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The Internet as anti-vaccine tool

It’s official now. The U.S. is on track to accumulate more cases of measles than it has seen in a decade:

The United States seems to be on track to have more measles cases than any year in more than a decade, with virtually all cases linked to other countries, including Europe where there’s a big outbreak.

Already there have been 89 cases reported so far. The U.S. normally sees only about 50 cases of measles in a year thanks to vaccinations.

Health officials are reluctant to make predictions, but acknowledge the pace of reports is unusually hot.

“It’s hard to say, but we’re certainly getting a lot,” said Dr. Greg Wallace, who leads the measles, mumps, rubella and polio team at the U.S. Centers for Disease Control and Prevention.

Europe, especially France, has been hit hard by measles, with more than 6,500 cases reported in 33 nations. International health officials are blaming it on the failure to vaccinate all children.

Just about all U.S. outbreaks were sparked by people bringing it here from other countries. This week, international health officials posted an alert urging travelers everywhere to get the recommended two doses of vaccine before flying overseas.


For the most part, U.S. measles vaccination rates remain reassuringly high. However, even though overall vaccination rates remain high, there appear to be increasing numbers of pockets of vaccine resistance where the percentage of vaccine uptake has fallen below that necessary for herd immunity, particularly in affluent coastal cities. When that happens, if measles finds its way into a community with low vaccine uptake rates, the chance of an outbreak, even a major outbreak, rises. Given that international travel is common and relatively easy, this means that low vaccine uptake rates overseas can represent a hazard to us here in the U.S., as travelers can bring the virus into populations whose herd immunity might not be adequate to prevent its spread. It also has to be remembered that the MMR vaccine, while very effective, is not 100% effective. As the article cited above notes, it’s quite possible to be fully vaccinated and become ill; the difference is that the odds of contracting measles are much lower if you’re vaccinated. That’s why the common anti-vaccine refrain that says that you shouldn’t worry about unvaccinated children being a threat to your children if you’ve vaccinated them is nonsense. True, they’re not as big a threat, but they’re still a threat.

The anti-vaccine movement, at least the Wakefieldian wing that says that the MMR vaccine causes autism, is definitely stronger in the U.K. than it is here and arguably also stronger in Europe than it it is here. It is therefore not surprising that we are seeing cases of measles in the U.S. as a result of European travelers bringing it here, although that is by no means the only source; travelers from Third World countries, where vaccine uptake rates can be quite low, are another major source. If we are not careful, MMR uptake rates could fall here as well, perhaps making American travelers vectors of infection delivering measles virus to other countries. Given how incredibly infectious and easily transmissible the measles virus is, it doesn’t take a lot. Be that as it may, it was interesting to me that less than a day before seeing the report above, I had run into this analysis on Eurosurveillance of the role of health information on the Internet in influencing decisions to vaccinate or not to vaccinate. After providing background about how vaccines have become a victim of their own success, such that people now focus far more on their potential side effects than the dangers of the diseases prevented by them, how distrust of vaccines fueled by the anti-vaccine movement has led to decreases in vaccine uptake rates, particularly in the U.K., and how the WHO failed to reach its goal of eradicating measles by 2010 and had to push that target back to 2015, the report sets the stage:

This paper takes a first step in exploring the role of the Internet in influencing anti-vaccination decisions from a psychological perspective and examines how vaccination risk perception and decision process are affected by information on the Internet. The main points were also presented at the 2010 Eurovaccine conference [6]. From a psychological point of view it is assumed that during the pre-decisional phase of the decision process, the problem at hand (to vaccinate or not) is identified and the person making the decision acquires the necessary information, e.g. via an Internet search (see Figure 1) [7]. In the selectional phase, potential outcomes of the alternatives are evaluated (appraisal, e.g. the risk of suffering from side effects after vaccination). Finally the decision is made. In the post-decisional phase the decision needs to be implemented and the person making the decision receives feedback (e.g. about the actual occurrence of side effects). All information is stored in the memory and will influence future decision processes. This paper focuses mainly on information search, its influence on risk perceptions, vaccination intention and finally behaviour.

