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.

Tuesday, September 30, 2014

Massachusetts Nurses Association Sues for Right to Endanger Patients

Yesterday, I wrote about how comedian Rob Schneider not only does not know anything about vaccines, but does not seem to understand the Constitution very well, either. Schneider was recently dropped by State Farm Insurance because of his vocal opposition to vaccinations. Understandably, a company that, in part, focuses on public health would not want to be associated with someone who argues against measures aimed at improving public health. The "Makin' Copies" guy has no business going anywhere near health related issues.

As a celebrity, Rob Schneider uses his fame to spread misinformation about vaccines, frightening people away from one of the most successful health measures ever devised. His notions regarding immunizations put others at risk. Public figures, particularly those with some measure of fame, ought to be careful when they speak out on matters of science and medicine. They might think that they are well-informed, but not infrequently, their rhetoric is based on lies and misunderstanding. Though they may seek to help others, they only serve to increase risk. Schneider is but one of the latest actors speaking out on issues for which he has absolutely no qualifications. But he's not the only one who ought to leave well enough alone when it comes to people's health.

MNA - Working to increase patient risk
The Massachusetts Nurses Association (MNA) apparently shares some of Schneider's misguided ideas of personal liberty at the expense of patients.

Monday, September 29, 2014

Rob Schneider, Censorship and Free Speech...and Measles

What is it with the anti-whatever mindset and claims of censorship? It seems to be a feature of these types of people, that they claim their free speech rights are being infringed upon when other criticize what they say or call for them to face reasonable consequences for their actions. I've written about this before, in the case of Jenny McCarthy, when she was being considered to join The View. Jenny McCarthy, as regular readers will know, was, for a time, the celebrity face of the anti-vaccine movement. She held rallies, gave interviews and was all around a very vocal proponent of anti-vaccination tropes. When the news came out that she was going to be on The View, many in the health and science community were concerned that she was being given a platform on which to spew her nonsense, lending her a legitimacy that she had not earned or deserved. They made their opinions known to the producers of the show. The anti-vaccine community, predictably, went into a frenzy, accusing science advocates of infringing on McCarthy's free speech rights and trying to censor her.

The latest D-list celebrity face of anti-vaccinationism is comedian Rob Schneider. He has not been shy, at all, about voicing his opinions on how bad he thinks vaccines are, whether on Twitter or in radio interviews. His public pronouncements on vaccines recently came back to bite him in the butt. And, once again, the tired old false arguments about free speech were trotted out and dusted off.

Friday, September 19, 2014

Happy Talk Like a Pirate Day!

Arrr. Ahoy there, mateys! It be Talk Like a Pirate Day. Time t' hoist the jolie rouge. Avast, ye wee creepies, for ye'll have no quarter.



Thursday, September 18, 2014

Arsenic and Old Lace Does Not Vaccine Injury Make

Arsenic and Old Lace
In 1939, playwright Joseph Kesselring wrote a play titled Arsenic and Old Lace, which was made into a film released in 1944. The basic plot of the comedy surrounds a family whose members are insane killers, including two elderly aunts who give their elderly male guests elderberry wine laced with arsenic, strychnine and cyanide, then bury the bodies in the basement. It is a classic piece of theatre and film, whose events may have been inspired by the sort of real life events discussed in Deborah Blum's book, The Poisoner's Handbook.
While the events of the play set the stage for a dark comedy, the real-life equivalents are no laughing matter. In fact, as recently as 2010, someone in Maine poisoned members of their church by lacing coffee with arsenic. Sixteen people tried the coffee, complaining of its bitter taste. Symptoms came on quickly, causing thirteen of the coffee drinkers to seek medical attention, with eight of them requiring hospitalization. One person died from acute arsenic poisoning. The perpetrator committed suicide five days after the event. It's an example of the deliberate contamination of something normally benign to inflict serious injury and death. No reasonable person would look at this incident and claim that coffee is harmful and should be avoided.

Anti-vaccine activists, on the other hand, aren't exactly reasonable people.

Monday, September 15, 2014

Package Inserts - Understanding What They Do (and Don't) Say

With the whole twitter tantrum over a supposed coverup revealed by an alleged whistleblower that really is much ado about nothing, a topic arose that I realized I hadn't written about before, other than in passing. It came up again last week when anti-vaccine activists tried to hijack the Twitter hashtag #vaccinesNOVA by astroturfing it with tons of copy-pasted tweets, rather than actually watching the excellent NOVA episode Vaccines - Calling the Shots and having a mature conversation about vaccines. It's the same tactic they used with the #CDCwhistleblower hashtag. They merely copied and pasted from a list of prepared tweets, rather than offering any original thoughts of their own, because they are convinced that they already know everything and have nothing to learn from a very informative program. If there's even a whiff of pro-vaccine message to a show or post, count on anti-vaxxers to rail and scream, rather than actually watching or reading, let alone understand.

At any rate, I engaged one of those tweeting easily disproved nonsense to #vaccinesNOVA. This individual brought up vaccine package inserts, pointing out that one vaccine insert actually mentions "autism" in the adverse events section. They linked to the insert for Tripedia, which protects against diphtheria, tetanus and pertussis (whooping cough). In their mind, this was ironclad proof that even vaccine manufacturers admit that vaccines cause autism. Of course, this person ignored the other bits in the paragraph that mentioned autism (emphasis added):
Adverse events reported during post-approval use of Tripedia vaccine include...autism...Events were included in this list because of the seriousness or frequency of reporting. Because these events are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequencies or to establish a causal relationship to components of Tripedia vaccine.
In other words, autism was included because it was deemed either serious or was frequently reported, not because there was any causal relationship found between the vaccine and autism. It is far from being the slamdunk "gotcha!" that my interlocutor thought it was. But it prompted me to consider how many people probably do not understand just what the package insert for a vaccine (or any other drug) actually is or what its contents mean.

So here we go, a primer on drug package inserts and what they mean for a lay audience.