Harvard Trained Immunologist Demolishes CA Legislation That Terminates Vax Exemptions 2016 Circle of

[pogoman]

University of San Diego just had a mumps outbreak last week.
5 people infected and so far no increase, looks like the herd immunity is doing its job.

 

[spacyrov]

no, myth is inappropriate if only by virtue of those definitions you nicely provided. Of course there is science to support the positions you disagree with; you just don't seem to feel that science or its conclusions are compelling enough. I fear, however, you are indulging yourself at the expense of an honest discussion. If you want to claim there is an error in logic, that is different, imo.

Please go back and read both of my posts again. It should have been obvious that I was trying to point out that anti-vaxxers like Obukhanych use faulty reasoning (i.e., errors in logic) to justify their scientifically untenable positions.

The point I am trying to make essentially boils down to this:

This being the real world, one has to remember that vaccines are not perfect. They are not 100% effective, and there can be rare serious side effects. What differentiates anti-vaccine cranks from, for example, scientists who deal with issues of efficacy versus side effects and potential complications all the time, is exaggeration far beyond what the scientific data will support. For example, if the influenza vaccine is less efficacious than perhaps we would like (which is true), then it must be useless. This is, in essence, the Nirvana fallacy, wherein if something is not perfect it is claimed to be utterly worthless. Part and parcel of this approach involves the complement, namely vastly exaggerating the potential side effects and complications due to vaccines to paint them as being far more dangerous than the diseases they prevent.

It's right there in my first post.

Also, I think you are misunderstanding what I am referring to as myths. These are some of the myths I'm referring to the open letter:

• choosing not to vaccinate your children does not and cannot endanger the rest of the public since the recommended vaccines have no effect on disease transmission
• vaccines are not effective at disease prevention
• herd immunity doesn't work so it's pointless to take measures to increase immunization rates
• vaccines are dangerous (i.e., serious adverse events are devastating and very common) whereas vaccine-preventable diseases are mild/harmless and the child will probably never be exposed to them anyway
• natural exposure to diseases is preferable to vaccination since vaccines aren't perfect

I find it very hard to believe that there is any science out there that supports these statements in any meaningful way (key word being meaningful). Therefore, I think it's appropriate to call them myths.

That doesn't mean I am denying the fact that there are issues with vaccine safety and efficacy; they definitely exist and we need to address them. I thought I made that clear when I said "There are responsible and constructive ways to discuss issues in vaccine safety (no one is denying that they exist)" in my last post.

I just want people to recognize the open letter for what it is. If this thread started off with a more objective and balanced article (e.g., a post discussing the reasons for and against eliminating non-medical exemptions), I wouldn't have felt the need to point all of this out. In contrast, here is an example of a discussion on vaccine safety that I can totally get behind. See the difference?

For instance, individuals object to not being informed of all the risks, or of all the importantly relevant efficacy stats (does it work 99%, 80%, 75%; are all strains impacted, etc). If I expose myself to a vaccine that clearly will be influencing my immune system, I want to know if it is only effective against a single strain of a disease that has 300 strains, and that it only carries a 75% efficacy for that single strain, and maybe needs a a booster...Multiply parallel concerns by how many vaccines? You get the idea?

Nobody is debating this part, though? We all want health authorities to be open and honest, informing individuals of all the risks and all relevant efficacy stats for every vaccine that is currently available. But this information needs to be provided in context.

The way the anti-vaccination movement tries to present some of this information is hugely misleading, however. They try to make vaccines seem like they're almost all risk with negligible benefits, stripping the scientific evidence of all context and only using the facts that support their narrative while leaving out the rest. This gives well-meaning but naive parents who happen to stumble upon their sketchy websites a very skewed perspective, increasing the perceived risk of vaccination and lowering vaccination intentions.

By the way, when I talk about anti-vaxxers, I'm not referring to the more level-headed people who are still getting their children vaccinated (because they know it's important) but are a little wary of the side effects and stuff like that.

The people I'm referring to are the ones who recommend rejecting vaccines altogether or, at the very least, putting children on an alternative/delayed vaccination schedule. I especially have a problem with those who engage in conspiratorial thinking (i.e., the government and Big Pharma are trying to poison our children in the name of corporate greed and must be stopped, doctors are just paid-off puppets who do their bidding so they can't be trusted) and spread propaganda about vaccines being toxic and dangerous.

Looking at Obukhanych's past work, I have reason to believe she is firmly in the anti-vaccination camp, even though her open letter might not make it immediately obvious.