So this study is looking solely at the pre-decision phase of vaccination; i.e., the information-gathering phase. As part of that analysis, the author first summarized data regarding the Internet as a source of health information in general and anti-vaccine information in particular, with some disturbing observations, making a rather disturbing observation. As a test case, a search was made for “hand cleaning” during the H1N1 pandemic of 2009-1010, which lead to WHO recommendations about handwashing and other infection prevention recommendations 75-80% of the time. In other words, for this term, the chance of someone searching about information on hand washing finding reliable health information was quite high, although I must admit that I was surprised that the percentage was only 80% at best. In contrast, searching for terms related to vaccines tend to have a higher chance of pulling up anti-vaccine websites, with the further observation that, the more general the term used, the more likely that anti-vaccine websites will appear higher on Google search results. This is relevant because of recent work cited that suggests that the parents’ knowledge about vaccination influence the complexity of the search terms they use. Parents who are better-informed will use more specific and complex search terms and be less likely to find anti-vaccine websites. In contrast, less knowledgeable parents are more likely to conduct searches and use less complex terms in doing so, leading to more anti-vaccine websites, which they are less able to evaluate critically because of their lack of knowledge. It’s a vicious circle.

The bottom line is that, as much as we make fun of them (and rightfully so, at least from a scientific perspective), anti-vaccine websites are effective through recycling several common arguments:

In terms of page content, all eight vaccine-critical Internet sites analysed by [3] were concerned with vaccine safety and claim a causal relationship between vaccinations and illnesses of unknown origin, e.g. multiple sclerosis, autism, asthma and sudden infant death syndrome. Arguments are continually repeated, for example: vaccines erode immunity (seven of eight), create only temporary or ineffective immunity (seven of eight), contain many ingredients and preservatives that will make you sick (eight of eight), overwhelm children’s immune systems, especially when administered in combination (three of eight). At the same time, treatments superior to vaccination are promoted, e.g. homeopathy (seven of eight). In addition, anti-vaccination websites are very well connected, as they all provide links to similar sites [3].

It’s true, too. One of the reasons anti-vaccine websites tend to percolate up so high on Google search results is because they are so highly inter-linked. They often have savvy web designers who know how to optimize their pages and blogs to appear as high as possible on Google search results for vaccine-related terms. In contrast, we who defend science-based medicine against the pseudoscience of the anti-vaccine movement are often far behind the curve.

But why are anti-vaccine websites so effective? The Eurosurveillance analysis confirms something I’ve been writing about from the very beginning of this blog, namely the power of testimonials. Testimonials aren’t just for cancer; they work for lots of anti-science and quackery, and their power is widely harnessed to serve the anti-vaccine movement by appealing to the emotions of parents, which when it comes to their children are particularly powerful:

A key feature on seven of the eight examined websites was the inclusion of emotive appeals, such as pictures and stories of children who were supposedly harmed by vaccinations. An example for such descriptions of personal experiences, posted on a German website, reads as follows: ‘My four year-old daughter received the five-in-one combination vaccine at nine months, she then had a fever for two weeks, was apathetic and had screaming fits, since then she has suffered from atopic dermatitis and many allergies. My son is now four months old and I don’t know if I should get him vaccinated or not (…)’. Parents appear to have a preference for personal information when searching on health related topics, i.e. information from parent to parent: even parents-to-be already search for such information, mainly through internet forums (bulletin boards) where they can post questions that are then answered by other parents [15].

The author summarizes that approximately 1 in 5 hits in Google searches on vaccines will lead to anti-vaccine websites and blogs (which, quite frankly, strikes me as a bit low, but the study was done before the rise of Twitter and Facebook), the vast majority of which prefer frightening testimonials of “vaccine injury” over scientific evidence. Indeed, one of my favorite examples of this the NVIC International Memorial for Vaccine Victims, which is nothing more than a bunch of unsubstantiated testimonials in which the adverse reaction reported may or may not be related to vaccines. Jenny McCarthy’s anti-vaccine group Generation Rescue takes it one step further, with a webpage featuring “vaccine-injured” children who were “recovered” using biomedical quackery. Because, as I’ve discussed many times before, correlation does not necessarily equal causation and autism is a condition of developmental delay with waxing and waning symptoms, these stories seem very compelling on the surface. These testimonials can be highly effective in producing an exaggerated perception of risk due to vaccines and an incorrectly low estimate of vaccine effectiveness in preventing disease. It is, as I have at times characterized it, misinformed consent, because the parent is refusing vaccination based on misinformation.

The effectiveness of misinformed consent is illustrated in this graph from the report:

i-e4cb65fb788775cd3d01c426f0bd02f4-BETSCH_Fig2.jpg

As you can see, anti-vaccine websites increase parents’ estimation of the risk of vaccinated and decrease their estimation of the risk of not vaccinating, the latter of which is frequently downplayed heavily in anti-vaccine websites.

