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No, the CDC did not just “admit” that this year’s flu vaccine doesn’t work

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Since the press release was originally issued on Thursday by now surely most of you have seen the news stories that popped up beginning yesterday morning with headlines like “CDC Warning: Flu Viruses Mutate and Evade Current Vaccine“, or “Flu vaccine protects against wrong strain, US health officials warn“, or “Flu shots may not be good match for 2014-15 virus, CDC says“, or “Health Officials Warn This Year’s Flu Vaccine Won’t Prevent New H3N2 Strain Of Influenza“. You get the idea. This year, apparently, the flu vaccine isn’t as effective as health officials and physicians would like. How could this have happened?

Those of you who are knowledgeable about the flu vaccine know that, as useful as it is, it’s not one of the greatest vaccines as far as effectiveness. Actually, that’s not true. Its effectiveness can and does vary considerably from year to year. The reason is simple. There are many strains of influenza, and the vaccine as currently formulated generally only covers a handful of strains. Basically, every year the World Health Organization, in collaboration with the CDC and other health organizations throughout the world, has to make an educated guess which strains of influenza will be circulating the following winter. Many months’ lead time is required because vaccine manufacturers require it to develop and test the new formulations and then to ramp up their manufacturing capabilities and distribute the vaccine. Generally, the WHO chooses the three strains it deems most likely to cause significant human suffering and death in the coming flu season. Specifically, the chosen strains are the H1N1, H3N2, and Type-B, although, starting with the 2012–2013 Northern Hemisphere influenza season, the WHO has also recommended a second B-strain for use in quadrivalent (four strain) vaccines. Basically, the WHO coordinates the contents of the vaccine each year to contain the most likely strains of the virus to attack the next year. Wikipedia has a helpful article that lists the formulations of all the flu vaccines recommended for the Northern and Southern Hemispheres dating back to 1998, to give you an idea what’s been recommended in the past. Also, there are exceptions. In the 2009-2010 season, for example, the H1N1 pandemic was occurring, and it was recommended that everyone be vaccinated against H1N1 in addition to the normal flu vaccine.
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Posted in: Vaccines

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Fear mongering about vaccines as “racist population control” in Kenya

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There are many conspiracy theories about vaccines, and they circulate almost continuously. Some are relatively new, but most are at least a few years old. They all tend to fall into several defined types, such as the “CDC whistleblower” story, which posits that the “CDC knew” all these years that vaccines cause autism but covered it up, even going so far as to commit scientific fraud to do so. Of the many other myths about vaccines that stubbornly persist despite all evidence showing them not only to be untrue but to be risibly, pseudoscientifically untrue, among whose number are myths that vaccines cause autism, sudden infant death syndrome, and a syndrome that so resembles shaken baby syndrome (more correctly called abusive head trauma) that shaken baby syndrome is a misdiagnosis for vaccine injury, the antivaccine conspiracy theory that vaccines are being used for population control is one of the most persistent. In this myth, vaccines are not designed to protect populations of impoverished nations against diseases like the measles, which still kills hundreds of thousands of people a year outside of developed countries. Oh, no. Rather, according to this myth, vaccines are in fact a surreptitious instrument of population control designed to render people sterile, for whatever nefarious reasons the powers that be have to want to control the population.

