Reality Bites Back

22 Mar

So many times I have heard it said by the anti-vaxx/autism believers how they are ‘the mainstream voice’ – *the* autism community.

Today, they got a bit of a reality check.

The New York Times discussed an NYT article in which parents who refuse to vaccinate their kids say:

I refuse to sacrifice my children for the greater good,” said Sybil Carlson, whose 6-year-old son goes to school with several of the children hit by the measles outbreak here………….Ms. Carlson said she understood what was at stake. “I cannot deny that my child can put someone else at risk,” she said.

This piece was written in the wake of a measles outbreak in San Diego:

In a highly unusual outbreak of measles here last month, 12 children fell ill; nine of them had not been inoculated against the virus because their parents objected, and the other three were too young to receive vaccines.

These are the same people who claim that measles is a ‘nothing’ disease – that they had it as kids and it never did them any harm. An argument that reminds me of the one elderly smokers wheel out that they smoked every day of their lives and it never did them any harm as they cough what remains of their lungs up and continue infecting the air with second hand smoke.

Lets be honest here. What these people are doing is very much akin to selfish smokers. They’re wandering up to you and effectively pissing in your face.

Here’s an article from Jan last year in New Scientist.

Deaths have fallen from 873,000 during 1999 to 345,000 by the end of 2005,” said WHO director-general Margaret Chan, on Thursday. “This is a 60% reduction.” And the news is even better in Africa, Chan said. “Deaths there declined by 75%, so Africa is leading the way.”

Measles deaths in children under five fell from 791,000 to 311,000 over the same period, globally.

The new figures estimate that, altogether, measles vaccinations have prevented 7.5 million deaths between 1999 and 2005, and 2.3 million of these were attributable to the intensified programme.

In 2005, 345,000 people *died* from measles. This is down from 873,000 people who *died* from this ‘nothing’ disease that never does anybody any harm. Are people really so purposefully stupid?

And what helped achieve this 60% drop in *deaths* – was it Jenny McCarthy doing chat shows? Was it a whole bunch of people deliberately misrepresenting what happened to a nine year old girl?

No. It was *vaccines* .

Anyway….

In the NYT thread, several stalwart commenter’s from the Age of Autism blog have turned up trying to make their points. The replies to them/before them/after them quite nicely demonstrate how isolated from the mainstream they actually are and how well informed the average person on the street has become both about the need for vaccines and about these people in particular. I do worry that they might start seeing every parent of an autistic child as an anti-vaxx loon but on the positive side, it has shown up very, very publicly how small the autism/anti-vaxx group actually is numerically as well as how little the average person believes them.

By the way, I am well aware that there is another discussion going on in another US papers comments section but I will not link to that as it contains comments about an individual that I want to distance myself from totally and will deny any knowledge of or participation in. Please do not allude to, link to or name either this individual or the newspaper in question.

About these ads

42 Responses to “Reality Bites Back”

  1. Science Mom March 22, 2008 at 14:52 #

    Anti-vaxers aren’t interested in statistics from developing or underdeveloped countries..they simply don’t apply to them (having the luxury of a first-world perspective) and well, it seriously refutes their arguments that VPDs are nothing to worry about.

    If you even mention them (third-world stats) you will be met with the predictable and unrealistic canard of, “Just send them clean water and food; they need good sanitation and nutrition, not vaccines”. The application of logic is wholly lost on them as they are operating in an alternate reality.

  2. mayfly March 22, 2008 at 15:48 #

    What really matters is the mortality rate. I saw a statement from WHO that there are about 30,000,000 cases per year. I don’t know if that figure relates to the higher and lower death toll you quote.

    However, the frequency of death from measles is certainly higher than the frequency of autism. If you then the mortality rates of the other diseases we can vaccinate
    against; If you then factor in that many of these diseases can cause brain damage; one would need to be a fool not to vaccinate.

    “The quote I will not sacrifice my child for the greater good.” sounds like the person is quite willing to take advantage of “herd immunity”, but unwilling to contribute to it.

  3. Schwartz March 22, 2008 at 16:00 #

    ScienceMom,

    The risk/benefit ratio of vaccines (or any medical intervention) is very different in Africa and third world nations than it is in a first world country. Why would you speak as if it’s the same?

    Kev, I wouldn’t read too much into replies from any newspaper blogs. They’re usually moderated (meaning they choose which entries to post) and I find they only represent the views of a small minority of the population that wait to post in such places.

    I must admit though, the NYT postings are better than I expected. The other one much less so.

  4. Joseph March 22, 2008 at 16:49 #

    The risk/benefit ratio of vaccines (or any medical intervention) is very different in Africa and third world nations than it is in a first world country. Why would you speak as if it’s the same?

    Of course it is, because of herd immunity. People who don’t get vaccinated (like your kids) in the industrialized world will probably be fine. You’re of course taking advantage of the fact that most people do get vaccinated. I’m not sure how I would characterize that, but I don’t think it’s a good deed.

