A tale of two news stories: The HPV and flu vaccines and why it’s so easy to confuse correlation with causation

And so it begins.

Well, it hasn’t really just begun. In fact, it’s been going on a long time. I’m talking about confusing correlation with causation when it comes to vaccines. For example, the “vaccines cause autism” variety of the anti-vaccine movement blatantly confuses the correlation with the beginning of the increase in autism diagnoses in the 1990s with the expansion of the vaccine schedule that occurred at roughly the same time. The same sort of thing is going on regarding the HPV vaccine. It began first with the credulous referring to reports of reactions to the Vaccine Adverse Events Reporting System (VAERS) database. Yet, as we have seen before, anyone can report anything to this database, whether it’s plausibly related to vaccines or not, and activist groups and lawyers have manipulated the database by encouraging reports of vaccines causing autism. Similarly, there have been a lot of reports of reactions to the VAERS database for the HPV vaccine, but a careful examination shows reports of these reactions to be no more than would be expected by random chance alone

Then there was this story three days ago:

In urgent investigation has been launched after a 14-year-old girl died shortly after receiving a cervical cancer vaccination at her school.

Natalie Morton was a pupil at the Blue Coat Church of England School in Coventry, where she was given the human papilloma virus (HPV) jab yesterday. She was taken to Coventry University hospital, where she died at lunchtime.

A letter to parents posted on the school’s website by the headteacher, Dr Julie Roberts, said a girl had suffered a “rare but extreme reaction” after being given the vaccine. The precise cause of her death remains unknown.

Three other girls from the school are reported to have experienced possible side effects of dizziness and nausea after receiving the Cervarix jab, which was given to female pupils as part of a national immunisation programme against HPV. Their symptoms were described as mild and none was taken to hospital.

Sounds really scary, doesn’t it? If you were the parents of this girl, you’d think for all the world that her tragic death was due to the vaccine. At the level of the individual, correlation sure does look like causation. After all, this was a 14-year-old girl, and children that young rarely just drop over and die. Imagine the shock and horror it caused the parents. The loss of a child is one of the worse things that can possibly happen.

Two days later, however, another story arose:

Natalie Morton died from a large and previously undetected tumour in her chest that could have killed her at any moment and not from a cervical cancer jab, an inquest was told yesterday.

The 14-year-old girl collapsed suddenly on Monday shortly after being given the vaccine as part of a national immunisation campaign.

Caron Grainger, joint director of public health for NHS Coventry and the city’s council, told Coventry Magistrates’ Court: “The pathologist has confirmed at the opening of the inquest into the death of Natalie Morton that she died from a large malignant tumour of unknown origin in the heart and lungs.

“There is no indication that the HPV vaccine, which she had received shortly before her death, was a contributing factor to the death, which could have arisen at any point.”

In the time between the story of this unfortunate girl’s tragic death and the revelation that she had a large malignant tumor in her chest that could have killed her at any time, there was plenty of tabloid journalism. Just check out The Lay Scientist, which posted a photo of a really badly done story about this poor girl’s death, in which the reporter spoke to Jabs, the U.K. anti-vaccine group. Meanwhile anti-vaccine groups had a field day with this tragedy.

In contrast to the bad journalism about Natalie Morton’s death, there was recently actually some good journalism about the H1N1 vaccine and the enormous effort going into monitoring it for safety:

WASHINGTON — More than 3,000 people a day have a heart attack. If you’re one of them the day after your swine flu shot, will you worry the vaccine was to blame and not the more likely culprit, all those burgers and fries?

The government is starting an unprecedented system to track possible side effects as mass flu vaccinations begin next month. The idea is to detect any rare but real problems quickly, and explain the inevitable coincidences that are sure to cause some false alarms.

“Every day, bad things happen to people. When you vaccinate a lot of people in a short period of time, some of those things are going to happen to some people by chance alone,” said Dr. Daniel Salmon, a vaccine safety specialist at the Department of Health and Human Services

Kudos to Laura Neergaard, the AP reporter who wrote this story! That’s exactly the problem with relying on anecdotal evidence of “vaccine injury.” Given that there are this number of people having heart attacks each and every day, during these few months when so many people are being vaccinated against H1N1, it is inevitable that there will dozens, if not hundreds of coincidences a day in which something bad happens to a person after having the H1N1 vaccine. If you’re one of those people, it will seem all the world as though the vaccine caused the badness to happen. It’s not because these people are stupid or ignorant; it’s because, not knowing the expected rate of these coincidences, most people assume that the rate of coincidence is far lower than it truly is. They assume that the rate is close to zero, that such a coincidence would be rare.

Consider another example. In 2007, there were 41,059 highway fatalities overall. That’s 112 deaths per day on average. We can expect that there will be a at least few people nearly every day who receive the vaccine and then die in a traffic accident; yet no one’s going to say that the H1N1 vaccine causes traffic fatalities. The lesson is that large numbers make coincidences, if not exactly common then not rare either. That’s why the government is going to incredible lengths in its post-marketing safety surveillance for the H1N1 vaccine:

On top of routine vaccine tracking, there are these government-sponsored projects:

  • Harvard Medical School scientists are linking large insurance databases that cover up to 50 million people with vaccination registries around the country for real-time checks of whether people see a doctor in the weeks after a flu shot and why. The huge numbers make it possible to quickly compare rates of complaints among the vaccinated and unvaccinated, said the project leader, Dr. Richard Platt, Harvard’s population medicine chief.
  • Johns Hopkins University will direct e-mails to at least 100,000 vaccine recipients to track how they’re feeling, including the smaller complaints that wouldn’t prompt a doctor visit. If anything seems connected, researchers can call to follow up with detailed questions.
  • The Centers for Disease Control and Prevention is preparing take-home cards that tell vaccine recipients how to report any suspected side effects to the nation’s Vaccine Adverse Event Reporting system.

What was that that anti-vaccine loons say about vaccines “not being tested” and not being monitored for safety? In actuality, the government goes to huge lengths to monitor vaccine safety. Even so, it’s very likely that by random chance alone there will be lots of stories coming out of the H1N1 vaccination program of horrific “reactions” that are almost certainly coincidence. The problem will be to identify real problems that are occurring detectably more frequently after vaccination or in vaccinated people versus the unvaccinated.

Unfortunately, you know that the anti-vaccine movement will never accept this explanation. They refuse to accept it for the vaccine/autism myth. They’re refusing to accept it for the death of Natalie Moore. Naturally (heh), Mike Adams at that repository of all things quacking, NaturalNews.com, is all over the case with some of his patented spectacularly full mental jacket conspiracy theories:

Today, the mainstream media is reporting an obviously-fabricated explanation for her death. A pathologist is declaring that Natalie died from a “malignant chest tumor” that just coincidentally and suddenly killed her within hours after she received the cervical cancer vaccine.

This explanation is obviously a cover story to protect the vaccine industry; and it’s not even a convincing cover story at that. Natalie Morton had never been diagnosed with a chest tumor before, and she showed absolutely no symptoms of a cancer tumor. Chest tumors don’t just “lash out” and attack their hosts all of a sudden, without warning. A typical death from a cancer tumor is more often a slow, painful wasting away that can take months or years. Natalie Morton was killed in hours, and the description of her symptoms exactly matches what might be expected from an inflammatory reaction to a chemical vaccine.

Um, no, Mike. You’re an idiot. A flaming, moronic, credulously conspiratorial idiot. Cancer doctors know that it’s amazing how large tumors can sometimes grow without causing much, if anything, in the way of symptoms. In sudden death cases like this, moreover, quite frequently in retrospect it is noted that there were symptoms before the death, often for weeks or months beforehand, symptoms such as easy fatigue, vague aches and pains, or other relatively nonspecific symptoms. (Pancreatic cancer is notorious for growing to a deadly extent while producing few, if any, symptoms.) While it is true that many advanced tumors do cause a slow wasting away, there are a number of complications from tumors in the chest that can cause rapid death. The most obvious example that comes to mind is for the tumor to erode into a major blood vessel, resulting in massive internal bleeding. Another mechanical effect that can result in cardiac failure and sudden death is pericardial tamponade, which is what occurs when the sack surrounding the heart fills with fluid and compresses the heart. This fluid can be serum (from a reaction due to the tumor) or blood (from a bleed). Because the pericardial sac is fairly stretchable, a tamponade can develop slowly but then, once the capacity of the pericardium to stretch is exceeded, quite rapidly result in critical right heart failure leading to death. Then there’s the fact that the blood in cancer patients often clots too easily; i.e., it’s hypercoagulable, due to factors secreted by the tumors That means cancer patients are prone to deep venous thromboses and, worse, to pulmonary embolus, large ones of which can quite easily cause sudden death. Also, large malignant tumors can also cause hypercalcemia (too much calcium) that can lead to cardiac arrhythmias, although the calcium level usually has to be quite high to result in bradyarrhythmias, bundle branch block, incomplete or complete atrioventricular block, asystole, and cardiac arrest, making this a less likely consideration, especially since it would be rare to have a calcium level that high without having some symptoms.

But that’s not the full extent of Adams’ idiocy. Get a load of this:

But why would a pathologist cover up the true cause of Natalie Morton’s death? It’s simple: There are billions of dollars in profits at stake. Natalie’s death threatened to put the entire first-world cervical vaccination program on hold. “News of Morton’s death came shortly before U.S. health regulators again delayed a decision on whether to allow Glaxo to sell Cervarix in the United States where a panel of specialists has recommended its use,” reports Reuters.

The continuation of global cervical cancer vaccination programs — which generate billions in profits — absolutely required blaming Natalie’s death on something other than the vaccine. Blaming it on cancer is very easy to do, since every person living today has cancerous micro-tumors in their body right now. All the pathologist had to do was locate such a micro-tumor in Natalie’s body, then dismiss the vaccine altogether.

