Categories
Autism Complementary and alternative medicine Medicine Popular culture Quackery

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.

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]

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

Where does he say not to tell your neighbors? I’d quite like to see the source of that.

Orac linked to Dr. Paul Offit’s Pediatric Journal article. Dr. Offit, quotes directly from Dr. Bob’s Vaccine book, about hiding in the herd:

http://pediatrics.aappublications.org/content/123/1/e164.full.pdf

Hide in the Herd

Perhaps the most disingenuous comment in the book is directed at parents who are afraid of the measles-mumps-rubella (MMR) vaccine. “I also warn [parents] not to share their fears with their neighbors,” writes Sears, “because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.” In other words, hide in the herd, but do not tell the herd you’re hiding; otherwise, outbreaks will ensue. Sears’ advice was prescient. Recent outbreaks of measles in 15 states,
caused by an erosion of herd immunity in communities where parents had chosen not to vaccinate their children, were the largest in the United States since 1996.

Research in Germany on recent cases of SSPE has shown a disturbing rising in the total number of cases of SSPE in relation to overall measles incidence rates (infants who get infected seem to be much more likely to develop the fatal SSPE later on)….this is a very bad thing, if confirmed, given the number of infants who could now be infected due to anti-vaccine stupidity.

Dr. Bob might poo-poo the relatively few cases,

Well, if most of the cases happen around the same place, “relatively” is the operative word.
Hippopotamuses maul a few people every year; planet-scale, it’s a relatively very low number, but if you happen to live next to a river in Africa…
Seven cases of measles aren’t a lot, but if they could be all tracked to the same patient zero…

I got the feeling Dr Sears is conflating “epidemic” and “outbreak”. It may be true there is no epidemic yet, but as for outbreaks, facts are stubborn.
I’m also confused about his patients asking about vaccination: is he speaking of adult patients asking about a booster for themselves, or parents about their unvaccinated children?
If it’s the latter (and I suspect it is), the way he said it, the children are just an appendage to the parents, e.g. “people wanting to know if they should come in for the vaccine”.

Re: the advice “don’t vaccinate and hide in the herd”. Yeah, nothing wrong could happen. To quote a demotivational poster, no single raindrop believes it is to blame for the flood.

So there are issues with vaccination in Switzerland? I didn’t realize it, but I didn’t look into it either.

“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.”

Ah yes. Everyone who is measles infectious has a sign round their neck?

You have to be in the same room, people.

In addition to that little annoying fact of infectious prior to symptoms, really, it’s more along the line of “you have to breathe the same air.” There’s a reason these people get negative air rooms completely separated from the rest of a hospital’s HVAC system.

What strikes me most is his attitude towards his patients’ concerns, which are very real and something I’m sure he assured them would never happen during the totally-science-based-vaccine discussions they had during well-visits. I can hear it now:
“Oh, don’t worry, we won’t see measles. Hide in the herd, herd immunity is strong, other people are taking on the risk of vaccination. It’s not that big of a deal.” Now, here it is, people are getting measles, many of whom are too young to even be vaccinated, and people are rightly scared because they were lulled into Dr. Bob’s false sense of security.

Oh, and P.S. Dr. Bob, we can get rid of measles. We’ve gotten rid of two viruses already, through vaccination. What’s keeping it around are people like you.

But, on a good note, I’m sure many have seen it but if not, search #jennyasks on Twitter for healthy innoculation of faith in mankind. I haven’t seen anyone mention it in any of the comments. Some of it’s getting a little mean, but, it’s been going for a week now and Christmas came 9 months early.

Hiding in the herd seems pretty silly strategy. If you don’t tell others about your fears of vaccines, what do you base your assumption that others are not doing the same? More like “hope that herd exists and hope for the best”.

AnObservingParty, I saw the Twitter comments. The pwnage of Jenny was both epic and total.

“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.

That “same room” is guaranteed soon to be this worthless excuse for a pediatrician’s waiting room.

