Dr. Bob Sears vs. Seth Mnookin: Measles outbreaks, AB 2109, and lacking the courage of one’s convictions

It would appear that Dr. Bob Sears, author of The Vaccine Book, is in the news again. Specifically, he’s brought himself back into the spotlight by publishing in that wretched hive of scum and quackery, The Huffington Post, a fallacy-filled attack on a bill in California, AB 2109, designed to tighten up the process for obtaining philosophical exemptions from vaccination requirements for school entry and improving the process of informed consent for parents seeking such exemptions. In this, Dr. Sears has solidly aligned himself with the worst elements of the antivaccine movement. Sadly, it is not the first time he has done so. This time around, however, an interesting little sidelight has come up that has revealed just how disingenuous and deceptive Dr. Sears can be, as you will see. But here’s a little background, for those of you not familiar with Dr. Sears.

Pretty much anyone who has an interest in issues related to vaccines, particularly regarding the antivaccine movement, has probably heard of Dr. Bob Sears. The reason, of course, is that Dr. Sears (or “Dr. Bob,” as he likes to be called), is the author of a book touting an “alternative” vaccine schedule. His book, The Vaccine Book, is the bane of pediatricians everywhere practicing science-based medicine, because many vaccine-averse parents use it as a justification for “questioning” or otherwise refusing to follow currently recommended vaccine schedule. Dr. Bob likes to present himself as somehow being more reasonable, and less “extreme” than the “two sides” in the “vaccine debate.” For example, here is an excerpt from his book:

But now almost all parents have worries about vaccines. In the old days most parents simply followed their doctor’s advice and automatically got their children vaccinated. But today, virtually every parent has heard that there may be some side effects and problems with vaccines, and parents are asking questions. The problem is, no one is giving complete answers. Or rather, they are giving one-sided answers. Either your doctor is telling you that all vaccines are perfectly safe and you have nothing to worry about, or your neighbor is telling you all vaccines are evil and deadly and you are crazy to vaccinate. So you find yourself with many unanswered, or inadequately answered, questions. You don’t want your child to catch any serious illnesses, so you want to vaccinate. But you want to know what the potential risks and side effects are. You want to make an educated decision. That’s what this book is all about. It is my goal to give you a balanced look at the pros and cons of vaccination.

Notice how Dr. Bob places himself between what he incorrectly represents as “two extremes.” He’s not like those dogmatic antivaccinationists at all! Oh, no! He’s not like that crazy neighbor telling you that all vaccines are “evil and deadly.” But neither is he like that apparently dogmatic pediatrician who refuses to recognize any risks whatsoever from vaccines. Oh no! He’s far more reasonable. His is a “middle way,” threading the needle between loony antivaccinationism and rigid, authoritarian medicine touting “one size fits all” solutions for your–yes, your!–children and refusing to recognize that your child is a special little flower that requires “individualized” vaccination.

The problem, of course, is that pediatricians such as what he describes exist primarily in the fevered paranoid imaginings of the antivaccine movement. Worse, Dr. Bob uses the logical fallacy known as argumentum ad temperantiam, also known as middle ground, false compromise, gray fallacy and the golden mean fallacy. This fallacy implies that the positions being represented are extremes of a continuum of options, that such extremes are wrong, and that the “middle ground” must be correct. It’s a very seductive fallacy, because whenever people see arguments in which two seemingly extreme positions are presented, their first tendency is to look for compromise by “splitting the difference” and assuming that the correct answer is somewhere in the middle. Yet such is not always the case, particularly in matters of science. For instance, the correct scientific position is not somewhere between that of anthropogenic global warming denialists and everyone else or somewhere between what creationists claim and what evolutionists know from science. Likewise, the correct answer regarding vaccination is not somewhere in the middle, between the claims of antivaccinationists and what real scientists say about vaccination. Yet, that’s the game Dr. Bob plays, giving credence to discredited claims about vaccines promoted by the antivaccine movement. It’s not for nothing that Dr. Paul Offit and others consider Dr. Bob to be, if not antivaccine, at least flirting with the antivaccine movement.