You might recall how a few years ago antivaccinationists leaped on a statement by Bill Gates that “if we do a really great job on new vaccines, health care, reproductive health services, we could lower that [population] by perhaps 10 or 15 percent.” They used it to accuse Gates of being a eugenicist and that vaccines were in actuality an instrument of global depopulation. It was a ridiculous charge of course. In context, it was clear that Gates was referring to how the expected population increase from 6.8 billion to 9 billion could be blunted by providing good health care, including reproductive care and vaccines, to impoverished people in regions where the population increases are expected to be greatest. He was clearly referring to decreasing the expected population increase by 10% or 15%, meaning that instead of going up to 9 billion the population would only increase to between 7.65 and 8.1 billion. In other words, he was referring to how good health care could decrease the expected rate of population growth, not how vaccines could be used to depopulate the world. However, because of the prevalence of the myth that vaccines are sterilizing agents intended for global depopulation, the charge that Gates is a eugenicist, as obviously off base as it is to reasonable people, resonated in the anti-science world of antivaccinationists. Similar claims, namely that there is “something” in vaccines that results in infertility and sterilization, have been unfortunately very effective in frightening people in Third World countries and have played a major role in antivaccine campaigns that have delayed the eradication of polio.
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Posted in: Religion, Vaccines

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Blaming breast cancer on autism

From the Wikimedia Commons, originally posted by Flickr user Alex E. Proimos (link)

From the Wikimedia Commons, originally posted by Flickr user Alex E. Proimos (link)

Gayle DeLong has been diagnosed with what she refers to as “autism-induced breast cancer”. She’s even given it an abbreviation, AIBC. Unfortunately, as you might be able to tell by the name she’s given her breast cancer, she is also showing signs of falling into the same errors in thinking with respect to her breast cancer as she clearly has with respect to autism. As a breast cancer surgeon, regardless of my personal opinion of DeLong’s anti-vaccine beliefs, I can only hope that she comes to her senses and undergoes science-based treatment, but I fear she will not, as you will see. Her brief post announcing her diagnosis and blaming it on autism, however, does provide what I like to call a “teachable moment” about cancer.

We’ve met DeLong before on this blog. For instance, she published an execrably bad study that—of course!—tried to link vaccine to autism and failed miserably, despite doing some amazing contortions of analysis, combining diagnoses willy-nilly, all in the service of the discredited vaccine-autism hypothesis. As I said at the time, it just goes to show that someone who is an associate professor of economics and finance shouldn’t be doing epidemiological research. As I also described at the time, if the sorts of analytical techniques she used in her study are acceptable in the world of economics and finance, no wonder our economy has been so screwed up for so long. Another time, DeLong wrote a broadside against the regulatory machinery that oversees vaccine development and safety that was full of the usual antivaccine misinformation, tropes, and pseudoscience and hugely exaggerated perceived “conflicts of interest” among the various parties.
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Posted in: Cancer, Neuroscience/Mental Health, Vaccines

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Brian Hooker and Andrew Wakefield accuse the CDC of scientific fraud. Irony meters everywhere explode.

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The antivaccine movement and conspiracy theories go together like beer and Buffalo wings, except that neither are as good as, yes, beer and Buffalo wings. (Maybe it’s more like manure and compost.) In any case, the antivaccine movement is rife with conspiracy theories. I’ve heard and written about more than I can remember right now, and I’m under no illusion that I’ve heard anywhere near all of them. Indeed, it seems that every month I see a new one.

There is, however, a granddaddy of conspiracy theories among antivaccinationists, or, as it’s been called, the central conspiracy theory of the antivaccine movement. That conspiracy theory postulates that “they” (in the U.S, the CDC) have known for a long time that vaccines cause autism, but “they” are covering it up. In other words, the CDC has, according to this conspiracy theory, been intentionally hiding and suppressing evidence that antivaccinationists were right all along and vaccines do cause autism. Never mind what the science really says (that vaccines do work don’t cause autism)! To the antivaccine contingent, that science is “fraudulent” and the CDC knew it! Why do you think that the antivaccine movement, in particular Robert F. Kennedy, Jr., went full mental jacket when Poul Thorsen was accused of financial shenanigans (i.e., fraud) with grant money from the federal government? It was a perfect story to distract from the inconvenient lack of science supporting the antivaccine view that vaccines cause autism. More importantly, from the antivaccine standpoint, it was seen as “validation” that the CDC studies failing to find a link between autism and vaccines were either fraudulent or incompetently performed. Why? Because Thorsen was co-investigator on a couple of the key studies that failed to find a link between the MMR and autism, antivaccinationists thought that his apparent financial fraud must mean that he committed scientific fraud. They’re the same thing, right? Well, not really. There were a lot of co-investigators, and Thorsen was only a middle author on those studies.
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Posted in: Neuroscience/Mental Health, Public Health, Vaccines

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What naturopaths say to each other when they think no one’s listening

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The true test of a man’s character is what he does when no one is watching.

