of Jenny McCarthy’s son Evan, he has gained even greater prominence in the antivaccine movement than ever, to the point where he gave a speech last summer to the antivaccine “Green Our Vaccines” march on Washington and where he is regularly called up by TV producers to give a false “balance” whenever a discussion of vaccines and/or autism comes up. He also wrote the foreword to Jenny McCarthy’s latest paean to autism quackery and attack on vaccines as the cause of autism in which he blithely repeated some of the worst distortions of the antivaccine movement. Unfortunately, Dr. Gordon lacks the intestinal fortitude to stop the piteous denials any time he is called out for his parroting of antivaccine pseudsocience and to embrace his inner antivaccinationist. Then, at least, we wouldn’t be treated to the spectacle of his simultaneously claiming he is “pro-safe vaccine, not anti-vaccine” while at the same time saying he “doesn’t give a lot of vaccines” and admitting that parents have actually had to persuade him to vaccinate “reluctantly.”

So what was the topic of the Michigan Law Review article that Dr. Gordon was apparently asked to pen? It’s actually an interesting question from a legal, political and civil rights standpoint, specifically: Whether or not parents should be held legally liable for refusing to vaccinate their children. Not surprisingly, Dr. Gordon took the “no” position. Unfortunately, as we’ve come to expect of Dr. Gordon, he uses a number of highly dubious arguments. However, more interesting to me, having had a nearly four year history sparring online with him off and on, was the seemingly “kinder and gentler” antivaccine stance that he took in this article.

But first, let’s take a look at the debate. The symposium published in First Impressions (the online companion to the Michigan Law Review) was entitled Liability for Exercising Personal Belief Exemptions from Vaccination, and it contained the following articles:

  1. Choices Should Have Consequences: Failure to Vaccinate, Harm to Others, and Civil Liability by Douglas S. Diekema.
  2. Parents Should Not be Legally Liable for Refusing to Vaccinate their Children by Dr. Jay Gordon.
  3. Unintended Consequences: The Primacy of Public Trust in Vaccination by Jason L. Schwartz.
  4. Challenging Personal Belief Immunization Exemptions: Considering Legal Responses by Alexandra Stewart.
  5. Gambling with the Health of Others by Stephen P. Teret and John S. Vernick.
  6. The Problem of Vaccination Noncompliance: Public Health Goals and the Limitations of Tort Law by Daniel B. Rubin and Sophie Kasimow

There were a number of fascinating issues raised here. Although it’s obvious that universal vaccination is a public health policy good, given that the higher percentage of vaccinated children, the greater the herd immunity, there is always the nagging question of how far the state should go to mandate vaccination in a free society; i.e., how much coercion is acceptable to bring about maximal levels of vaccination? In other words, what is the proper balance between the needs of society as a whole and the rights of the individual? The next interesting legal and moral question is whether parents who refuse to vaccinate should be held liable for injuries to other children if their unvaccinated child passes on an infectious disease. Personally, I tend to believe that it is entirely reasonable to require vaccination as a precondition for school or day care and that exemptions should be primarily medical in nature. I grudgingly allow that the freedom of religion guaranteed in the First Amendment probably requires religious exemptions (although I do not understand why religion should be given such a privileged place in society that it can endanger public health), I am far less convinced that philosophical exemptions should be mandated. I realize many may disagree with this position, but I would hope that our disagreements would be based on (1) the best science regarding the benefits and risks of vaccination and (2) honest beliefs regarding the proper balance between public health concerns and individual liberty. Clearly, this is an area of debate. I also tend to believe that if parents refuse to vaccinate their child and that child passes an infectious disease to another child, then those parents should be potentially legally liable. Indeed, Douglas Diekema argues this position very well.

Unfortunately, Dr. Gordon does not meet at least condition #1 above. He does not base his arguments on the best science.