All of this is why what Seth Mnookin writes about Dr. Bob is quite telling when he asks the question about Sears, Bob Sears: Bald-faced liar, devious dissembler, or both? In it, Mnookin reveals Dr. Bob’s version of the truth to be rather fluid regarding his involvement with “patient zero” for the measles outbreak that occurred in San Diego in 2008. The reason this came up is after Dr. Bob’s attack on AB 2109 because a commenter, in order to illustrate the consequences of not vaccinating and argue that Dr. Sears, either wittingly or unwittingly, promotes beliefs that have negative health consequences asked asking Dr. Bob about the patient believed to be responsible for the San Diego outbreak, using Seth Mnookin’s account in his book The Panic Virus as his source. This led Dr. Bob to respond:

I will set the record straight. I was NOT the pediatrician who saw the measles patient and let him sit in my office. As far as I know, that occured in a San Diego pediatrician’s office. I don’t know whose. I was not involved in that at all. I haven’t read Seth Minooken’s book, NOR have I ever even spoken with Seth. So I’ve no idea what he’s said about me in his book. I actually had no idea that any of you were even wondering about this. No one’s brought it to my attention before this. I heard something about some journalist writing a book about vaccines, but hadn’t bothered to read it.

In response, frequent commenter here lilady challenged him:

Really, Dr. Sears?

Is this the same Dr. Bob Sears who appeared on the Dr. Oz Show? How about commenting on this video (at 1:00 minutes into the Part 4 “What Causes Autism” Show), Dr. Sears. Dr. Ari Brown stated succinctly to you that she believed the young patients infected by measles were your patients.

http://www.doctoroz.com/videos/what-causes-autism-pt-4

You never “corrected” Dr. Brown and you quickly changed the subject. Why did you not deny that your patients were involved in the outbreak and…why did you change the topic, Dr. Sears?

We all await your explanation.

That explanation was:

Of course I remember the show, and her comment. BUT, she wasn’t accusing me of being the pediatrician that the measles patient went to see when he had measles and sat in his waiting room. She simply stated that that child was my patient (which is correct, but they didn’t come to see me during the measles illness). She was baiting me, and suggesting that the fact that that family had decided against the MMR vaccine long before they ever became my patients was MY fault. I wasn’t about to give her the satisfaction of acknowleding her comment.

What I was referring to by the statement “I had no idea” was that I never knew anyone, much less a supposedly respected reporter, was spreading the FALSE rumors that I was the pediatrician involved in the outbreak. I have simply been the family’s pediatrican over the years, but I practice far away from them, so they went to a local ped for THIS problem. Anyone who has written or suggested otherwise printing false information.

Talk about not owning up to one’s actions! Dr. Bob “empowers” and supports antivaccine parents in their decision not to vaccinated, and then he whines when it is pointed out that one of his unvaccinated patients was the nidus for a major measles outbreak.

All of this brings us to Seth Mnookin’s post from yesterday. Mnookin pointed out that Dr. Bob’s pandering to the antivaccine movement went so far as to advise “hiding in the herd” (i.e., taking advantage of herd immunity for measles) and, even worse, to say to parents hiding in the herd, “I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.” In other words, Sears on the one hand excuses parents who do not vaccinated and on the other hand advises them to be parasites taking advantage of herd immunity provided by parents who were willing to take on the responsibility and risks of vaccination to protect their children at zero risk to their children and telling them not to encourage others to do the same because it would degrade herd immunity and eliminate the advantage of being a parasite!

In light of Dr. Bob’s advice, pointing out that Dr. Bob’s patient was probably the vector responsible for starting a measles outbreak in San Diego was a legitimate point. It serves to emphasize that Dr. Bob’s arguments have consequences. That’s why it’s a joy to see Mnookin take Dr. Sears down a peg or two by pointing out that Dr. Bob is either dissembling or lying:

Sears’s involvement with patient zero was not some sort of secret: It was also reported in a December 19, 2008 episode of This American Life, in the middle of an interview with Sears himself. (You can hear that part of the broadcast–“That’s Dr. Bob Sears. … Dr. Bob, as people call him, is also the doctor for the non-vaccinating family that went to Switzerland”–here. For people interested in the whole show, Sears comes in just before the the 34-minute mark.) It was also reported in Sears’s hometown newspaper, The Orange County Register. I wasn’t the first person to write about it, and I wasn’t the last-but for some reason, Sears has decided now is the time to speak out about this-and he’s doing so in the comments of his latest Huffington Post vaccine scare-mongering lunacy.

