I’m currently putting the finishing touches on a presentation for the The Ontario Public Health Convention next week, where I’ll be speaking, with occupational therapist Kim Hébert, about the anti-vaccine movement and social media (SM): how antivaccine advocates use it, and the challenges and opportunities for public health advocates. I’m pleased to see Seth Mnookin, author of The Panic Virus and someone whose work is likely known to many SBM readers, is one of the keynote speakers – his perspective will be valuable for the public health crowd which has traditionally relied on fairly static “key messages” for disseminating information on vaccine safety and effectiveness. The panel discussion of which I am a part will be an examination of challenges and opportunities presented to public health advocacy, and particularly vaccine advocacy, in a Web 2.o environment. What seems clear is that the old public health channels don’t cut it anymore: these methods are distant and insufficient to address the wide and rapid spread of misinformation in an era of social media. We all remember the anxiety over H1N1 just a few years ago – and judging by the poor uptake of the vaccine, it seemed the anti-vaccine movement had some success in propagating fear, uncertainty, and doubt. I’d almost forgotten about this chestnut from the Health Ranger himself:
Posts Tagged Vaccines
One of the hallmarks of science as it has been practiced for the last century or so is that scientists share their discoveries in the peer-reviewed literature, where their fellow scientists can evaluate them, decide if they’re interesting, and then replicate them, usually as a prelude to building upon them. While the system of publication and peer review in science is anything but perfect (and, indeed, we have discussed many of its shortcomings right here on this very blog), I tend to like to view it in much the same way Winston Churchill characterized democracy:
Many forms of Government have been tried and will be tried in this world of sin and woe. No one pretends that democracy is perfect or all-wise. Indeed, it has been said that democracy is the worst form of government except all those other forms that have been tried from time to time.
I would rephrase this as:
Many forms of evaluating science have been tried and will be tried in this world of sin and woe. No one pretends that peer review is perfect or all-wise. Indeed, it has been said (by me) that peer review is the worst form of evaluating science except all those other forms that have been tried from time to time.
As mainstream medicine has become more scientific over the last century in the wake of the Flexner Report, physicians and medical researchers have similarly come to view publication in the peer-reviewed literature to be a very important component of communicating and evaluating medical discoveries. It’s not as though this is even a particularly high bar to pass, either. After all, many are the absolutely execrable papers that I (and my partners in crime here at SBM) have discussed over the last four years, nearly all of which were in peer-reviewed journals, some very prestigious. After all, if papers on “energy chelation” can find their way into decent journals and the likes of Mark and David Geier can publish in the peer-reviewed literature, while someone like Christopher Shaw can get cringe-worthy confusions of correlation with causation published, I don’t take seriously the whines of cranks who claim that they can’t publish in the peer-reviewed literature for one reason or another.
That’s why I view being published in the peer-reviewed literature as a minimum, but by no means sufficient, requirement good science. It’s also why, whenever I see a new claim, my first reaction is to see if (1) the person making the claim has published on it and (2) there are publications in the peer reviewed literature that support the claim. The first criterion helps me judge whether the person is a serious scientist; the second, whether there is any plausibility to his ideas. Sure, it’s not a foolproof scheme, but it is helpful.
I only wish antivaccinationists would do the same. That they don’t explains why they seem to be embracing someone named Dr. Hanan Polansky.
I’ve spent the last three weeks writing about a “brave maverick doctor” by the name of Stanislaw Burzynski who claims that he can cure cancers that regular oncologists cannot. He uses a combination of what he calls “antineoplastons” (which, it turns out, are more or less than the active metabolites of an orphan drug known as sodium phenylbutyrate) plus a very expensive cocktail of chemotherapy and targeted agents chosen in a haphazard fashion and thrown together with little rhyme or reason. This week, I had planned to move on. However, I felt that I had to mention the Burzynski saga because it provides me with the most appropriate segue to a topic I’ve been meaning to write about for a long time, possibly since this blog began. In fact, it’s about as perfect a framework as I can think of upon which to drape the points I want to make in this post.
What I will discuss is perhaps the most effective, devastating attack that proponents of quackery, woo, and nonsense aim at supporters of science-based medicine (SBM). As far as that is the case, it is not effective because it’s fact-based, evidence-based, or science-based. Far from it. Rather, it’s effective because it appeals to the emotions and very effectively demonizes SBM proponents to the point where they often have a hard time standing their ground when it is used. Sometimes, it preemptively prevents them from even speaking up in the first place. It’s a little tactic that I like to call the “compassion gambit,” which means trying to discredit critics of “alternative” medicine by painting them as cold, unfeeling, uncaring, arrogant monsters who want to hurt or kill children (and probably get a big smile on their faces when they torture puppies, to boot).
