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Vaxxed and the Tribeca Film Festival: How Robert De Niro learned the hard way about Andrew Wakefield and the antivaccine movement

Robert De Niro made a massive mistake last week.

Robert De Niro made a massive mistake last week. Fortunately, he started to make up for it.

One of the disadvantages of only doing one blog post a week here at Science-Based Medicine is that sometimes stuff happens at too fast a pace for me. If something happens on Tuesday, by the time Sunday rolls around and it’s time for me to do my weekly post, it’s often old news, too old to bother with. That’s why it’s a good thing that I have my not-so-super-secret other blog, where I can keep up with such events. On the other hand, the advantage of a once-a-week posting schedule is that there are times I can look back at a story that evolved over the last week and, instead of blogging about it in daily chunks, I can put together a post that tells the whole story and puts it in context. Something like that happened last week. The beauty of it is that I played a major role in bringing the story to public consciousness, followed the story as it evolved, and now can provide a fairly complete recounting. Or so I hope.

First, however, let’s take advantage of another good thing about waiting to blog about a story, namely getting to see the reactions of quacks to what happened. No one can do it better than everybody’s favorite all around quack, crank, and all-purpose conspiracy theorist Mike Adams, who greeted me yesterday morning with this headline: VAXXED film pulled from Robert De Niro’s Tribeca Film Festival following totalitarian censorship demands from pharma-linked vaccine pushers and media science trolls. What on earth is Adams talking about, you might wonder? In case you haven’t been following the news, here’s a link to the New York Times story on the same incident: “Robert De Niro Pulls Anti-Vaccine Documentary From Tribeca Film Festival.” Basically, the 2016 Tribeca Film Festival selected an antivaccine documentary directed by Andrew Wakefield for screening and then thought better of it after a major uproar and a whole boatload of bad press.

I’ll deal with Adams’ post a bit later because it’s so hilariously nutty but also because it is basically the propaganda line that antivaccinationists are putting on this PR debacle brought about by Andrew Wakefield and Robert De Niro. (I never thought I’d use those two names in the same sentence.) Let’s go back a week and see what I mean. (more…)

Posted in: Book & movie reviews, Science and the Media, Vaccines

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Are the recommended childhood vaccine schedules evidence-based?

The vaccine schedule: Safe and efficacious.

The vaccine schedule: Safe and efficacious.

We write about vaccines a lot here at SBM, and for a very good reason. Of all the medical interventions devised by the brains of humans, arguably vaccines have saved more lives and prevented more disability than any other medical treatment. When it comes to infectious disease, vaccination is the ultimate in preventive medicine, at least for diseases for which vaccines can be developed. We also know that when vaccination rates fall, it opens the door for diseases once controlled to come roaring back. We saw this phenomenon with the measles a year ago in the Disneyland measles outbreak. We’ve seen it around the country, with measles outbreaks occurring in areas where a lot of antivaccine and vaccine-averse parents live. Perhaps the most spectacular example occurred in the UK, where prior to Andrew Wakefield’s fraudulent case series in The Lancet that was used to link the MMR vaccine to autism, measles was under control; it came roaring back as MMR uptake plummeted in the wake of the publicity his research engendered. By 2008, ten years after Wakefield’s case series was published, measles was again endemic in the UK. Measles outbreaks flourished. Although MMR uptake is improving again in the UK, there remains a reservoir of unvaccinated children aged 10-16 who can transmit the virus.

Thanks, Andy.

Fortunately, Wakefield has been relegated to sharing the stage with crop circle chasers, New World Order conspiracy theorists, sovereign citizen cranks, and other antivaccine cranks like Sherry Tenpenny. Unfortunately, the damage that he has done lives on and has metastasized all over the developed world. Given the persistence of the antivaccine movement, which fuels concerns about vaccines in parents who are not themselves antivaccine but are predisposed to the antivaccine message because they distrust government and/or big pharma or have a world view that overvalues “naturalness,” I was quite interested in an article that appeared in The BMJ last week. Basically, it asked the question “Is the timing of recommended childhood vaccines evidence based?
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Posted in: Clinical Trials, Epidemiology, Public Health, Vaccines

