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Battling misinformed consent: How should we respond to the anti-vaccine movement?

Antivaxers frequently claim that they are champions of “informed consent.” In reality, their version of informed consent is a parody of consent that I like to refer to as “misinformed consent.”

As Vaccine Awareness Week, originally proclaimed by Joe Mercola and Barbara Loe Fisher to spread pseudoscience about vaccines far and wide and then coopted by me and several other bloggers to counter that pseudoscience, draws to a close, I was wondering what to write about. After all, from my perspective, on the anti-vaccine side Vaccine Awareness Week had been a major fizzle. Joe Mercola had posted a series of nonsensical articles about vaccines, as expected, but Barbara Loe Fisher appeared to have sat this one out, having posted nothing. Well, not quite. More like almost nothing. I noticed that the NVIC did publish a new post earlier this week that I had somehow missed entitled Plug Into New NVIC Advocacy Portal & Protect Vaccine Exemptions. What is this portal? Barbara Loe Fisher describes it thusly:

The weeklong series of articles about vaccination published on Mercola.com includes the launch of NVIC’s Advocacy Portal, which is a free online interactive database and communications network that empowers citizens to protect and enhance vaccine exemptions in all 50 states.

And there you have it, the real mission of the anti-vaccine movement in general and the NVIC in particular, to discourage vaccination wherever possible under a false mantle designed to camouflage its true purpose, the mantle of “informed consent” and “health freedom.” What, you say? Who could ever argue with the concept of informed consent or health freedom? I can, not because I don’t support the right of individuals to determine what they will do with their bodies or what treatments they will or will not accept. Rather, it’s because the “informed consent” that anti-vaccinationists promote should more properly be referred to as “misinformed consent.” At every turn the anti-vaccine movement promotes pseudoscience, misinformation, and quackery to frighten parents into not vaccinating. After all, all informed consent is based on providing an accurate accounting of the risks and benefits of an intervention being proposed. The anti-vaccine movement and the NVIC downplay the potential benefits with frequent propaganda claiming that, for example, flu vaccines don’t work. More importantly, they hype the risks of vaccination to make them seem orders of magnitude more severe than science does, and if they can’t come up with a real potential complication, they make one up! After study upon study failing to find an association between vaccines and autism, they still promote the idea that vaccines cause autism. Heck, the head of Generation Rescue, J.B. Handley, was doing it just the other day!

In fact, if there’s one thing I’ve learned over the years, it’s that the idea behind the “informed consent” argument is not real informed consent. Rather, anti-vaccinationists hide behind the term to provide a set of information to parents consisting of cherry picked studies, misinformation, and pseudoscience that so completely demonizes vaccines and denies their benefits that the only rational response to such information, if the information is accepted as valid, would be to refuse vaccines. Because most parents don’t have the scientific background to recognize the misinformation promoted by the anti-vaccine movement, many parents do tend to accept the propaganda as accurate–or at least as sufficient to sow fear and doubt in their minds about vaccines. This is what I meant by “misinformed consent.” Couple the technique of promoting misinformed consent to an appeal to the idea that refusing vaccines is akin to freedom, and that combination produces a powerful appeal, particularly here in the U.S., where appeals to “health freedom” can be mixed into libertarian “get the government off my back” politics. Mercola and Fisher explicitly tap into that sort of sentiment in announcing the NVIC program:

“The national forced vaccination lobby is well organized and they have billions of taxpayer dollars plus billions more from Big Pharma at their disposal to persuade state legislators to approve more and more vaccine mandates,” said Dr. Mercola, “That is why I am partnering with NVIC and encouraging everyone to join with us and take action now to protect vaccine exemptions in all states.”

NVIC co-founder and president, Barbara Loe Fisher, said “Dr. Mercola and I know it is time to get serous about legally defending the human right to informed consent to medical risk-taking in America. Everyone who registers for NVIC’s Advocacy Portal will learn how to work in their own state for the legal right to make voluntary vaccine choices for themselves and their children.”

Note the “framing,” if you’ll excuse the term. To Fisher and Mercola, public health officials aren’t referred to as public health officials. That’s way too neutral a term. Rather, they’re the “forced vaccination lobby.” Even worse than that, they aren’t just the “forced vaccination lobby” out to steal your freedom away; they’re the “forced vaccination lobby” funded by an unholy cabal made up of the government and big pharma. Similarly, to Fisher and Mercola, undergoing vaccination to prevent disease is not, as science tells us, a high benefit/very low risk medical procedure. Oh, no. To Fisher and Mercola, it’s “medical risk-taking,” as though vaccinating were some sort of game of Russian Roulette. This is what I mean by “misinformed” consent, and Fisher’s been playing the game of representing her anti-vaccine views as “pro-freedom” for a very long time. She’s been quite good at rebranding the NVIC to be seen not as the crank organization that it is, but rather as a “vaccine safety watchdog.” This framing allows the NVIC to represent its portal as a “one stop shop for vaccine choice advocates”:

“The religious and conscientious/philosophical belief exemptions to vaccination are being targeted for elimination by drug company lobbyists and doctors and organizations with financial ties to vaccine manufacturers,” said Dawn. “We wanted to create a one-stop shop for informing people in real time about what is going on with vaccine laws and policymaking in their states to help level the playing field. Now concerned families can make their voices heard and be represented in their own state legislatures.”

Dawn emphasized that the NVIC Advocacy Portal, which took more than a year to develop, is still “a work in progress.” “Even though the NVIC Advocacy Portal is in its infancy, we knew we needed to launch it now to give people a way to take immediate action,” she said.

What does this portal offer anti-vaccine activists? A fair amount of stuff, including contact information for legislators, instructions for how to try to persuade legislators to expand vaccine exemptions, online training sessions on “vaccine choice” advocacy, a rapid response system that alerts anti-vaccine activists to legislation that the NVIC wants them to oppose or support, message boards, and online newsletters. Come to think of it, I’m half tempted to join the NVIC Advocacy Portal in order to keep tabs on them. And so I would have if they didn’t ask for my address. On the other hand, I’ve been meaning to get a post office box for a long time.

Still not convinced that this whole project is anti-vaccine, not pro-freedom or pro-safe vaccine? Check out this flourish at the end:

“Barbara and I know that freedom is not free,” said Dr. Mercola. “We need to organize and raise millions to fight Big Pharma and Corporate Medicine. We must fight the forced vaccination lobby that wants to enslave us and make us buy and use more and more vaccines so drug company stockholders make bigger and bigger profits. I have selected NVIC as one of my favorite charities because I want to win this war against forced vaccination in America.”

Oh, goody. The NVIC and Joe Mercola, two crappy woos that taste crappy together–and endanger our children as well.

It turns out, though, that Barbara Loe Fisher and Joe Mercola aren’t the only anti-vaccine loons getting in on the act. SafeMinds has apparently decided to break out a new anti-vaccine propaganda effort to persuade people not to be vaccinated against influenza this year. As Autism News Beat points out, now that the election is over, vaccine rejectionists are calling for a “fresh start” in persuading legislators to pass antivax-friendly laws. Besides having produced a new brochure and trying to get its followers to contact their legislators, SafeMinds is trying to raise money to show this video (among others) in movie theaters during the holiday season:

Note the intentionally inflammatory juxtaposition of images of pregnant women with toxic waste dumps, the implication being that injecting pregnant women with the flu vaccine is the equivalent to injecting them with toxic waste. SafeMinds makes a big deal over a claim that thimerosal can’t be disposed of in a landfill. Actually, lots of drugs and medical waste can’t be disposed of in a landfill either. There are special landfills for them. The utter intellectual dishonesty and sheer, neuron-apoptosing stupidity behind these images makes baby Jesus weep. Sure, they say in the ad dthat they only want to tell you “not to take the risk” and to demand “mercury-free” vaccines, but in reality, this is of a piece with SafeMinds’ general anti-vaccine stance. This is made plain in a followup video SafeMinds released the other day. If the first video was the media-friendly mild plea, this one goes full-on conspiracy-mongering anti-vax crazy:

Let’s see. Voice of doom narrator? Check. Montage of mainstream media and blogs arguing against SafeMinds as though in a conspiracy? Check. The narrator intones ominously, “Listen to mainstream science and the media, and you might think the vaccine-autism debate is over and done with. The ‘vaccines don’t cause autism’ drumbeat is steady.”

Why, yes. Yes it is. From a scientific standpoint, the vaccine-autism “debate” (in reality a manufactroversy or pseudodebate) is over and done with. It has been for a long time. In fact, even though I’ve criticized her for being a little careless with her facts from time to time, I really liked one of the clips in the video featuring Dr. Nancy Snyderman. In it Dr. Snyderman repeatedly and aggressively slapped down the annoying Matt Lauer when he kept referring to the vaccine-autism link as “controversial,” telling him (quite correctly) it is not controversial–because it isn’t controversial among scientists and physicians. As I’m wont to say from time to time, from a scientific standpoint, the vaccine-autism hypothesis is pining for the fjords. It’s passed on! This hypothesis is no more! It has ceased to be! It’s expired and gone to meet its maker! It’s a stiff! Bereft of life, it rests in peace! (Except that it doesn’t; it’s a zombie that keeps rising from the dead.) Its metabolic processes are now history! It’s kicked the bucket, it’s shuffled off its mortal coil, run down the curtain and joined the bleedin’ choir invisible!!