    The suggestion that vaccines don’t work, or that vaccine preventable diseases are ‘nothing’ is what’s at issue. Do you at least concede that these positions (common in your side of the debate) are absurd?

  5. century March 22, 2008 at 17:30 #

    Science mom

    “Just send them clean water and food; they need good sanitation and nutrition, not vaccines”.

    And do you believe in the opposite – vaccinate them all and stuff the living conditions? I presume you live in 1st world luxury

  6. Kev March 22, 2008 at 17:46 #

    Where did you get that from century? I didn’t see Science Mom say or even suggest any such thing.

  7. Science Mom March 22, 2008 at 18:24 #

    The risk/benefit ratio of vaccines (or any medical intervention) is very different in Africa and third world nations than it is in a first world country. Why would you speak as if it’s the same?
    No kidding Schwartz. Does that mean that developed countries have zero risk of disease epidemics, morbidity and mortality? After all the treatment for measles has not changed as in there is none and how do you stop a baby from being born with congenital rubella syndrome?

    And do you believe in the opposite – vaccinate them all and stuff the living conditions? I presume you live in 1st world luxury
    Of course I said nothing of the sort, I was merely parroting the flip and mindless suggestions of the anti-vax ignorati that are speaking from a first-world perspective and don’t have a single clue of what it means for a vaccine to be the difference between living past childhood or death. The next time you decide to defend that canard century think of this: How preferable it would be for such countries to have a sustainable infrastructure to become self-sufficient; instead, health agencies have to battle with corrupt dictators, genocidal warlords, wars, ignorance, fear and abject poverty just to get a couple days worth of clean water and basic nutrition to a village. See, it’s not so simple.

  8. HCN March 22, 2008 at 20:10 #

    century said “And do you believe in the opposite – vaccinate them all and stuff the living conditions? I presume you live in 1st world luxury”

    And what about Japan? They are a 1st world country, and yet when they stopped measles vaccination measles came back. With several deaths per year, and them being embarrassed as a nation as a source of imported measles in other countries. See:
    http://www.ncbi.nlm.nih.gov/pubmed/18346240? … which says “Trend of exported measles cases from Japan to the United States has corresponded with the measles activity trend in Japan. Most of the cases were unvaccinated. This international health problem should be solved by strong leadership of Japanese public health professionals.”

    Which is the same that can be said for Switzerland, the source of the recent measles outbreak in San Diego, CA, and the recent outbreaks of measles in the UK.

    Did the sanitation in these countries deteriorate?

  9. Schwartz March 22, 2008 at 22:51 #

    Joseph,

    You honestly can’t believe that herd immunity is the only differing variable in health risks between the third and first countries?

    That is what your post makes it sound like.

    Obviously herd immunity is one variable, but there are a lot of others. In many cases the people won’t have access to doctors for long periods of time. In those cases, it certainly makes sense to pre-emptively prevent illness when in the case of disease, there won’t be access to health care.

    There are many other variables that come into play that have everything to do with affecting the risk of damage or death once a disease is contracted.

  10. Schwartz March 22, 2008 at 23:00 #

    Science Mom,

    You are the one who made a blanket statement about a stereotypical group, not me. You are making arguments like they apply equally to both first and third world countries. They do not. You need to do the risk/benefit analysis for each location and then make an informed decision in each. To suggest otherwise is ignorant.

    There are other vaccination strategies that effectively eliminate CRS without requiring mass vaccination of everyone at birth (or 1 year old).

    Are you claiming that the strategy for treating a serious case of measles (and it’s complications) in a place without clean water, medicine, or good food is the same as in a western hospital?

  11. Schwartz March 22, 2008 at 23:03 #

    HCN,

    Out of curiosity, have you been vaccinated for Hib, Hep B, MMR and DTaP, Pnemoccocal and Prevnar in the last 10 years?

    If not, you are likely contributing to the herd immunity problem.

  12. Schwartz March 22, 2008 at 23:09 #

    HCN,

    I forgot about varicella, apparently the most recent news about that vaccine is that it is less effective than originally claimed (the efficacy rate was ~ 10% less than advertised) resulting in outbreaks due to primary vaccine failure.

    I witnessed this firsthand as my daughters contracted it from their vaccinated cousin.

  13. Joseph March 23, 2008 at 00:00 #

    You honestly can’t believe that herd immunity is the only differing variable in health risks between the third and first countries?

    Swartz,

    Of course not. But in the case of diseases that are basically eradicated in the first world but still rampant in the third world, I’d say herd immunity is key, don’t you agree? It’s undeniable that vaccination programs in the third world have an impact on mortality and so forth.

    I believe you avoided my main question, though. Do you or do you not concede as absurd the notions that vaccines don’t work and that vaccine preventable diseases are trivial?

  14. Ms. Clark March 23, 2008 at 00:17 #

    I got the MMR within the past 10 years. It was mandatory for me to get into community college. No really. I was all brave and got the shot. Survived and everything. Apparently measles is extremely, extremely contagious. If it was common for adults to have no immunity to it then there would have been lots of adults who came in contact with these kids who would have become sick and spread the disease even further. So I’m guessing that immunity from earlier measles or measles vaccine hangs in ther pretty good. I got spooked when I was exposed to Whooping cough a couple of years ago, I went and got a TdAP shot. Survived and everything. I got the Hep A shot about 10 years ago…. somehow survived that one. I’ve had several flu shots in the past few years. Survived them too, even with all that mercury in them.