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What naturopaths say to each other when they think no one’s listening, part 2

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When last I visited this topic, I started out by making a simple observation, namely by quoting John Wooden’s famous adage, “The true test of a man’s character is what he does when no one is watching.” What I was referring to was a private discussion forum for naturopaths known as Naturopathic Chat, or NatChat for short, and how a leak from the group had revealed the sort of pure quackery that naturopaths talk about when they are among themselves and think that no one else is listening. Basically, NatChat revealed just how quacky naturopaths are, based on the advice they gave each other about patients and their general discussions of what passes for “naturopathic medicine.” I found examples of naturopaths recommending intravenous peroxide, homeopathic drainage therapy, black salve (for a huge protruding breast cancer), and even ozone to treat a postsurgical J-pouch abscess that clearly required the attention of a colorectal surgeon. After naturopaths on NatChat became widely aware that someone on the list had revealed discussions on the list, apparently the moderators, instead of moving to another platform, stayed on Yahoo! Groups.

None of what I’ve described in this brief recap of my first post about NatChat should be surprising to regular readers of this blog, who would also know that we are not particularly fond of naturopaths, even the nice ones, who might be perfectly fine as people. Of course, it is naturopathy we don’t like, mainly because it is, as I like to describe it, 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, whenever the topic of naturopathy comes up, I like to refer readers to Scott Gavura’s excellent recurring series “Naturopathy vs. Science,” which has included editions such as the Facts Edition, Prenatal Vitamins, Vaccination Edition, Allergy Edition, Diabetes Edition, Autism Edition, Fake Diseases, and, of course, the Infertility Edition. We’ve also described just what happens when a naturopath tries to treat a real disease like whooping cough. The results are, to put it very mildly, not pretty.

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.

Interestingly, what led the Reddit user and naturopathy critic NaturoWhat (who inspired my earlier post regarding NatChat) to give me the heads up as to what’s going on in NatChat again is an incident on the discussion board involving a naturopath who featured in the previous edition of my coverage of NatChat, Eric Yarnell. He’s a naturopath who tried to point out to his fellow naturopaths how black salve is a really nasty treatment because of the way it fries normal tissue just as badly as it fries abnormal tissue. He also appears to be one of those rarest of beasts, a seemingly pro-vaccine naturopath. I say “seemingly,” because whenever I encounter a naturopath billing herself as pro-vaccine (e.g., Erika Krumbeck), a closer examination of his or her views almost always reveals he or she believes in at least some antivaccine misinformation. Surprisingly, Yarnell is the naturopath who comes closest to actually being pro-vaccine that I’ve seen.
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Posted in: Naturopathy, Vaccines

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Michigan HB 5126: Who thought it was a good idea to make it easier for parents to obtain nonmedical exemptions to school vaccine mandates and harder for local county health officials to do their jobs?

The Michigan House of Representatives: Not the sharpest knives in the drawer.

The Michigan House of Representatives: Not the brightest bulbs on the Christmas tree.

We have a problem with antivaccinationists here in Michigan. It’s a problem that’s been going on a long time that I first started paying attention to in a big way a few years ago when we started seeing pertussis outbreaks again due to low vaccine uptake. It’s a problem that’s persisted as last year we suffered from outbreaks of pertussis and measles, again because of pockets of low vaccine uptake. And what is the reason for these pockets of low vaccine uptake? Well, consistent with what we already know, namely that the risk of pertussis outbreaks is elevated in states where exemptions to school vaccine mandates are easier to get, it’s because our state is one of the worst in the country when it comes to nonmedical exemptions to vaccines. Indeed:

Michigan has one of the highest vaccine-waiver rates for kindergartners in the country, three times the national median, according to the Centers for Disease Control and Prevention. And the number of kindergartners getting vaccine waivers is growing. In five years, it’s increased 23 percent, the CDC says.

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Posted in: Politics and Regulation, Public Health, Vaccines

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How not to debate a “pro-vaxer”

When people debating against vaccines win, children lose.

When people debating against vaccines win, children lose.

