Pediatricians versus the Dunning-Kruger effect on vaccines

Some fuel for the fire: This “heartbreaking” primer for new moms is today circulating among a fairly influential network of supporters of newly birthed and breastfeeding moms and was raising vax warnings and flying Naturopath flags. It includes a large section quoting one Heather Zwicky talking specifically about delaying vaccinations, and possibly avoiding pertussis vaccines as “potentially unrequited”.

http://birthbootcamp.com/your-baby-is-born-what-happens-next-might-brea…

An interview with Zwickey here

http://wellwire.com/health/vaccines-health/talking-vaccinations-with-dr…

Quite frankly, I think the pediatricians should get together as a group and make a policy of not allowing sick, at the very least, or any, unvaccinated children in their waiting rooms. They should insist upon seeing those children at home, and they should charge a very significant amount of money for that service, which I would hope would not be covered by insurance. Sometimes there's nothing like a stab to the wallet to try to get people to change their behavior.

I have seen a similar situation in which doctors who are too lazy to do, and charge for, nasal swabs on their influenza patients send them instead to a hospital outpatient department where, among other things, chemotherapy patients were waiting for their turn in the outpatient infusion unit. The practice was maddening.

When I read this yesterday, I just *knew* that Orac would .. er _enjoy_ it.

Remember of course that the Rev has a history of disparaging medical professionals' decisions ( see Alex).

TMR produces propaganda that denigrates SBM and simultanously hypes Mother Wisdom (tm) and Gaia Think: so many of their posts include a how-to guide to doctoring that celebrates taking matters into their own hands. "If only I had quit believing before vaccination", they whine.
Because they truly believe that vaccines cause autism.

They express feelings of being an accomplice to the great crime of autism induction by vaccine: they brought the child to the doctor's office, put him ( usually) on the examining table and stood by whilst the nurse, in effect 'stole his soul'.

Their own feelings of guilt must be insurmountable so they must of necessity assuage that guilt by blaming others:
they were lied to, forced or charmed into taking these rash actions . It wasn't THEIR fault: it was a huge conspiracy that has already inveigled THOUSANDS,, even millions of others. And now they have become leaders of a great uprising to destroy these destroyers of children.. ( see websites of Jake and Brian Hooker esp) Obviousl this must make them feel better abouut themselves.

Thus their braggadocio and cavalier attitude towards reality has its roots in believing those who have lied to them. And it ain't SBM.

I think I may have shared this story here, but I'll share it again. This one person I know who used to work at a busy family practice had a non-vaccinating family as patients. The mom and dad in the family had been told that they were welcomed to bring their kids to the practice with one caveat: They had to call before they came in so that they would not go into the waiting room and go in the back door and into the far rear room, which also had negative pressure to it. The practice did not want to risk measles or chickenpox in the waiting area because there were several children being seen there who had immune deficiencies. (One had leukemia and was being treated. I forget what the other two had.)

On more than one occasion, the mother showed up with the five unvaccinated children (ages toddler to second grader) into the waiting room and to the front desk. She didn't call or put masks on the kids. One of those times, she brought in the children because SHE HAD TAKEN THEM TO A CHICKENPOX PARTY AND THEY WERE FEVERISH. I wish I was joking.

The family was discharged from the practice for failing to follow the simple instruction of calling ahead and being seen away from the waiting room. They complained over and over but to no avail. The practice was well within its right to do this after the family had been warned several times. Because the community where this happened is close-knit (with only one other family practice and one pediatric practice), the family had to travel 15 miles up the road to the next town. None of the other practices in town would take them, except for emergencies.

My friend in the practice sent me a letter that the mother wrote on why she didn't vaccinate. (All identifying info was blacked out, of course.) It really is something to see. All the typical anti-vaccine stuff is in there, with citations to whale, AoA, NaturalNews, and Mercola, of course. Rarely did she cite CDC or WHO, and only to point out that vaccines worked by showing that there were no cases of polio or measles and that other vaccine-preventables were on the decline. Of course, she never acknowledged the roles of vaccines in that little miracle.

