critique my critique on anti vaxer argument

[mr friendly guy]

Earlier I posted a thread in SLAM where I mentioned on another board people love posting bullshit, and I needed an article from the journal Nature to refute bullshit from a natural alternative medicine bullshit website.

http://bbs.stardestroyer.net/viewtopic.php?f=5&t=154750

Now I want to try my hand at refuting other articles posted by the same people. These people who get information from Info wars (the crazy website run by this nutter).

Here is the article in question.

Study: Polio vaccine campaign in India has caused 12-fold increase in deadly paralysis condition

Tuesday, April 17, 2012 by: Ethan A. Huff, staff writer

(NaturalNews) The mainstream media has been busy hailing the supposed success of India's polio vaccine campaign over the past few years, with many news outlets now claiming that the disease has been fully eradicated throughout the country. But what these misinformation puppets are failing to disclose is the fact that cases of non-polio acute flaccid paralysis (NPAFP), a much more serious condition than that caused by polio, have skyrocketed as a result of the vaccine's widespread administration.

A recent report published in the Indian Journal of Medical Ethics (IJME) explains that, clinically, NPAFP is indistinguishable from polio paralysis. But according to the Office of Medical & Scientific Justice (OMSJ), NPAFP is twice as deadly as polio paralysis, and yet was not even an issue in India prior to the rollout of the massive polio vaccine campaigns.

In 2011, for instance, the year in which India was declared to be polio-free, there were 47,500 known cases of NPAFP, which is a shockingly high figure under the circumstances. And based on data collected from India's National Polio Surveillance Project, cases of NPAFP across India rose dramatically in direct proportion to the number of polio vaccines administered, which suggests that the vaccines were responsible for spurring the rapid spread of this deadly condition.

Similarly, cases of vaccine-associated polio paralysis (VAPP), a condition in which paralytic symptoms similar or identical to those caused by wild-type polio manifest themselves following the administration of polio vaccines, are also on the rise. Not only are the paralysis symptoms associated with NPAFP and VAPP typically far worse than those brought about by wild-type polio, but they can also accompany other negative side effects including neurological damage.

Far from being a success, in other words, India's polio vaccine campaign appears to have induced a new epidemic of a much worse type of polio-related paralysis that is even more deadly than the first one. And based on the figures, overall rates of NPAFP in particular are now 12 times higher in India following the polio vaccine campaigns, with some areas of the country reporting rates as elevated as 35 times higher.

India spent billions on the polio eradication scam when it could have used that money to improve water and sanitation

According to the IJME report, the entire polio vaccine scam in India was spawned from initial grants made by the Bill & Melinda Gates Foundation and various other groups that claimed the program would eventually pay off. But the overall costs once India started paying for the program quickly ballooned to more than 100 times the initial investment amount, with more than $2.5 billion and counting still being funneled into it.

"The Indian government finally had to fund this hugely expensive program, which cost the country 100 times more than the value of the initial grant," write the authors. "From India's perspective the exercise has been extremely costly both in terms of human suffering and in monetary terms. It is tempting to speculate what could have been achieved if the $2.5 billion spent on attempting to eradicate polio were spent on water and sanitation and routine immunization."

In their conclusion, the authors basically decry what Bill Gates and the others have done by injecting monetary grants for the program, noting that it epitomizes "nearly everything that is wrong with donor funded 'disease specific' vertical projects at the cost of investments in community-oriented primary health care (horizontal programs)."

Sources for this article include:

http://www.omsj.org/blogs/polio-gone-bu ... l-continue

http://www.naturalnews.com

http://www.infowars.com

The relevant article from the Indian Journal of Medical Ethics has been uploaded on my Scribd account Here.'

My critique to follow shortly.