  15. HCN March 23, 2008 at 01:51 #

    Young man, I am old enough to have gotten measles, mumps, rubella and chicken pox as a child. Back in the day when kids in my school disappeared and possibly ended up at the School for the Deaf in Fremont, CA (or in some other institution).

    I am current on all my vaccinations.

    More than likely, your parents made sure you were fully vaccinated (you sound young enough to get the MMR, which came out in 1971, about 3 years after I had mumps).

    I was always fully vaccinated, including things like smallpox, yellow fever and typhus (Army brat, moved around lots). About the only thing I have not had that you might have had is BCG for tuberculosis (since in the USA it interferes with the tine test).

    All of my kids have been fully vaccinated (except they all got the actual disease of chicken pox a year before the vaccine was available). The younger two got their second MMR a bit early because a nearby private school with lots of non-vaccinated students had a fairly large outbreak of measles imported from Korea (older child already had his second dose).

    What does this have to do with measles in Japan, Switzerland and the UK?

    Your point?

    Oh, wait… you don’t have any other than being against vaccines on general purpose. You do not have disabled children (like many of us), or children with medical conditions that make them more susceptible to the actual diseases (like mine).

    (my son’s last seizure was during a now vaccine preventable disease when he was 15 months old, he was diagnosed with HCM when he was 14… not that you care, because your kids are protected from herd immunity, leeching off of the largess of Health Canada)

  16. Schwartz March 23, 2008 at 04:42 #

    Joseph,

    “I’d say herd immunity is key, don’t you agree?”

    Yes. I agree. One caveat though. Herd immunity only affects the risk of contraction. I firmly believe that the risk of death or damage upon contracting the disease is very different in the third world than it is in the first, and that is irrespective of herd immunity.

    “Do you or do you not concede as absurd the notions that vaccines don’t work…”

    I did not mean to avoid the question. I certainly agree that certain vaccines work. Specifically, I believe vaccines that target specific diseases are generally effective.

    I am not convinced of the theory that eliminating a small fraction of strains of a particular disease is effective in obtaining the objectives.

    “… and that vaccine preventable diseases are trivial?”

    I do not believe that all vaccine preventable diseases are trivial. In fact, I don’t believe any disease is trivial in every circumstance. Having said that, I do not agree that the line of net benefit is clear in the first world. I also believe that the risk of death and damage in the first world is exaggerated by the CDC.

    I fully agree that certain vaccines work very well (including measles) and that they are net beneficial in the third world without knowing the full safety aspects.

    However, I believe that not knowing the
    safety aspects in the first world is unacceptable and the line of net benefit is grey in specific cases of vaccines.

  17. Science Mom March 23, 2008 at 05:28 #

    You are the one who made a blanket statement about a stereotypical group, not me. You are making arguments like they apply equally to both first and third world countries. They do not. You need to do the risk/benefit analysis for each location and then make an informed decision in each. To suggest otherwise is ignorant.
    Schwartz, no blanket statements, nice try though. The risk/benefit analyses aren’t that different when a.)A global disease has not yet been eradicated and b.)One is not just free-riding on herd immunity. Are you suggesting that a country like the U.S. doesn’t need to vaccinate for measles or polio because only those ‘other countries’ have them? Do you believe that those 2 diseases would remain as lowly endemic as they are now? To suggest otherwise is what is ignorant.

    There are other vaccination strategies that effectively eliminate CRS without requiring mass vaccination of everyone at birth (or 1 year old).
    Let’s take a look at those other strategies shall we? In Japan, only women are vaccinated and are still contracting rubella during child-bearing years and pregnancies; Italy? Not doing so well there either due to nomadic groups and less than adequate vaccine uptake for herd immunity. The vaccine strategies that incorporate 2 vaccinations for both boys and girls have been the most effective at preventing CRS and no one vaccinates at birth for it.

    Are you claiming that the strategy for treating a serious case of measles (and it’s complications) in a place without clean water, medicine, or good food is the same as in a western hospital?
    There is no treatment for measles, only some sequelae benefit from Western medicine and of course the outcome can be dictated by the host’s fitness. There were and still are plenty of mortalities and severe morbidities resulting from measles infections in developed countries. What do you know of SSPE? It is 100% fatal and a result of natural measles infections and is rather non-discriminatory as evidenced by a 2001 paediatric index case that infected 9 unvaccinated children and infants in Germany. One is dead and another has been diagnosed with SSPE. I didn’t know that Germany was on the list of underdeveloped countries.

    We don’t live in a vacuum and it is incredibly myopic and ethnocentric to dismiss or discount global disease epidemiology.

