The strange science and ethics of the anti-vaccine movement

One of the great things about having declared Vaccine Awareness Week is that it gives me a convenient excuse to revisit topics and blog posts that I had meant to address but that somehow didn’t make the cut the first time around. This is the sort of thing that happens fairly frequently in blogging, where there is far too much woo and idiocy for one blogger to have even a hope of ever addressing it all.

And that’s just the anti-vaccine movement.

In any case, if there’s one thing about the anti-vaccine movement that I’ve noticed, it’s that its members have a very warped view of both science and ethics. Last week on the anti-vaccine crank propaganda blog Age of Autism in the form of two posts within two days of each other. The first was by Kent Heckenlively, who is notorious for having taken his autistic daughter to Costa Rica for stem cell quackery and for subjecting her to all manner of biomedical woo. His post is entitled “Science Stoppers” and the Question of Autism. In this post, Heckenlively tries to liken those who criticize his pseudoscientific pontifications about autism and vaccines to creationists–evolution deniers!–and labels them, like creationists, as “science stoppers.” The second post is by the ever-clueless Jake Crosby, who tries to amp up the moronicity even higher by attacking Art Caplan and Paul Offit for “endangering children” through their unrelenting defense of vaccines. It would be hilarious if it weren’t so pathetic, particularly given how much arrogance it takes for Jake to think that he can actually stand his own arguing ethics with an internationally respected senior bioethicist and how Jake tries to parody the title of Paul Offit’s forthcoming book by entitling his post How Vaccine Damage Deniers Threaten Us All.

Denialism. You both keep using that word. I do not think it means what you think it means.

Let’s deal with Heckenlively first. He starts out by proudly trying to burnish his scientific cred by pointing out how much he loves evolution:

Professor Padian was one of the chief expert witnesses in the Dover trial in which a local school board was trying to adopt a creationist textbook. Now I should probably confess I’ve been an evolution freak since the age of three when I fell in love with dinosaurs. My job as a science teacher gives me free rein to talk about such issues and also get paid for my eccentric interests.

Heckenlively also doesn’t want to piss off the religious too much; so he tries to have it both ways by invoking without naming Stephen J. Gould’s “non-overlapping magesteria”:

I don’t have much energy for attacking creationists, being a Catholic, and knowing our own tumultuous history of trying to mix faith with science. Although I went to a Catholic college with a Galileo Science Hall, it would still be several years after I graduated that the Catholic Church finally rescinded his excommunication. After a couple centuries wrestling with the issue I think we’ve come up with a pretty good formulation that “science without faith is blind, and faith without science is lame.” I believe in God (I’m actually a eucharistic minister in my parish) and science, but they live in different zip codes.

Wow! That sounds so…reasonable–or at least accommodationist. Now, don’t worry. I’m really not going to get into the whole “militant” versus “accommodationist” wars over how best to overcome resistance to science that derives from religious beliefs or ideology. I’m really not. Although I leapt head first into the “framing wars” back in the day, these days I find such discussions tiresome in the extreme and now almost actively avoid such discussions. I’m far more interested in using Heckenlively’s utter missing of the point to demonstrate something about the anti-vaccine movement. First, here’s where Heckenlively introduces his point:

What really interested me in professor Padian’s talk was the masterful way in which he showed multiple lines of evidence for the turning of a fin into a foot, the development of feathers in theropod dinosaurs, and how whales went from land to water animals. Then he said something about creationist arguments against evolution which I felt went to the heart of why so many of us don’t trust the medical authorities when it comes to the vaccine-autism issue.

He said that creationist arguments against evolution are “science stoppers” because they discourage the efforts of the human mind to understand evolution in all its complexity.

It’s true, too, of course. Creationist arguments against evolution, when stripped of all their science-y sounding glitz, basically boil down to “God did it” or a “God of the gaps” argument. Such arguments are indeed “science stoppers.” Unfortunately, as we say in the science biz, what we have here is a massive failure to generalize the example of creationism to other forms of science. Instead of understanding that vaccine denialism is every bit as much of a “science stopper” as the anti-evolution arguments favored by creationists, a-vaccine activists like Kent Heckenlively yoke the same sorts of fallacious arguments in the service of their anti-science agenda. As I described yesterday, they twist science to serve their agenda, favor anecdotes over epidemiology and science, cherry pick data, and make liberal use of logical fallacies when arguing. Kent often goes one further, though, in representing his pseudoscientific flitting from one woo to another based on whatever he’s happened to heave heard about through the autism biomed quackery grapevine as being real scientific investigation, rather than disordered flights of fancy.