[mr friendly guy]

The article in question is from Indian Journal of Medical Ethics Vol IX No 2 April-June 2012, titled Polio programme: let us declare victory and move on
Their main salient points are

1. There has been a rise in non-polio Acute Flaccid Paralysis (AFP) in areas where polio vaccine is more frequently use. Wait you ask, what do you mean its more frequently used? Shouldn’t it be used the same amount if you are trying to eradicate polio? I will explain down below.
The corollary to this correlation is that the polio vaccine could be the cause of it, hence doctors while well meaning, can inevitably be doing harm. They decry that this association has not been associated, but by the same token, you cannot claim this correlation is the cause.

2. Eradication of polio is impossible because it can now by synthesised in the laboratory.

3. The money wasn’t giving India, bang for its buck, and the money could be better spent elsewhere. Note that 2.5 billion dollars Indian spent pales in comparison to 40.4 billion Indian spent on defence in one year alone.

To elaborate further on this, while there was initial foreign funds to help this program (around $20 million), India ended up providing most of the funding.

I will also add a fourth point raised by the Natural news website which used this article from the Indian Journal of Medical Ethics.

4. Bill Gates is THE EVEL – yeah, it’s a recurring theme. These people don’t like Bill Gates much apparently. Maybe because they are anti vaxxers and Gates champions vaccination programs.

Note on a humourous note, the first source quoted from the Indian Journal article is the Russian news Pravda. Granted the Russian site was just reporting that India was polio free (like many others), but it strikes me as weird that they would even look at a site which engages in what rational wiki describes as” woo, denialism and various conspiracy theories. Pravda means "truth" in Russian, something you won't probably get by surfing on it. The name (and a few former collaborators, apparently) is the sole link with the former communist newspaper Pravda.”

Lets do with this point by point. I will say straight off, that point 3 will be harder to talk about, because it ventures into the realm of “what ifs”.

[mr friendly guy]

Damn it. I meant to type "They decry that this association has not been investigated", but I ended up typing this association has not been associated.

[mr friendly guy]

Point one
As they say, the devil is in the detail. A rise in non-polio Acute Flaccid Paralysis (AFP) in areas where polio vaccine is more frequently use. This seems to be a case of India’s vaccination program being different from WHO guidelines in some areas. Its not clear to me why India engages in such a program, nor is it explained in the journal article. To elaborate.
World Health Organisation's guidelines on polio vaccines in both English and I assume French

The primary series of 3 OPV vaccinations should be administered according to the schedules of national immunization programmes, for example at 6 weeks, 10 weeks, and 14 weeks, or at 2 months, 4 months, and 6 months. In addition, a birth dose should be given as soon as possible after birth when the potential for poliovirus importation is very high or high and the transmission potential is high or moderate

So they recommend about 3 times, plus one at birth if at high risk (ie endemic areas) for oral polio vaccine.
Here is what India has been doing in the areas with a high incidence of non polio AFP, taken from the very article from the Indian Journal of medical ethics.

In the states of Uttar Pradesh (UP) and Bihar, which have pulse polio rounds nearly every month, the non-polio AFP rate is 25- and 35-fold higher than the international norms.

Now now, the apologist are just going to say, I am just trying to pin something on the Indians. So lets hear what the journal article itself has to say further.

The relationship of the non-polio AFP rate is curvilinear with a more steep increase beyond six doses of OPV in one year. [/u] The nonpolio AFP rate during the year best correlates to the cumulative Indian Journal of Medical Ethics Vol IX No 2 April - June 2012[ 115 ] doses received in the previous three years. Association (R2) ofthe non-polio AFP rate with OPV doses received in 2009 was 41.9%. Adding up doses received from 2007 increased the association (R2 = 55.6% p < 0.001) (30). Population density did not show any association with the non-polio AFP rate, although others have suggested that it is related to polio AFP (31).

They do some statistical analysis, however with a p-value of <0.001 I am happy that there is statistical significance, ie the association is unlikely to be due to chance. So an association of non polio AFP occurs when you use the vaccine beyond 6 doses in one year, ie not per WHO guidelines. Note this is just an association, and not causation.
Not satisfied. Sure I could have made this p-value shit up, what would I know about medicine, its not like I have a degree in it… oh wait. Never mind, lets hear what the article concludes.

