Trump is OK with pseudoscience
Scientists in the U.S. and from around the world are weighing in on Donald Trump’s election as the next president of the most powerful country on earth:
Trump will be the first anti-science president we have ever had . . . The consequences are going to be very, very severe.
Michael Lubell, director of public affairs for the American Physical Society in Washington, DC:
I am simply stunned. . . Trump’s election does not bode well for science or most anything else of value.
Neal Lane, a Democrat who led the National Science Foundation and served as White House science adviser under President Bill Clinton, now a physicist and university professor at Rice University in Houston, Texas:
It’s going to be critically important for researchers to stand up for science.
Jennifer Zeitzer, director of legislative Relations at the Federation of American Societies for Experimental Biology in Bethesda, Maryland:
I do breast cancer research for my PhD . . . Scared not only for my future but for the future of research and next years @NIH budget.
Sarah Hengel, a graduate student at the University of Iowa in Iowa City:
This is terrifying for science, research, education, and the future of our planet . . . I guess it’s time for me to go back to Europe.
María Escudero Escribano, a postdoc studying electrochemistry and sustainable energy at Stanford University in California:
One of the common tropes of the anti-vaccine movement is that vaccine-preventable diseases are not all that bad. Perhaps the most direct manifestation of this is the self-published children’s book, Melanie’s Marvelous Measles, by Australian author and anti-vaccine activist Stephanie Messenger. Throughout the book Messenger claims that measles is nothing to be frightened of and in fact makes the body stronger.
This is an absurd and counterfactual claim, resulting, it seems, from a desire for a simple, clean narrative. People are born lawyers – we pick a side and defend it jealously. So, if you believe vaccines are dangerous you must also believe they are useless and the diseases they prevent benign. All the facts have to align in one direction.
The evidence strongly supports the conclusion that vaccines are safe (although not risk free), that they work (although are not 100% effective), and the diseases they prevent can sometimes cause serious complications. (more…)
On January 1, 2018, the California Naturopathic Doctors Act will be automatically repealed unless the California Legislature deletes or extends that date during the 2017 legislative session, which convenes on December 5, 2016. In addition, according to California law, the Naturopathic Medicine Committee of the Osteopathic Medical Board of California, which regulates naturopathic doctors (NDs), is subject to review by “appropriate policy committees of the Legislature” in the upcoming session.
The California Legislature should not extend the date of the Naturopathic Practice Act. Currently licensed naturopathic doctors could be allowed to continue their practices under a substantially revised practice act but no new licenses should be issued. Frankly, I do not think naturopaths, whether they claim they are “doctors” or not, should be allowed to practice at all. However, the political realities of getting a bill passed completely doing away with the practice of naturopathy may require some accommodation to currently licensed NDs. (more…)
The worst flu season ever. And it peaked early.
I was asked this question by one of my infection control practitioners. We started offering the flu vaccine the first week of October and some have delayed getting the shot for fear that immunity will not last the season. She pointed me to this NPR article, “Yes, It Is Possible To Get Your Flu Shot Too Soon,” as driving the fear of too little too soon.
So when should you get the flu shot?
Short answer – I don’t know.
There are multiple variables that make it a difficult question to answer. When does flu season start? When does it end? Influenza has immunologic variation from year to year and different strains circulate each year. How good is the match between the circulating strains of influenza and the vaccine? How good is the immunologic response of the host?
So many questions. By answering these question maybe we can come up with an estimated optimal time to receive the flu vaccine. (more…)
Dr. William Coley. Not a brain surgeon.
With apologies to my colleagues, but infectious diseases really is the most interesting specialty in medicine. There are innumerable interesting associations and interactions of infectious diseases in medicine, history, art, science, and, well, life, the universe and everything. ID is so 42.
A recent email led me to wander the numerous interactions between infections and cancer.
There are the cancers that are caused by infection. HPV and cervical and throat cancer. EBV and lymphoma. HHV8 and Kaposi’s Sarcoma. I certainly hope I am not reincarnated as a Tasmanian Devil. (more…)
A few years ago some colleagues and I at the Institute for Science in Medicine were debating what our official position should be regarding non-medical vaccine exemptions. We all agreed that the ideal situation would be no non-medical exemptions. There is no legitimate reason for such exemptions and the evidence clearly shows that states who allow non-medical vaccine exemptions have lower vaccination rates.