So how to combat this emotive misinformation? Based on this report, it’s hard to say. The author discusses the use of emotive pro-vaccine appeals that play on the fear of disease, for instance by showing pictures of children who suffered encephalopathy after measles? However, most scientists are very uncomfortable about this approach, and the author correctly asks, “Should fear be fought with fear?” She also cites a study finding that stronger statements of risk negation can paradoxically lead to a higher perception of risk than weaker statements of risk negation, as well indicating that the source matters a lot. Indeed, strong statements of risk negation by a source parents find untrustworthy actually appear to increase the perception of risk. Of course, different parents will find different sources more or less trustworthy. For instance, anti-vaccine parents do not trust Paul Offit; his pronouncements are actually probably more likely to harden their positions. However, parents who are on the fence probably do not view him as negatively and might even view him positively, making him more effective with this population.

The resurgence of measles stresses the particular urgency to answering the question of how to communicate science and relative risk accurately to the public in a way they can understand. Failure could well result in the return of, if not the bad old days before vaccines could prevent so many deadly diseases, days that are quite bad enough.

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]

124 replies on “The Internet as anti-vaccine tool”

DAMN! DAMN! DAMN! I don’t want to be get measles at age of 40-something. I am NOT immune, the vaccine doesn’t work for me (or at least, has not in the past) and I’ve FREAKING HAD THE MEASLES!!! I don’t want them again. I want to crawl into a plastic bubble until people get their heads out of their collective rears and realize that there are many of us of all ages at risk due to their stupid beliefs about fradulent data. Damn Andy Wakefield. Damn AOA and DAMN the uneducated people who believe vaccines cause autism crap.

(little augie warning: don’t post your usual trolling remarks or I will be tempted to “out” you to the most fun people I know on the internet. If you post anything, make it evidence based, without straw men, ad hominens or lies.)

I live near one of those affluent coastal cities…I have a baby girl, who is fully vaccinated. It really annoys me that I have to ask other parents if they vaccinate before visiting or for playgroups. One local playgroup is almost entirely unvaccinated. We went once before I found out. I am not willing to risk exposure on the chance that one of the vaccines isn’t fully protecting her.

Many of my neighbors are immigrants, and they always vaccinate their children. I asked about it once – some of the diseases are still prevalent in their home countries so they are pro-vaccine.

The amount of bad and conflicting information out there is horrible. I have been having really bad acid reflux the past 2 months, and trying to determine what is safe to eat. Most sites I find are really just scrapes of other sites with ads put on. Most sites (esp alt med) have really horrible advice.

For instance: they will blindly list stuff that makes your stomach feel better, but acid reflux is not an ulcer or gastritis (and i had gastritis on top of the reflux) some things that help gastritis actually worsen acid reflux esp. if they relax smooth muscle tissue. But you won’t find that nuanced advice. But to an acid reflux sufferer it is definitely important!

I got my tdap last year. I have been trying to convince my girlfriend to get one I think i will try harder. I wonder if measles needs a booster.

@Laura:

From http://www.medicinenet.com/measles_rubeola/page2.htm
“anyone who has had the measles is believed to be immune for life”.

Generally, that is true, but according to numerous titers I have had in my life, I am not immune and the vaccines don’t give me immunity. And my mother knew well what measles looked like so she is certain that I had them. (Documented in my baby book as well as my immunization record from my doctor).

“Should fear be fought with fear?”

Yes, and lies should be met with ridicule. Seriously, there’s a difference between scientifically-grounded fears of death and complications of vaccine-preventable childhood disease and the lies of chicken little. It’s perfectly legit to combat chicken little by pointing at the fox waiting in the cave (the return of vaccine preventable diseases, expensive and ineffective and/or directly harmful CAM.)

It also has to be remembered that the MMR vaccine, while very effective, is not 100% effective.

*Yawn*

This is why I’m glad the pre-school my daughter will be starting at in the Fall requires that all its students be fully vaccinated.

according to numerous titers I have had in my life, I am not immune and the vaccines don’t give me immunity.

You have been re-vaccinated as an adult and it didn’t build up your antibody levels? Yikes.

@enkidu Thanks for the measles warning. That’s about 20 minutes from us and my mom’s immune system is compromised at the moment from her chemo treatments.

@Laura

Yeah, vaccines, and even natural infection at times, may on rare occasions fail to give a person immunity. René Najera wrote up a nice post explaining why this happens.

Ok, so . . .

{anecdote}
“Boy, am I glad I had my child vaccinated when I did. Her school had several non-vaccinated children in it who caught Pertussis, and if it hadn’t been for the vaccine, it could have been her! I’ve heard all the people say that vaccines cause autism, but there’s really nothing to it. And I -know- vaccines saved my daughter from getting sick!”
{/anecdote}

No better than what the anti-vaxxers have, but it should be at least as effective, no?

Orac should advise its minions to take remedial classes in Immmunology 101 than parading their ignorance in this board.