To say that the relationship that antivaccine activists have with science and fact is a tenuous, twisted one is a major understatement. Despite mountains of science that says otherwise, antivaccinationists still cling to the three core tenets of their faith, namely that (1) vaccines are ineffective (or at least nowhere near as effective as health officials claim; (2) vaccines are dangerous, causing autism, autoimmune disease, neurodevelopmental disorders, diabetes, sudden infant death syndrome, and a syndrome that is misdiagnosed as shaken baby syndrome; and, of course, (3) the Truth (capital-T, of course!) is being covered up by a nefarious combination of big pharma, the medical profession, and the government (in the US, primarily the Centers for Disease Control and Prevention, which works with pediatricians to produce the recommended schedule of vaccines). Because vaccine rejectors don’t have science on their side, they have to resort strategies common to science denialists like those who reject the scientific consensus about evolution or human-caused global climate change. These fallacious strategies include (but are not limited to) selective citation of evidence (i.e., cherry picking), misrepresentation and logical fallacies, impossible expectations about what science can deliver (e.g., vaccine denialists expecting 100% efficacy and 100% safety from vaccines or cancer quacks expecting 100% cure rates and no side effects from chemotherapy); fake experts (e.g., Andrew Wakefield); and, of course, conspiracy theories. Add to that appeals to personal freedom and “health choiceüber alles and painting any form of vaccine mandate as incipient totalitarianism, with those rejecting vaccines taking on the role of the Jews in Hitler’s Germany, and you have a pretty good idea of the sorts of arguments antivaccine activists resort to.

Not surprisingly, even the most diehard antivaccine advocate can get frustrated. After all, it must be very frustrating to have one’s posterior handed to one in arguments on the science of vaccines time and time again. Of course, for that purpose, like most science denialists, antivaccine activists have the Internet. In particular, they’ve taken full advantage of Facebook, and, more recently, Twitter. One such online gathering place is the public group known as Vaccine Resistance Movement (VRM). I encourage pro-science advocates to peruse this group, just to see that when I refer to people being anti-vaccine, there is no doubt that that is what they are. It was there that I found a rather telling document posted, for the benefit of antivaccine advocates everywhere.
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Posted in: Critical Thinking, Vaccines

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The suffering the search for “natural immunity” inflicts on children

Yes, there are people out there who believe that there are "natural" remedies for pertussis and willing to let their children suffer the consequences.

Yes, as hard as it is to believe, there are actually people out there who believe that there are “natural” remedies for pertussis and willing to let their children suffer the consequences.

I realize that Scott Gavura has already covered this particular case (and quite well), but it’s so egregious that I couldn’t resist discussing it myself because it is one of the most horrifying examples I’ve seen in a long time of the consequences of the sorts of beliefs that fall under the rubric of naturopathy. Quite frankly, reading the story angered me to the point that I didn’t feel it would be unduly repetitious to discuss it again. The result in this case was the prolonged and unnecessary suffering of three children, while the mother believed she was helping them.

Naturopathy is a cornucopia packed to the brim with virtually every quackery known to humankind, be it homeopathy, much of traditional Chinese medicine, vitamin C for cancer, or basically any other pseudoscientific or prescientific treatment for disease that you can imagine. I feel obligated to start most of my posts about naturopathy with a statement like this not just because it’s true but because I want to remind my readers that it’s true. I particularly want to remind my readers when I see naturopaths revealing their true quack selves when they think no one’s watching, but I want to remind them even more when I see a post like the one by a naturopath named Heather Dexter entitled Natural Remedies for Whooping Cough: Getting Through It IS Possible. The post has been disappearing and reappearing with new edits for the last few days, but it seems to have disappeared for good. Fortunately the Internet never forgets, and in addition to the versions captured by Scott, the original text can still be found on Reddit, although it takes some scrolling to find it, and, for now, a Google cache version still exists.

If you want anecdotal evidence of the depths of quackery to which naturopaths can descend, read this post now. Because the link to the original post was removed once, I saved the text and will quote it liberally, but, for whatever reason, the post appears to be up again at Like-Minded Mamas, which promises “easy, natural answers for every mama’s journey.” What Dexter sees as natural treatment of her children with whooping cough, I see as child abuse. Worse, Dexter is practicing in my own state in Grand Rapids, MI.
Dexter describes herself thusly:

Heather Dexter is a Board Certified Naturopathic Doctor, Certified Affiliated Bradley Method Instructor, Certified Holistic Doula, Certified Usui Reiki Master Practitioner.

