They Just Don’t Learn: CDC Votes To Poison Children Again With Two Doses of Vaccines

Parents of children over 6 months and under 9 years beware. The Centers for Disease Control (CDC) is once again choosing to adopt policies which poison your children with what is now two doses of seasonal flu vaccine this fall.

So she emailed the guy the following:

Editors of PreventDisease.com,

It is this kind of fear mongering and sensationalism that lead me to unsubscribe. You should be ashamed to publish this. The use of “votes to poison” and “poison your children” is paranoid and unethical. As an educated, thoughtful person, mother and teacher, I feel your newsletter is insulting.

He replied:

From: dave.mihalovic@yahoo.com
Subject: RE: your article
cc: susan.mchilley@preventdisease.com

Are we talking about the truth or semantics here? Could you please explain to me what the “big difference” is between deliberately vaccinating children and poisoning children? Anybody who votes to inject any child with known neurotoxins, immunotoxins and sterile chemicals is, in my opinion a criminal and poisoning that child. I’m not using lies to get people to read the article…it is an unequivocal fact that vaccines are poison. If you are debating that with me, please provide your evidence that suggests the opposite.

Dave

I deal every day with people like Dave who simply deny science or medicine. Many of them are very much of the “Nothing can convince me” mindset: Dave has, quite obviously, been given all the information about vaccines time and time again; he simply denies it all and believes that his own notions are better founded. He’s probably not malicious and probably does not want children to die from preventable disease. He’s most likely just scientifically illiterate (like most people) and places more emphasis on anecdotal information that supports his ideology than on information that clashes with it.

My sense is that it’s probably futile for my friend to “provide the evidence” that he pretends to be interested in seeing. How, then, do we reach such people, people who are out actively advocating against public health? I put the question to you.

Another ideological alliance is brewing – that between the anti-vaccine movement and extreme environmentalists. This post is not a commentary on environmentalism, and please do not take it as such – the purposes and  claims of the two movements are quite distinct. But they share a common thread: distrust of scientific experts and government regulators who reassure the public that environmental exposures are safe.

Robert F. Kennedy Jr. has been the most prominent environmentalist to take up the anti-vaccine cause, in several articles and speeches. While he appears to be only a part-time anti-vaccinationist, his celebrity and street cred among evnironmentalists led a great deal of weight to his paranoid musings about scientific fraud and government coverups. It seems he wants to recapitulate the moral clarity that his uncles displayed in the 1960s, defending the little guy against abuses by the powerful and privileged. He is ready to see a conspiracy, and he wants to be the crusader for environmental justice – and if kids are the alleged victims, all the better. His article in the Huffington Post – “Attack on Mothers,” says it all.

Now there appears to be another environmentalist, who is also a journalist, getting into the anti-vaccine game – one Steven Higgs who writes for The Bloomington Alternative. He came to our attention recently when he wrote a fawning piece about Generation Rescue’s J.B. Handley. David Gorski and I attempted to reason with him over e-mail, but the result indicated to us that Higgs is not an objective journalist but an anti-vaccine activist – and he came to this position largely through his environmental activism – a budding RFK Jr. (David covers this topic also over at Science-Based Medicine today.)

In a recent article Higgs wrote:

I’ve spent most of the past 28 years journalistically investigating conflicts between environmental victims and experts in the relevant fields. And, I can say without qualification, the victims have been right and the experts wrong in every significant story I’ve covered. I can’t think of a single exception.

Such a definitive statement should raise a red flag – no qualifiers or exceptions? That sounds like confirmation bias. Many of the famous environmental cases usually end ambiguously, in that there is no definitive scientific evidence of harm from the environmental exposure, but the families and activists believe they have been harmed. So I guess if someone always sides with the alleged victims, regardless of the scientific evidence, that could confirm the belief that the victims are always right and the experts always wrong.

Another source of confirmation bias is that when claims of environmental toxicity first come to light, the standard scientific approach is to be cautious but investigate. Good scientists are initially skeptical, and require a threshold of evidence before they accept a claim. So initially scientists may say, “Wait a minute, slow down, this evidence is not compelling, we need better evidence.” If eventually the evidence suggests that there was environmental toxicity, then Higgs and others can claim that the experts were wrong – but this is a gross misreading of the nature of scientific skepticism.

This article from 1980 about the Love Canal is a good example – the scientists are simply calling for better evidence, but that can be interpreted as concluded that there was no problem. Love Canal also demonstrates that these issues are complex. There were toxins being dumped into the environment by industry who tried to deny responsibility, local residents were exposed, but the actual health consequences remain a bit controversial, and were likely not as bad as the worst of the media hype suggested. But eventually the science sorted itself out and the government cleaned up the spill and relocated all the residents.

The lesson is – that environmental stories like this one are complex, and anyone who takes a one-sided position “without qualification” is either not looking into it deeply enough or has an axe to grind.

