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I read a good article recently on The Problem With Dr Bob's Alternative Vaccine Schedule that really puts into words some of the issues I've seen with the anti-vaccine movement. Most of you know that I try to get vaccinations per my doctor's recommendation, and make every attempt to make sure my child is vaccinated on schedule. I always attributed my attitude to the fact that I'm an engineer/scientist and believe that there's something to be said for trusting experts on these things... my friends and family fly on airplanes so of course I'm trying to make them as safe as I possibly know how, and would be horribly insulted by anyone accusing me of covering up a safety hazard to make a quick dollar. And that's just what I hear vaccine rejectionists doing. And it grates on me.

But anyway the article also addressed two more key points: first, I've heard rejectionists say that they've spent so many hours googling that they know WAY more about vaccinations than doctors, and that doctors should be required to have in-depth knowledge on any possible ingredient in a drug they'd inject into a child. Personally, I give my kid cereal that's got ingredients that I don't know the makeup of, so it seems weird that I'd expect a doctor to hold the same body of knowledge as a pharmaceutical researcher. Here's the take added by the article:

Although Sears is correct that doctors do not often review all of the studies on vaccine science, safety, and efficacy, he ignores the expert committees that do, specifically the Advisory Committee on Immunization Practices, which advises the Centers for Disease Control and Prevention (CDC), and the Committee on Infectious Diseases, which advises the American Academy of Pediatrics.... their advice to doctors has served us well; during the past century, vaccines have helped to increase the lifespan of individuals in the United States by ∼30 years, with an excellent record of safety.


In other words, by telling your doctor he doesn't know as much as you, you're really telling a LOT of doctors they don't know as much as you, even collectively, like you'd take them all on if left in a room and defeat the years of schooling with the late fees you paid at the library reading anti-vaccine books. I just find that hard to believe.

But here's what really gets me:

Sears often takes the position that, if parents think that a vaccine is problematic, then the vaccine is problematic. He believes that parents' fears should be indulged by offering alternative schedules, not countered by scientific studies, and he fails to explain that good science is the only way to determine whether a vaccine causes a particular adverse event. Instead, Sears alludes to evidence on both sides of any issue, failing to distinguish studies on the basis of their quality, internal consistency, or reproducibility and failing to distinguish those that are accepted by the scientific community from those that are not.


A while back I blogged about my thoughts on the Pluto classification, how so many people in America felt like if their gut told them Pluto was a planet, that if it's the way they were raised, then it should not change. The more I think about it, the more similarities I see among anyone who rejects the opinions of the scientific community. Now, Pluto clearly isn't a big deal, it's not dangerous for you to believe that Pluto is a planet just like Mars. But the whole idea that people can just decide as individuals what is scientifically correct is what I'm finding problems with.

I'm a protestant, I've read the stories about Martin Luther declaring that people must decide for themselves what the right path to heaven may be, that God speaks to us and no higher-up person with his flaws can decide what you should believe. But that's religion. Science is science.

Yes, we should look out for ourselves, do research and reading, it doesn't hurt. But individuals need to think very seriously about what they're doing when they go against the entire scientific community, giving no credit to the institutions formed to collect research and distribute opinion. That's what gets dangerous. And these books that say "oh decide for yourself, whatever you feel in your gut is right must be right for you" are feeding into the danger.

Comments

( 25 comments — Leave a comment )
athene
Jan. 30th, 2013 11:21 pm (UTC)
Good food for thought.

We're doing an alternate vaccination schedule mostly because I am one of those people who always reacts strongly to vaccines and I figured that if my child took after me, I'd rather give him less at once. He seems to take them in stride though. I'm still glad we're spacing them out more. But I do plan on having him get all the vaccines, except for maybe chicken pox. Somehow I feel like that one is a thing that all kids should get. I'm probably just being weird about it though.
astrogeek01
Jan. 30th, 2013 11:35 pm (UTC)
No, get him the chicken pox vaccine. It doesn't just help with chicken pox it reduces the chance that he'll get extremely painful shingles later in life. Also, the chicken pox can scar (I have one on my face), whereas having a vaccine won't. (be careful googling that because the top link is a quack who has been ordered by the FDA to stop making false claims)
aryanhwy
Jan. 31st, 2013 08:20 am (UTC)
Another reason is that if he doesn't get vaccinated and then doesn't get chicken pox as a kid (perhaps because all his friends have gotten the vaccine and thus there's no one to spread it around school), he runs the risk of getting it as an adult, which can have far serious repercussions.