  18. Schwartz March 23, 2008 at 06:09 #

    HCN,

    I’m pretty sure I’m not vaccinated with MMR but likely with the monvalent versions, and I’m probably older than you think… old enough to enjoy the young man comment. I also had chicken pox as a child.

    Some of the examples of outbreaks point clearly to primary vaccine failure, which is an issue of efficacy. You can read the analysis about it.

    I am not against all vaccination in principal at all. I am against irresponsible mass medication that is not properly safety tested. Without the safety tests, we don’t really know what we’re trading off. There is absolutely no attempt to identify at-risk children from vaccine reactions, and that is completely unacceptable in our society today.

    Why did I ask about your vaccinations? I asked because I don’t know a single adult in my peer group that has ever updated their vaccinations, let alone bothered to get the new ones like Prevnar or pnemococcal. This same peer group thought I was crazy for questionning vaccines (with one exception, and he’s an actuarial scientist who calculates risk for a living) but clearly doesn’t really care about herd immunity.

    One other friend now questions vaccines, but there is a suspicion that there is a good chance her sister (a medical doctor who worked in the third world) acquired MS from multiple Hep B vaccines.

    As for leeching, call it what you will. When the government or the doctors decide to take responsibility for the outcome of the vaccinations, then I might reconsider. Until then, every outcome of the vaccination decision is completely my responsibility, and my first responsibility is to their health. Until someone can provide credible numbers to calculate the risk/reward ratio appropriately, I choose not to undergo most of the medical interventions where the risk of damage or death is very low. (one daughter has recently been vaccinated for DTaP).

    “… not that you care, because your kids are protected from herd immunity… ”

    You really can’t know what I care about just from a bunch of arguments on the internet.

  19. Schwartz March 23, 2008 at 08:10 #

    ScienceMom,

    “Schwartz, no blanket statements, nice try though.”

    Let’s look at what you said:

    “Anti-vaxers aren’t interested in statistics from developing or underdeveloped countries..they simply don’t apply to them”

    Looks like a stereotype and blanket statement to me.

    “The risk/benefit analyses aren’t that different when… ”

    The risk of damage or death upon contraction is certainly very different for someone who has access to clean water, good food, and modern health care. Since the risk of damage or death is what we’re really interested in, I can’t believe you insist its the same here as it is in the third world. The risk of death or damage is multiplied by the risk of contraction to derive actual risk of death or damage.
    You are fixated on incidence, not damage.

    “There is no treatment for measles, only some sequelae benefit from Western medicine and of course the outcome can be dictated by the host’s fitness.”

    The WHO doesn’t agree:

    Severe complications can be avoided. General nutritional support and the treatment of dehydration with oral rehydration solution are necessary. Antibiotics should be prescribed for treating eye and ear infections and pneumonia. To improve survival, it is important that children with measles receive adequate nutrition and fluids.

    All children in developing countries diagnosed with measles should receive two doses of vitamin A supplements given 24 hours apart. This can help prevent eye damage and blindness. Moreover, vitamin A supplementation has been shown to reduce the number of deaths from measles by 50%.

    Looking alone at Vitamin A treatment, your casual dismissal of treatment results in a 50% difference in mortality. Not a trivial number by any measurement. Are you saying a minimum of 50% reduction from a single aspect of treatment is not much difference?

    Even better, lets look at some real numbers:

    From 1997:

    Incidence – Deaths – Percentage
    Africa( 11,439K – 549K – 4.7%)
    America ( 53,661 – 61 – 0.11%)
    Europe ( 1,923K – 5.5K – 0.29%)

    Even in Europe (which included Eastern Europe in 1997 conditions) the risk of death was 16 times lower than in Africa. In America we’re talking 40 times difference.

    “There were and still are plenty of mortalities and severe morbidities resulting from measles infections in developed countries.”

    Why don’t you define plenty for me? I would say there are plenty of known severe vaccine reactions and deaths in developed countries as well, let alone the unknown ones (since only a fraction are tracked, unlike measles cases). And since we don’t study anything past several days in the case of some vaccines, you have no idea what other effects there are. So what does either of our anecdotal examples mean? Not a whole lot without good data on both sides of the risk/reward ratio.

    “… 2001 paediatric index case that infected 9 unvaccinated children and infants in Germany. One is dead and another has been diagnosed with SSPE.”

    And what do you know of the health records of that one who died? You can’t take an isolated fact about a case and make assumptions about the rest of it. Too many times you read the details and find out that these children were already quite sick when they contracted measles. You can’t look at a fraction of the information and draw any conclusions.

    WRT to Rubella, I am willing to listen. However, as you alluded to, the problem in Japan can’t be blamed squarely on vaccination strategy or lack of herd immunity because they were only achieving an estimated 70% coverage of females. That looks more like a coverage problem to me, not one of strategy. I don’t agree with forcing everyone to vaccinate at birth (and undergo extra risk) because it’s more convenient.