The story of thimerosal in vaccines is far more complex. When I first looked deeply into this issue I actually was not sure which way I would go – I wanted to get the bottom line correct, and did not want to commit myself without fully wrapping my head around this complex story. At points in my research I felt there might really be something going on. It wasn’t until after I fully digested all the science and all the arguments that I was convinced there is no correlation between vaccines and autism or autism spectrum disorder (ASD).

Steven Higgs claims to have done the same thing, as an environmental journalist, but he came away with the opposite conclusion. I am interested in why – how can two people look at the same information and come to opposite conclusions? Of course, I think I am correct (although I am always willing to reconsider my position in light of new information or arguments) and I detect in Higgs the tell-tale signs of bias, as I noted above. Higgs was prepared from an environmental scandal, and he found one.

I have also seen many intelligent and well-meaning people get sucked into a complex pseudoscience – essentially they are overwhelmed by misinformation in an area where they lack expertise, and therefore cannot put that information into context. When one is confronted by a large volume of information all pointing in one direction, it seems compelling. I have even known skeptics who, after watching Loose Change, thought there had to be some hanky panky going on with 9/11. I have debated creationists who are loaded with information – all subtly distorted against evolution. Sophisticated and complex pseudosciences are a nuisance in this way, and the anti-vaccine movement has now developed into just such a pseudoscience.

What is more interesting is how Higgs has responded to scientists with whom he disagrees – and this reflects the danger of “going down the rabbit hole” of a complex pseudoscience, especially those with a conspiracy angle. Higgs wrote:

And with respect to vaccines and autism, I say again, without reservation, parents like J.B. Handley and grandparents like Dan Burton are right about vaccines and autism. The experts are wrong, and their behaviors — their vitriolic attacks upon those who disagree, their underhanded political tactics — suggest they know they were wrong.

We know we are wrong? The undeniable implication (although Higgs denied this to me and David in an e-mail) is that we are lying. We are therefore complicit in a cover up. Also – look at the extreme bias. Higgs thinks that scientists are guilty of “vitriol.” Mostly, scientists will sharply but accurately criticize Handley and his ilk, and some science bloggers will get “insolent” and that can be considered vitriolic. But it is nothing – nothing – compared to personal smear campaign that Handley and others have launched against those scientists trying to educate the public about vaccines. Remember the infamous “baby-eating” Photoshop job that was published on Handley’s propaganda blog, Age of Autism (and then taken down after it disgusted even the vitriolic echochamber of that blog community). Higgs’ characterization of the situation is so out of touch with reality that it is inexcusable for a journalist.

Also note the populist anti-intellectualism of stating that the experts are always wrong. This reminds me of creationist McLeroy’s famous comment, “Somebody has to stand up to those experts.” In his e-mail to us, Higgs coupled this with the argument ad populi logical fallacy, that he must be right because the anti-vaccine movement has successfully scared much of the public about vaccines.

He also stated that what scientists do is not hard – “That,” as Yoda said, “is why you fail.” Forgive me, but science is hard. That is, doing rigorous science, or even just properly interpreted a complex set of scientific data, is complex, tedious, and exacting. There are numerous pitfalls, and even experienced scientists can get it wrong. We need a community of scientists pouring over methods and data, and correcting each other, to grind out a consensus. I’m sorry, but being a passionate journalist (or parent) does not qualify you (as Handley himself has demonstrated on numerous occasions). It is worse to not even have any pause about the fact that the scientific community disagrees with you. That is hubris.

But I am willing to believe that Higgs and others are sincere crusaders, who are just grossly mistaken in their approach and conclusions. Higgs and Handley are not willing to give us the same courtesy – they think we are lying, dishonest, and on the take. They demonstrate that personal attacks is what you do when you don’t have science or even logic on your side.

When it comes to the details of the analysis of the scientific evidence, Higgs buys the anti-vaccine propaganda down the line. Clearly he has consumed Handley’s campaign of misinformation. With regard to a large CDC study showing no correlation between thimerosal and neurodevelopmental disorders, Higgs writes:

The study, titled “Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years,” found that exposure to mercury between birth and 28 days was related to significantly poorer “speech articulation.” It also found a “significant negative association with verbal IQ” among girls.

I have dealt with this this claim here – essentially the study looked at many outcomes, and a couple (when looked at individually) were correlated greater than chance, some positive, and some negative. But when considered as a whole, this is what we expect from chance alone. In other words, the results of this study are exactly what we would predict if there were no correlation between thimerosal and any neurodevelopmental disorder. Put into scientific parlance – this study fails to reject the null hypothesis. Understanding statistic on this level is one of those things experts do that Higgs thinks is so easy.

