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.
SB277, which eliminates nonmedical exemptions to school vaccine mandates in California, is a very good law, but it’s not perfect. Unfortunately, one provision allows the issuance of medical exemptions based on the say-so of doctors using antivaccine misinformation and pseudoscience.
I realize that it’s a cliché to say so, but some clichés are true. Time really does fly. It’s hard to believe that a year ago California—and, by proxy, the rest of the country—was in the throes of a major political war over the bill SB277. SB277, you will recall, was a bill introduced into the California Assembly in the wake of the Disneyland Measles outbreak in early 2015 that eliminated non-medical exemptions to school vaccine mandates beginning with the 2016-2017 school year. Ultimately, SB277 passed and was signed into law by Governor Jerry Brown last July. It was an uncommon victory for science and public health, and already appears to be having a positive effect on vaccine uptake in kindergarten children.
Unfortunately but not unexpectedly, to say that the proposal and passage of SB277 into law drove the antivaccine movement into even greater fits of crazy in response is to put it mildly. It became a common trope on antivaccine websites and blogs to see SB277 compared to fascism, in particular the Holocaust. Robert F. Kennedy, Jr. and “Dr. Bob” Sears explicitly compared SB277 to the Holocaust. Truly, the Godwin was strong in the antivaccine movement. One particularly offensive meme that went around at the time consisted of antivaccinationists suggesting that SB277 was a major step in the direction of requiring unvaccinated children to wear a badge or armband to identify themselves, the way that the Nazis required Jews to wear badges or armbands with a yellow Star of David on them. One, Heather Barajas, even went so far as to be photographed with her children wearing such an “unvaccinated” badge and juxtapose that photo with photos of Jews from the Third Reich wearing yellow Stars of David. (more…)
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. (more…)
I was mistaken in my pessimism, and I’m happy about that. I’m grateful to all those who didn’t see passing this law as an impossible task, such as Senators Richard Pan and Ben Allen, and who worked tirelessly to see it through, as some of our regular readers did. I was also pleasantly surprised that Governor Jerry Brown didn’t betray California children by watering down the bill with a signing statement, as he did three years ago when an earlier bill (AB 2109) was passed to make it more difficult for parents to obtain personal belief exemptions to school vaccine mandates.
So since SB 277 is law in California, what now? (more…)
As I write this, I am currently at the Center for Inquiry (CFI) Reason for Change conference, where on Friday Steve, Harriet, and I did a panel on—what else?—alternative medicine and how it’s become “integrative medicine.” As a result, I’ve been very busy, which means that parts (but by no means all) of this post will look familiar to those of you who follow me at my not-so-super-secret other blog. However, it occurred to me after we did our panel discussion that there are important things happening in California that we’ve only barely touched on here on this blog. I’m referring, of course, to a bill (SB 277) that’s wending its way through the California legislature. SB 277, if passed, would eliminate nonmedical exemptions to school vaccine mandates. That’s not to say we haven’t discussed the issue of nonmedical exemptions, of which there are two types: religious and personal belief exemptions (PBEs), which can all be simply described as PBEs. Both Steve Novellaand I have addressed them on SBM. For example, when an earlier bill (AB 2109) was passed that mandated that parents seeking PBEs consult with a physician or other listed health care professionals (which, unfortunately, included naturopaths) before a PBE would be granted, I documented how the antivaccine movement strenuously objected even to this minor tweak in the law that would make PBEs slightly more difficult to obtain. Unfortunately, even though, against all expectations, the bill passed, Governor Jerry Brown sabotaged it with a signing statement that betrayed California children by reinstating, in essence, religious exemptions. Specifically, Gov. Brown ordered the California Department of Public Health to include a check box on the form that parents could check to say they have religious objections to vaccines. Parents who checked that box could thus bypass even the anemic requirement to consult with a pediatrician before being granted a PBE.
