An Epidemic of Fear (Anti-Vaccination Bullshit)

[Rogue 9]

Wired magazine

An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All

By Amy Wallace | October 19, 2009 | 3:00 pm

To hear his enemies talk, you might think Paul Offit is the most hated man in America. A pediatrician in Philadelphia, he is the coinventor of a rotavirus vaccine that could save tens of thousands of lives every year. Yet environmental activist Robert F. Kennedy Jr. slams Offit as a “biostitute” who whores for the pharmaceutical industry. Actor Jim Carrey calls him a profiteer and distills the doctor’s attitude toward childhood vaccination down to this chilling mantra: “Grab ‘em and stab ‘em.” Recently, Carrey and his girlfriend, Jenny McCarthy, went on CNN’s Larry King Live and singled out Offit’s vaccine, RotaTeq, as one of many unnecessary vaccines, all administered, they said, for just one reason: “Greed.”

Thousands of people revile Offit publicly at rallies, on Web sites, and in books. Type pauloffit.com into your browser and you’ll find not Offit’s official site but an anti-Offit screed “dedicated to exposing the truth about the vaccine industry’s most well-paid spokesperson.” Go to Wikipedia to read his bio and, as often as not, someone will have tampered with the page. The section on Offit’s education was once altered to say that he’d studied on a pig farm in Toad Suck, Arkansas. (He’s a graduate of Tufts University and the University of Maryland School of Medicine).

Then there are the threats. Offit once got an email from a Seattle man that read, “I will hang you by your neck until you are dead!” Other bracing messages include “You have blood on your hands” and “Your day of reckoning will come.” A few years ago, a man on the phone ominously told Offit he knew where the doctor’s two children went to school. At a meeting of the Centers for Disease Control and Prevention, an anti-vaccine protester emerged from a crowd of people holding signs that featured Offit’s face emblazoned with the word terrorist and grabbed the unsuspecting, 6-foot-tall physician by the jacket.

“I don’t think he wanted to hurt me,” Offit recalls. “He was just excited to be close to the personification of such evil.” Still, whenever Offit gets a letter with an unfamiliar return address, he holds the envelope at arm’s length before gingerly tearing it open. “I think about it,” he admits. “Anthrax.”

So what has this award-winning 58-year-old scientist done to elicit such venom? He boldly states — in speeches, in journal articles, and in his 2008 book Autism’s False Prophets — that vaccines do not cause autism or autoimmune disease or any of the other chronic conditions that have been blamed on them. He supports this assertion with meticulous evidence. And he calls to account those who promote bogus treatments for autism — treatments that he says not only don’t work but often cause harm.

As a result, Offit has become the main target of a grassroots movement that opposes the systematic vaccination of children and the laws that require it. McCarthy, an actress and a former Playboy centerfold whose son has been diagnosed with autism, is the best-known leader of the movement, but she is joined by legions of well-organized supporters and sympathizers.

This isn’t a religious dispute, like the debate over creationism and intelligent design. It’s a challenge to traditional science that crosses party, class, and religious lines. It is partly a reaction to Big Pharma’s blunders and PR missteps, from Vioxx to illegal marketing ploys, which have encouraged a distrust of experts. It is also, ironically, a product of the era of instant communication and easy access to information. The doubters and deniers are empowered by the Internet (online, nobody knows you’re not a doctor) and helped by the mainstream media, which has an interest in pumping up bad science to create a “debate” where there should be none.

In the center of the fray is Paul Offit. “People describe me as a vaccine advocate,” he says. “I see myself as a science advocate.” But in this battle — and make no mistake, he says, it’s a pitched and heated battle — “science alone isn’t enough … People are getting hurt. The parent who reads what Jenny McCarthy says and thinks, ‘Well, maybe I shouldn’t get this vaccine,’ and their child dies of Hib meningitis,” he says, shaking his head. “It’s such a fundamental failure on our part that we haven’t convinced that parent.”

Consider: In certain parts of the US, vaccination rates have dropped so low that occurrences of some children’s diseases are approaching pre-vaccine levels for the first time ever. And the number of people who choose not to vaccinate their children (so-called philosophical exemptions are available in about 20 states, including Pennsylvania, Texas, and much of the West) continues to rise. In states where such opting out is allowed, 2.6 percent of parents did so last year, up from 1 percent in 1991, according to the CDC. In some communities, like California’s affluent Marin County, just north of San Francisco, non-vaccination rates are approaching 6 percent (counterintuitively, higher rates of non-vaccination often correspond with higher levels of education and wealth).

That may not sound like much, but a recent study by the Los Angeles Times indicates that the impact can be devastating. The Times found that even though only about 2 percent of California’s kindergartners are unvaccinated (10,000 kids, or about twice the number as in 1997), they tend to be clustered, disproportionately increasing the risk of an outbreak of such largely eradicated diseases as measles, mumps, and pertussis (whooping cough). The clustering means almost 10 percent of elementary schools statewide may already be at risk.

In May, The New England Journal of Medicine laid the blame for clusters of disease outbreaks throughout the US squarely at the feet of declining vaccination rates, while nonprofit health care provider Kaiser Permanente reported that unvaccinated children were 23 times more likely to get pertussis, a highly contagious bacterial disease that causes violent coughing and is potentially lethal to infants. In the June issue of the journal Pediatrics, Jason Glanz, an epidemiologist at Kaiser’s Institute for Health Research, revealed that the number of reported pertussis cases jumped from 1,000 in 1976 to 26,000 in 2004. A disease that vaccines made rare, in other words, is making a comeback. “This study helps dispel one of the commonly held beliefs among vaccine-refusing parents: that their children are not at risk for vaccine-preventable diseases,” Glanz says.

“I used to say that the tide would turn when children started to die. Well, children have started to die,” Offit says, frowning as he ticks off recent fatal cases of meningitis in unvaccinated children in Pennsylvania and Minnesota. “So now I’ve changed it to ‘when enough children start to die.’ Because obviously, we’re not there yet.”

The rejection of hard-won knowledge is by no means a new phenomenon. In 1905, French mathematician and scientist Henri Poincaré said that the willingness to embrace pseudo-science flourished because people “know how cruel the truth often is, and we wonder whether illusion is not more consoling.” Decades later, the astronomer Carl Sagan reached a similar conclusion: Science loses ground to pseudo-science because the latter seems to offer more comfort. “A great many of these belief systems address real human needs that are not being met by our society,” Sagan wrote of certain Americans’ embrace of reincarnation, channeling, and extraterrestrials. “There are unsatisfied medical needs, spiritual needs, and needs for communion with the rest of the human community.”

Looking back over human history, rationality has been the anomaly. Being rational takes work, education, and a sober determination to avoid making hasty inferences, even when they appear to make perfect sense. Much like infectious diseases themselves — beaten back by decades of effort to vaccinate the populace — the irrational lingers just below the surface, waiting for us to let down our guard.