Higgs also engages in massive cherry picking. He still thinks that thimerosal is responsible for an epidemic of autism – even though the evidence suggests there is no epidemic of autism. But more to the point – the final nail was put into the coffin of the thimerosal hypothesis when almost all of the thimerosal was removed from the vaccine schedule by 2002. The anti-vaccine crowd (most notably David Kirby – another journalist gone astray) predicted that autism rates would plummet. They didn’t – they continued to rise. I and others predicted they would continue to rise, but ultimately would have to level off once diagnostic rates reached saturation. There are some early signs that diagnoses are starting to level off, but it’s too early to say yet. But they did not plummet.

Higgs is now trying to use some recent and minor decrease in a narrow data set in the Ohio Valley to conclude that the much predicted decline in autism rates is finally here (better late than never). He does not mention that the California data, which is the data that the anti-vaccine crowd originally used to argue for a correlation – shows no decline. David takes down this argument further on SBM – for example, the rates are leveling off for all age groups, not just the youngest cohort, which is what you would predict if this were really an effect of removing thimerosal.

This episode also reminds me of David Kirby, who in 2005 was trumping a very short-term downward deflection in the California numbers and happily extrapolating to the predicted “plummet.” But short term trends cannot blithely be extrapolated – as the California data showed. It was just a fluctuation – but the trend continued upward at the same slope.

Conclusion

Steven Higgs appears to be another player in the anti-vaccine scene. His path to this particular pseudoscience appears to be (like RFK Jr.) through environment activism. But the intellectual failings are the same that skeptics encounter over and over again in denial and pseudoscience. Higgs is cherry picking data, dismissing experts, misunderstanding statistic, and engaging in massive confirmation bias. He then shields himself from the very people who can point out his errors by denigrating them and writing them off as tainted (the Handley method).

Meanwhile he embraces the likes of J. B. Handley and turns a blind eye to his shenanigans.

I like to examine people like Higgs the way doctors study disease – there is pathology there, and by understanding it perhaps we can get better at fighting it. I tried the “seek common ground and understanding” approach over e-mail with Higgs, but he was not interested. Maybe my observations gave him a moment of pause. I doubt it, but I try never to give up on optimism.

Here is a pdf of the complaint.

The subject of the suit is the excellent article by Amy Wallace criticizing the anti-vaccine movement. Wallace was attacked for this piece by anti-vaccinationists – essentially because she got the story correct. Wallace pointed out that the science strongly favors vaccine effectiveness and safety, and that the anti-vaccine movement is dangerously wrong – hurting the public health with their misinformation. The anti-vaccinationists were apparently very upset over be called out by a mainstream journalist. They got a lot of bad press this year, the Chicago Tribune also did a series of articles detailing the dangerous pseudoscience of the anti-vaccine movement. Wallace’s article earned her a place in the infamous baby-eating photo (along side Offit and yours truly) that only served to further embarrass the anti-vaccine movement via the blog, Age of Autism.

The law suit, in this context, seems like just the next step in the campaign against Offit and Wallace.

The NVIC, despite its innocuous name, is an ideological anti-vaccination group, and they were targeted among others in the Wallace piece. Fisher found a sentence in the article that she felt she could build a libel case around.

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.

“She lies” will now be the subject of as much analysis as the term “bogus” was in Singh’s article about the BCA, so I might as well start. Critics often walk a fine line – we want to accurately portray the actions and claims of the targets of our criticism, without holding any punches, but we have to be clear in our terminology and careful not to inadvertently give the wrong impression. The term “lie” is problematic. It is not necessarily inaccurate, but it can carry implications not intended by the writer, because it may imply something about what another person knows or believes.

Often we speculate, when someone makes a claim that is demonstrably false, are they deliberately lying or are they grossly mistaken. But this is a false dichotomy. There is a vast gray zone in between. Making a claim without due diligence is a form of deception. Often people will make claims as if they are verified and documented truths, without acknowledging that the claim is controversial, or without really verifying the facts. People may care more about the utility of a claim and its relationship to their ideology than whether or not it is objectively true. Are making such claims lying? It is more than being wrong, but not quite a knowing lie.

However, when one is engaged in a public debate and advocacy about an important health issue, one has a responsibility to get basic information correct and to relay it in as unbiased a manner as possible. Being recklessly wrong in such a case may be the moral equivalent of lying.

On the NVIC website there are numerous examples of misinformation. For example, about squalene (a vaccine adjuvant) they write:

However, the use of squalene type vaccine adjuvants, which were allegedly added to experimental anthrax vaccines and made Gulf War soldiers sick, is controversial.

OK – they write “allegedly” so I guess they are covered. But this is still deceptive, and meant to scare people off vaccines. It turns out that there was no squalene in the anthrax vaccines given to Gulf War soldiers. And soldiers who developed unexplained symptoms in the Gulf War were not more likely to have antibodies to squalene. The anthrax vaccine-squalene-Gulf War syndrome connection has been completely demolished at every point. It is no longer “controversial” among scientists.

So is the NVIC statement above a “lie” or is it just sloppy misinformation – and is there a functional difference between the two?