Comments like these…

I am NOT immune, the vaccine doesn’t work for me (or at least, has not in the past) and I’ve FREAKING HAD THE MEASLES!!! I don’t want them again.

[…]but according to numerous titers I have had in my life, I am not immune and the vaccines don’t give me immunity.

Yeah, vaccines, and even natural infection at times, may on rare occasions fail to give a person immunity.

…show just how they have embraced a non-thinking process and continued the path towards ignorance and utter humiliation.

@Todd,
You forgot to include the url for the nice post.
If I’d had vaccines that didn’t work, I’d probably want to investigate why and look into getting vaccinated again.

That’s why the common anti-vaccine refrain that says that you shouldn’t worry about unvaccinated children being a threat to your children if you’ve vaccinated them is nonsense. True, they’re not as big a threat, but they’re still a threat.

Anybody with a brainstem should worry about Orac’s logic.

@Laura: it is generally an idiosyncratic thing. In my case, it’s very weird, because I have developed normal titers for all other illnesses (vaccine-preventable) that I either had or had the vaccine for. Don’t know why I don’t get immunity to measles. Don’t know why having the measles didn’t give me immunity. But I don’t want to get them again. (I’ve had the single measles injection, WAY back in the 1960s, after I had the measles, I had the MMR in the 1970s, and another MMR when I went to graduate school in the 1990s since my titers showed non-immunity. If measles hits my state, I will probably ask my doctor for another one, just to see if the 5th time is the charm…)

I can’t access Rene’s post to give you the URL. Todd? Repeat please?

PS Ignore Thing. Thing is a troll who believed children are never exposed to illness if they have good parents. Thing also believes other hilarious things and can be good for laughing and pointing when you are in a bad mood.

I read some things online saying that in the 1960’s, a lot of people in the US were vaccinated with a measles vaccine that wasn’t effective. This may be part of why measles is getting more common. See http://www.npr.org/templates/story/story.php?storyId=5497945
So if you don’t have enough measles antibodies, that doesn’t necessarily mean that measles vaccines don’t work for you.
I would have been vaccinated in the 60’s …

Orac should advise its minions to take remedial classes in Immmunology 101 than parading their ignorance in this board.

No, you should.

The immune system is random. Sometimes B cells make an antibody that recognizes, but does not neutralize the virus. If these dominate the immune response, then there won’t be any humoral immunity from the immune insult. Upon reexposure, the same B cells are activated again and you get the same nonproductive immune response.

Great… Given that I may have knocked my wife up last month, and I ride public transit twice a day, in an affluent Eastern city…

…time to get some boosters.

Orac:

Indeed, one of my favorite examples of this the NVIC International Memorial for Vaccine Victims, which is nothing more than a bunch of unsubstantiated testimonials in which the adverse reaction reported may or may not be related to vaccines.

Someone tried to tell how bad vaccines were by sending me to that site. When I checked it the testimonial was about vaccines causing Down Syndrome, also known as Trisomy 21 because of the specific chromosome!

Oh, and ignore Th1Th2. She lives in her own reality where the DTaP vaccine is intravenous because she says so.

Let me try to understand Th1Th2’s logic. “If it’s not 100% effective, don’t bother?” Last time I checked, driving defensively isn’t 100% effective. Does that mean it’s perfectly fine to drive recklessly?

Oh, and ignore Th1Th2. She lives in her own reality where the DTaP vaccine is intravenous because she says so.

The Internet is not the only anti-vaccine tool.

CG,

The immune system is random. Sometimes B cells make an antibody that recognizes, but does not neutralize the virus. If these dominate the immune response, then there won’t be any humoral immunity from the immune insult. Upon reexposure, the same B cells are activated again and you get the same nonproductive immune response.

It’s so obvious you just created that stuff. I am pretty sure you are not confident with your answer as well.

Chris, in ThWorld anything that eventually winds up in the blood stream is intravenous. I just had an intravenous dose of vanilla coke (one of my weaknesses) and tonight I’ll have an intravenous dose of delicious barley soup.

Chris,

the DTaP vaccine is intravenous because she says so.

Which part of the that link where it says intravenous Bordetella pertussis vaccine don’t you understand?

So you’re saying the pertussis vaccine cannot be given intravenously? Just give the ol’ nurse lilady a pertussis vaccine and she’ll give it you intravenously. You know that nurse can give PPD test beneath the skin and able to get away with negligence repeatedly. Oh yeah you can also have the triad DTaP IV as well!

Oh Chris, when are you going to stop ridiculing yourself?

It’s so obvious you just created that stuff. I am pretty sure you are not confident with your answer as well.

This shows exactly how little you actually know about immunology. It’s a well known phenomenon, particularly with regards to HIV.