Sears has caused severe harm to vaccination rates in the US, helping create these clusters of non-vaccinating parents who use him as their crutch. It’s not surprise some of the worst vaccine-preventable disease outbreaks we have seen in the last few years have been in California–the home court of Sears. And it’s also not surprising that these outbreaks center on two very vaccine-preventable diseases that Sears regularly tells us are not dangerous (and not to vaccinate against)–whooping cough and measles. Well, we all saw in full HD resolution yesterday the boundless ego, arrogance and stupidity/ignorance of Sears. To have the nerve to publicly piss and moan about extremely legitimate medical phone calls to one’s pediatric office in the middle of a measles outbreak–well, that’s inexcusable.

And while I’m calling out those who have no excuse for not knowing better, the AAP owns part of this, too. Their continued pathetic inaction against this anti-vaccine loon of a pediatrician again casts severe doubt on whether they give a damn about their motto: “Dedicated to the Health of All Children”. For the health of all children, dear AAP leadership, please call out this fool and toss him from your herd where you’ve let him hide far too long.

Chris Hickie, MD, PhD

I wonder if Dr. Bob would articulate exactly how many cases of measles would be required for him to get “concerned?”

How bad does it have to get before he’d change his tune?

I suspect Dr. Sears became anti vaccine due to the attachment parenting movement being closely linked to the anti vaccination movement. Basically since he couldn’t win over his patients, he joined them.

My town was lucky, thus far we have had two cases of measles but no more. They’re not letting unvaccinated kids return to the school where it happened until next Thursday.

@Fergus Glenncross

Everyone who is measles infectious has a sign round their neck?

Not only that, but every enclosed space (rooms, buses, subway/train cars, elevators, hallways, etc.) come equipped with measles virus detectors to they can alert you when someone who is infectious has been there within the last two hours or so.

I mean, it’s not like anything bad could happen among “relatively few” cases.

So, when SHOULD someone worry? If an actual direct exposure has occurred from a known case, then you might be at risk.

But, but, but: If getting measles is a justified cause for concern, then doesn’t it follow, as a matter of simple, inferential logic, that….Well. Never mind.

That’s a horrifying and disgusting little homily.

I don’t know more about the study than I learned from Reuters just now at the following link. But fwiw, there’s also this cheery news:

http://www.reuters.com/article/2014/03/19/us-medical-conspiracies-idUSBREA2H22K20140319

Measles will never go away – it’s always going to be a very small risk.

The first part of that sentence would appear to be a self-fulfilling prophecy, the second part, wishful thinking.

I do sometimes wonder how large an outbreak and how many deaths would be required to scare Sears and his patients (more to the point their parents) into changing their views.

I also wonder what these unvaccinated people do when they reach adulthood and want to travel abroad, especially to parts of Asia or Africa, or even Europe, where these diseases and others are endemic. When I did a bit of traveling, getting all the typhoid, cholera, hepatitis A and other shots I have probably forgotten, along with anti-malaria medication was bad enough (in terms of expense and time). I can’t imagine getting MMR, chicken pox, DTaP, polio and others as well. Presumably they either stay at home or just hope for the best and bring whatever infections they pick up home with them, as we have seen in the past.

Of course everybody should be vaccinated against measles!

One little irony is that the likes of Dr Bob may be right – though their conclusions wrong – that vaccination may increase the case fatality rates. Note, this does NOT mean mortality rates increase, as there will be many fewer cases.

The younger you get measles the more likely you are to develop SSPE which, as you have said, is a ghastly, progressive, and invariably fatal disease. The risk is much lower after the age of 2 or 3 years.

After that, people who get measles prior to adolescence tend to do better than those who get it later in life. Case fatality rates are higher in older (post-adolescent) people.

Vaccination leads to herd immunity, which provides a level of protection. Measles is extremely infectious, so you need the proportion of the population who are susceptible to be below about 5% to achieve herd immunity. (Since a single dose of vaccine is only about 94% effective, so you need a high proportion of the population to have had two doses of vaccine for this) Once measles is introduced into a population, unless you have this very high level of immunity, some of those who are not immune will become ill.

Historically, in the pre-vaccine era, most of us would have caught measles before we reached adolescence; but in the vaccine era more people can remain susceptible to measles and not become infected until later in life. Since case fatality rates are higher later in life, this may lead to an increase in average case fatality rates.

This is, of course, a strong argument for MORE measles vaccination; but it can be distorted by antivaccinationists who choose to misinterpret it.