It is an ex-hypothesis, and, yes, I do so love Monty Python’s Dead Parrot Sketch.

The room temperature nature and lack of scientific metabolic activity of the vaccine-autism hypothesis don’t stop Bernadine Healy, though. How predictable. Ever since Bernadine Healy went over to the dark side in order to become Age of Autism’s Person of the Year for 2008 for her increasing flirtation with the anti-vaccine movement, she’s become the go-to woman for anti-vaccine crankery. I’ve discussed Healy on more than one occasion here; I don’t feel an obligation to discuss her again other than to point out that she’s become a hack of late. But because she was the Director of the NIH back in the 1990s, she’s the best friends anti-vaccine loons could ever have because she grants them the patina of scientific respectability. In fact, she’s the first person shown after the voice of doom intones that “not all scientists agree.” Just as creationists and global warming denialists trot out scientists with no experience or training in evolution or climate science to attack the scientific consensus, SafeMinds trots out Bernadine Healy when the need arises, as it apparently did here. Elsewhere, it’ll trot out Boyd Haley and other scientists from unrelated disciplines.

While viewing this video, like Autism News Beat, I felt as though I were taking a trip down memory lane to peruse the anti-vaccine movement’s greatest hits. It’s all there, the rebranding of autism as a mitochondrial disease in the Hannah Poling case, the Bailey Banks case, claims that the government has compensated children for vaccine-induced autism, and a number of anti-vaccine tropes. Given that Autism News Beat has refuted each of the points in the SafeMinds video, I’ll refer you there. The video concludes with the voice of doom intoning, “So, as you see, vaccines don’t cause autism, except for when they do.” Bravo for the pure propaganda.

That SafeMinds even had to do this video is rather telling. Five years ago, which is when I got involved in refuting the lies of the anti-vaccine movement in a big way, news coverage of the vaccine-autism manufactroversy was nearly always credulous, giving far more credence to the proposed link than the science would indicate. SafeMinds and other anti-vaccine groups were given prominent coverage; even J.B Handley appeared regularly on TV and radio. Over the last year or two, I’ve noticed a welcome new trend in that the media is actually starting to demonstrate a bit of skepticism and, far more often than I can recall, getting the story right. Most likely this is because of outbreaks of vaccine-preventable diseases in populations with low vaccine uptake coupled with a continual drumbeat of scientific studies that have asked the question whether vaccines are associated with an increased risk of autism and come up with a resounding “No!” as the answer.

Even so, the question remains: How do we combat the problem of anti-vaccine propaganda. I came across an possibly depressing example of how badly we do it from Jason Goldman, who in a post entitled Vaccination, Confirmation Bias, and Knowing Your Audience described an event at GlaxoSmithKline’s headquarters about vaccination:

For a corporation that depends on communicating science to the public, they did a terrible job of it! For a certified card-carrying data-whore like myself, the Powerpoint presentations (which broke every. single. rule. of effective presentations. I highly recommend that they hire my friend Les Posen to teach them how to present properly) did not have enough detail. They would present some statistic, but without the level of detail required for me to make any real sense of the data. I will grant that I was not the intended audience of the talk, so I will forgive them their lack of error bars and missing p-values. For a general audience without a scientific data-driven background, the presentation was even more useless! It was all statistics, bar graphs, and numbers. If you’re going to communicate science to a general audience (and I’d like to think that I know a thing or two about communicating science to a general audience), you need to engage them emotionally. You need to tell a story, not drown them in statistics. The presenter might say something like, “Last year, three gazillion people died because they were not vaccinated against a Terrible Disease That Kills People In Gruesome Ways But Which We Could Eradicate In Less Than A Decade If Everyone Would Just Get Vaccinated.” Everyone would agree that this is a Bad Thing, at least. More likely, it is a Terrible, Horrible, No Good, Very Bad Thing.

[…]

Giving us incidence and death rates and other such statistics doesn’t really get the job done. It doesn’t communicate what they want it to. Nor will glossy pamphlets (like the one they gave me) featuring Mia Hamm telling us to get vaccinated. What will get the job done is story-telling, appealing to emotion, and utilizing accessible analogies. Instead of telling us how many gazillions died last year, tell us how many airplanes full of people, or how many football stadiums full of people died last year.

The GSK corporate blog also provides an account of the visit, as do Nutgraf and Scrutiny by the Masses. Nutgraf emphasizes the technical aspect of vaccine production, in particular the absolute cleanliness required as does Mom to the Screaming Masses. Apparently last year GSK arranged a similar program.

As I thought about the NVIC initiative and the SafeMinds video propaganda program, these efforts by GSK seemed completely ineffectual for the very reasons that Jason outlined, but more than that. First of all, you have to consider the messenger. To anti-vaccine parents, pharmaceutical companies like GSK are Satan incarnate. No matter how much a company like GSK tries, it’s unlikely to be trusted because, in the view of the anti-vaccine movement, it’s only in it for the money and it’s the entity that caused their children’s autism. I understand why GSK might have wanted to try anyway, but in reality it is the worst possible messenger, no matter how good it is at PR (and apparently it wasn’t that good). Put a sympathetic mother up against a pharmaceutical company for PR purposes, and the pharmaceutical company will lose every time. Worse, bloggers who accept trips like this risk being painted as in the thrall of big pharma.

Yet, at the same time, I really don’t like Jason’s solution, either. I understand that appealing to emotions is important, but matching the anti-vaccine movement story for story is a game that scientists are likely to lose at. We are constrained by the facts; the anti-vaccine movement is not. We feel vaguely dirtied by using manipulative stories the same way the anti-vaccine movement; that is to our credit. Yet, there’s no denying that such methods can be extremely effective. There has to be a mix that provides the human impact, the emotional hook, necessary to combat the blatant emotionality of the anti-vaccine movement, but without betraying scientific accuracy. I just don’t know what that balance is. I wish I did, but I don’t.

So in the meantime, I soldier on in my own little way, hoping that my efforts have an effect.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

281 replies on “Battling misinformed consent: How should we respond to the anti-vaccine movement?”

In response to your title question, how to respond to the anti-vaxers:

*With ridicule,* and derisive laughter, and a dismissive tone.

Most of the anti-vaxers are playing the follower game: going along with their social circle in order to strengthen their sense of belonging. Belief in wacko stuff strengthens belonging by requiring a greater degree of commitment in order to adopt and publicly espouse the beliefs. If I believe that the moon is made of rock, it’s no big deal to go talking about it; but if I believe that the moon is made of green cheese, it’s a very big deal to risk saying so in public, and taking that risk cements more strongly my relationship with my social group.

So.

When anti-vaxers find themselves subjected to major ridicule everywhere they go, they will be faced with a choice: opt for a greater degree of anti-vax extremism, or change their beliefs or at minimum not go spreading the pernicious memes.

Most do not have the energy to go to war over this issue, so they will opt for silence.

So let’s assume that we don’t change their beliefs but we do succeed at making it too embarrassing for them to try spreading their memes in public.

OK, now we’ve turned them from carrier/spreaders to carriers only, who are not spreaders. Excellent! This reduces spread. Meanwhile we keep up with our campaign to embarrass the antis, to the point where eventually they decline in number to below a threshold that has any effect or carries any risk to others.

I hear where you’re coming from.

We’ve our own little Vaccine Awareness Week at sciblogs in New Zealand (click on my name and browse around the larger site).

An earlier article I wrote (just before the week) looked an issue raised by a local journalist and vaccine campaign that perhaps the medium matters too. Scientists in general (i.e. outside of science bloggers) don’t use the social medium well, so perhaps this is another avenue to think about.

A comment I recently wrote there was that perhaps one way of viewing the anti-vaccine efforts scams, but rather than being based around a sales pitch, the emphasis is on using social media to build a “community with a bias”. (And anger.)

A wider way to look at it might be a change in the “it must be real, I saw it on TV” thing. Mass-market “broadcasting” and writing (YouTube, blogs) are now in the hands of anyone, without the editorial control you’d hope to get in better newspapers or TV channels. (You hope that is, what you actually get is patchy…)

I’m going to leave this thought at this point for now. (I might later expand on it on my blog if I find time and am inclined). Thing is, I think understanding the marketing being used would go some way towards understanding how to counter it.

Before I leave: your efforts do contribute. I know many people who use your words as something that they can present to others.

I plan to respond with fact, more facts, and then some more facts on top of that, layered with some humor. They throw opinion at us. I’ll fire back with facts. Since truth cannot dismiss truth, I think I’ll be okay.

On the subject of engendering faith in vaccinations, Ben Goldacre did an article in the Guardian about how people perceive crimes against the individual as more serious than crimes against a group, even when it’s the same crime with the same consequences, such as murder, fraud etc. ( sorry, no link as I’m on my phone)

Maybe this is what we need to do to persuade people of the benefits of vaccines – find some devastated parent who failed to vaccinate their child, said child then dying of some horrific, preventable childhood illness, and get them in an advert.

Nah, that’s not ethically dubious at all…

Compare the anti-vaxxers to other anti groups – creationists, 9/11 truthers, anti global warmers, holocaust deniers. They all use virtually identical tactics.