A Change of Story

The first thing I noticed when I read Dr. Gordon’s article is that this is a very different Dr. Gordon than I’m used to seeing. Gone are the claims that vaccines cause autism. His most noticeable new trait is that gone are his usual assertions that vaccines cause autism. Indeed, Dr. Gordon didn’t even mention mercury or vaccines as a potential cause of autism once in his entire article! If I believed in miracles, I would write to the Pope and demand that the Church investigate this Michigan Law Review article as being every bit the equal of a divine healing at Lourdes, given Dr. Jay’s history! In order to emphasize the amazing change in Dr. Gordon’s demeanor towards vaccines, let’s take a little trip down memory lane, shall we? Let’s see what Dr. Gordon really thinks about vaccines:

  1. “Vaccines can cause autism.” (from the Foreword to Mother Warriors: A Nation of Parents Healing Autism Against All Odds by Jenny McCarthy.)
  2. “Yes, most vaccines have much less mercury, but wait until the evidence against aluminum in vaccines becomes common knowledge. The body of research regarding aluminum’s harm to human cells already contains hundreds of articles.” (from the Foreword to Mother Warriors: A Nation of Parents Healing Autism Against All Odds by Jenny McCarthy.)
  3. “We can only guess what harm we might be causing to babies with the huge overdoses of aluminum.” (from the Foreword to Mother Warriors: A Nation of Parents Healing Autism Against All Odds by Jenny McCarthy.)
  4. “The official position of the American Academy of Pediatrics may be the same as my personal position, but they are far too involved with the pharmaceutical industry to actually do anything but pay lip service to an open discussion. The CDC and the AAP are filled with doctors whose research, speaking engagements, and travel are often funded by the manufacturers of vaccines. Many of these same doctors are paid consultants, and some later go to work full-time for the pharmaceutical industry.” (from the Foreword to Mother Warriors: A Nation of Parents Healing Autism Against All Odds by Jenny McCarthy.)
  5. “We doctors need to stop deceiving our patients into thinking that immunizations are ‘free.’ Every medical intervention costs the body something, and we have a legal and moral obligation to tell parents.” (from the Foreword to Mother Warriors: A Nation of Parents Healing Autism Against All Odds by Jenny McCarthy.)
  6. “I think the immune system, like every other system of the body, matures slowly, and that it can better tolerate viral infection at older ages and better tolerate one virus at a time. The other thing is that vaccines all contain other ingredients. They contain aluminum, they contain tiny bits of formalin [an aqueous solution of formaldahyde]. So I recommend waiting as long as parents are comfortable, and vaccinating very, very slowly.” (Interview with Cookie Magazine.)
  7. “I don’t give a lot of vaccines.” (from An Open Letter on Vaccines, deconstructed by Steve Novella on SBM.)
  8. “In 1980 I abandoned the recommended vaccine schedule. I received dozens and dozens of phone calls from moms and dads reporting that their child had received shots a couple of days ago and they were acting “a little different.” They couldn’t quite put their finger on it but their child was just not acting quite the same as before I gave the shots. They’d ask if this was okay…was it normal? Initially, as I was trained to do, I replied ‘yes.’ After dozens and dozens and dozens of phone calls, I decided that I had better listen to these moms a lot more.” (from An Open Letter on Vaccines, deconstructed by Steve Novella on SBM.)
  9. “I gave a half dozen vaccines today. I gave some reluctantly but respected parents’ wishes to vaccinate.” (Link.)
  10. “I think that the public health benefits to vaccinating are grossly overstated. I think that if we spent as much time telling people to breastfeed or to quit eating cheese and ice cream, we’d save more lives than we save with the polio vaccine.” (Interview with Cookie Magazine.)

Note that Jenny McCarthy’s book, for which Dr. Gordon wrote the Foreword, was published in September 2008. In fact, none of these are old quotes by Dr. Gordon. Also note that Dr. Gordon has been palling around with some of the most rabid antivaccinationists out there and has become much in demand as a speaker on the antivaccine circuit and a guest on TV shows. That’s because it’s clear that Dr. Gordon believes vaccines do great harm, and he’s good for the “vaccine skeptic” viewpoint. He believes that vaccines are chock full of nasty “toxins” and that they cause autism. He long ago abandoned the conventional vaccination schedule and now is a “brave maverick doctor” who goes his own way. No meekly following along with the herd of pediatricians in thrall to big pharma-controlled whims of the CDC and AAP, he! No reliance on large epidemiological studies showing no link between either mercury in vaccines and autism or vaccines themselves and autism!

So what does he say about vaccination for this article for the Michigan Law Review? As I said before, we see a “kinder, gentler” Dr. Gordon:

Over many years, seeing thousands of children, my point of view about childhood vaccines has changed. I believe that parents have the right to decide when and how their children receive vaccinations and also have the right to decline any or all vaccines. Like many medical interventions, vaccines have risks and benefits, and parents may elect nonvaccination as the better choice for an individual child. The societal ramifications are significant and should certainly be a part of any discussion.

So far, this is nothing different from what Dr. Gordon’s been saying all along, albeit couched in less inflammatory language and cleverly framed as an issue of individual freedom. What has changed is that Dr. Gordon now admits that societal ramifications are important and that they should be part of any discussion. Quite frankly, in all my years sparring with him, I do not recall his ever admitting that societal ramifications mattered one whit. Perhaps this is the beginning of a change in Dr. Gordon.

Or not:

When children or babies who have been in contact with other children (or adults) contract most illnesses, there is no feasible way to know from whom they got the disease. Whether one is talking about a routine winter viral illness, chickenpox, or whooping cough, the contagion could have come from a child with overt disease signs and symptoms, an asymptomatic carrier, or another, perhaps mutual, contact. Vaccines are not 100% effective, so that even a fully vaccinated child can contract an illness or carry that illness and give it to another child. Blaming a specific individual—let alone suing one—because your child gets sick has no credible medical basis.

As Autism News Beat points out, this is easily demonstrably false. He used the example of the recent San Diego outbreak of measles, where it was quite feasible to trace the outbreak to a single unimmunized seven-year-old who caught the disease while on vacation in Switzerland. In fact, it was possible even to determine with a high degree of probability when and where this child infected other children with his particular strain of measles. Apparently the disciplines of molecular diagnostics and forensics are too new for Dr. Gordon to be aware of them. But it’s even worse than that. He seems completely oblivious that such techniques are applied to outbreaks all the time to identify the strains of bacteria or virus that are responsible for an outbreak. It’s done all the time in the case of outbreaks of food contamination: The specific strain of E. coli or Salmonella is routinely traced back to the manufacturer all the way back through the chain of distribution, starting at the product purchased and following the infection back to through the chain of distribution to the manufacturer. The concept is the same for tracing the source of an outbreak. It beggars the imagination that Dr. Gordon could be so oblivious to these simple facts. Of course, he’s more interested in demonizing vaccines than in being scientifically accurate. Same as it ever was. He’s just become subtler about it:

There are many valid reasons to support vaccination, but they don’t support removing the right to refuse vaccinations. There are also situations—medical and personal—which justify waiving all or some childhood vaccines, but these are not good reasons to abandon vaccines altogether.

There you go again, Dr. Jay, with the false dilemma. No, it is not a matter of either abandoning vaccinations altogether versus total support. It’s not a choice between supporting vaccination or abandoning vaccines altogether. But, again, Dr. Gordon’s false dilemma is even more false than that. It doesn’t require abandoning vaccination altogether to endanger public health. Just having the vaccination rate drop below the rate necessary for herd immunity (90% in most cases) will do. At that point, outbreaks become increasingly more likely, as our British friends have discovered. Indeed, that’s the reasons measles is now endemic again in the U.K. after having been declared eradicated a mere 15 years ago. It was the antivaccine movement spurred on by the dubious “findings” of the “research” of Andrew Wakefield that scared U.K. parents into not vaccinating, with MMR uptake rates falling below 80% in some areas. The results were predictable, and they came true.

Dr. Gordon also goes on to pull out the false equivalency argument:

Parents who vaccinate their children base their decisions on the advice they receive from their pediatricians and the other knowledge they have gathered. Parents who choose to waive vaccinations do so for similarly valid reasons.

Very clever, Dr. Jay. Unfortunately, Dr. Jay neglects to mention that there are antivaccine groups out there dedicated to feeding an unrelenting stream of propaganda based on dubious or no science demonizing vaccines to parents, aided and abetted by certain pediatricians. I do like the not-so-subtle implications that Dr. Gordon’s advice based on his own easily fooled personal clinical observations, is the equivalent of science-based recommendations about vaccinations. I’ll give him a hint.

They aren’t.