The use of libel suits to intimidate critics and have a chilling effect on open discussion is an old strategy. As I said, the BCA attempted to do that by suing Simon Singh, taking advantage of the horrible English Libel laws. Uri Geller sued James Randi in the past for saying he cannot really bend spoons. Matthias Rath sued Ben Goldacre for criticizing his health claims. Skeptics have, to a degree, engaged in public criticism of pseudoscience with the constant threat of being sued. Even when such suits are legally unsuccessful, they can be financially ruinous and therefore an effective bullying tool.

The ability to sue for libel is an important right to redress legitimate wrongs. But this right can easily be abused to silence open discussion. For this reason many states have SLAPP laws (strategic lawsuit against public participation). Recently the Canadian Supreme Court ruled that the need for open public discussion of important issues is a legitimate defense against a libel suit.

This is also the point behind the Keep Libel Laws out of Science movement, which is partly a backlash against the BCA suit against Singh.

Now the anti-vaccine movement in getting in the game, using the threat of libel to place a chill on legitimate criticism of their dangerous misinformation. It is time for the scientific and skeptical communities to rally behind Paul Offit as we did Simon Singh. I suspect this lawsuit will backfire against Fisher as much as the Singh suit did against the BCA. Let’s take a close look at the claims Fisher makes and whether they constitute “lying”. I suspect she will not hold up well under close scrutiny, just as the BCA claims did not.

Skeptical analysis is all about shining the light of science into those dark places of dubious claims and ideology that fear the light. Libel suits are often used as a tool to shield against the light of open examination, but we should fight back by using them as opportunities to shine even more light. Fisher better put on her sunglasses.

The Richard Dawkins Award will be given every year to honor an outstanding atheist whose contributions raise public awareness of the nontheist life stance; who through writings, media, the arts, film, and/or the stage advocates increased scientific knowledge; who through work or by example teaches acceptance of the nontheist philosophy; and whose public posture mirrors the uncompromising nontheist life stance of Dr. Richard Dawkins.

The part that caused controversy was the bit about “advocates increased scientific knowledge.” A number of skeptics (Orac, I think, was most verbose)  had a problem with this because Bill Maher is an advocate for medical pseudoscience. He does not believe in vaccines, he denigrates “western medicine” as a scam, and he has a problem with germ theory.

On RichardDawkins.net Josh Timonen gave was appears to be the official defense of the decision:

Whilst Richard was not involved in the decision, he is nevertheless happy to go along with it. Just as he worked with Bishop Harries to protest against creationist schools in the UK, and just as he regularly recommends Kenneth Miller’s books on evolution to religious people, he understands that it is not a prerequisite to agree with a person on all issues in order to unite in support of a common objective. Richard and Christopher Hitchens don’t see eye to eye on all political matters, but that doesn’t stop them from working together against the dangers of religion. Honoring the creation of ‘Religulous’ does not imply endorsement of all of Bill Maher’s other views, and does not preclude Richard’s arguing against them on future occasions. It is simply showing proper appreciation of his brilliant film.

This misses the point, in my opinion. If the award were solely for Religulous, and that were clear, I don’t think anyone would have a problem with it. But the award specifically cites “science” as a necessary criterion for the award. Giving the Richard Dawkins Award to Maher was the equivalent of giving a prominent advocate of creationism and intelligent design a science award because of their opposition to the 911 truther movement. I suspect that such a decision would not sit well with Richard Dawkins and some others who were perceived to be soft on AAI’s decision. The analogies to Miller and Hitchens are not apt – Maher is so far outside the scientific mainstream on medicine that it is incongruous to give him any science award.

I did not attend the AAI conference, but reports from those who did say that Dawkins, in introducing Maher, took care to criticize his views on medicine. PZ Myers writes:

The good news for all the critics of this choice is that Dawkins pulled no punches. In his introduction, he praised Religulous and thanked Maher for his contributions to freethought, but he also very clearly and unambiguously stated that some of his beliefs about medicine were simply crazy. He did a good job of walking a difficult tightrope; he made it clear that the award was granted for some specific worthy matters, his humorous approach to religion, while carefully dissociating the AAI from any endorsement of crackpot medicine. It won’t be enough, I know, but the effort was made, and talking to Dawkins afterwards there was no question but that Maher’s quackery was highly objectionable. I also got the impression that he felt the critics of the award were making good and reasonable points, and that he felt the awkwardness of the decision.

This can be seen as recognition by Dawkins that there were problems with the award. I can only assume that this was specifically in response to criticism about giving Maher the award, since when Dawkins was first asked about the decision he simply said that he was not aware of Maher’s views on medicine.

In the final analysis, the problem that many of us have with Maher getting the award is that the totality of his views clearly indicates that Maher is not a rationalist. Because his religious views happen to coincide with those of the AAI does not mean that his views stem from a rational or scientific worldview. In my opinion, AAI simply got snookered. They focused on one aspect of Maher’s opinions, ignored the big picture, and in the end gave a science award to a pseudoscientist.