Here’s an indication: If you believe in reiki enough to practice reiki, you are a quack.

More importantly, if you treat your children the way Dexter describes, you are a child-abusing quack, in my not-so-humble opinion. Why do I say this? Because in her post Dexter describes how she tortured her children by letting them “get through” pertussis. Let me repeat that again in a different way. She let her children suffer through the natural course of a pertussis infection in order to acquire “natural” immunity. She even brags about it near the end of her post:
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Posted in: Naturopathy, Vaccines

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Antivaccinationists and the Nation of Islam protest in front of the CDC, but don’t you dare call them “antivaccine”

Flyer for "CDC Truth" Rally. Apparently a bunch of antivaccine activists showed up in Atlanta on Saturday to annoy CDC employees and try to use the manufactured "scandal" of the so-called "CDC whistleblower" to attack vaccines. Same as it ever was.

Flyer for “CDC Truth” Rally. Apparently a bunch of antivaccine activists showed up in Atlanta on Saturday to annoy CDC employees and try to use the manufactured “scandal” of the so-called “CDC whistleblower” to attack vaccines. Same as it ever was.

If there’s one thing that’s guaranteed to anger most antivaccine activists, it’s a skeptic calling them “antivaccine.” The reason, of course, is that (1) many of them actually believe they are “not antivaccine” but rather “pro-vaccine safety,” even though their words and actions proclaim otherwise and (2) they crave legitimacy. They want desperately to be taken seriously by the government and scientific community. The problem is that, again, by their very words and actions they make it almost impossible for anyone who knows anything about vaccines to take them seriously, except as a threat to public health. They have no one but themselves to blame, as a critical perusal of Age of Autism, The Thinking Moms’ Revolution, VacTruth (and VaxTruth), or any number of antivaccine websites and blogs will indicated to anyone of a scientific bent who has the intestinal fortitude to plunge down any or all of those rabbit holes of magical thinking and pseudoscience.

Another thing that I’ve come to understand over the more than a decade that I’ve been doing this is that there is a profound tension between what I like to call the two wings of the antivaccine movement. Basically, as is the case in most political or ideological movements, antivaccine activists gravitate towards one of two views. The first (and most prominent view) tends to be the pragmatic view. These are the antivaccinationists who deny vociferously that they are “antivaccine” and instead portray themselves as “pro-safe vaccine.” They want to appear reasonable and are willing to take partial victories on an incremental path towards achieving their ends. Then there are the “loud and proud” antivaccine activists. They don’t eschew or hide from the term “antivaccine.” They embrace it and proudly proclaim that they believe that vaccines are irredeemably toxic, that they don’t protect against disease, that big pharma is a criminal syndicate intent on poisoning their children and turning them autistic, and that the CDC is complicit in the whole plot. Of course, like all ideological movements, there is not a dichotomy; rather, there is a continuous spectrum between the two. Also, in this case, the two groups differ more on tactics than actual beliefs. As I’ve found many times, push a “reasonable” antivaccinationist, one who proclaims herself “not antivaccine” but “pro-vaccine safety,” and it’s usually not hard to get them to say things indistinguishable from the hard core antivaccinationists. They’ll basically cling to their self-perception as “pro-safe vaccine, while making the same evidence-free claims that vaccines cause autism, sudden infant death syndrome (SIDS), autoimmune diseases, diabetes, and all the other conditions on which antivaccinationists blame vaccines.
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Posted in: Politics and Regulation, Public Health, Religion, Vaccines

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Sarah Hershberger: “Health freedom” and parental rights vs. child welfare

Sarah Hershberger, pictured with her family in a 2014 Reason.tv video.

Sarah Hershberger, pictured with her family in a screenshot from a 2014 Reason.tv video.