Yes, indeed, it’s those evil pharmaceutical companies and their blasted need for profits, no matter how many people they kill! Now, Adams’ sheer insanity aside, I’ve said before that I’m not yet entirely sold on the HPV vaccine. I don’t say that because I think the vaccine is dangerous or has killed anyone. I don’t, and, as far as I can tell, it hasn’t, Mike Adams’ blather and all those reports to the VAERS database notwithstanding. Rather, I say this because the vaccine is very expensive compared to other vaccines. In developed nations vaccination against HPV provides probably only a modest benefit, given that most women undergo yearly Pap smears, which can achieve more or less the same end of decreasing death from cervical cancer. In other words, I think it’s a worthwhile vaccine, but I’m not sure if it’s yet a good idea to make it mandatory, given that it risks diverting resources from other vaccines that protect against highly infectious diseases now (such as MMR, Haemophilus influenzae B, etc.). However, those are, I think, reasonable quibbles with the vaccine. Nothing Adams says resembles anything close to rationality or reason. Indeed, I wonder how he thinks this stuff up.

He’s also full of crap when he invokes the dreaded “microtumors” argument. In fact, that’s such an obvious load of fetid dingo’s kidneys, it leads me to think that Adams, besides being profoundly ignorant, is also profoundly cynical, viewing his readers as so incredibly stupid that it is a wonder that they can manage to breathe and walk at the same time. Let’s see. What did the pathologist say? Oh, yes, he said that Natalie died of a “large malignant tumour of unknown origin in the heart and lungs.” If any pathologist tried to attribute Natalie’s death to “microtumors,” he would have provoked quite justifiable skepticism not just from those who fear vaccines but from the medical community itself. But, hey, Adams can never let a few inconvenient facts get in the way of a good rant, and rant he does:

It takes a real cold-hearted CEO to watch your product potentially kill a 14-year-old girl in mere hours and then continue to recommend that same product to millions more.

This astonishing dismissal of concern about the vaccine’s safety is indicative of the kind of quackery taking place today with vaccines and modern medicine. Notice how scientific thinking is replaced with blatant dogma…

You know, I think this is the time, as it was for Adam Dreamhealer, to reply to Adams with the immortal words of Inigo Montoya:

Mr. Adams, you keep using those terms “scientific thinking” and “dogma.”I do not think they mean what you think they mean. (All right, I’ll lay off that quote for a while.)

Unfortunately, as nutty as Mike Adams is, he’s not alone. Check out this amazing piece of winguttery Meryl Dorey, who belongs to a group with the amazingly Orwellian name Australian Vaccination Network entitled Natalie Morton’s death-convenient pre-existing condition or vaccine cover-up? Yes, to this loon, Morton’s preexisting tumor is a “covenient” excuse:

Our buddies from the scumbags organisation (well, if Paul Keating can say it, I can too!) have been emailing me all morning to demand that I take down the article I posted a couple of days ago in which I stated that I didn’t believe that Natalie’s death was coincidental to the Cervarix vaccine.

I won’t do that. Because I still don’t believe in coincidence. Not when it comes to vaccines.

And that’s the problem, isn’t it? I bet she believes in coincidences when it comes to other issues. But not vaccines. Never vaccines. For vaccines, when bad things happen, it’s never a coincidence; it’s always the vaccine. I often think that, if a person were to be vaccinated, walk out of the doctor’s office, and then be hit by a passing car, loons like Adams or Dorey would somehow find a way to blame the vaccination. Because to anti-vaccinationists, it is always, first and foremost, about the vaccines. For example, look at what the grand dame of the anti-vaccine movement, Barbara Loe Fisher, has to say about this:

Federal health officials are already pre-emptively warning Americans that most of the deaths and cases of brain inflammation, seizures, paralysis, multiple sclerosis, rheumatoid arthritis, lupus, strokes, heart attacks, miscarriages and other serious health problems that develop after swine flu vaccination will be considered a “coincidence” and not related in any way to the flu shots just given.

Uh, no. As the AP story quoted above shows, federal officials are putting quite a bit of money and effort to investigate scientifically and epidemiologically whether any adverse reactions reported after H1N1 flu vaccination are coincidence or could plausibly have been related to receiving the H1N1 vaccine. They’re working very hard to distinguish correlation from probable causation. Nice misrepresentation, though!

But it’s not just Barbara Loe Fisher. It’s also all about the vaccines and nothing but the vaccines to Mike Adams; it’s about the vaccines to Dorey at the Australian Vaccination Network; and it’s about the vaccines to Generation Rescue, the National Vaccine Information Center, Jenny McCarthy, J.B. Handley, Jim Carrey, and all the other anti-vaccine loons out there. It always has been; it is now; and it always will be. To them, reason and science mean nothing except when they can be misused to try to “prove” that vaccines are deadly or cause autism.

Fear and loathing of vaccines are everything, damn the price.