Posted on 11/16/2008 4:55:09 PM PST by neverdem
Passionate intensity, but little rationality, in the anti-immunization movement
Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure, by Paul A. Offit (Columbia University Press, 328 pp., $24.95)
For some reason, the immunization of children has always aroused opposition of almost religious fervor. For example, a mass movement led resistance to smallpox vaccination in Britain for 70 years and was supported by intellectuals of the stature of George Bernard Shaw, who never believed in the germ theory of disease and thought that Pasteur and Lister were charlatans. Politicians have won or lost elections on their attitude to vaccination. And the extensive literature produced by the antivaccination movement attributed virtually every human ill, from general failure to thrive to the recrudescence of leprosy, to the practice. The movement also imputed the worst possible motives to vaccinators, including Edward Jenner himself, the developer of the smallpox vaccine.
Fears about immunization have reappeared with monotonous regularity. Perhaps it is the medical and social pressure to immunize that stirs up such opposition, especially in countries that pride themselves on their sturdy individualism. And while everyone agrees that prevention is better than cure, a single case of a complication wrought by immunization has more emotional impact than a million cases prevented. The former, after all, is a definite presence, the latter a ghostly absence.
The combined measles, mumps, and rubella vaccine is the latest to act as a lightning conductor for parental discontent. Paul Offit’s new book, as readable as a good detective novel, tells the story of how autism, a disorder of psychological development, came falsely to be blamed first on the MMR vaccine and then on thimerosal, a preservative found in several vaccines. It is a tale about bad science, worse journalism, unscrupulous political populism, and profiteering litigation lawyers.
In 1998, a young British surgeon named Andrew Wakefield published a paper in The Lancet suggesting an association between the measles component of the triple vaccine and the development of childhood autism. Though the paper stressed that no causative relationship had been proved, Wakefield took the most unusual (and self-promoting) step of calling a press conference, in which he suggested that the vaccine should be withdrawn. Panic ensued, immunization rates declined, and measles made a comeback in Britain. The panic spread across the Atlantic.
Wakefield’s paper, though, was a very bad one, and the editor of The Lancet—one of the most prestigious medical journals in the world—should never have countenanced publication of such rotten science. The ensuing uproar made necessary expensive and time-consuming epidemiological research that repeatedly failed to find any connection between the vaccine and autism. It seems likely, moreover, that Wakefield knowingly falsified some of his results. Those that he did not falsify were based on grossly deficient laboratory technique. An investigative journalist discovered a few years later that Wakefield had received payments from a serial litigation lawyer who hoped to mount a class-action suit against the vaccine’s manufacturers. Despite all this, Wakefield still has faithful followers, as do all false messiahs who survive their own predictions of the end of the world.
Closely allied with the MMR theory is the contention that thimerosal in vaccines causes autism. There is not the slightest evidence in favor of this conclusion, but it, too, has devoted believers. Parents who first notice their children’s autistic traits soon after immunization with MMR are understandably difficult to persuade that their experience is of almost no value in deciding the question of causation. Where two events, such as MMR vaccination and the development of autistic traits, are common, it is inevitable that people will mistakenly associate them with each other. But it is shameful that politicians and journalists should fail to understand this fairly simple point. I cannot make up my mind whether it would be worse if the politicians were merely cynical or actually ineducable.
False theories of causation are apt to call forth absurd or even dangerous methods of cure, and so it was in this instance. Children have been assaulted—often at great expense—with a host of special diets and medicaments in the hope of cure. One can only sympathize with the desperate parents, eager to clutch at any straw to find a satisfying explanation for the misfortune that has befallen them. But for the false messiahs, at best self-deceived and at worst outright fraudulent (and sometimes, I suspect, a little of both), one can feel nothing but outrage.