  20. Catherina March 23, 2008 at 11:19 #

    And what do you know of the health records of that one who died? You can’t take an isolated fact about a case and make assumptions about the rest of it. Too many times you read the details and find out that these children were already quite sick when they contracted measles

    I know everything about Micha, the first child to developed SSPE, because I talked to his mom and uncle. He was a perfectly healthy, fully breastfed 5 months old baby when he contracted measles. He didn’t have any problems with the acute measles infection, he was a perfectly healthy toddler and preschooler until SSPE struck when he was about 5. He is blind now, has hundreds of myoclonic seizures every day – here is a recent post of his mom’s:

    http://www.rehakids.de/phpBB2/ftopic30537.html

    ‘Micha needs morphine now – his spasticity got worse…” here, have a look:

    These cases are, of course, extreme, but Germany has on average 7 to 8 new SSPE cases per year. 1 out of about 3000 babies who gets measles will come down with SSPE.

    But even in the ‘normal course’ of measles, unvaccinated children will fare a lot worse than vaccinated children. In the 1999/2000 measles epidemic in Ireland, all toddlers who needed to be admitted to ICU were unvaccinated, average hospital stay in 1x vaccinated toddlers was shorter than in unvaccinated. Same for measles mortality in developed countries. The German children who died of measles over the past years were ALL unvaccinated, every single one.

    BTW, both Micha and the girl who came down with SSPE due to the unvaccinated index case, are still alive (although in ‘awake coma’ dependent on round the clock care by 2 carers). Two other children (a 2 year old and a 13 year old) died in Germany of measles in 2007.

    Catherina

  21. century March 23, 2008 at 18:03 #

    Science Mom, HCN, Kevin and others

    Your choice – for hypothetical African country.

    Either vaccinate all (most) against measles or give the country clean water and sanitation? – your budget will only do one.

    Which one?

  22. Catherina March 23, 2008 at 19:42 #

    Hear the canard quack…

    In real life, humanitarian aid often brings both at the same time – see for example here:

    http://www.unicef.org/pakistan/reallives_3150.htm

    There is no ‘either/or’, also not in the developed world (‘we have sanitation, therefore we do not need vaccination’).

  23. HCN March 23, 2008 at 20:53 #

    century,

    Why are Japan, the UK and Switzerland seeing an increase in measles? Is it because their level of sanitation went down or the vaccination levels went down?

  24. Science Mom March 23, 2008 at 21:16 #

    Science Mom:
    Anti-vaxers aren’t interested in statistics from developing or underdeveloped countries..they simply don’t apply to them
    Schwartz:
    Looks like a stereotype and blanket statement to me.
    Oh OK, you got me; and what are you saying to disprove me?

    I am not fixated on incidence only; I am clearly interested in outcome but it is you and your ilk that insist upon everything will be sunshine and roses if everyone has a level playing field of health status and that simply isn’t true nor ascertainable at this juncture. Neither I nor the WHO disagrees with one another. Vitamin A is not a treatment for measles, it is a cure for vitamin A deficiency which is integral to immune function. You are introducing host factors that are not in dispute thus constructing a strawman. Of course their outcome improves and for illnesses other than measles. There is still very high morbidity and mortality and such areas serve as sources for exported disease which is why they cannot be discounted nor dismissed and why developed countries cannot become complacent and allow vaccination coverage to fall below protective levels for herd immunity.

    Why don’t you define plenty for me? I would say there are plenty of known severe vaccine reactions and deaths in developed countries as well, let alone the unknown ones (since only a fraction are tracked, unlike measles cases).
    OK, According to the WHO there were 92,004 reported cases of measles in Europe for the years of 2005 and 2006 with 23 fatalities and that doesn’t include the 6-10 cases of SSPEs that will statistically occur. That is not zero and most of those cases occur amongst unvaccinated. That is not an acceptable risk for me to take with me and my children.

    You never answered my questions with regards to the ‘what if’ scenario. The U.S. reported 400,000-500,000 cases of measles/year (coincides with birth cohort) pre-vaccine era so that means statistically, 400-500 cases of encephalopathies and 28-55 cases of SSPE just to mention a couple of measles sequelae that could potentially occur if we no longer vaccinated.

    WRT to Rubella, I am willing to listen. However, as you alluded to, the problem in Japan can’t be blamed squarely on vaccination strategy or lack of herd immunity because they were only achieving an estimated 70% coverage of females. That looks more like a coverage problem to me, not one of strategy. I don’t agree with forcing everyone to vaccinate at birth (and undergo extra risk) because it’s more convenient.
    Schwartz, coverage is intrinsically tied to strategy; ‘catching’ infants of both genders at young ages confers immunity to females of child-bearing age and by vaccinating boys, further interrupting transmission. Even though, it seems to make more sense to just vaccinate teenage girls, it’s not working out well.

    And what do you know of the health records of that one who died? You can’t take an isolated fact about a case and make assumptions about the rest of it.
    I guess I will be guilty of making another sweeping generalisation but why do anti-vaxxers always assume that a child that dies of a vaccine-preventable disease must have some underlying health problems.

  25. Science Mom March 23, 2008 at 22:53 #

    Kev, My latest post appeared then disappeared. Have you seen it? You can email me if there was a problem.