Before smallpox was eradicated with a vaccine, it killed an estimated 500 million people. And just 60 years ago, polio paralyzed 16,000 Americans every year, while rubella caused birth defects and mental retardation in as many as 20,000 newborns. Measles infected 4 million children, killing 3,000 annually, and a bacterium called Haemophilus influenzae type b caused Hib meningitis in more than 15,000 children, leaving many with permanent brain damage. Infant mortality and abbreviated life spans — now regarded as a third world problem — were a first world reality.

Today, because the looming risk of childhood death is out of sight, it is also largely out of mind, leading a growing number of Americans to worry about what is in fact a much lesser risk: the ill effects of vaccines. If your newborn gets pertussis, for example, there is a 1 percent chance that the baby will die of pulmonary hypertension or other complications. The risk of dying from the pertussis vaccine, by contrast, is practically nonexistent — in fact, no study has linked DTaP (the three-in-one immunization that protects against diphtheria, tetanus, and pertussis) to death in children. Nobody in the pro-vaccine camp asserts that vaccines are risk-free, but the risks are minute in comparison to the alternative.

Still, despite peer-reviewed evidence, many parents ignore the math and agonize about whether to vaccinate. Why? For starters, the human brain has a natural tendency to pattern-match — to ignore the old dictum “correlation does not imply causation” and stubbornly persist in associating proximate phenomena. If two things coexist, the brain often tells us, they must be related. Some parents of autistic children noticed that their child’s condition began to appear shortly after a vaccination. The conclusion: “The vaccine must have caused the autism.” Sounds reasonable, even though, as many scientists have noted, it has long been known that autism and other neurological impairments often become evident at or around the age of 18 to 24 months, which just happens to be the same time children receive multiple vaccinations. Correlation, perhaps. But not causation, as studies have shown.

And if you need a new factoid to support your belief system, it has never been easier to find one. The Internet offers a treasure trove of undifferentiated information, data, research, speculation, half-truths, anecdotes, and conjecture about health and medicine. It is also a democratizing force that tends to undermine authority, cut out the middleman, and empower individuals. In a world where anyone can attend what McCarthy calls the “University of Google,” boning up on immunology before getting your child vaccinated seems like good, responsible parenting. Thanks to the Internet, everyone can be their own medical investigator.

There are anti-vaccine Web sites, Facebook groups, email alerts, and lobbying organizations. Politicians ignore the movement at their peril, and, unlike in the debates over creationism and global warming, Democrats have proved just as likely as Republicans to share misinformation and fuel anxiety.

US senators John Kerry of Massachusetts and Chris Dodd of Connecticut have both curried favor with constituents by trumpeting the notion that vaccines cause autism. And Robert F. Kennedy Jr., a scion of the most famous Democratic family of all, authored a deeply flawed 2005 Rolling Stone piece called “Deadly Immunity.” In it, he accused the government of protecting drug companies from litigation by concealing evidence that mercury in vaccines may have caused autism in thousands of kids. The article was roundly discredited for, among other things, overestimating the amount of mercury in childhood vaccines by more than 100-fold, causing Rolling Stone to issue not one but a prolonged series of corrections and clarifications. But that did little to unring the bell.

The bottom line: Pseudo-science preys on well-intentioned people who, motivated by love for their kids, become vulnerable to one of the world’s oldest professions. Enter the snake-oil salesman.

When a child is ill, parents will do anything to make it right. If you doubt that, just spend a day or two at the annual conference of the nonprofit organization Autism One, a group built around the conviction that autism is caused by vaccines. It shares its agenda with other advocacy groups like the National Autism Association, the Coalition for SafeMinds, and McCarthy’s Generation Rescue. All these organizations cite similar anecdotes — children who appear to shut down and exhibit signs of autistic behavior immediately after being vaccinated — as proof. Autism One, like others, also points to rising rates of autism — what many parents call an epidemic — as evidence that vaccines are to blame. Finally, Autism One asserts that the condition is preventable and treatable, and that it is the toxins in vaccines and the sheer number of childhood vaccines (the CDC recommends 10 vaccines, in 26 doses, by the age of 2 — up from four vaccines in 1983) that combine to cause disease in certain sensitive children.

Their rhetoric often undergoes subtle shifts, especially when the scientific evidence becomes too overwhelming on one front or another. After all, saying you’re against all vaccines does start to sound crazy, even to a parent in distress over a child’s autism. Until recently, Autism One’s Web site flatly blamed “too many vaccines given too soon.” Lately, the language has gotten more vague, citing “environmental triggers.”

But the underlying argument has not changed: Vaccines harm America’s children, and doctors like Paul Offit are paid shills of the drug industry.

To be clear, there is no credible evidence to indicate that any of this is true. None. Twelve epidemiological studies have found no data that links the MMR (measles/mumps/rubella) vaccine to autism; six studies have found no trace of an association between thimerosal (a preservative containing ethylmercury that has largely been removed from vaccines since 2001[1]) and autism, and three other studies have found no indication that thimerosal causes even subtle neurological problems. The so-called epidemic, researchers assert, is the result of improved diagnosis, which has identified as autistic many kids who once might have been labeled mentally retarded or just plain slow. In fact, the growing body of science indicates that the autistic spectrum — which may well turn out to encompass several discrete conditions — may largely be genetic in origin. In April, the journal Nature published two studies that analyzed the genes of almost 10,000 people and identified a common genetic variant present in approximately 65 percent of autistic children.

But that hasn’t stopped as many as one in four Americans from believing vaccines can poison kids, according to a 2008 survey. And outreach by grassroots organizations like Autism One is a big reason why.

At this year’s Autism One conference in Chicago, I flashed more than once on Carl Sagan’s idea of the power of an “unsatisfied medical need.” Because a massive research effort has yet to reveal the precise causes of autism, pseudo-science has stepped aggressively into the void. In the hallways of the Westin O’Hare hotel, helpful salespeople strove to catch my eye as I walked past a long line of booths pitching everything from vitamins and supplements to gluten-free cookies (some believe a gluten-free diet alleviates the symptoms of autism), hyperbaric chambers, and neuro-feedback machines.

To a one, the speakers told parents not to despair. Vitamin D would help, said one doctor and supplement salesman who projected the equation “No vaccines + more vitamin d = no autism” onto a huge screen during his presentation. (If only it were that simple.) Others talked of the powers of enzymes, enemas, infrared saunas, glutathione drips, chelation therapy (the controversial — and risky — administration of certain chemicals that leech metals from the body), and Lupron (a medicine that shuts down testosterone synthesis).

Offit calls this stuff, much of which is unproven, ineffectual, or downright dangerous, “a cottage industry of false hope.” He didn’t attend the Autism One conference, though his name was frequently invoked. A California woman with an 11-year-old autistic son told me, aghast, that she’d personally heard Offit say you could safely give a child 10,000 vaccines (in fact, the number he came up with was 100,000 — more on that later). A mom from Arizona, who introduced me to her 10-year-old “recovered” autistic son — a bright, blue-eyed, towheaded boy who hit his head on walls, she said, before he started getting B-12 injections — told me that she’d read Offit had made $50 million from the RotaTeq vaccine. In her view, he was in the pocket of Big Pharma.

