“Tell both sides” strikes again in vaccine reporting

Over the years that I’ve been following the anti-vaccine movement, I’ve become familiar with typical narratives that reporters use when reporting on the vaccine fears stirred up by anti-vaccine activists. One narrative is the “brave maverick doctor” narrative, in which an iconoclastic quack (such as Mark Geier or Andrew Wakefield, for example) is portrayed fighting a lonely battle against the scientific orthodoxy. This particular narrative is extremely popular because it feeds into the story of the “underdog,” coupled with a healthy disrespect of the powers that be, particularly the government and big pharma, both of which are very popular themes. Such stories can range from being completely credulous, chock full of testimonials praising the brave maverick doctor as being the only one who knows how to cure cure or treat autism and/or actually cares about patients with the condition, to a bit more skeptical, as in, “look at this quirky character with his quirky ideas.” Frequently underlying such narratives is a subtle (or not-so-subtle) implication that can be summed up as a question, “What if this guy is right?”

Another type of story about the anti-vaccine movement begins with an activist stating his or her objections to vaccination, followed by whatever narrative the reporter wants to impose on the story. Sometimes it’s supportive of the activist; sometimes not so much. Sometimes it’s even what could be called a debunking of the activist’s pseudoscientific claims. The problem with even this latter narrative structure, however, is that it puts the claims of the anti-vaccine activist front and center in such a way that they tend to be more memorable than the refutation of the nonsense being spewed. Such were my thoughts when I came across this article in the L.A. Times over the weekend entitled Medical community confronts vaccine fears, which begins:

No matter how many times the medical community reassures parents that vaccines are safe and necessary to prevent life-threatening diseases, some people remain unconvinced.

“I believe that herd immunity is a complete myth,” says J.B. Handley, co-founder of an autism advocacy organization called Generation Rescue that is critical of the way vaccinations are carried out in the U.S. “It’s a tactic used to scare the public.”

OK, I’ll give the reporter, Amanda Mascarelli, credit for this opening. Basically, she sets the stage by letting Mr. Handley’s words speak for themselves and reveal him to be a complete crank when it comes to vaccines. Think of it this way: Here he is, denying that a well-established scientific principle behind vaccines, namely herd immunity, is a myth. Let’s put it this way. On the one side, we have immunologists, infectious disease specialists, bacteriologists, virologists, pediatricians, epidemiologists, and a variety of scientists who have studied vaccines and infectious disease telling us that herd immunity occurs and depends on a high level of vaccination. On the other side, we have Mr. Handley, who may have expertise in finance but has no discernable expertise in the relevant sciences undergirding vaccines–or the science of autism, for that matter–claiming that herd immunity is a myth. Who’s more likely to be right? Hmmmm. Let me think about that…

I’ve thought long enough. Handley’s a crank.

As an aside, I will note that these days herd immunity tends to be more often called something like the “herd effect” or “herd protection,” because, after all, the concept behind herd protection is that the unimmunized are indirectly protected by a high level of vaccination in the population because high levels of vaccination make the spread of disease more difficult between even the unimmunized. In other words, the unimmunized are not “immune” to the disease, but they are protected, because the natural reservoir for the infectious agent being vaccinated against is much smaller. Whatever nomenclature one decides to use, though, herd protection contributed to the eradication of smallpox and is critical to the success of several other vaccines in greatly decreasing the prevalence of the diseases against which they protect, as reviewed here. Points to remember are that the herd effect is real and that it can be measured. Handley has no clue what he’s talking about–as usual.

Next, Handley employs the shopworn gambit I like to call, “we’re not ‘anti-vaccine’; we’re just ‘concerned’ about the vaccine schedule”:

Handley, a father of three in Portland, Ore., has an 8-year-old son with autism. He believes that the cocktail of immunizations his son received when he was 13 months old is to blame

“Do I think a vaccine appointment was a trigger for his decline into autism? Yeah, with every fiber of my being I do,” he says. “And I’ve met several thousand parents who feel exactly the same way.”

Handley insists that his organization, led by actress-turned-activist Jenny McCarthy, isn’t opposed to vaccines altogether but believes they shouldn’t be given until children turn 2 years old and their immune systems are mature enough to handle them.

This is nonsense on so at least four levels. First, it’s nonsense from a scientific standpoint; there’s no compelling evidence that “too many too soon” is a valid complaint against the current vaccine schedule, and the current vaccine schedule contains far fewer antigens than it did 25 years ago, thanks to the use of antigens produced by recombinant DNA technology replacing older, whole cell lysate-based vaccines. Second, there is no compelling evidence that vaccines cause autism, and a lot of evidence that they don’t. There’s not even good evidence that vaccination is correlated with autism. Mr. Handley continues to base his anti-vaccine activism on a common cognitive error to which human beings are incredibly prone, confusing correlation with causation. Third, delaying vaccines until two years of age would leave babies unprotected from diseases that don’t have the politeness to wait until a baby is two to strike, such as pertussis. Indeed, in the case of pertussis, delaying vaccination until after age two is probably almost as bad as not vaccinating at all, given that the infants between the ages of 1 and 2 are most susceptible. Even with our current schedule, babies too young to be vaccinated can die of pertussis. In other words, balancing the risks and benefits of delaying the vaccine schedule, the risks include illness and death from disease in unprotected infants, and the benefits include nothing discernable by science.

Finally, I don’t for a minute believe Handley and other anti-vaccine activists when they oh-so-self-righteously and oh-so-woundedly claim that they “aren’t anti-vaccine.” I believe that they either delude themselves into believing they aren’t anti-vaccine or make the claim as a useful strategic aim, given that admitting to being anti-vaccine would lead public health officials to stop being so obsequious in dealing with them. Which it is in Handley’s case, I don’t know.

Of note, Handley also refers to a study published last year in Acta Neurobiologiae Experimentalis in which infant Macaque monkeys were injected with vaccines mimicking the vaccine schedule in the U.S. from 1994-1999) and reported that the brains of the vaccinated monkeys appeared “less mature” than the control group. Of course, this is the infamous “monkey business” study that I’ve written about at least three times, most recently about a year ago. Click the link for the details, but the CliffsNotes version is that this study was poorly designed, underpowered, poorly analyzed, and highly unethical to the point of being a horrific abuse of primates.

Not that that matters to Handley or his merry band of anti-vaccine activists. To them, it’s all about the vaccines. It’s always been about the vaccines, even when it was about the thimerosal in vaccines.

The rest of the article is a fairly standard reassurance of the public that vaccines are safe, pointing to the the exhaustive science on vaccine safety and, of course, the dangers of delaying vaccines:

But researchers have affirmed the safety of the U.S. vaccine schedule in numerous studies, including a 2002 review article in the journal Pediatrics, a 2010 study in Pediatrics and in many clinical trials in children, says Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“Why would you delay vaccines?” Offit says. “You have diseases like pneumococcus, whooping cough, Hib and chickenpox which can severely, and fatally, infect young children. Why would you ever take the chance?”

The article concludes on a hopeful note, stating that anecdotally pediatricians are reporting less resistance to vaccination than a year ago. I certainly hope that’s true, and if it’s true it’s definitely a good thing.

Still, it bothers me that even this article falls into the classic journalistic trope of “tell both sides,” in which on the one side we have a bunch of doctors and scientists citing research and clinical data, and on the other side we have a complete crank, with the two being presented as though their viewpoints had equal validity and as if there were a real scientific debate rather than a manufactured controversy. I think Dara O’Briain put it best:

Yeah, I’ll use any excuse to post that clip.