My husband never had chicken pox as a kid, and now that we're back in a country that routinely vaccinates against it, we're going to get him in to get the shot as soon as we find a dr.
saintvictoria
Jan. 31st, 2013 01:29 am (UTC)
Get the chicken pox vaccination, please, my ex husband got shingles at 13! It was awful, scars and he said the worst pain ever, and he has come off many a motorbike.
tooby3
Jan. 31st, 2013 03:37 am (UTC)
You can only get shingles if you have been exposed to the chicken pox virus either naturally or from the vaccine. It is not at all accurate that the vaccine protects against shingles. There is a separate shingles vaccine (that is marginally effective but I digress). It is also worth mentioning that researchers are currently trying to determine whether the increase in shingles deaths in the elderly is from the lack of exposure to chicken pox due to the vaccine.

None of this is to say get or don't get the vaccine but to correct the misinformation here.
astrogeek01
Feb. 1st, 2013 02:05 am (UTC)
I'd like to see a source on this, because from what I read on the medical websites (again not as good as having peer-reviewed articles), it seems to me that it does actually help protect against shingles. I suppose I could go ask my doctor friends.

The first link that comes up if you google gives the quack that says the vaccine -> shingles and about the elderly deaths, but he's a well known quack.
tooby3
Feb. 1st, 2013 02:41 am (UTC)
Shingles and chicken pox are the same virus. Shingles is reactivated chickenpox. Once you have had the auto immune response that protects you from getting chicken pox you can get shingles. Ask a doctor you trust, use google. This isn't "quack" logic it is very widely understood. If you have never before been exposed to the chicken pox virus you will never get shingles. You will potentially get chicken pox which can get more severe the older you are. But shingles is a secondary condition that results from a primary exposure to herpes zoster whether through the real virus or vaccine version.

The concern about increased death from shingles relating to the chicken pox vaccine in the elderly is a theory. The fact that there have been more shingles deaths since the chicken pox vaccine is fact. Try CDC, they may have the data.
lepid0ptera
Feb. 19th, 2013 04:06 pm (UTC)
You can only get shingles if you have had chicken pox at some point in your life. Therefore, if you get the vaccine, and the vaccine successfully prevents you from contracting chicken pox, you will not get shingles. Ergo, the chicken pox vaccine prevents shingles.

Edited at 2013-02-19 04:20 pm (UTC)
tooby3
Feb. 19th, 2013 10:10 pm (UTC)
"Varicella vaccine contains live attenuated VZV, which causes latent infection. The attenuated vaccine virus can reactivate and cause herpes zoster. People who get vaccinated against varicella may develop herpes zoster later in life."

From here
http://www.cdc.gov/shingles/hcp/clinical-overview.html
aliki
Jan. 31st, 2013 11:16 am (UTC)
I think your decision regarding chicken pox is similar to the Pluto-idea that Spacefem posted previously. It's based on emotional, singular experiences without scientific proof or logical evidence.

Chicken pox can be dangerous to many children, life-threatening even, and if your child infects others, especially immuno-compromised such as children with leukemia (half of children with leukemia who get infected, die from chickenpox) or women who are pregnant (women who are pregnant and contract it get severe fetal deformities).

Please reconsider.
lepid0ptera
Feb. 19th, 2013 03:59 pm (UTC)
Once you get infected with the chicken pox virus (Varicella zoster), he'll have it forever. The virus that causes chicken pox is actually a herpes virus (http://en.wikipedia.org/wiki/Varicella_zoster_virus) and like other kinds of herpes, once you contract it it's with you for the rest of your life, even after you recover from the initial outbreak.