But Dr. Gordon’s not finished yet with the false dilemmas yet:

Adverse outcomes can occur from both vaccination and nonvaccination. Vaccines work very well at creating immunity to illnesses, so there are very few situations that would likely lead to transmission of an illness from an unvaccinated child to a vaccinated child. The obvious exceptions would be infants too young to have received a full complement of shots and immuno-compromised children. Parents must protect these two groups of children by keeping them away from too many other children. Period. Newborns and young babies are at risk any time they are in public. We can only vaccinate against a very small minority of contagious illnesses; it is unwise to bring your newborn into preschool when you pick up your toddler, and equally risky to attend older children’s birthday parties with this baby. Further, parents of children taking high dose steroids for asthma or receiving immunosuppressive medicine for other diseases are strongly cautioned by their doctors to avoid the potential dangers I have described.

Although I am highly gratified that Dr. Gordon has finally–finally!–admitted the efficacy of vaccination in preventing infectious disease and that unvaccinated (or undervaccinated) children should be kept away from the unvaccinated, I reluctantly have to point out that the vaccinated can be infected by the unvaccinated. The reason, of course, is that no vaccine is 100% effective, as much as we would wish that it was. Indeed, if vaccines were 100% effective, then herd immunity wouldn’t be so important. Vaccinated children can be infected by the unvaccinated.

Dr. Gordon goes on to question the efficacy of the influenza and varicella zoster (chickenpox) vaccines. Note how he chooses vaccines that are a bit more controversial and for which the evidence supporting universal vaccination is not quite as overwhelming as for other vaccines. The reason is transparent, at least to me. By going after the “weaker” vaccines in the vaccine schedule, Dr. Gordon hopes to convince readers that there is a similar level of doubt about the entire vaccine schedule, a level of doubt so high that it is not unreasonable for parents to refuse to vaccinate based on the beliefs that vaccines are not that efficacious in preventing disease and that they carry unacceptable risks. Everything in Dr. Gordon’s editorial is designed to cast the efficacy and risks of vaccines in the worst possible light. Then he plays the “victim” card, whining that parents who refuse to vaccinate have been unfairly “vilified”:

In the absence of facts, doctors and others are trying to frighten people into vaccinating or not vaccinating. That fear includes the notions that unvaccinated children pose a great threat to others and that parents of these children are not being responsible. In fact, these parents are choosing what they consider to be the safest course of action for their children and pose very little, if any, danger to other children and adults.

I find this particulary ironic, given that Dr. Gordon and the mother of one of his patients, Jenny McCarthy, have been two of the most prominent of those frightening people into not vaccinating their children. Dr. Gordon appears oblivious to any responsibility he might bear for appearing on TV shows arguing that vaccines cause autism or credulously repeating the exaggeration and misinformation spread by Jenny McCarthy, J.B. Handley, and the rest of the antivaccine movement about formaldehyde, aluminum, and other allegedly horrible “toxins” in vaccines that are not toxic at the levels present in vaccines. He himself has joined in spreading fear–fear of vaccines–by demonizing vaccines every opportunity he gets, including this law review article. Indeed, he takes it to a level I haven’t seen before:

Some medical interventions are not controversial, and some prompt only mild controversy. For example, if a child has acute lymphocytic leukemia, the cure rate with conventional medical care approaches ninety percent, and very few doctors or parents will argue against the standard treatments offered in spite of their known complications and adverse reactions. But vaccines are presently controversial, and purported truths about safety and efficacy are challenged daily by lay people and physicians.

Wow. Just wow. Did Dr. Gordon actually just compare vaccines to chemotherapy for ALL? I believe he just did, even though any level of risk from vaccines is many orders of magnitude below those that chemotherapy poses. He also falsely labels vaccines as “controversial.” They are not, at least not among science-based physicians. The “controversy,” such as it is, is in reality what is commonly termed a “manufactroversy,” in other words, a controversy manufactured where none existed before, at least among scientists. Dr. Gordon is desperate to paint the manufactroversy about vaccines as a real scientific controversy. Of course, he’s a bit hamstrung in that he seems unable or unwilling in this particular venue to let his freak flag fly and come right out and say that he believes vaccines cause autism, neurodevelopmental disorders, and a variety of immune disorders, such as asthma, as he has in other venues. What he does do is to point out the “CYA” language in the package inserts of vaccines and try to “jazz it up” as evidence that vaccines are very, very dangerous. He then returns to his favorite technique in this article, the false dichotomy:

The list of side effects from adverse reactions to vaccines, in a Physicians’ Desk Reference “warning” section, given out of context, would probably frighten many parents out of vaccinating at all. There are thirty or more items on that list. Similarly, the list of symptoms and complications of the illnesses against which we vaccinate could scare parents into giving every shot available as soon as possible.

