After all this time, Dr. Bob Sears finally tips his hand on vaccines, part IV

As hard as it is to believe, there was once a time when I (sort of) gave “Dr. Bob” Sears the benefit of the doubt. You remember Dr. Bob, don’t you? Son of the famous pediatrician Dr. William Sears, who was best known for his “Sears Parenting Library” and is a not infrequent guest on TV, where he goes by the name of “Dr. Bill.” Like his father, Bob Sears, likes to do the “Dr. First Name” thing and calls himself “Dr. Bob.” (What is it with pediatricians and this annoying affectation?)

Along with his wife Martha Sears, RN, Dr. Bill is known as a major proponent of “attachment parenting.” Unfortunately, the woo that Dr. Bob has chosen appears to be antivaccinationism. Oh, sure, he’ll deny it to high heaven, but a close examination of the book that made him famous, Dr. Bob’s The Vaccine Book: Making the Right Decision for Your Child, reveals otherwise. Basically, Dr. Bob’s Vaccine Book advocates an “alternative vaccine schedule,” that strikes me more than anything else as being based on a favorite trope of the antivaccine movement, the claim that children receive “too many too soon.” (Indeed, Dr. Bob has even publicly admitted that it’s not evidence-based, meaning that he pulled it out of his nether regions, if you know what I mean.) Its rationale was deconstructed very well by—who else?—Paul Offit a while ago. John Snyder also did a detailed takedown.

Indeed, there was a time when I asked the question, “Dr. Bob Sears: stealth antivaccinationist?” No more. Now it’s not a question any more. I say that Dr. Bob definitely is an antivaccinationist. He’s tipped his hand on vaccines so many times now that I just don’t buy his weaselly denials anymore. I mean, seriouslyl, there appears to be no antivaccine trope that he won’t repeat. Dr. Bob has become antivaccine to the core, to the point where he’s even an admin on an antivaccine Facebook group.

So perhaps I shouldn’t be surprised by Dr. Bob’s little rant on his Facebook page yesterday. It revealed a level of antivaccine stupid that was irresponsible and ignorant even by Dr. Bob’s standards. It was blatantly self-serving, too, even more so than Dr. Bob’s blather usually is. Indeed, it nauseated me to read Dr. Bob prove that he is utterly unworthy to be a doctor. I’m going to reprint the whole thing, in case Dr. Bob sends it down the memory hole:

Measles Epidemic . . . NOT!

Why is it that every time there are a few cases of measles, everyone panics? I just don’t get it. So, here’s the situation in the O.C., where I live and practice. Seven cases. Seven. That’s 7. Not 700, not a million. Seven. So, why do people panic? Here’s one reason: the ^$#@*&%&*$# media. News reports go out stating that there are outbreaks of measles, and everyone needs to be concerned. Everyone is quick to blame those who don’t vaccinate, AND those who don’t vaccinate start to panic. We’ve gotten dozens of calls to our office with people wanting to know if they should come in for the vaccine.

Here’s my take on it:

EVERY single year in the U.S. we have measles – between 50 and 150 cases. Last year there were two large outbreaks – 58 cases in New York and over 20 in Texas. Both those outbreaks died out. No one has died from measles in the U.S. in over 10 years. So, there is ALWAYS the potential for measles. ALWAYS. If you choose not to do the vaccine, then you just have to accept that fact, and not panic whenever you hear the “M” word. You’ve lived with this risk for years, so why panic just because there are 7 cases in the county you live in? This year there will be more than usual, the way it’s looking so far, but it’s not a reason to panic. Make your choice – do vaccine, or don’t do the vaccine.

So, when SHOULD someone worry? If an actual direct exposure has occurred from a known case, then you might be at risk. This doesn’t mean a case in the county in which you live: it means that you’ve actually been in the same room with someone who has had measles. Or, at the most, maybe the same building. But transmission almost always requires close proximity (same room). There have been a handful of cases over the decades in which someone sitting across a stadium has caught it, but that is almost unheard of. You have to be in the same room, people. If THAT happens, call me. If not, then just relax and go about your life as usual.

IF we see more cases, I’ll let you know. Actually, just to give you a heads up, we probably WILL see a few more cases. But virtually all measles outbreaks are limited to 10 to 20 cases in any given county. So, the chance that any one of your unvaccinated children is going to be a case is very very very very very small. I love you all, and love caring for you all. But just chill out. Measles will never go away – it’s always going to be a very small risk. If you aren’t comfortable with that, get the vaccine. If you don’t want the vaccine, accept the risk.

Remember, California is in the midst of a measles outbreak as Dr. Bob rants at his patients.Not surprisingly, the antivaccine political group The Canary Party loves Dr. Bob’s rant so much that it posted a copy on its Facebook page.

So Dr. Bob’s gotten dozens of calls at his office from parents asking whether they should get the MMR vaccine for their children? Good! The parents of Dr. Bob’s patients should be concerned! If Dr. Bob had even the slightest bit of responsibility as a physician, his answer would be, “Yes, yes, yes, a thousand times yes!” But, then, having observed him for a few years now, I’ve come to the conclusion that Dr. Bob takes no responsibility, has no honor, and no longer behaves like a responsible pediatrician—strike that, no longer behaves like a pediatrician or even a physician. He demonstrates that quite emphatically with is little rant above. My guess from the rant above is that his answer is not the correct one, but rather the weaselly one. In fact, the entire rant is a complete abdication of professional responsibility. Instead of urging his patients to get the MMR vaccine, he’s basically telling them they’re on their own. He’s washing his hands, telling them, in essence, “Well, if you’re worried, then just get the vaccine. Or don’t. I don’t care.” Yes, that sure is how he comes across.