I know lots of people who are in their late 50s and older who have gotten shingles, which is an outbreak of the chicken pox virus. They say it's the most incredibly painful thing they've ever experienced. The people I know have gotten it on their face, buttocks, and legs; why would you put him through that if it's easily avoided?

Edited at 2013-02-19 04:07 pm (UTC)
astrogeek01
Jan. 30th, 2013 11:58 pm (UTC)
So that Dr Sears is like, the son of the other one, who wrote The Pregnancy Book and The Baby Book, right? Because I could swear (I've lent them out) that the books were pretty much "and get the vaccines on time". But maybe I'm just selectively remembering. I thought the book mixed a good amount of "and research shows" with more holistic views of things, which was nice.

Anywho. I too am very sick of anti-science people. So. Sick. Of. It. You do not get to decide science based on how you feel.
tooby3
Jan. 31st, 2013 04:04 am (UTC)
I am not anti vaccine or anti science but I am very supportive of parents questioning the medical establishment. There is extensive, well done research that shows where medical doctrine is not always evidence based. If I can agree that ACOG takes some bad stances on maternity care and the AAP makes some poor judgements off of weak data about things like circumcisions and cosleeping, it is not hard to see flaws in other routine healthcare practices. Plus I just disagree with the suggestion that a non md can't possibly know more about a niche area of medicine if they don't have the degree. If you have access to the right information and the intellect to consume it, it's there for everyone.

The cochrane report just release a huge, well done study into the flu vaccine that above all else said that the poor quality and ineffectiveness of that vaccine is due in large part to the widespread public belief that all vaccines are good and prevent all illness. Basically because there are so many folks happy with an inferior product, the drug cos. have no business case to invest in bringing a better product to market. </p>

I'll also bring up the insanity that crazy anti vac folks caused the whooping cough outbreaks when in reality it was the result of a bad vaccine and smug parents that rested on the belief that getting the shot was foolproof.

These vaccines are produced by huge companies with the largest profit margins in the healthcare industry. Lets not confuse the business with the guys wearing the lab coats. Scientists have little say over what makes it to market. If it were scientists running this show we would all be better off.

aliki
Jan. 31st, 2013 11:12 am (UTC)
On the flip side of the whopping cough outbreak, the inability to eradicate polio is due solely because of refusal of vaccines, is it not? Also, see smallpox.
tooby3
Jan. 31st, 2013 03:28 pm (UTC)
Actually no: The issue with eradicating polio, like most other things we vaccinate against, is the vaccine itself.

"The global campaign to eradicate polio began in 1988. Since then, naturally occurring cases worldwide have dropped to, at last count, around 650 in 2011.
Completely eliminating polio requires a change in the current vaccination program because one component in the most widely used vaccine now causes more cases of polio than it prevents.
The World Health Assembly is expected to approve a plan this May that should decrease the number of vaccine-linked cases of polio and may speed up overall eradication efforts.
Yet questions have arisen over the safety of making the change rapidly. If health officials do not manage this transition correctly, polio could continue to cripple children for years to come." From here: http://www.scientificamerican.com/article.cfm?id=polios-last-act

Here's a news story for more validation: http://www.nbcnews.com/id/21149823/

I've never read anything about small pox.
naath
Jan. 31st, 2013 04:56 pm (UTC)
Whilst that may be an issue (and I admit to having zero knowledge of that issue) there is ALSO the issue that the CIA have been using polio-vaccination program in Pakistan to find (alleged) terrorists and this is bad for getting people vaccinated (people don't trust the vaccine because it's a CIA plot, terrorists attack vaccinating doctors because it's a CIA plot...).
lepid0ptera
Feb. 19th, 2013 04:18 pm (UTC)
Completely false.

The problem with eradicating polio is lack of money and doctors in third world countries.

There are two polio vaccines; one contains a killed virus, and is an injectable, which cannot cause polio. This is what we administer in first world countries.