— John Wooden

 

Regular readers might have gathered from reading this blog that we are not particularly fond of naturopaths. Actually, naturopaths themselves might be perfectly nice people; rather it’s naturopathy we don’t like, mainly because it is a cornucopia of quackery based on prescientific vitalism mixed with a Chinese restaurant menu “one from column A, two from column B” approach to picking quackery and pseudoscience to apply to patients. Indeed, Scott Gavura features as an excellent recurring series “Naturopathy vs. Science,” which has included editions such as the Facts Edition, Prenatal Vitamins, Vaccination Edition, Allergy Edition, and, of course, the Infertility Edition. Of course, as I’ve pointed out, any “discipline” that counts homeopathy as an integral part of it, as naturopathy does to the point of requiring many hours of homeopathy instruction in naturopathy school and including it as part of its licensing examination, cannot ever be considered to be science-based, and this blog is, after all, Science-based Medicine. Not surprisingly, we oppose any licensing or expansion of the scope of practice of naturopaths, because, as we’ve explained time and time again, naturopathy is pseudoscience and quackery.

A couple of weeks ago, over at my not-so-super-secret other blog, I was “celebrating” (if you will) Naturopathy Week. During that week, one of my readers brought to my attention something that, more than anything else, shows the truth of the quote with which I started this post and another similar quote by J.C. Watts that goes, “Character is doing the right thing when nobody’s looking.” I’m referring to the contents of a subreddit posted by a user going by the ‘nym “Naturowhat,” Read what naturopaths say to one another. Conclusion: manipulative, poorly trained, and a threat to public health. Now, I’m not a big fan of Reddit, largely because I can’t figure out how to find things easily, and I hate the sheer ugly and user hostile format of it. However, beggars can’t be choosers; so Reddit it was to examine what naturopaths say to each other when they think no one is looking. I hadn’t planned to comment on this again, but Jann Bellamy thought that our readers would be interested, and who am I to question Jann’s judgment, particularly on a weekend when I was deep into grant writing?
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Posted in: Naturopathy, Vaccines

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Andrew Wakefield, the MMR, and a “mother warrior’s” fabricated vaccine injury story

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As the time came to do my usual weekly post for this blog, I was torn over what to write about. Regular readers might have noticed that a certain dubious cancer doctor about whom I’ve written twice before has been agitating in the comments for me to pay attention to him, after having sent more e-mails to me and various deans at my medical school “challenging” me to publish a link to his results and threatening to go to the local press to see if he can drum up interest in this “battle.” I’ve been assiduously ignoring him, but over time the irritation factor made me want to tell him, “Be very careful what you ask for. You might just get it.” Then I’d make this week’s post about him, even though I wasn’t thrilled with the idea of giving in to his harassment and giving him what he wants.

That’s why I have to thank the ever-intrepid investigative reporter Brian Deer for providing me an alternative topic that is way more important than some self-important little quack and a compelling topic to blog about in its own right. Brian Deer, as you might recall, remains the one journalist who was able to crack the facade of seeming scientific legitimacy built up by antivaccine guru Andrew Wakefield and demonstrate that (1) Wakefield’s work concluding that the MMR vaccine was associated with “autistic enterocolitis” was bought and paid for by a solicitor named Richard Barr, who represented British parents looking to sue vaccine manufacturers, to the tune of over £400,000; (2) Wakefield expected to make over £72 million a year selling a test for which Wakefield had filed a patent application in March 1995 claiming that “Crohn’s disease or ulcerative colitis may be diagnosed by detecting measles virus in bowel tissue, bowel products or body fluids”; and Wakefield’s case series published in The Lancet in 1998 was fraudulent, the equivalent of what Deer correctly characterized as “Piltdown medicine.” Ultimately, these revelations led to Wakefield’s being completely discredited to the point where The Lancet retracted his paper and even Thoughtful House, the autism quackery clinic in Austin, TX where Wakefield had a cushy, well-paid position as scientific director, had to give him the boot. Yes, Wakefield is a fraud, and it’s only a shame that it took over a decade for it to be demonstrated.