Offit’s book raises questions much broader than his ostensibly limited subject matter would suggest. What is the place of scientific and scholarly authority in the modern world, and how is it to be institutionalized in a democracy? Is it inevitable that the best should now lack all conviction while the worst are full of passionate intensity? What is the relation between information, on the one hand, and knowledge and wisdom, on the other? Cranks are often oversupplied with the former and deficient in the latter, not realizing that there is a difference between the two. Autism’s False Prophets gives no easy answers, but it does provide a rich source of material for political philosophers and even epistemologists, who ought to assign it to their students.
A final note on the question of passionate intensity: Offit, a prominent public defender of child immunization (who recognizes that, as with any medical treatment, it can sometimes have harmful effects), has been persecuted and threatened by activists who disagree with him. He begins his book with the startling statement, “I get a lot of hate mail.” He has been branded on some websites as a terrorist, and he has sometimes needed police protection. I found out firsthand how deep the passions against him run when I published a positive review of one of his previous books and received abusive e-mails in reply. Readers accused me not merely of error, but of complicity in corruption and depravity. This is surely extraordinary.
Theodore Dalrymple, a physician, is a contributing editor of City Journal and the Dietrich Weismann Fellow at the Manhattan Institute.
Fears about immunization. Where did they come from? The news?
The thing is, without immunization, the USA becomes vulnerable to biological attack.
I say that all the time, myself, Theodore. Only I'm a humble redneck breeder, so it comes out as, "Are they evil, or just hawg-stupid?"
Dierdre Imus is another one.
“The movement also imputed the worst possible motives to vaccinators, including Edward Jenner himself, the developer of the smallpox vaccine.”
What planet is this guy on?
Is he not aware that the smallpox vaccine for health care workers was discontinued because of the number of deaths associated with it? He brushes that off as though it’s of no consequence.
“The thing is, without immunization, the USA becomes vulnerable to biological attack.”
That’s a different issue.
Being immunized for an attack like that is nothing like being immunized against something like chicken pox. The public is willing to vaccinate against serious illnesses in the event of an attack but the real issue is that there is a lot of money to be made off of vaccines.
Vaccines are oversold in this country. The effectiveness of most of them is not nearly what people expect, and the immunity conferred by most of them wears off after a few years (even for ones that don’t have boosters).
A better way to effectively vaccinate would be to do a blood test to see if someone has developed antibodies as would be expected. This would tailor the dose to each individual instead of the same dosage for a 120-lb. woman and a 250-lb man.
If the fact does not fit, you must reject it!
Unless the attack is chicken pox or polio or T.B.....
“Unless the attack is chicken pox or polio or T.B..... “
Chicken pox is a completely different issue than polio or T.B.
It’s silly for you to put that one in there.
Ditto. I have a kid who is autistic. My suspicion is not about the mercury preservatives but the interactions of too many shots givened in such a short time from newborn to four years old. That is the new theory emerging on Gulf War Syndrome possible caused by the interaction amongst the shots givened to soldiers prior to deployment. Someone did a study on the Amish in PA. Surveying two counties they found only two cases of autism. The two kids were adopted under the age of 2 years old. Like the states to expand on the study to determine why the Amish have a low austism rate (is it immunization, no processed foods, etc, etc, etc) and compare it to the non Amish population.
“If the fact does not fit, you must reject it!”
Here’s another factoid:
The August 2008 issue of The Lancet reported that research shows that the influenza vaccine is ineffective in preventing pneumonia in the elderly who have been exposed to the flu.
Preventing pneumonia as a side effect of influenza is one of the big selling features of the flu vaccine.
Now the question is, will the maker of the vaccine stop advertising this non-existent benefit?
That’s absurd.
“That’s absurd.”
Try responding to what I said with facts and logic next time instead of wasting bandwidth like that.
Exactly...
Autism is a genetic disorder.
It is an x-linked chromosomal disorder.
However, for many and most diseases, genetic and environmental factors both play a part.
With autism that is not certain. The vaccine preservative may be just one of many environmental triggers. To blame it as the cause is entirely irresponsible...