We will get past this, but it is a sore spot that will continue to ache, because Maher is not going away. Every time he spouts his nonsense about medicine it will cut a little deeper. He is still at it – take a look at this recent interview with Bill Frist.

Frist is a doctor who has apparently kept up with the literature, and he seems to know what he is talking about. Although I have criticized Frist in the past for putting his own ideology ahead of science on the Terry Schiavo case. But in this interview, Frist was the side of reason. Maher repeated his denigration of “western” medicine.

He also gets his facts wrong – he quotes Jonas Salk about the risks of live virus vaccines, without pointing out that the flu vaccine injections he is referring to are dead virus vaccines. Maher further argues that the flu vaccine does not work, when the data say otherwise. Here is an excellent review by Mark Crislip. The bottom line is that the flu vaccine works, but it is not perfect, and the primary problem (which Maher did get right sort of – it seems he can know the facts when it suits him) is that the flu strains are constantly evolving.

Maher also downplays the risks of the H1N1 pandemic. Here he is simply wrong – while H1N1 is not any more risky overall than the regular seasonal flu (which kills 36,000 people a year in the US alone), it kills more young healthy adults and pregnant women. Maher was telling pregnant women not to get vaccinated – Maher’s advice kills.

And that leads us back to the specific reason why many of us had a problem with the AAI award – it adds to the reputation of a medical crank who is using his celebrity to harm the public health (not intentionally, but that is irrelevant).  There is direct harm in Maher’s medical views, and to me that trumps any other view he might have.

The Thoughtful House agreed to the interviews because they figured they would get fair treatment from the likes of Matt. I’m interested to see what kind of a program NBC has put together on this very sensitive subject.

Depending on how this major media outlet writes the script, it could either be a major affirmation of what many within the science community already know, or it could increase the divide between anti-vax’ers and science.

Please, Matt… don’t go Jenny McCarthy on us. Don’t do the usual journalistic job of being “fair-and-balanced”. This is not a “he said, she said” issue. This is science. Do tell the world what the science supports.

About 10 years ago, Wakefield published a study dealing with children who were autistic, developing symptoms shortly after getting their shots, and linked this with irritated intestinal tracts. This study came under a lot of fire, and eventually most of the authors retracted the conclusion that autism was associated with "environmental factors", that is, vaccinations. By then, though, it was too late, and the modern antivaccination movement was born.

The Sunday Times investigated Wakefield’s original research, and alleges that the symptoms Wakefield reports in his research do not match hospital records of the 12 children studied at the time. In only one case were there symptoms that arose after the injection; in many of the other cases symptoms started before the children had been vaccinated (in fact, there have been allegations for some time that neurological issues occurred in the children before they had actually been vaccinated, casting doubt on Wakefield’s work). Also, hospital pathologists reported that the bowels of many of the children were normal, but Wakefield reported them as having inflammatory disease in his journal paper.

If these allegations are true, then it means that Wakefield out-and-out lied in his original work. He has denied this, according to the Sunday Times, but won’t make further comments.

This may cause a firestorm in the antivax community, but there are two things I will guarantee: the first is that in the end antivaxxers will stick to their beliefs that vaccines cause health problems like autism, because this is not and never has been, for them, about the facts and evidence. It’s a belief system, and like most other belief systems, it is impenetrable to evidence. If you have any doubts, I suggest you read the comments to the post I made the other day about measles being on the rise in the UK. One commenter on that post is saying all manners of outrageous things, and ignores the evidence that I (and a pediatrician) have left in the comments to him.

Second, and somewhat related, this hardly matters. Many, many independent tests have shown that vaccines are unrelated to the onset of autism. There is vast evidence that vaccines are very safe, and what small risk they pose is massively outweighed by the good they do. Whether Wakefield faked his results or not, he’s still wrong.

The good news is that if this pans out, then perhaps there will be a net loss of people from the antivax side of the argument. The ones who are true believers won’t waver in their faith, of course, but anyone with doubts may finally see reality for the way it is.

I will be very interested indeed on following this story. If anyone finds more information, please send it along.

Tip o’ the syringe to BABloggee Todd Cissell.

The Centers for Disease Control has put out an alert: in Minnesota in 2008, there were five confirmed cases of Haemophilus influenzae type b (or Hib) among children younger than five years old. Of these five cases, three of the children were unvaccinated, one had started the series of vaccines but did not complete the series due to shortages, and the fifth — who had been fully vaccinated — had an immune deficiency.

Five cases may not sound like a lot… until you learn that one of the unvaccinated children died. This was a baby, just a seven-month-old infant.

I can barely type that sentence out; my heart is aching so. I can only imagine what the parents are feeling. I literally have nightmares about such things.

There are several things to note about this incidence of Hib:

1) It’s the largest number of cases in one year since 1992 in Minnesota, when 10 cases were reported. In the intervening years, between 0 and 4 cases were reported per year (1994 saw four cases, the average is about 2). These are small number statistics, so 5 cases may just be a normal statistical fluctuation. But the stakes are very, very high here.