The rest of his post is a pathetic list of self-serving excuses.

What do I mean by that? If you’ve read Seth Mnookin’s book The Panic Virus, you know that in his book Mnookin reported that “patient zero” in a major measles outbreak in San Diego in 2008 was a patient of Dr. Sears. Since then, Dr. Bob’s account of that incident has been—shall we say?—fluid. This is odd, given that his involvement with patient zero was not a secret. It was reported by This American Life and the Orange County Register. Basically, a then seven-year-old patient of Dr. Bob’s (unvaccinated, it would appear) went to Switzerland, where there is a big problem with antivaccinationists, and came back with the measles. Eventually, eleven other children were infected, and in the outbreak dozens more were quarantined (some for up to three weeks). It was the largest outbreak in California in almost two decades.

What amazes me about Dr. Sears is just how whiny he is. He has no one to blame for his situation but himself. He’s the one who’s become the darling of the antivaccine movement. He’s the one who thinks children get “too many too soon.” He’s the one who has at every turn downplayed the severity of the infectious diseases against which we vaccinate. He has spread messages that include, among others:

  • Vaccination Has Eliminated Infectious Diseases at the Price of Causing Chronic Diseases
  • Vaccine Safety Testing Is Insufficient
  • Natural Infection Is Better Than Vaccination
  • Vaccine-Preventable Diseases Are Not That Bad
  • Vaccine Mandates Should Be Eliminated

Indeed, most recently, Dr. Sears was a vocal opponent (along with antivaccine comedian Rob Schneider) of California Bill AB 2109, which was an effort on the part of the state of California to make it more difficult for parents to obtain non-medical exemptions from vaccine mandates by requiring parents to have a physician (or certain other health care providers) counsel the parents and sign the waiver. That was it. The idea was that such parents should hear from physicians the actual medical science regarding vaccines before they are allowed an exemption from the requirement that their child be vaccinated before he can attend school.

Perhaps what’s the most irresponsible and, yes, despicable aspect of Dr. Bob’s rant is his complete dismissal of the seriousness of measles. The CDC lists the seriousness of the measles and its complications: 1 out 20 patients with measles get pneumonia; 1 in 1,000 will develop measles encephalitis; 4 to 11 out of 100,000 will get SSPE (subacute sclerosing panencephalitis), a fatal neurodegenerative disease; 1 or 2 out of 1,000 will die. Before the measles vaccine was developed:

In the decade before the measles vaccination program began, an estimated 3–4 million people in the United States were infected each year, of whom 400–500 died, 48,000 were hospitalized, and another 1,000 developed chronic disability from measles encephalitis. Widespread use of measles vaccine has led to a greater than 99% reduction in measles cases in the United States compared with the pre-vaccine era, and in 2012, only 55 cases of measles were reported in the United States.

However, measles is still common in other countries. The virus is highly contagious and can spread rapidly in areas where vaccination is not widespread. It is estimated that in 2008 there were 164,000 measles deaths worldwide—that equals about 450 deaths every day or about 18 deaths every hour.

However, what’s worrisome is that in 2013 there were 189 cases of measles, the second largest number since measles was thought to be eliminated in 2000, including the largest outbreak since 1996 (58 cases), which occurred in an orthodox Jewish community in Brooklyn. Dr. Bob might poo-poo the relatively few cases, but we know from experience in the UK that it doesn’t take much degradation of herd immunity for measles to come roaring back. In the U.K., for instance, thanks to Dr. Bob’s new buddy Andrew Wakefield and his stoking of fear of the MMR vaccine as a cause of autism, MMR uptake plummeted, and measles came roaring back, a process that still hasn’t been reversed, even after vaccine uptake has started to recover. In 2013 there were 1,843 confirmed cases of measles, compared to 56 cases in 1998, the year Andrew Wakefield first published his case series in which he implied that measles was correlated with autistic enterocolitis. We know that the numbers fluctuated a few years before continuing their upward march. In Europe the situation is even worse, with over 10,000 cases of measles in 2013, the vast majority in children who are either undervaccinated or unvaccinated. What health officials worry about is that a spike in measles cases or an outbreak like the one in Brooklyn might presage a massive surge in measles due to degradation of herd immunity.

Funny I should mention herd immunity. Dr. Sears has basically urged parents who don’t want to vaccinated to “hide in the herd,” telling parents who don’t vaccinate not to tell their neighbors about their fears of vaccines, lest those parents become afraid too and fail to vaccinate, leading to further degradation in herd immunity and increased risk of measles in the unvaccinated. Basically, Dr. Bob cynically urges vaccine-averse parents to mooch off the herd immunity maintained by those who do the responsible thing.

But what can Dr. Bob do when the herd becomes too thin to hide in anymore? Maybe one day his patients will hold him accountable. Unfortunately, given that they’ve listened to his scientific ignorance this long, I fear that they’ll continue to do so.