The central message at these conferences boils down to this: “The medical establishment doesn’t care, but we do.” Every vendor I talked to echoed this theme. And every parent expressed a frustrated, even desperate belief that no one in traditional science gives a hoot about easing their pain or addressing their theories — based on day-to-day parental experience — about autism’s causes.

Actually, scientists have chased down some of these theories. In August, for example, Pediatrics published an investigation of a popular hypothesis that children with autism have a higher incidence of gastrointestinal problems, which some allege are caused by injected viruses traveling to the intestines. Jenny McCarthy’s foundation posits that autism stems from these bacteria, as well as heavy metals and live viruses present in some vaccines. Healing your child, therefore, is a matter of clearing out the “environmental toxins” with, among other things, special diets. The Pediatrics paper found that while autistic kids suffered more from constipation, the cause was likely behavioral, not organic; there was no significant association between autism and GI symptoms. Moreover, gluten- and dairy-free diets did not appear to improve autism and sometimes caused nutritional deficiencies.

But researchers, alas, can’t respond with the same forceful certainty that the doubters are able to deploy — not if they’re going to follow the rules of science. Those tenets allow them to claim only that there is no evidence of a link between autism and vaccines. But that phrasing — what sounds like equivocation — is just enough to allow doubts to not only remain but to fester. Meanwhile, in the eight years since thimerosal was removed from vaccines (a public relations mistake, in Offit’s view, because it seemed to indicate to the public that thimerosal was toxic), the incidences of autism continue to rise.

In the wake of the latest thimerosal studies, most of the anti-vaccination crowd — even Autism One, despite the ever-changing rhetoric on its Web site — has shifted their aim away from any particular vaccine to a broader, fuzzier target: the sheer number of vaccines that are recommended. It sounds, after all, like common sense. There must be something risky about giving too many vaccines to very young children in too short a time. Opponents argue that for some children the current vaccine schedule creates a “toxic overload.”

“I’m not anti-vaccine,” McCarthy says. “I’m anti-toxin.” She stops just short of calling for an outright ban. McCarthy delivered the keynote address at the Autism One conference this year, just as she had in 2008. She drew a standing-room-only crowd, many of whom know her not from her acting but from her frequent appearances on TV talk shows, Oprah Winfrey’s Web site, and Twitter (@JennyfromMTV). McCarthy has authored two best-selling books on “healing” autism and is on the board of the advocacy group Generation Rescue (motto: “Autism is reversible”). With her stream-of-consciousness rants (”Too many toxins in the body cause neurological problems — look at Ozzy Osbourne, for Christ’s sake!”) and celebrity allure, she is the anti-vaccine movement’s most popular pitchman and prettiest face.

Barbara Loe Fisher, by contrast, is indisputably the movement’s brain. Fisher is the cofounder and president of the National Vaccine Information Center in Vienna, Virginia, the largest, oldest, and most influential of the watchdog groups that oppose universal vaccination. At the Autism One conference, Fisher took the podium with characteristic flair. As she often does, Fisher began with the story of her son Chris, who she believes was damaged by vaccines at the age of two and a half. A short film featuring devastating images of sick kids — some of them seemingly palsied, others with tremors, others catatonic — drove the point home. The film, accompanied by Bryan Adams’ plaintive song “(Everything I Do) I Do It For You,” ended with this message emblazoned on the screen: “All the children in this video were injured or killed by mandatory vaccinations.”

Against this backdrop, Fisher, a skilled debater who often faces down articulate, well-informed scientists on live TV, mentioned Offit frequently. She called him the leading “pro-forced-vaccination proponent” and cast him as a man who walks in lockstep with the pharmaceutical companies and demonizes caring parents. With the likely introduction of a swine flu vaccine later this year, Fisher added, Americans needed to wake up to the “draconian laws” that could force every citizen to either be vaccinated or quarantined. That isn’t true — the swine flu vaccine, like other flu vaccines, will be administered on a voluntary basis. But no matter: Fisher’s argument turns vaccines from a public health issue into one of personal choice, an unwritten bit of the Bill of Rights.

In her speech, Fisher borrowed from the Bible, George Orwell, and the civil rights movement. “The battle we are waging,” she said, “will determine what both health and freedom will look like in America.” She closed by quoting the inscription above the door of the Holocaust Memorial Museum in Washington, DC: “The first to perish were the children.” And then she brought it home: “If we believe in compassion, if we believe in the future, we will do whatever it takes to give our children back the future that is their birthright.” The audience cheered as the words sank in: Whatever it takes. “No forced vaccination,” Fisher concluded. “Not in America.”

Paul Offit has a slightly nasal voice and a forceful delivery that conspire to make him sound remarkably like Hawkeye Pierce, the cantankerous doctor played by Alan Alda on the TV series M*A*S*H. As a young man, Offit was a big fan of the show (though he felt then, and does now, that Hawkeye was “much cooler than me”). Offit is quick-witted, funny, and — despite a generally mild-mannered mien — sometimes so assertive as to seem brash. “Scientists, bound only by reason, are society’s true anarchists,” he has written — and he clearly sees himself as one. “Kaflooey theories” make him crazy, especially if they catch on. Fisher, who has long been the media’s go-to interview for what some in the autism arena call “parents rights,” makes him particularly nuts, as in “You just want to scream.” The reason? “She lies,” he says flatly.

“Barbara Loe Fisher inflames people against me. And wrongly. I’m in this for the same reason she is. I care about kids. Does she think Merck is paying me to speak about vaccines? Is that the logic?” he asks, exasperated. (Merck is doing no such thing). But when it comes to mandating vaccinations, Offit says, Fisher is right about him: He is an adamant supporter.

“We have seat belt rules,” he says. “Seat belts save lives. There was never a question about that. The data was absolutely clear. But people didn’t use them until they were required to use them.” Furthermore, the decision not to buckle up endangers only you. “Unless you fly through the window and hit somebody else,” he adds. “I believe in mandates. I do.”

We are driving north (seat belts on) across Philadelphia in Offit’s gray 2009 Toyota Camry, having just completed a full day of rounds at Children’s Hospital. Over the past eight hours, Offit has directed a team of six residents and med students as they evaluated more than a dozen children with persistent infections. He pulls into the driveway of the comfy four-bedroom Tudor in the suburbs where his family has lived for the past 13 years. It’s a nice enough house, with a leafy green yard and a two-car garage where a second Toyota Camry (this one red, a year older, and belonging to his wife, Bonnie) is already parked. Let’s just say that if Offit has indeed made $50 million from RotaTeq, as his critics love to say, he is hiding it well.