You speak of disingenuousness; the irony is striking, as this has been claimed to be a core issue concerning some manufacturers of vaccines, as well as their key "supporters".

Can you provide any evidence for this claim? Because this just sounds like pure propaganda to me.

Many, too, believe that vaccines can serve a good purpose, just not all vaccines at such an exposed age for infants and toddlers . . .

"Too many, too soon" is a classic anti-vaccine trope that has no scientific basis. Alternative vaccination schedules are based on unfounded fears, not science. This is what the WHO has to say about this misconception:

"Giving a child multiple vaccinations for different diseases at the same time increases the risk of harmful side effects and can overload the immune system".

Children are exposed to many foreign antigens every day. Eating food introduces new bacteria into the body, and numerous bacteria live in the mouth and nose, exposing the immune system to still more antigens. An upper respiratory viral infection exposes a child to four to ten antigens, and a case of "strep throat" to 25 - 50. According to "Adverse events Associated with childhood vaccines", a 1994 report from the Institute of Medicine in the United States, "In the face of these normal events, it seems unlikely that the number of separate antigens contained in childhood vaccines . . . would represent an appreciable added burden on the immune system that would be immuno-suppressive."

Indeed, available scientific data show that simultaneous vaccination with multiple vaccines has no adverse effect on the normal childhood immune system.

A number of studies and reviews have been conducted to examine the effects of giving various combinations of vaccines simultaneously. These studies have shown that the recommended vaccines are as effective in combination as they are individually, and that such combinations carry no greater risk for adverse side effects.

. . . There are two practical factors in favour of giving a child several vaccinations during the same visit. First, we want to immunize children as early as possible to give them protection during the vulnerable early months of their lives. This generally means giving inactivated vaccines beginning at two months and live vaccines at 12 months. The various vaccine doses thus tend to fall due at the same time. Second, giving several vaccinations at the same time will mean fewer clinic visits for vaccinations, which saves parents both time and money and may be less traumatic for the child.

@barbc56 already did a great job showing how much effort goes into developing the U.S. childhood vaccination schedule, but I just wanted to add a direct quote from the CDC itself.

Who recommends vaccines and what is considered in the recommendation process?

The Centers for Disease Control and Prevention (CDC) sets the U.S. childhood immunization schedule based on recommendations from the Advisory Committee on Immunization Practices (ACIP)—a group of medical and public health experts. This schedule also is approved by the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). To develop comprehensive recommendations for each vaccine, ACIP works throughout the year, reviewing available data on new and existing vaccines. The information ACIP reviews for each vaccine always includes—

• The safety and efficacy of the vaccine when given at specific ages—only vaccines licensed by the Food and Drug Administration (FDA) are recommended, and vaccine makers must conduct rigorous tests to show that a vaccine is safe and effective at specific ages.
• The severity of the disease—vaccines recommended for children prevent diseases that can be serious for them, potentially causing long-term health problems or death.
• How many children get the disease if there is no vaccine—vaccines that do not provide benefit to many children may not be recommended.
• The differences in how well a vaccine works for children of different ages—the ability of vaccines to help the body produce immunity can vary depending on the age when the vaccine is given.

Steven Novella also makes a convincing case for why it's best to stick with the current vaccination schedule.

. . . or anyone whose immune system may not be fully developed or operational.

The new law in California only eliminates non-medical (i.e., personal and religious belief) exemptions. Medical exemptions for the school mandate remain intact so it doesn't really affect those that have documented problems with their immune system.

It's a bit trickier for people who have good reason to believe they have a dysfunctional immune system (e.g., ME/CFS patients) but have a hard time getting their doctor to take them seriously. No system is perfect and there will always be people who fall through the cracks. But the more practical solution would be to call for more research into these conditions and how vaccines affect these groups, not trying to fight a law that is being put in place to protect the public.

And then there is the notion that any govt should have the right to impose its will about the health of a purported majority of its citizens at the expense of the minority. Although this reflects democracy in its undiluted form, I think it also speaks to a darker and more dangerous aspect.

This is about minimizing harm for as many people as possible, not about sacrificing the minority to protect the majority. It doesn't make any sense to say that since vaccines are not 100% safe in all cases, the government has no right to 'force' them on us and that the rest of us should just suck it up and deal with the outbreaks as they happen because freedom. You do realize that containing outbreaks can get very expensive, right?

Also, what makes you think that the individuals who are more likely to experience a serious adverse event after getting vaccinated would emerge unscathed in the event of an outbreak? Here is a quote from the article I linked to earlier:

Even if immunization does prove risky for certain children, withholding the vaccine could pose a greater threat. Vaccine-preventable diseases can be particularly severe or even fatal for patients with metabolic disorders, says Marshall Summar, chief of the division of genetics and metabolism at the Children's National Medical Center in Washington DC.