As much as I hate how it took discrediting Wakefield the man as a fraud rather than just discrediting his bogus science to really begin to turn the tide against the annoying propensity of journalists to look to Wakefield or his acolytes for “equal time” and “balance” whenever stories about autism and vaccines reared their ugly heads, I can’t argue with the results. Wakefield is well and truly discredited now, so much so that, as I noted, his prominent involvement probably ruined any chance promoters of the “CDC whistleblower” scam ever had to get any traction from the mainstream press.

What is sometimes forgotten is the effect Wakefield’s message has had on parents. These are the sorts of parents who tend to congregate into groups designed to promote the idea that vaccines are dangerous and cause autism, such as the bloggers at the antivaccine crank blog Age of Autism, the equally cranky blog The Thinking Moms’ Revolution, or groups like The Canary Party. It is Wakefield’s message and the “autism biomed” quackery that it spawned that have led to unknown numbers of autistic children being subjected to the rankest form of quackery in order to “recover” them, up to and including dubious stem cell therapies and bleach enemas.
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Posted in: Health Fraud, Homeopathy, Neuroscience/Mental Health, Vaccines

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VacciShield: Pixie dust for an imaginary threat

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I know by now I shouldn’t be, but I am still amazed by how readily so many people buy into the seemingly endless array of bogus sCAM nostrums. Many are marketed and hawked for the treatment or prevention of diseases that are poorly managed by science-based medicine. There are countless examples of dietary supplements that are purported to effectively treat back and joint pains, depression, anxiety, autism, chronic pain, and chronic fatigue; the list goes on and on. The lure for these treatments is at least understandable and, although frustrated that scientific literacy and rational thought loses out, I empathize with the desire to believe in them. On the other end of the spectrum is the even more ethically corrupt substitution of safe and effective treatments with products that are not. I encountered what I find to be possibly the most frightening and dangerous example of this recently at my practice. A family new to the area called to schedule a routine health-maintenance visit for their 5-year-old daughter. When our nurse reviewed the medical records the mother had faxed over, she noted that the child was unimmunized and explained to her that she would need to begin catch-up vaccinations. The mother matter-of-factly stated that her daughter was actually fully vaccinated with a vaccine alternative. She had received a series of homeopathic vaccines from a naturopath. I am not going to discuss this egregious example of sCAM here, though it was addressed in previous SBM posts.1,2 Instead I’d like to focus on another part of the sCAM spectrum. Here lies a form of sCAM that, in some ways, is even more difficult for me to comprehend. These are products invented, marketed, and sold solely for the treatment or prevention of fictitious diseases or problems that exist only in the realm of fantasy. (more…)

Posted in: Herbs & Supplements, Medical Ethics, Naturopathy, Nutrition, Science and Medicine, Vaccines

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How “they” view “us”

Over the weekend, I was perusing my Google Alerts, along with various blogs and news websites, looking for my weekly topic, when I noticed a disturbance in the pseudoscience Force. It’s a phenomenon I’ve noticed many times before, but, as far as I can tell, I haven’t actually blogged about it here, at least not specifically, although I have mentioned it, particularly in posts about Stanislaw Burzynski. I have, however, blogged about it over at my not-so-super-secret other blog, which means that some of the thoughts (if you can call them that) that I plan to lay down in this post will likely seem familiar to some of you, but I think this is an important enough topic that I should cover it here, too. As arrogant as I might sometimes seem, even I’m not so deluded as to think that the fraction of SBM readers who are regulars at my not-so-super-secret other blog is anything greater than a clear minority, and even for those of you for whom there’s overlap I’ll try to make things different enough to be interesting.