Normally I love your hyperbole but this one seems a little over the top. I think discussions of relative risk are important and appropriate. He also tells patients that if they’re that worried then to get vaccinated. I get that there is a large contingency out there who would like to see bodily autonomy go away and have all children forcibly vaccinated but it’s not going to happen. The combination of hipster scoffing combined with pearl clutching doesn’t seem in proportion to the statement at hand.

For full disclosure, I think my life has been greatly improved for not having had a host of crappy diseases and as a result I vaccinate my children. However I rarely give a damn about the “greater good” as it is commonly defined so if vaccination did not confer a greater benefit than a perceived risk, I likely wouldn’t do it.

So, when SHOULD someone worry? If an actual direct exposure has occurred from a known case, then you might be at risk.

And if an unvaccinated patient has been exposed, what exactly is “Dr. Bob” going to do about?

I get that there is a large contingency out there who would like to see bodily autonomy go away and have all children forcibly vaccinated but it’s not going to happen.

Where do you get that?

for·ci·bly/fôrsəblē, adverb:

1. using force or violence.

However I rarely give a damn about the “greater good” as it is commonly defined

You must be a delight to sit next to at dinner parties and on airplanes.

“in the vaccine era more people can remain susceptible to measles and not become infected until later in life. Since case fatality rates are higher later in life, this may lead to an increase in average case fatality rates.”

I thought the MMR offered very long term immunity against measles: MMR: http://www.cdc.gov/Mmwr/preview/mmwrhtml/00053391.htm.

for measles “…both serologic and epidemiologic evidence indicate that the vaccine induces long-term — probably lifelong — immunity, in most persons.”

If anyone knows different, I’d like to know.

“I think discussions of relative risk are important and appropriate. He also tells patients that if they’re that worried then to get vaccinated. I get that there is a large contingency out there who would like to see bodily autonomy go away and have all children forcibly vaccinated but it’s not going to happen”

Dr. Sears did not discuss relative risk. He downplayed the risk.
Telling a doctor not to encourage patients to decline from protecting their children against a dangerous disease – or to legitimize that problematic choice – is not forcing anyone to do anything.

I get that there is a large contingency out there who would like to see bodily autonomy go away and have all children forcibly vaccinated but it’s not going to happen.

Where? All I ask is the responsibility that comes with risky behavior; you don’t vaccinate your kids, you must find an alternative education system that doesn’t risk others. You work in healthcare and refuse a flu shot, you wear a mask. Much like if you drink, you are not allowed to drive.

The choice/freedom is there and always will be. But those things do come with responsibility. It needs to be better better enforced. That’s all we ask.

@Dorit,

Dr. Sears did not discuss relative risk. He downplayed the risk.

There’s a misconception, or rather, conspiracy, amongst antivaxxers that the medical/scientific community doesn’t want people to be educated. No, we want PROPER education. Which you are right, Sears is not providing. Downplay risk of disease, inflate risk of vaccines. I like my education filled with facts, not nonsense.

I think truthful discussions of relative risk are important and appropriate. The statement by “Dr. Bob” does not meet that standard.

@ Mary #16 -I don’t know anyone here advocating forced vaccination.

That being said, I believe it is necessary and very justifiable to work to change state vaccine exemption laws so that the only children who can attend school without all their vaccines are those with a valid medical exemption from a licensed MD or DO. Two states in the US have laws this strict–all other states have either personal belief or religious belief exemptions that anti-vax parents routinely exploit. Schools are unfortunately some of the worst places for infection exposure and we need to have herd immunity levels in them. If you electively don’t want to vaccinate your child, you can keep them home.

And, there is no hyperbole today. When I checked with the publisher of Sears’ book on vaccines (an execrable work) in 2012, they had sold over 250,000 copies of it. He has over 15,000 gulled followers on his FB page. There is no doubt Sears owns part of these outbreaks, and his behavior yesterday was inexcusable for a pediatrician.

@ Mary

hipster scoffing

Yeah, we are true rebels, we vaccinate. Not vaccinating is so last century…

He seems to emphasize that close proximity is needed for transmission. However, uh, I must ask – does Dr. Bob realize how often a lot of us are in close proximity to others – including strangers?