The huge costs of repeated rounds of OPV in terms of money and non-polio AFP shows that monthly administration of OPV must cease. The low incidence of non-polio AFP in places given less than six doses, suggests that routine immunisation is relatively safe.

So did they just suggest that vaccinating less than six doses is safe. You mean doing it as per WHO guidelines. Say it ain’t so. Not only will this save India money in terms of using less vaccines, but also in terms of human suffering, ie in the case of non polio AFP, assuming of course there is a causation and not just a correlation, which the article points out. Don’t believe me when the article said that, lets go straight to the horse’s mouth.

It is sad that, even after meticulous surveillance, this large excess in the incidence of paralysis was not investigated as a possible signal, nor was any effort made to try and study the mechanism for this spurt in non-polio AFP.

I will be up front and say the authors do suspect polio vaccine as a cause, but they won’t outright say it… because investigations have not been done, which is perfectly fair. Too bad Natural News chose not to hold such an honest stance, preferring to swipe at Bill Gates instead. What did Windows crash on them or something, or are they jerking off on their linux system.
But wait, it gets even better. Lets give it to them that polio vaccine has caused 100% of the non polio AFP cases in India. All 47,500 known cases. Happy now anti vaxxer fan boys.
Don't be.

India has 200 000 cases of polio before introducing vaccination in 1978. Its recent pulse polio program was introduced in 1995-96. In other words vaccinations have decreased more cases of polio than the new cases of non polio AFP its alleged to cause. Keep in mind that the 200 000 cases was from 1978, where India has a much lower population than todays. Its population in 1980 for example was around 682.25 million vs 1.19 billion of today. From a Utilitarianism ethics point of view, it’s a win win for vaccines.
To summarise
1. There is a correlation but not proven cause that polio vaccinations cause the increase incidence of non polio AFP
2. The authors admit the correlation seems to be due to using high doses (ie > 6 times) in one year of the vaccine, which I note is not in accordance with WHO guidelines. It the Indian government followed WHO guidelines, they arguably will still be polio free, possibly have less incidence of non polio AFP and it would have cost less money.
3. Even if the polio vaccine was the cause of non polio AFP, its still produced superior utility than not vaccinating.

I will address further points as I get to them. Please critique my analysis.

[madd0ct0r]

4. This extra high rate of repeated vaccination (stupid in itself) should not be necessary now that India is polio free. As a result, we might expect to see new cases of AFP also dropping incredibly fast in the next few years.

This is a weak argument though, as it defends the poor practice of the multiple vaccinations. It's not as weak as arguing that Indians would have been better off without vaccination at all.

[mr friendly guy]

Point two
Ok, this seems to be what we on SDN would call semantic whoring. Numerous definitions of eradication have been proposed, however the article has its own definition.

Elimination is reduction of the incidence of a disease to zero in a defined geographical area as a result of deliberate efforts. Even after elimination, continued intervention is needed to maintain the incidence at zero.

Eradication is the permanent reduction to zero of the worldwide incidence of infection as a result of deliberate efforts such that intervention is no longer needed.

Extinction is said to have occurred when the specific infectious agent no longer exists in nature or in the laboratory.

Obviously the savings in eradication comes when the disease is no longer in the “wild” we no longer have to fund immunisation programs for it. For example smallpox. Polio is one where there is a push to eradicate, however its come up against problems in the sense not all nations are doing their parts, and they can reinfect neighbouring nations. For example, despite being declared polio free since 2000, China had a recent outbreak in 2011 acquired from neighbouring Pakistan.

Eckard Wimmer has noted the WHO’s current policy calls for cessation of OPV vaccination three years after the last case of poliovirus-caused poliomyelitis. Injectable polio vaccine (IPV) will replace OPV in countries which can afford it. The risks inherent in this strategy are immense. Herd immunity against poliomyelitis will rapidly decline as new children are born who have not been infected with wild-type viruses or were not vaccinated, a situation that has never existed in human history. Thus, any outbreak of poliomyelitis will be disastrous, whether it is caused by residual samples of virus stored in laboratories, by vaccine-derived polioviruses, or by poliovirus that is chemically synthesised with malignant intent.