Non-neutralizing antibodies have been shown to have some role especially in non-lytic viruses like HIV.

It’s so obvious you just created that stuff. I am pretty sure you are not confident with your answer as well.

If it’s so obvious, why haven’t you provided any evidence showing otherwise?

Which part of the that link where it says intravenous Bordetella pertussis vaccine don’t you understand?

Chris understood it perfectly. What you failed to notice was that the vaccines were given to mice.

So you’re saying the pertussis vaccine cannot be given intravenously? Just give the ol’ nurse lilady a pertussis vaccine and she’ll give it you intravenously. You know that nurse can give PPD test beneath the skin and able to get away with negligence repeatedly. Oh yeah you can also have the triad DTaP IV as well!

Find me a textbook which states veins and capillaries are identical, then I might believe you. Not going to happen, however.

dedicated lurker writes:

I just had an intravenous dose of vanilla coke

Hey, I was That Guy who loved Diet Vanilla Coke, probably because it tasted so much of no natural anything.

Gray,

Let me try to understand Th1Th2’s logic. “If it’s not 100% effective, don’t bother?” Last time I checked, driving defensively isn’t 100% effective. Does that mean it’s perfectly fine to drive recklessly?

You see, there’s a big difference between driving safely and vaccine-induced infections. Infection-promoters like you should definitely focus on the latter because even with simple analogy, you guys fail miserably. So when do you plan to drive recklessly?

Considering your strategy is “don’t expose yourself to disease” (because all infected people turn blue or something) I’m sure your strategy for avoiding car crashes is “don’t get in to an accident.”

dedicated lurker,

Considering your strategy is “don’t expose yourself to disease” (because all infected people turn blue or something) I’m sure your strategy for avoiding car crashes is “don’t get in to an accident.”

If you can read vaccine labels and understand science, then you must also avoid vaccines. Apparently, you’re incapable of such.

BTW, vaccination is never an accident. It is routine. It has a schedule and it is recommended. Its intent is to infect whether you like it or not. So stop analogizing and stick with science. Unfortunately, for vaccine apologists, analogies far outweigh the science.

I gave birth about two weeks ago in an upscale NJ suburb. We had an outbreak of measles in the town as a result of two idiots from France.

http://www.my9tv.com/dpp/my9_news/nj_videos/nj-restaurant-linked-to-measles-outbreak

It gets worse. We were watching television during the labor. As the anesthesiologist was dropping the epi needle into my back, he started a tirade against vaccines!

I swear the crazies are everywhere. My newborn will leave our house as little as possible for time being.

infect

“You keep using that word. I do not think it means what you think it means.”

At the same time, treatments superior to vaccination are promoted, e.g. homeopathy

Now that is what I call badly phrased.

The interesting thing about figure 2 is that it seems as though the dominant factor in influencing intent to vaccinate is not perception of the risk of vaccination, but rather perception of the risk of not vaccinating. So perhaps the message here is to concentrate on informing people of the dangers of vaccine-preventable diseases.

dedicated lurker,

Chris, in ThWorld anything that eventually winds up in the blood stream is intravenous.

You know for sure you don’t have any proof that I claimed such. You’re speculating as usual.

PS Ignore Thing. Thing is a troll who believed children are never exposed to illness if they have good parents. Thing also believes other hilarious things and can be good for laughing and pointing when you are in a bad mood.

Triskele, I hope you’re right. What concerns me is the possibility, suggested by the abbreviation “Th1Th2” that we may be dealing with both Thing One and Thing Two. If I recall correctly, those two fairly destroyed Sally’s house while trying to fly kites indoors after the Cat[1] in the Hat, in a disastrously ill-advised move, let them in. Now, granted, here we appear to be dealing with a string of non-sequiturs framed as weirdly distorted but almost recognizable references to terms plucked at random from an immunology text, which is not quite as bad as flying kites in the house. But it cannot end well.

[1]Bipedal, which is the international sign of a mischievous cat. Cats with more than two legs are fine by me.

CG,

This shows exactly how little you actually know about immunology. It’s a well known phenomenon, particularly with regards to HIV. Non-neutralizing antibodies have been shown to have some role especially in non-lytic viruses like HIV.

Oh really? We should stop vaccinating then since its worthless a.k.a. not 100% effective.

worth·less/ˈwərTHlis/Adjective
1. Having no real value or use.

@triskelethecat I had the same problem with the hepatitis B vaccine – despite numerous doses my antibody titers never reached the recommended level. I just take a great deal of care when working with blood, which is wise given the prevalence of HIV anyway, though it’s nowhere near as infectious as hep B.

Gray,

Chris understood it perfectly. What you failed to notice was that the vaccines were given to mice.