  26. Schwartz March 24, 2008 at 04:25 #

    Catherina,

    Thank you for the information. Do you know further information about the two children who died in 2007?

    Does the SSPE usually occur in children who contract measles below a certain age? I’m asking because of the way you worded the 1 in 3000 statistic. From what I’ve read, it’s those who contract it at a younger age are at higher risk, but I couldn’t find a lot of information.

  27. Schwartz March 24, 2008 at 05:13 #

    Science Mom,

    “Oh OK, you got me; and what are you saying to disprove me?”

    I am saying that stererotypes and blanket statements don’t make logical arguments, so there’s nothing to disprove.

    “I am clearly interested in outcome but it is you and your ilk that insist upon everything will be sunshine and roses if everyone has a level playing field of health status and that simply isn’t true nor ascertainable at this juncture.”

    And you continue with the stereotype again. I have stated here that I believe that the risk/reward ratio in third world countries results in net benefit for specific mass vaccination (measles certainly among them) even given the unknown safety profile. I am not convinced of the same in the first world and I find the unknown safety profiles unacceptable.

    “Vitamin A is not a treatment for measles, it is a cure for vitamin A deficiency which is integral to immune function.”

    Just like fluids or supporting saline isn’t a cure for severe diarhea because it’s actually a cure for dehydration. You may be technically correct, but the WHO doesn’t agree with you again, as they explicitly list it as a recommended treatment for measles.

    “You are introducing host factors that are not in dispute thus constructing a strawman.”

    Not at all. Your claim:

    “he risk/benefit analyses aren’t that different when a.)A global disease has not yet been eradicated and b.)One is not just free-riding on herd immunity.”

    I have demonstrated through both actual statistics and specific reasoning that the the risk/benefit analysis is quite different even under the scenarios you’ve listed. How is that a strawman?

    Would you say Germany has lost herd immunity? If so, do you believe the risk of death or damage is equal to that of a third world country?

    “That is not zero and most of those cases occur amongst unvaccinated. That is not an acceptable risk for me to take with me and my children.”

    You don’t know the risk of damage from the vaccines, so how do you know if it’s worthwhile? I’m not arguing that there aren’t risks, because clearly there are risks. The disease is dangerous to some children regardless of the environment. However, the actual numbers matter because everything has a tradeoff. The sad part is, we haven’t bothered to measure what we’re trading off.

    “You never answered my questions with regards to the ‘what if’ scenario. ”

    I’m sorry I missed that part earlier. I believe there is value in the vaccination program (otherwise I wouldn’t even participate in the limited fashion that I do). I do not believe we should stop vaccination of everything. Polio and measles vaccines both have merit IMO and Rubella in a scenario that works. However, I firmly believe that both should be purely optional until the scientists study the health effects of the vaccines and make some attempt to identify at risk children ahead of time.

    “Schwartz, coverage is intrinsically tied to strategy; ‘catching’ infants of both genders at young ages confers immunity to females of child-bearing age and by vaccinating boys, further interrupting transmission. Even though, it seems to make more sense to just vaccinate teenage girls, it’s not working out well.”

    Yes I agree, and there are different strategies to increase coverage that don’t involve forced vaccination in infancy. If a male infants are damaged by a rubella vaccine because it was more convenient or a cheaper strategy then I think there is an ethical problem as there is no direct benefit whatsoever for that medical intervention for that infant. I won’t claim to be an expert on the failings of the Japanese efficacy rates, but I certainly won’t accept that the whole strategy is a failure because one country’s policy didn’t get good coverage. I should research the UK success rate was before the introduction of MMR.

    “I guess I will be guilty of making another sweeping generalisation but why do anti-vaxxers always assume that a child that dies of a vaccine-preventable disease must have some underlying health problems.”

    Catherina provided more information which helps one make a better judgement. I ASKED for the information and pointed out that I have read of cases where the children were ill or had complicating circumstances.
    My main point is that if you’re going to examine specific cases, you have to look at more information than the final statistic. I imagine you are approaching the Hannah Polling case similarly, as we all should. You don’t need to twist arguments into blanket statements and sterotypes.

    BTW, I never defended Century, and I didn’t reference any of his/her points. I’m not sure where you got that from either. I think you tend to lump everyone who doesn’t agree with you in the same bucket and then label them anti-vax.

  28. century March 25, 2008 at 11:40 #

    Shwartz

    “BTW, I never defended Century, and I didn’t reference any of his/her points.”

    I asked 2 questions, made no points nor gave an opinion.

    and
    “I think you tend to lump everyone who doesn’t agree with you in the same bucket and then label them anti-vax.”

    Very true

  29. Catherina March 25, 2008 at 14:01 #

    Thank you for the information. Do you know further information about the two children who died in 2007?

    The first one was a three year old, unvaccinated because of an immune defect who developed a fulminant encephalitis when he contracted measles in 2006, then initially recovered (as far as I recall) and then succumbed to MIBE (the SSPE cousin in immune-deficient patients) in 2007.

    The other child was an unvaccinated 13 month old. I don’t have more background on that child at this time.