They focus on small inconsistencies and nitpick. They abuse statistics. They misrepresent results. They quote mine. They rely on incredulity. They employ falacious reasoning. They compile lists of scientists or authority figures who “agree” with them. They argue to teach the “controversy”. They ascribe underhand motives for those who choose to agree with the evidence supported explanation. They wrap the whole lot of a blanket of pseudo science. They lie, distort and oversimplify.

Basically any tactic that stops them having to address the evidence or even acknowledge it exists. They just parrot the same lies and untruths, one after the other. When one gets refuted they move onto the next and repeat. Forever.

The problem is:
“My kid didn’t die from a horrible illness she never caught because she was vaccinated” just doesn’t make a good story.
Ridicule is a good thing, knowing all their wonderful fallacies is good, too, but I’ve noticed in conversations that people get really pissed off if you give them facts. Suddenly you become a bully for saying A, B and C and this has been researched and proven by XYZ while all they sprout is “oooh them poor babies, don#t hurt them”

In my mind, I divide the US population into three groups: vaccine advocates; the persuadable middle; and vaccine rejectionists. A communications strategy for promoting vaccine should address each group.

Vaccine advocates need reliable data and up to date information on current events (disease outbreaks, research, AAP press releases, etc). Basically, we keep doing what we are doing.

The persuadable middle needs to be made more aware of the dangers of vaccine rejectionism. That’s where our friends in the news and entertainment media come in. On the plus side, the media narrative has shifted dramatically over the last few years, from “some parents say vaccines injured their children” to “vaccine rejectionism threatens us all.” The latter narrative needs to be repeated and enforced. On the negative side, we still have Oprah and Faux News.

Vaccine rejectionists, as g724 says, deserve scorn, and for the reasons described – to discourage the persuadable middle from hooking up with the malicia, and to discourage the fallen from boasting about their deviant predilections.

By encouraging the media and science drumbeat against rejectionism, we reduce the number of defections from the persuadable middle, and add more vaccine promoters to our side. By making it acceptable, fashionable even, to ridicule vaccine rejectionism, we thin the ranks of Jenny’s angry mob, and turn her drumbeat into the annoying drip of a leaky faucet.

So why is Lyn Redwood presenting this in a MD’s office/lab? I thought she was a nurse by profession.

You may not want to use GSK as your shining example of a drug manufacturer trying to save our children.

http://business-ethics.com/2010/10/26/1740-glaxosmithkline-to-pay-750-million-fine-whistleblower-to-get-96-million/

They are nearing the legendary Johnson and Johnson when it comes to unethical business practices. If they are this sloppy with their drug production which they are liable for, what would make you think they’d be any better producing vaccines which they are indemnified from liability?

In it Dr. Snyderman repeatedly and aggressively slapped down the annoying Matt Lauer when he kept referring to the vaccine-autism link as “controversial,” telling him (quite correctly) it is not controversial–because it isn’t controversial among scientists and physicians.

While I applaud Dr. Snyderman for stating the truth this bluntly, locka99 points out that this technique is not always effective–if it were, the creationists and global warming denialists would have long since vanished. People in the journamalism business, like Lauer, thrive on controversy, no matter what the facts are. Ridicule is a useful tool in the fight, but it cannot be the only tool.

Forget the rabid anti-vaxxers, we’re never going to convince them. The trick is to convince the swinging vaccinators that they are unreliable or at least take away their forum. I personally play to my strengths – I’m a science teacher and have a minor following doing science for kids. Most of what I’ve seen from doctors goes way over the average parent’s head, such as the difference between ethyl and methyl mercury. But take it back a step and the vast majority can understand that there is no mercury in vaccines. We all have strengths we can use, not just scientists or doctors.

The Stop the AVN campaign works on a similar principal, even though some outsiders don’t seem to realise it. We haven’t been trying to convince the AVN, what we are doing is shutting down their access to the media and changing their public perception. Rather than the go-to voice for balance, they now have a public health warning against them, have been done for copyright violations (incidentally stopping them distributing much of their material) and are facing possible fraud charges. They no longer appear trustworthy to media and the public.

Well said, Eric Lund. Ridicule and bluntness certainly have their place, but they cannot be the sole method.

Minnesota — vaccine manufacturers are not actually indemnified from liability. They are partially protected by the Vaccine Court, which pays settlements out of a tax on vaccines. But no plaintiff is barred from suing the manufacturer directly after failing to obtain satisfaction from VICP.

True to form, Mikey Adams ( NaturalNews; today) informs us that vaccination rates are falling among the ” better educated”, only the “ignorant” choose vaccination, and we shouldn’t “start a needle habit”. Gary Null constantly whines, ” _We_ have the science!”, followed by a BigPharma-BigGovernment conspiracy chaser (Braggadocio unemcumbered by higher mental processes!) How do we counter this? Our web woo-meisters perserverate that *they* are protecting the public – they are self-less, *good* people without ulterior motives, true scientists, valiant whistle-blowers, investigative reporters uncovering corruption, greed, and the lies of the “elites”, ad nauseum. So we can show how they aren’t. They are *corporations* earning millions of dollars. Their web sites (a/k/a Ads) include (over-priced) products for sale, listings of available jobs ( Mercola), photos of palatial estates( Adams and Null). Websites like manta.com and spoke.com provide estimates of annual sales figures ( e.g. Null at $10.9 million and $10 million, respectively). The governmental actions they decry as being detrimental to “The People” or “Health Freedom” are regulations which would cut into their sales.

You may not want to use GSK as your shining example of a drug manufacturer trying to save our children.

Or maybe you would. GSK is a large company consisting of lots of different people doing lots of different things. Strange as this may sound to the average anti-vaxer, drug companies aren’t the Borg and there is no hive mind controlling them. GSK definitely screwed up with quality control. They may or may not have fixed it policy wise. But they’re also doing useful work and apparently attempting to get their product to people who need it but can’t pay. Treating them-and all companies-with due caution and funding oversight agencies to catch them when they screw up is a more productive approach then simply dismissing the whole company because of one incident.

The stories are important too. Thanks to vaccines, we now live in a time where most parents with ‘immunizable’ kids have little or no life experience with the diseases that vaccines protect from. People tend to be very bad at risk/benefit analysis, so when these parents go in for vaccines, the paperwork they must sign tells them (informed consent) there is a certain mathematical risk associated with the given vaccine. And parents read this simply as “risk.” They also know there’s a very good chance that after vaccination their child is going to be feverish and fussy: not necessarily risky, but not fun either. Opposed to this they must consider the ‘risk’ of the disease, and again, many parents read this as “no risk” because they simply have not seen it. Add to this that inaction is almost always easier than action, plus a certain amount of exposure to rumors that “vaccines cause autism” and you end up with a number of parents (not necessarily ‘anti-vaxxers’) who choose not to fully vaccinate their children.

Somewhere I once read a comment (from a nurse) to a post on vaccination; she described a child who had to have his legs amputated and the process he went through as he grew older and the leg stumps had to be re-opened again and again to allow for bone growth. I read science blogs and books a lot, and there’s tons of vaccination information floating around in my head, but nothing has stayed with me as powerfully as that story did. It put a ‘face’ on the disease risk for me, even though I’m old enough that I had measles and mumps, my sister had scarlet fever, and even though I got chicken pox as an adult (horrible memory).

@KWombles

Wow. That message from Dr. Jay reads as if he’s telling people that if their kid has a persistent cough, don’t bother checking it out because it probably isn’t pertussis, and testing for it is really hard, so it’s not worth the effort.

You know, even after reading all of these posts, I still don’t understand why, at the most fundamental level, the anti-vax movement really exists. I kind of get what motivates, say, climate change deniers. In particular, I get what motivates the people who fund the movement. But why would anyone actively want to prevent people from getting vaccines? Is it really just money (to sell snake oil)? Is it just magical thinking? Are they just really, really stupid? Is it like a religious thing–they believe their own spiel so strongly that no contrary fact will ever change their minds? Sure, vaccines aren’t absolutely perfect, but the risks are nothing like what they say, and they work. I don’t get it.

Your implication that parents who choose not to vaccinate are gathering their information from bogus websites like mercola.com is as ludicrous and insulting as those who say parents are obtaining their parental views from celebrities like Jenny McCarthy. And regardless of where their information comes from, your argument that they shouldn’t retain their parental rights because they are too stupid is outlandish. Scienceblogs has been as biased about the vaccine issue as the sites your referring too. There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community. Parents owe it to their children to assess their own child’s health risks, not the health risks of the collective. Those that have contraindications to vaccines certainly should not be getting them. Unfortunately, pediatricians rarely find out if those contraindications exist before vaccinating. That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information, I assure you that us college educated, successful, and responsible parents are very much capable of navigating through the bullshit. Oh, and I certainly hope the autism debate isn’t really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren’t able to definitively link it to anything else either. So, I would say our work and debate is hardly over. If you want parents to be more knowledgeable when it comes to vaccines, maybe a healthy dialogue would be a good start.