As you wished, your resident nurse lilady can give them to you per IV. You don’t have to doubt her. There’s no way she can possibly miss a vein.

Find me a textbook which states veins and capillaries are identical, then I might believe you. Not going to happen, however.

No one said they are identical.

You have to remember that are various times Thingy as claimed:

The MMR vaccine causes a chronic infection.
Subunit and killed vaccines cause infections.
Modern human vaccines are given IV.
Ect.

It doesn’t understand basic biology and will twist words so it never has to admit it is wrong.

Th1Th2,

Step 1.

Pick up janeway’s immunobiology.

Step 2.

Start reading

Step 3.

Stop trolling.

“CG,

The immune system is random. Sometimes B cells make an antibody that recognizes, but does not neutralize the virus. If these dominate the immune response, then there won’t be any humoral immunity from the immune insult. Upon reexposure, the same B cells are activated again and you get the same nonproductive immune response.

It’s so obvious you just created that stuff. I am pretty sure you are not confident with your answer as well.”

Granted, the immune system is not necessarily “random” per se, but your reply to your quoted text is just stupid. Clearly you have no understanding of immunology because you would have refuted your quoted text with actual facts on how these mechanisms are known to work. Perhaps B cells were selected and clonally expanded, but had low affinity for antigen. Perhaps there was a problem with the constant region of produced antibodies that didn’t allow for opsonization. Perhaps there was a premature isotype switch that inhibited the action of said antibodies. Learn about clonal selection and expansion, and immunological memory. Then get back to us.

@triskelethecat

I have developed normal titers for all other illnesses (vaccine-preventable) that I either had or had the vaccine for. Don’t know why I don’t get immunity to measles. Don’t know why having the measles didn’t give me immunity.

I read that the measles vaccine is particularly likely to fail. It doesn’t necessarily work for babies; the killed vaccine used in the 60’s wasn’t very effective; the live vaccine used later is fragile and may become ineffective if it isn’t stored exactly right. The WHO factsheet on measles says that 15% of children don’t develop immunity after the first vaccination, so they recommend two vaccinations (and perhaps they have to be at a certain interval). See http://www.who.int/mediacentre/factsheets/fs286/en/
So your experience doesn’t necessarily imply that your immune system reacts unusually to measles. That you would say this about measles in particular, when there are all these problems with the measles vaccine, makes me wonder if you just haven’t been vaccinated effectively.
The WHO also says flatly that people who recover from measles are immune for life. So this is at least quite rare. Maybe you were misdiagnosed, maybe you actually had German measles or something else. From what the WHO says, it’s quite a heavy-duty disease to go through.

@jre “Cats with more than two legs are fine by me.”

A-hem. And what have *I* ever done to you, pray tell?

I’m willing to bet triskelethecat is also bipedal, too.

Oh really? We should stop vaccinating then since its worthless a.k.a. not 100% effective.

Except the odds of that happening are quite rare, and the second dose does help.

The Fab of an antibody is essentially random due to rearrangements and random mutations. This allows our immune system to recognize an infinite number of antigens.

If a B cell happens to make an antibody that recognizes a viral protein, that B cell will divide. If the the antibody doesn’t neutralize the virus (ex. block viral entry), that clonal expansion of B cells and long lived plasma cells won’t really help prevent infection.

Upon reinfection those memory cells will again expand and create even more non-neutralizing antibodies. The second exposure will also stimulate more primary B cells, so more exposures decrease the odds of a person not mounting a neutralizing response.

Everyone please, remember Rule 14 of the Internet and don’t feed the troll.

Regarding triskelethecat’s unique situation; when she was young her mother said she had measles…mostly like so…as measles was considered a childhood disease that most kids contracted before the age of 15 and before the single antigen vaccine became available. People born before 1957 are “considered immune” to measles. If you work in the health care field, testing for the presence of IGG antibodies against measles is always done…in the rare instance of an older person who somehow avoided the disease.

She also had a single antigen measles vaccine in the 1960s…which may not have been an effective vaccine, but had two combined antigen MMR vaccines in the 1970s and in the 1990s upon entry into grad school. Post immunization testing reveals a level of IGG that is not in the immune range. This is a rare response to the MMR immunizations. Studies have shown that immunizing with a third MMR may evoke an “anamnestic response” (exposure to an antigen boosts the IGG antibody)…but in most instances it is a temporary rise in the IGG antibody. Would such people be able to mount an immune response, if only temporary, when exposed to the actual measles virus…not the live attenuated virus contained in the vaccine? There are no studies that I know of and no research being planned to deliberately expose such people, because it is unethical…same as the Vaccinated-vs-Unvaccinated studies proposed the anti-vax crowd.