    Does the SSPE usually occur in children who contract measles below a certain age? I’m asking because of the way you worded the 1 in 3000 statistic. From what I’ve read, it’s those who contract it at a younger age are at higher risk, but I couldn’t find a lot of information.

    The overall incidence of SSPE is estimated at 1 reported SSPE case per 4’500 reported measles cases. Bellini and others have calculated this very nicely based on the 1989 to 91 US epidemic: http://www.ncbi.nlm.nih.gov/pubmed/16235165 Some underreporting can be assumed so that the overall risk is probably closer to 1 in 10’000. The risk for children under 1 or 2 years of age is significantly higher. Of 6 children who were diagnosed with SSPE in Germany in 2006, 4 had had measles before their first birthday, only 1 child had been older than 18 months when they contracted measles. Stefan Arenz, a German SSPE specialist, speaks of a risk of 1 in 5000 measles cases (which is probably an underestimate – the 6 SSPE cases in 2006 follow several years of under 5000 reported measles cases per year in Germany).

    Has herd immunity broken down in Germany

    No, not generally. Measles break out and spread from “islands” of low vaccination coverage. Usually, these are Steiner/Waldorf daycare centers and schools.

    Would children in the developed world die at the same rate as children in the developing world

    Absolutely not. Death rate from measles in the developing world can often be counted in percent. Death rate in the developed world would be counted in per thousand (most likely the 1 reported death per 1000 reported cases that we have observed for the past 20 years). The 2006 outbreak in NRW in Germany had under 1800 reported cases, 2 deaths and 1 permanent disability.

  30. bones March 25, 2008 at 15:16 #

    Ahhhh….another day, another Schwartz three-step.

    1) ask vague and misleading questions about every post.

    2) re-phrase all responses, to said misleading questions, in over-broad terms not explicitly mentioned nor intended by responder.

    3) see step 1.

    If I didn’t know any better, I’d say you’re a U.S. politician.

  31. HCN March 25, 2008 at 16:16 #

    Except, fortunately for those of us in the USA, he is Canadian.

    Still wondering which caused the increase of measles in Japan, UK and Switzerland:
    1) Reduction in sanitation.
    2) Reduction in measles vaccination.

    Just answer either “1” or “2”.

  32. bones March 25, 2008 at 18:18 #

    HCN, yes, as I am one of those citizens.

    century, you offer a false choice.

    Clean water and/or sanitation may help against the spread of polio, however, it is not going to prevent a measles, mumps or rubella outbreak. Likewise, one cannot be vaccinated against dysentery, typhoid, or botulism.

    The treatment and prevention of infectious disease is a multi-front effort.

  33. century March 25, 2008 at 22:08 #

    HCN

    “Still wondering which caused the increase of measles in Japan, UK and Switzerland:
    1) Reduction in sanitation.
    2) Reduction in measles vaccination.

    Just answer either “1” or “2”.”

    Or answer 3) there is no long/medium term increase – just natural short term variation?

    Your assertation of increase needs reference.

  34. century March 25, 2008 at 22:16 #

    Bones

    “century, you offer a false choice.

    Clean water and/or sanitation may help against the spread of polio, however, it is not going to prevent a measles, mumps or rubella outbreak.”

    Not what I asked.

    Choice – vaccine for measles or sanitation/clean water, on budget where only 1 possible. Go on, which one would you choose?

    (NB for thickies – I did not say the 2 are interchangeable/inter-related/mutually inclusive etc – remember the limited hypothetical budget)

  35. HCN March 25, 2008 at 23:10 #

    century, see the link above on March 22nd post for the increase in Japan (it is a Pubmed article). It was in the news last year that college campuses were closed in Japan because of an increased outbreak of measles.

    Then it has been in the news about San Diego’s index case came from Switzerland, but in recent news “Swiss Say Fans Should Get Measles Shot”:

    http://ap.google.com/article/ALeqM5i6Fvbb4-cgu6ae0cqkzQpS62g04gD8V3K49G1

  36. HCN March 25, 2008 at 23:11 #

    Continuing because it would not let me use more than one URL:
    And it has been well known for a while that measles has become more and more of a problem in the UK:

    http://news.bbc.co.uk/2/hi/uk_news/england/london/7291248.stm

    Now why has there been an increase of measles in these three countries (oh, and a quick look at google.news shows an outbreak in North Queensland in Australi)?

    1) A decrease in sanitation?
    or
    2) A decrease in measles vaccination?

    Choose either “1” or “2”.

    Oh, and stop with the strawman choice: Vaccine or sanitation. It is clearly stupid. Most are provided when aid is provided. This is especially important after natural disasters. When a hurricane destroys the area relief organizations bring in both clean water and tetanus shots. You’ve already been told that diseases are carried by different vectors, and you cannot choose one or the other.

    What you CAN do is tell why a certain disease in on the increase in three developed countries.

  37. bones March 26, 2008 at 00:40 #

    century, I never said they were interchangable.

    My point is you might as well be asking “How would you prefer to suffer? Measles or Dysintery?”

