Wednesday, February 25, 2015

Is the Government Taking Away People's Beliefs?

Measles has been in the news a lot, lately. And it's not surprising, with the unusual 644 cases in 2014 and 154 (as of Feb. 20)  and counting already in 2015. The outbreaks have not only grabbed the attention of the media, but politicians are starting to take notice, as well. Several state legislatures are either already considering or will be introducing bills aimed at improving tracking of vaccine uptake and improving immunization rates overall. Some of these bills require disclosure of immunization rates for each school. Others go much further and would remove philosophical exemptions from school immunization requirements. These latter bills would bring those states more in line with Mississippi and West Virginia, which only allow for medical exemptions for students' school shots (and also just happen to have some of the lowest rates of vaccine preventable diseases).

To say that those who, either in total or just the mandated school-entry immunizations, are opposed to vaccinations are unhappy would be an understatement. Moves to remove non-medical exemptions from school vaccination requirements are met with arguments about personal freedom, that this is no different than what the Nazis did to the Jews during the Holocaust, or that the government is taking away people's beliefs or rights.

So what's going on? Is the government taking away people's beliefs? Are they infringing on our rights as citizens? And what about the children who are affected by all of this?

Thursday, February 19, 2015

Genotypes, Serotypes and the MMR: Cognitive Dissonance in Action

Many of those who have bought into the anti-vaccine message seem to hold very tightly to their chosen belief. The more emotionally invested they are, the more likely they will go to great lengths to justify or rationalize their position. True, this is not unique to anti-vaccine activists or those closely associated with them, but it quite commonly dictates their reaction to evidence that challenges their beliefs. Evidence that contradicts their worldview, causing cognitive dissonance, leads to different mechanisms to cope with the psychological discomfort that results. The less entrenched individuals may look at the evidence, accept it as valid, and change their prior beliefs to fit with the new evidence. Some may simply ignore the evidence and pretend it doesn't even exist (e.g., "vaccine have never been studied for safety" despite numerous studies doing exactly that). But more commonly, they will invent rationalizations to explain away the contradicting.

The most recent example of this is the current outbreak of measles that started at Disneyland in California, and to a lesser extent last year's historic case count (644 cases) that hasn't been seen in the past 20 years and surpassed the number of measles cases from the previous five years combined. The Disney outbreak has resulted in 125 cases (through February 8) in just over one month (141 cases in two outbreaks as of February 13) resulting in 17 known hospitalizations. The majority (88%) of cases were either unvaccinated (45% of the total) or had unknown or undocumented vaccination status (43% of the total). The unvaccinated have been a significant contributor to the size of this outbreak and the speed with which it has spread. And the media has taken notice, with the majority of outlets putting the blame right where it belongs: on the anti-vaccine movement.

So how have anti-vaccine types responded?

Thursday, February 5, 2015

Demystifying Vaccine Ingredients - Aluminum

People, in general, tend to have a fairly poor grasp of chemistry. I don't blame them; there's an awful lot to learn and it can get pretty complex. To make matters worse, this lack of understanding is often coupled with what some would call "chemophobia" (not a very good name, as it's not a real phobia, nor does it generally rise to the level of debilitating pathology). In short, people tend to have an inherent, emotional distrust of "chemicals" and substances that have weird, hard to pronounce names or that tend to have negative associations. For example, who wants to ingest 7,8-Dimethyl-10-[(2S,3S,4R)-2,3,4,5-tetrahydroxypentyl]benzo[g]pteridine-2,4-dione? Maybe you'd prefer C17H20N4O6? But that chemical is in a lot of foods that we eat. Many processed foods, like cereals, pastas and cheeses contain it. Don't eat processed foods and eat nothing but an all-natural, organic, "healthy" diet? You still won't avoid that chemical, since it's also in a lot of leafy greens and legumes. Both of those are the same chemical, also known as riboflavin, or vitamin B2. What about potassium? It's a metal that, when exposed to water, reacts very violently, exploding almost immediately. If you are exposed to excessive amounts of potassium, you can develop muscle paralysis and heart palpitations. And yet, it is an essential part of our diet. Your body needs potassium in order to function properly.