FMJ,

Learn about clonal selection and expansion, and immunological memory. Then get back to us.

Talk about random. Do you actually think adaptive immunity is found in Chapter 1? Check it again.

Laura, the measles portion of the MMR is not the same as the 1963 measles vaccine. Yes, it takes more than one to achieve greater than 98% efficacy. That only means that triskelethecat falls in that remaining 2%, and the even smaller than 1% who can never become immune to measles. It has to do with a subtle bit of genetic variation, nothing to do with the vaccine technology.

And, more importantly, it shows why herd immunity is so important.

Th1Th2,

Actually, it’s part 4 of the book. You most likely don’t possess any texts on immunology, so it really doesn’t matter.

And, what was the point of your latest post?

I’m willing to bet triskelethecat is also bipedal, too.

I suspect this is Severian’s kitty buddy we’re talking about, so I’ll take that bet.

And I note that you have not specifically denied being mischievous.

@1 … A low titer does not always mean you are susceptible. It may mean you are one of the rare people who made an odd-ball antibody that the titer test doesn’t detect.

FMJ:

And, what was the point of your latest post?

To see who will continue to feed her trolling.

FMJ,

Actually, it’s part 4 of the book. You most likely don’t possess any texts on immunology, so it really doesn’t matter. And, what was the point of your latest post?

Of course, it matters. So tell me why are you discussing immunological memory in Chapter 4? Does the human immune system begin in Chapter 4?

What are you trying to say, Th1Th2? Do you have any idea how complicated the human immune system is? I only know the basics, and I know that it involves assembling RNA strands and protein chains like LEGO bricks, which is not simple.

Also, at least FMJ’s given a source. So far, all you’ve told us is that “it’s obvious”. Th1Th2, where are you getting your information?

CG,

Modern human vaccines are given IV.

Be honest at least to yourself. You know I didn’t say that. But lilady can give any parenteral vaccines through IV.

Now, Th1Th2 said in post number 27: “Just give the ol’ nurse lilady a pertussis vaccine and she’ll give it you intravenously.” In post number 58, she denies ever claiming modern human vaccines are given intravenously. Tell me Th1Th2, did you think we wouldn’t notice?

Please ignore stupid troll. Nothing to see here (nothing remotely rational – she should be taking her meds in an attempt to win some sort of revised visitation schedule with her kids).

CG,

Except the odds of that happening are quite rare, and the second dose does help.

That’s coming from the mouth of a real infection-promoter because reinfection equals second exposure and the second dose does help. Yeah right.

“But, jimbobboy, Severian never had a cat named Triskele.” Yeah, yeah — it’s in the apocrypha. I swear, wolfies are worse than trekkies.

But that’s not important now. What I’m interested in is how best to reach the general population with a persuasive defense of science-based medicine. We’ve already seen that the crude straight-to-the-amygdala approach, coupled with some savvy Google-smithing, has been remarkably effective in reducing vaccination rates. How can we respond to that with a candid account of the evidence that’s likely to get through to people? I don’t mean J.B. and the Things; I mean the intelligent, as-yet-uncommitted general public.

Of note, there is a workshop on “Promoting and Defending Science-Based Medicine” at this year’s TAM. I’ll be there. Orac and the gang at SBM need to be there handing out the halberds and morning stars of the truth, because this is a cause worth fighting for.

@Th1Th2

show just how they have embraced a non-thinking process and continued the path towards ignorance and utter humiliation.

Take it as gospel, friends, because if there’s anyone posting here who personifies ignorance and utter humiliation, it’s Thingy.

dedicated lurker,

Well, I posted this and your response was this so…

Did I say it was intravenous injection?

Cats with more than two legs are fine by me.

Please reconsider.

The mischief capacity of Thing One and Thing Two pales by comparison with six-legged Sphinxian treecats.

“But, jimbobboy, Severian never had a cat named Triskele.”

Someone has confused the BOTNS with the helpful cat in Wizard.

Gray,

Now, Th1Th2 said in post number 27: “Just give the ol’ nurse lilady a pertussis vaccine and she’ll give it you intravenously.” In post number 58, she denies ever claiming modern human vaccines are given intravenously. Tell me Th1Th2, did you think we wouldn’t notice?

What part of the vaccine insert which states CAUTION: DO NOT ADMINISTER INTRAVENOUSLY, don’t you understand?

You want proof that parenteral vaccines CAN be given IV? Let nurse lilady show it to you.

I suspect that the internet with all its conspiracies…big pharma and big government manipulation…is custom made for selling snake oil and disinformation. Still others visit popular web sites to get “the latest”, “most scientific” information about health care, alternative treatments and supplements offered up by con artists.