Offit acknowledges that he received a payout — “several million dollars, a lot of money” — when his hospital sold its stake in RotaTeq last year for $182 million. He continues to collect a royalty each year. It’s a fluke, he says — an unexpected outcome. “I’m not embarrassed about it,” he says. “It was the product of a lot of work, although it wasn’t why I did the work, nor was it, frankly, the reward for the work.”

Similarly, the suggestion that pharmaceutical companies make vaccines hoping to pocket huge profits is ludicrous to Offit. Vaccines, after all, are given once or twice or three times in a lifetime. Diabetes drugs, neurological drugs, Lipitor, Viagra, even Rogaine — stuff that a large number of people use every day — that’s where the money is.

That’s not to say vaccines aren’t profitable: RotaTeq costs a little under $4 a dose to make, according to Offit. Merck has sold a total of more than 24 million doses in the US, most for $69.59 a pop — a 17-fold markup. Not bad, but pharmaceutical companies do sell a lot of vaccines at cost to the developing world and in some cases give them away. Merck committed $75 million in 2006 to vaccinate all children born in Nicaragua for three years. In 2008, Merck’s revenue from RotaTeq was $665 million. Meanwhile, a blockbuster drug like Pfizer’s Lipitor is a $12 billion-a-year business.

To understand exactly why Offit became a scientist, you must go back more than half a century, to 1956. That was when doctors in Offit’s hometown of Baltimore operated on one of his legs to correct a club foot, requiring him to spend three weeks recovering in a chronic care facility with 20 other children, all of whom had polio. Parents were allowed to visit just one hour a week, on Sundays. His father, a shirt salesman, came when he could. His mother, who was pregnant with his brother and hospitalized with appendicitis, was unable to visit at all. He was 5 years old. “It was a pretty lonely, isolating experience,” Offit says. “But what was even worse was looking at these other children who were just horribly crippled and disfigured by polio.” That memory, he says, was the first thing that drove him toward a career in pediatric infectious diseases.

There was something else, too. From an early age, Offit embraced the logic and elegance of the scientific method. Science imbued a chaotic world with an order that he found reassuring.

“What I loved about science was its reason. You have data. You stand back and you discuss the strengths and weaknesses of that data. There’s just something very calming about that,” he says. “You formulate a hypothesis, you establish burdens of proof, you subject your hypothesis to rigorous testing. You’ve got 20 pieces of a 1,000-piece puzzle … It’s beautiful, really.”

There were no doctors in the Offit family; he decided to become the first. In 1977, when he was an intern at the Children’s Hospital of Pittsburgh, he witnessed the second event that would determine his career path: the death of a little girl from a rotavirus infection (there was, as yet, no vaccine). The child’s mother had been diligent, calling her pediatrician just a few hours after the girl’s fever, vomiting, and diarrhea had begun. Still, by the time the girl was admitted, she was too dehydrated to have an intravenous line inserted. Doctors tried everything to rehydrate her, including sticking a bone marrow needle into her tibia to inject fluids. She died on the table. “I didn’t realize it killed children in the United States,” Offit says, remembering how the girl’s mother, after hearing the terrible news, came into the room and held her daughter’s hand. “That girl’s image was always in my head.”

The third formative moment for Offit came in the late 1980s, when he met Maurice Hilleman, the most brilliant vaccine maker of the 20th century. Hilleman — a notoriously foulmouthed genius who toiled for years in the Philadelphia labs of Merck — invented vaccines to prevent measles, mumps, and rubella (and later came up with the combination of the three, the MMR). He created vaccines for hepatitis A and B, Hib, chicken pox, pneumococcus, and meningococcus. He became Offit’s mentor; Offit later became Hilleman’s biographer.

Offit believes in the power of good storytelling, which is why he writes books, five so far. He dearly wants to pull people into the exciting mysteries that scientists wrestle with every day. He wants us all to understand that vaccines work by introducing a weakened strain of a particular virus into the body — a strain so weak that it cannot make us sick. He wants us to revel in this miracle of inoculation, which causes our immune systems to produce antibodies and develop “memory cells” that mount a defense if we later encounter a live version of that virus.

It’s easy to see why Offit felt a special pride when, after 25 years of research and testing, he and two colleagues, Fred Clark and Stanley Plotkin, joined the ranks of the vaccine inventors. In February 2006, RotaTeq was approved for inclusion in the US vaccination schedule. The vaccine for rotavirus, which each year kills about 600,000 children in poor countries and about 40 children in the US, probably saves hundreds of lives a day.

But in certain circles, RotaTeq is no grand accomplishment. Instead, it is offered as Exhibit A in the case against Offit, proving his irredeemable bias and his corrupted point of view. Using this reasoning, of course, Watson and Crick would be unreliable on genetics because the Nobel Prize winners had a vested interest in genetic research. But despite the illogic, the argument has had some success. Consider the CDC’s Advisory Committee on Immunization Practices, which reviews new vaccines and administration schedules: Back in the late ’90s and early ’00s, Offit was a member of the panel, along with experts in infectious diseases, virology, microbiology, and immunology. Now the 15-person panel is made up mostly of state epidemiologists and public-health officials.

That’s not by accident. According to science journalist Michael Specter, author of the new book Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet and Threatens Our Lives, the controversy surrounding vaccine safety has made lack of expertise a requirement when choosing members of prominent advisory panels on the issue. “It’s shocking,” Specter says. “We live in a country where it’s actually a detriment to be an expert about something.” When expertise is diminished to such an extent, irrationality and fear can run amok.

Hence the death threats against Paul Offit. Curt Linderman Sr., the host of “Linderman Live!” on AutismOne Radio and the editor of a blog called the Autism File, recently wrote online that it would “be nice” if Offit “was dead.”

I’d met Linderman at Autism One. He’d given his card to me as we stood outside the Westin O’Hare talking about his autistic son. “We live in a very toxic world,” he’d told me, puffing on a cigarette.

It was hard to argue with that.

Despite his reputation, Offit has occasionally met a vaccine he doesn’t like. In 2002, when he was still a member of the CDC’s advisory committee, the Bush administration was lobbying for a program to give the smallpox vaccine to tens of thousands of Americans. Fear of bioterrorism was rampant, and everyone voted in favor — everyone except Offit. The reason: He feared people would die. And he didn’t keep quiet about his reservations, making appearances on 60 Minutes II and The NewsHour with Jim Lehrer.

The problem with the vaccine, he said, is that “one in every million people who gets it dies.” Moreover, he said, because smallpox is visible when its victims are contagious (it is marked by open sores), outbreaks — if there ever were any — could be quickly contained, and there would be plenty of time to begin vaccinations then. A preventive vaccine, he said, “was a greater risk than the risk of smallpox.”

Ah, risk. It is the idea that fuels the anti-vaccine movement — that parents should be allowed to opt out, because it is their right to evaluate risk for their own children. It is also the idea that underlies the CDC’s vaccination schedule — that the risk to public health is too great to allow individuals, one by one, to make decisions that will impact their communities. (The concept of herd immunity is key here: It holds that, in diseases passed from person to person, it is more difficult to maintain a chain of infection when large numbers of a population are immune.)