So, no, the people who get fired from practices for not doing the bare minimum to take care of their children are not "thinkers". They're sheep. They're the worst kind of sheep because they are ignorant AND they think they know better. I have more respect for blind followers than for blind preachers.

A couple pediatricians, a chiropractor, a whole foods nutritionist (who understands grains and the gut), homeopath, naturopath, and homotoxicologist are all good team members.

I don't see an acupuncturist on that list, but that covers most if not all of the other major flavors of woo. Crank magnetism at its finest!

"This thinker has a remarkably healthy child who eats well and is developing normally with no learning disabilities or developmental delays".

The self righteousness and arrogance is astounding. Most children *are* remarkably healthy. Do they think that most other children, especially those who vaccinate, are listlessly walking around in a perpetual state of bad health? The Rev's own child had bronchitis 3 weeks ago. Reaaalllly stoopid.

B----- hell!, those people are not just downright nuts, they're dangerously nuts. 'I tried my best to tackle it with essential oils and homeopathy... Some Galilean olive oil with a dab of Thieves and she was good to go.' If you submitted a film script with that line in it, you'd be laughed out of Hollywood.

So they're all sitting around getting loosey-goosey on an ample supply of wine, eh? Sounds like 'Drinking Moms' Revolution' to me.

If getting fired by one's pediatrician makes one a Thinker, then I suppose getting reported to the police for medical child abuse makes one a Genius. What does it take to become an Einstein, getting a confirmed diagnosis of Münchausen By Proxy syndrome? Or do they have an exclusive club for that, called The Münchies?

As for 'Chicken Pox Parties,' why are those not immediately prosecutable as child endangerment? You would think the police (or the Met or the FBI) would want to swoop down on those things as if they were opium dens. Has anyone even tried to prosecute? Or does the 'belief exemption' from vaccinations (not to mention the law of gravity) also give parents the right to infect their kids with potentially fatal diseases?

'Tackling it' with homeopathy is like throwing a forward-pass to an hallucination.

I hardly dare to ask what a "homotoxicologist" is....

What does it take to become an Einstein, getting a confirmed diagnosis of Münchausen By Proxy syndrome? Or do they have an exclusive club for that, called The Münchies?

You owe me a computer keyboard. I was drinking my coffee as I read that...

I hardly dare to ask what a “homotoxicologist” is….

I believe I've blogged this before. The search box is yours. :-)

@ lurker:

Right. They often host wine and whine parties.

Notice that the olive oil is *Galilean* with *Thieves*?
Is that like J-sus?

@ Mrs Grimble

I hardly dare to ask what a “homotoxicologist” is….

I have no idea either. A form of homeopath?

Since my wife and I both work, I can't imagine how anti-vax parents handle the idea (or the reality) of taking weeks off from work if their kids come down with a VPD.....

@Helanthius: Yup. They're called "homotoxicologists" (or sometimes "homeotoxicologists"). Again, the search box should reveal all.

I see that I was all wrong about homotoxicology. I assumed the diagnosis would be done by waving crystals on a string over blood samples and treating with magic water. But No! They diagnose your condition of humoral imbalance by Real Medical Tests!! Then they Treat you with the homeopathic magic water!!! Note, this is Humor, for the snark-impaired!!!! (Hey Orac, did you get the journal article?)

I'm always stunned at the amount of money these "Thinkers" have to burn on chiropractors, naturopaths, and "homotoxicologists."

Ism: Do they think that most other children, especially those who vaccinate, are listlessly walking around in a perpetual state of bad health?

Yeah, they do. To the point of diagnosing lots of kids, based on a quick glimpse, as having gluten allergies.
I remember one mom taking ''dark under-eye circles' as an indication of celiac disease; a normal person would have thought 'reading under the covers disease.'
And they think colds are an indication of an unhealthy immune system. Frankly, if my immune system weren't chowing down on two or three cold viruses a year, it'd probably turn on me.

FYI
www.scientificamerican.com/article/antivaccination-parents-dig-in-heels…

@Anon - yes, people are too stupid for their own good it seems.....