The second is in pill form and contains live weakened virus, which in some cases can mutate and cause polio.

The reason the pill form is administered in the third world is that the killed version requires refrigeration, is more expensive, and since it has to be injected, must be administered by a nurse. All of this costs money.

Even so, providing the vaccine in pill form has done a lot to reduce polio and we're on track to eradicate it.
aryanhwy
Jan. 31st, 2013 08:18 am (UTC)
But the whole idea that people can just decide as individuals what is scientifically correct is what I'm finding problems with.

Hear, hear!
sandokai
Jan. 31st, 2013 01:15 pm (UTC)
I think people have different priorities though. The organizations and doctors want as many people to get as many vaccines as possible as early as they see reasonably possible. But parents don't necessary value that. Ex: Hep B at birth. Maybe makes sense if you're a doctor/organization knowing some mamas have Hep B they could pass onto their child, but if you know you have a 0% chance of having Hep B, eh, the timing seems sort of silly.
sandokai
Jan. 31st, 2013 01:16 pm (UTC)
Also science isn't as infallible as it tends to think it is... or it accepts a certain % risk as okay, whereas parents might prefer a higher or lower % of risk. I just don't think science is that infallible.
tooby3
Jan. 31st, 2013 03:35 pm (UTC)
I 100% agree with this. To me, any scientist unwilling to question their own research is one that's letting his/her ego run their brain. Science is about a continuing pursuit of truth. Rarely, especially in medicine, are we talking about proven theories. I would hope someone that values their field welcomes skepticism as motivation to improve on the validity of their findings.
astrogeek01
Jan. 31st, 2013 10:40 pm (UTC)
The problem is when the quacks start to impinge on actual science being done. Take Jenny McCarthy and the rest of the "vaccines cause autism" crowd. The problem is that rebuffing those claims over and over and over and over again takes away resources from actually trying to find the real causes of autism. It gets really wearing on scientists to have to constantly fight against the level of crap that is out there.

Part of the problem is, of course, that peer reviewed research articles are not available and free to the general public. Part of it is also that the language we use as scientists tends to be in terms which have much more specific meanings in science than they do in lay speech, which causes confusion. Part of it is that, of course, science doesn't always get things right -- it is a process -- and while science tends to self-correct that can be a slow process. And people tend to remember the wrong things, not how many things we get right.

All this applies to all kinds of science, not just medicine. You spend years and years and become an expert and any dude on the street thinks he knows more than you. About climate change. About medicine. About anything.

Yes, do research. I do. Everyone should. The last time I went to the doctor I said "So I read on the internet...and I know that's not the best place, but..." and I told him my concerns. And he listened, and he talked with me, and we actually were able to look into the problem in more detail. But in the end I'm going to take his opinion over something I read on the internet. Because he is an expert.
naath
Jan. 31st, 2013 05:00 pm (UTC)
Well, with most medicine a good doctor can say "this thing is 90% likely to solve this problem and 5% likely to give you this side effect" but only the patient (or the parent of a child-patient) can make choices like "what side-effect risks are acceptable in relation to the size of the problem".

For instance if I get cancer and am offered a cancer drug that will (probably) give me an extra year of life but will (almost certainly) make me spend that all year vomiting three times a day then maybe I don't want that...

I think the main issue with vaccines is that much of the benefit of vaccination programs is the herd immunity; so the selfish position is to not risk the (usually very small) chance of side effects but expect to get (most of) the benefit because everyone else is willing to do so.
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Ckwop
Feb. 1st, 2013 10:45 pm (UTC)
Do not agree at all..

But simply painting "unvaccinating" parents as the big bad meanies who want to spread diseases, and completely brushing the concerns of millions of parents under the rug, does not do much to restore confidence in the safety of the product.


But you are being a meanie?

You're being antisocial because you're depending on people who rightly vaccinate their children to ensure your child doesn't get sick.

You're depending on that herd immunity so you can feel good about yourself. I'm sorry if that's harsh but it's basically correct.