Just for interest, I would have thought Indians would be more worried about reinfection via a country which hasn’t controlled polio, ie neighbouring Pakistan (which already occurred in the above example) then from biological polio weapons. But since that’s the card the journal article decided to play, lets go with it.

Lets start with their definition of eradication. Basically when the incidence is zero and intervention is no longer required. They argue that intervention will still be required because someone with malignant intent (oh what the heck, they most probably mean terrorists cough Pakistan cough China cough) could just conjure it up in a lab. To wit

Wimmer writes that the test-tube synthesis of poliovirus has wiped out any possibility of eradicating poliovirus in the future. Poliovirus cannot be declared extinct because the sequence of its genome is known and modern biotechnology allows it to be resurrected at any time in vitro. Man can thus never let down his guard against poliovirus. Indeed the 18-year-old global eradication campaign for polioviruses will have to be continued in some format forever.

So the devil is once again in the detail. It depends on whether how likely someone will manufacture it in the lab and release it, or it will escape from the lab (small pox didn’t, although the evil American government certainly manufactured small pox and we needed renegade FBI agents Mulder and Scully to save the day).

If its not likely its stretching the definition. Going on, I am unaware any government trying to stock up enough drugs to cover the whole population in the event of a biological attack, which essential the journal article argues we have to do with polio. In fact how many biological weapons have actually devastated human populations more so than natural endemics, like flu or small pox. Answer – none. So in other words, I query whether they are talking up the effect of a player with malignant intent.

Lets to on. Lets see who will analyse these players.

Non state actors – again the best known biological attack by a non state actor I am aware off, was the anthrax scare a few years ago. Hardly devastating compared to the flu pandemics. Also you run into the problem where are they going to find the funding to develop their biological weapons. Is biological weapon development even cheaper than some alternatives. For example the Aum Supreme Truth Sect ended up using chemical (Sarin gas) to kill Japanese subway commuters.

State actors – these clearly have the money. I am unaware that the US still does it (but I know these people who love infowars also believe the believe the US created HIV) so that most probably won’t work. However, the State actor also runs the risk of blow back from their own biological weapon. If State actors aren’t crazy enough to nuke the opposition and risk nuclear retaliation, it’s a hard sell to explain why they are willing to dabble in biological weapons and risk their own blow back.

Also notice the authors want their cake and to eat it as well. To wit.

It is tempting to speculate what could have been achieved if the $2.5 billion spent on attempting to eradicate polio were spent on water and sanitation and routine immunisation. Perhaps control of polio, to the level of elimination, may well have been achieved as it has been in more developed countries. When the US was badly mired in Iraq in 2005, Joe Galloway suggested that the US must simply declare victory, and then exit (35). Perhaps the time is right for such an honourable strategy with regard to polio eradication.

And earlier I noted they said

Wimmer writes that the test-tube synthesis of poliovirus has wiped out any possibility of eradicating poliovirus in the future. Poliovirus cannot be declared extinct because the sequence of its genome is known and modern biotechnology allows it to be resurrected at any time in vitro. Man can thus never let down his guard against poliovirus. Indeed the 18-year-old global eradication campaign for polioviruses will have to be continued in some format forever.

So basically on one hand, they say that the money on polio would have been spent on water and sanitation and just “routine immunisation” (which they appear to define as oral vaccine e< 6 doses) yet on the other they admit that this campaign against polio in its current format must continue because of the risk of some terrorist, er I mean person of malignant intent synthesising it in the laboratory.

So if currently polio (ie natural one, which exists) is not that important, how can they with a straight face then talk about the threat of polio being synthesised in the laboratory and being used against India (ie its non existent at this point in time and purely speculative).

To further emphasis just how worried the authors are about polio coming back after its “eradicated” from the methods listed previously, here is what they say about India’s ability to defend against it.