The problem with nonmedical exemptions to school vaccine mandates is that vaccine-averse and antivaccine parents tend to cluster mostly in areas where white, affluent people live, as demonstrated in California and my own state of Michigan. So, even though antivaccinationists frequently tout high statewide vaccination rates as evidence that the process for obtaining PBEs does not need to be tightened up, they are disingenuously using a straw man argument against vaccine mandates, because it’s the pockets of low vaccine uptake that compromise local herd immunity that are the problem. We see these in Oregon, California, Michigan, and many other states with PBEs, and we also know that ease of obtaining PBEs is correlated with more PBEs and more outbreaks of vaccine-preventable diseases.
All of this came to a head earlier this year with what is now known as the Disneyland measles outbreak, a large multistate outbreak originating at Disneyland and traced to unvaccinated children. This outbreak so shocked California that the unthinkable happened. The possibility of passing a law eliminating nonmedical exemptions to vaccine mandates, something virtually everyone would have considered as much a fantasy as many of the characters played by the recently deceased great Christopher Lee played during his career, suddenly became an attainable goal. Senators Richard Pan and Ben Allen introduced SB 277, which would eliminate the personal belief exemption for children attending state licensed schools, daycares, and nurseries in California. (more…)
Editor’s note:There is an extra special bonus guest post today in addition to my regular post. It’s by Paul Knoepfler, a stem cell biologist, and it’s about unregulated stem cell clinics. Be sure to check it out!
Last week, I wrote about a rather impressive measles outbreak at the “happiest place on earth,” a.k.a. Disneyland. At the time I wrote that post, the outbreak, which had reached several states, had spread to 17 people. As I sat down to write this, I wasn’t actually sure that this topic needed another post, but then I saw this:
As the number of measles cases continues to rise in Southern California following an outbreak at Disneyland last month, about two dozen unvaccinated students at one Orange County high school have been forced to stay home after a classmate contracted the disease.
In a message to students and parents at Huntington Beach High School on Thursday, Pamela Kahn, health and wellness coordinator at the Orange County Department of Education, said that students “who do not have any documented [measles, mumps and rubella] immunizations will be excluded from attending school until January 29.”
Also, the number of confirmed measles cases has climbed to 52, 46 of them in southern California. In Orange County itself, there were 16 cases as of Friday, ten of them linked to Disneyland, the rest not, a finding that’s led health officials to conclude that “measles has become more widespread throughout the county.” Not surprisingly, health officials in Californian are warning that the number is likely to go higher still. In fact, it’s already happening as “satellite” outbreaks are being reported as children infected at Disneyland come home and infect others. (more…)
Last week, the self-proclaimed “happiest place on earth” wasn’t so happy.
One of the disadvantages of posting once a week is that, unless I muscle in on someone else’s day I can’t respond rapidly to stories that appear early. Of course the flip side of that is that if a story appears over the weekend it’s all mine, and, besides, I have my not-so-super-secret other blog to respond to issues that occur earlier in the week. Another advantage is that, if I do decide to write about something from earlier in the week, I have the advantage of time to think.
You’ve probably figured out that what I’m referring to is the latest measles outbreak. Not surprisingly, it happened in the Los Angeles area. Surprisingly (or perhaps not so much), it happened at Disneyland. I say “not surprisingly” because it’s been well-publicized over the last few years that there are pockets of low vaccine uptake and high personal belief exemptions in California, complete with measles and pertussis outbreaks. This is thanks to pockets of affluent, entitled parents full of the Dunning-Kruger effect who think that they can learn as much about vaccines and autism via Google University as pediatricians and researchers who have devoted their entire professional careers to studying them. Of course, these parents are also facilitated by pediatricians who cater to their fears, the most famous of whom is Dr. Bob Sears, whose The Vaccine Book is a very popular, reasonable-sounding (to parents not aware of the antivaccine tropes within) bit of antivax lite, but there is also our old buddy Dr. Jay Gordon and a host of others.
I’ve heard it said (actually, I’ve said it myself) that if you don’t have the science and evidence to back up your point of view, in order to persuade someone, make a movie. At least, this seems to be the philosophy of a number of cranks who have produced movies promoting pseudoscience over the last five years or so. The first one of these movies that really caught my attention was an anti-evolution, pro-“intelligent design” creationism documentary narrated by Ben Stein and released in 2008, Expelled: No Intelligence Allowed. The movie was pure creationist propaganda, complete with Ben Stein visiting Auschwitz and Dachau, the better to try to link “Darwinism” to the Holocaust.