Risk is also the motivating idea in Offit’s life. This is a man, after all, who opted to give his own two children — now teenagers — the flu vaccine before it was recommended for their age group. Why? Because the risk of harm if his children got sick was too great. Offit, like everyone else, will do anything to protect his children. And he wants Americans to be fully educated about risk and not hoodwinked into thinking that dropping vaccines keeps their children safe. “The choice not to get a vaccine is not a choice to take no risk,” he says. “It’s just a choice to take a different risk, and we need to be better about saying, ‘Here’s what that different risk looks like.’ Dying of Hib meningitis is a horrible, ugly way to die.”

Getting the measles is no walk in the park, either — not for you or those who come near you. In 2005, a 17-year-old Indiana girl got infected on a trip to Bucharest, Romania. On the return flight home, she was congested, coughing, and feverish but had no rash. The next day, without realizing she was contagious, she went to a church gathering of 500 people. She was there just a few hours. Of the 500 people present, about 450 had either been vaccinated or had developed a natural immunity. Two people in that group had vaccination failure and got measles. Thirty-two people who had not been vaccinated and therefore had no resistance to measles also got sick. Did the girl encounter each of these people face-to-face in her brief visit to the picnic? No. All you have to do to get the measles is to inhabit the airspace of a contagious person within two hours of them being there.

The frightening implications of this kind of anecdote were illustrated by a 2002 study published in The Journal of Infectious Diseases. Looking at 3,292 cases of measles in the Netherlands, the study found that the risk of contracting the disease was lower if you were completely unvaccinated and living in a highly vaccinated community than if you were completely vaccinated and living in a relatively unvaccinated community. Why? Because vaccines don’t always take. What does that mean? You can’t minimize your individual risk unless your herd, your friends and neighbors, also buy in.

Perceived risk — our changing relationship to it and our increasing intolerance of it — is at the crux of vaccine safety concerns, not to mention related fears of pesticides, genetically modified food, and cloning. Sharon Kaufman, a medical anthropologist at UC San Francisco, observes that our concept of risk has evolved from an external threat that’s out of our control (think: statistical probability of a plane crash) to something that can be managed and controlled if we just make the right decisions (eat less fat and you’ll live longer). Improved diagnostic tests, a change in consumer awareness, an aging society determined to stay youthful — all have contributed to the growing perception that risk (of death, illness, accident) is our responsibility to reduce or eliminate. In the old order, risk management was in the hands of your doctor — or God. Under the new dispensation, it’s all up to you. What are the odds that your child will be autistic? It’s your job to manage them, so get thee to the Internet, and fast.

The thimerosal debacle exacerbated this tendency, particularly when the American Academy of Pediatrics and the Public Health Service issued a poorly worded statement in 1999 that said “current levels of thimerosal will not hurt children, but reducing those levels will make safe vaccines even safer.” In other words, there’s no scientific evidence whatsoever, but you never know.

“When science came out and said, ‘Uh-oh, there may be a risk,’ the stage was already set,” Kaufman says, noting that many parents felt it was irresponsible not to have doubts. “It was Pandora’s box.”

The result is that science must somehow prove a negative — that vaccines don’t cause autism — which is not how science typically works. Edward Jenner invented vaccination in 1796 with his smallpox inoculation; it would be 100 years before science, such as it was, understood why the vaccine worked, and it would be even longer before the specific cause of smallpox could be singled out. Until the cause of autism is discovered, scientists can establish only that vaccines are safe — and that threshold has already been met.

The government is still considering funding more research trials to look for a connection between vaccines and autism. To Kaufman, there’s some justification for this, given that it may be the only way to address everyone’s doubts. But the thimerosal panic suggests that, if bungled, such trials could make a bad situation worse. To scientists like Offit, further studies are also a waste of precious scientific resources, not to mention taxpayers’ money. They take funding away from more pressing matters, including the search for autism’s real cause.

A while back, Offit was asked to help put together a reference text on vaccines. Specifically, his colleagues wanted him to write a chapter that assessed the capacity of the human immune system. It was a hypothetical exercise: What was the maximum number of vaccines that a person could handle? The point was to arm doctors with information that could reassure parents. Offit set out to determine two factors: how many B cells, which make antibodies, a person has in a milliliter of blood and how many different epitopes, the part of a bacterium or virus that is recognized by the immune system, there are in a vaccine. Then, he came up with a rough estimate: a person could handle 100,000 vaccines — or up to 10,000 vaccines at once. Currently the most vaccines children receive at any one time is five.

He also published his findings in Pediatrics. Soon, the number was attached to Offit like a scarlet letter. “The 100,000 number makes me sound like a madman. Because that’s the image: 100,000 shots sticking out of you. It’s an awful image,” Offit says. “Many people — including people who are on my side — have criticized me for that. But I was naive. In that article, I was being asked the question and that is the answer to the question.”

Still, he hasn’t backed off. He feels that scientists have to work harder at winning over the public. “It’s our responsibility to stand up for good science. Though it’s not what we’re trained to do,” he says, admitting that his one regret about Autism’s False Prophets is that it didn’t hold scientists accountable for letting fear of criticism render them mute. “Get out there. There’s no venue too small. As someone once said, it would be a very quiet forest indeed if the only birds that sang were those that sang best.”

So Offit keeps singing. Isn’t he afraid of those who wish him harm? “I’m not that brave,” he says. “If I really thought my life was at risk or my children’s lives were at risk, I wouldn’t do it. Not for a second.” Maybe, he acknowledges, he’s in denial.

Later, I ask his wife the same question. When it comes to her husband’s welfare, Bonnie Offit is fiercely protective. A pediatrician with a thriving group practice, she still makes time to monitor the blogosphere. (Her husband refuses to read the attacks.) She wants to believe that if you “keep your finger on the pulse,” as she puts it, you can keep your loved ones safe.

Still, she worries. On the day I find myself sitting at her dining room table, every front page in the nation features an article about George Tiller, the abortion doctor gunned down at his church in Wichita, Kansas. When her husband leaves the room, Bonnie brings up the killing. “It upsets me,” she says, looking away. “I didn’t even tell him that. But it absolutely upsets me.”

Her husband, meanwhile, still rises every morning at 4 am and heads to his small, tidy study in a spare bedroom. Every morning, he spends a couple of hours working on what will be his sixth book, a history of the anti-vaccine movement. Offit gets excited when he talks about it.

In 19th-century England, he explains, Jenner’s smallpox vaccine was known to be effective. But despite the Compulsory Vaccination Act of 1853, many people still refused to take it, and thousands died unnecessarily. “That was the birth of the anti-vaccine movement,” he says, adding that then — as now — those at the forefront “were great at mass marketing. It was a print-oriented society. They were great pamphleteers. And by the 1890s, they had driven immunization rates down to the 20 percent range.”