Pediatricians and other physicians use the latter option on a daily basis.I share my colleagues’ disdain for scare tactics from the “antivaccine” camp, but I object equally to doctors using fear and misinformation to try to convince parents (and legislators) that vaccines are risk free. Both sides are distorting the truth for their own purposes. Childhood illnesses are part of the first decade of life; immunity is acquired, and the consequences are almost always minor.

I suppose that’s why the “harmless” measles is the leading cause of preventable mortality worldwide, killing around 200,000 children a year worldwide. Of course, it was much worse before mass vaccination programs. Ten years ago, measles killed around 900,000 children. And why has the mortality fallen so much. The reason is mass vaccination programs spearheaded by WHO.

My irony meter also just about exploded at Dr. Gordon’s “disdain” for the scare tactics from the antivaccine camp (note his use of quotation marks!) given that he himself has engaged in many of the exact same scare tactics of the antivaccine fringe, be they the “formaldehyde” gambit, the “toxins” gambit, or fear mongering about mercury. The hypocrisy and use of the logical fallacy of the false dichotomy are astounding, even by Dr. Gordon’s usual standards.

So much for the “kinder, gentler” Dr. Jay, I guess.

    Conclusion

I’m very, very disappointed in the editorial staff of the Michigan Law Review, including Editor-in-Chief Adrienne Fowler, and Managing Editor Stefan Atkinson, for having fallen for Dr. Gordon’s portrayal of himself as some sort of expert on issues related to vaccination, be they medical or legal. He is an expert on neither immunology, vaccination, nor the law. As an alumnus of the University of Michigan, albeit not the Law School, I’m very unhappy to see such a self-inflicted black eye. The reason is simple, and I’m going to use a saying that I have permission to steal blatantly from a couple of online acquaintances: Relying on Dr. Jay Gordon for legal acumen and advice is akin to appointing Judge Judy to the Supreme Court. It’s bad enough that the line between news and entertainment has all but disappeared. There are two exceptions, of course. Judge Judy is actually a retired judge; Dr. Gordon has no experience in the legal profession. In addition, Judge Judy, while chaff entertainment, does not have a reputation for being spectacularly wrong so often. Dr. Gordon, as shown above, does. Apparently the editors were blinded by the glare of his celebrity associations. I can’t really think of any other reason why they would have chosen him as an “expert” to write an editorial as part of this online symposium.

That is why I, as a disheartened alumnus of the University of Michigan, urge any other fellow alumni of U. of M., or anyone concerned with medical and legal accuracy and the application of science-based medicine to the issue of mandatory vaccination, to write to Ms. Fowler (aefowler@umich.edu) and Mr. Atkinson (stefanat@umich.edu) to voice a strong complaint over their having published the misinformation and exaggerations of a pediatrician known to be an apologist for the antivaccine movement. The issue of legal liability for parents who refuse to vaccinate is a contentious and fascinating issue that is ill-served by the self-serving and misinformed posturing of someone like Dr. Gordon. Indeed, reading all the articles in this rather interesting issue, it is clear to me that the debate is actually far more informative without Dr. Gordon’s contribution, such as it is.

And if you do write to the Michigan Law Review, please feel free to cc: a copy to Dr. Jay himself. Tell him Dr. Gorski said hi.

Posted in: Politics and Regulation, Public Health, Vaccines

Leave a Comment (18) ↓

18 thoughts on “Since when did an apologist for the antivaccination movement, Dr. Jay Gordon, become an “expert” in vaccine law?

  1. Ex-drone says:

    You mean he missed the chance to cite his interview with Cookie Magazine in his article? Such modesty.

  2. DevoutCatalyst says:

    He’s a polio denier?

  3. MKandefer says:

    “I grudgingly allow that the freedom of religion guaranteed in the First Amendment probably requires religious exemptions (although I do not understand why religion should be given such a privileged place in society that it can endanger public health), I am far less convinced that philosophical exemptions should be mandated.”