Movies promoting religious pseudoscience such as intelligent design creationism are not the only kinds of pseudoscience propaganda films. Indeed, medicine is rife with them, and Wally Sampson has referred to this particularly pernicious genre of documentary as “medical propaganda films.” During the existence of this blog, we’ve reviewed a few such films (or at least written about what we could find out about them without paying for the DVD). For example, I’ve written about The Beautiful Truth, a paean to the Gerson protocol for cancer, complete with coffee enemas, and reviewed Simply Raw: Reversing Diabetes in 30 Days, a film dedicated to the claim that you can cure almost everything (including not just type II but type I diabetes) with a raw vegan diet. Harriet reviewed The Living Matrix: A Film on the New Science of Healing, a movie promoting “energy medicine” quackery. There’s even a film out now praising Stanley Burzynski and his highly dubious “antineoplaston” therapy that I’ve been meaning to review. I finally found a free copy of it to watch, and perhaps I’ll get to it before the end of the month. In the meantime, there’s a documentary people have been begging me to check out called The Greater Good that has been making the rounds of various film festivals and will be debuting at the IFC Center in New York on November 18. The very fact that Joe Mercola has hosted the movie streaming on his website in celebration of what he and Barbara Loe Fisher have dubbed “Vaccine Awareness Week” should tell you all you need to know about the movie.
I’m going to tell you more, though, because I’ve actually managed to sit through the whole thing. The things I do for my readers! To give you an idea of what you’re in for (in case the video is no longer available by the time that you read this), here’s the trailer:
The first thing I noticed about The Greater Good is that it’s slick and very well produced—considerably better produced, I think, than Expelled! The only aspect of it that I found annoying (besides the sheer quantity of anti-vaccine misinformation, pseudoscience, talking points, and distortions, all of which were plenty annoying) was the little animated segments. (Well, the little animated segments and any segment featuring Dr. Bob Sears.) However, given the sheer mass of anti-vaccine propaganda contained within this documentary, quibbling about a stylistic element like that is rather like quibbling about the arrangement of the deck chairs on the Titanic.
The documentary is structured, as many documentaries are, around three families, the better to provide the human interest “hook” for the rest of the story. Interspersed with segments about each family are interviews with various experts. Perhaps I should say two experts arrayed against a whole lot of “experts,” because defending vaccines we have real experts like Dr. Paul Offit; Dr. Melinda Wharton of the CDC; Dr. Norman Baylor, who is Director of the Office of Vaccines Research and Review in the FDA’s Center for Biologics Evaluation and Research; and Dr. Mark B. Feinberg, Vice President for Medical Affairs and Policy for Merck Vaccines and Infectious Diseases at Merck & Co., Inc. Arrayed against them we have a whole lot of anti-vaccine pseudoexperts, such as Barbara Loe Fisher, grande dame of the anti-vaccine movement and founder of the Orwellian-named National Vaccine Information Center (NVIC); Dr. Bob Sears, a pediatrician known for his non-science-based “alternative” vaccination schedule, who of late appears to have ceased mere flirting with the anti-vaccine movement and thrown his lot in with it; Dr. Lawrence Palevsky, a “wholistic” pediatrician; Dr. John Green III, who is described as a “specialist in clinical ecology and nutritional medicine“; and several trial lawyers known for representing parents suing for “vaccine injury,” lawyers such as Clifford Shoemaker, Kevin Conway, and Renee Gentry. (more…)
The year 2011 is starting out rather promisingly, at least from the point of view of science-based medicine. Its beginning coincides with the release of two — count ’em, two! — books taking a skeptical, science-based look at vaccines and, in particular, the anti-vaccine movement. First off the mark is a new book by a man whom the anti-vaccine movement views as the Dark Lord of Vaccination, sitting up in Barad-dûr (apparently the University of Pennsylvania and Children’s Hospital of Philadelphia), a man utterly reviled by anti-vaccine quacks everywhere, Dr. Paul Offit. He has been subjected to considerable bile and harassment due to his simply standing up for the science behind vaccines. The book is entitled, appropriately enough, Deadly Choices: How the Anti-vaccine Movement Threatens Us All. Also being released is a new book by Seth Mnookin entitled The Panic Virus: A True Story of Medicine, Science, and Fear. Mnookin is a contributing editor at Vanity Fair and whose work has appeared in numerous publications. Because I got a copy of Deadly Choices before my copy of The Panic Virus arrived, I decided to review Deadly Choices first; after I’ve managed to read The Panic Virus, I’ll write a review of it as well. Both books are arrows shot at the heart of the pseudoscience and fear at the heart of the vaccine manufactroversy, and it might well be useful to compare and contrast the two once I’ve finished The Panic Virus.
In the meantime, let’s take a look at Deadly Choices, an excellent, well-researched book with which I have relatively few disagreements. It is a followup to Dr. Offit’s last book, Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure, which I reviewed back when it first came out. In contrast to Autism’s False Prophets, which concentrated primarily on the manufactroversy that claims that vaccines are responsible for the “autism epidemic,” Deadly Choices steps back to take a broader look at the anti-vaccine movement. Regular readers of SBM hardly need to be reminded how pervasive and dangerous the modern-day anti-vaccine movement has become. Indeed, it is a frequently discussed theme of this blog, given that the anti-vaccine movement is such a major force among the forces that deny the efficacy of scientific medicine and seek either to replace it with unscientific or pseudoscientific “alternatives” or to “integrate” pseudoscience into science-based medicine. Indeed, anti-vaccine sentiment infuses large swaths of what we refer to as “complementary and alternative medicine” (CAM), be it chiropractic, homeopathy, traditional Chinese medicine, or a wide variety of other modalities and systems.
In examining the modern anti-vaccine movement, Dr. Offit structures his book into three major sections. First, beginning in a chapter entitled The Birth of Fear, Dr. Offit begins with a description of the birth of the modern anti-vaccine movement, which in the U.S. Dr. Offit traces, in large part, to the broadcast of an irresponsible and anecdote-driven news documentary about the diptheria-pertussis-tetanus (DPT) vaccine in 1982, and in the U.K. to a scare about the DPT triggered by a presentation by Dr. John Wilson to the Royal Society of Medicine about horrific complications thought to be due to the pertussis vaccine in the DPT. Next, Dr. Offit goes back into history to describe the development of the anti-vaccine movement in the 1800s in England and notes parallels with the modern day anti-vaccine movement. Finally, the story shifts back to today, where he describes the situation now, how demands for vaccines turned into fear of vaccines, and what we might do about it. (more…)
Coat of arms for the University of Toronto, where the conference took place.
If there’s one thing that purveyors of pseudoscientific medical modalities crave, probably above all else, it’s legitimacy. They want to be taken seriously as Real Scientists. Of course, my usual reaction to this desire is to point out that anyone can be take seriously as a real scientist if he is able to do science and that science actually shows that there is something to his claims. In other words, do his hypotheses make testable predictions, and does testing these predictions fail to falsify his hypotheses? That’s what it takes, but advocates of so-called “complementary and alternative medicine” (CAM) or “integrative medicine” (IM, or, as I like to refer to it: “integrating” quackery with scientific medicine) want their woo to be considered science without actually doing the hard work of science.
There is, however, a third strategy. How do scientists communicate their findings to other scientists, as well as meeting and mingling with other scientists? Why, they hold scientific meetings, of course! These meetings can be small or even as large as the American Association for Cancer Research meeting, which is attended by around 15,000 cancer researchers each year. So, too, do cranks hold meetings. These meetings often have all the trappings of scientific meetings, with plenary sessions, smaller parallel sessions, poster sesssions, and an exhibition hall, complete with exhibits by sponsoring companies. Sometimes these meetings can even appear so much like the real thing that they take in legitimate researchers and legitimate universities. Here, I present two examples of such conferences. (more…)