Immediately, smallpox took off again in England and Wales, killing 1,455 in 1893. Ireland and Scotland, by contrast, “didn’t have any anti-vaccine movement and had very high immunization rates and very little incidence of smallpox disease and death,” he says, taking a breath. “You’d like to think we would learn.”

Offit wants the book to be cinematic, visually riveting. He believes, fervently, that if he can hook people with a good, truthful story, maybe they will absorb his hopeful message: The human race has faced down this kind of doubt before.

His battle is, in at least one respect, probably a losing one. There will always be more illogic and confusion than science can fend off. Offit’s idea is to inoculate people one by one, until the virus of fear, if not fully erased, at least recedes.

- - -

1. An earlier version of this story suggested that no childhood vaccines contain thimerosal; in fact some versions of the influenza vaccine, which is not typically mandated for children’s admission to school, does contain the preservative. Go here for a further explanation.

Something the article doesn't mention that I feel should be addressed more: Even if vaccines cause autism, which there is absolutely no evidence of, you don't die of autism. Many of the diseases vaccinated for will kill you dead. I'd rather be alive and autistic than crippled by polio or dead of smallpox.

[Guardsman Bass]

It's like Offit said - for many of these anti-vaccine people with young children, who were vaccinated themselves and grew up in an era where wide-spread vaccination had wiped out many of humanity's deadliest diseases (including Smallpox), it's like these diseases and the threat of them don't really exist.

[Darmalus]

A have a feeling that a lot of these people would rather see their children dead than autistic. I remember someone (Sir Nitram?) talking about the rather vile things that get said when a child starts showing symptoms. Calling them a changeling, the light died in their eyes, etc.

[Simon_Jester]

Given the sheer mental strain of dealing with autistic children, and the fact that there's no way for the parents to make it stop, I can sort of understand how that would happen.

People can move on with their lives after a child dies; there's closure. With autism, there's no closure- you're dealing with it on a day to day basis and you can't even hope for it to go away.

[open_sketchbook]

Doesn't change the fact that their retarded "looking for somebody to blame" mentality is costing lives, not to mention there has been at least one situation where a treatment for autism has actually resulted in the death of a child.

On top of that, they make the entire autism spectrum seem like a perpetual death sentence, and something that needs to be "cured", something that pisses the high-functioning autistics and those with Asperger syndrome off to no end. While it is true that Autism causes tons of problems and stress for parents and caretakers, it's not a disease; you'd figure that of all people, the parents of those with it would understand that it can't be cured.

[Azazal]

NPR follow up on all the shit Amy Wallace has had to put up with from the anti-vaccine crowd

Journalist Amy Wallace's article in the November issue of Wired Magazine about the passionate, and sometimes angry, debate over whether vaccines cause autism drew some vitriolic response.

"I've heard a lot of anger. I've heard that I'm stupid. I've heard that I'm greedy. I've heard that I did this to get famous," Wallace tells NPR's Melissa Block. "I've heard that I'm a whore, I'm a prostitute."

Wallace's article, An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All, profiles pediatrician Paul Offit, who invented the vaccine for rotavirus and is a lightning rod for criticism in the anti-vaccination community. In his book, Autism's False Prophets, last year, Offit said any risks of vaccination are dwarfed by the risks of childhood diseases.

"We, at Wired, wanted to use a profile of him as a way into a broader issue, which is vaccine panic, which is not just an American problem — it's a global issue," Wallace says. "And ... educated people are afraid. ... Even people who do vaccinate are worried about the impacts on their children."

Wallace says vaccines have done such a good job of removing the visible threat of diseases such as whooping cough or measles that some people see vaccination as a greater risk than childhood disease. Because of that, she says, many educated people in parts of the U.S. have decided not to vaccinate their children.

This has "left whole pockets of the community very wide open to an outbreak of illness," she says.

Wallace calls part of the discourse that has followed her article "a bullying tactic." She points to JB Handley, founder of Generation Rescue — which contends that too many vaccines are given too soon and blames autism on vaccines — for many attacks against her in the blogosphere. She says such tactics dissuade many scientists from taking a stand in the debate. It is important to speak out against those tactics, she says, adding that she has been commenting regularly about the issue on Twitter.

"There are some things in life that are true, and I think the debate needs to be civil," Wallace says. "That's part of what I've been trying to participate in — a civil discussion of these issues."

[Simon_Jester]

Doesn't change the fact that their retarded "looking for somebody to blame" mentality is costing lives, not to mention there has been at least one situation where a treatment for autism has actually resulted in the death of a child.

No, it does not. You are correct. I said it was comprehensible, not right.

[CaptainChewbacca]

My google-fu is weak, does anyone know where I can find infant and child death rates in the US prior to 1950 delineated by disease? It would be really usefull for some of the mothers at my church if I can say 'The chance Billy will die of a vaccination is 1 in 30 million, the chance he'll die if he gets mumps is X'.

[Cairber]

You don't even really need the 1950 numbers. Measles has a 1 in 1000 death rate- recent outbreaks in Europe have had 3 in 1000.

But for the best information on each vaccine preventable disease, the CDC Pink Book is a great source:

http://www.cdc.gov/vaccines/Pubs/pinkbo ... apters.htm

[The Big I]

And so it begins....

Breaking news



Diphtheria case 'shocking': AMA

From: AAP
May 03, 20112:26PM

THE death of an Australian woman from diphtheria, a disease virtually unheard of in Australia, is shocking, the Australian Medical Association says.

The 22-year-old Brisbane woman died in hospital last week after contracting the bacterial throat infection from a friend who had returned from overseas.

It's believed she wasn't immunised.

Queensland Health said it last confirmed a case of diphtheria in the state in 1993, but AMA vice president Steve Hambleton said he had never heard of a case in Australia in 30 years of working as a health professional.

"In the (early) 1900s it was the most common cause of death from an infectious disease," Dr Hambleton said, with rates as high as 400 cases per 100,000 people.

But in 1932 vaccination against the infection began and by the late 1950s rates had plummeted and were "virtually zero".

Now, almost 90 per cent of Australians have been vaccinated against the infection.

Children are given the jab as part of their childhood vaccines and adults get a top up with their tetanus.

"Any cases we get in Australia or the United States or the United Kingdom usually are imported from overseas," Dr Hambleton said.

"It's quite infectious, if someone catches it they can spread it for up to four weeks.

"It's a very serious infection that's got quite a high death rate if you catch it.

"It's a terrible disease."

Diphtheria is spread through coughing and sneezing, and can lead to difficultly swallowing, breathing and suffocation.

Queensland Health said authorities had given preventative antibiotics to people the Brisbane woman had been in contact with.

They said people travelling overseas to Third World countries where diphtheria is common should ensure their vaccinations are up to date.


Read more: http://www.news.com.au/breaking-news/di ... z1LGYdONXE

http://www.news.com.au/breaking-news/di ... 6049167793

[Chirios]

And so it begins....
:

tbf, That woman was 22, so that might not have been because of anti-vaccination. She might've easily forgotten to get the vaccination, or her particular vaccination might've failed, and because of the whole, herd immunity thing, she just never realised.