All these "Thinkers" IMHO appear to supper from a "ginormous" dose of hubris. If I were a betting man (and I am not), I would bet most of not all have:

1. Little if any medical training
2. Little if any credible medical knowledge
3. No experience in the healthcare industry

Their arguments from ignorance is awe inspiring and makes one ponder if said ignorance should be measured in astronomical terms as miles, kilometers, pounds, kilograms etc do not adequately describe/quantify their level of stupid.

Having worked in the healthcare industry for many years, and 7 of those in pediatrics, the nurses are duty bound to ask about such things by law or risk (in litigation) loss of license for not doing so in the event someone claims (after a purported medical injury) that the medical professional did not adequately inform them of the risks/dangers of their behavior. It is the parents "right" to decline the service/procedure/intervention (which is to me morally reprehensible) but the provider must provide the most accurate and up to date information to that an individual can make an informed decision.

The pediatrics office I worked with (it was a residency program) had a policy of discharging patient's who's parents did not want to vaccinate because of the inherent risk it posed to other patient's who had the right not to be exposed to the preventable communicable disease (as some of the patients could not get vaccines for medical reasons).

These "thinking" moms should have to go to the pediatric hospital wards to witness firsthand the heartbreak, death, pain, debilitation suffered by the children who acquire the disease which these vaccines prevent to see how their "morals" stand up to reality. They should also have to be registered with DOH so that (such as those who are diagnosed with TB or Typhoid) were tracked as society as a whole has the right to keep themselves safe as well as their children from these leptons of ignorance. "There is no cure for stupid" Ron White

Timely article Orac as I was feeling bad for you and others who practice adult medicine today. I asked a preschooler who was telling me how cute her baby brother is if she knows she is cute. She told me she is "astounding". I also got to play with toy trucks and airplanes during well visits.
There are those reluctant parents that I can educate and those I have to tell I cannot be their child's ped when we reach an impass. As Paul Offit has said to me "We fight the good fight"

My kids went to a chicken pox party, before there was a vaccine. It was called "day care." I was not amused, and my kids were so miserable. I can't IMAGINE why any parent would do that to their child deliberately. Idiots.

@lsm

Do they think that most other children, especially those who vaccinate, are listlessly walking around in a perpetual state of bad health?

Yes.

@Lawrence

I imagine that such an idea never enters their thoughts. And if it does happen, they will either snap out of the dumb-induced haze they've been wandering through (see, e.g., Megan Sandlin) or they will double-down on the cognitive dissonance and rationalize away the problem, blaming something other than their decision for the reason their kid got sick.

@notation Wherever you are. My son was born in '69 fully vaccinated acccording to the schedule at the time. He is a very healthy competitive bike racer, treker, surfer, granola cruncher who vaccinated his kids according to a different schedule. I see nothing wrong with that decision and resent having "opinions" shoved down my throat.

@ NH Primary Care Doctor:

I get the impression by reading them daily that several of the TMs ( none specifially identified by me) that- despite their protests of AlWAYS being strapped for cash- have more money than is average and live in posher than average suburbs/ cities.

As one of my relatives notes: " You have to be rich to be middle class around here". They're in a similar position. Plus organic foods, supplements and altie treatments cost.

Days after she got the clean bill of health, she came down with an ear infection. Some Galilean olive oil with a dab of Thieves and she was good to go. Sometimes allopathic medicine is an option. Sometimes, simply educating ourselves about proper nutrition and preventative care is an option, too.

As one of those children unfortunate enough to suffer frequent S. pneumo otitis media--not the viral as this clearly was--complete with ruptures and ER visits in that lovely time period after tubes started to fall out of favor for confirmed bacterial infections but before the Pneumo vaccine was available to kids, I'd like to raise two enthusiastic middle fingers to the Rev. There was a period of time when I was on prophylactic Bactrim. I would have killed for a vaccine, and I shudder to think of what would happened if my mother had gone all natural and tried to treat me with olive oil that's is exactly the same as the Wegmans' brand I buy to cook with.

