Does @VaxCalc Provide Valid Info on Vaccines? Not Really...

Twitter can be a really useful tool for getting information out to lots of people in a very short amount of time. The down side is that the 140-character limit on your message means there isn't a whole lot of space for nuance or detail. This leaves plenty of room for misinterpretation of messages. It also means that those with an agenda to drive can ignore nuance in favor of their own spin. For example, the Twitter account @VaxCalc, run by the Orwellian named National Vaccine Information Center (NVIC). @VaxCalc pumps out a steady stream of...uh...words (I refuse to call it "information," since it is nothing of the sort) that, while containing a speck of a grain of truth, aim to persuade people away from vaccines. Don't believe me? Have a look:

But I thought they removed it!

The link in the tweet takes you to a table on the FDA's web site about thimerosal in vaccines. Thimerosal, as most of you know, is a preservative that is used to prevent vaccines from being contaminated with bacteria, fungi or viruses, which can be very bad, indeed (as evidenced by the 1928 Bundaberg Disaster, in which 12 children died because a vaccine became contaminated). It caused a stir because it is metabolized into ethylmercury, which some erroneously linked to autism.

Anyway, is that tweet correct? Well, yes and no.

Follow the Bouncing Ball

Back in January, I wrote about an outbreak of chicken pox at a day care facility. The outbreak involved four children, three of whom were siblings. One of the siblings was too young to receive the varicella vaccine. The three other children were all old enough, but their parents had not had them immunized due to a general distrust of vaccines. The facility was unaware that the kids were unimmunized because of two things: a) the parents allegedly faked their children's immunization records and b) the facility reportedly did not do their due diligence to validate the records. To make things worse, two of the day care staff were pregnant, one of whom had an uncertain history of immunity (either by vaccine or infection) to varicella, and thus was at risk for contracting chicken pox and passing it on to her fetus. In addition to increased risks to the mother (PDF), there would also be a risk of congenital varicella syndrome for the unborn child. To top it all off, the state in which this outbreak occurred does not require reporting of chicken pox cases unless they are fatal, so the whole thing may have gone unnoticed by anyone involved with public health.

That last bit is not the case in Alaska, where chicken pox cases are required by regulation to be reported to the Alaska Section of Epidemiology (SOE). I bring this up because, in 2011, Alaska's Kenai Peninsula also saw an outbreak of chicken pox at a day care facility. And, like the outbreak mentioned above, it occurred late in the year and also involved kids whose parents had eschewed vaccination.

Madonnaplot Health Officials Shun Social Media Following 'Mystery Illness' Deaths

March 7, 2012 - On Monday, reports went out that three members of a Lousy, Madonnaplot family had died following a mystery illness. A fourth member of the family was hospitalized and is critically ill. Speculation began almost immediately, spreading via internet media, like Twitter and Facebook. Some suggested it was SARS or bird flu. Others claimed anthrax. Prominent news outlets picked up the rumors before any press releases had been issued by the Madonnaplot Department of Health and Mental Hygiene.

Finally, authorities released a statement that the mystery illness appeared to be confined to the family and that no precautions were necessary. However, local authorities, as well as FBI agents alerted by top DHMH officials, donned hazmat gear before entering the family's home. Amid wild speculation, why did it take so long for authorities to address the rampant rumors?

I.D.I.O.T. Director Muzzles Public Health Educator for Being Mean

March 1, 2012 - In a shocking move, Bouffon L. Kiekenlever, MSW, Director of the Infectious Disease Information Outreach Team (IDIOT) at the Madonnaplot State Department of Health and Mental Hygiene, muzzled a public health advocate and educator's personal outreach efforts. In a statement released by the IDIOT, Ms. Kiekenlever acknowledges that she literally gagged Robert Morgan Sliepcevich, an infectious disease investigator for the department, and tied his hands in response to several complaints made by members of the public.

"He had developed a habit of teaching people, in easy to understand terms, concepts about infectious diseases, epidemiology and statistics," said Kiekenlever. "That upset people."

The complaints were lodged by members of the online community Age of Unreason, many of whom subscribe to the tabloid broadsheets published by the National Vaccine Misinformation Center. One of these letters was leaked to Harpocrates Speaks.

Of Maths and Measles

There are times that I really despair for our country. Specifically, the educational system troubles me from time to time. Take simple mathematics, as an example. By the time one graduates high school and becomes a, presumably, productive adult in our society, regardless of whether said individual goes on to college or jumps right into the workforce, there are certain simple skills that they should have. All the basics should be well in hand: addition, subtraction, multiplication, division. They should have a good understanding of decimals, fractions and percentages. Even if someone needs to use a calculator, rather than doing it in their head or scratching a problem out on paper, they should at least have an understanding of how these things work and how to use them.

This woe for the state of education came bubbling up again as I read a comment on a PBS article about the measles outbreak in Indiana. Allie Morris, the author of the article, wrote that at least 13 of the individuals who had contracted measles had a history of MMR vaccine refusal. The commenter, Mmavallet, couldn't believe this number, suggesting that it was statistically impossible for there to be 13 individuals who were all unvaccinated, coupled with a belief that the vaccine couldn't be 95% effective (it's not, BTW, being >99% effective):

I don't buy that all 13 people spread over various counties were all unvaccinated. And the MMR does not have a 95% efficacy rate or else you wouldn't be having these outbreaks in a population where 98% of people vaccinate. It's statistically impossible. If you really research the numbers on these outbreaks, about 50% of those infected are vaccinated! If they really worked, you wouldn't have to continually get revaccinated for the same illness. It's not immunity if it wears off...only natural immunity is permanent.