On Friday, Sharon Hill published a post over at Doubtful News entitled Chiropractors get their spine out of place over critique. It’s about how chiropractors have reacted to a post by Steve Salzberg over at Forbes entitled New Medicare Data Reveal Startling $496 Million Wasted On Chiropractors. Salzberg’s blog post was basically about just that, namely the amount of money billed Medicare by chiropractors, information that’s possible to obtain since the government released Medicare billing data for individual practitioners. Salzberg pointed out that half a billion dollars is a lot of money, more than twice as much as what is wasted every year on the National Center for Complementary and Alternative Medicine (NCCAM) and the National Cancer Institute’s Office of Cancer Complementary and Alternative Medicine (OCCAM). The result was rapid. Chiropractors swarmed, complaining to Forbes.com, and making the usual threats to sue, much as they actually did sue Simon Singh and, fortunately, saw their lawsuit blow up in their faces.

This, of course, can be looked upon as a purely mercenary protection of turf and livelihood not unlike how Daniel Kopans attacks any study that finds mammography to be less effective than thought (or even ineffective) in decreasing deaths from breast cancer. There is, however, a form of backlash against criticism of pseudoscience that is different and, when I first encountered it, more disturbing to deal with. It’s a level of pure, visceral hatred that is difficult to understand; that is, until you try to put yourself into your “enemy’s” shoes. Consider this post an exercise in doing just that, an exercise that will no doubt shock at least one of our readers.
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Posted in: Cancer, Chiropractic, Critical Thinking, Genetically modified organisms (GMOs), Science and the Media, Vaccines

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Facebook’s reporting algorithm abused by antivaccinationists to silence pro-science advocates

This is not what I had wanted to write about for my first post of 2014, but unfortunately it’s necessary—so much so, in fact, that I felt the obligation to crosspost both here and on my not-so-super-secret other blog in order to get this information out to as wide a readership as possible.

I’ve always had a bit of a love-hate relationship with Facebook. On the one hand, I like how easily it lets me stay in contact with family and friends across the country, people whom I would rarely see more than once or twice a year, if even that. On the other hand, I have the same privacy concerns that many other people have with respect to putting personal information, as well as pictures and videos of myself, family, and friends, onto Facebook. Now that I’ve become a (sort of) public figure (or, as I like to refer to myself, a micro-celebrity), I’ve thought that I should cull my friends list to just real friends with whom I have a connection (or at least have met in person or had private e-mail exchanges with) and set up a Facebook page for my public persona, to prevent people whom I don’t know or barely know from divebombing my wall with arguments. As I tell people, I don’t want obnoxious arguments on my Facebook wall; that’s what my blogs are for.

My personal social media preferences aside, Facebook does indeed have many shortcomings, but until something else comes along and steals the same cachet (which is already happening as teens flee Facebook to avoid their parents) and even after, Facebook will remain a major player in social media. That’s why its policies matter. They can matter a lot. I was reminded of this about a week ago when Dorit Reiss (who has of late been the new favored target of the antivaccine movement, likely because she is a lawyer and has been very effective thus far in her young online career opposing the antivaccine movement) published a post entitled Abusing the Algorithm: Using Facebook Reporting to Censor Debate. Because I also pay attention to some Facebook groups designed to counter the antivaccine movement I had already heard a little bit about the problem, but Reiss laid it out in stark detail. Basically, the merry band of antivaccinationists at the Australian Vaccination Network (soon to be renamed because its name is so obviously deceptive, given that it is the most prominent antivaccine group in Australia, that the NSW Department of Fair Trading ordered the anti-vaccine group to change its misleading name) has discovered a quirk in the algorithm Facebook uses to process harassment complaints against users and abused that quirk relentlessly to silence its opponents on Facebook.