The problem however is that the manufacturers of OPV may cease to produce the vaccine - a scenario that was predicted for India eight years ago (36). The Government of India is in a
quandary, having given up its capacity to manufacture OPV indigenously, on misguided advice from overseas (37). It is now dependent on international manufacturers for its supplies. India needs to urgently ensure that adequate supplies of the vaccines that it requires are available for our children, so that this eradication adventure does not transform itself into an epidemic disaster.

So no matter how the Natural News article tries to spin it, the authors clearly do advocate immunisation. What they argue about is
a) This tendency to give >6 doses of vaccine (not in accordance with WHO guidelines), and prefer what they call routine immunization

b) Whether this money is well spent. Note when India introduced its Pulse Plus program (what the article calls it, wiki calls it polio plus) program in 1995, the idea was to increase the vaccination rate from 95% to 100%. Its hard to say whether that extra 5% was worth it, but it certainly is a far cry from the anti vaccine spiel Natural news gave us.

c) They are worried that when polio is eradicated, eventually India as per WHO protocol will stop vaccinating, which means they are vulnerable to a re-emergence of polio from the methods discussed. They openly call for India to be able to produce its own vaccine.

I am taking a break now, and will try to address points 3 and 4, which should be shorter.

[mr friendly guy]

Point one
As they say, the devil is in the detail. A rise in non-polio Acute Flaccid Paralysis (AFP) in areas where polio vaccine is more frequently use. This seems to be a case of India’s vaccination program being different from WHO guidelines in some areas. Its not clear to me why India engages in such a program, nor is it explained in the journal article.

On further reading I think I have found the answer.


I notice in Wikipedia that some provinces in India have a low seroconversion rate (~80% after three doses against type 1) whereas the average is 95% seroconversion. We need 80-86% immunity in the population for herd immunity to kick in (ie if sufficient people are immunised, people who are not will still be protected).

The WHO article I linked to earlier did mention postulates various reasons for this lower seroconversion, eg other enteric pathogens. They however suggest various methods to increase seroconversion, eg vaccinating at birth, and maybe adjusting the number of doses.

The evidence appears that 6 doses is relatively safe, but India obviously went beyond that.

Now back to the points.

Point 3
Firstly I would like to draw attention to this.

India spent billions on the polio eradication scam when it could have used that money to improve water and sanitation.

What natural news said, and now compare to what the journal article said.

It is tempting to speculate what could have been achieved if the $2.5 billion spent on attempting to eradicate polio were spent on water and sanitation and routine immunisation.

Hmm. So Natural news mentions that the polio eradication money could have been spent on water and sanitation. The journal article mentions the polio eradication money could have been spent on water and sanitation. It also mentions that the money could be used on routine immunisation (ie not the monthly vaccines India was administering). Funny how Natural News chose to conveniently ignore that last part even though its in the same line as mentioned in the article. Sins of omission indeed.

But lets get to the crux of the matter. Could the money had been better spent on something else? Perhaps, but without an analysis (which the article does not do) there is no way to say whether spending on water and sanitation would be better spent. Certainly now that India has been declared polio free, we would expect the incidence of non polio AFP to drop (assuming its caused by the vaccine) and India to save money as the WHO policy states for “cessation of OPV vaccination three years after the last case ofpoliovirus-caused poliomyelitis” (from the journal article).
So that would free up money for India to spend on water and sanitation. As I noted earlier the money spent on this program over, what more than a decade (India started a program to supplement its normal vaccination of polio in a bid to not just control, but to eradicate it in 1995), is dwarfed by what India spends on its military in a given year. If you are going to go down this route, I could equally point out that India hasn’t fought a war with China during that time, so what would 2.5 billion dollars mean? Its not like Pakistan are going to beat them alone. At least what India spent on polio eradication actually achieved is goal of reducing the incidence of polio to zero.