One of the more depressing topics that I regularly write about on this blog includes of analyses of news stories of children with cancer whose parents decided to stop science-based treatment (usually the chemotherapy) and use quackery instead. There are, of course, variations on this theme, but these stories take form that generally resembles this outline: A child is diagnosed with a highly treatable cancer with an excellent cure rate. Standard science-based treatment is begun, but the child suffers severe side effects from the chemotherapy. After an incomplete course of chemotherapy, the parents, alarmed at their child’s suffering, start balking at further chemotherapy, either because the child refuses further treatment or because they do. At some point in this process the parents become aware of the claims of practitioners of this or that alternative medicine, who tell them that their child’s cancer can be cured without toxic chemotherapy, and, wooed by the siren song of a promise of a cure without suffering, the parents choose that instead. At this point, physicians, alarmed at the parents’ choice, call in their state’s child protective services team, and a court battle ensues. Sometimes the court battle results in an order that the child complete conventional therapy, as it did with, for example, Daniel Hauser or Cassandra Callender. Sometimes it ends with a compromise in which the child and/or parents can choose an unconventional practitioner, as in the case of Abraham Cherrix. All too often the courts utterly fail to protect children with cancer, as the Canadian courts did in the cases of Makayla Sault and JJ. Not infrequently, if the court rules against the parents, the parents flee with their child to avoid treatment, as happened with Daniel Hauser, Abraham Cherrix, and Sarah Hershberger. Usually, they ultimately come back.

However they turn out, over the years of looking into them I’ve found that these stories tend to bear a depressing similarity and predictability. For example, if the child does well, it is always attributed to the alternative treatment, even when the child received a significant amount of conventional therapy. This attribution derives from a fundamental misunderstanding of how the treatment of cancer works in that the problem with incomplete cancer treatment is not that it can’t cure the cancer but that it has less of a chance of doing so. As I’ve explained many times, the reason that treatment regimens for many pediatric cancers involve two years’ worth of chemotherapy is that over time pediatric oncologists learned the hard way that, although the first cycle of chemotherapy (usually called induction chemotherapy) can lead to remission, without the additional cycles the chances of recurrence are very high—unacceptably so. Consequently, children who stop chemotherapy early can be in remission; they’ve just been put at a high risk of recurrence.
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Posted in: Cancer, Herbs & Supplements, Naturopathy, Politics and Regulation

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Donald Trump and the dangerous vaccine politics of the 2016 Presidential race

Republican candidates Ben Carson and Donald Trump during the CNN Republican presidential debate at the Ronald Reagan Presidential Library and Museum on Wednesday, Sept. 16, 2015,

Republican candidates Ben Carson and Donald Trump during the CNN Republican presidential debate at the Ronald Reagan Presidential Library and Museum on Wednesday, Sept. 16, 2015

I’ve been writing about vaccines and the antivaccine movement since the turn of the millennium, first in discussion forums on Usenet, then, beginning in 2004, on my first blog (a.k.a. the still existing not-so-super-secret other blog), and finally right here on Science-Based Medicine (SBM) since 2008. Vaccines are one of the most important, if not the most important, topics on a blog like this because (1) arguably no medical intervention has prevented more deaths and suffering throughout history than vaccines; (2) few medical interventions are as safe and effective as vaccines; and (3) there is a vocal and sometimes effective contingent of people who don’t believe (1) and (2), blaming vaccines for all sorts of diseases and conditions to which science, despite many years of study, has failed to link them. The most prominent condition falsely linked to vaccines is, of course, autism, but over the years I’ve written about a host of others, including sudden infant death syndrome, shaken baby syndrome, autoimmune diseases, and even cancer. In a similar vein, antivaccine activists will try to claim that vaccines are loaded with “toxins” or even tainted with fetal “parts” or cells because some vaccines’ manufacturing process involves growing virus in two cell lines that were derived from aborted fetuses many decades ago. Even the Catholic Church doesn’t say that Catholics shouldn’t use these vaccines, but that doesn’t prevent some antivaccine groups from portraying vaccines as virtually being made by scientists cackling evilly as they grind up aborted fetuses to make vaccines. (I exaggerate, but not by much.)