Your implication that parents who choose not to vaccinate are gathering their information from bogus websites like mercola.com is as ludicrous and insulting as those who say parents are obtaining their parental views from celebrities like Jenny McCarthy. And regardless of where their information comes from, your argument that they shouldn’t retain their parental rights because they are too stupid is outlandish. Scienceblogs has been as biased about the vaccine issue as the sites your referring too. There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community. Parents owe it to their children to assess their own child’s health risks, not the health risks of the collective. Those that have contraindications to vaccines certainly should not be getting them. Unfortunately, pediatricians rarely find out if those contraindications exist before vaccinating. That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information, I assure you that us college educated, successful, and responsible parents are very much capable of navigating through the bullshit. Oh, and I certainly hope the autism debate isn’t really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren’t able to definitively link it to anything else either. So, I would say our work and debate is hardly over. If you want parents to be more knowledgeable when it comes to vaccines, maybe a healthy dialogue would be a good start.

How should we respond to the anti-vaccine movement?

Perhaps legally? IANAL, but it seems to me that one’s free speech rights end when people suffer direct harm.

If a stranger walks up to you and asks for driving directions, and you deliberately send him against one-way traffic leading to a fatal accident, I’m thinking your actions would be liable for a civil suit if not criminal charges.

We now have ten deaths from whooping cough in California alone this year, most of which can be laid directly at the door of the anti-vax movement. These people have been informed by medical experts that their advice is scientifically invalid – this is not an issue of simple opinion. Their persistence to misinform the public is therefore deceptive, premeditated, demonstrably dangerous, and arguably directly responsible for morbidity and mortality.

It would be very interesting to see if an antivaxxer-influenced parent who has lost an unvaccinated child due to the deliberate misadvice of the anti-vax movement could successfully sue. One successful suit would be worth a thousand clinical studies.

Oh, and I certainly hope the autism debate isn’t really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren’t able to definitively link it to anything else either.

Yes, the rate of autism is increasing. Yes, the cause is unknown and may be multifactorial. But one thing we know as surely as we can know anything is that it is NOT related to vaccination. Multiple studies have found NO link whatsoever. There is no plausible grounds for linking autism and vaccination. There is strong evidence against such a link. Why focus on practically the only thing we know doesn’t cause autism?

Yet, at the same time, I really don’t like Jason’s solution, either. I understand that appealing to emotions is important, but matching the anti-vaccine movement story for story is a game that scientists are likely to lose at. We are constrained by the facts; the anti-vaccine movement is not. We feel vaguely dirtied by using manipulative stories the same way the anti-vaccine movement; that is to our credit. Yet, there’s no denying that such methods can be extremely effective. There has to be a mix that provides the human impact, the emotional hook, necessary to combat the blatant emotionality of the anti-vaccine movement, but without betraying scientific accuracy. I just don’t know what that balance is. I wish I did, but I don’t.

I think the problem is that scientists can’t be the ones telling the story. Or doctors. Or a drug company. They’ll always have a problem putting a human face to the story in a way that doesn’t seem patronizing, overly complicated or self-serving.

However, but there are parents out there telling the story of how their children were scarred for life – or worse – by a vaccine-preventable disease. It is those parents that need a forum to explain that withholding vaccines from children potentially have disastrous consequences. There is no equivalent organization for Generation Rescue for those families – and if there is, it’s certainly not as media savvy.

@19:

You know, even after reading all of these posts, I still don’t understand why, at the most fundamental level, the anti-vax movement really exists.

I’ve always said there is a cult element to the anti-vax movement. People who are susceptible to the claims and charms of the anti-vaxers aren’t that dissimilar to those who could fall into any number of other cult-like entities. That makes it scarier, at some level, than other forms of denialism.

@Kelly

Orac, and the regular commenters here, would very quickly admit that vaccines have real risks. We would also readily agree that parents should be informed, and that doctors do not always do their due diligence in discussing vaccines with their patients/parents.

Part of the problem is that some parents do get their information from places like Age of Autism, mercola.com, SafeMinds, TACA, the NVIC, etc. Worse still, some media outlets also spread the same misinformation. And it can be very convincing. Some of the pieces sound quite rational, unless you have followed the arguments for quite a while or have read the actual scientific literature. Just a couple of examples of people who fall for the tripe at those sites, we have a troll that pops on here every now and then named Jen. She regurgitates whatever the latest post on AoA was, with no evidence of her having actually thought through or critically evaluated what she read. I personally have a friend who regularly shares news items from mercola.com, and that friend is a very smart, college-educated individual with a background in biology. It really hurts me when I see my friend post that kind of stuff, because I know how smart they are.

As to the autism debate, it is not over. The “vaccine-autism” debate, on the other hand, pretty much is, barring any new evidence to suggest any manner of connection. There is still considerable research and investigation into the cause(s) of autism, and that’s not something that is going to end anytime soon, thankfully. Very complex set of disorders that it would be good to more thoroughly understand.

Kelly:

. There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community.

Okay, tell us what they are, and compare them to the very real risk of getting measles, mumps, Hib and pertussis. Four diseases that we are seeing again.

Please use that real science by telling us the journal, title, and date of the the studies supporting your claim. Please stay away from quoting random websites, news reports and package inserts.

Yes, there are contraindications to vaccines… some very real ones. But you cannot get away by arguing by blatant assertion that “pediatricians rarely find out if those contraindications exist before vaccinating. That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information,”… you need to give the data you are basing that statement on.

If you want to argue that one contraindication is mitochondrial, you’ll have to explain the risks in getting every child a tissue biopsy. Plus, go against the general rule that those with that disorder should be vaccinated because getting fevers through the disease is much worse.

If you want to argue that risk from autism is a contraindication, then you need to provide real evidence that getting vaccines poses a greater risk than getting pertussis or influenza. At the present the science shows that there is not “one autism” disorder, so there really is no “one cause of autism.” Plus numerous epidemiology studies covering hundreds of thousands of children in over half a dozen countries show to casual link between autism and vaccines.

In short: provide evidence, not assertions.

@21:

That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information, I assure you that us college educated, successful, and responsible parents are very much capable of navigating through the bullshit.

So in other words, you’re suggesting that vaccines may play a role in autism despite all good evidence to the contrary – and you came to that conclusion without giving credence to Jenny McCarthy. Who happens to be the front person for the largest clearinghouse of autism-vaccine nonsense that I know of?

I call shenanigans.

And sorry, a college education doesn’t mean that you’re smart. Or able to understand good science from scientific crap. The “I’m a college educated parent” is the lamest appeal to authority ever, because most of the leading lights in the anti-vax movement are the allegedly college educated. They’re not the yokels you are subtly implying they are.

There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community.

There are definite risks to vaccines. Autism is not one of them, but everyone acknowledges that there are risks. Some children and adults should not receive certain vaccines. This makes it all the more critical that healthy people without contraindications receive vaccines in a timely manner: the herd immunity helps prevent infection in people who can not be vaccinated. The anti-vax advise on herd immunity is basically “Screw them.” Almost in so many words: Dr. Sears suggests “hiding in the herd” and I’ve seen several anti-vaxers write things like “Why should my child take a [nonexistent] risk for the sake of the community?” Not really the best role models altogether, people who don’t care if children die as long as their fantasies are catered to.

Your implication that parents who choose not to vaccinate are gathering their information from bogus websites like mercola.com is as ludicrous and insulting as those who say parents are obtaining their parental views from celebrities like Jenny McCarthy.

No, the parents aren’t all getting their misinformation from bogus websites and crappy books. Probably most of it is word-of-mouth from friends and relatives. Where do you think the “information” is coming from?

And regardless of where their information comes from, your argument that they shouldn’t retain their parental rights because they are too stupid is outlandish.

Show me one place where anyone on this blog has called parents “stupid” for being mislead. This term is reserved for those who spread misinformation that is – well – stupid.

Scienceblogs has been as biased about the vaccine issue as the sites your referring too. There are a variety of actual risks associated with vaccinations that are recognized by both the science and medical community.

– and these have been acknowledged and discussed on this blog.

Parents owe it to their children to assess their own child’s health risks, not the health risks of the collective.

Why is this an “either-or”? You could consider both. The “collective” includes your friends and family, too.

Those that have contraindications to vaccines certainly should not be getting them. Unfortunately, pediatricians rarely find out if those contraindications exist before vaccinating.

Citation needed.

That leaves the burden up to parents, and while it may be exhausting to filter through all the biased and bogus vaccine information, I assure you that us college educated, successful, and responsible parents are very much capable of navigating through the bullshit.

In your case, I am not assured.

Oh, and I certainly hope the autism debate isn’t really over for scientists, since 1 out of 90 boys is now being diagnosed with the disorder. While Science may not be able to link it to vaccines, they so far, aren’t able to definitively link it to anything else either.

Ummm…genetics?

So, I would say our work and debate is hardly over. If you want parents to be more knowledgeable when it comes to vaccines, maybe a healthy dialogue would be a good start.

Yes, it would. Care to join in?

Your implication that parents who choose not to vaccinate are gathering their information from bogus websites like mercola.com is as ludicrous and insulting as those who say parents are obtaining their parental views from celebrities like Jenny McCarthy.

So Kelly, tell us, where ARE those parents getting their information from? Presumably, because you imply that they have reputable sources, you should be able to name some.

Full disclosure: I am the blogger who writes the blog Mom to the Screaming Masses and the sideblog Scrutiny by The Masses. I was on the sponsored GSK trip and was quoted above.