2) We do not know why three of the five children were unvaccinated. It may be due to the antivax crowd, or it may be due to any number of other factors; the report doesn’t say (however, see (5) below).

3) Out of three unvaccinated children, one died. The historical rate of death from Hib, once infected, is about 1 in 20, so this is something of a fluke. But 1 in 20 is still way, way too high… and of the ones who do survive the infection, 1 in 5 will suffer deafness, blindness, or severe, permanent brain damage.

Russian roulette has better odds than 1 in 5; do you want to play that with your baby? If that sounds harsh, good. We’re dealing with babies’ lives here. The best thing you can do is make sure they don’t get the disease in the first place.

4) Getting a vaccine does not guarantee not getting the disease. We don’t know how many babies were vaccinated, and how many weren’t that didn’t get the disease. But with 1 in 20 odds, I know which way I fall.

5) There is a shortage of Hib vaccines right now, and it’s expected to last for a few more months. However, according to the CDC report, there are adequate supplies to have infants inoculated and complete the primary three-dose infant series.

Data were reviewed for 25,699 children born between November 1, 2007 and March 31, 2008… Among children aged 7 months, 3-dose primary Hib series coverage was 46.5%, which is lower than the age-appropriate coverage for children who had received pneumococcal conjugate or diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccination. In contrast, data from the 2007 National Immunization Survey, conducted prior to the shortage, showed that Hib vaccination coverage among children in Minnesota aged 19 months to 35 months was high and did not differ from the national average, suggesting that coverage has declined as a result of the shortage.

So there has been a decline in coverage due to the shortage, with roughly half the children in the survey being vaccinated.

Putting this all together is difficult, with so many unknowns. But to belabor the obvious, we do know one thing: of the three unvaccinated children who got Hib, one died. The doctors from the CDC add this editorial comment:

Before development of Hib conjugate vaccines, Hib was the most common cause of bacterial meningitis in children aged <5 years. Since implementation of the Hib conjugate vaccine immunization program in the United States in the early 1990s, the incidence of Hib disease has declined from a peak of 41 cases per 100,000 children aged <5 years in 1987 to approximately 0.11 cases per 100,000 in 2007.

In other words, the infection rate among infants dropped by a factor of nearly 400 after the Hib vaccination was developed. This recent increase may reflect a loss of herd immunity, meaning too many kids are not getting vaccinated.

Folks. Please. Vaccinate your children. The science is in, the tests have been done, the results are solid: vaccinations do not cause autism. What vaccines do is save the lives of thousands of children who would otherwise be suffering the effects of preventable diseases… and one of these effects can be death.

Save your kids’ lives. Take them to a doctor and get his or her advice on this. And if they recommend vaccinations, then do it.

My thanks to Dr. Joe Albietz for providing me with some of the numbers in this article.

While anti-vaccine cranks have been around as long as vaccines, it is only recently that they have captured the attention of the mainstream media and the skeptical movement and the battle has really been engaged.

Anti-vaccinationists have focused much of their recent efforts on the claim that vaccines cause autism. At first the MMR vaccine was blamed, sparked by a now-discredited study performed by Andrew Wakefield. This led to declining vaccination rates in the UK and a resurgence of measles.

As the MMR claim was in decline (although by no means abandoned), attention shifted to thimerosal – a mercury-based preservative in some vaccines. There are many flaws with the thimerosal hypothesis, and numerous studies have shown no link between thimerosal and autism or any neurological disorder. But the fatal blow to the thimerosal hypothesis was struck when thimerosal was removed from the routine childhood vaccine schedule (thimerosal, incidentally, was never in the MMR vaccine) in the US by 2002. In the subsequent 6 years the rate of autism diagnoses kept increasing at their previous rate, without even a blip. Only the most rabid (or scientifically illiterate)  anti-vaccine fanatics still cling to the thimerosal claim.So attention has shifted yet again. Now the anti-vaccine crowd are hedging their bets with the “toxin gambit.” They blame various “toxins” in vaccines for its alleged and unproven side effects. Mercury is still on the list, but they have added aluminum, which is added to vaccines to make them more effective. They cite hydrochloric acid, which they don’t understand is added to balance the pH of vaccines. They try to scare people by saying vaccines contain formaldehyde, but neglect to mention that formaldehyde is already naturally present in our blood in higher amounts than are found in vaccines. They even make up some toxins (aided by their limitless scientific ignorance) by misreading chemical names. Jenny McCarthy, for example, has repeated numerous times (despite being called on it) the canard that vaccines contain ether and anti-freeze – both untrue. They also try the scare tactic of saying that vaccines contain viral proteins – uh, yeah, that’s the point. And that they may contain fetal tissue – which is a gross distortion. Some vaccine components were cultured in cells that were derived years ago from fetuses.