This is a real problem in the philosophy of science. Immunology, unless you are God, is as much art as science. Coming up with hypotheses about how to foil a particular pathogen is a matter of inspiration and narrative—then you have to test them with robotic objectivity. All the cool-headed objectivity in the world won't make up for a deficiency in the artistic part of science. In short, scientists are often geniuses, but are men limited in the scope of their thinking, and can't consider every angle.
That's one source of uncertainty when it comes to the real or imagined hazards of vaccines. The second is the sheer idiocy of the public-health machine, as third-rate minds set out to apply the creations of first-rate ones. I sympathize with much of what the author is saying, but it's unfortunate that he doesn't mention some well-established problems. For instance, chicken eggs are used in the making of some vaccines, and some young children have catastrophic allergic reactions to egg, including brain damage or death, especially when it's injected. The bloodstream is not made to have anything put into it directly—we have digestive systems, noses, and skin to prevent that. (AIDS, anyone?) So you might expect that going around our defenses could produce some complications.
Do doctors and nurses administering vaccines try to find out if the patient has any notable allergies? Occasionally. Do they ask about family histories of allergies, when the patient is a newborn? I've never heard of it.
Vaccination is applied to populations, but populations are made of individuals. One-size-fits-all medicine, maintained by the stick of regulation and the carrot of subsidy, produces the chaos, contempt for the customer, and ham-handed silliness that always accompanies socialism. May it please God, one day U.S. medicine will operate in a free market, and the theory and practice of immunization will improve along with it.
Bioterrorism’s Deadly Math - Despite billions spent, we’re not yet ready for a big attack.
A federal scheme in 2003 to inoculate half a million health-care workers against smallpox foundered after Washington failed to provide guarantees that workers who fell ill because of the vaccine would be compensated; only 40,000 workers volunteered to be vaccinated, 8 percent of the target.
As healthcare institutions are a focus of smallpox transmission early in an epidemic, several mathematical models support pre-event smallpox vaccination of healthcare workers (HCWs). The deciding factor for HCW voluntary vaccination is the risk of disease exposure versus the risk of vaccine adverse events. In a United States military population, with careful screening to exclude atopic dermatitis/eczema and immunosuppression, over 1 million vaccinia (smallpox) vaccinations were delivered with one fatality attributed to vaccination. Among 37901 United States civilian volunteer HCWs vaccinated, 100 serious adverse events were reported including 10 ischemic cardiac episodes and six myocardial infarctions - two were fatal. This older population had a higher rate of adverse events due to age-related coronary artery disease. T-cell mediated inflammatory processes induced by live vaccinia vaccination may have a role in the observed acute coronary artery events. With exclusion of individuals at risk for coronary artery disease, atopic dermatitis/eczema, and immunosuppression, HCWs can be smallpox vaccinated with minimal risk. A carefully screened multidisciplinary cadre (physician, nurse, infection control practitioner, technician), pre-event vaccinated for smallpox, will supply the necessary leadership to alleviate fear and uncertainty while limiting spread and initial mortality of smallpox.
I have repeatedly sounded off on this topic. I will make it simple this time. Offit is full of CRAP and all too selective with his choice of “facts”. Wakefield is essentially correct despite abandonment by many colleagues. While unusual, his ideas are not that radical and what he is asking for is entirely practical. He NEVER said don’t take the vaccines, just space them apart. That’s it. For this he’s vilified. Just amazing.
But the health officials fought the simple idea tooth and nail.
P.S. We are still waiting for a good explanation as to why Amish kids, who do not get vaccinated, rarely have autism.
If the fact does not fit, you must obscure it!
(Yes, this is the sum total of Johnny Cochran's legacy.)
Read the entire article, very good.
Two vaccines that have had the greatest impact on the U.S and probably the rest of the world are the polio and small pox vaccines, effective, safe, and conferring long term immunity.
Insofar as vaccines being oversold, oversold in what way?
Whooping cough and diphtheria were once deadly serious childhood diseases yet how many children die of them now?
Indeed if the effectiveness of such vaccines wears off why don't millions of adults come down with such diseases?