The Greater Good: Pure, unadulterated anti-vaccine propaganda masquerading as a “balanced” documentary
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.
Dr. Gorski is in the throes of grant-writing, so I’m filling in for him today by following up on a topic introduced a few months ago. It involves a key medical player in the U.S. government: Dr. Josephine Briggs, Director of the National Center for Complementary and Alternative Medicine (NCCAM).
Steve Novella and I first encountered Dr. Briggs at the 2nd Yale Research Symposium on Complementary and Integrative Medicine in March, 2010. I reported here that she seemed well-meaning and pro-science but that she also seemed naive to the political realities of her office and to much of the content of “CAM” (as illustrated by her recommending the NCCAM website, which is full of misinformation; previously I’d noticed her unfortunate innocence of “acupuncture anesthesia,” which is to be expected of most academics but not of the CAM Explicator-in-Chief).
Here’s an excellent news report from Australia on the human costs of the anti-vaccine movement:
The video features Viera Scheibner, who has nothing good to say about vaccines and thinks that vaccines are dangerous and infectious diseases in childhood are good. It also features the stories of children who caught vaccine-preventable diseases. This is how it’s done.
I was asked to review the book Make an Informed Vaccine Decision for the Health of Your Child by Mayer Eisenstein with Neil Z. Miller. Fortunately my public library had it so I didn’t have to buy a copy. Reading it was a painful déjà vu experience. I can honestly say it met all my expectations: I expected that its concept of “informed decision” would equate to deciding not to vaccinate, and that it would rely on the same tired old fallacious arguments that have been heard before and rejected by knowledgeable scientists. The only thing that surprised me was a warning/disclaimer statement that admitted
this book tends to find fault with vaccines, therefore readers are advised to balance the data presented here with data presented by “official” sources of vaccine information, including vaccine manufacturers, the FDA, CDC and World Health Organization.
The fact that the book omitted all that balancing data undermines its pretense that it is intended to help readers make a truly informed decision.
A good case of smallpox may rid the system of more scrofulous, tubercular, syphilitic and other poisons than could otherwise be eliminated in a lifetime. Therefore, smallpox is certainly to be preferred to vaccination. The one means elimination of chronic disease, the other the making of it.
Naturopaths do not believe in artificial immunization . . .
—Harry Riley Spitler, Basic Naturopathy: a textbook (American Naturopathic Association, Inc., 1948). Quoted here.
Here’s what a good case of smallpox will do for you:
If you’re lucky enough to beat the reaper (20-60%; 80% or higher in infants) or blindness (up to 30%), those blisters will leave you scarred for life. Oh, and the next time a good smallpox epidemic comes around, your children born since the last one will catch it and contribute their fair share to the death rate. But not you because you’ll be immune, so you’ll have the “preferred” experience of watching your children die well before you do.
The anti-vaccine movement is a frequent topic on the Science-Based Medicine blog. There are a number of reasons for this, not the least of which being that the anti-vaccine movement is one of the most dangerous forms of pseudoscience, a form of quackery that, unlike most forms of quackery, endangers those who do not partake of it by breaking down herd immunity and paving the way for the resurgence of previously vanquished diseases. However, anti-vaccine beliefs share many other aspects with other forms of quackery, including the reliance on testimonials rather than data. Even so, although the intelligentsia (and I do use the term loosely) of the anti-vaccine movement realizes and exploits the power of anecdotes and testimonials and how human beings tend to value such stories over dry scientific data, leaders of the anti-vaccine movement realize that science is overwhelmingly against them and that testimonials alone are not adequate to counter that science in the realm of public policy and relations.
That’s why, over the years, various anti-vaccine “scientists” (and I use that term very loosely as well) have produced poor quality, sometimes even fraudulent studies, which are then touted as evidence that vaccines cause autism or at least as evidence that there is actually still a scientific controversy when in fact from a scientific standpoint the vaccine-autism hypothesis is pining for the fjords. Examples abound, including the work of Mark and David Geier, whose studies led the to use chemical castration to treat autistic children; Andrew Wakefield, whose small case series almost certainly included fraudulent data; a truly incompetent “phone survey” commissioned by Generation Rescue designed to compare “vaxed versus unvaxed” children; and an even more incompetent “study” in which Generation Rescue used a cherry picked group of nations to try to argue that nations that require more vaccines have higher rates of infant mortality. These efforts continue. For example, last year Generation Rescue requested $809,721 from the Airborne settlement to set up a “vaxed versus unvaxed” study, despite the known difficulties with such a study and the low likelihood of finding anything without huge numbers of children.
Last week, they were at it again.