A few days ago, a physician posted on RI about the parents of her young patients “hovering” over the kids and being so subject to scary stories that they hear. The New York Times Magazine featured an article about “helicopter parenting”…which unfortunately is the case with so many young parents. Helicoptering leads to overly doting parents who tend to anticipate every need that the child wants…no wonder there is a burgeoning group of children who are speech delayed. Jeez parents, how about letting the toddler babble…that is how they learn to enunciate real words.

Helicoptering also leads to concerns about their child’s health and this is the psychological advantage that the sharks on the internet use every day.

So we now have absolute charlatans on the internet hawking their wares and some very educated and credentialed physicians who now offer “integrated” health care to appeal to parents who believe that anecdotal information, mommy intuition and what they read on the internet should form the basis of health care for their child.

So sad.

@jre: Caught! Yes, the original Triskele the Cat was named for the dog in the story. I keep his name out of how much I loved him.

@Laura; Actually, I also had German measles (rubella) which I did develop an adequate response to and chicken pox (immune there, too). My mother was (is) the daughter of a GP and used to make rounds with him. She saw plenty of measles. She was very well aware of the presentation. While she admits she didn’t know I had rubella until it was nearly gone, she can tell quite lovely stories about trying to keep me in bed when I had measles. I was quite sick and the household rules were if you had a fever you had to stay in bed. With my brother in the house, she was not able to watch me as much as she wanted, and would often find me in the bathtub (the cool enamel was nice to lie on). I do quite clearly remember the cold water enemas used to lower my fever.

So the WHO is wrong when(if) they claim that recovering from measles will provide the person with lifelong immunity. It may provide MOST people with lifelong immunity. I am not one of them.

It’s sometimes hard to combat information that is received *first*- (PI) but still, I would hope that we can reach reasonable parents by *explaining* the tactics and MO of anti-vaccinationists, producing historical numbers about illness, and showing the horrible “science” used by anti-vaxxers as justification before using fear-induction as a last resort. (BTW, I had measles: just prior to getting my shot, I contracted it – the entire episode remains a blur, although I remember a darkened room, endless coughing, a doctor visiting, and relatives being very nice to me. My much older cousin tells me I was sick “for weeks”- the adults “worried” about my vision especially.)

On a lighter note, anti-vax’s Big Kahuna, RFK jr, is hosting a *grande fete au plein air* to which *your truly* is invited. I am *so* tempted to congratulate Robert on helping to clean up the river and enabling the anti-vax trend as well.

Congratulations on your child, anastacia. I am headed to Lancaster County this weekend with my six month old for a family reunion, and I’m frightened, too.

You should have seen the look on my doc’s face when I asked him how soon she could get her MMR. He doesn’t hear that often in my over-educated liberal coastal city. When my baby was born I idiotically took her to a few “sling wearing” classes so I could learn to properly carry her when walking the dog. As soon as I learned they were a bunch of homeopathic anti-vax woonuts, I ran.

Some even attended a school recently shut down due to the Pertussis outbreak!

On a darker note: Seth Kalichman (2010; J. Aids & Behav.)shows the internet as an HIV/AIDs denialist tool spreading mis-information about transmission ( and other data) that is reflected in attitudes of young gay men. He shows that the “newbie”( to the internet) phenomenon is an important factor in the subjects’ acceptance of the mis-information.

@triskelethecat

My mother was (is) the daughter of a GP and used to make rounds with him. She saw plenty of measles. She was very well aware of the presentation.

Doctors make misdiagnoses too, quite often. Measles gets misdiagnosed as other illnesses, and other illnesses must get misdiagnosed as measles.
I am just saying that you have a “story”, a way that you’ve interpreted your experiences, and it may not be true, given all the known problems with measles vaccines, and that people apparently rarely can get measles again if they’ve had it before.
Your interpretation has you being vulnerable to this bad disease as an adult and not much you can do about it. So if it’s wrong, that would be a good thing to know; maybe something other than getting MMR repeats separated by many years, would give you immunity. Maybe, as someone else pointed out, you already have immunity, just that your antibodies aren’t picked up by the standard test. After all, you haven’t actually gotten measles more than once, so you aren’t known to be in that rare group of people.
I’ve had to change my “story”, the way I see things, in much more major ways than this. So I’m just saying, you can be mistaken in your interpretation of things.
If you are interpreting things wrong, I guess it’s not that big of a deal. You would only be unnecessarily creating fears for yourself. Lots and lots of people do that, it’s an epidemic and no little needle jab can stop it.

Orac, I’m still confused: What does your headline about an “anti-vaccine tool” have to do with J. B. Handley?

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