I don’t know the exact breakdown, but anti-vax people are very often (if memory serves me right) urban. Hence, they are probably living in fairly close proximity to each other. Why, just this morning, I took a bus, then a train, then a trolley to reach my job. It was rush hour, so all of them were quite crowded. I must have been in close proximity (at times, very close) to at least 50 people – and this is all before 9 am. I will repeat this same situation going home tonight. I think Dr. Bob has a case of willful blindness going on.

Couldn’t get past the description of attachment parenting as a ‘smothering’ type of parenting, followed more for the parent than child. This demonstrates a complete lack of understanding of what attachment parenting is. Please, please don’t denigrate a whole ethos of parenting without even a thought. I am pro vaccination but am tired of the sneering tone of these types of blogs.

I’ve enjoyed your articles and learned a lot but as one who considers herself an attachment parent (who vaccinates, by the way) I find your snarky dismissal of attachment parents very hurtful and I fail to envision myself being able to read any future posts without fear of continued bashing. I hope you do some real research into the practice and learn how beneficial it is for the child, parent and community.

I’d be willing to consider force vaccination is certain, narrow circumstances if by that we mean vaccinating a child below the age of consent over parental preference. If a child is at high risk – for example, a child bitten by a dog suspected of having rabies – I think it’s justified for the state to step in.

That’s because the parent is not making the decision for herself. I would not support force vaccinating an adult or force vaccinating a child in most circumstances.

“It is a truism that almost any sect, cult, or religion will legislate its creed into law if it acquires the political power to do so.”

– Robert A. Heinlein

To clarify my previous statement.

This is something I read that one of the anti-vaxxers posted somewhere that I think actually has a point.

If we try to legislate and force vaccination on those who refuse this life-saving procedure, then it will provide them with more of the martyrdom complex that we’ve seen.

The only way we’re going to be able to counter these idiots is with science.

@Arctic – again, no one is advocating for mandatory vaccinations….but if you are going to have your children in a public education environment, then there is a responsibility to the public health to mandate that vaccines be up to date or have a valid medical reason not to…..because there is always a choice to send kids to private schools or homeschool.

@Lawrence

Fair enough. I’m just cautious when it comes to talking about legal action against non-vaccinators. FSM knows that we hear enough of their drivel.

Alison, Tina – I understand that you were offended by Orac’s comments about attachment parenting. Orac has his opinion about this; if you’d like to help him change that, please tell him why he’s wrong in his assessment. Stating that you find his opinion offensive has not been, historically, the most effective way to get him to change his statements.

FWIW – I have not looked at attachment parenting in any detail and have no view on it.

Taken by themselves, I can’t really argue with some of Dr. Sears’s statements. His basic message – measles has not been eliminated, it is spread through the air over a relatively small range (typically measured in yards rather than miles), and if you don’t get vaccinated you are taking a risk (so either get vaccinated or stop panicking about a risk you’ve chosen to take) – seems accurate enough.

I can also buy his message that if you’re not going to vaccinate, for heaven’s sake don’t try to convince your friends not to vaccinate.

All that’s necessary to make these reasonable is to add, “you really should vaccinate to help keep these diseases at bay as well as protecting yourself and your family”.

By the way, I thought Dr. Offit’s did an even better job highlighting the problems with Dr. Bob’s book in the relevant chapter in Deadly Choices than he did in the article above.

@Tina

You can’t “agree to disagree?”

That’s a shame. A person who chooses to avoid a milieu that carries any risk of holding opinions different than their own rarely learns anything new, in my experience.

Granted, if I stopped visiting places like AoA and Fox News, my days might be somewhat more tranquil, but I prefer to keep an eye on the oppo…

I’m not sure what the objection to attachment parenting is about either. It seems to me that there’s no reason why it shouldn’t be an excellent thing when good parents practice it well and wisely (which fully assumes that it suits the child, btw.) And if the reverse, the reverse. There’s no one-size-fits-all parenting style, obviously. But I don’t see anything inherently self-serving in the basics, at least.

@Tina —

FWIW, that didn’t read to me as sneering. I understood it more as “angry and upset about the irresponsibility wrt vaccines and in no mood to be scrupulously fair to any Sears enterprise.”

I can see how attachment parenting might be stressful and oppressive for some children, if overdone. As might many other styles and approaches.