There are quite a few parallels here with the debate on gun control. I guess it ultimately comes down to what one values more: public health or personal liberty.

Personally, I feel that a top-down approach is necessary in this case, as trying to respect everyone's 'right to choose' with respect to vaccination obviously isn't working. There is just too much at stake.

P.S. I might not be able to reply for a while due to PEM...

 

[duncan]

Agreed: There IS too much at stake; in my opinion, that means too much at stake to cede such an important decision concerning one's family to state-protected corporations, bureaucrats, and organizations like the CDC. You have to weigh the data and make a personal call.

Btw, citing the CDC to this audience may not elicit the response you desire.

I believe if you feel a strong support for vaccines, then you should have the freedom to get them - for you and your family.

I just wish people would respect my right to decline them if I so choose.

 

[spacyrov]

Agreed: There IS too much at stake; in my opinion, that means too much at stake to cede such an important decision concerning one's family to state-protected corporations, bureaucrats, and organizations like the CDC. You have to weigh the data and make a personal call.

That's not what I meant by "too much at stake". You are agreeing with me while at the same time arguing the exact opposite of what I said. So no, we don't agree. Sometimes I wonder if you even bother reading my posts...

Btw, citing the CDC to this audience may not elicit the response you desire.

I cited the CDC because they set the U.S. childhood immunization schedule. I'm not suggesting that people accept everything they say as completely true without doing any research (please take care to avoid the sketchy websites though). I'm not exactly a fan of them either. But just because they are wrong in one area doesn't mean that everything they say can't be trusted. Healthy skepticism is great, conspiracy theories (with no evidence) are not so great.

I believe if you feel a strong support for vaccines, then you should have the freedom to get them - for you and your family.

I just wish people would respect my right to decline them if I so choose.

I can't respect your right to decline them if your decision is based on misinformation like Obukhanych's letter, and when it means that it will put the rest of us at risk for these diseases. Nope, sorry (not sorry).

 

[duncan]

I see, I guess.

Is it something along these lines: There is only one true political option, and only the righteous or intelligent get it, and everybody else better buy into it and accept it, too, or else?

I seem to always get this stuff wrong. I usually pick the wrong line in the grocery store, too.

I even got the wrong disease.

But at least they're my mistakes to make.

 

[geraldt52]

When the vaccination schedule ultimately has to rely on force, rather than acceptance, for compliance, one has to question the strength of the argument for the schedule. Ironic too that the states and communities with the lowest levels of education tend to be among the ones with the best compliance (think Mississippi), and the states and communities with the highest levels of education (think Colorado) tend to be among the ones with the worst compliance...one would certainly think it would be quite the opposite.

I believe "vaccination" has become more religion than science, and I've never known or seen a single person's mind changed by arguing. I don't care that we can't agree, I do care that one side's faith is now being forced onto the other.

 

[IreneF]

When the vaccination schedule ultimately has to rely on force, rather than acceptance, for compliance, one has to question the strength of the argument for the schedule. Ironic too that the states and communities with the lowest levels of education tend to be among the ones with the best compliance (think Mississippi), and the states and communities with the highest levels of education (think Colorado) tend to be among the ones with the worst compliance...one would certainly think it would be quite the opposite.

I believe "vaccination" has become more religion than science, and I've never known or seen a single person's mind changed by arguing. I don't care that we can't agree, I do care that one side's faith is now being forced onto the other.

Mississippi does not allow non-medical exemptions.

Vaccinations are not faith-based. That is one of the arguments that creationists throw at people who accept evolution as the best explanation for speciation--they call it "scientism"--equating a "belief" in science to a belief in God.

 

[geraldt52]

Mississippi does not allow non-medical exemptions.

Vaccinations are not faith-based...

Indeed they are. Unless you are invoking superior intellect, you have faith that the science regarding vaccines is settled, I have no such faith. I don't mind you having such faith, we all rely on faith in certain institutions to one extent or another, but I do mind you imposing your faith on me.

I'd love to see the issue before the Supreme Court but, having just finished The Great Courses series of lectures on the history of the Supreme Court, I'm not so inclined to have much faith in them either.

 

[IreneF]

Indeed they are. Unless you are invoking superior intellect, you have faith that the science regarding vaccines is settled, I have no such faith. I don't mind you having such faith, we all rely on faith in certain institutions to one extent or another, but I do mind you imposing your faith on me.

I'd love to see the issue before the Supreme Court but, having just finished The Great Courses series of lectures on the history of the Supreme Court, I'm not so inclined to have much faith in them either.

The issue went before the Supreme Court in Jacobson v. Massachusetts.

Faith is belief that is not based on proof; science changes as new evidence is found. Neither is perfect, but I'll put my money on a system based on observations and experiments. People who think vaccinations should be mandatory for healthy children have evidence, not faith, behind them.

 

[geraldt52]

People who think vaccinations should be mandatory for healthy children have evidence, not faith, behind them.

Faith in their evidence, with its inherent limitations.

Christians think they have evidence for their beliefs in the Bible, and by cherry-picking history. Muslims think they have evidence in their beliefs in the Koran, and by cherry-picking history. Neither has any particular confidence in, or even respect for, the others evidence...hence the (often tenuous) agreement to disagree, and not force ones beliefs on the other.

The collective body of knowledge we call science isn't static. It changes with new thought, new investigation, new technology. Things science was once quite certain of we now know to be nonsense. Your faith in vaccines may in the end prove to be warranted, or it may in the end prove to be nonsense. I can't know, and neither can you. So is it really justifiable to impose your faith on someone else as though it were a certainty.

 

[duncan]

Science does not change as new evidence is found, @IreneF . Scientific opinion does.

Scientific opinion is not just predicated on evidence. It is also often a creature of perspective or interpretation. Ultimately, it is an amalgam of facts and perspectives and personalities.

Scientific opinion is not static. It changes. It can change about the same subject, and it has done this often.

Faith comes into play when you become vested in the belief that a given scientific opinion will not change.

My scientific opinion might not trump anyone else's - or visa versa. By the same token, for me, someone's faith does not give them the right to impose their beliefs on me or mine..

 

[geraldt52]

... Vaccinations are known to be unsafe for some and there is an avenue for complaint in the USA, so why not put in a complaint...

If a person "put in a complaint" are they able to restore a normal life to the injured person? And why the need to indemnify the vaccine manufacturers, and deny a person a normal trial before a jury?

 

[Undisclosed]

If a person "put in a complaint" are they able to restore a normal life to the injured person? And why the need to indemnify the vaccine manufacturers, and deny a person a normal trial before a jury?

Why ask me. I don't work for the program in the US that deals with vaccine injuries. Google it.

 

[IreneF]

Science does not change as new evidence is found, @IreneF . Scientific opinion does.

Scientific opinion is not just predicated on evidence. It is also often a creature of perspective or interpretation. Ultimately, it is an amalgam of facts and perspectives and personalities.

Scientific opinion is not static. It changes. It can change about the same subject, and it has done this often.

Faith comes into play when you become vested in the belief that a given scientific opinion will not change.

My scientific opinion might not trump anyone else's - or visa versa. By the same token, for me, someone's faith does not give them the right to impose their beliefs on me or mine..

I already said that the process was imperfect. There is no point in quibbling over vocabulary.

Not all opinions are created equal. The opinion of the Supreme Court, for example, trumps the opinion of the lesser courts. By the same token, the consensus of the most knowledgeable people trumps that of the less knowledgeable.

 

[duncan]

The consensus of the most knowledgeable people trumps that of the less knowledgeable? Not all opinions are created equal?

Those are two scary declarations.

Who is the arbiter of what constitutes knowledge? Who decides one person's opinion matters more than another?

 

[Undisclosed]

Just to note, this thread is becoming increasingly off-topic and argumentative. Please stick to the topic of the thread. Thank you.

 

[spacyrov]

I will reply to the other stuff later but I just wanted to quickly respond to the following comment:

If a person "put in a complaint" are they able to restore a normal life to the injured person? And why the need to indemnify the vaccine manufacturers, and deny a person a normal trial before a jury?

Jeffrey Kluger wrote an excellent article for TIME explaining how the vaccine injury court works and it shows how, if anything, the numbers prove that vaccines really are as safe as the health authorities say they are. Anyone who is concerned about vaccine injuries should take the time to read it.

. . . . Since 1988, when the National Vaccine Injury Compensation Program (VICP) began, more than 16,000 claims have been considered and a whopping $3.18 billion have been awarded to families alleging some kind of harm from vaccines. That sounds awfully damning, and in this case, unlike in so many other cases, the anti-vaccine crowd isn’t just making stuff up. The numbers are real and the federal government is the first to admit it.

. . . .

The purpose of the court is to reckon with the reality that while vaccines are every bit as safe and life-saving as health authorities say they are, no drug or medical procedure is entirely without risks. Since many millions of children get vaccinated every year, even a few bad outcomes could subject the drug-makers to a storm of liability suits. Some claims might be legitimate, but far more could be frivolous or even fraudulent. Either way, the endless litigation could drive up the costs of vaccines.

In order to ensure that vaccines would be as affordable and available as possible, Congress thus created the VICP, establishing a trust fund for awards financed by an excise tax of 75 cents on every vaccine administered. Under the program, cases are adjudicated on a no-fault basis, with attorneys for the government and attorneys for the families arguing before one of eight special masters. The goal is to settle the matter as quickly and fairly as possible, though petitioners (the no-fault system avoids the word “plaintiffs”) who are unhappy with the special master’s ruling are free to take their case to the traditional civil court system.

. . . .

Even without blame being established, the billions the government has handed over in payouts since the VICP was created does seem to suggest that a whole lot of people are being harmed. But that is not the case. From 2006 to 2014, approximately 2.5 billion doses of vaccines were administered in the U.S. In that time, a total of just 2,976 claims were adjudicated by the special masters and only 1,876 of those received compensation. Divide that number by the vaccine dose total and you get less than a one in a million risk of harm. Going all the way back to 1988—before the flu vaccine became part of the recommended schedule of vaccines—a total of 16,038 claims have been adjudicated and 4,150 have been compensated, bringing the total payouts up to the $3.18 billion figure.

. . . .

“In cases in which there is a lifetime injury, the award will be the equivalent of many millions of dollars,” says New York-based attorney Robert Krakow, who has represented petitioners in hundreds of vaccine injury claims. “It could be $20 million over a lifetime.” Just three such claims a year—out of the many millions of vaccines administered annually—0ver the course of the 27 years the VICP has been in effect can account for half of the total dollars spent on awards.

 

[duncan]

Eh.

Give me good old fashion accountability any day.

 

[barbc56]

Scientific opinion is not just predicated on evidence. It is also often a creature of perspective or interpretation. Ultimately, it is an amalgam of facts and perspectives and personalities

The fact that vaccines work is not an opinion. It's backed by valid science. The fact that vaccines work and are safer than not, has evolved from data and what is known about the human body.

I can only speak for myself but if the evidence showed vaccinations as being dangerous or that they didn't work, I would be against them.

Vaccinations should be required for those in the health professions, those who work with children or are around them. It's part of the job and about not putting others in jeopardy.

I've had my say and will let others continue. We now are at the point of repeating ourselves or getting off topic and I need to save my mental energy. So QED and I will move on to other matters.

 

[Snow Leopard]

Vaccines do work - once herd immunity is achieved, infection rates drop to close to zero.

Vaccines do also have rare cases of adverse reactions - studies show rare, but very real risks of developing autoimmune disease.

(In animal models, vaccines and adjuvants are part of standard protocols in inducing autoimmune disease - for the purpose of studying autoimmune diseases (note that the dosages and where they are injected can differ). This is why the whole-cell pertussis vaccine was so controversial and ultimately phased out.)

So I don't have much sympathy for either the "vaccines don't work and are unnecessary" or the "vaccines are almost 100% safe and we should not worry about adverse reactions" groups.

In Australia we do not have a vaccine compensation scheme - so it is much more ethical to opt out in Australia vs the USA. Yet our vaccination rates are among the highest in the world (and have been increasing continuously for 20 years).

These days the risk of either an adverse effect or getting the underlying infection for most vaccine preventable diseases is almost zero (since herd immunity has been achieved). This includes measles, mumps, polio etc. Demonising the small percentage of people who voluntarily opt out may actually be counter productive since it just polarises them - they aren't actually going to change their behaviours. Secondly, this group is only a small percentage of the group that is not fully vaccinated - lack of health care access, lack of trust of the health care system etc are the big problems preventing 100% vaccination rates in most countries rather than anti-vaxxer propaganda.

I find it interesting that given the risks of either measles or an adverse reaction to MMR, that people spend so much time worrying about it. The most risky thing you do is drive a car. The leading cause of death of young people is car accidents. (The second leading cause is suicide!) More than one in ten thousand Americans are killed each year and many more are permanently disabled. Yet driving in a car is a risk that few people think twice about.

Rather than pretend there is no risk, or that vaccines don't work, perhaps we need to accept that risk and take much better care of those who are injured?

Declared conflict of interest: I became very ill shortly after an oral polio vaccine I received as a teenager (I had severe lower limb weakness and couldn't walk, it was described as Guillain-Barr-like symptoms). While I recovered the ability to walk, I am still unwell today.