I really don’t want Mondays to be come “let’s refute and make fun of the conspiratorial antivaccine nonsense Bill Maher said on his show Friday night.” I really don’t. However, I figured that I might have to devote Monday to that one more time this week after Maher really let his antivaccine freak flag fly again for the first time in five years on his February 6 show. As a result of the criticism, Maher apologists crawled out of the woodwork, trying to argue that, really and truly, Maher is not antivaccine—except that he is and has been for as long as I’ve been paying attention to these issues. He just hid it for a while after the epic slapdowns he received in 2009 over the same sort of nonsense over the H1N1 pandemic and flu vaccine.
So, yes, I rather suspected that Maher wasn’t done yet, and he wasn’t. On Friday’s show, he couldn’t resist revisiting the issue, even though he really should have resisted.
I actually didn’t watch the show when it aired because, well, I had better things to do at the time, like go out with my wife to see the Oscar-nominated shorts. But the e-mails and comments kept coming in, and then my blog bud Mark did a lovely rant about Maher; so finally I broke down and watched the video. Unfortunately, unlike last week, Maher’s crew didn’t post just the vaccine segment, but rather other segments of the show, although Maher did post a relatively low resolution version of the whole show on his Google+ feed. So I’ll just tell you the relevant time marks as I go through this, and you can go look at the video if you wish.
The first thing I noticed was that Maher started out with an interview with Robert Kenner, who produced and directed the 2008 documentary Food, Inc., which examined the industrialization of the food system and how the food industry promotes unhealthy food consumption habits. Apparently he has a ne film coming out, Merchants of Doubt, inspired by the book of the same title by historians Naomi Oreskes and Erik Conway. The book famously discussed how industry and free market politicians twist science to sow “fear, uncertainty, and doubt” about established science, starting with the evidence that smoking causes cancer and moving on to acid rain, the effects of ozone on the atmosphere, and, of course, anthropogenic global warming/climate change (AGW).
It’s a fairly straightforward interview about how industry and free market fundamentalist politicians collude to cast doubt on inconvenient (to them) science about, for instance, food, pharmaceuticals, and AGW. In the context of what happens later, it’s hard not to see this as setting up the vaccine segment later in the show, given how during the previous week Maher used his anti-pharmaceutical views as part of his basis for casting his own fear, uncertainty, and doubt about vaccines. Later on in the show, beginning at the 17:30 mark, the panel discusses Scott Walker, who apparently denied belief in evolution. He didn’t actually do that, but rather said he was going to “punt” on the question because it’s a question a politician “shouldn’t be involved in.” Of course, this does give Maher an opportunity to do one of his anti-religion bits that he does so well, proclaiming that science and faith are not compatible and declaring that “stupidity is not another form of knowledge.”
Clearly the irony of that last statement was lost on Maher. However, in the context of the show, one can’t help but wonder if this interview was intentionally set up to cast the light Maher wanted on his discussion of vaccines later in the show.
That vaccine discussion begins during Maher’s interview with David Duchovny, who was on the show to promote his new book. As a sidebar, Maher mentions that he’s a “big animal rights guy.” Of course, the animal rights group he’s chosen to associate himself with is PETA, and he’s been on its board since 1997. Not surprisingly, a vocal supporter of the group. It’s a group that, as I’ve discussed on many occasions, takes pseudoscientific positions that are sometimes impossible to parody.
At about the 35:00 mark, the discussion between Duchovny and Maher works its way to factory farming and the amount of antibiotics given to the animals. This is, of course, a real problem that’s contributed to widespread antibiotic resistance in a number of organisms. By the 36:00 mark, Maher has led the discussion to “the herd,” flowing from his discussion with Duchovny of factory farming and antibiotics. This is reminiscent of Maher’s “JAQing” off about whether, like overuse of antibiotics, we can ever overuse vaccines. So right off the bat I knew this was going to go south, as in antivaccine talking points south, in a hurry. And it did.
Digging himself in deeper, Maher begins by defending parents who argue that the measles is “not a big deal,” parroting the common antivaccine talking point that, oh, you know, if the disease were really bad, of course he’d recommend vaccinating against it. But this is just the measles, and that’s not very severe. He then equates the measles vaccine with the flu vaccine in terms of herd immunity:
MAHER: …we didn’t get to the part about the herd, and I’m very sympathetic to parents who say I don’t want my kid to get the measles even though I also understand why parents have a right to say certain diseases you’d be remiss not to protect your kids from, but that one doesn’t seem that dangerous to me. But, if we’re going to say that the herd must be protected, everybody has to get the shot. What if we said flu shot? That kills people. What if everybody now has to get a flu shot? Is this the slippery slope?
DUCHOVNY: I think that with the flu shot it’s not A to B, like with measles you’re targeting measles. I think with the flu they’re guessing which flu is coming, so they’re not…
MAHER: That’s why I don’t get it.
DUCHOVNY: …well, well, I think that you may be smart on that. In order to join in society with millions of people on this planet you have to make sacrifices you don’t want to make. So to join the herd, to get the benefits of being in the herd, you may have to do some things you may not like.
MAHER: So if the herd is saying that if you don’t get a flu shot or a measles shot, then you’re selfish, I’d also like to say to the herd: “If you have six kids, you’re selfish.” That is also a scientific fact.
DUCHOVNY: There are officials in China who would agree with you.
Of course, both Maher and Duchovny denigrate the flu vaccine because it’s such a difficult vaccine. While I’m happy that Maher has finally admitted that influenza can kill people, I don’t think he quite gets it yet. Both he and Duchovny make it sound as though scientists just take wild guesses about which antigens to include in the flu vaccine every year, as if they throw three or four darts at a board with the various strains written on it and pick the ones closest to where the darts hit. As I’ve described before in more detail, there is a long process by which the flu vaccine strains are chosen every year, and they have to be chosen by around now (February) in order to have adequate stocks of vaccine ready for fall. Scientists at the WHO basically look at the circulating strains at the time and use what they know to make the best predictions they can as to which strains will be predominating in the fall and winter. Sometimes they predict well. Sometimes, as is the case this year, they don’t, thanks to antigenic drift in which a flu strain not expected to predominate came to predominate. By the time scientists realized this it was too late to reformulate this year’s vaccine, and this year’s vaccine is not that effective in comparison to years past.
Maher also includes a variant of the antivaccine trope that I like to call “argumentum ad Brady Bunch,” based on a 1969 episode of The Brady Bunch in which the whole family caught the measles and it was played for laughs. It’s the claim, echoed by antivaccine pediatricians Dr. Bob Sears and Dr. Jay Gordon that the measles just isn’t that bad. Wrong, wrong, wrong, wrong.
Then notice how Maher is clearly stung by accusations of “selfishness,” adding a dig against religion by deriding how God said “Be fruitful and multiply.” Witness how he conflates the selfishness of parents who don’t vaccinate and ride on the herd to the “selfishness” of parents who have six children because population growth in unsustainable. It’s a breathtakingly inane argument even by Bill Maher standards, particularly given that the rate of population growth in Europe is virtually nonexistent (actually, many European countries are seeing declines in population) and in the US is very low, with even that growth rate being due mostly to immigration.
He’s also conflating different purposes of vaccination. Measles is one of the most highly contagious diseases there is, but the vaccine for it is very effective, which makes herd immunity even more important. It also demands a very high rate of vaccination to achieve herd immunity because the disease is so infectious, which is why 90-95% is the threshold typically quoted. Influenza, as infectious as it is, is still much less infectious than measles. Herd immunity can be achieved at lower rates of immunization. Here’s the other difference. In general, with the flu vaccine, we’re talking about adults, and there is no mechanism to compel vaccination. With children and measles, it makes a lot of sense to mandate measles vaccination as a condition of entering into a crowded place where lots of kids can pass various diseases around, particularly given how easily one child could infect many with the measles.
Never one to stop a good rant, Maher continued:
MAHER: What about when the herd eats sugar and corn syrup all day and their immune systems are down and they get the flu more? I don’t get the flu.
DUCHOVNY: The herd is not going to listen to any of that shit. [Laughter.] The herd by definition does not listen.
DUCHOVNY: But the herd also tells their doctors to give them antibiotics. for everything, and…that..I’m more scared of bugs that are antibiotic-resistant than I am of the measles. What about the herd there, herd?
THURSTON: I think you’re mixing up a lot of science.
MAHER [interrupting]: No, I’m not.
THURSTON [continuing]: I do. I do. Really. [Thurston trying to continue with Maher and Duchovny interrupting.] I think antibiotic resistance—I’ll talk to both of you [gesturing to Maher and Duchovny]. Antibiotic resistance is not the same as your skepticism about vaccines. It’s just not. We’ve saved so many lives from sanitation, clean water, and vaccines.
MAHER: This is the straw man I’m always fighting. I am not skeptical that vaccines “work” [air quotes]. I get it that they work. Lots of things work. Antibiotics work—at a cost. Chemotherapy works. It might get rid of my tumor…
THURSTON: But what is this cost you’re talking about for vaccines?
MAHER: OK. I said this last week. This is a scientific fact. There have been no long-term studies done on vaccinated versus unvaccinated, long term health outcomes. If you never give your immune system a chance to fight a disease…
THURSTON: That’s not a cost, that’s a question.
MAHER: That is a question that science has not answered.
THURSTON: But the studies that have come in so far have not proven any distinct issues.
ZANNY MINTON BEDOES [Editor-in-Chief of The Economist]: What we do know is that vaccines have prevented an enormous number of diseases.
MAHER: No one is saying that’s not true.
THURSTON: Here’s where I come in, and I don’t think—I did watch your show last week—I don’t think that it’s wrong to ask questions. I agree with you very much that vaccines can be better. There are better technologies than a 160 year old needle to deliver this.
At this point, I suspect that Maher knew he was losing; so he tried to bring it back to the question of whether it’s “selfish” to have six children. Thurston would have none of it:
THURSTON: If you’re knowingly increasing the exposure of a deadly disease within the population, that’s a very different thing than having another child.
MAHER: Measles is not really that deadly a disease.
Once again, nonsense.
Surprisingly (because Maher’s guests are usually fairly clueless about these sorts of things), Bedoes notes that she thinks the US has a good policy in not having mandatory vaccines, but rather vaccine requirements that children must meet if they go to public schools. She notes also that we have religious and philosophical exemptions, echoing my sentiment that, if we have such exemptions, they should be much harder to get, although my view has changed more over the years to the contention that we should not allow non-medical exemptions any more.
Bill Maher and his apologists frequently gasp in indignation whenever someone like myself or other skeptics call him antivaccine. Unfortunately, as I showed last week, antivaccine tropes fly fast and furious out of his mouth. His misleading claim about the lack of vaccinated/unvaccinated studies is not only misleading, but objectively not not true. It simply isn’t. Also, whenever antivaccine organizations try to do such studies themselves, inevitably they’re utterly worthless and/or actually show the exact opposite of what antivaccinationists had hoped. When vaccinated/unvaccinated studies are planned, they are actually attacked by antivaccine groups because these groups know that the studies won’t show what they hope they’ll show.
Yes, the claim that there’s never been a “vaccinated/unvaccinated” study is an antivaccine trope, tried and true. What Maher said about it would have been perfectly at home on the websites of antivaccine groups, such as Age of Autism, SafeMinds, VaxTruth, and the National Vaccine Information Center. Ditto his analogies about the immune system “needing a workout” by combatting “real disease,” an analogy so breathtakingly ignorant of actual immunology and infectious disease that Maher should really just hang his head in shame.
In fact, I mentioned irony above. It’s ironic that Maher had Kenner on his show promoting his movie about how industry and free market conservatives promote doubt about settled science through misinformation and cherry-picked science because, when it comes to vaccines, Maher does exactly the same thing using the same sort of dubious arguments about how “the science isn’t settled” and “what’s the price of vaccines?” Maher will never see that, of course.
After the last two weeks of incredibly embarrassing anti-science rants by Bill Maher, my retort to his wounded indignant cry that he’s “not antivaccine,” is simply to say: If you’re not antivaccine, then stop repeating long discredited antivaccine talking points as though they were scientifically valid. That’s what antivaccinationists do, and if you continue to do such things, then you shouldn’t be surprised when people conclude that you are antivaccine. It’s a reasonable conclusion based on your own words and failure to be educated over the course of many years.
Finally, I really hope that I don’t have to do this again next Monday.