But I obviously don’t know what Orac had in mind.

“The only way we’re going to be able to counter these idiots is with science”

That is not necessarily true. I thought there had been studies done that showed presenting scientific evidence to some people made them less likely to accept the science. It has more to do with trust than scientific literacy or knowledge.

I think some of the problem with the differences of opinion on attachment parenting is that it hasn’t been defined in this conversation. My experience has been that AP isn’t a very useful term because it means something different to different people. Based on some people’s take of the meaning, I do AP but based on other people’s definition, I clearly do not do AP. I think a more meaningful conversation could be had if the discussion was broadened to include what AP means to each of those who is disagreeing.

Discussing attachment parenting is off topic for this post, and I really don’t want this thread to devolve into a discussion of attachment parenting. If that’s what’s going to happen (and it does appear that that’s happening right now), I’ll just remove the damned sentence or two about it, because it is such a very, very, very minor part of the post that has almost nothing to do with the main message of the post: Dr. Sears spreading antivaccine views and shirking his responsibility as a doctor. If any criticism of attachment parenting, no matter how tiny a part of a 2,000 word post, is so very, very distracting that people can’t possibly stand to read the rest of the post or discuss anything other than their offense at having attachment parenting questioned, then I’ll just get rid of it because I don’t need the annoyance today.

And, yes, I’m being a bit pissy—unapologetically so. After all, it’s known as “Insolence.” 🙂

There. It’s gone. I hope everyone’s happy now.

Now please stay a little more on topic, as there’s plenty there to discuss, and leave attachment parenting for another time. Maybe I’ll do a full post on it sometime.

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.

Forgot to mention in this post: If this isn’t one of the most irresponsible, petty, whiny statements I’ve ever heard from someone who claims to be a physician, I don’t know what is. The reason to fear these outbreaks is that they could well be harbingers of much bigger outbreaks.

Sears didn’t love us all enough to leave most of our posts up on his Facebook page.

“I love you all, and love caring for you all.”

And children with whooping cough, measles, and other VPDs require lots more caring for by the pediatrician than children protected by vaccination.

I do not like any kind of parenting style that has a label. I don’t care what it is, it isn’t good for anyone. It seems to lead to bullying.

Just yesterday, I encountered a former coworker who is now a parent and has fallen for the too-many-too-soon argument and pulled the ol’ “What’s the harm / I’ll count on herd immunity” tropes.

I pointed out that if their infectious-but-asymptomatic child happened to be in the vicinity of my father around, oh, two months ago, he’d be dead by now as his then-undiagnosed leukemia was already doing a number on his immune system.

Unsurprisingly, I’ve not heard back from her. *sigh* Maybe she’s actually re-thinking her decision…

“I wonder if Dr. Bob would articulate exactly how many cases of measles would be required for him to get “concerned?””

He has been asked that many times over by many people. He blocks and deletes those questions/comments on Facebook, ignores those comments on HuffPo, and outright denies doing/saying some things. Seth Mnookin had an AUDIO RECORDING of Bob talking to him, and Bob still said he had never heard of or talked to Seth. It doesn’t get more deluded than that.

@janerella:

Holy crap. I either forgot (or didn’t know) about Dr. Bob’s having penned the foreword to The Thinking Moms’ Revolution antivaccine book.

@Arctic Snowbird

Legislation to force vaccination will never come about. It won’t happen not so much because of the populace opposition. It won’t happen because law makers who don’t vaccinate their kids would never risk being found out. (Just giving my two cents — hee hee hee.)

Don’t forget Sears is also an admin on the Parents and Others Against Vaccination (PAOV) Facebook page that includes the worst of the AV crowd.

law makers who don’t vaccinate their kids would never risk being found out.

Well, it is certainly heartening to think that our elected representatives wouldn’t want to be thought of as fools (assuming their children don’t have medical reasons not to be vaccinated).

Meantime, Jay Gordon, that FAAP-wit, is busy on Twitter condemning the news media for causing a “panic” about measles. No biggie, says Jay.

https://twitter.com/JayGordonMDFAAP

As I recall, Jay did a Bob Sears awhile back, noting that parents shouldn’t be concerned about protecting their kids from measles with vaccination, since the measles rate is so low. You see, it takes a functioning neuron threshold to realize that the rate is so low because of vaccination. Jay isn’t quite there yet.

Drug pushers,

Come to think of it — in all my time here, I forgot to ask a simple question: It is said that the ”mystical’ herd immunity is achieved if over ninety percent of the population is vaccinated, yet vaccines effectiveness wears off relatively quickly and this would leave a significant portion of the adult population who hasn’t received boosters unprotected. How then can any claims be made about upholding herd immunity?

Let the lying, denials, obfuscations, deflections, distortions, and all other disengenuos tactics begin…

Dr. Jay is one of those doctors on Dr. Bob’s “Vaccine Friendly Doctors” list. We did convince Dr. Jay to remove all traces of his whale.to links about vaccines, but haven’t, as yet, convinced him to link to the California Department of Public Health or the CDC for reliable information about childhood vaccines. He’s a work in progress, I suppose.

“But virtually all measles outbreaks are limited to 10 to 20 cases in any given county.”

Yeah, Dr Bob, but what exactly does it say when all of the cases in a county are in one pediatrician’s office — yours? You recommend your patients hide in the herd, but then guide them to “antivax friendly” doctors, which means you’re leading them out of the herd, to cluster where they are more likely to be infected. You are screwing them over twice — discouraging them from vaccinating and discouraging them from getting the full protection of the vaccinated community around them, which means you are making it far more likely for *your* patients to get measles than, for instance, some kid who is allergic to the MMR and so doesn’t get it for that reason.

And you have the gall to blame the media for pointing out that there are suspicious clusters? Sounds like somebody just doesn’t want his pride pricked. Somebody’s ego is more important than the lives of his patients, apparently.

Obviously you don’t want this discussion to be about AP, but I feel I should respond to those who called me out. I’m open to other ideas – that’s why I read (and sometimes shared) this blog. But Orac’s characterization of and language directed at AP parents was uncalled for and demeaning. Orac, if you do in fact write an article about AP, I hope you will contact Dr. Laura Markham for her take on the topic.

No one “called you out.” I simply made a snarky little side remark about AP, as I make snarky little side remarks about lots of things. If I were “calling out” AP parents, they would get a full heaping’ helping or Orac’s not-so-Respectful Insolence, not just a throwaway jibe.

And that’s all I want to say on the subject anymore here.

Dreg @57

“Legislation to force vaccination will never come about. It won’t happen not so much because of the populace opposition. It won’t happen because law makers who don’t vaccinate their kids would never risk being found out. (Just giving my two cents — hee hee hee.)”

Dreg, I doubt someone as intellectually bankrupt as you can muster enough neurons to rub together to even get a single penny.

I rather like this study, which was published in the Pediatrics journal, about the 2008 measles outbreak. I wonder if Dr. Bob has actually read it:

http://pediatrics.aappublications.org/content/125/4/747.full.pdf

Measles Outbreak in a Highly Vaccinated Population,
San Diego, 2008: Role of the Intentionally Undervaccinated

Abstract

Objective: In January 2008, an intentionally unvaccinated 7-year-old boy who was unknowingly infected with measles returned from Switzerland, resulting in the largest outbreak in San Diego, California, since 1991. We investigated the outbreak with the objective of understanding the effect of intentional undervaccination on measles transmission and its potential threat to measles elimination.

Methods: We mapped vaccination-refusal rates according to school and school district, analyzed measles-transmission patterns, used discussion groups and network surveys to examine beliefs of parents who decline vaccination, and evaluated containment costs.

Results: The importation resulted in 839 exposed persons, 11 additional cases (all in unvaccinated children), and the hospitalization of an infant too young to be vaccinated. Two-dose vaccination coverage of 95%, absence of vaccine failure, and a vigorous outbreak response halted spread beyond the third generation, at a net public-sector cost of $10376 per case. Although 75% of the cases were of persons who were intentionally unvaccinated, 48 children too young to be vaccinated were quarantined, at an average family cost of $775 per child. Substantial rates of intentional undervaccination occurred in public charter and private schools, as well as public schools in upper-socioeconomic areas. Vaccine refusal clustered geographically and the overall rate seemed to be rising. In discussion groups and survey responses, the majority of parents who declined vaccination for their children were concerned with vaccine adverse events.

Conclusions: Despite high community vaccination coverage, measles outbreaks can occur among clusters of intentionally undervaccinated children, at major cost to public health agencies, medical systems, and families. Rising rates of intentional undervaccination can undermine measles elimination.

You have to be in the same room, people.

Dr. Bob seems not to have heard. They have invented these things called airplanes. They allow people to travel rapidly between distant places: any two places in the world with airports are at most 48 hours apart. Some of these places are countries where measles is still endemic. Others, as Orac mentions in the post, are places where antivaccinationists have seriously damaged herd immunity.

That’s why measles isn’t going away any time soon, as Dr. Bob correctly notes. But contra Dr. Bob, it is an argument in favor of vaccination.

The attachment parenting movement and the antivaccine movement aren’t unrelated. Especially when discussing the Sears. Admittedly, I did not read the offending sentences about attachment parenting before they were removed, but it’s annoying that an offhanded mention of this parenting style–and really, that’s a mild way to put it–became a cause celebre for some on this blog. I don’t want to bring this topic back up out of context, but I think that ignoring attachment parenting when discussing the dangerous anitvaccine position and influence of Dr. B Sears is like ignoring the elephant in the room, pardon my trope. So my pared-down point: Dr. W. Sears encourages parents to rebuke the medical establishment and be wary of the advice of ‘old-school’ pediatricians and doctors. He also encourages parents to make medical choices based on ‘feelings’. Having been exposed to Dr. W. Sears’ rhetoric and ideas, many attachment parents are primed to rely on internet research and ‘gut’ when making parenting decisions. And this leads us to the son, Dr. B. Sears. Dr. B. Sears has a wide audience (attracted to the Sears Brand) that is predisposed to the idea that pediatricians/doctors aren’t always reliable sources when it comes to vaccines and that parents should research vaccines independently (oh and create customized vaccine schedules!). And unfortunately but not unsurprisingly, this independent research can lead to, shall we say, unscientific ideas that are well documented on this blog.

So a disclosure: I’m a mom to a 9 month old who uses some ‘attachment parenting’ practices, but I am under no illusion that research backs up some of my choices–I find that the ‘research’ is not compelling on many parenting topics. But not vaccines! Oh and attachment parents: you don’t want Orac to do a post on this…(sorry, sorry, sorry…unrelated)

sorry sorry…I did stray off topic and posted the above before reading the last couple posts. My bad.

I don’t want to bring this topic back up out of context, but I think that ignoring attachment parenting when discussing the dangerous anitvaccine position and influence of Dr. B Sears is like ignoring the elephant in the room, pardon my trope

I can well believe that, and even though it’s tangential to the original post, I still find it interesting to hear about what it involves and the mindset it encompasses.

I have no direct interest – I have no kids and will not have any – but I live in the world with everyone’s kids, so this is of interest nonetheless.

Um…there are additional cases of measles in California and the California Department of Public Health has provided us with the number of measles cases in children who were deliberately not vaccinated against measles.

http://www.scpr.org/news/2014/03/18/42870/majority-of-states-measles-cases-were-unvaccinated/

“14 of California’s 32 measles cases this year were intentionally unvaccinated”

“It was last month that public health officials first identified seven measles patients as having been intentionally not vaccinated. They were between the ages of 7 and 32, said CDPH spokeswoman Kathleen Harriman.

“They were all minors other than two young adults,” said Harriman “And the young adults, it was their parents’ decision, obviously, not to have them vaccinated when they were children.”

CDPH officials could not immediately provide KPCC with the ages of the seven additional people it has determined were intentionally not vaccinated.

The 32 measles cases have been reported in Alameda (1), Contra Costa (4), Los Angeles (10), Orange (6), Riverside (5), San Mateo (1), San Diego (4) and Santa Clara (1) counties. The CDPH has not said where the 14 intentionally unvaccinated people live.”

Sears didn’t love us all enough to leave most of our posts up on his Facebook page.

I’d say the odds of his personally managing this part of his media presence are nil.

lilady @73 — If I were that 32-year-old measles case, I would be hopping mad at my parents.

Hopping. Mad.

Comments are closed.

%d bloggers like this: