Tuesday, November 15, 2011

Vaccination conversation, Part 5

The conversation on vaccines continues. Indented text is written by others. All text has been lightly edited for clarity and to remove personal references.
In our last discussion I tried to point out several flaws in the research methodology methods that were being used. You stuck to your guns 100%. Once upon a time, all the studies said that smoking was fine. Doctors even recommended it. It was only those with, as you put it, no biological or medical knowledge, minus a few, that were most vocal.
When you posted that article, I was curious how it affected your 100%, no doubt (except for maybe the flu shot) attitude. You answered my question quite clearly. It didn't. It may apply to other areas of science, and maybe even some medical disciplines. But not vaccines. Okay. Once again I can't imagine anything I could possibly say.
As for the Vaccine Safety Manual: no, I can't summarize it. It is like a text book. It goes  through the history of every vaccine, the corresponding disease, and is filled with a multitude of peer review articles. It is extremely well researched and very thorough. I ordered you a copy. Enjoy it as research, fairly tales or as a booster chair for one of your kids. Your call.
As for Wakefield: to be honest, as I stated before, I am not sure how anyone can understand anything about the entire controversy. I have seen so much propaganda, fluff and hate from both sides that I have no idea how you came to the conclusion you did. What little I read on this issue showed no blatant fraud or lies. Serious problems with methodology and ethics, yes, but that's it. It doesn't matter very much as I have never used him as a reference.
I was very excited about a study that he was about to publish about a year ago. He took two groups of primates, gave one group the regular US vaccine schedule and gave the other, the control group, nothing. Preliminary results showed delayed neurological and survival instincts in the test group. As the paper was about to be published, the Lancet suddenly decided after something like 10 years to retract his original article. Also, at the same time the UK medical board decided to suspend and eventually revoke his medical license. If that wasn't enough, there was then a giant media smear campaign against him. It seemed like very interesting timing to me. Bottom line: I didn't believe any of it. Both sides are little more than sensationalism, propaganda, and fear mongering. And both sides have financial motivations to argue as they do.
Listen to this lecture or don't. I don't really care. [Ed note: I have been unable to find a video or transcript of this lecture. The original link now redirects to a blog post about autism and iPads.] What I say still stands. During his lecture to European Parliament in 2010 after he lost is medical license, he quotes several peer reviewed studies to support his claims. I didn't have a pen and paper handy to write them all down for you. You asked for "help" in understanding how intelligent people have the ideas / beliefs that vaccines are not worth the risk and I thought this was a useful resource.
What about evolution? One of the points I wanted to bring up earlier is the evolutionary significance of some diseases. We don't know what the long term effects of not having certain diseases in our environment really are. They have been around as long as we have, most likely longer. To assume that we have been living with them for thousands of years but they serve no useful purpose or benefit is a little odd, no? To think that we can just eradicate entities that we have been cohabiting the planet with for the entire life span of our species, and not have some kind of detrimental effects, is a little arrogant. This is a very long and separate argument, but I wanted to mention it here for you to think about. It's all part of the greater package that I see as totally untested and untestable.
Finally, my entire overview is based on a medical model that differs from the standard view. It is based on science and research, but it is not the standardized approach to wellness / sickness. I am not sure if I am capable of writing about it. I think I could do a so-so job of presenting it orally. 
I will not repeat what I have already written, but refer to my previous responses.

Double-blind peer reviewed research is not perfect , and the article indicated that greater caution is warranted when using a single study or only this method to argue a point. Like democracy, it has its flaws – but it’s the best we have. What would you replace it with?

You asked why I think vaccinations are safe. I provided a robust response. Studies were one pillar on which my argument rested; that pillar may not be as strong as I had previously thought, but the other arguments are unchanged. On what foundation does your argument rest? I still don’t understand.

You claim that all the research that has concluded that, on balance, vaccines are safe and effective are flawed by methodological problems, self-interest, corruption, and/or failing to account for long-term effects. You have provided no credible evidence to back that up. Let’s assume the contents of the Vaccine Safety Manual make a good argument – I will look at it when it arrives. But given your radical skepticism about medical findings, how CAN it be convincing? Through research? Studies? Why is the research done by your authors true and accurate, but the research done by hospitals and governments (among others) around the world for decades invalid?

The tobacco analogy is fatally flawed. See my previous posts for a list of various institutions that have conducted various types of vaccine research. Drug companies are included, but only as a small part of that list.

The whole point of vaccination is to develop long lasting or lifetime antibodies without getting the disease. We inject dead or attenuated versions of the disease to trigger an immune response. And it works (not 100% of the time, but enough that it makes a HUGE impact on incidence and mortality – we eliminated smallpox entirely due to a decades-long comprehensive global vaccination program). To claim otherwise is to deny reality.

Do you think that surviving a disease is better than getting vaccinated for it? Let’s follow this line of reasoning. If nobody is vaccinated, lots of people get sick and many die from disease X. If everyone is vaccinated, few people get sick and a very small number die from disease X. How is the first scenario superior to the second? I am baffled.

I think you misunderstand evolution. Any complex and successful organism will suffer from parasites who want a free ride. You are claiming that diseases (let’s say hepatitis) benefit us. I think you’re out of your mind to say such a thing. In principle, there may be some esoteric benefit to a broad range of diseases running rampant in the human population. But the cost in human lives and misery is enormous – are you really claiming it’s worth it? Who is arrogant here? Life before modern sanitation, technology, and medicine was nasty, brutish, and short.

The argument that we cannot understand the long term (or if we do, the very long term, or the very very long term) effects of an intervention can be applied to just about any advance in human society or technology – surgery is unnatural, as is any form of representative government, as is birth control. I think that all these are good things. Don’t you? We evolved into our current form long before any of these innovations. To be consistent, why are you so against vaccinations but not, say, cell phones? Or electricity in our homes?

Every argument you have provided so far against vaccinations – every single one – is either a) false or wildly improbable (all positive vaccine studies are corrupt or lax), b) scientifically incoherent (avian RNA), c) irrelevant (toxic additives), d) data-free (nut allergies), e) allusions without explanations (Vaccine Safety Manual), or f) actually in favour of routine vaccinations (Australia). You have not acknowledged an error or retracted a single claim throughout this entire discussion. I hope you’ll forgive me for being unconvinced by the arguments and evidence against vaccination presented thus far.

I was a little disturbed by your response to the Wakefield clip. I guessed how you felt about him and thought I presented it properly. Put that aside and listen to his sources - everything he cites is done by others.
For the record, I am using electricity right now, I use antibiotics for the kids, and the Vaccine Safety Manual is filled with peer reviewed studies, so I am not sure how I led you to believe that I was against and fundamentally rejected all of these things.
I want to say three things that have had a big influence on my view of the medical model.
1) Gould's Mismeasure of Man. He and others like him step back, and look at the situation as a whole. In this book he didn't say that intelligence testing was not the best that they had when they did it. He broke from the system and tried to give an objective view from today's perspective. I wish it was mandatory reading for people who preform the actual IQ test. I wish there was an equivalent for the medical model, and the experimental model.
2) Once [someone I knew] was waiting for his chemotherapy treatment, and there was a major delay -  literally hours. Keep in mind that chemo is like battery acid being injected into one's bloodstream. After a few hours he started cracking up laughing. Everyone started looking at him, and he said, "Can you imagine what people in the future are going to say about us? Something like, 'Not only did they inject themselves with raw poison, but the idiots actually stood in line and waited for it. What morons!'" It was an interesting reality check for me. I am sure bloodletting worked to some degree but when we look back... There is no reason to think that same won't be said about us and all of our current practices, regardless of how right we think we are today - especially if we don't update the model, or how our thinking is structured.
3) You once wrote, "In theory, theory and practice are the same. In practice, they're not." Funny and profound, and very true. All the research in the world is, at best, theoretical. This doesn't mean that research isn't helpful or that it doesn't need to be continued. It just means that that's all it was. Research. A study, a statistic, an average. Practice is not the same as theory.
Wakefield violated just about every ethical and professional standard in his now retracted study. The man is indirectly responsible for thousands of children falling ill and hundreds of deaths from easily preventable diseases. Independent investigations have now concluded that he also guilty of fraud. He attributes every criticism of his work to reputational hit men and pharmaceutical company conspiracies. He is vile.

