Blowing the antivaccine dog whistle again

You remember Dr. Bob, don’t you?

I’m referring, of course, to Robert “Dr. Bob” Sears, the Capistrano Beach, CA pediatrician who’s arguably the most famous of the antivaccine pediatricians who have been spreading fear, uncertainty, and doubt (FUD) about vaccines. (Sorry, Dr. Jay, but, regardless of your being Jenny McCarthy’s son’s pediatrician, I’d bet that more people have heard of Dr. Bob than have heard of you.) Dr. Bob has achieved this fame/notoriety based on his book, The Vaccine Book: Making the Right Decision for your Child, which is chock full of exaggerations about the dangers of vaccination and advocates a “delayed” vaccine schedule that is backed up by no scientific evidence. Dr. Bob has basically been cashing in on fear for a long time.

Given that the epicenter of the Disneyland measles outbreak (i.e., Disneyland) and other recent measles outbreaks is uncomfortably close to Dr. Bob’s practice, he’s been feeling the heat lately. Beginning about a year ago during an earlier measles outbreak he started lashing out on social media at the parents of his patients who, quite understandably concerned about the measles outbreak, were calling his office. It began last March, when he downplayed the risk of the measles and told his patients’ parents, “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.” Not long after that, Dr. Bob basically told his parents’ patients, “Don’t worry, be happy, and if you’re worrying and not happy get the vaccine. Just don’t bother me about it anymore. Oh, and you nasty pro-science vaccine supporters out there are big meanies for pointing out that Dr. Bob is irresponsible.” Then, beginning about a month ago, Dr. Bob went on an embarrassing tear on Facebook, condescendingly downplaying the risks of measles-related pneumonia with a jaunty, “Ya, you don’t want those things to happen, but they are treatable” and then whining about it when it was pointed out to him that at no time in his prior rant did he recommend getting vaccinated in the middle of an outbreak. It was the tried-and-untrue antivaccine trope that the measles isn’t dangerous.

There’s a term I coined reading Dr. Bob’s nonsense: The antivaccine dog whistle. In politics, a “dog whistle” refers to terminology that sounds benign to most people but in reality tells those holding objectionable viewpoints that the speaker is sympathetic to them (or even one of them). In other words, most people can’t “hear” the message, and only those for whom it’s intended can “hear” it, recognizing for what it is. Let’s just put it this way. Dr. Bob is very good at antivaccine dog whistling. (So is Rand Paul.) Now, in a “point-counterpoint” pair of editorials, Dr. Bob does it again. Now, don’t get me started on the idiocy of false balance that presenting point-counterpoint editorials represents about a scientific topic like vaccination. Unfortunately, lately false balance has been rising from the grave again. (Apparently, like Michael Myers or Jason Voorhees, it never dies.) Dr. Bob’s editorial is entitled Mandatory vaccination is not the answer to measles and it starts out with some serious dog whistling right out of the box:

Measles. It used to be just a disease. Now it’s become a banner under which politicians gather to threaten one of our most sacred rights – the right to give informed consent for medical treatment.

Whether you are for vaccines, against them, or neutral, allow me to ask this question: Is vaccination a medical treatment which should fall under the protection of informed consent, or does the government have the right to force them on every American?

See what I mean? Right out of the box, Dr. Bob is trying to reframe the debate over a bill being considered in the California legislature that would eliminate non-medical exemptions to school vaccine mandates. I realize that often the editorial writer doesn’t pick the title (usually the editor does), but the very title “mandatory vaccination” helps Dr. Bob frame the issue not as one of public health but rather personal freedom, just as Rand Paul did. Notice how obviously but nonetheless rather cleverly he does it, with a little rhetorical prestidigitation in which he’s saying, “You know, what’s important is not whether you’re for vaccines or antivaccines or “neutral” (whatever that means in this context), it’s that the government can’t take away our FREEDOM!

Of course, this is Dr. Bob, and there’s a whole lot of BS there. For one thing, what Dr. Bob advocates is not really “informed consent,” but rather what I like to call “misinformed consent,” wherein the severity of vaccine-preventable diseases and efficacy of vaccines are very much downplayed and the risks of vaccination exaggerated. It’s one reason why Dr. Bob was so opposed to California Bill AB 2109, because that bill required that real informed consent be given by parents requesting philosophical exemptions to California’s vaccine school vaccine mandate by requiring them to have a physician or other specified health care provider sign an attestation that the parents had been told the risks of not vaccinating.

The issue thus reframed, Dr. Bob launches into a list of the horrors of vaccination and the joy of measles. OK, I’m exaggerating, but not by a heck of a lot. It’s the same stuff Dr. Bob’s been spewing all along since the measles outbreaks began, antivaccine tropes about how the measles isn’t that bad and how vaccines are “dangerous,” all in the form of bullet points. For example:

• About 2,000 severe reactions are reported to the CDC each year which result in prolonged hospitalization, permanent disability, or death. Most reactions aren’t even reported, so the true number may be even higher. Yet, because they can’t be proven, the medical community denies that they can happen.
• Over $3 billion have been paid out to victims of vaccine reactions. Not $3 million. Not $30 million. Not even $300 million. But $3 billion. Are we paying that much money to victims of pretend reactions? I think not.

Dr. Bob should change that last sentence from “I think not” to “I don’t think,” as in “I don’t think,” a general statement of Dr. Bob’s intellectual prowess with respect to vaccines. I’m guessing that 2,000 severe reactions a year is probably referring to the > (VAERS) database, which, as regular readers here know, is an open database to which anyone can report any “reaction” to vaccination, whether it’s actually related to a vaccine or not. VAERS is not authoritative, and the adverse events are not generally verified. Indeed, as has been reported before, one pro-vaccine blogger, Dr. Jim Laidler, reported that the influenza vaccine turned him into the Incredible Hulk. True, the VAERS staff did contact this blogger and ask him about it, but, as he noted, if he had refused to remove the entry, it would still be there. Another pro-vaccine blogger, Kevin Leitch, verified that VAERS lets you enter basically anything by reporting that a vaccine had turned his daughter into Wonder Woman. That’s why VAERS is the antivaccinationist’s favorite database, and I like to refer to dubious correlations reported from VAERS as dumpster diving. Not surprisingly, antivaccine lawyers have made the database almost worthless as a source of information over the incidence of adverse events due to vaccines by encouraging their clients to enter all sorts of reports, in particular reports claiming that vaccines caused autism. Most recently, the Toronto Star completely misinterpreted how VAERS data should and shouldn’t be used in its utterly botched story falsely linking all sorts of horrific reactions to Gardasil.

Then Dr. Bob lists a bunch of bullet points, all consisting of tired antivaccine misinformation that was old when Dr. Bob was in medical school, including (my favorite) the claim that measles isn’t dangerous, a claim rebuked by medical science. For instance:

• It has killed no one. It can kill about 1 person in every 1000 cases. Will someone die of measles in the United States in the years to come? Maybe. But it hasn’t killed anyone in the past 15 years or more.
• The last time measles hit us hard was 25 years ago. Not last year, not this year, yet.
• It’s measles, people. It’s not the plague. It’s not polio. It’s not Ebola. It’s measles. If the plague hits, let’s force everyone to vaccinate. But measles? Measles? We need something a lot more dangerous than that if we are going to rob each and every patient of the sacred right of informed consent.

So, measles is no big whoop, even though it can kill one out of a thousand children who get it. Of course, Dr. Bob neglects to note other, more common, complications of the measles that can be very serious, such as pneumonia (which he at least mentioned in his earlier rants) and he very much failed to mention how about one in four victims of this year’s measles outbreak have had to be hospitalized.

But notice the overall construction of Dr. Bob’s argument. To him, measles isn’t serious (which he explicitly states multiple times) and the vaccine is dangerous (which he implies with his listing of “severe complications” of vaccination in general); so to him it follows that “forcing” vaccination is an unacceptable affront to freedom:

Let’s stop panicking over what measles might do and calmly examine what it is doing. It has a small and intermittent presence in our country. It makes people sick, then they get over it. It has complications, but rarely so. Vaccination is important and protective. But it cannot be forced; a parent must give consent.

If you would rather make your own medical decisions within the sacred confines of the doctor/patient relationship, then let Sacramento know now. If you would rather give politicians the power to make medical decisions for you, then give them your support. But you better hurry; the outbreak is winding down, and so is the fear. Give them the power before it’s too late. I’m sure they’ll make plenty of other wise medical decisions for you in the years to come.

Rand Paul couldn’t have said it better. Do you hear the dog whistle? Vaccine “choice” is freedom for parents, the health of their children and yours be damned.