The debate was about whether or not that should be our only position, to take a strong and uncompromising stance, or should we also advocate that states who do allow non-medical exemptions to make them as difficult as possible (which also is effective in reducing vaccine refusal). The concern was that the perfect solution was politically too difficult and the lesser solution was at least something (like a prosecutor including lesser charges in case they lose on the big charge).
I advocated for the latter position, which is what we ultimately decided. After the Disneyworld measles outbreak, however, I think the political calculus has changed. It is much more politically viable to simply advocate for the elimination of all non-medical exemptions. (more…)
Prevention has long been a priority of conventional medicine
One of the common criticisms we hear from alternative and integrative medicine proponents is that doctors don’t do anything to prevent illnesses and have no interest in prevention. They claim that doctors are only trained to hand out pills to treat existing illnesses. Sometimes they even accuse them of deliberately covering up cures and wanting to perpetuate illnesses like cancer so they can make more money by treating patients. Nothing could be more absurd. Every reputable doctor would rather prevent illnesses than treat them. In his book Heart 411, cardiologist Steven Nissen even said he would be glad to see his specialty become obsolete: “Don’t worry about us; we will gladly hang up our scalpel and stethoscope if we can find a better way to lead you to a heart-healthy life.”
Doctors own prevention. They invented it, from vaccines to clean water to preventive screening tests. Mainstream medicine was responsible for the greatest preventive achievement in history: the smallpox vaccine campaign succeeded in preventing anyone from ever getting smallpox again. I defy you to comb through historical records and find any doctor who ever said “Let’s stop vaccinating for smallpox so we can make more money treating its victims.”
Prevention is one of the six fundamental principles of naturopathy. Alternative practitioners pride themselves on prevention, but they don’t actually do a very good job of it. In fact, there is evidence that their patients are less likely to get immunizations and some of the standard preventive screening tests recommended by the USPSTF. Instead of rigorously implementing evidence-based preventive strategies, they tend to offer other speculative, untested recommendations.
How do we deal with parents who would rather their babies face diseases than vaccines?
As long as there have been vaccinations, there has been an antivaccine movement, and as long as there has been an antivaccine movement, there have been parents who refuse to vaccinate. In a past that encompasses the childhood of my parents, polio was paralyzing and killing children in large numbers in yearly epidemics, the fear of which led to the closure of public pools every summer. In such an environment, the new polio vaccine introduced by Jonas Salk in the mid-1950s wasn’t a hard sell. In fact, satisfying the initial demand for it was the problem, not parents refusing to vaccinate their children. Since then, more and more vaccines have been developed to protect more and more children from more and more diseases, to the point where the incidences of most vaccine-preventable diseases is so low that, unlike 60 years ago, most parents today have never seen a case or even known other parents whose child suffered from a case. Even as recently as the 1980s, Haemophilus influenza type B was a dread disease that could cause meningitis, pneumonia, sepsis, and death. Since the introduction of the the Hib vaccine a mere quarter century ago, Hib has been virtually eliminated. Most pediatricians in residency now have never seen a case.
As much of a cliché as it is to say so, unfortunately vaccination has been a victim of its own success, at least in developed countries. Parents no longer fear the diseases childhood vaccines protect against, which makes it easy for antivaccine activists to provide what I like to call “misinformed consent,” by spreading misinformation that vastly exaggerates the risk of vaccines compared to the benefit of vaccinating. Parents who believe the misinformation conclude, based on a warped view of the risk-benefit ratio of vaccines, that not vaccinating is safer. Add to the mix fear mongering against the MMR based on Andrew Wakefield and his dubious 1998 case series that popularized the then-recent idea that vaccines cause autism, and it’s no wonder that parents decide that not vaccinating is safer than vaccinating. If you believe the misinformation, it’s not an entirely unreasonable conclusion. Then add to that the easy availability of “personal belief exemptions” to school vaccine mandates in many states, which include anything from religious exemptions to parents just signing a form that says they are “personally opposed” to vaccination, and it isn’t a huge surprise that vaccine uptake has fallen in some areas to the point where outbreaks can occur. It was happening in California and my own state of Michigan. (more…)
I’ve finally seen it. I’ve finally seen Andrew Wakefield and Del Bigtree’s “documentary” VAXXED: From Cover-up to Catastrophe, and I didn’t even have to pay to see it! Now, having watched Wakefield and Bigtree’s “masterpiece,” I can quite confidently say that it’s every bit as accurate and balanced a picture of vaccine benefits and risks as Eric Merola’s two movies about the quack Stanislaw Burzynski and his Second Opinion: Laetrile at Sloan-Kettering are about cancer and cancer research, The Beautiful Truth is about the Gerson protocol for cancer, Simply Raw: Reversing Diabetes in 30 Days is about diet and diabetes, Expelled! No Intelligence Allowed is about evolution, and The Greater Good is about…vaccines! Of course, based on what I knew of the story, saw of the VAXXED trailer (which deceptively edited together statements by William Thompson), and have discussed about the efforts of Andrew Wakefield, Del Bigtree, and Polly Tommey to use VAXXED as a tool in a publicity campaign to try to spread fear, uncertainty, and doubt (FUD) about vaccines using the “CDC whistleblower” conspiracy theory (about which a primer can be found here), I shouldn’t have been surprised, but I was actually surprised (slightly) at the manipulative depths to which this film sinks.
On the plus side, its production values are better than those Eric Merola’s films (although I, with no experience, could probably make a film with better production values than Merola), but that just makes it somewhat more effective propaganda. In my review and discussion of the movie and its claims, I will discuss the claims made by Bigtree and Wakefield as well as the movie as a movie. Unfortunately, there is so much misinformation in this 91 minute documentary that I will only be able to hit the “high” points without going far, far beyond even a Gorski level of logorrhea in this post. Worse, there is a considerable amount of dishonest framing, in which actual facts and events are presented in a deceptive manner to tell a distorted narrative. Before that, though, let’s meet the key players.
NOTE: Anyone who has seen several derogatory articles about me on the web and is curious about what the real story is, please read this and this.
I was going to write about something else this week, but events over the last several days led me to change my mind. The first was the reaction of a pseudonymous antivaccine “warrior” going by the ‘nym Levi Quackenboss to a viral video posted by a 12-year-old boy named Marco Arturo. The second was my learning that other antivaccine “warriors” had resumed abusing the Facebook reporting algorithm to get pro-science advocates supporting vaccines banned from Facebook for periods up to 30 days and thereby silence them. I wrote about this latter tactic a couple of years ago, when the Australian antivaccine group the Australian Vaccination Network (AVN), or AVN (which was forced to rename itself the Australian Vaccination Skeptics Network in 2014), started abusing Facebook’s algorithm for reporting harassment and abuse in order to get members of the skeptic group Stop the Australian Vaccination Network (SAVN) temporary Facebook bans. It’s a tactic that has continued, with a fresh batch of temporary bans issued by Facebook in response to bogus complaints over the last few days.
I’ve frequently written about how often the preferred tactic of antivaccinationists and others pushing medical pseudoscience is not to answer criticism with evidence, science, and rational argument, but rather to respond with attacks and attempts to intimidate and silence. The reason, of course, is that they do not have any of that to support their beliefs. At some level, I suspect that many of them know it. Be that as it may, those of us who lament how few physicians and scientists, even those sympathetic to scientific skepticism, are willing to publicly speak out and call the quacks to task know that the consequences of doing so are often quite unpleasant: Online attacks, poisoning of one’s Google reputation, attempts to get one banned from Facebook, and, of course, the antivaccinationists’ favorite: Harassment through one’s job by complaining to one’s bosses. To illustrate these hazards, I’ll start with the story of Marco Arturo, before moving on to a more organized effort. (If you read my not-so-super-secret other blog, you’ll have heard of Marco’s story before, but I’ll summarize here as well.) Then I’ll update you on how Facebook continues to allow its reporting algorithms to be abused to silence pro-vaccine voices there. I’ll finish up with examples of what we at SBM have experienced and some thoughts on what can be done. (more…)