He is also clever. He could make up research results or inaccurately portray the results (perhaps by enumerating all risks but no benefits); he could quote them out of context (by not differentiating between a one in ten risk and a one in a billion); he could attribute conclusions to papers that the authors never intended. I do not want to verify every one of his claims. The bottom line is, I do not trust Wakefield, and don’t want to waste my time on him. If there is good research supporting his claims, there should be plenty of more trustworthy people defending the anti-vaccination viewpoint.

1) I also read Gould’s Mismeasure of Man. So let’s look at the big picture. No vaccinations – hundreds of thousands or millions ill, tens of thousands of deaths in North America every year. Everyone vaccinated – hundreds OR thousands ill, tens of (perhaps a hundred) deaths. The rest is details.

2) Chemotherapy is horribly primitive. Its basic premise is to kill the person slightly slower than the disease. It is also, for now, the best option for many people afflicted with cancer. I look forward to the day when we have techniques that render it (and its cousin, radiation treatments) obsolete. The answer lies in more research: better understanding of the disease, devising new avenues to attack it, demonstrating that the new methods work as they should, tweaking and improving them, etc.

3) Studies are not all done with test tubes in a lab. Many are observational – looking at what happens in the real world to real people. When dealing with hundreds of millions of people, statistics are required. That’s why you need a mix of theory (does this make sense in principle?) and practice (does it actually work in the way we expect in the real world?) Different types of studies can provide both. See 1) above.

I don’t necessarily disagree with any of these points, but utterly fail to see any connection between them and your position on vaccination. As always, I am not looking to convince you, but to understand the basis for your position. And I am as baffled as ever.
Hey there. Please read this article. There's no need to discuss or debate; I'm just addressing the peer review issue and the "scientist" and "scientific method" on both sides.
This article is a summary of ways some people have guessed that vaccines might cause harm over the decades. Many of these have been debunked. So the author states (presumably correctly), "No one has proven that this vaccine component doesn't cause autism." If someone studies this vaccine component and finds no harm of any kind to any people, will another possible danger from some other ingredient arise from the mist? Is this discussion the debate equivalent of whack-a-mole? Please remember that no one has ever shown that any component causes autism in any way.

How about some evidence that any such proposed harm has, in fact, transpired? (The only argument I found in the article is one of correlation - and you have probably heard the aphorism "Correlation does not imply causation.")

This paper is little more than data-free guessing. It is a repetition of the unsupported (or demonstrated to be false) claims of others over the past several decades. There is no information to connect any statement in the paper to reality - it's just repeating what someone else once said. And so all of my previous comments stand.

A quick search on the paper title revealed an impassioned rebuttal (heavily cross-linked) of this paper by a pro-vaccine surgeon that may or may not be of interest to you.

You once again make the assertion that vaccines are not nearly as safe as I (and most people, and virtually all medical professionals) think they are. But you have not presented one shred, not one iota, not a single tidbit of evidence to back up that claim. Nothing. Not one thing. Not a single piece, in all the messages we've traded over the course of the many months this conversation has been going on.

Look at it this way. There are at least two possible reasons for the utter lack of studies showing a link between vaccines and significant detrimental effects:
  • There are no links. Any submissions to journals that purport to show them had major issues, so they were filtered out during peer review (or withdrawn after publication). When methodological problems were corrected, the negative effects they described disappeared.
  • There are such effects, but a wide-ranging conspiracy between drug companies, hospitals, journal editors, researchers, doctors, and medical bodies around the world suppress any mention of them in the published literature. 
Obviously, I lean toward the first explanation.

If you think the second one is more accurate, why doesn't Ratajczak mention any anti-vaccine results in her paper, now that she's free from the chains and constraints of her former bosses?

At this point, the Vaccine Safety Manual arrived. I took extensive notes on selected chapters. My review of the book will be the content of the next post.

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