I also can’t resist pointing out that, for all his transparent attempts otherwise, so toxic is the issue of evolution that Heckenlively managed to royally piss off some of his AoA readers. Indeed, there are several comments taking Heckenlively to task for having chosen the particular analogy that he chose, although they are just as hilariously off-base as Heckenlively’s himself. Indeed, a commenter named Willie was particularly outraged that Heckenlively gave “the reader the impression that you believe that the theory of evolution has merit and creation and God do not in a similiar way that biomedical is discounted by pro vaccine idiots.” Truly, this is crank magnetism in action. Heck, it’s a veritable crank schism over the issue of evolution. In any case, Heckenlively accuses scientists of the same sins against science that evolution denialists commit because they don’t accept the pseudoscience:

With voluminous accounts of parents detailing how the problems of their children began after a vaccination it’s nothing less than a crime that the medical authorities stop the science by claiming that the question has been “asked and answered.” Nothing could be further from the truth. They have refrained from doing the type of population studies of vaccinated and unvaccinated populations which might yield promising information. How about also doing extensive biological studies of their immune systems to see what is going wrong?

Because, perhaps, we need some actual–oh, you know–scientifically convincing preliminary data that there is something going wrong? You know, just like we need actual evidence more convincing that small studies showing correlations between XMRV and both autism and chronic fatigue syndrome before doing huge studies to see if XMRV is actually a causative or contributing factor to either of these conditions.. Once again, Heckenlively values anecdote over science and doesn’t understand that both science, practical, and ethical concerns actually do limit the sorts of science that can be done. We can’t, for example, do a randomized, double blind of vaccinated versus unvaccinated children, even though that would be most bulletproof study. The logistics of even doing just an epidemiological study of vaccinated versus unvaccinated children are completely unappreciatedby the likes of Heckenlively and other anti-vaccine loons. So is the simple consideration that there has to be a biologically plausible mechanism, coupled with preclinical data including animal studies, to justify doing a human study.

Which brings us to Jake Crosby’s attempt to take on a respected bioethicist, Art Caplan. Given Jake’s past conspiracy-laden excretions, the results are ugly. Very, very ugly. I’m almost embarrassed for Jake. Well, not really. The kid’s got to learn, except that, unfortunately, I don’t think he’s teachable.

The straw men fly fast and furious right out of the box. But first Jake can’t resist his usual invocation of the pharma shill gambit. Really, Jake is so predictable that it wouldn’t be hard to write a program to generate Jake Crosby posts. Simply program it to mention pharmaceutical companies any time a vaccine defender like Paul Offit or Art Caplan is mentioned, couple it with a whole lot of conspiracies mentioning big pharma, and add a dash of referring to vaccine science as “tobacco science” à la Dr. Jay Gordon. Actually, making a Jake Crosby AoA Post Generator would be so trivial that it would be unlikely that any decent programmer would want to do it. Too boring. After all, Jake seems to think that coopting the title of Paul Offit’s book Deadly Choices: How the Anti-Vaccine Movement Threatens Us All is the height of cleverness and wit.

Jake tries to counter Art Caplan’s argument that vaccines are good because they not only protect the recipient but protect others, thanks to herd immunity, which is a fairly simple ethical argument to make. Jake, showing that he’s never taken an ethics course (or if he did he didn’t retain anything from it), tries to turn that argument on its head:

What Caplan does not acknowledge, just setting aside efficacy and duration of vaccinations that also come into play, is that any adverse reaction associated with a vaccine will have a higher attributable risk by virtue of the fact that it is recommended for the general population as opposed to specific individuals. So, by holding vaccines to a lower standard of safety and stating people should have no choice over whether or not they get vaccinated as bio”ethicists” such as Caplan argue, the result is much more potentially devastating than it would be for a prescription pharmaceutical not administered to the population at large. In compelling everyone to vaccinate to protect herd immunity, there would also be a substantially greater herd risk. Perhaps this highlights the inherent conflict of public health officials being charged with both vaccinating as many people as possible and making sure the shots are safe.

Now that’s a hunk of burning stupid, even by Jake’s previous flaming standards.

First, Jake clearly doesn’t seem to realize that attributable risk is defined as the difference in the incidence rate of a condition between an exposed and unexposed population. In other words, it’s a fraction (as in 1 out of 100 or 1 out of 1000). I suppose, based on Jake’s later statements, that he’s trying to argue that vaccinating the entire population will endanger a greater fraction due to vaccine shedding (more below), but even that argument doesn’t help him. Still, this is the least confused of Jake’s confused argument that all derives from Jake’s misconception that vaccines are somehow held to a lower standard of safety than other pharmaceutical medicines, which is absolutely ridiculous. It’s actually because vaccines are administered to healthy children in order to prevent disease that necessitates holding vaccines to a very high degree of safety indeed. In order to make an argument that vaccines can cause a high attributable risk in the general population, it is necessary for Jake to rely on the usual anti-vaccine exaggerations of the true risk of vaccinating. Indeed, he’s taken a page from AoA in vastly overplaying the potential harm and, more importantly, in exaggerating the chances that vaccines will cause harm. There are very real ethical issues regarding vaccinating populations against disease given that there is the very possibility of rare severe reactions. Jake’s cartoonish treatment of the issue does none of these issues credit. In fact, Jake intentionally spits on the real ethical dilemmas that lie at the heart of public health interventions, so anxious is he to argue that vaccins do more harm than good.