    There’s been an issue recently in New York about this. The group My Kids, My Choice is looking to get a bill (A883) passed that prevents probing interviews like the one depicted here: http://www.youtube.com/user/freechoiceforall

    I can’t say that I disagree with the language of the bill as it seems too invasive to ask individuals to justify their religion, which is being used to opt out of the vaccination program. In the video depicted the individuals are Catholics, and the nazi-pope hasn’t yet taken his anti-science agenda to vaccinations, as far as I know, so it is dubious claim in the first place. However, who’s to say that these people are interpreting certain passages of their magic book erroneously? Certainly, this lawyer has chosen to, but in doing so in this manner, has made the state and the vaccination program appear malicious.

    That said, I’m against opting out of the vaccination program for religious reasons. Once your religious beliefs can demonstratively cause harm, then they should no longer be protected under the law. Whether it be your god’s demands for blood sacrifice, or that your god’s words of protection are the only things you feel are necessary to protect you. It’s ridiculous that others must suffer for another’s delusions.

  4. mariawolters says:

    “[...] it is unwise to bring your newborn into preschool when you pick up your toddler, and equally risky to attend older children’s birthday parties with this baby.

    What? What???!!!??? What is this guy smoking – and he calls himself a pediatrician? How ON EARTH is a mother supposed to pick up her toddler from preschool while leaving her baby at home? So that’s no more parties, preschool, or play dates for the older kid, then?

    The preschool germs will make their way into your house and your newborn whether you pick your older child up or not. They like to travel in a precious little warm and toasty container called Child Number One and will be snotted, spat, and rubbed all over Child Number Two in no time.

    Of course, where Dr Gordon practices, One has a Nanny (or two) to ensure that Newborn is kept in pristine isolation.

  5. Karl Withakay says:

    There are limits to the first amendment rights of free speech and freedom of religion.

    You can’t sacrifice your first born or your neighbor to the god of your choice, and you can’t yell “fire” in a crowded building when you know there’s no fire.

    The is a point where your religious beliefs cannot be allowed to endanger the lives or welfare of others.

    There is also a point, where sufficient evidence has been presented to you as proof that there is no fire, or even smoke, that you should not be allowed to continue to yell fire in a crowded building even though you still personally believe there is a fire.

    I’m sure someone will respond with a slippery slope argument.

  6. Diane says:

    I found this podcast very interesting – it’s an interview with Paul Offitt who has written the book, Autism’s False Prophets.

    You can find it by going here.
    http://docartemis.com/blog/2009/01/31/books-25-vaccines/

    The interview is by Ginger Campbell, an ER physician who still finds time to produce a large number of podcasts for a series she calls Books and Ideas, as well as another series, Brain Science Podcasts.

    Her mission seems to be to spread good information out to everyone/anyone who might be on the receiving end of bad information. To that end she has become very adept at using internet technology.

  7. I note Jay Gordon seems to love to show up on your other blog to make sure to address you as “Dave” and spout off about his “beliefs.” Somehow he likes it better than over here, where there are multiple, non-pseudonymous physicians to take him on. Could it be he basks in the publicity and exposure of the other site??? Hmmmmm… ;)

  8. ingridity says:

    This blog seems to have just as strong “beliefs” around the safety of vaccines as the anti-vaxers have around the danger of vaccines. They are beliefs and opinions based on just as much problematic “science” as the anti-vaxers.

    Until you can definitively PROVE that vaccines are safe – which has NOT been done – go actually LOOK at the science behind those studies – it is ridiculous to require people to get shots that contain toxic substances, especially for very low risk diseases like chicken pox! As long as vaccine safety is up for debate, there is absolutely no reason to hold anyone liable for choosing to forgo vaccines.

    How would one prove vaccines are safe and not responsible for the autism epidemic? Definitively?

    For me, if I could see a group of studies that show there is no higher rate of neurological disorders between vax’d and non-vax’d kids, then that would be rather convincing. However – NO STUDIES have been done in this vein. NONE. Until such studies are done, the case is not closed. And the crazy part here is – HOW HARD would it really be to do such studies? It seems nuts to me that we haven’t!