—-One thing that I am struck by again and again was powerfully illustrated above. Commenter #24, who is listed as a-non, states:
I think the problem is that scientists can’t be the ones telling the story. Or doctors. Or a drug company. They’ll always have a problem putting a human face to the story in a way that doesn’t seem patronizing, overly complicated or self-serving.

However, but there are parents out there telling the story of how their children were scarred for life – or worse – by a vaccine-preventable disease. It is those parents that need a forum to explain that withholding vaccines from children potentially have disastrous consequences. There is no equivalent organization for Generation Rescue for those families – and if there is, it’s certainly not as media savvy.—

This is exactly true. I am not speaking as a scientist, for I have no scientific background, but as a parent of six children, two of whom are on the autistic spectrum. I have many friends who are vehemently anti vax, and we’ve gone around the circuit again and again. I have never seen the effects of Mumps, Polio, Smallpox or Rubella firsthand. But having children on the spectrum gives me a first hand sighting into the fear that a parent feels when a child is being immunized. If you see something that you think may have caused a problem – it’s going to make you think twice.

However. I have seen the effects of cervical cancer on my step daughter and niece, and that vaccine is a definite for my children – boys and girls. I have seen terrible bouts of the flu, and so that is a no brainer. Putting a face to the disease helps personalize it, and we all know from watching those tear jerker “Don’t let me be euthanized” pet commercials – it’s much more difficult to say no when it’s not an abstract – which is what polio, rubella and the like are to the vast majority of us.

Talking with my mom and my father in law, both of whom remember diseases I’ve never seen, was educational for me.

The long term effects of not being vaccinated are not being discussed. What about the young girl, 20 years from now, who gets pregnant and contracts German Measles? thanks, mom! How thoughtful of you not to vaccinate me! How about the young boy who contracts mumps as a young adult and becomes sterile? thanks again! you didn’t want grandchildren anyway, did you? Shingles, anyone? And with more and more unvaccinated children running around, this is can become a reality.

I absolutely agree that researchable statistics are key to assessing vaccine risk. Part of the problem is that the statistics generally used by the cdc on those ubiquitous handouts you get at the pediatrician’s office state mostly worldwide statistics-like rotavirus killing 500,000 children annually. Well, if you go to the CDC’s website and look for a number of fatalities among American infants, there isn’t one. The estimation is less than 40. How many of those less than 40 deaths were otherwise healthy individuals? don’t know. Meanwhile, I do know the FDA pulled the first rotavirus vaccine in 1999 for causing bowel obstruction in infants. That is incredibly fatal by the way and there were at least 23 confirmed cases. One of the two Rotavirus brands was also pulled by the FDA just this year for a pig virus contamination. I found it interesting that this wasn’t covered by any mainstream media outlet and as a parent of two children under 2 years old with another on the way, I received no letter from Merk about the recall. Luckily for the estimated million children who recieved that vaccine, the virus was found to be benign in humans.
In 2008, VAERS received more than 25,000 reports of adverse events from vaccines in the U.S. 9.5% serious-causing disability, death, or life-threatening illness. In 2009 the CDC reports only 71 cases of measles in the U.S. They listed no reported deaths. The WHO states that 95% of measles deaths occur in low-income countries with weak health infrastructures.
Since 2006, the CDC reports HIB disease is estimated to occur in .11 cases per 100,000 in the U.S.
So the facts that I use as a parent to assess the risk to my own children are stats from the CDC, the FDA, VAERS, and other such reputable sources. While I do vaccinate my children for diseases I consider to be life threatening to them, like DTap, HIB, PCV, and MMR, I also choose not to vaccinate my newborns against HepB, and I don’t vaccinate against Rotavirus as I feel, for my stay-at-home breast-fed children, its hardly enough of a risk. I haven’t yet vaccinated my oldest against hepA or Chickenpox.
I struggle with my decision to vaccinate or not vaccinate daily. I admit that some of my fear is based on emotion, and I realize that while the numbers of disease outbreaks may be low now, that could change if If less parents vaccinate. Yet, I will only base my decision on what the stats are today. Not what they were 20 years ago or what they could be. I also won’t put my child at risk of developing a high fever or any other adverse reaction simply because the CDC cannot get enough compliance from adults to be vaccinated-as is the case with HepB.
The real point here, is that I am a parent trying to assess risks, and unhealthy dialogue and banter from the medical community is far from helpful. I would love to have easier access to more statistics, trust me! I am less concerned with Autism and vaccines than I am with other documented side-effects like seizure, high fever, and respiratory ailment. Our children are plagued with chronic illnesses today and parents are going to be looking at all aspects of their child’s environment-including vaccines. Whether you like it or not, the more vaccines that are added to the already packed schedule, the more stats and proof parents will want that their children really are facing life-threatening risks. One more thing to note, as the dialogue has become increasingly unethical on the medical side, so have the number of parents not vaccinating.

OH, and a new contraindication announced by the CDC this past June was dealing with Rotavirus and SCID. Rotavirus is routinely administered in 2 month old infants. SCID is rarely diagnosed this early.

Well, if you go to the CDC’s website and look for a number of fatalities among American infants, there isn’t one. The estimation is less than 40. How many of those less than 40 deaths were otherwise healthy individuals?

Meaning what? That a less than perfectly healthy individual had no right to live anyway? That you’re ok with your kid getting rotavirus because you couldn’t bother to take the 1 in 1 million risk of a bad reaction like a transient fever, cough on a sicker kid, and kill him or her?

@Kelly

One more thing to note, as the dialogue has become increasingly unethical on the medical side, so have the number of parents not vaccinating.

What’s interesting to note, as well, is how the anti-medical side appears to largely get a free pass for its ethical lapses.

Kelly,

No where in this article has Orac suggested, as you claim, that:

they [parents] shouldn’t retain their parental rights because they are too stupid [from your comment #20/21]

Orac’s point is quite clear (I am citing from his post here):

And there you have it, the real mission of the anti-vaccine movement in general and the NVIC in particular, to discourage vaccination wherever possible under a false mantle designed to camouflage its true purpose, the mantle of “informed consent” and “health freedom.” What, you say? Who could ever argue with the concept of informed consent or health freedom? I can, not because I don’t support the right of individuals to determine what they will do with their bodies or what treatments they will or will not accept. Rather, it’s because the “informed consent” that anti-vaccinationists promote should more properly be referred to as “misinformed consent.” At every turn the anti-vaccine movement promotes pseudoscience, misinformation, and quackery to frighten parents into not vaccinating. After all, all informed consent is based on providing an accurate accounting of the risks and benefits of an intervention being proposed. The anti-vaccine movement and the NVIC downplay the potential benefits with frequent propaganda claiming that, for example, flu vaccines don’t work. More importantly, they hype the risks of vaccination to make them seem orders of magnitude more severe than science does, and if they can’t come up with a real potential complication, they make one up! After study upon study failing to find an association between vaccines and autism, they still promote the idea that vaccines cause autism. [Emphasis mine.]

To summarize:

  • Your claim: Orac is claiming that parents shouldn’t retain the right to informed consent vis-à-vis vaccinating their children on account of some intrinsic mental defect.
  • Orac’s claim: Parents’ rights to informed consent are being disrupted by the anti-vaccine movement’s continual dishonest misrepresentation of the risk/benefit profile of vaccines, a misrepresentation which the movement hides behind a smokescreen of support for informed consent and health freedom.
  • Your attempt to rebut Orac does not credibly advance your position when you argue based on something he did not actually claim.

Right Dianne. What I am saying is that I am not going to put my kid at risk of a fever, low-grade or high-grade if I don’t feel there is risk of my kid getting rotavirus. 1 in 1 million chance? Where are your stats? the CDC says 1 in 20 children will get a fever over 101. In an infant that can quickly turn serious. In fact, my oldest daughter after receiving a HIB vaccine came down with a fever of 104. If that was a one in a million experience than I should play the lottery. I still vaccinate her. But that is for a disease I am actually fearful of her getting. Not so much worried about diarrhea.
And again, less than 40 isn’t a number its an estimation. It could be 2 or it could be 39, who the hell knows, thats the point.
The Science and Medical community is using the over and done with Autism-Vaccine non-link to continuously promote the idea that vaccinations are safe and parents not only shouldn’t be skeptical but are misinformed or irresponsible for being so. That is no more ethical than the “anti-vaxers” that use the autism-vaccine debate to oppose vaccinations.
How about then focusing on the myriad of other concerns that parents have about vaccines?

T. Bruce McNeely:

Show me one place where anyone on this blog has called parents “stupid” for being mislead. This term is reserved for those who spread misinformation that is – well – stupid.

And very few of those are actually parents. Those would include Little Auggie, Sid O, and the ever morphing “Medicien Man”/”Dr. Smart”. The ever present “you are all stupid, vaccines are dangerous” argument by assertion is done by a couple of parents, one being “jen”, and I don’t think we’ve seen Common Sue for a while (she started with her name, then to Common Sense, and finally to several morphing names).

Two parents have been banned, John Best and Dawn Crim. But not for their views, but for their abject cruelty and total obnoxiousness when Orac wrote about personal tragedy. Kelly, I hope you do not condone such behavior.