Point 4
Natural news seems to have a hard on of hate for vaccinations.
http://www.naturalnews.com/polio_vaccine.html
Bill Gates seems to be a particular target for them, most probably because he is high profile.
Lets see what the journal article mentions

India’s programme has largely been self financed. The country has thus far spent more than Rs 120 billion (US$2.5 billion US$ 1 = Rs 50) on polio eradication after the programme started here in 1994 (2). The $2.5 billion spent by India must be seen against $2 billion spent by the United States of America on world-wide polio eradication (3), the $1.3 billion expended by Bill Gates (4), and the $0.8 billion raised by the loudest voice for polio eradication - Rotary International - over the last 20 years (5).

So lets see. If we are going to blame Bill Gates for non polio AFP, where India chose to do more than the recommended vaccinations, we should look in context of how much he contributed. India mainly contributed to its own push to eradicate polio (as mentioned earlier). Gates contributed 1.3 billion dollars mostly elsewhere. So has Gates funding of polio caused non polio AFP elsewhere?

Lets see what the article said.

The international incidence of non-polio AFP is said to be 1 to 2/100,000 in the populations under 15 (32, 33). The benchmark of good surveillance is the ability to detect one case of AFP per 100,000 children even in the absence of polio (34).

According tothis website (2005 stats unfortunately) the cases of non polio AFP is mainly around that. Now lets compare to countries which actually eradicated polio. Looking at India’s neighbour China which eradicated polio in 2000, their AFP rates at 0.8 is lower than India (using the journal article's figures). In fact, the 3 countries which had problem with polio vaccinations, Afghanistan, Nigeria and Pakistan had higher non polio AFP rates than most countries which had eradicated polio.
Again blaming Gates for the increase in non polio AFP seem spurious, when polio eradication attempts elsewhere hasn’t caused a rise in non polio AFP, Gates didn’t contribute much money to India’s own program, which as I will say again is caused by vaccinating frequently beyond WHO guidelines.

[Irbis]

I will address further points as I get to them. Please critique my analysis.

Overall, it's pretty solid, but... For who it is, exactly? Most people who would read that would agree with it already, while people who need to read it would need an education refreshment first, and would dismiss it as too long, boring and sciencey as it is. I'm just curious, who is target audience?

[mr friendly guy]

Its mainly on another messageboard where I mainly peruse the Chinese economic, political forums, plus the science forums. There are several forums on Chinese military (its the board's primary focus) but I just look at the pretty pictures since I am not knowledgeable enough to comment. Some of the topics discussed seem to be ones already hashed out a few years ago on SDN, eg peak oil, resource crunch related threads, Chinese economic growth vs Indian economic growth etc. So most members are ethnic Chinese (either from the Chinese diaspora or from the PRC) with some Indian and Pakistani posters as well with guys from other countries as well. IIRC there was only one other Australian besides myself.

Generally some of the regular posters are science friendly, in the sense they love it and can quote the scientific method, even if I disagree with how they apply it sometime.

Some give lip service to science, but when you push them clearly know less than I did in high school. Unfortunately some members seem prone to conspiracy theory thinking, and thats a polite way of describing them. Combine that with Crank Magnetism and a distrust of "mainstream media" (which is naturally Jewish controlled ) and you have a tendency to believe bullshit, apply pseudo scientific thinking, yet at the same time sing the praises of science (naturally without understanding it). So at least they accept science. Thats a start.

These guys tend to post articles from "alternative newsites" like infowars, natural news (which appears to be a Taiwanese site), and find it easy to believe the works of racists like Rushton (which was discussed in this thread) and others crank sites. Its getting to the stage where they are now starting to post these articles in threads not related to the topic being discussed. So I get irritated when I am trying to read up on Chinese science and technology (like reading up on the latest launch of the Beidou GPS competitor) and I come face to face with WESTERN SCIENCE IS TEH EVEL posts, in a thread dedicated to Chinese technology and science.

In case you are wondering, the members who are this credulous seem to be from the Chinese diaspora rather than the PRC itself. But then we don't have that many members yet, so who knows.

As with these types of post, its less so to convince the idiots who subscribe to conspiracy theories, but to people watching from the sidelines. I know I have at least convince some people, because the board has a "like" function where if you like a post made by someone, you can click on it and I know people have liked it. And the fact one of the mods has backed me when I have clashed with them.