Let's take a closer look at the issue, shall we?

Mark Geier Ordered to Stop Practicing Medicine

I haven't written about Dr. Mark Geier or his son, David, in a fair while. My last post was a map showing which states Dr. Geier has (or had) licenses to practice medicine. Every so often, I have gone back to it to check the status of his various licenses to update the map and license details. If you'll recall, Geier's license to practice medicine in the state of Maryland was suspended on April 27, 2011 (PDF). He challenged that decision, but the state board of medicine affirmed the suspension on May 12, 2011 (PDF). He currently is appealing the suspension. However, until his appeal is resolved, his license is still suspended.

As a result of his suspension in Maryland, his license was suspended in five other states, and his application was put on hold in a sixth. He is still able to practice in 6 states, and surprisingly, in two of those states, his license was scheduled to expire on Jan. 31, 2012, but inexplicably were renewed without mention of the actions in other states.

At any rate, it looks like Dr. Geier is facing some more trouble that he's created for himself. On February 22, 2012, the Maryland Board of Physicians issued a Cease and Desist order (PDF) to stop practicing medicine.

A Bowl of Measles? Super!

Last November, there was a flurry of blogging and news about a rather strange approach to children's health: mailing chicken pox-contaminated lollipops with the aim of infecting one's child. All the problems of violating laws regarding the sending of infectious materials by mail aside, there are numerous other reasons that giving someone else's used lollipop to your kid in order to get them sick. The most obvious is that if the virus actually survives, an infection with the varicella zoster virus is not without risks. A successful infection promises the likely recurrence of the virus later in life in the form of shingles. These are all much higher risks than from the vaccine. The other big concern with posted pox pops is that you don't know what other viruses or bacteria may be present. Food-borne viruses, like Hepatitis A, might just be waiting for an unsuspecting victim.

As foolish as mailing chicken pox-laced items by post is, what really surprised me was that people were actually looking for measles as well! Chicken pox is generally mild, and the serious complications tend to be a bit rarer, but measles can be quite dangerous. I imagine that if a cereal like Rubeoleos, tasty Os sprinkled with rubeola virus, actually existed, these parents who have been so frightened away from vaccines and led to believe that childhood diseases are benign by organizations like NVIC or Age of Autism would be gobbling it up, so to speak. While a hearing trumpet (or hearing aid) could be included in the box, parents would probably have to collect box tops for the medical attention their children may require should they suffer more serious complications. Yet in spite of the dangers of the disease, an underestimation of the virus' risks and ability to spread quickly would not stop them from serving up a big bowl to their dear little darlings. A super bowl, perhaps.

Which brings us to Indiana.

More Than Just Infectious Excitement at Super Bowl 46

This past weekend saw a huge annual event here in the United States: the Super Bowl. Two football (that's American football, not the rest of the world's football, aka soccer) teams face off to do battle to determine who will come out on top, and like Highlander, there can be only one. This event draws thousands of people from all over the country, and probably even some from around the world. It is, quite simply, an epic event. They even had a whole "village" erected in the middle of Indianapolis, this year's host to the game. The village provided over a week of activities, both indoors and out, for tourists and fans.

Where's rubeola? (Image by Mike Fender/The Indy Star)

But it wasn't just football fans that paid a visit. Something else had some fun in the village on Friday, February 3, two days before the big game.

Contagion of Fear: A Review of The Panic Virus

Several months ago, I took a look at Michael Willrich's excellent book, Pox: An American History. Pox examines the social and political climate of the early 20th century United States' smallpox epidemic and many of the anti-vaccination sentiments and governmental responses that made controlling the outbreaks so problematic. Many of the arguments used and fears expressed by our ancestors of that era are strikingly similar to the worries and claims promulgated by today's vocal anti-vaccine activists. But while the appearance is the same, the reasons today's activists came to their position is different.

Enter journalist Seth Mnookin, author of the blog The Panic Virus and the book of the same name. I recently had the pleasure of reading the recently released paperback edition of The Panic Virus: The True Story Behind the Vaccine-Autism Controversy, Mnookin's investigation into the origins of the modern anti-vaccine movement.

Of Wood and Woo

I've done some work as a carpenter. If you have never done it, you should give it a try. You can get lost in the work. Measuring, cutting, assembling. I've built sets for plays, taking simple pieces of wood and shaping them into imaginary lands that transport the audience into a different world, a different time. There is a simple sort of pleasure in woodworking: the feel of tools in your hands, the focus on the project. All of the stresses and annoyances of everyday life fade into the background. True, there are other pressures there. Get the structure done before first tech rehearsal. Finish painting and dressing the set before first full dress, or, when things really get down to the wire, before opening. There are also a lot of different issues revolving around personalities and egos, but all in all, those are relatively minor things with which to deal.

As I was reflecting on this, I thought of how there are some similarities to how we may interact with those with whom we disagree. When we argue with anti-vaccine activists, promoters of pseudoscience and so forth, there are techniques we use to make our point, to convince others.