When it comes to medical products, there is an even greater uncertainty around the ingredients. Not only do the problems above come into play, but add on distrust of faceless companies or unsavory associations, and the fear increases. I illustrated this in two of my previous posts, one on formaldehyde and one on monosodium glutamate. Some vaccines contain small amounts of these substances as a part of the manufacturing process. But there is a vaccine ingredient that gets even more bad press than either of those: aluminum (or aluminium, if you prefer). Let's take a look at this substance, how we're exposed, how our bodies deal with it, and its role in vaccines.

Thursday, January 29, 2015

It's Past Time to Pay the Piper

In the story The Pied Piper of Hamelin, the German town of Hamelin suffers from an infestation of rats. When things are looking bleak, along comes a piper dressed in bright colored clothes. He claims that he can rid the town of the rats. The mayor makes a deal, promising to pay a handsome sum of money if the piper should accomplish this feat. At once, the piper sets to the task, playing his magic flute. The rats begin streaming out of the houses and shops, following the piper to the nearby Weser River, where all of the rodents drown. Having held up his end of the deal, the piper goes to collect his due, but the mayor shirks his responsibility. He reneges on the deal and refuses to pay the piper the agreed upon sum. Angry, the piper leaves, vowing to have his revenge. He returns later and once more plays his magic flute. This time, all of the children of the village flood the streets to follow the piper out of the village, never to return.

The story inspired a lovely phrase, "pay the piper", to describe those situations where one must accept the unpleasant or undesired consequences of one's actions. It's a phrase that is particularly appropriate when talking about the anti-vaccine movement, their enablers and the current, and distressing, measles outbreak originating at Disneyland. For years and years, anti-vaccine activists and the handful of physicians who eschew their professional obligations in order to pander to them have downplayed the risks of vaccine-preventable diseases like measles, exaggerated the risks of the vaccines, and done their damnedest to bring down vaccination rates across the country. The natural consequence of this is that we are seeing the return of diseases that we eliminated from endemic circulation.

Wednesday, January 21, 2015

Grant Opportunity: Help Advance Vaccine Safety

Photo credit: James Gathany
Source: CDC/Judy Schmidt
I know I've had a bit of a dry spell lately, having written nothing since my posts in November on so-called "Right to Try" laws in the U.S. and the Medical Innovation Bill (aka the Saatchi Bill) in the U.K. Life outside of the blogosphere took up a bit of my time, getting me out of the habit of sitting down to write. So, my apologies to my readers.

To get back into the swing of things, I thought I'd start off with a brief post about a grant opportunity from the Department of Health and Human Services' National Vaccine Program Office (NVPO). NVPO plans to award two grants of up to $250,000 each to support research aimed at improving the safety of vaccines. Vaccine safety research is something I can get behind. In fact, some of you may recall that a few years ago, I put my life on the line to support vaccine research by racing through 5km of zombie-infested countryside. (The zombies got me, but I recovered!)

So what is this grant all about?

Monday, November 24, 2014

The Saatchi Bill, or, How England Could Become Quack Paradise

"Hi. I'm Lord Maurice Saatchi, and I'm trying to help quacks."
The other day, I wrote an open letter to members of the various state legislatures in the United States about so-called "right to try" laws. These laws purport to make it easier for terminally ill patients to seek out and obtain treatment with experimental drugs. The reality is that the laws leave patients in the lurch. State right to try laws simply create false hopes for patients and leave them to take on incredible risks while giving up some of their rights to legal redress. So far, five states have passed right to try laws without any serious critique by legislators. To some degree, I don't blame them. Who wants to deny a patient the right to try anything to prolong their life? Yet those legislators who pass these laws are being far more cruel than any who vote these laws down.

But if you think state right to try laws in the United States are bad, take a look at the United Kingdom's Medical Innovation Bill (HL Bill 48 [full text]), also known as the Saatchi Bill, after its sponsor, Lord Maurice Saatchi. As with right to try laws, the intent of the Saatchi Bill is well-meaning, but the end result is likely to be far more harmful for patients than imagined by the bill's supporters.

Tuesday, November 18, 2014

An Open Letter to State Congress Members on Right to Try Laws

Dear Members of Congress,

"Right to try" laws, that is, laws designed to purportedly make it easier for terminally ill patients to gain access to unapproved, experimental drugs, have been in the news quite a bit recently. Several state legislatures have overwhelmingly supported these types of bills, with little or no opposition, let alone serious, critical examination. Although advocates of these laws claim to have the rights and interests of terminal patients in mind, much of the legislation, and the long-term consequences, are likely to do more to benefit unscrupulous companies and hucksters while doing little to help, or even increasing the harm to, patients in great need, not to mention legitimate companies.