Mnookin also points out that Sears is attacking a straw man by railing against him for having allegedly allowed the child with measles to sit in his waiting room with other children. Neither Mnookin, any of the commenters in HuffPo, nor anyone else accused Dr. Sears of that. They merely pointed out that it’s been widely reported, and apparently acknowledged by Dr. Sears himself, that patient zero for the San Diego measles outbreak was a non-vaccinating patient of Dr. Sears. That’s it. It was Dr. Bob who either jumped to the conclusion or disingenuously attacked a straw man that he was being accused of having let a child with measles spread the disease to his other patients. He wasn’t.

One wonders if Dr. Bob has a bit of a guilty conscience. In fact, the final bit of his most recent comment sure does sound that way. One of Dr. Bob’s arguments agains AB 2109 was that doctors would refuse to sign the form. He uses the mention of his non-vaccinating patient who sparked a measles outbreak as a cue to rant (and I do mean rant):

PLUS, I WOULD LIKE TO THANK YOU, AND SOME OF THE OTHER NEGATIVE COMMENTORS TO MY BLOG, FOR HELPING TO PROVE MY POINT. It seems that when a doctor’s patient chooses not to vaccinate, then catches one of the diseases, IT BECOMES THE DOCTOR’S FAULT? SO, WHY WOULD DOCTORS TAKE FURTHER RESPONSIBILITY AND LIABILITY FOR THEIR PATIENTS’ DECISION AND SIGN THEIR NAME TO THE EXEMPTION FORM? That’s my point; I appreciate you furthering my cause against AB2109.

It’s rather amusing how, when challenged, Dr. Sears reverts to writing like one of my more wingnutty commenters, complete with lots of ALL CAPS. Here’s a hint to Dr. Sears: Although the (very) occasional word or phrase in ALL CAPS can be used effectively to add emphasis, it’s a tool that needs to be used very sparingly. To do otherwise is to look like a ranting loon, which is what Dr. Bob looks like above. There’s a reason why one of the Flame Warriors is referred to as ALL CAPS and it is pointed out that ALL CAPS is the Internet equivalent of shouting, in which “from a tactical point of view, too much shouting alerts other Warriors to the opponent’s verbal WEAKNESS and emotional EXCITABILITY.”

Be that as it may, it would appear that Dr. Sears is a coward as well in that he doesn’t have the strength of his own convictions. Think about it. He advises parents who refuse the MMR not to tell others about it so as not to degrade herd immunity. If he really believed that the MMR is not safe enough, then why on earth would he not trumpet it to the world and advise the parents of his patients to do the same? He “supports” parents who don’t vaccinate; yet he says he won’t sign simple forms for them confirming that he has counseled them about the risks and benefits of vaccines. That’s all that AB 2109 asks him to do; yet he blames fear of liability for his decision. I have one question: Has any physician in this country ever been successfully sued for malpractice after one of his patient suffered from a vaccine-preventable disease on the basis that he supported the decision of the parents not to vaccinate or advised them not to? I’m certainly not aware of one. Truly, it bears repeating: Dr. Sears doesn’t have the strength of his convictions.

Unfortunately, Dr. Bob joins the list of pediatricians who have found fame, validation, and a bit of lucre pandering to the antivaccine movement. Like many of them, he does not see himself as being antivaccine, and maybe he isn’t, at least not the way luminaries of the antivaccine movement such as Barbara Loe Fisher, J.B. Handley, Sallie Bernard, Andrew Wakefield, and the like are antivaccine. He does, however, give credence to their views and, by using false balance to present fears about vaccines based on pseudoscience, making him very much a part of the problem.