    All the “good science” studies done to date are problematic because they don’t have a control group they’re looking at – a group where the children haven’t been vaccinated at all. If you compare kids who receive 30 shots to those who receive 31 and don’t find a difference in the rates of neurological disorders – what does that prove about vaccine safety? Nothing. It proves that one shot is not enough to make a difference in the rate of neurological disorders. Big whoop. It’s like studying the difference in cancer rates between people who smoke 30 cigarettes a day vs 31… and then seeing that the cancer rates are the same – would YOU conclude that there’s no link between smoking and cancer because one cigarette did not make much of a difference? And yet this is the conclusion vaccine manufacturers want us to jump to after they study the MMR vaccine … it’s bizarre!

  9. David Gorski says:

    I note Jay Gordon seems to love to show up on your other blog to make sure to address you as “Dave” and spout off about his “beliefs.” Somehow he likes it better than over here, where there are multiple, non-pseudonymous physicians to take him on. Could it be he basks in the publicity and exposure of the other site??? Hmmmmm…

    He’ll be there again after today’s post. Trust me. As for “ingridity,” she is spewing the same antivax talking points that I get tired of rebutting. Perhaps I’ll incorporated some rebuttals into my post for Monday, in which I had planned on discussing Wakefield and the Autism Omnibus verdicts as part of a more global view.

  10. Oh, I’m looking forward to it!

    :gets popcorn:

  11. just the facts says:

    As an alumnus of the University of Michigan and a person interested in the accurate representation of facts, I have some comments on your review of the January issue of the Michigan Law Review. Your comments about Jay Gordon’s lack of legal expertise imply that the authors of the five other opinions in the Review are all legal experts. On the contrary, only two of the six opinions are written by legal experts. Two opinions were written by physicians and the remaining two were written by experts in bioethics and public health. Two joint contributors have knowledge in both areas (Teret, JD, MPH and Vernick, JD, MPH), although one could argue whether or not a MPH qualifies one as a medical expert.

    You list the titles and authors of the six reviews, yet you include the professional title of only one, Jay Gordon. This is misleading as it appears he is the only physician contributing to the forum. Douglas Diekema is also a physician. Your comments about lack of legal expertise would apply equally to him, as well as to the bioethics expert Mr. Schwartz and the Public Health expert Ms. Stewart. None of these people were chosen for their knowledge of the law.

    According to the biographical information in his opinion piece, Jay Gordon has been a pediatrician in private practice for almost thirty years. Douglas Diekema also has some experience in pediatric care, as attending physician for the emergency department of Seattle Children’s Hospital. Jay Gordon is the only person contributing to this review who is qualified to speak as a practicing pediatrician. As the majority of immunization practices take place in pediatricians’ offices, he provides valid input.

  12. just the facts says:

    You make a blanket statement about the societal benefits of vaccine-induced herd immunity that is quite a powder keg for a proponent of science based medicine. “Although it’s obvious that universal vaccination is a public health policy good, given that the higher percentage of vaccinated children, the greater the herd immunity….” Herd or community immunity theory is a complex subject and your statement is apparently based upon an oversimplified version of that theory.

    As you may know, it is a misconception that there is one all-encompassing herd labeled “society as a whole”. For epidemiological purposes there are different societal “herds” based upon age, socioeconomic status, ethnicity, etc. For some diseases, such as measles and varicella, mass vaccination benefits some “herds” while creating new “herds” of higher risk susceptibles due to the temporary nature of vaccine-induced immunity (resulting in waning immunity or secondary vaccine failure). With measles in particular, even if 100% of the school age “herd” are vaccinated, due to the combination of primary and secondary vaccine failure there will continue to be increasing numbers of new higher risk susceptibles in the infant and adult “herds”.

    What’s the solution? Life-long boosters for adults? It is unlikely that the U.S. adult “herd” will ever comply with mass vaccination at the unprecedented coverage rates we currently see in the school age “herd”. One reason is the lack of legal enforcement for adult vaccination analogous to the individual state-mandated school entry requirements for children. Where does that leave us? Two studies published in peer reviewed journals model a “post-honeymoon period” U.S. re-emergence of measles over time such that by 2050 the same percentage of the population as a whole (10%) will be susceptible to measles as was susceptible in the pre-vaccine era, but the susceptibles will have been redistributed from the school age “herd” to the adult and infant “herds”, with much higher risk of complications and mortality. The Levy study cited below states that in theory, a measles epidemic in 2050 could result in over 25,000 deaths. The pre-vaccine era annual mortality rate was approximately 450.