He then spits on science, too, by doing what we in the biz call “making shit up.” Well, not exactly. What he does is to cite all manner of pseudoscience as though it were true in order to pump up the apparent risk of vaccinating. He does this by trying to attack the herd immunity argument by claiming a “herd” harm due to vaccines:

Moving on to the MMR now, this vaccine may not pose the same kind of health threat – being a live-virus vaccine free of thimerosal – but it may very well adversely affect more than just those who take it. Research has confirmed the presence of vaccine-strain measles in the guts, blood, and cerebrospinal fluid of children with autism and bowel disease. However, no studies have been done to determine if the vaccine-strain causing these persistent infections can be communicable to others like wild measles, which is highly contagious. Despite the absence of proof, there is evidence that this may well be the case, based on what we already know about both the measles and live-virus vaccines. It has been known that virions from the latter can be shed from the recipient, causing other people to become sick, as is the case with smallpox vaccines. It is certainly plausible, at the very least, that this can happen with the MMR, too, and who knows what other live-virus childhood vaccines. The recipients of the chicken pox vaccine, for instance, are known to shed virus, causing shingles.

There’s a famous line in Animal House in which Dean Wormer tells Flounder, “Fat, drunk and stupid is no way to go through life, son.” My advice to Jake would be “Proudly and arrogantly ignorant is no way to go through life, son.” There is a tool known as PubMed, which is your friend. Use it. Love it. Heed it. If you do, you’ll find that secondary transmission of measles due to vaccination has never been documented despite the millions, if not billions, of doses of MMR given over the last 40 years. That’s actually pretty persuasive evidence that virus shedding due to vaccines is not a significant risk to children who come in contact with vaccinated children. Moreover, if there were some cases reported–even just cases that were suspicious for secondary transmission through vaccine sheddnig–you can bet that scientists would want to study them. Even if it’s possible, epidemiological evidence, specifically the lack of even a single well-documented case even after l’affaire Wakefield strongly suggests that it’s really rare–possibly even nonexistent–even though virus shedding has been measured by PCR and documented.

Meanwhile, new measles vaccines are being developed, and scientists are testing them for vaccine-strain measles shedding, while there are occasional case reports of measles being detected away from the injection site after vaccination. In fact, there are studies looking at new vaccines, and these studies include–yes–measurements of vaccine shedding by various means. Seriously, one might argue whether adequate studies have been done, but to claim that no studies have been done is so ludicrously wrong that it beggars the imagination that someone would make such a claim when some fairly easy PubMed and Google searches easily show otherwise.

After echoing Heckenlively’s invocation of XMRV as a new way to cause autism, Jake then proceeds to dive into tinfoil hat territory. In particular he parrots the claim that the CHAT polio vaccine used 50 years ago in Africa is the origin of HIV and AIDS, a claim that refuses to die despite multiple refutations (1, 2, 3, 4, 5). Basically, testimony by eyewitnesses, documents from the time, epidemiological analysis, as well as phylogenetic, virologic and PCR data all converge to reject as false the hypothesis that HIV/AIDS was derived from this polio vaccine.

Adding these up, Jake concludes:

But even setting aside all of these emerging scientific realities – adverse vaccine events still pose a grave public threat beyond just those who have negative reactions. That threat lies in the enormous costs of care for those people that society will incur – because everyone is recommended to receive vaccines; thus, a very high number of people are adversely affected, even if not directly. Society will be obligated to pay the tab for the immense morbidity caused – putting a strain on the healthcare system by raising everybody’s insurance premiums while diverting funds from other health services. The net result is an adverse effect on care, and ultimately on the collective health of society. We don’t think about it this way as much as we do about herd immunity, even though the net impacts of the former stretch far beyond the latter.

Basically, here Jake is taking estimates of vaccine complications not supported by science (such as his belief that vaccines cause autism) and problems exaggerated beyond all plausibility, mixing them with pure fantasy (the HIV/AIDS connection, for example) and putsthem all together in a blender to create a smoothie of non-data-based estimates of how much harm vaccines allegedly cause. He then compares this estimate to herd immunity and declares that his fairy dust has won out over science. It’s pathetic and desperate, really. Jake knows that the herd immunity argument used by Art Caplan is a very, very powerful ethical argument; so he tries to dismantle it. Unfortunately for him, the argument is so powerful that the only way he can take it on is through the massive application of cherry picking, pseudoscience, and the massive exaggeration of vaccine risks, coupled with risks he can make up or twist to claim that vaccines cause harm to other people the way vaccines protect other people through herd immunity.

He fails spectacularly, as always. If this sort of essay is the best reasoning he can come up with, I shudder to think about what he’s turning in to his professors. Let’s put it this way: Learning at the feet of David Kirby, Kent Heckenlively, Dan Olmsted, and J.B. Handley is not a good way to bolster your academic credibility. Science stopper, indeed.