I'm currently in Las Vegas at The Amazing Meeting. Believe it or not, I was even on a panel! While I'm gone, I'll probably manage to do a new post or two, but, in the meantime, while I'm away communing with fellow skeptics at TAM7, I'll be reposting some Classic Insolence from the month of July in years past. (After all, if you haven't been following this blog at least a year, it'll be new to you. And if you have I hope you enjoy it again.) This particular post first appeared in July 2008.
I suppose I had better get ready for another e-mail with a wounded, puppy-dog, plaintive complaint of "I'm not really anti-vaccine" in it. You see, that's what has happened in the past a couple of times after I wrote about that pediatrician to the children of the stars (in particular Jenny McCarthy's child) and ubiquitous go-to pediatrician whenever the media wants to hear some "skepticism" about the safety of vaccines, Dr. Jay Gordon. Clearly, it really, really bothers him when someone refers to him as being "anti-vaccine," but what other term fits him so well these days? After all, Dr. Gordon toes the anti-vaccine party line from Generation Rescue, Talk About Curing Autism, and, of course, the celebrity mom of his patient, and he has the "too many, too soon" spiel down pat. He shows up at rallies to give speeches to parents carrying explicitly antivaccination signs proclaiming their children as "poisoned" and "damaged' by vaccines, one sign even referring to them as "weapons of mass destruction."
Honestly, what am I supposed to call Dr. Gordon, if not "anti-vaccine"? He hangs out with hard-core antivaccinationists--more than that, leaders of the anti-vaccine movement--and talks the anti-vaccine talk so well. He's become the go-to interview whenever a lazy journalist wants some vaccine "skepticism" from a medical professional. What more does one need?
The other day, once again Dr. Gordon demonstrated his skill with anti-vaccine talking points in this interview with Cookie Magazine. It's painful to read such idiocy flowing from the lips of a physician. Indeed, it's even worse than listening to Dr. Michael Egnor spew creationist nonsense hither and yon, because at least for Dr. Egnor evolution is not part of his area of expertise. For Dr. Gordon, vaccines should be considered part of his area expertise, but you'd never know it from the data-free, anecdote-filled nonsense he spouts. For example, listen to his response to a question about why he buys into the "too many, too soon" mantra and advocates "staggering" vaccines:
I think the immune system, like every other system of the body, matures slowly, and that it can better tolerate viral infection at older ages and better tolerate one virus at a time. The other thing is that vaccines all contain other ingredients. They contain aluminum, they contain tiny bits of formalin [an aqueous solution of formaldahyde]. So I recommend waiting as long as parents are comfortable, and vaccinating very, very slowly. I also ask parents to wait at least six months before the first vaccine. I prefer to wait a year.
Formaldehyde? Aluminum? Oh, my God! Toxins! I can't believe a physician is parroting the "toxin" gambit about vaccines. That's the single most idiotic and scientifically ignorant rhetorical gambit antivaccinationists use, and Dr. Gordon apparently buys into it. Did Dr. Gordon skip pharmacology class in medical school?
Of course, Dr. Gordon, showing that even physicians can be prone to putting too much stock in testimonials and anecdotes over science and epidemiology, points out the cases of regression he's seen after vaccination, argues:
Now, many people would argue that vaccines are only for the better. I would say that there's no free lunch; it is lovely to be immune to whooping cough, but if I have to diminish your health a little bit to do that, I have to hesitate. Integrity demands that I tell you other parts of the story: I saw one child who developed seizures two days after her two-month appointment, and she didn't get any shots. It's true that the onset of autism often coincides with the time that kids are getting their shots. But the vast majority of times that I see a temporal relationship, I'm assuming it's not a coincidence.
Assuming? Note that Dr. Gordon cannot produce a single scientific study to support his beliefs. Not one. In fact, I once replied to one of his e-mails chastising me for referring to him as "anti-vaccine." In my response, having seen snippets of his video posted to YouTube and other places as well as a video of his speech to the "Green Our Vaccines" rally, I asked him pointedly but politely if he could provide me with the references to the scientific studies that support what he said in those videos and, most importantly, at the Green Our Vaccines rally.
Dr. Gordon never got back to me. I wonder if he'll get back to me now.
While I wait, I'll point out that Dr. Gordon continues to say truly dumb things about the MMR like:
It's a live-virus vaccine. A live-virus vaccine, in order to work, creates a little bit of an infection. And when you get measles, you get it through your nose and your throat, [which triggers a very specific immune response.] When we inject measles, we are bypassing that system and going right into the bloodstream. And we're finding that yes, there can be some impact on the intestinal tract and to the brain from the measles vaccine. And it's a vaccine of almost no benefit to American children, one by one. Now, in terms of public health, I don't want to be the guy who said, "Boy, this vaccine stinks." It doesn't stink. It works very, very well. The reason we don't have measles in America is because the vaccine works great. But sit down, please. Let's talk about the fact that your cousin and your other cousin both have autism. Or that your son has some questionable neurological issues, he seems to be speaking or walking a little later. I don't want to mess with him.
Number one: The measles vaccine is not of "almost no benefit to American children." It keeps measles at bay, and the resurgence of measles that we have seen in the U.K. and are now seeing in the U.S., thanks to decreased levels of vaccination due to fearmongering about the MMR vaccine shows how little it would take for herd immunity to fail. Number two: There is zero scientifically sound evidence that the MMR causes autism or other neurodevelopmental disorders--or even "autistic enterocolitis." None. All we have is Andrew Wakefield's litigation-driven and incompetent "research," research so badly done that his co-authors almost all disavowed it when its deficiencies came to light. That Dr. Gordon apparently believes that shoddy pseudoscience does not speak well of him.
It gets worse. Gordon parrots the usual misinformation about mercury in flu vaccines and even mentions a 7-year-old getting a tetanus booster with mercury in it. It makes me wonder if he served as an uncredited background consultant for Steve Wilson, so similar is his patter to the misinformation served up by that "investigative journalist." Here's a hint, Dr. Gordon: Most children do not get the flu vaccine, especially not under two years of age, and, even as the use of the flu vaccine is encouraged, flu vaccines containing more than trace amounts of thimerosa are increasingly uncommon because of low demand. It is likely that the marketplace will soon render them all but extinct. Also, children don't suddenly get autism at age 7 after getting a vaccine. The bottom line is that children's exposure to thimerosal from vaccines is lower than it has been since the 1980s and is continuing to decline, but there's no sign of a significant decline in autism diagnoses. None. That's about as bulletproof epidemiological evidence as there is showing no correlation between the two. I know, I know, I'm probably wasting my time, given the way that Dr. Gordon goes back to the whole "toxins" idiocy again:
Right now we're creating vaccines using ingredients that are cheap preservatives, but it could be done better. It means, let's see if we can get the aluminum out of them. Let's see if we can get the formaldehyde out of them. Let's see if we can produce them in a way that makes a little more sense for safety.
Word to Dr. Gordon: Aluminum is not a preservative. It is an adjuvant. It's there to make the vaccine produce a stronger immune response and thus make the vaccine work better. It's an integral component of what makes the vaccine work. There's also no evidence it has anything to do with autism or any other neurodevelopmental or immunological disorder. Of course, now that the mercury is gone from all vaccines routinely given to children under two, we all know that aluminum is becoming the new mercury for antivaccinationists. Never mind that aluminum has been used for 80 years and has an exemplary safety record.
Oh, and, please, Dr. Gordon, please stop with the formaldehyde bit. I know it's a convenient scary-sounding chemical used in the vaccine manufacturing process that antivaccinationists like to point to, but by the time the finished vaccine is made, there's nothing more than a trace amount in any vaccine. You breathe more formaldehyde sitting in an L.A. traffic jam in your Mercedes (or whatever no doubt highly expensive care you drive, thanks to credulous patients like Jenny McCarthy) than is in any vaccine. The plastic products and varnishes in your house produce more. Really, Dr. Gordon, I'm not kidding when I say that it's downright embarrassing to me as a physician to see a fellow physician like you saying something so utterly scientifically ignorant for public consumption. Really. Take it as a bit of advice from one physician to another. Your repeating that particular bit of antivaccinationist propaganda just makes you look really, really ignorant. Of course, if you actually believe that stuff about formaldehyde, you are really, really ignorant. If you don't believe it, then you're really, really cynical. Take your pick.
On the other hand, perhaps you don't care. What else could explain your pièce de résistance? What else could explain this statement:
I think that the public health benefits to vaccinating are grossly overstated. I think that if we spent as much time telling people to breastfeed or to quit eating cheese and ice cream, we'd save more lives than we save with the polio vaccine.
The stupid, it sears. It burns thermonuclear. No, it flames supernova. Yeah, that's right, Dr. Gordon. Breast feeding and keeping cheese out of the diet will prevent the spread of infectious diseases better than vaccines. Funny, but Europeans eat lots more cheese than Americans, and they don't seem to be any less healthy than we are. On the other hand, per capita U.S. cheese consumption has been rising since the 1980s. Hey, I have an idea! Maybe it's maternal cheese consumption, not vaccines, that causes autism! In the meantime, we can have a whole bunch of svelte kids suffering from vaccine-preventable diseases.
As bad as Dr. Gordon's interview was, there was one thing even worse. I bet you know what it was if you've taken the time to look at the actual interview. That's right, the title of the web page is Q&A: Vaccine Experts. Dr. Gordon, a "vaccine expert"? I think not. But it's worse than that. Dr. Gordon's fact- and science-free interview is presented on equal footing, as a sort of "Point/Counterpoint" format with a real vaccine expert, Dr. Paul Offit. This is akin to telling "both sides" of the evolution-creationism manufactroversy by pairing Richard Dawkins or Sean Carroll as the expert supporting the theory of evolution and Ken Ham or Casey Luskin as the "expert" supporting creationism. It's the whole lazy, wretched "tell both sides of the story as though they are equivalent" habit that journalists just can't seem to stop writ large. As long as this is how anti-vaccine propaganda is reported by the media, advocates for the value of vaccines as a public health measure are losing. As long as Google searches for "vaccine" and other vaccine-related terms inevitably turn up page after page of anti-vaccine propaganda, we're losing, as PalMD points out. One website, the Vaccine Education Center, is not enough, nor is one book like Do Vaccines Cause That? (hat tip: Skeptico).
Finally, one last word to Dr. Gordon: If you're going to e-mail me and complain about how mean I am, please do me a solid. Please don't bother unless you can stir yourself to provide me something other than whines about how unfair I'm being when I describe you as "anti-vaccine." You think I'm being unfair? Prove it. Of course, doing so would take some actual--oh, say--scientific evidence to back up your statements, and you've assiduously avoided providing that in the past.
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Yes, let's talk about that. Why don't we sit down and watch the pop-science version from NOVA Science NOW that aired last week?
http://www.pbs.org/wgbh/nova/sciencenow/0402/04.html
Although it isn't perfect, it makes Perfectly Clear to anyone that autism is GENETIC, caused by changes in genes for brain development whose effects aren't apparent until the child reaches the age where those genes kick in. That's why it's relevant if someone has autistic (or geeky) relatives. Not because their children will inherit some susceptibility to vaccines, but because the more of these genes the child inherits, the more likely they are to develop autism, or the more severe it will be.
One of the most obvious oversimplifications in the segment is that they don't specifically address high-functioning autism or Asperger's. Still, they got the most important message across in a short amount of time, and I hope it makes sense to people who haven't had Cell Biology or Animal Physiology.
Those are anti-vac comments. He says vaccines are dangerous, and he says they're not necessary. The only concession he makes is that they work, and given that you would have to be blind, deaf, crazy and stupid to claim that they don't (as well as totally unaware of polio) it's not much of a concession.
As a new parent, my child's welfare is of the utmost importance. When my daughter was born, I looked very seriously at the question of vaccines. Someone at the time gave me a book (I don't remember the title at the moment) that was very anti-vaccine and many new parents I spoke to were fighting with the decision to vaccinate or not.
I read the book, but having a critical nature and being an academic librarian, I never do anything without solid research. I was put off by the lack of research identified in the book and the questionable quality of the research that was identified.
In the end, I decided to have my daughter vaccinated because my research told me that was the right decision, but I didn't come to this decision lightly.
While researching, I was extremely frustrated by the lack of clear, backed-up information on both sides. The anti-vaccine groups are full of fear-mongering and anecdotal evidence and the government and medical groups advocating vaccines were also full of fear mongering, a lack of detailed information, and a complete failure to address parents concerns.
The evidence is there to support vaccines, but if you don't have the research skills to find it, good luck. All you find are government and medical groups telling you not to be stupid, don't risk your child's life, and just do it.
The public has no reason to trust government and medical organizations blindly. Because we say so, is not good enough. If you want to fight the anti-vaccine movement, you need to provide full and unbiased information that addresses parents concerns and treats them with respect. In the end, I am confident parents will make the right decision.
Sincerely,
Anthony Pash
As a new parent, my child's welfare is of the utmost importance. When my daughter was born, I looked very seriously at the question of vaccines. Someone at the time gave me a book (I don't remember the title at the moment) that was very anti-vaccine and many new parents I spoke to were fighting with the decision to vaccinate or not.
I read the book, but having a critical nature and being an academic librarian, I never do anything without solid research. I was put off by the lack of research identified in the book and the questionable quality of the research that was identified.
In the end, I decided to have my daughter vaccinated because my research told me that was the right decision, but I didn't come to this decision lightly.
While researching, I was extremely frustrated by the lack of clear, backed-up information on both sides. The anti-vaccine groups are full of fear-mongering and anecdotal evidence and the government and medical groups advocating vaccines were also full of fear mongering, a lack of detailed information, and a complete failure to address parents concerns.
The evidence is there to support vaccines, but if you don't have the research skills to find it, good luck. All you find are government and medical groups telling you not to be stupid, don't risk your child's life, and just do it.
The public has no reason to trust government and medical organizations blindly. Because we say so, is not good enough. If you want to fight the anti-vaccine movement, you need to provide full and unbiased information that addresses parents concerns and treats them with respect. In the end, I am confident parents will make the right decision.
Sincerely,
Anthony Pash
Anthony - I have to ask, what reason do you have to not trust the AAP? Do you think they have an agenda that does not involve providing the best medical care for american youth?
Back to Gordon: In the end, these challenges to Gordon about providing scientific studies and whatnot are basically worthless. In recent months, Gordon's comments here have made it clear that he doesn't care about scientific studies. In fact, he has acknowledged that there is no scientific basis for his claims. In his mind, his personal anecdotes trump any scientific studies. _He_ is a working pediatrician, and therefore has special insight. Of course, he doesn't like to address his insult to the overwhelming majority of working pediatricians who think he is just as much full of it as the armchair theorists do.