On a strictly scientific, medical level, antivaccine claims such as the ones described above are fringe, crank viewpoints. There is no serious scientific support for any of them and lots of scientific evidence against them, particularly the most persistent myth, namely that vaccines cause autism. It also used to be the case that, politically, antivaccine views tended to be those of the fringe. Unfortunately, in the current election cycle, those fringe views seem to be coming to the fore among prominent candidates for the Republican Presidential nomination. This was most evident at the second Republican Presidential debate last week, where Donald Trump spewed antivaccine tropes and neither of the two physicians also running for the Republican nomination mounted a vigorous defense of vaccines. Even candidates who have previously issued strong statements defending vaccines (Senator Marco Rubio and Louisiana Governor Bobby Jindal) remained silent.

(Video of the exchange can be found here.)

How did we get to this point? And why is it that antivaccine views, which in the past were stereotypically associated with crunchy lefties in the mind of the public, seem now to have found another comfortable home among small government conservatives, including the man who currently appears to be the frontrunner for the Republican nomination? In the days that followed the debate, there have been many discussions of Donald Trump’s antivaccine views, but none that take the long view. All seem to flow from the idea that it’s mainly just Donald Trump and his wacky views, rather than Trump being part of a more widespread phenomenon. I’ve frequently said that antivaccine beliefs tend to be the pseudoscience that knows no political boundaries, occurring with roughly equal frequency on the left and the right. However, it’s virtually inarguable that right now, in 2015, the loudest political voices expressing antivaccine views (or at least antivaccine-sympathetic views) are in the Republican Party. Yes, Robert F. Kennedy, Jr. is back in a big way, partying like it’s 1999 with Bill Maher over thimerosal-containing vaccines and autism, but neither he nor Bill Maher holds public office or is currently running for office. The über-liberal website The Huffington Post might have been promoting antivaccine propaganda since its inception, but its writers are not running for office, either, and of late it seems to be much less antivaccine than before. (more…)

Posted in: Neuroscience/Mental Health, Politics and Regulation, Vaccines

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Vaccine Whistleblower: BS Hooker and William Thompson try to talk about epidemiology

Vaccine Whistleblower – a highly edited misrepresentation of the facts

Vaccine Whistleblower” – a highly edited misrepresentation of the facts.

Here we go again with the whole “CDC Whistleblower” thing, this time with a book about the recorded conversations between Brian J. Hooker and William Thompson. Well, not the whole conversations, of course. If they were to release the whole conversations, we might get the truth, and the truth always gets in the way of the antivax crowd. Instead, we get an edited transcript of the conversations between those two in which, according to them and the book’s editors and authors, there is some sort of massive cover-up at all levels of science, government, and public health. What’s the cover-up? As usual, vaccines are evil and whatnot.

I’m not going to review the whole book for you because Dr. Gorski has already done so, and Dorit Reiss has discussed the legal aspects of what is discussed in the book. You can go read his review and/or Prof. Reiss’ analysis and then come back, or stay here and read what I have to say about the failed attempts at epidemiology from both BS Hooker and Thompson.

Let’s start by reviewing BS Hooker’s credentials. He is a bioengineer and chemical engineer, not an epidemiologist, despite what the author of the book wants you to believe:

With the publication of Kevin Barry’s Vaccine Whistleblower: Exposing Autism Research Fraud at the CDC, any claims of credibility for the CDC’s science has collapsed. Barry built his book upon four legally taped conversations between CDC senior vaccine safety scientist Dr. William Thompson and Simpson College professor and epidemiologist, Dr. Brian Hooker.

Later in the book, in the transcript of one of the conversations between BS Hooker and Thompson, BS gets a list of things he needs to do to earn an “honorary” degree in epidemiology. Among those things was to look at some of the earlier studies that Thompson had coauthored. And BS did. He would go on to write a flawed paper that I critiqued here and ended up being retracted, as I told you about here. That paper alone should tell you everything you need to know about BS Hooker’s epidemiological understanding, but the transcripts given to us by his camp in the form of the book really reveal his ignorance.

So let’s go through the calls we have transcripts for and pick at the epidemiological and biostatistical missteps that Thompson suggests for BS Hooker. (more…)

Posted in: Politics and Regulation, Public Health, Vaccines

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