(For a more thorough review of the science behind recent anti-vaccine claims you can browse through my many blog posts on the topic, or read this overview I wrote for the Skeptical Inquirer.)

The Anti-Vaccine Players

Active players on the anti-vaccine side include a number of organizations, such as Safe Minds and Age of Autism. They have been given an incredible boost by the internet, as the skeptical movement has, and have been tireless in spreading their misinformation and ideology on their websites and blogs.

Andrew Wakefield, despite being discredited, has not recanted his claim that there is a link between MMR and vaccines. He now portrays himself as a martyr to the cause. As a doctor and researcher he remains an icon of the anti-vaccine movement.

Other anti-vaccine researchers include the father and son team of Mark and David Geier. They have made a career publishing bogus studies claiming to show a statistical correlation between vaccine and autism. Their studies crumble under peer-review, however. They have also spent a lot of time as expert witnesses for attorneys suing over vaccine injury. Their worst contribution to anti-vaccine nonsense, in my opinion, is a recent study in which they are treating autistic children with Lupron and chelation therapy. They were only able to get approval for this ethically dubious study by putting together their own IRB board packed with cronies.

Dr. Jay Gordon is a “pediatrician to the stars” and prominent figure in the anti-vaccine pantheon, despite his coy and unconvincing protests that he is not anti-vaccine. He is notorious for relying upon his gut instinct as a clinician rather than actual published scientific evidence, and makes a slew of anti-vaccine claims that are completely unsupported by evidence. For example he is proponent of the notion that the childhood vaccine program gives too many vaccines too soon – without any scientific rationale or evidence.

J.B. Handley is the co-founder of generation rescue, a parent-based autism support group that is dedicated to the notion that autism is a vaccine-injury. His group also favors and promotes a number of biological therapies for autism, such as chelation therapy, all based either on the mercury poisoning hypothesis, or any dubious alternative therapy that comes along.

David Kirby is a journalist who gave the thimerosal hypothesis a huge boost with his 2006 book Evidence of Harm.  In it he puts forward the claim that there is a vast conspiracy among the pharmaceutical industry, the government (via the FDA and CDC) and the medical establishment to hide the evidence that thimerosal in vaccines causes autism. He has subsequently built his career around that book, and clings tenaciously to the thimerosal claim. He blogs for The Huffington Post, where he repeats his anti-vaccine propaganda on a regular basis. Kirby is most notorious for specifically claiming that autism rates should plummet following the removal of thimerosal from the vaccine schedule, and then subsequently moving the goalpost on his prediction.

Robert F. Kennedy Jr. is a lawyer and environmentalist who has championed the hard-core conspiracy theories surrounding the anti-vaccine claims. He wrote Deadly Immunity (published simultaneously Rolling Stone magazine and Salon.com), and followed up with a ridiculous screed called Attack on Mothers. He has been particularly shrill and paranoid in his writings, and just as scientifically clueless. This was the primary reason for the controversy that erupted when his name was floated for an Obama appointment to head the EPA.

The reigning superstar of the anti-vaccine movement is actress Jenny McCarthy.  After deciding that her son, Evan, was an indigo child (actually, she is an “indigo” and Evan is a “crystal” – divine manifestors here to save the earth, so they have that going for them) McCarthy later decided that Evan had autism caused by the MMR vaccine. So she shifted from crusading to spread the word of indigo children to the world to spreading anti-vaccine propaganda. She has subsequently been relentless in spreading her scientific illiteracy and fear mongering, and was the primary force behind the “Green or Vaccine” march earlier this year. She believes that we should listen to her “mommy instinct” rather than scientific evidence. Eager for a celebrity face to put on their movement, McCarthy was rapidly positioned as the de facto leader of the anti-vaccine crowd.

Her celebrity has indeed made her dangerous. She has also managed to rope in her boyfriend, Jim Carrey, who is also as clueless as he is famous.

Also a huge player in the anti-vaccine movement is the media. In general the mainstream media have been mixed in the quality of their approach to this issue. Sometimes a mainstream outlet does a decent job, but mostly they allow Jenny McCarthy and her ilk to have a free ride, with perhaps lame token skepticism thrown in.

But beyond mainstream media incompetence, there are several outlets that have actively promoted the anti-vaccine movement, and they deserve a large share of the blame for the harm that results. This includes the Huffington Post, which I already mentioned as the blog home of David Kirby. Larry King has also allowed his show to be used to promote anti-vaccine pseudoscience. But the queen of shilling for dangerous quackery is Oprah Winfrey. She has the largest and most adoring audience. She has promoted Jenny McCarthy and Dr. Jay Gordon on her show numerous times. She doesn’t even bother with the token science.

There are many others, but those are the names that have been prominent in the media recently.