  38. Schwartz March 26, 2008 at 01:22 #

    bones,

    You’re back, I’ve been wondering where you were. I’m honoured you follow me around.

    But I’ll answer your half question. U.S. politicians are far more skillful than I. I wouldn’t even make the cut here in Canada.

  39. Schwartz March 26, 2008 at 01:29 #

    HCN,

    I never proposed that sanitation would reduce measles incidence. I certainly believe it will reduce measles mortality.

    I’ve already stated that I believe the measles vaccine to be effective and thus it’s very possible that any increases could be due to falling coverage. I highly doubt any increases in the UK, Japan or with the Swiss are due to sanitation.

  40. bones March 26, 2008 at 02:54 #

    Schwartz, now’s not the time for modesty. Shine on you crazy diamond.

  41. notmercury March 26, 2008 at 12:46 #

    Schwartz: I think you tend to lump everyone who doesn’t agree with you in the same bucket and then label them anti-vax.

    There was a time when I would have fit the definition of anti-vax, though I would have strongly protested the label at the time. As the saying goes, it takes one to know one and I would have to say that you, Schwartz, land squarely in the category. I don’t mean that as an insult but rather a simple observation.

    To review, it doesn’t seem that you have an autistic child, or even a ‘vaccine injured’ child, yet you post quite a bit of opinion and commentary, shared by the anti-vax organizations, on autism related blogs and forums.

    You appear to be intelligent enough to recognize flawed science and conclusions yet you are rarely critical of either when they come from those critical of vaccines or the vaccine program.

    Though you maintain that you know a few autistic people, you don’t seem at all bothered by the lingering effects and long term fallout that does an will effect autistic people as a direct result of efforts to link autism to poisoning by vaccine ingredients including thimerosal.

    I don’t disagree with all you say but I don’t hesitate for a moment to label you anti-vax.

  42. Schwartz March 28, 2008 at 02:10 #

    Notmercury,

    “There was a time when I would have fit the definition of anti-vax”

    Can I respectfully ask for your definition of anti-vax? Remember, I do participate in a very limited way in the vaccine program.

    “I don’t mean that as an insult but rather a simple observation.”

    Your post is not insulting. However, the common use of the term is and most of the time it is an ad-hom argument.

    “To review, it doesn’t seem that you have an autistic child, or even a ‘vaccine injured’ child”

    That is correct.

    “, yet you post quite a bit of opinion and commentary”

    Yes, because I’ve invested many, many hours researching to make an informed decision. Online discussions are a way to learn more and that involves communication with others. There are many people asking questions, and if I’ve done the research and invested a lot of time in an opinion, I will comment.

    “shared by the anti-vax organizations, on autism related blogs and forums.”

    Here is the slippery slope. Just because some of my opinions might be similar to what I would consider anti-vaccination, that does not make me anti-vaccine — by my definition, someone who believes all vaccines are ineffective and harmful and there should be no vaccines used at all. I guarantee you and I share at least some similar opinions yet you certainly wouldn’t consider me having the same opinion as you on a wide range of topics. I’m sure you espouse some similar ideas to Pharma shills, but I certainly don’t consider or label you one.

    “…yet you are rarely critical of either when they come from those critical of vaccines or the vaccine program.”

    That is accurate. Rarely is also correct, for I do criticize bad science against vaccines on occasion. The main reason for this is probably similar to the reason that your or most people commenting here rarely criticize bad science supporting vaccines. (Interestingly, I agree with more aspects of today’s post than disagree). I am of the impression that there are plenty of worthy commenters that are very quick to point out the bad science against vaccination.

    Interestingly, there are places where the discussion is very one-sided — with the exception of viscious ad-hom attacks — all of the places certainly have a leaning bias. This is a real shame, reading the posts of only those people that share a common opinion, or pure attacks on others of differing opinion, results in little worthwhile discourse, and certainly no advancement in ideas or understanding — which benefits no one. Opposing opinions force one to constantly examine positions carefully and sometimes result in large shifts of opinion.

    “Though you maintain that you know a few autistic people, you don’t seem at all bothered by the lingering effects and long term fallout that does an will effect autistic people as a direct result of efforts to link autism to poisoning by vaccine ingredients including thimerosal.”

    Although I think I understand what you’re trying to say, it’s a bit strange. It’s almost as if you’re saying that certain potential problems shouldn’t be investigated because the outcome might anger some people. The efforts to draw a link will only succeed if ultimately, there is science to back it up. There may or may not be a link, only the proper investigation will determine the answer. I don’t advocate ignoring potential problems just because the outcome may be unpopular, especially if it has the potential to become an ongoing health issue.

    “I don’t disagree with all you say but I don’t hesitate for a moment to label you anti-vax.”

    Applying labels to people in logical arguments serve no purpose. If I meet your personal definition of anti-vax, then so be it. Weilding it in an discussion (as it is usually done by most people) serves no purpose other than to distract from the actual argument.

Comments are closed.

Follow

Get every new post delivered to your Inbox.

Join 1,150 other followers

%d bloggers like this: