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In which Orac uncloaks and gets to meet his heroes Drs. Richard Pan and Peter Hotez

A week and a half ago, Orac got to travel to San Diego to participate in a panel discussion about the antivaccine movement. Even better, he got to meet two heroes of his, California Senator Richard Pan and Dr. Peter Hotez.

Those of you who are my Facebook friends or otherwise follow me on social media other than blogs know that I was out of town the week after Thanksgiving. Specifically, I traveled to the San Diego area to participate in a panel discussion at a conference and, while I was there, made a vacation out of it with my wife. The conference was the World Vaccine and Immunotherapy Congress West Coast 2018, and the panel was Addressing the epidemic of misinformation. As I pointed out when I was invited, I’m not by any means an expert in vaccines (although the conference did have some interesting talks on cancer vaccines and immunotherapy), but I do now consider myself to be an expert in the antivaccine movement (at least in the US) and antivaccine messaging. It was for that role that I was invited to participate. Another appealing aspect of the panel was the opportunity to meet two of my heroes. First, of course, there was California State Senator Richard Pan, the pediatrician turned politician who co-authored SB 277, the law passed in 2015 that eliminated nonmedical “personal belief exemptions” to school vaccine mandates in California. It’s a bill that was highly contentious but has clearly worked to decrease the number of personal belief exemptions. Then there was Dr. Peter Hotez, the Texas Children’s Hospital Endowed Chair of Tropical Pediatrics and the founding dean and chief of the Baylor College of Medicine National School of Tropical Medicine. He also wrote an excellent book, “Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad“, because he has an autistic daughter who is now an adult.

I must admit that I was unfamiliar with the other two members of our panel. First, there was the moderator, Robb Butler, who is a social scientist currently assigned to UNICEF to establish a global center for vaccine demand and acceptance, supported by the Bill and Melinda Gates Foundation. He also previously served as a behavioral scientist for the WHO Regional Office for Europe before becoming that program’s lead. That’s some serious stuff, and it was very useful to have a more European perspective. Then there was Dr. Eve Dubé, a medical anthropologist working at Quebec National Institute of Public Health, a researcher at the Research Center of the CHU de Québec-Université Laval, and an invited professor in the Anthropology Department at Laval University. Her research focuses on the socio-cultural field surrounding immunization, particularly vaccine hesitancy and how to address it. She also leads the Social Sciences and Humanities Network of the Canadian Immunization Research Network. Her perspective, too, was quite valuable.

I’ll now relate what happened last Wednesday. I wish the talk and panel had been recorded, but as far as I know it wasn’t. Also, I’m going totally by memory because, as a panel participant, I really didn’t have much of an opportunity to take notes. As a result, this account might be a bit stream-of-consciousness. However, given that that’s how I frequently blog anyway I doubt that many will notice the difference.

The morning began with Dr. Pan’s keynote address, which was basically the saga of how SB 277 was passed. I knew some, but far from all, of the background covered by Dr. Pan. One of the things he confirmed for me is something that I’ve been discussing for a long time, and that’s how the Republican Party has become, if not the antivaccine party, the party most receptive to the arguments of the antivaccine movement against school vaccine mandates. Some of you might remember when I discussed elsewhere an antivaccine campaign event held the last week of the state primary season by a candidate for the Republican nomination to run for the open seat in Michigan District 11 in the US House of Representatives. It was a roundtable that was anything but rounded in that it was all antivaccine activists and quacks, plus the candidate (Kerry Bentivolio), plus my state representative (Jeff Noble), plus a Republican candidate for the gubernatorial nomination, my very own state senator Patrick Colbeck (who has serious antivaccine tendencies and co-sponsored legislation to reverse a policy change that made it harder to get personal belief exemptions, or, as I like to put it, to “make measles great again“). Basically, Sen. Pan confirmed that similar dynamics are at work in California as in Michigan. Specifically, I point to a remark by Rep. Noble in the Q&A in which he mentioned that the Republicans on the Health Policy Committee were the only ones receptive to “vaccine choice” initiatives, while the Democrats won’t even consider them and characterized their position as wanting to “shove vaccines down your throat (or arm)”.

Sen. Pan wanted to make a point that support for vaccines is bipartisan and that many of the Republicans who were balking at voting for SB 277 weren’t hesitant because they were antivaccine. I also suspect that the reasons that many Republicans in the Michigan legislature are more receptive to “vaccine choice” initiatives is not because they are antivaccine, either. Rather, it’s because the antivaccine movement has so successfully co-opted the messages of “freedom”, “parental rights”, and anti-regulation ideology that many Republicans now actually fear being challenged from their right if they are too receptive to vaccine mandates. As Sen. Pan characterized it, he was told that parents who vaccinate did care, but to antivaxers SB 277 is the issue they cared about more than any other and one that they wouldn’t forget about come election time. Indeed, I note that this very thing happened in Texas this year when Lisa Luby Ryan, an interior designer, beat three-term state Representative Jason Villalba in the Republican primary in March, aided by far-right groups, particularly Texans for Vaccine Choice. Sen. Pan, speaking legislator-to-legislator to these Republicans told them that he understood (which he did) and that he understood that the best thing that could happen for them is to vote no and have the SB 277 pass anyway. However, he warned them that, if they voted no and SB 277 didn’t pass, he’d make sure that they’d never forget it the next time there were outbreaks of vaccine-preventable disease.

In any event, SB 277 is a triumph, but it’s an uncommon one. Nothing like it has been passed in the last three years. If anything, it’s been fighting against antivaxers trying to weaken or dismantle school vaccine mandates, and now we have an antivaccine governor-elect in Oklahoma, Kevin Stitt, after having had three gubernatorial candidates who were antivaccine. Worse, a recent study has shown that 53% of vaccine-related legislation introduced between 2011 and 2017 proposed to increase the ease with which parents could receive exemptions to school vaccine mandates.

Perhaps the most important message that Sen. Pan emphasized during his talk is that it can’t just be doctors, scientists, and politicians advocating for vaccines. The antivaccine movement has powerful stories by parents. From my perspective, they are stories in which parents misinterpret the role of vaccines in causing their children’s illnesses, neurodevelopmental disorders, and other conditions, but they are undeniably powerful. Given that humans are storytelling and pattern-forming apes, parents telling them that their children received vaccines and then became autistic are far more influential than all the scientists and doctors citing studies and data in the world. So, Sen. Pan pointed out how advocates of SB 277 formed a parents group, Vaccinate California, to advocate for SB 277 and how firmly convinced he is that SB 277 would never have passed without parental advocacy. The problem, of course, is that parents who vaccinate, like most pro-science advocates, tend to take the science for granted. They support vaccines, but vaccination is just one important issue among several. In contrast, to antivaxers vaccines and vaccine mandates are their single issue, the thing they care about more than anything else. A minority group with intensity can win out over a majority group without it.

Which brings us to the conference. The problem was outlined in light of recent bad news about measles:

The number of reported measles cases around the world increased by more than 30 percent from 2016 to 2017. A new report by the World Health Organization and the CDC attributes that to a gap in vaccine coverage.

Measles outbreaks increased in all but one of the WHO regions — the Western Pacific, which actually reported a decrease in cases. That region is also the only one to have maintained 95 percent coverage of the vaccine’s first dose, while global coverage has stalled around 85 percent.

The WHO’s deputy director general for programmes expressed concern about the vaccine gap. She said in a statement, “Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under-, or un-immunized children, we risk losing decades of progress in protecting children and communities against this devastating, but entirely preventable disease.”

And:

But medical experts say those global successes have depended on the vaccine. Regions that do not have a high rate of vaccine coverage, whether due to a lack of access or conscious rejection by parents, are susceptible to a rise in measles — even relapses in areas where the disease had been nearly or entirely eliminated.

In the U.S., for instance, 220 measles cases have been reported so far this year as of Nov. 3, according to the CDC. There were 86 cases in all of 2016.

And the European Union has seen a measles outbreak that epidemiologists have tied to falling rates of vaccination, due to occasionally erratic vaccine supplies and anti-vaccine movements. In the first half of this year, the WHO says more than 41,000 children and adults in Europe were infected with measles — in other words, nearly double the cases recorded all of last year, which, in its own right, was the highest annual total in years.

What interested me was how, right off the bat, there was a bit of a disagreement. No, that’s not exactly right. What we had was a difference in perspective between the European experience, as discussed by Robb Butler, and the US experience, as discussed by Sen. Pan, Dr. Hotez, and me (and, to a lesser extent, Dr. Dubé). In the US, we tend to have high vaccine uptake overall, with pockets of low uptake that can be attributed primarily to areas with large numbers of vaccine-hesitant parents whose fear is fueled by the antivaccine movement. In contrast, Butler argued rather vigorously that the main problem in Europe isn’t the antivaccine movement, but rather issues in supply and parental complacency. To be honest, I wondered at the time if Butler’s perspective was colored by his role with WHO, which tends to be all about access to public health interventions and less concerned about politics and ideology, but I had to take him seriously.

Sen. Pan pointed out that antivaxers in the US are increasingly organized, social media savvy, and well-funded. As examples, he noted how antivaxers raised at least a half a million dollars to oppose SB 277 and then later Robert F. Kennedy, Jr. backed a left wing candidate who was also antivaccine, joking that in their attempt to unseat him antivaxers had a lot of money but were not particularly savvy in how they used it. As part of this discussion, I chimed in about how antivax is the pseudoscience that is embraced by all political persuasions: On the right, it’s fed by distrust of government and science while on the left it tends to be fed more by distrust of big business (e.g., the pharmaceutical industry) and the belief in more “natural” treatments. Even as I pointed to how now, in 2018, the most influential and powerful voices in the antivaccine movement come from the right, we noted that this predates Donald Trump’s rise to become President. Sen. Pan, in fact, explicitly pointed this out by expressing disbelief at something I had written extensively about, namely how two physicians, Ben Carson and Rand Paul, running for the Republican nomination in 2016, both refused to endorse the safety and efficacy of vaccines, leading me to point out that Rand Paul is antivaccine and believes against medical and scientific evidence that vaccines cause autism and other conditions. To Sen. Pan this indicates that the politics of vaccine mandates has shifted, and I tend to agree. Examples outside of the US include various populist movements in Europe, such as the Five Star Movement in Italy, which also promotes “vaccine freedom”.

As you might imagine, when it came to what to do about the tsunami of antivaccine misinformation that pediatricians and science advocates are dealing with, answers were less satisfactory. As Dr. Dubé and several others noted, it is not due to information deficits that people become antivaccine, and information alone will not change people’s minds. Dr. Hotez expressed dissatisfaction with what he views at the wimpy response of the CDC in promoting vaccines, but Sen. Pan pointed out that government agencies are limited in what they can do and are always looking over their shoulders to see what the legislators who keep them funded want. As an example, he referenced (although not by name) the Dickey Amendment, the 1996 amendment to a Congressional appropriations bill that stipulated “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention [CDC] may be used to advocate or promote gun control.” As we’ve noted here before, this was clearly intended to intimidate the CDC by directly threatening its funding, and the tactic worked. The CDC got the message, and, in effect, nearly all research into gun violence at the CDC stopped. To be honest, I’m not sure that the same would be true for vaccines; even in Congress as it is now I don’t think there are enough powerful antivaxers there who might do the same in response to the CDC becoming too vocal about promoting vaccines. Even most conservatives would likely agree that vaccines are a legitimate public health tool and that the CDC would be well within its purview to promote vaccination, but I saw Dr. Pan’s point.

In the end, we were all a bit pessimistic. Dr. Pan said that he knew we would win, but it was only a question of how many would have to suffer and die first. His point was, depressingly, that antivaccine sentiment will lose favor as vaccine-preventable diseases are resurgent and start harming and killing people. I wished that I could disagree, but I couldn’t. On a more hopeful note, we realized that the best way to promote vaccination would likely involve something along the lines of Vaccinate California, grassroots organizations led by parents who have compelling stories plus science to use to counter antivaxers’ compelling stories plus pseudoscience. Unfortunately, we had to concede that the obstacles to such an approach are huge, given the differential in resources between antivaccine and pro-vaccine groups and PACs. Still, even when you know that the solution is difficult and you’re outgunned, getting together with a couple of your heroes plus a sympathetic audience can help to recharge your batteries and rev you up to rejoin the fray. It also can’t be understated how important it is to make scientists realize just how pervasive antivaccine views are and how dangerous they can be.

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]

106 replies on “In which Orac uncloaks and gets to meet his heroes Drs. Richard Pan and Peter Hotez”

Orac writes,

…getting together with a couple of your heroes plus a sympathetic audience can help to recharge your batteries and rev you up to rejoin the fray.

MJD says,

In my opinion, you’ve been the Energizer Bunny™ trying to make the word “antivaccine” legitimate. Occasionally, you’ve used the term “vaccine hesitant”, much to my delight. Furthermore, anti-vaccine is a violent word intended to ridicule and alienate many who are simply vaccine hesitant. In the spirit of respectful insolence, please bring civility to the vaccine debate and replace “antivaccine” with “vaccine hesitant”.

Thank you Michael. I agree. I work in the field of Chinese Medicine (Acupuncture and Herbs) and as a Clinical Intern at the Disney Cancer Center Department of Integrative Medicine. Out of care and concern for my patients, I am fully vaccinated. But I am vaccine hesitant because I was injured by a vaccine that I was forced to take as a part of IVF treatments (CA requirement). I did not titre for Chickenpox and was forced to be vaccinated – Varicella. At the age of 36, within days of the vaccine, I broke-out in shingles. I don’t know how the elderly handle it – it’s excruciating. (BTW – I have successfully treated patients for pain from shingles – call it quackery but my patients were relieved and their PCP had no solutions that worked.) So, of course, I am now vaccine hesitant! This is not a battle between good science and bad science. It is a battle between ideas of best practices. More importantly, there is the science side of the debate and then there is the political side. First and foremost – if the government can govern and legislate what I do with my body, that means they can govern and legislate my sexual practices and my birth plans. From a political perspective, this cannot happen. From the perspective of science – yes – for herd immunity but if the government is to be enlisted to support vaccination it should not be to force people to do things with their private and sacred bodies. The political concern (body politic) should be for education and for demanding better and safer products at fair prices that everyone can afford.

Better and safer products like the body parts of endangered animals? How often do you prescribe pangolin?

You were not “forced” to do anything. You simply had to comply with best practices if you wanted the treatment.

My daughter got a horrible case of German measles following a vaccination that was firmly recommended (not forced) after her first child was born. It is very rare, but it can happen. She was miserable, but we never blamed the doctors, or the vaccine itself. She has no lasting damage and she and her family contine to be fully vaccinated with no histitancy whatsoever.

My husband recently had shingles. He was treated at the Veteran’s Hospital very effectively–without any pseudoscience hocus-pocus. He was, at that time, scheduled for the two-step vaccine which he has now–with NO hesitancy–completed.

My anecdotes are way better than yours.

Never pangolin. Or any animal products actually. I am a vegan and an advocate of conservation. But what you are implying is the equivalent of saying that Psychiatrists treat with lobotomy. Old and irrelevant practices do not define the efficacy of a medicine. Yes – people in China are the driving factor on poaching – and it’s horrifying. Again – not relevant to practitioners here.

The VA is hiring thousands of Acupuncturists to combat the opioid crisis and because their own studies have shown the efficacy of treatment – though science is still trying to figure out all of the mechanisms at play. But it’s exciting times for us! We’re making new discoveries about the body and health. All good things.

Why would sticking needles to somebody cure anything ? Cosmic energy currents would not be an answer. Indeed Orac did analyse that VA paper.
Selling parts of endangered animals for cure would be comic, expect that they indeed are endangered.

Sadly, using body parts of endangered species isn’t a practice limited to TCM. An example is a german? producer of homeopathic remedies DHU. They happily sell dilutions of Apis mellifica, which is the bee. Bees are endangered and incredibly important!

@ Cheesymaus
But one bee goes a long way in homeopathy. Which of course doesn’t make it right to use any bee for it.

Do you think it’s just coincidental that vaccines have prevented and even eliminated some epidemic-causing diseases, but traditional Chinese medicine hasn’t?
Where are the acupuncture points for preventing yellow fever, typhus, smallpox, plague, measles, varicella, and the rest?
Can you show me the points and meridians that cure HIV infection? Send a link so I can see it for myself.
Only one kind of needle has ever reduced or ended epidemic or endemic diseases, and it sure ain’t the kind you’re using.

The VA is hiring thousands of Acupuncturists to combat the opioid crisis and because their own studies have shown the efficacy [sic] of treatment

Well, that’s government work product, so where the fuck are they?

though science is still trying to figure out all of the mechanisms at play.

See above.

If use of endangered animal body parts wasn’t relevant to TCM in the US, then why is Customs constantly impounding smuggled shipments? It is still used in China and in the US, and it is part of the practice. It’s nice that you don’t use it, but you are a single drop in the bucket of bear bile.

And isn’t is great to heart that the VA has money to waste on acupuncture instead of actual pain treatments, but they don’t have money to spend on programs to reduce risk of HepC. And how is the VA measuring “efficacy” of acupuncture? By how many people come back? Because if you tried to treat my major limb injury with toothpicks (shown in double-blind studies to be just as effective as acupuncture needles) then maybe I would just quit coming, or quit complaining of pain since it’s obvious you’re not actually going to treat it.

I’m sure you think you’re helping, but you aren’t. You’re hurting people and destroying the environment.

JustaTech DECEMBER 11, 2018 AT 4:02 PM
“If use of endangered animal body parts wasn’t relevant to TCM in the US, then why is Customs constantly impounding smuggled shipments?”

Because there are foolish wrong minded people the whole world over. I can tell you with absolute certainty that the use of pangolin, bear bile, rhino horn and the like are not a part of my practice and the practice of any practitioner I have ever met. Again – there are still Psychiatrists that practice lobotomy…

It is still used in China and in the US, and it is part of the practice. It’s nice that you don’t use it, but you are a single drop in the bucket of bear bile.

Not true. This is not a part of the practice as it is taught today. We do not use these products. I challenge you to go into a practitioner and request these “products.” I guarantee you that 9.8 times out of 10 the practitioner will tell you to take a hike

And isn’t is great to heart that the VA has money to waste on acupuncture instead of actual pain treatments, but they don’t have money to spend on programs to reduce risk of HepC. And how is the VA measuring “efficacy” of acupuncture? The studies were done long ago and that is why there are “Battlefield Acupuncture” protocols. And, yes, that is under attack too…

By how many people come back? Because if you tried to treat my major limb injury with toothpicks (shown in double-blind studies to be just as effective as acupuncture needles) then maybe I would just quit coming, or quit complaining of pain since it’s obvious you’re not actually going to treat it.

I’m sorry for you injuries. I hope you get relief.

I’m sure you think you’re helping, but you aren’t. You’re hurting people and destroying the environment.

I work to save the environment from my eating habits – no meat, to my recycling and consumption habits – zero sum plastic 5 of 7 days per week… I clean trash on the beach. I bought all of the children in my life stuffed animals from WWF for Christmas so that every dollar I spend is for animal conservation. But it sounds like you are quite environmentally conscious too? What do you do ??

What do I do? What do I do? Well I don’t lie to people that I’m treating their pain, for starters. Would you volunteer to have your arm broken and your pain only treated with acupuncture? Of course not, and no doctor would help you because that’s obviously nuts. I don’t have any pain (I was speaking in the hypothetical) but I did see a program I developed to address HepC in the VA be denied because of funding, so you can see why throwing away money on acupuncture might grind my gears.

And if the use of endangered animal parts wasn’t part of TCM, then why did the Chinese government lift the ban on the sale of those items? Hmm? Even if you never use them and turn away people who ask for endangered animal bits, by continuing to practice the other parts of TCM you are legitimizing the rhino-horn people.

If you want to have a who’s more environmentally concious dance-off you’ll win. I recycle and I compost and I re-use and I pack a lunch, bla bla bla. But I also generate huge amounts of plastic trash that go straight to the incinerator. Because I’m treating cancer, right here, right now, with real science and solid data.

Would you volunteer to have your arm broken and your pain only treated with acupuncture?

Heh. I went to the university hand clinic today. Reading of the X-rays led to a diagnosis of carpomatacarpal arththritis in my my right thumb (yes, repeated use of a can opener in a cat shelter can aggravate a preexisting condition).

Now, this is only relevant because I reported pain in the joint to my PCP. Should I have seen an acupuncturist instead to treat the pain? Can TCM diagnose the separation in the joint using pulse measurements and examination of my tongue?

I’m going with the splints and exercises, Intern Ali.

“anti-vaccine is a violent word intended to ridicule”

wishing harm and possible death on innocent children (by denying them proper medical vaccination) IS violent and people who are this ignorant SHOULD be ridiculed.

Dr. Hotez supports using the term “antivaccine” in lieu of “antivax”, which he thinks is more likely to raise hackles among those who are, well, antivaccine.

To sound a bit Orac-ian, that’s a distinction without a difference.

Those who are virulently opposed to immunization and continually recycle false and distorted information about vaccines in the face of good evidence are anti-immunization/ant-vaccine/antivax, and their angst about being described as such is due to their belief that being labeled “anti” costs them support among some in the general public who look askance at “antis” as being negative sorts of people.

If you’re antivaccine, anti-abortion, anti-Trump, anti-anything, wear your anti-ness with pride. Don’t try to hide behind weasel-words.

But there’s a difference between “vaccine hesitant” people (such as parents who aren’t sure about vaccines and have heard stories about autism, but who can be reasoned with by pediatricians) and “anti-vaccine” people who are on a hellbent crusade to ensure that no one is stuck with needles (unless they’re receiving IV Vitamin C or curcumin).

or curcumin

L-rd, I was subjected to an episode of Shark Tank last night in which a couple successfully pitched “Mother Beverage,” which is a variety of zany apple cider vinegar concoctions, one of which involves turmeric as a flavoring, because curcumin.

Turmeric tastes freakin’ awful. A reasonable amount in a curry recipe used to be 1/4 teaspoon, now you find people calling for ten times that. Adding it to vinegar…I can’t…

The sesquiterpenes of Turmeric are well researched for their potency and efficacy. Here’s a good place to start to understand the components. I recommend you pick one of the volatile compounds from this study and then do a cross reference for the biochemical used in pharma. It’s really cool how nature makes things that are healthful. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525583/

What part of that study has to do with biochemical effects on humans? It looks like just a bunch of chemistry experiments.

The sesquiterpenes of Turmeric are well researched for their potency and efficacy.

Uh-huh. What is well researched is that whatever effect it may may, it can’t be achieved through oral ingestion of turmeric.

As Chris said this is just chemistry. Return when you have something tested for safety and efficiency

An acupuncturist named Ali
Took a stroll down anti-vax alley,
..When out of the shadows and darkness,
..crept a grim and familiar likeness.
That’s nobody’s friend! it’s Hindawi!

I’m not by any means an expert in vaccines

Oh, c’mon. You can internalize, say, this, right? I don’t think it’s necessary to be able to author it.

I have a friend in Germany who has a now 15-month-old who is fully-vaccinated (I asked on my visit there last summer), BUT three weeks ago he contracted chicken pox from his great-grandmother who had shingles (she thought it was just a rash on her neck from her necklace) and snuggled with the baby of course. He was eligible for the varicella vaccine at 11 months, although the policy is stated for the first dose as “between 11 and 14 months”.

I am pretty certain that this is an unfortunate coincidence and that the mother had only not yet scheduled the shot, but I wil try to find out if she was aware of it–if she was notified and such. The child was very ill according to the mother, but she doesn’t seem overly alarmed and has not mentioned the vaccine at all. I haven’t been able to clarify whether or not she is aware of the vaccine. I do know that she only allows “bio” (organic) food to pass his lips, but other than that, she is a very sensible person and promptly returned a homeopathic teething remedy–although she wouldn’t have known had I not expressly pointed it out to her. I recently gifted her Edzard Ernst’s book in German and she was delighted.

In general, I found Germans to be incrediby credulous about all things “natural” and “alternative”. “Bio” is big and widespread beyond WF-type of stores. I would expect vaccine “hesitancy” to be common. Hesitancy implies that one simply pauses to consider and then proceeds. I wonder if most “hesitaters” proceed?

Friend of a friend used to be a bureaucrat in one of the German regulatory agencies that policies the food supply. Even she was dismayed that Germans seem to be targets for anything marketed as pure and natural. She also said that sooner or later there will need to be some kind of government initiative to wean them off their faith in homeopathy, which is widely used. She faced some strong opposition in trying to get better controls on supplements. They’ve finally managed to stop funding for homeopathy through the NHS in the UK, where I think only one NHS-funded facility can still prescribe and thus pay for it, but it was a long fight.

Yes, I’ve been following all that at Edzard Ernst’s blog. What you report about Germans is why I sent my friend Ernst’s book–in-German, her English is so-so–to elaborate on homeopathy because even though she was upset about buying it and returned it, I fear she’ll be told otherwise by the faithful. I’m trying to “inoculate” her!

The good news is that the child – if it is healthy – will most likely live and thrive. There are over 3.5 million cases of varicella each year and 100 deaths. But what is even more interesting is that: “Studies indicate that overall rates of herpes zoster appear to be increasing, however, introduction of the varicella vaccine does not seem to be affecting this increase.”

https://www.cdc.gov/chickenpox/surveillance/monitoring-varicella.html

On the up side – that child is going to have better immunity for the disease than anyone who received the vaccine. That’s a fact.

No Ali, the child had to suffer through chicken pox rather than get a vaccine which, in all likelihood would not have done anything except provide immunity to chicken pox. Why do you people celebrate disease? Watching my infant gasp from pertussis and then crap and puke his insides out from rotavirus didn’t quite seem like a party atmosphere to me.

1) People can get chicken pox more than once.
2) Catching a disease to gain immunity to it is like burning something to fireproof it. You yourself admit that people can die from chicken pox.

“There are over 3.5 million cases of varicella each year and 100 deaths.”

Why do you think that amount of suffering with dozens of itchy open wounds (pox) and a hundred deaths is acceptable? Have you ever taken care of six month baby with chicken pox? It is not pretty, plus the child has a higher chance of shingles in their twenties… especially since they are now a grad student.

Only an evil sadistic child hater would wish chicken pox on a kid.

There is no immunity from chicken pox. You can get it again because it never goes away. Once you get the virus sleeps in your nerves only to pop up later as shingles. In younger persons when they are under stress, like what happens in grad school.

And as far as any increasing numbers of those with shingles… do you understand basic math? First of all, the vaccine has only been around for less than twenty five years. Shingles affects those who are older than sixty. So why is the generation born between 1945 and 1963 called Baby Boomers? The peak of that generation was between 1956 and 1958. This is a yes or no question: Would the age of that generation have anything to do with an increase of conditions related to that age?

Circle one: “Yes” or “No”

Okay. Stop the trolling. We’re all people. I work in public health and I work for the public good. I do not celebrate disease. I have devoted my life to making people healthy. Relax. I am not a child hater for quoting stats from the CDC. I have done nothing to you so do not be angry and violent with your words, please. Let’s be civilized.

I am a vaccinated person in support of vaccination for herd immunity.

I am in NO way in denial that a child can die of the Varicella virus and I have not stated otherwise. So… again… relax.

Chris – shingles does not effect “only people over 60.” And, whether or not a person wishes a child to get chicken pox has nothing to do with the reality that children are susceptible to viruses. I am not your enemy. I love children and people. Again. Relax.

The discussion I had hoped to have with rational thinking people will clearly not happen in this forum. I will find a place with more thoughtful people who are enthusiastic about discovering best practices that do not mean the government will legislate our bodies. We can have a compliant public without a police state. That is what I am working toward.

Also – if I have personally attacked any of you or made assumptions about your person – I apologize. But, I’m quite certain that if you re-read my posts, there is nothing personal there. I do not troll. I support information and discussion rather than personal attack, ad-hominem, and assumptions.

May you all feel safe.
May you all feel peace.
May you all be healthy.
And if you suffer, may your suffering be a doorway.

In the name of science and all that is good. Namaste.

Having your bad ideas called out is not “trolling”. In fact, you are now tone trolling.
For someone who claims she is in favour of vaccination for herd immunity, you are certainly reciting a lot of antivaccine arguments.

I was injured by a vaccine…

Your anecdote is, to put it mildly, unconvincing.

This is not a battle between good science and bad science. It is a battle between ideas of best practices.

You are mistaken. Most of the antivaxx claims made are bad science. Correlation causation; downplaying the harms of diseases; exaggerating the risks of vaccination; naturalistic fallacy.

…if the government is to be enlisted to support vaccination it should not be to force people to do things with their private and sacred bodies.

The government can force you to be quarantined to prevent the spread of diseases. I am surprised that someone who works for the VA (or so you claim) doesn’t know this.

…demanding better and safer products at fair prices…

Vaccines are exceptionally safe. What to you is an acceptable rate af severe adverse events per 1,000,000 doses of vaccines administered?

…that child is going to have better immunity for the disease than anyone who received the vaccine. That’s a fact.

It is? Some people get these diseases twice. Some people are unable to seroconvert no matter what. In addition, measles can obliterate immune memory. If you suffered an infection and then developed measles, you would once again be susceptible.
TL:DR you are reciting claims that we have seen and refuted multiple times already.
When it comes to vaccination, it is a simple question of a risk reward ratio. The risks of catching the disease and developing negative sequlae are far greater that that of severe adverse evennts from vaccination. The calculation overwhelmingly favours the vaccines.

“May your suffering be a doorway”.

This is the most offensive comment I have read on this site.

A doorway to what? Pain? Misery? Death?

Ali Young writes,

We can have a compliant public without a police state.

MJD says,

In parallel, we can have respectful insolence at this blog in the absence of not-so respectful insolence. With exception, when one of Orac’s minions are commenting. 🙂

In parallel, we can have respectful insolence at this blog in the absence of not-so respectful insolence.

You just cannot or simply refuse to get this through your fucking head: I am not Orac. RI is the title of the blog. You deserve as much respect as you give to the commentariat, which is exactly fucking zero, and you’re going to continue to be reminded of it, wither on the vine, or both.

Ali: ‘Chris – shingles does not effect “only people over 60.”’

Where did I use the word “only”? I also mentioned it affects younger persons, especially if they had chickenpox as babies.

Deliberately misquoting is a classic form of trolling.

When I read Chris’s earlier comment, I mentally inserted “mainly” where Ali used “only”.

There is no magic age when it starts, but 60 was the age picked for recommending or reimbursing the shingles shot.

I have an elderly friend who will probably spend the rest of her life with shingles. I’m glad I got my shot.

“The good news is that the child – if it is healthy – will most likely live and thrive.” Until it reaches middle age and comes down with the shingles.

You’re a truly rotten person if you think a baby catching chicken pox is in any way “good news.”

“anti-vaccine is a violent word intended to ridicule”
Personally, I prefer “pro disease.” It’s a more fitting description.

Something we should all keep in mind:
most people support vaccination for school attendance ( see Pew Research, 2/2/2017)

82% believe that healthy children should be required to be vaccinated for school
88% believe that benefits outweigh risks
Most rate benefits high and risks low ( slightly lesser effect for parents of kids age 0-4)

17% believe that parents should be able to decide whether to vaccinate or not
10% believe risks outweigh benefits
11% risk of side effects are high

Even the largest number, 17%, reflects beliefs about parental rights, not safety, risk/ benefit
Anti-vaxxers make it sound as if those numbers are quite different.

SRSLY: we can find many outlandish beliefs that can garner more support than 10 or 11%.

from seattlepi.com April 2013

11% the government had a hand in 9/11
13% Mr Obama is the Anti-Christ
14% Bigfoot exists
14% the government created the crack epidemic
15% Pharma creates diseases
15% television is an organ of governmental mind control

I have a long-time friend who is now an engineer (specializes in optics) and who is generally skeptical about things but who still believes in Bigfoot, just sort of for the heck of it. 🙂

Re: Bigfoot–I kind of feel the same way about fairies, not so much because I believe in them deep down but because they’re a good sanity test. For example, fairies are stealing children right after they are vaccinated and replacing them with changelings. It’s not vaccines, it’s fairies sniffing out denatured measles.

It’s especially relevant because it appears that most alleged changelings were developmentally disabled.

Well, television is an organ of mind control, I’m just not sure I’d blame the government. (Is it a bi-partisan conspiracy I woodier?).

Denice, I’m sure you see the problem lurking behind those numbers.

If 17% believe parents should decide, then let’s be conservative and say 50% of those would not get their kids vaccinated: that’s 8.5%. If 10% believe risks outweigh benefits, that’s a roughly convergent number, etc.

But for certain diseases, herd immunity depends on population vaccine uptake of 95% or above, so 8 to 10% refuseniks means uptake level 90 – 92%, which misses the mark and leaves the population at risk of an outbreak that can spread.

We need to get about half or more of those “vax-hesitant” people to change their opinions and get onboard with us. The most likely solution is via influencers in their in-person social networks, and the next-best solution is celebrity “influencers” in their online social networks.

Frankly it it was up to me I’d just pass mandatory vaccination laws for kids in any school environment, and for adult. driver’s license renewal. I’d also ban Oscilloquackinum and suchlike from sale in pharmacies, and ban hate speech, and (etc.). Liberty is not license; in particular it’s not license to threaten, harm, and kill others.

Of course. In addition, they flock together and there will be pockets where it’s much worse. NY probably has good coverage for school children but every now and then, there will be an outbreak in specific communities with Ultra Orthodox schools. The same with California and its hippie/ hipster enclaves.

My reason for quoting those numbers is that the anti-vax faithful want their followers and potential initiates to believe that they are approaching a majority and that eventually will win. They unrealistically thought that they could get rid of Dr Pan who won his race handily.

Alt med folk believe that they are a rising tide: anti-vax, veganism and quackademia are their surfboards.

and for adult. driver’s license renewal

Wouldn’t pass rational-basis muster under the 14th Amendment. The only reason suspending licenses for failure to pay child support works is the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.

I’d also ban . . . hate speech

So, basically, you’re willing to toss the First Amendment overboard so that some people would rather get their knickers in a twist than accept that the answer to objectionable speech is more speech? Fantastic.

Well, despite seeing chainsaw sculptures of him at the Legend of Bigfoot in Garberville, CA, I don’t think that he’s real unless if you count hallucinations and cannabis dreams. It IS Humboldt County.

As a long time reader of fantasy and science fiction, I so want to believe in some of that stuff (telekinesis!). I really enjoyed the series “Sanctuary” in which things like Bigfoot was real.

It’s not telekinesis, but I did have a “weird coincidence” moment recently (I’ve been having quite a few of them.) I found out that there’s a Zen temple not far at all from me (out here in the woods on Mt. Adams, of all places!) and I was in my therapist’s office telling her about it, and that I had called the temple to see about catching a ride with someone but that they hadn’t called me back yet, and right at that moment they called me on my cell.

I also emailed a friend recently (a former Russian student with whom I’ve kept in touch), and when he replied, he said that it was slightly weird that I had just emailed him, because (after a long period with no emails between us) he had been meaning to email me for a week to talk about The Death of Stalin (which I haven’t seen yet.)

There was another one involving Bill Clinton playing the saxophone on Arsenio Hall, but you get the drift. 😉

“Death of Stalin” is dark and hilarious. Though the plot resolution relies heavily on ** SPOILER ALERT ** Marshal Zhukov as a deus-ex-machina.
Not ideal as political commentary.

I’ve been to Garberville. I cannot BELIEVE I missed seeing that artwork. My visit was a long time ago in a Cessna that made a very precipitous 3000 foot drop to get to the airfield. I may have been a bit too nauseous to appreciate the thing if it was there.

If you google ‘legend of bigfoot” you’ll encounter a Roadside America and Trip Advisor entries: it’s a gift shop on101 and has ( ridiculous) Bigfoot and other wood carvings
I didn’t go inside, it was quite enough to contemplate the art from the car. Some sculptures were large.

Coincidence? Synchronicity? OR …

I was once instructing naïve concepts of energy from earlier cultures/ classical psychology, and said something like… Freud and Jung didn’t mean literally that it was like electrical power-
AS the lights went out in a power failure. REALLY.

There’s an odd movie about magicians wherein Mr Tesla ( David Bowie!) teleports/ clones objects with his machine INCLUDING
top hats and black cats resulting in a pile of hats and cats

About “Death of Stalin”, someone I know watched it on a plane last summer to mixed reviews. I watched ” Call Me by Your Name” , better reviews.

My best coincidence happened some years ago. I was driving someone and went to put on a rock station. My passenger didn’t like rock; she said that rock was all ‘Boom. boom, boom.” The station came up in the middle of John Mellencamp’s “R.O.C.K. in the USA”, specifically at the point was as the “lyrics” go “Crack! Boom! Bam!” I turned off the radio.
However you think these things happen, just remember that in a large enough universe everything that can possibly happen will happen.

His point was, depressingly, that antivaccine sentiment will lose favor as vaccine-preventable diseases are resurgent and start harming and killing people.

In the minds of the antivax conpiracists, this is already turning into “Dr Pan confessed to planning a false-flag engineered epidemic!!!”

Richard Pan thinks the most dangerous ingredient in vaccines is water because it causes drowning.
If this Richard Pan is Orac’s hero, Orac has now qualified for the title of Orquac.

Dr. Pan was making the point that the dose makes the poison, and water in large doses can kill, too. In fact, we have a lot more water-related deaths than deaths from other ingredients. It may have come across awkwardly, but his point is correct.

doritmi writes,

It may have come across awkwardly, but his point is correct.

MJD says,

Dr. Pan made a mistake using the water-hazzard analogy as it relates to vaccines. When medical scientists adhere to the vaccine-safety argument that “the dose makes the poison”, the dose must be considered based on the vaccine’s composition parameters. Extending the debate outside said parameters, to make a point about a components potential hazard, may be considered misleading and manipulative. If Orac is a friend of Dr. Richard Pan, he should consider providing some respectful insolence to his hero; preferably uncloaked.

When medical scientists adhere to the vaccine-safety argument that “the dose makes the poison”, the dose must be considered based on the vaccine’s composition parameters. Extending the debate outside said parameters….

“Parameters”? “Said parameters”? Misusing words that you don’t understand does not have the effect that you apparently think it does.

Really it was illustrating how ridiculous the antivaxx arguments about ingredients are. There is nothing manipulative about it.

Julian Frost writes,

You’re just annoyed that we use it to describe you and that you ARE antivaccine.

MJD says,

A week ago a dear friend had an accident which required emergency surgery, the nurse said she needed a tetanus shot. My dear(est) friend is vaccine hesitant, and she looked at me for guidance. My response was absolutely get the vaccine. It was administered under the right circumstance, and this is proof that MJD is 100% vaccine hesitant.

@ Vinu,

You made me laugh with the word “Orquac.” It was a very clever, and sneaky, spelling in that we all know Orac is substantially free of “quack.”

@ Dangerous Bacon,

Orac is definitely “anti-quack”, although, he often uses the subjective weasel-word “anti-vaccine.”

Like a CD that skips back to the same sector, I’ll continue to state that the unwillingness of physicians to sanction anti-vax physicians (as in take their license and kick them out of practicing medicine for harming public health) is fueling a large part of the AV movement. This started with Bob Sears, but has spread in the last 10 year to the formation of the anti-vax group PICC (Physicians for Informed Consent–an extreme misnomer). However, the group “Association of American Physicians and Surgeons” (AAPS), led by self-proclaimed anti-vax leader Jane Orient MD, may have taken that dishonor of most anti-vax US physician group with their “official” publication of a regurge B.S. Hooker’s botched “re-analysis” of the Destephano et al’s 2004 MMR/autism paper. Hooker can’t analyze his way out of a paper bag, but AAPS could care less and has given him his undeserved podium. (http://www.jpands.org/vol23no4/hooker.pdf). We reap what we sow, and when the weeds are ignored this is what we get.

I’d like the anti-vax contingent to articulate exactly how many kids have to get sick and die of vaccine-preventable diseases before they consider it to be a “problem.”

Regions that do not have a high rate of vaccine coverage, whether due to a lack of access or conscious rejection by parents, are susceptible to a rise in measles — even relapses in areas where the disease had been nearly or entirely eliminated.

OT, sorta…
A webcomic author I’m reading isn’t font of antivaxers and recently inserted them into her stories:

http://www.agirlandherfed.com/1.1639.html

Well, not as villains, but as tools: unwitting accessories to the story’s archvillain.
Her objective? Mostly, obtain everlasting fame as a mass murderer.
Plan A – taint water supplies with radioactive elements. But that’s just ablative armor for:
Plan B – biowarfare. She is about to release in public areas a highly-contagious, airborne virus. Guess which one?

NARAD:

This analysis suggested that curcuminoids regulated turmeric oleoresin ingestion-induced expression of glycolysis-related genes and also that curcuminoids and turmeric essential oil acted synergistically to regulate the peroxisomal β-oxidation-related gene expression induced by turmeric oleoresin ingestion. These changes in gene expression were considered to be the mechanism by which the turmeric oleoresin affected the control of both blood glucose levels and abdominal adipose tissue masses. All of these results suggest that the use of whole turmeric oleoresin is more effective than the use of either curcuminoids or the essential oil alone.

Here is the source: https://pubs.acs.org/doi/abs/10.1021/jf061788t

It says ingestion-induced. So… Let’s have your research please.

NARAD

It’s not an acronym. In fact, it’s an allusion to my own fallibility.

It says ingestion-induced. So… Let’s have your research please.

Not so fast, Intern. Explain to everyone how KK-Ay mice are a useful proxy for your assertions.

^I should note that I don’t have access to the full paper until I get to the library (which is a hellhole, as it’s the end of finals week). Then again, I sorely doubt that the intern bothered to try in the first place.

Check out the diet they threw at the mice, “to exaggerate the status of diabetes.” Uh-huh. Perhaps they meant “exaggerate the significance of the results.”

The microarray analysis, although tediously long even for a short paper, seems like little more than an excuse to restate what they’ve already concluded.

All right, I’m just skimming, but already there’s this:

the essential oil also inhibits the production of prostaglandin E2 and NO

Personally, I could use more nitric oxide.

Chr!st in a side car. Didn’t you already flounce? I hope you aren’t the product of an actual medical education, Intern Ali.

“May your suffering be a doorway…”

I’m so sorry you feel threatened by things you don’t know about. This is a buddhist saying for peace – a part of the Metta Meditation for compassion.

You’re going to be okay.

And… to be clear… I am NOT an Anti-Vaxxer. I am fully vaccinated. For the record, I simply think it is fair to discuss the issues at the core of why people are Vaccine Hesitant – as a part of a workable and respectful public discourse. Binary thinking is gonna be the death of civility.

This is a buddhist saying for peace

Dear fucking G-d, you don’t know shit about Buddhism, either. “Namaste,” my ass. Go read the damn Heart Sutra or something. I have to go do and actually do some Bodhisattva work now.

“I am NOT an Anti-Vaxxer.”

If you believe catching the chicken pox is better than getting vaccinated, you certainly are.

Oh, dear L-rd, the Metta at hand is of vague Theravadan descent. Both are an embarrassment to Buddhism, IMNSHO, unless one is ultimately motivated by selfishness, the sine qua non of Theravada.

That’s just what us Mahayanists say, Uncle Smut, to feel better about ourselves or something. I’m afraid friend Narad may have taken it seriously.

Metta isn’t my favorite thing, but mostly because I’m not big on guided-type meditation. I do shikantaza and that’s it. I did do metta at the temple up the road. I dunno, it was short at least, and it was just a little thing at the end. (The place seems a little bit Disney/Bambi to me, but it’s primarily Vietnamese-inflected, and I think maybe it’s just a more relaxed tradition than, say, the Japanese.)

The part about Theravada being selfish. The whole “Hinayana” thing is pretty retrograde. I mean, even the Lotus Sutra basically says “They’re really part of the Mahayana, but ssshhhh, don’t tell them.” (Or rather, all Dharmas are part of the Ekayana, the One Vehicle.)

Theravadan monks do all kinds of social things, from free meditation retreats to hunger relief and other work (see Buddhist Global Relief, for example.) Plus teaching, translation, etc.

Prison and post-prison outreach seems to be more of a Mahayana gig, though. I wonder if I could get some other folks together for psych ward and post psych ward outreach. (Considering that the period after release from a psych wards is the highest risk time for suicide. Even if the person wasn’t there because they were suicidal, as it turns out.)

So, Ali Young’s curcumin research references have included 1) a study of compounds produced in plants grown in a greenhouse, 2) a review by a couple of TCM supporters promoting the idea that curcumin is “warm and attributive to the liver and spleen meridians, while Curcumae Radix is cold and attributive to the liver,heart, and lung meridians…Curcumae Radix is particularly effective in activating qi for resolving stagnation(行气解郁), clearing heart and cooling blood (清心凉血), together with normalizing gallbladder to cure jaundice(利胆退黄)” (wow, I’m really convinced) and 3) a publication on effects in obese diabetic mice (the latter sounds like an excerpt from a famous announcer’s test*).

Maybe by the time Ali graduates from integrative intern to full-blown integrative practitioner he’ll have a handle on what constitutes relevant, convincing research. But I wouldn’t lay money on it.

Ali: “Binary thinking is going to be the death of civility.”

The kind of “binary thinking” that holds that there’s a desirable middle ground between evidence-based medicine and pseudoscientific quackery (including antivax beliefs) will be the death of real science.

*”Nine apathetic, sympathetic, diabetic old men on roller skates with a marked propensity towards procrastination and sloth, but who were entirely cured by curcumin**.”
**OK, I made up that last part.

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