[Highlord Laan]

Personally, I'd arrest charge each and every parent that refuses to get their children vaccinated with child endangerment and child neglect.* Rampant idiocy on the level of these hooting primates should be publicly slapped down with authority and gusto, but I guess such a brutally proactive response is unamerican.

*And no, religion is not and excuse. Get your kids inoculated or be forced to explain and pay the price for them being barred from school, public venues, and any other place where they'd encounter other people.

[Broomstick]

The only people who should be excused from vaccination are those with a medical reason (allergies that can't be worked around by substituting another formulation, compromised immune systems, severe illnesses like cancer or severe chronic conditions like organ transplants). If that rule was rigidly enforced then there would be enough herd immunity for those who truly didn't have vaccination as an option.

I can't help but contrast that to when I was an infant. Despite the fact I had active eczema I was still given a smallpox vaccine, despite the real risk of a side effect that, had it occurred, would have resulted in a (then) untreatable side effect and a horrible, agonizing death (eczema vaccinatum). In other words, 45 years ago people at real risk of deadly side effects were still given vaccinations. They weren't given a choice.

My, how the world has changed.

Anti-vaxxers are idiots and they endanger the public at large. Unfortunately, we can't properly punish them for their positions.

[madd0ct0r]

anecdote alert.

among other things, I belong to a hippy yahoo group called 'Plants for the future'

it's mostly about the above - sustainable cropping, herbs and fruits, composting tricks and other uses of plants and trees.

One member recently posted a question, asking if she should get her daughter vaccinated for measles, with replies via private email.

A later got a reply. Apparently I was only one of 2 people in the group who said give her the injection. sad really.

[PeZook]

I would strongly prefer if there was more discussion of the issues involved with people denying vaccination, like the initial necromancing post, rather than inane talk of "Duh those anti vaccers are stewpid".

Otherwise I'm locking this thread.

[PainRack]

And so it begins....
:

tbf, That woman was 22, so that might not have been because of anti-vaccination. She might've easily forgotten to get the vaccination, or her particular vaccination might've failed, and because of the whole, herd immunity thing, she just never realised.

The whole anti vac scare flared up again in the nineties. Since the normal schedule has the DPT vaccine being given as an infant to a child, I gotta agree with Chirios.

Without more evidence, I won't say this was caused by anti vaccinators. But rather, maybe just pure bad luck?

[Akhlut]

I would strongly prefer if there was more discussion of the issues involved with people denying vaccination, like the initial necromancing post, rather than inane talk of "Duh those anti vaccers are stewpid".

Otherwise I'm locking this thread.

Like the initial article said, it's mainly people with a Master's in Google thinking they know more about the subject than people who actually study medicine, combined with the human tendency toward magical thinking (which is basically a lot of post hoc assumptions tied with the idea of contagion, at least as far as vaccines are concerned).

Another major issue is trying to re-establish expert authority on the matter, especially as other people try to tear it down or make themselves experts (looking at you, Ms. McCarthy). It's similar to that thread from long ago about Suzanne Somers who was taking plant steroids and pissed off her doctor because she didn't tell the doctor she was taking them and she got some hideous fungal infection that appeared to be cancer. Ms. Somers makes herself to be an expert and talks about all this completely untested bullshit like a guru, but doesn't even realize what her own "cures" really are.

So, we have a pincer attack on science consisting of magical thinking and distrust of real experts while exalting self-made experts who don't know shit.

Now, the real question is how to combat this. I would say education, but, unfortunately, a lot of this stuff follows Alexander Pope's lines: "A little learning is a dang'rous thing; Drink deep, or taste not the Pierian spring: There shallow draughts intoxicate the brain, And drinking largely sobers us again." Unfortunately, there aren't enough hours in the day to teach everything one needs to know about why vaccines are safe, given that most of this education needs to be done with adults in a doctor's office to convince them to vaccinate their kids.

[PainRack]

In response to the mod....

http://www.adelaidenow.com.au/all-three ... 6041226031

. Prof Wilson said it was important the course was completed, ideally within that timeframe.

"We don't know why women aren't taking it up," she said. "We need more detail about why girls and young women are not getting their second and third doses."

Australian Medical Association SA President Dr Andrew Lavender said girls should have all three doses.

http://www.montrealgazette.com/health/D ... story.html

MONTREAL - Health Canada's decision to approve the Gardasil vaccine for women up to the age of 45 has renewed the debate about the purported benefits of the shots and whether they might even be necessary.

Kirkland-based Merck, maker of Gardasil, announced that Health Canada has extended the vaccine's indication beyond the existing 9-to-26-year-old female age group for the prevention of cervical cancer and genital warts caused by the human papillomavirus.

In a study commissioned by Merck in women 24 to 45 years old, Gardasil was reported to be almost 89 per cent effective against HPV infections that can lead to cervical cancer.

But McGill University epidemiologist Abby Lippman, a longtime critic of Gardasil, questioned the usefulness of the vaccine.

"For a lot of the older women in that age range, the vaccine may not be at all necessary," Lippman said.

"We have to avoid calling it a cervical cancer vaccine because there has not been enough follow-up to know if it will really be changing the cancer rates.

"The benefits are still not known right now, in terms of how long protection lasts," she added.

In 2008, Quebec introduced the HPV vaccination program for girls and young women. Lippman, however, reiterated her position that rather than spend millions of dollars on HPV vaccination, the government should implement a Pap smear screening program.

"To me, anybody - whether they are or are not vaccinated - needs to have Pap testing done. We need that in place. Why are we rushing to vaccinate before we have that in place?"

Gardasil protects against four of the 15 HPV strains that are cancercausing. Those sexually transmitted strains are responsible for 70 per cent of cervical cancers.

Lippman noted that most women who are sexually active "will get infected with one of the HPV viruses and will clear it all by herself without even knowing it." Regular Pap screening can detect pre-cancerous lesions that can be effectively treated.

Dr. Alex Ferenczy, a professor of obstetrics and gynecology at McGill, endorsed the vaccine as "evidence-based."

"Whatever the reason, there's a tendency for women to remain at risk of acquiring new HPV infections as they get older," he said in a statement included in Merck's press release.

"Whether they are changing their social status or not, women should talk to their doctors about the HPV protection provided by the quadrivalent vaccine."

Officials with the Society of Obstetricians and Gynecologists of Canada were unavailable for comment on Tuesday.

In a statement made public in 2007, the Society threw its support behind Gardasil.

"The Gardasil vaccine being used in this immunization program is one of the most extensively tested vaccines to ever come to the Canadian market," it said. "Over 25,000 women participated in carefully monitored top quality clinical trials, and over a decade of research and development has now gone into this vaccine."

However, in an editorial published in the Journal of the American Medical Association two years later, Dr. Charlotte Haug concluded that "the net benefit of the HPV vaccine to a woman is uncertain. Even if persistently infected with HPV, a woman most likely will not develop cancer if she is regularly screened."