Now, on a lighter note: isn’t there supposed to be some really ground breaking news that will show how wrong we are? Hello, STY, are you there? We are all on pins and needles waiting for your big revelation where you claimed:

Something has been in the making since 2004 that is going to make many dead people roll over in their graves. It will be completed by about October/November 2010, but it may be a little bit after that when you all become very familiar with it. But once you do, you will all finally see where you went wrong, because you most certainly have, and even the worst of the worst of them, such as Paul Offit, will even finally acknowledge just how wrong he was once and for all.

(oh, Kelly, look at the first phrase of that full paragraph in the link, and tell us why we should be very very nice to STY)

The stories are important too. Thanks to vaccines, we now live in a time where most parents with ‘immunizable’ kids have little or no life experience with the diseases that vaccines protect from.

I’m really glad I paid attention to my grandmother (who grew up in the Great Depression) and the Mark Twain books I read in school. For them, disease was a fact of life. Sickness was intimately part of the natural order: Some of your childhood friends would inevitably die or become disabled from a childhood illness.

As many bloggers like Orac have said, vaccines have become a victim of their own success: The diseases they prevent are so rare, few people know how dangerous they can become. They don’t listen to history, so they’re unaware of the toll these “mild” childhood diseases can take on someone’s life. Vaccines have been so successful, people take health for granted and act as if healthy humans are the natural order and disease is the aberration.

Makes it a lot easier for them to conjure up more “golden age” fantasies when there was some mystic culture that prospered for living in “natural” ways. Our health care systems are far from perfect (and some further from others), and they attribute those imperfections not to nature being red in tooth and claw (and microbe), but to our “sins” of using knowledge to live longer, healthier lives.

I also choose not to vaccinate my newborns against HepB,

Ever seen someone die of cirrhosis or liver cancer? It’s not pretty. I sincerely hope your children never encounter hepatitis B or any other hepatitis. In fact, if I never see another case of hep B related liver cancer I’ll be happy. IRIC, hep B is human carried only. The possibility of extinction of the virus in the wild is within reach…but only if people vaccinate.

“I also won’t put my child at risk of developing a high fever or any other adverse reaction simply because the CDC cannot get enough compliance from adults to be vaccinated-as is the case with HepB.”

You are, of course, putting them at risk of catching HepB instead- 30-40% of chronic infections are acquired during childhood.

http://shotofprevention.com/2010/05/06/why-infants-should-receive-the-hepatitis-b-vaccine-at-birth/ :

“the virus remains viable and infectious in the environment for at least 7 days and can remain present in inanimate objects absent of visible blood. Since only 7 out of 10 infected adults show any signs or symptoms, and infected children under age 5 rarely show any symptoms at all, it is obvious how the infected population can easily, and unknowingly, be transmitting the disease to others.”

When infected at a young age, HepB frequently leads to liver cancer and/or liver failure.

@Dianne

IRIC, hep B is human carried only. The possibility of extinction of the virus in the wild is within reach…but only if people vaccinate.

That’s one of the things that really irks me about anti-vaccine folks. They complain about there being too many vaccines, yet the best way to eliminate a number of them is for everyone to get vaccinated so the damn diseases disappear! Polio is so close to being wiped out. Measles was to be next on the list. Diseases that only reside in humans, that have no other reservoir, can be done away with for good, thereby eliminating the need to vaccinate against them.

Kelly, regarding your note from comment #33:

Part of the problem is that the statistics generally used by the cdc on those ubiquitous handouts you get at the pediatrician’s office state mostly worldwide statistics-like rotavirus killing 500,000 children annually. Well, if you go to the CDC’s website and look for a number of fatalities among American infants, there isn’t one. The estimation is less than 40.

Have you thought about what factors might result in there being such a disparity between US and worldwide rotavirus mortality in children?

Would it be reasonable to suggest the following?

  1. First, the rotavirus vaccine on the pediatric schedule in the US prevents the transmission of rotavirus, meaning most children don’t get exposed to it to begin with.
  2. Second, when children are exposed to rotavirus and do come down with the disease (i.e. because they weren’t vaccinated, weren’t able to get vaccinated, or because the vaccine didn’t provide immunity), the better sanitary conditions and medical technology reduces the mortality.

In fact, my oldest daughter after receiving a HIB vaccine came down with a fever of 104.

I’m not a pediatrician and I don’t know anything about your daughter but what you’ve told me but that sounds like a potential contraindication to future vaccination. If it is, would you rather she, in her partially protected state, be surrounded by people who are vaccinated or by people carrying HiB, a formerly common cause of meningitis and other nasty infectious diseases?

Kelly:

In 2008, VAERS received more than 25,000 reports of adverse events from vaccines in the U.S. 9.5% serious-causing disability, death, or life-threatening illness. In 2009 the CDC reports only 71 cases of measles in the U.S. They listed no reported deaths.

What part of “Please use that real science by telling us the journal, title, and date of the the studies supporting your claim.” did you not understand? Give us the study of the VAERS reports and compare ot to what happens in measles.

A bit of explanation: VAERS is a self-selected reporting system where the raw data is of the lowest form possible (that is Statistics 101). For instance here is an example of a parent in the UK (not where VAERS is supposed to work) reporting a vaccine turned his daughter into Wonder Woman.

Also, the rotavirus vaccines were not really recalled. So a bit of pig DNA was found, it was only during a very very deep PCR scan. Since they are both oral vaccines, consider them made better with a little bacon.

Kelly you ended with:

How about then focusing on the myriad of other concerns that parents have about vaccines?

Pray tell, what are those? What evidence do you have that they are issues? If you claim seizures, then I will ask you what is the risk of seizures from the actual disease. I have had a child have a Grand Mal seizure while he had a now vaccine preventable disease, so I am really interested in your educated and well documented answer.

@Kelly: so, your kids will not come into contact with any other children until they are school age? How will you know if any of their classmates have HepB? (My daughter was exposed to HepB when she innocently helped a classmate, who had falled down on the playground and had a bloody nose. Fortunately, she’d had her vaccines, although we did watch for any problems. No one at the school was aware, except for the part-time school nurse, that this girl was HepB positive.) You won’t allow them to play with other kids, who may bite, spit, bleed, share food with your children?

Yes, vaccines are scary. But do you mean to tell me it’s scarier to get your child vaccinated, knowing there is a fever risk so you can watch (and maybe prevent, with antipyretics) for a day or two, than to go wake up your baby and find them burning with a fever? Or that it’s easier to stay at home for 21 days with your unvaccinated child who was exposed to someone with chicken pox, not knowing whether or not your child will get it? And will you be one of the lucky ones who has a child with a mild case? Or one of the unlucky ones whose child ends up in the hospital?

And what pediatrician do you have that they don’t talk about contraindications? Mine asked me EVERY time about reactions to previous shots, family history of reactions to new vaccines. I’d look for a new doctor, if yours isn’t doing that.

Lastly, as has been pointed out to you, you ARE aware, aren’t you, that anyone can report to VAERS? You could report your daughter’s 104 fever from her HIB to VAERS. In fact, you should, unless your pediatrician already did. That is what VAERS data can be used for – looking for trends that might need additional research. It does not, in and of itself, indicate true issues, because the data needs to be looked at compared to what is expected in the general population. But, say, if 100 people report that their child got a 104 fever from X HIB dose, on X date, and in the general population, you only expect 20 children to get a fever, then that form of HIB would be looked at. However, as has been pointed out, VAERS data needs to be reviewed. Since anyone can report to the database, and the information is not vetted for verifiability, caution needs to be used when looking at the data.

MI Dawn

Kelly,

Show me where the CDC says that “1 in 20 kids who get the rotavirus vaccine get a high fever”. The only common risk of the rotavirus vaccine I’m aware of is mild diarrhea.

If you think rotavirus is mild, tell that to the 1 in 17 infants who end up in the ER because of it.

Well, I didn’t say I was not going to vaccinate my children against hepB ever, I said not as infants and until the medical community can give me a good reason not to wait until they are closer to adolescence, than hoping I will be swayed by unproven risk of liver cancer in my newborn will not have much impact.
I also would like to address my comment about the implication that parent’s rights should be removed because they are stupid, since that has gotten a lot of attention. My point was that the implication that parents cannot differentiate between biased and unbiased research when it comes to their child’s health is basically calling them stupid. And because their is anti-vax rhetoric that is unethical does not mean that this is what parents who selectively vaccinate their child are using to make those decisions.
As I previously stated, my information comes from the CDC, the FDA, and VAERS. Not Jenny McCarthy regardless that some of you find that hard to believe-but again, thats part of the problem. I was simply trying to shed some light on the fact that many parents today just aren’t convinced their child is at risk of serious injury from some of these vaccine preventable diseases. While that may infuriate some of you, it is the truth. It doesn’t make us horrible people or bad parents. I am not afraid of Chickenpox, thats right, not in the least. Maybe because everyone I know got it and recovered from it. However, I do fear that if my kids don’t obtain immunity from it as a child they have greater risks if they contract it as adults. So, I will immunize them if they have not yet contracted it naturally by school-age, as I suspect they won’t.
And no, a college education does not equal a higher level of intelligence, I guess. I mean, I’m sure universities would like to think it does. People who have the capacity to do research, however, are unlikely to dismiss reasoning when it comes to the most important and valuable aspect of their lives – their children.
I often do wonder though, since parents who don’t vaccinate are referred to so often as “mislead” or “misinformed” that if a study was done to find out how much time and resources a parent who doesn’t vaccinate put into researching vaccines as opposed to a parent who does vaccinate, what the study would find. And yes, my implication is that parents who follow the CDC schedule to the letter have probably also done the least amount of vaccine research.
My objective in this discussion was to point out that parents have every right to be skeptical of all aspects of their child’s life and health, especially when childhood chronic illnesses including asthma, obesity, learning disabilities, and mental health issues are on the rise. Whether this correlates with vaccines I don’t know, and the point is, neither do you. So maybe if the geniuses of the science community, along with the medical community could spend less of their energy attacking parents, and more of it trying to figure out why our children’s health has gone to shit, that might be more productive for society.