It's because the vaccines are effective over long periods, so effective diphtheria is viral unknown in the U.S. as one example.
So apparently the vast majority have and do understand that a widely vaccinated population is a more healthy population.
What has been demonstrated that it ISN’T, is caused by vaccines.
What was the number of deaths? Deaths to whom? The health care workers? Associated in what way? This statement is meaningless,
“Is he not aware that the smallpox vaccine for health care workers was discontinued because of the number of deaths associated with it? He brushes that off as though it’s of no consequence.”
virtually not viral
Honestly, on the vaccines that have been around for years - DPT, polio, etc - IMHO are fine (given that my medical qualifications are roughly as good as Ms McCarthy's). What concerns me are the newer vaccines that are being pushed hard - Hpv comes immediately to mind. Frankly, I think that any vaccine that needs its own primetime TV ad campaign, is suspect. If it's OK, then it should be able to stand on its own merits. After all, it's not like there are competing vaccines for Hpv out there.
You are correct.
What you're missing out on is that they already are.
Vaccines are not just stamped with a big fat approval stamp. The HPV vaccine test subjects (something like 15,000 women and girls) were followed for more than 5 years, and that was after a long drug approval process.
Now, if you're objecting to mandating HPV vaccination, I agree with you: celibate women are not at risk for the disease. Let's make this requirement, instead. Women who get birth control from Planned Parenthood must submit to mandatory vaccination. Let's see how the libs like that.
Some of the other new vaccines really do need to be made mandatory. For example, we really do have a Hepatitis pandemic in this country, and the newer Hep vaccines should be given to everybody, not just children.
My comment on this post isn't really about those issues, however. Rather, it is about a number of paranoiacs who're easily convinced that there are conspiracies afoot behind every new therapy, and who've been able to use some really simple-minded boobs (like McCarthy and Imus) to push a public debate that there's some relationship between vaccination and autism. There simply isn't. These idiots have been trying to peddle this connection by one mechanism or another for years. After Thimerosal was discontinued, they continued to pretend it was a cause, even claiming the Thimerosal use hadn't actually been discontinued and was merely being hidden, or that expired vaccines were still being given. No. This "link" is crap from start to finish, and no epidemiologist of any standing has ever taken the so-called link seriously. There are no serious studies about this because frankly, none of the indicators necessary to trigger interest in research have ever met the threshold. Meantime, people are placing their children and the larger society at risk over the opinions of these kooks.
It’s silly for you to put that one in there
Living in the Century after a vaccine has been found, that can easily be said. But Chicken pox can, and has been a serious disease
http://dermatology.about.com/cs/chickenpox/a/chickencomp.htm
Chickenpox is typically a benign, self-limited disease, but serious complications can arise. About 14,000 people are hospitalized because of chicken pox and approximately 100 people die of chickenpox every year. The risk of complications is highest in people with compromised immune systems, newborns, and adults.
http://www.nativeremedies.com/ailment/natural-treatments-for-chickenpox-rashes.html?ysmchn=MSN&ysmcpn=MSN+Main&ysmgrp=Chikkie+Spot+Soother&ysmtrm=chicken+pox&ysmtac=PPC#question5
What complications can occur during chickenpox?
People with a high risk of complications from chickenpox such as pregnant women, newborn infants or those with weakened immune systems need immediate medical attention if exposed or develop chickenpox. They may be prescribed antiviral drugs such as acyclovir or intravenous immune globulin (IGIV).
Other complications that may result from chickenpox include bacterial infections of the skin, pneumonia or inflammation of the brain (encephalitis). If you have had chickenpox as a child, there is a likelihood of developing shingles (when some of the varicella-zoster virus remains in the nerve cells and reactivates and surfaces as shingles).
Chickenpox can also cause serious complications during pregnancy. When the infection occurs early in the pregnancy or just before the birth, a number of problems such as low birth weight, fetal abnormalities such as limb abnormalities, neurological damage and scarring of the internal organs can develop.
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