    Levy, D. The future of measles in highly immunized populations: a modeling approach. Am J Epidemiol (1984);120:39-48

    Mossong J, Muller CP, Modelling measles re-emergence as a result of waning of immunity in vaccinated populations, Vaccine 21 (2003): 4597-4603

    In my opinion, one problem with the self-proclaimed “skeptical” perspective is that it purports to be based on fact, but is so often accompanied by a healthy dose of bias and ego. A more objective review of the facts would behoove this “science based medicine” forum.

  13. Chris says:

    just the facts said

    Levy, D. The future of measles in highly immunized populations: a modeling approach. Am J Epidemiol (1984);120:39-48

    Mossong J, Muller CP, Modelling measles re-emergence as a result of waning of immunity in vaccinated populations, Vaccine 21 (2003): 4597-4603

    Dude, those are just mathematical models done on computers. I did not notice this before, but looking at the abstracts: They don’t say what you want them to say. In fact the final sentence in the Levy abstract is “Present vaccine technology and public health policy must be altered to deal with this eventuality.”, which basically means booster shots!

    (by the way, as a structural dynamist who uses comptuter models, let me tell you… they are far from perfect!)

  14. Chris says:

    just the facts said “n my opinion, one problem with the self-proclaimed “skeptical” perspective is that it purports to be based on fact,”

    Oops, just noticed this (and my previous comment is in the ether). This is funny, considering the papers you cited were not based on fact, but are actually epidemiological computer models.

  15. just the facts says:

    The fact that infants are a new and growing group of susceptibles is well documented. This is what accounts for the higher mortality rate of the 1989-91 resurgence.

    “During the 1989 to 1991 measles resurgence in the United States, the age-specific incidence of measles was highest among infants 15 months of age (the standard age for measles vaccination at that time). Despite comprising only 2% of the general population, infants 15 months of age accounted for 24% of the 55 622 reported measles cases from 1989 to 1991. This is the highest proportion of cases accounted for by this age group since detailed age reporting began in 1985, and this supports the theory of increased susceptibility to measles in this age group.”

    “Most infants are protected from measles by passively acquired maternal antibody from birth until the antibody is depleted. The duration of protection is dependent to a great extent on the amount of antibody received by the infant during pregnancy, which is directly related to the maternal antibody titer. Women who have had measles disease have high measles antibody titers, women who have not had measles but have been vaccinated effectively have lower antibody titers, and women who have neither had measles nor been vaccinated effectively have no measles antibody. ”

    “Infants whose mothers were born after 1963 are more susceptible to measles than are infants of older mothers. An increasing proportion of infants born in the United States may be susceptible to measles.”

    Increased Susceptibility to Measles in Infants in the United States
    Mark Papania, MD, MPH et al PEDIATRICS Vol. 104 No. 5 November 1999, p. e59

  16. just the facts says:

    That fact that infants are a new and growing group of susceptibles is well documented.

    “During the 1989 to 1991 measles resurgence in the United States, the age-specific incidence of measles was highest among infants 15 months of age (the standard age for measles vaccination at that time). Despite comprising only 2% of the general population, infants 15 months of age accounted for 24% of the 55 622 reported measles cases from 1989 to 1991. This is the highest proportion of cases accounted for by this age group since detailed age reporting began in 1985, and this supports the theory of increased susceptibility to measles in this age group.”

    “Most infants are protected from measles by passively acquired maternal antibody from birth until the antibody is depleted. The duration of protection is dependent to a great extent on the amount of antibody received by the infant during pregnancy, which is directly related to the maternal antibody titer. Women who have had measles disease have high measles antibody titers, women who have not had measles but have been vaccinated effectively have lower antibody titers, and women who have neither had measles nor been vaccinated effectively have no measles antibody.”

    “Infants whose mothers were born after 1963 are more susceptible to measles than are infants of older mothers. An increasing proportion of infants born in the United States may be susceptible to measles.”

    Increased Susceptibility to Measles in Infants in the United States
    Mark Papania, MD, MPH et al PEDIATRICS Vol. 104 No. 5 November 1999, p. e59

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