Okay, in retrospect, that last comment was awfully snarky. I don’t doubt the medical and science community is very diligently trying to what’s best for our children, just as parents are.

I know from personal experience rotavirus is best avoided. Not only are you dealing with rivers of diarrhea, but it sucks when you catch it too. I actually borrowed diapers from my kid! Oh, that is the disease that caused my kid’s seizures and trip to the ER. Not a fun time.

Oh, and just in case you think chicken pox is no big deal: a pox story.

@Kelly

My point was that the implication that parents cannot differentiate between biased and unbiased research when it comes to their child’s health is basically calling them stupid.

No, it is calling them human. As I pointed out before, some of the information put out by anti-vaxers can be very convincing and sound quite reasonable…until you actually look at the facts from scientific literature.

I’ll take Wakefield as an example. This man is very suave. He speaks clearly and is quite engaging. The things he presents sound quite rational. Without knowing anything else about vaccine issues or immunology, it would be quite easy to believe that what he says is true. Despite all of that, the stuff that comes out of his mouth is pure drivel. I don’t blame any parents for falling for his crap. They aren’t stupid; they just fell for a con-man’s line. As I also shared, a friend of mine with a biology background regularly posts nonsense from Mercola’s site.

I am not afraid of Chickenpox, thats right, not in the least. Maybe because everyone I know got it and recovered from it. However, I do fear that if my kids don’t obtain immunity from it as a child they have greater risks if they contract it as adults.

What about shingles?

Kelly:

As I previously stated, my information comes from the CDC, the FDA, and VAERS.

But you said:

the CDC says 1 in 20 children will get a fever over 101. In an infant that can quickly turn serious.

I am confused about what you are talking about. The Hib vaccine… the CDC Pink Book Hib chapter says:

Adverse reaction following Hib conjugate vaccines are not common. Swelling, redness, or pain have been reported in 5%–30% of recipients and usually resolve within 12–24 hours. Systemic reactions such as fever and irritability are infrequent. Serious adverse reactions are rare. Available information on adverse reactions suggests that the risks for local and systemic reactions following TriHIBit administration are similar to those following concurrent administration of its individual component vaccines, and are probably due to the DTaP vaccine.

And in the rotavirus chapter is says:

These data indicate the background incidence of intussusception in infants, as evidenced by its occurrence in infants who received a placebo. They also show that while intussusception is to be expected in recipients of rotavirus vaccine, the risk is no higher than among children who are not vaccinated.

and…

A variety of other adverse reactions were reported during the 7 or 8 days after rotavirus vaccination in the clinical trials, including vomiting in 15% to 18%, diarrhea in 9% to 24%, irritability in 13% to 62%, and fever in 40% to 43%. However, the rate of these symptoms in vaccinated children was similar to the rate in unvaccinated children. No serious adverse reactions attributable to rotavirus vaccine have been reported.

(by the way, the percentages of actual reports, not all doses)

What you are saying, and what your “sources” are saying are two completely different things. We will need you to actually document and link to the sources of your claims.

And I repeat: VAERS is just self-selected raw data. It is not useful until the reports are actually investigated.

I would like to inject some unbiased information into this discussion. Please take a look at Vaccines ProCon.org.

It is produced by a 501 (c)(3) public charity called ProCon.org – an organization dedicated to providing the best possible pro and con information about controversial issues.

The site contains a wealth of information on the issue of vaccination and associated risks along with a good number of expert quotes on both sides of the vaccination issue and links directly to full PDFs of a number of important studies on the issue.

Did you know: About 30,000 cases of adverse reactions to vaccines have been reported annually to the federal government since 1990, with 13% classified as serious, meaning associated with permanent disability, hospitalization, life-threatening illness, or death. [23]

Last year, three gazillion people died because they were not vaccinated against a Terrible Disease That Kills People In Gruesome Ways But Which We Could Eradicate In Less Than A Decade If Everyone Would Just Get Vaccinated.”

He’s talking about the mumps, isn’t he? Exploding cheeks and testicles, gruesome.

The VAERS statistics are EASILY checkable on the VAERS website. Its not from a journal. Just like the CDC claims I make are on the actual CDC website. But, since many of you seem to actually want to know why parents aren’t vaccinating, obviously because you don’t know, meanwhile accusing them of being misinformed, there was recently a study done by the oxford journal looking at exactly that. I suggest you take a look at it before you presume to know what parents are thinking and then criticizing them for it.
her.oxfordjournals.org/cgi/reprint/12/3/355.pdf
And, no my children will presumably not have classmates until they are school-age. Until then they aren’t in any daycare setting either. While I agree that adverse events related to vaccines are “rare”, HepB in an infant that does not go to daycare or have any immediate family with HepB is also “rare”.
Yes, the 104 fever absolutely is a contraindication for her to receive another HIB vaccine, but that was her third in the series. To answer the question of whether I would feel as empathetic towards parents who choose not to vaccinate if my child could otherwise not be vaccinated, that is a question I have struggled with, but yes, I still maintain that parent’s should make the best choice for their child. To expect that parents do otherwise is unnatural. So while I don’t fear my kid contracting HepB as a newborn, I also don’t fear her spreading it.
To composer99, of course I have taken that into consideration. Thats sort of my point. The risk of my American child, because my child lives in America, is less even if she does contract the rotavirus. I mean, really? I should give her a vaccine the FDA promoted as “safe” when it turned out to cause fatal bowel obstruction, simply because she may get diarrhea? You all seem to not want to acknowledge that the medical community and the FDA make mistakes, and have made mistakes in regards to vaccines, and could still make mistakes.

He’s talking about the mumps, isn’t he? Exploding cheeks and testicles, gruesome.

What about rotavirus? Or measles, which can kill infants? My parents grew up in the age of polio, what about that?

Given Chris’s rebuttal from the CDC Pink book, I have to ask Kelly: can you provide a more detailed source for your claim that the CDC says that 1 in 20 will get a 101 (or 104 or whatever it is) fever from the vaccine?

You attribute it to the CDC, but we need a more specific place to verify that.

Sadly, I fear you are only parroting what you say somewhere else, and didn’t get it from the CDC. Show me that I’m wrong.

@Kelly

Re: VAERS, you may want to give this link a quick read.

Looking at the raw VAERS reports is not going to give you any really meaningful information. There is a combination of underreporting and unrelated reporting.

Well, I didn’t say I was not going to vaccinate my children against hepB ever, I said not as infants and until the medical community can give me a good reason not to wait until they are closer to adolescence, than hoping I will be swayed by unproven risk of liver cancer in my newborn will not have much impact.

Sorry, I think I must have misunderstood you. You don’t think that reducing your child’s risk of liver cancer (since, as described in earlier posts, infants CAN and DO get exposed) is a good reason? That’s what you seem to have just said, but I suspect that’s not what you meant.

I also would like to address my comment about the implication that parent’s rights should be removed because they are stupid, since that has gotten a lot of attention. My point was that the implication that parents cannot differentiate between biased and unbiased research when it comes to their child’s health is basically calling them stupid.

No, it is calling them non-experts who, like everyone, can be susceptible to getting conned by people who seek to deceive them.

I was simply trying to shed some light on the fact that many parents today just aren’t convinced their child is at risk of serious injury from some of these vaccine preventable diseases. While that may infuriate some of you, it is the truth. It doesn’t make us horrible people or bad parents.

It does, however, make you factually wrong.

I am not afraid of Chickenpox, thats right, not in the least. Maybe because everyone I know got it and recovered from it. However, I do fear that if my kids don’t obtain immunity from it as a child they have greater risks if they contract it as adults. So, I will immunize them if they have not yet contracted it naturally by school-age, as I suspect they won’t.

SHINGLES.

I often do wonder though, since parents who don’t vaccinate are referred to so often as “mislead” or “misinformed” that if a study was done to find out how much time and resources a parent who doesn’t vaccinate put into researching vaccines as opposed to a parent who does vaccinate, what the study would find. And yes, my implication is that parents who follow the CDC schedule to the letter have probably also done the least amount of vaccine research.

Depends on your definition of “research.” If we restrict it to research based on reliable sources, as opposed to whatever some schmuck can post online, I suspect we’d find that parents who decline vaccination have, for the most part, done NO research. REAL research would involve PubMed.

My objective in this discussion was to point out that parents have every right to be skeptical of all aspects of their child’s life and health, especially when childhood chronic illnesses including asthma, obesity, learning disabilities, and mental health issues are on the rise.

