Dr. Snyderman, please be more careful…

Nancy Snyderman isn’t helping. At least, she wasn’t helping yesterday.

Don’t get me wrong. I like the fact that NBC’s Chief Medical Editor Dr. Nancy Snyderman is a staunch defender of vaccination. She’s one of the rare talking head doctors on TV who pulls no punches when going after the anti-vaccine movement, so much so that the big macher of the anti-vaccine movement and head of the anti-vaccine crank blog Age of Autism J.B. Handley has referred to her as a “NBC’s pharma-whore in residence.” Let’s just put it this way: Anyone whom J.B. detests and labels with a term like that can’t be all bad, right?

Unfortunately, in her zeal, Dr. Snyderman doesn’t always get her ducks all in a row when she’s on a roll, which irritates me to no end. For example, she was on The Today Show yesterday morning to discuss the pertussis outbreak in California:

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In it, Dr. Snyderman is very passionate and points out that there are large numbers of unvaccinated children in many of the areas where pertussis outbreaks have occurred. She then makes this claim when asked if she thinks the pertussis outbreaks will spread to other states:

I have no doubt that it’s going to. It peaked in California. Last year in Minnesota and in Philadelphia we know children died of measles.

No, actually, we don’t. There was not a single measles-related death in the U.S. last year–fortunately. It’s not for the lack of anti-vaccine advocates trying to drive down vaccination rates and destroy herd immunity, but over the last couple of years we have been fortunate. Measles kills hundreds of thousands of children a year in Third World countries. In countries fortunate enough to have the advantages of good sanitation, nutrition, and vaccines, deaths from measles remain fortunately quite rare. For now. If the anti-vaccine movement has its way, we could join the U.K. with a resurgence of measles to endemic levels a decade after having been declared as under control, thanks to vaccination. Such is the damage that Andrew Wakefield, with the fawning and eager help of British tabloids, wrought. Now Jenny McCarthy appears to be trying to duplicate Wakefield’s feat here across the pond.

My guess is, as speculated at Autism News Beat, that Dr. Snyderman was in part referring to the haemophilus influenzae b (Hib) outbreak that have occurred in Minnesota, although the Minnesota outbreak occurred in 2008, not last year. One child did die in November 2008. Two children did die in Philadelphia last year in a pertussis outbreak. In any case, as much as I detest the anti-vaccine movement and view it as a profound threat to public health I try to be careful not to leap to premature or erroneous conclusions blaming them for outbreaks. Doing so undermines the credibility of the pro-vaccine argument. Worse, it provides an opening for anti-vaccine loons to focus like a laser on obvious factual errors like the one Dr. Snyderman made and ignore her broader point, which remains valid, namely that vaccines do not cause autism and are safe and effective. The propagandists over at Age of Autism may be advocates of pseudoscience and dead wrong about medicine, but they aren’t stupid. They know debating tricks, and they know how to jump on an opponent’s errors. They can distort and cherry pick studies all they want. We on the science-based side of things don’t have that luxury and wouldn’t want it even if we did. We have to deal with all the messy nuances and try to boil them all down, as Dr. Joe Albietz did in discussing the pertussis outbreak.

Of course, one point that needs to be hammered home over and over again is a point made by Sullivan over at LBRB and that’s that the various “alternative” vaccine schedules championed by various anti-vaccine advocates endanger children and the pertussis outbreak represents a “teachable moment” to show how and why. One of the favorite “alternative schedules” touted by Generation Rescue was created by Dr. Donald Miller (a crank we’ve heard about before in the context of his extreme distrust of peer review). The interesting thing about this schedule is that he recommends not vaccinating at all before age 18 to 24 months, which is far too late for pertussis, which is most lethal to babies under that age. The GR schedule also calls for a single pertussis vaccine after age two. As Sullivan points out, no such vaccine exists; pertussis requires multiple boosters to achieve immunity.

It’s a general rule in skepticism and science that pseudoscientists have the advantage. They can distort; they can cherry pick data; they can Gish gallop. Countering these tactics takes a lot of energy and care. On the skeptical side, we have very little room for error because even one error, even a relatively minor one, can provide advocates of pseudoscience a club with which to pummel us, or, at the very least, a hand puppet with which to distract the audience form our main points. I like that Dr. Snyderman is willing to take on the anti-vaccine movement. I just wish she were more careful to make sure that she has her facts in order. Unfortunately, this isn’t the first time she’s screwed up like this. I’m just an itty bitty blogger (well, in comparison to being seen by millions of people the reach of this little blog is quite paltry), and even I can’t get away with it.

Dr. Snyderman. Please be more careful! I’d hate to see a post on AoA in the morning attacking you for this slip, but it wouldn’t surprise me in the least if I wake up to just such a post.