Merck has stated that the most common adverse reaction to Gardasil is a headache. There have been reports of far more serious complications associated with the vaccine, but Lippman refused to comment on its safety.

In February 2010, Health Canada approved Gardasil for boys and men age 9 to 26 for the prevention of infection and genital warts. A study published by the New England Journal of Medicine in February found that Gardasil was effective in preventing 90 per cent of HPV-related external genital lesions, including warts, in boys and men.

Read more: http://www.montrealgazette.com/health/G ... z1LOSihotD

I'm posting this because I recently got into a discussion with a student nurse about the vaccination. Her reluctance is due more to the cost rather than fear, but her attempts to get fellow students to join her for moral support failed.

Its something new afterall and the "news" about side effects is quite frightening.

Which brings us to the question of causation vs correlation, or even if such news about side effects is true or not, as opposed to hoaxes. If the later, god damn such liars.

[Broomstick]

It also has to do with a breakdown in trust of government. Now, there are some valid reasons why people aren't as trusting of governments as they used to be, but far too many (at least in my country) go to the extreme of lacking any trust in government whatsoever, to the point that they will actively do the opposite of what a government agency recommends.

If you trust an authority, and that authority says "vaccinate your kids" you'll be inclined to do that. On the other hand, if you don't trust that authority you are more likely to listen to some nutjob on the internet and NOT vaccinate your kids.

Funny thing - I sometimes go to a knitting circle on Monday mornings (social opportunities are somewhat limited around here and hey, I like knitting) and it's mostly elderly women. Somehow, we got to talking about shingles during this week's litany of aches and pains and diseases. In the ensuing conversation it turns out one of our ladies has, apparently, never had chickenpox. This is a bit unusual, as she is in her late 50's. It's also alarming as her husband might have shingles (he was going to the doctor that afternoon). Most of us were urging her to tell the doctor that, as there were ways to test to see if she had any immunity to H. zoster virus or not, and getting chickenpox in ones late 50's would be a very, very serious illness. The words "possibly fatal" were passed around. Granted I'm the only one there with a college degree, and these aren't the most informed people in the world, but they're old enough to remember when childhood diseases killed people.

But no-chickenpox-lady was extremely reluctant about the whole thing "Aren't vaccines dangerous?". Um, look, any possible danger from a chickenpox vaccine is very slight, and pales in comparison to what the disease will do to you if you catch in your 50's. I don't know anyone past 25 who caught that virus for the first time who didn't wind up in intensive care. If her husband has shingles he is likely to be shedding the virus and if she has no immunity... well, that needs to be known. Maybe they can put her on anti-virals prophylactically or something. No, lady, "just washing my hands a lot" isn't going to cut it on this one. Sure, wash your hands a lot, it helps, but really.... Meanwhile, some of the other ladies were talking about getting shingles vaccine, and how horrible shingles can be, and so forth.

Then it evolved into a discussion of how their sons and daughters were careless about their grandkid's vaccinations, and how foolish the younger generation was being, and so on. Maybe that's something that pisses me off - the parents currently deciding to not vaccinate have been the life-long beneficiaries of vaccination themselves.

It's a generational thing, and vaccination has become a victim of its own success. Kids aren't dying or being maimed by things like measles anymore, so parents ignore the dangers. Add in people with their own pet agendas proclaiming themselves experts and you have our current mess, which is only getting worse.

[PainRack]

Now, the real question is how to combat this. I would say education, but, unfortunately, a lot of this stuff follows Alexander Pope's lines: "A little learning is a dang'rous thing; Drink deep, or taste not the Pierian spring: There shallow draughts intoxicate the brain, And drinking largely sobers us again." Unfortunately, there aren't enough hours in the day to teach everything one needs to know about why vaccines are safe, given that most of this education needs to be done with adults in a doctor's office to convince them to vaccinate their kids.

Most people simply don't know how vaccines work, period.

The range of opinions range from drugs, to homeopathy to chemicals "faking" the immune system.

Simplistic explainations of how vaccines "train" the immune system doesn't help to innoculate people against foolishness..I wonder sometimes if it would be better if we simply market vaccines as helping the immune system to produce more antibodies.

[Broomstick]

Oh, then you get people going on about how vaccines "fool" the immune system and how that's deceptive and not as good as "the real thing"... actual things I have heard from people. Goes right along with people blaming vaccines for increasing allergies and cancer, because meddling with the immune system has to be bad, right?

You almost have to get tuned in with the mental hiccup of the person you're speaking with. Are they the sort that thinks exposure to germs strengthens the immune system? Then tell 'em it's like that, so you're "exercising" your immune system to make it stronger. Concerns about side effects? Might be trickier to address if they've bought into the whole autism hoax, but maybe they'd be willing to vaccinate the kids eventually outside that "window" which, although not ideal, helps the public health goal of getting people vaccinated eventually, even if not at the optimal time.

Something like gardasil has its own problems - it involves an STD and, at least here, there is still a strong current of stay-virgin-until-married so a teen getting it is essentially saying she's a slut. Or her parents think her to be a slut. Or can't control her enough to keep her from being a slut. It becomes a twisted badge of honor - "I'm such a good girl I don't need the vaccine!". Or, more likely, the parents are in denial that their daughters are having sex and could use the vaccine. On top of that, for the follow up doses - you can't trust young people that age to take birth control pills or use a condom or even not to text while driving a car, you're expecting them to 1) remember and 2) go to the trouble of getting jabbed in the arm at intervals? And while I appreciate some of the points in the arguments from the people who promote pap smears over vaccinations, they're missing the point that I see that, sad to say, not every woman is going to get every single pap smear she should even if cost is not a factor, and this makes it less likely that missing one or two will have tragic consequences. It shouldn't be a matter of EITHER pap OR gardasil, it should be both being promoted and access being provided. Of course, we don't live in an ideal world, I know that.

As time goes by I think public health is about 75% battling cultural issues (which would include both lack of education and persistent rumors) and 20% making sure access is reasonably easy and only about 5% actual medicine.

[someone_else]

In the end will be a thing that self-corrects in a generation or so. At the cost of an increased mortality for a while.
Although then it will then likely begin the cycle anew.

What is annoying is that they will have to let people suffer and (probably) die so that the survivors can learn.

I'm assuming that the survivors of such generations (still a relatively large margin) will learn. I hope they will.

[Broomstick]

The flaw with that reasoning is that willingness to vaccinate is not genetically passed on. As I pointed out, the vast majority of today's anti-vaxxers are actually the descendants of pro-vax parents.

[SirNitram]

As someone brought up a request for more on the impacts of these idiots...

77976 preventable diseases since June 3, 2007, to April 23rd 2011. 719 preventable DEATHS.

And rising.

[PeZook]

I was always wondering about the methodology used by the Jenny McCarthy body count, though. Where do they get their data? They don't say that on their website.