Yet being skeptical of vaccination in that regard has no more foundation than being skeptical of, say, cargo pants. Should everyone avoid cargo pants because they might lead to learning disabilities?

Whether this correlates with vaccines I don’t know, and the point is, neither do you.

Actually, on many of those points, we do know, or at least have strong evidence. Learning disabilities and mental health issues, for instance, appear more common because we’re better at spotting them these days.

So maybe if the geniuses of the science community, along with the medical community could spend less of their energy attacking parents, and more of it trying to figure out why our children’s health has gone to shit, that might be more productive for society.

Who attacks parents? Attacking those who deceive parents into harming their children, sure. That’s done, and that’s highly productive and important.

And the medical community puts an IMMENSE amount of effort into researching such issues; far more than the entire total amount of energy devoted to countering the antivax loons’ attempts to kill off our children with infectious diseases.

He’s talking about the mumps, isn’t he? Exploding cheeks and testicles, gruesome.

Kelly, THIS guy is stupid.

Kelly, I did not ask how easy VAERS is. I wanted you to point out the studies that evaluate the raw data.

For the third time: VAERS is self selected RAW data.

Self selected data is by definition biased and worthless until the details are studied. It includes everything, even parent in another country reporting his daughter turned into Wonder Woman. Sometimes the cause of reaction is something else, like congenital heart problems or even in the case of a drug overdose in one teenager.

It is NOT valid for proving your statements. Which is why we are requesting studies from the VAERS data, not the data itself.

Okay, your child had a 104o fever after the Hib. It could have been something else, like a viral infection that you were not aware of. So your doctor played the odds and said no more Hib vaccine, which depending on the age is a good bet if herd immunity is high enough. That means you have a doctor who listens and responds to his clients, it is not evidence that the Hib vaccine often causes fever.

I do realize the VEARS stats are just “reports”, but if 25,000 people a year, nearly 250 of them “report” a fatality or life-threatening illness that is certainly compelling to a parent. And I also know that most of these cases will not be substantiated by the vaccine courts. I also know that there is a vaccine injury compensation fund for a reason. And while, the U.S. medical community renounces over and over that the MMR is safe, Japan seems to feel otherwise. I guess that a whole developed country who is just “mislead”. India’s top pediatricians have continually lobbied against the introduction of the Pentacel vaccine in their current schedule. Why is that? Why do they still believe it’s linked to those infant fatalities that the WHO discredits? I guess they too are misinformed anti-vaxers. I work in a hospital pharmacy and know that human error is and should be part of one’s health risk assessment. You wouldn’t take a medication without first being sure you needed it. All I ask for, as a parent, are more concrete localized numbers. I want to know what the rate of measles outbreaks are in my region of the country, I want to know what the risk of fatality is if my child contracts rotavirus, I want to know all of that. Unfortunately it is not a simple thing to find out, but that doesn’t mean parent’s should not have the right to seek out that information and make a decision based on their findings. If the medical community wants more input in the decision, they should offer more information and be more transparent- like giving media coverage to the fact that a pig virus was found in the rotavirus vaccine. That way, parents like myself don’t happen upon that information without any commentary. Because I’m sure many people would freak if they saw “pig virus” with all the hype about swine flu.
OH, and for goodness sake, when is the medical community going to get off the whole dr. wakefield stuff? I mean, you have been discrediting the guy for years and parents still fear a link between autism and the mmr. It may be time to move on to a possibly more effective strategy.

@Bruce

Your ability to consistently contribute nothing to the conversation is remarkable

@Ginger

now have ten deaths from whooping cough in California alone this year, most of which can be laid directly at the door of the anti-vax movement.

That’s absurd. Care to provide evidence

From my laywoman’s view, it seems like a major issue with people who are afraid of vaccines (or any of many other minor risk issues) is a lack of perspective on comparative risk. What I would love to see is a handy little chart:

Your child’s risk of dying from [insert vaccine-preventable disease] if they and most of their community receives the vaccine: ….
Your child’s risk of dying from [ ] if they don’t receive the vaccine but others do:
Your child’s risk of dying from [ ] if neither they nor the members of their community receive the vaccine:
Your child’s risk of dying from vaccine complications:
Etc.

I think if it was more prominently displayed how small the risk of injury from a vaccine is, compared to how large the risk is from those illnesses if we are not vaccinated, at least some minds could be changed.

Kelly:

Japan seems to feel otherwise.

You are aware that Japan became a leading importer of measles to the USA? A few years ago they closed several schools due to a measles outbreak, which killed several people. It is now having a return to mumps.

By the way, their MMR vaccine used the Urabe mumps strain, and is not the same as the American MMR vaccine that has been in use since 1971. I suggest you learn a bit more before trying another uneducated “argument by assertion.”

You can start with:
http://www.ncbi.nlm.nih.gov/pubmed/19209100
and
http://www.ncbi.nlm.nih.gov/pubmed/20847499

Newsflash: Other countries have other issues and use different vaccines. You cannot state that if the MMR (with Urabe mumps strain) caused a problem in Japan and the UK, that the MMR vaccine (with the Jeryl Lynn mumps strain) will cause the same issues in the USA and Canada.

I repeat: VAERS is not valid for proving your claims.

@Kelly

And while, the U.S. medical community renounces over and over that the MMR is safe, Japan seems to feel otherwise. I guess that a whole developed country who is just “mislead”.

IIRC, the reason the combo MMR vaccine was discontinued in Japan was due to the particular strain of mumps they used. I believe it was the Urabe strain, which was associated with a number of increased adverse event risks. They stopped using MMR and witnessed an increase in measles incidence. Now, they administer the measles and rubella vaccines separately. I’m not certain what, if any, efforts are underway to get approval for a different MMR vaccine there that does not use Urabe strain of mumps.

India’s top pediatricians have continually lobbied against the introduction of the Pentacel vaccine in their current schedule.

Do you have a citation for this?

I mean, you have been discrediting the guy for years and parents still fear a link between autism and the mmr. It may be time to move on to a possibly more effective strategy.

Evidence that we need to keep hammering home where the origin of the MMR myth came from, though, yes, perhaps other strategies would work better.

From Kelly:

“The VAERS statistics are EASILY checkable on the VAERS website.”

From the VAERS website:

“When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.”

“VAERS is a passive reporting system, meaning that reports about adverse events are not automatically collected but require a report to be filed to VAERS. VAERS reports can be submitted voluntarily by anyone, including healthcare providers, patients, or family members. Reports vary in quality and completeness. They often lack details and sometimes can have information that contains errors.”

“DISCLAIMER: Please note that VAERS staff follow-up on all serious and other selected adverse event reports to obtain additional medical, laboratory, and/or autopsy records to help understand the concern raised. However, in general coding terms in VAERS do not change based on the information received during the follow-up process. VAERS data should be used with caution as numbers and conditions do not reflect data collected during follow-up. Note that the inclusion of events in VAERS data does not infer causality.”

In short, VAERS is not a source of valid data on the prevalence or incidence of adverse reactions to data, nor does it give information about what adverse reactions are caused by vaccines. It wasn’t set up to be a source of data; it was set up to be sensitive to indications of potential adverse effects that weren’t detected in pre-approval trials. It is expected to provide a large number of “false alarms”.

Prometheus

@Kelly

BTW, I just want to say that I am impressed that you actually go to the FDA and CDC web sites for your information, even if I take issue with some of the interpretations you draw from your reading. That’s more than a lot of people will do, and far more honest than the folks from AoA, NVIC, etc. do.

Thank you, Kelly, you are finally learning. Did you notice it said Mild Problems?

Now we just have to get you to figure out the problems with the raw VAERS data. Obviously your college education did not include a basic statistics class.

@Composer

Orac’s claim: Parents’ rights to informed consent are being disrupted …

If Orac is indeed claiming that parents have a right to “informed consent” I wonder if he supports states that do not allow parents to exercise these rights in regards to school attendance

@Kelly: but what you aren’t admitting, that we are trying to point out to you, is that those 250 deaths may have had NOTHING to do with the vaccine. For example, one VAERS reported death, Gardasil vaccine, was a girl killed in an automobile accident on the way home from getting her shot. Care to explain how the vaccine was the cause of her death? Or the girl in England who died after a vaccine, and her autopsy showed she had a lethal cancer? Just because a death is reported after a vaccine, you can’t determine the vaccine was the cause of death without further detail.

Yes, vaccines are not 100% safe. No medication is; if you work in a hospital pharmacy, you should know that. You should also know that medications are given to save lives, not (generally) kill them. But tell that to the husband whose wife died of malignant hyperthermia after an elective surgery. Or the parents whose child died from anaphylaxis after getting her/his first dose of penecillin. Drugs can kill. ANY drug. (Yeah, I’m ex-hospital, my husband is still in a hospital pharmacy).

Since you keep your kids home all the time, never take them to the store, the mall, the park, you can keep them from being exposed to diseases. But you never know. You never know who is sick, they may not be aware themselves at the time. How about the kid who exposed thousands of people to measles during the Canadian Olympics? Or the other kid, in California, who caused the measles outbreak there? All the children who caught it from him were at their doctor’s office. Do you not take your children to the doctor either?

I won’t even comment on your Japan and India statements,since others have already done so.

I’ll just leave (going out tonight) with this: CITATION NEEDED for your statements.

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