Choosing not to do this isn't taking some stand AGAINST anything. It's simply doing nothing.


Suppose your child gets measles and passes it on to my grandma who then dies. Can I sue you for gross negligence?

You're messing around with people's lives here!

If nearly everyone is vaccinated, viruses find it really hard to spread. This effect is called herd immunity. Herd immunity doesn't just protect your child, it protects everyone else! People who are immune compromised, the elderly etc. But it only works if most of the population is vaccinated.

This is one of the really good reasons to get your child vaccinated.


I would rather ask the scientific community to prove to us, as parents/patients/consumers of their product that we should OPT for what they are selling us.


All vaccines go through controlled trials that cost millions of dollars. The process is slow, expensive and meticulous.

It's so maddening that people in the West live so comfortably that can afford to be so reckless about this stuff.

Before vaccinations, _millions_ of people died. Millions and millions of preventable deaths. Countless more were maimed by Polio, suffered permanent lung damage from TB, nerve damage from shingles, ovarian cancer from HPV..

And you're worried if there's additives in the injections? Are you out of your god-damn mind?

These viruses don't care about you, your child or any of their family. They will gladly sacrifice your loved ones to spread themselves.

There are many ways to end up dead and for children one of the most common ones is contracting a preventable illness. Across the world, 8 million children a year under the age of five die of preventable diseases.

By the time you've finished reading my reply, a few more children will have died.

You're fortunate to live in a time and place where we have weapons against them. Don't be an idiot and use them.


Edited at 2013-02-01 11:11 pm (UTC)
(Deleted comment)
Ckwop
Feb. 2nd, 2013 10:28 pm (UTC)
Re: Do not agree at all..

Are you a parent?


Yes, I have two month old. I live in the UK so our vaccine programme is likely to be different from yours but we intend to get my son vaccinated with every vaccine the NHS offers.


Who trusted their doctor and took their healthy, walking, talking toddler to an appointment and walked out with a kid who was never the same?


There's a problem here in that a lot of these problems start to rear their head at the same time as vaccinations are administered.

There is no peer reviewed evidence published in a medical journal that I know of that shown a link to vaccinations and child development issue. No study that hasn't been discredited anyway.


And then had doctors refuse to acknowledge that anything was wrong, that the vaccine caused any problem?


Maybe because the vaccine wasn't the problem?


Because I have. And they are not as rare as you might hope. They are fucking everywhere (oh look, I can swear too!).


People are _terrible_ at judging risks. Really, really, really bad. It cuts through so many areas of public policy in the West that proper risk analysis should be taught in every school in the world.

I have to make assumptions here (I don't know you personally!) but you probably drive your young one around in a car. This is a very effective way to kill your family. About 32,000 people in the US die every year in car accidents. That's a 9/11 every few weeks for decades and decades.

Public policy around the West is silent on this matter.

Americans buy huge numbers of guns for defence of their "castle" yet the statistics show that the majority of firearm murders occur from people within their own family. The "castle" is compromised from within.

Parents will ensure their children wear bicycle helmets, even though statistics show they don't really reduce injury. Moreover, your child is much more likely to die in a swimming pool than by cycling.

Many parents worry about their teenage children consuming illegal drugs. Yet taking Aspirin is more likely to kill you than taking Ecstasy. Nicotine also happens to be more addictive than heroine.

It's the same sort of things with vaccines. It is far more likely that your child will come serious grief through a virus than through a vaccine.


Or would I be able to live with myself if, knowing what I know, I took them in for vaccinations and they suffered permanent damage from that? The answer for me was clear, and I'm the one who has to live with it.


That's one way of looking at it. The other is that if your child contracts Measles as an adult and becomes infertile - could you live with yourself?

If they contract TB and die could you live with yourself?

If they contract Polio and end up with a serious disability could you live with yourself?

Being alive is risky. We all have to take some risk, even with our children. The goal is to reduce the overall level of risk.


I'm not really interested in the approval of internet strangers.


A fair point!

Edited at 2013-02-02 10:42 pm (UTC)
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