The driving premise behind right to try laws is that terminally ill patients have nothing to lose by trying unproven treatments, and that they ought to have the right to gain access to those treatments without undue burden. A dominant view among right to try proponents is that the Food and Drug Administration, and the various regulations they enforce, create inappropriate barriers to the timely release of potentially life-saving drugs. Advocates believe that earlier access will save lives, coupled with the belief that the government should not interfere with a patient's right to decide what treatments they wish to pursue.

While right to try laws seem, on their surface, to do nothing but benefit patients, they will very likely fail to do so, and perhaps even harm patients, for a number of reasons.

Wednesday, October 22, 2014

To Talk, Perchance to Understand

I  try to keep an open mind about things, try to keep the mindset that no matter how sure I might be about what I believe, there's always the possibility that I could be wrong. Maybe I misinterpreted something. Maybe I don't have enough evidence, yet, that I'm missing some key bit of data. Along with that, I try to be open to honest discussion, even if I don't necessarily agree with my interlocutor. In fact, that's something that people tend to remark about to me. I have the patience of a saint, they say, because I tend to stay engaged in dialogue well beyond the point that most people would just throw their hands in the air in frustration. It's really because I view those traits as ideals that I should live up to, if I want to be able to call myself a skeptic. Sometimes I'm more successful than at other times, but I try.

What got me thinking about this, about talking with others, and especially with those with whom you disagree, was a brief exchange I had on Twitter. While doing a quick perusal of blog mentions, I came across a comment made by an individual who claimed that Occam's razor says that vaccines cause autism, and any studies that say otherwise are flawed. I saw this as a great opportunity to engage this person in discussion about Occam's razor, what it is and how it applies to the vaccine-autism question. It struck me that perhaps this person did not really understand Occam's razor, viewing it more as a buzz word to prop up their argument than truly getting how it would apply. Here was an opportunity to talk about the issue, to try to share my thoughts with them and to learn why they thought Occam's razor supported their position.

My efforts weren't exactly fruitful.

Saturday, October 4, 2014

Brian Hooker's Paper on Increased risk of ASD in African American Boys Retracted

Just a very quick post to let my readers know a bit of recent news about that whole Hooker-MMR-CDC coverup nonsense. The journal that originally published Brian Hooker's paper originally issued a statement of concern about the conclusions and possible undeclared conflicts of interest. Yesterday, October 3, 2014, the journal fully retracted Hooker's paper. Here is their statement regarding the retraction:
The Editor and Publisher regretfully retract the article [1] as there were undeclared competing interests on the part of the author which compromised the peer review process. Furthermore, post-publication peer review raised concerns about the validity of the methods and statistical analysis, therefore the Editors no longer have confidence in the soundness of the findings. We apologise to all affected parties for the inconvenience caused.
I sent an email to the journal asking for more details. If I get a response, I will update this post accordingly.

Thursday, October 2, 2014

When Vaccine Injury Isn't Vaccine Injury

A couple weeks ago, I wrote about an incident in Syria in which it was reported that a large number of children had died after receiving the measles vaccine. As I noted, the anti-vaccine community went wild, pointing to this as an example of vaccines being dangerous. This, of course, was before many details were known. I speculated that the vaccine itself was not the cause of the injuries. It was an educated guess, based on the very, very good track record of the measles vaccine. After all, the risk of a serious reaction, like a severe but non-fatal allergic reaction, has a roughly 1 in 1 million chance of occurring. The chances of one child dying after MMR were slim. The chances of dozens in that short a time frame? Next to zero.

The most likely cause was some sort of contamination. One guess floating around at the time was that the vaccines were intentionally poisoned by Syria's Bashad al-Assad as a way to subvert the rebellion. Given the situation in that country, it was not that crazy of an idea. Some suggested bacterial infection with Staphylococcus aureus. Only lab tests would confirm the presence of the bacteria. Another guess was that the vaccines were expired. If that were the case, however, the vaccine would simply have been less effective, not more likely to cause an adverse reaction. And then there were preliminary reports that there was a mixup, with the muscle relaxant Atracurium being used instead of the sterile diluent.

Now we have an interim report from the World Health Organization.