Defending Science

The list of players opposing the anti-vaccine movement is not as long.  The most prominent opponent is Dr. Paul Offit, a pediatrician and researcher who recently published a book on the topic called Autism’s False Prophets. He has endured personal threats in order to tirelessly attack the pseudoscience of the anti-vaccine crowd. He is certainly their enemy #1. He understands the issue inside and out and is an effective public speaker and writer.

Recently actress Amanda Peet decided to go up against Jenny McCarthy in a celebrity death match over the issue (or at least that’s how the media likes to play it). She has become a spokesperson for the vaccine program, and has specifically targeted anti-vaccine propaganda. She also has made an effective swipe at McCarthy exploiting her celebrity to promote her own wacky ideas. Peet stresses that she is not an expert, and that she defers to the scientific consensus on vaccines. She is not trying to substitute her own opinion for that of experts, she is simply trying to get the word out that vaccines are a safe and effective public health measure.

But those who have been in the trenches countering anti-vaccine propaganda at every turn are skeptics and science bloggers. I have been writing about the issue since 2005, and in fact have been engaged directly by David Kirby and others. David Gorski, who blogs for Science-Based Medicine and Respectful Insolence, has also been blogging very effectively on this issue for years. Dr. Gordon, in fact, treats him as his personal nemesis. Our allies across the pond include Ben Goldacre who write the Bad Science column. Even non-physician skeptical bloggers will occasionally take on anti-vaccine nuttery. Phil Plait, for example, will take time away from astronomy to dismantle the latest anti-vaccine pseudoscience. There are others, and my apologies to anyone I did not specifically mention.

Some bloggers in the autism community, like the autism diva,  have also opposed the anti-vaccine crowd, partly because in order to bolster their fear mongering the anti-vaccinationists have portrayed autism as a universally “life sucking”disorder. It is not hard to understand why some autism parents would be offended at that characterization of their children, or why they would resent the use of autism to fear-monger about vaccines.

The government and mainstream medical community has been largely ineffective on the issue. They try, with occasional official statements about the science, but they simply don’t have the experience dealing with a dedicated pseudoscientific popular movement.

The Stakes

The consequences of this particular battle are quite high.  Obviously, everyone wants effective vaccine regulation and safety monitoring. There is broad support for the vaccine compensation program, that streamlines the process of financially compensating children and families that have suffered legitimate side effects from vaccines. On any particular claim, we want the scientific chips to fall where they may. If some vaccine ingredient is causing harm, we need to find out right away and make the necessary changes. Only a cartoonish, handlebar mustache-twisting villain would want to allow children to be harmed through compulsory vaccines. Anti-vaccine hysteria, however, hampers effective vaccine safety by diverting attention and resources to false claims.

The most direct consequence of the anti-vaccine movement, and their recent successes with Jenny McCarthy and Oprah, is stoking public fears about the vaccine program leading to declining vaccination rates. This has already resulted in increased outbreaks of measles and mumps.  Vaccine hysteria in Nigeria set back the goal of eradicating polio from the world for years.

Not having ones’ children vaccinated does not only put your children at risk but others as well. As vaccination rates drop, infectious diseases they would normally prevent are allowed to spread through the population. This puts everyone at risk, but especially those people who cannot be vaccinated because of a medical contraindication.

The anti-vaccine crowd has also opposed attempts to shield vaccine manufacturers from liability. No one is arguing that vaccine producers get a free pass – they are still responsible for their product, and are certainly tightly regulated by the government. However, if they were vulnerable every lawyer trying to make a buck off of anti-vaccine pseudoscience, it would quickly become impossible to produce vaccines. It would not be worth it for any company to sell vaccines – and of course that is the goal of the anti-vaccine movement. They want to end vaccines, and harassing lawsuits are just one method. This is partly why the government set up the vaccine compensation program – there is a small tax attached to every vaccine, and that tax goes into a pool that is then paid out to those injured by vaccines, as determined by a federal court.

This brings up another risk of the anti-vaccine movement. There are now about 5,000 cases before the vaccine injury compensation program by parents who allege that their children’s autism was caused by vaccines. The courts now have to spend time and taxpayer money legally settling a question that the scientific community already has.

Conclusion

The anti-vaccine movement is a recent skeptical battleground, and one that is still very active.  This is certainly one of the biggest issues from 2008, and likely will continue to be for the foreseeable future. Skeptics have been particularly effective in dissecting the claims of the anti-vaccinationists and pointing out the dangers of anti-vaccine hysteria. But the anti-vaccinationists have the momentum, due largely to Jenny McCarthy and Oprah Winfrey. Vaccine rates are declining.

It seems as if we may be seeing a momentum shift, however. Next year will be very telling.

One thing is clear – the skeptical movement has to keep vigilant and keep the pressure on. We have to oppose anti-vaccine pseudoscience at every turn. We need to make ourselves available to the mainstream media and be effective at the public relations end of the game. We need to get the mainstream scientific and medical communities more active and show them how it’s done.

This is a fight we can win, and I think we are making headway.