I’ll let Reiss explain:

Over the weekend of December 21-22, an unknown person or persons used a new tactic, directed mainly at members of the Australian organization “Stop the Australian Vaccination Network” (The Australian Vaccination Network – AVN – is, in spite of its name, an anti-vaccine organization – see also here; SAVN had been very effective in exposing their agenda and mobilizing against them). In an attempt to silence pro-vaccine voices on Facebook, they went back over old posts and reported for harassment any comment that mentioned one person’s name specifically. Under Facebook’s algorithm, apparently, mentioning someone’s name means that if the comment is reported it can be seen as violating community standards. Which is particularly ironic, since many commentators, when replying to questions or comments from an individual, would use that individual’s name out of courtesy.

Several of the people so reported received 12-hours bans. Some of them in succession.

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Posted in: Computers & Internet, Public Health, Vaccines

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Vaccines work. Period.

Over my blogging “career,” which now stretches back nearly nine years, and my hobby before that of engaging in online “debates” on Usenet newsgroups back before 2004, I developed an interest in the antivaccine movement. Antivaccinationism, “antivax,” or whatever you want to call it, represents a particularly insidious and dangerous form of quackery because it doesn’t just endanger the children whose parents don’t vaccinate them. It also endangers children who are vaccinated, because vaccines are not 100% effective. The best vaccines have effectiveness rates in the 90%-plus range, but that still leaves somewhere up to 10% of children unprotected. Worse, because herd immunity requires in general approximately 90% of the population and above to be vaccinated against a vaccine-preventable disease to put the damper on outbreaks, it doesn’t take much of a degradation of vaccination rates to put a population in danger of outbreaks. That’s why, even though overall vaccine uptake is high in the US, we still see outbreaks, because there are areas with pockets of nonvaccinators and antivaccinationists who drive vaccine uptake down to dangerous levels. We’ve seen this in California and elsewhere. Other countries have observed even more dramatic examples, the most well-known being the way that fear of the MMR vaccine stoked by Andrew Wakefield’s bad science and the fear mongering of the British press led MMR uptake to plummet. The result? Measles came roaring back in the UK and Europe, from having been considered under control in the 1990s to being endemic again by 2008.

As much as I get chastised by concern trolls for saying this, to antivaccinationists it really is all about the vaccines. Always. They blame autism, other neurodevelopmental conditions, and a wide variety of chronic diseases on vaccines, without evidence that there is even a correlation. They even falsely blame sudden infant death syndrome (SIDS) on vaccines, even though there is no evidence of an association and, indeed, existing evidence suggests that vaccines likely have a protective effect against SIDS more than anything else. No matter what happens, no matter what the evidence says, antivaccinationists will always find a way to blame bad things on vaccines, even going so far as to claim at times that shaken baby syndrome is a misdiagnosis for vaccine injury.

One thing, however, that is often forgotten, is that they also do their utmost to downplay the beneficial effects of vaccines. One such tactic is for antivaccinationists to claim that the pertussis vaccine doesn’t work because we are seeing resurgences of pertussis even in the face of high vaccine uptake. For example, another common trope is what I like to refer to as the “vaccines didn’t save us” or the “vaccines don’t work” gambit, in which it is pointed out that the introduction of vaccines doesn’t correlate tightly with drops in mortality from various diseases. Julian Whitaker even used this gambit when he debated Steve Novella. The fundamental flaw in this trope neglects the contribution of better medical care to the survival of more victims of disease, which decreased mortality. If you look at graphs of disease incidence you will see a profound and powerful effect of the introduction of vaccines on specific vaccine-preventable diseases. In other words, vaccines work. (more…)

Posted in: Epidemiology, Public Health, Vaccines

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