And I have no long-term damage aside from scar tissue, it just sucked that much. Weeks of bronchitis without antibiotics...it terrifies me how much these kids are suffering with things so easily treatable/preventable. And how much money does she spend on all those specialists? Surely they're all doing it for little cost and out of the goodness of their hearts...

anon @25 --

who vaccinated his kids according to a different schedule.

Good on him for vaccinating!

But it should be noted that the recommended schedules are worked out carefully by people who have forgotten vastly more about infectious disease than most of us will ever know. Why second-guess them?

I get the impression by reading them daily that several of the TMs ( none specifially identified by me) that- despite their protests of AlWAYS being strapped for cash- have more money than is average and live in posher than average suburbs/ cities.

All that homeopathy and other quackery, particularly the "biomedical" quackery to try to "recover" their children costs a lot of money. Just being upper middle class or even a bit more affluent won't cut it; you'll still be hurting for money after spending for quackery. Doubly so if you live in an expensive city like Chicago.

I can’t imagine how anti-vax parents handle the idea (or the reality) of taking weeks off from work if their kids come down with a VPD…
That was the main reason my parents still had measles and chickenpox parties - gather all the kids in one location and rotate care as required. Of course, late 60s didn't have good vaccines available either yet, or I'm sure they'd gladly skipped that.

The anti-vaccination sentiment is clearly ridiculous, but it's not so obviously ridiculous to try treating simple respiratory and ear symptoms with traditional medicine before rushing to the MD. A kid with a respiratory infection who is very active and has no fever is, firstly, not likely anywhere near sick enough to warrant ominous threats about "hoping "it's not tooo laaaate", and secondly, probably doesn't have a bacterial infection at all so doesn't "need" and won't benefit from an antibiotic. If you were less inclined to believe that any cough or earache, save for allopathy, could be certain death, you could rightly have identified her proclamation that the kid "needed" an antibiotic as another instance of [genuine!] Dunning-Kruger effect.

@oldmanjenkins #21:

Their arguments from ignorance is awe inspiring and makes one ponder if said ignorance should be measured in astronomical terms as miles, kilometers, pounds, kilograms etc do not adequately describe/quantify their level of stupid.

A solar mass of ignorance? It would fit well with burning stupid.

If you were less inclined to believe that any cough or earache, save for allopathy, could be certain death

Nice Strawman ya got there. Avoid open flames.

@Michael, #2: I wish and dream and hope someday the stodgy , out-of-touch and rather clueless leadership of the AAP will get off their duffs and (1) come out for vaccines as vocally as groups like NVIC speak against them, (2) change their policy which recommends not firing families who won't vaccinate but was made during a time when vaccination rates were much higher, and (3) Actually kicks anti-vaccine pediatricians like Dr. Bob Sears and Dr. Jay Gordon (who make lots of money selling anti-vaccine books and materials) out of the AAP.

Until then, it's just depressing as heck to watch the continual increase in vaccine-preventable diseases in the US thanks to non-thinking anti-vaccinationists.

Chris Hickie, MD, PhD

Ugh...blockquote fail.

who vaccinated his kids according to a different schedule.

Your son is a pediatrician? An immunologist? An infectious-diseases RN?

(Didn't think so).

Thinkers reminds me a bit of Brights. Both dumb. As a hospitalist, I deal with anti-vax ideology perhaps not as frequently as an office based pediatrician, but when I do it often forces me to order labs and treatments that a vaccinated kid wouldn't need. Perhaps it is selection bias, but rarely have parents of unvaccinated or partially vaccinated kids complained about the blood cultures and doses of ceftriaxone. A few have refused a lumbar puncture but that also happens with vaccinated children at times.

There is a sense of learned helplessness with this issue. As well meaning and motivated as pediatricians often are, it is difficult to have to do the antivax talk over and over again. I've had many instances where I just ignore it if the kid is in for something unrelated. I need the parents to trust me and be on board with my plans and it sometimes doesn't seem worth it if their child is admitted for colitis. But when I sense that there is even a small chance of success, I'll sit in the room for as long as I can and discuss the safety and benefit of vaccines.

I laughed when I read The Rev's list of self-limited and mild conditions for which her essential oils and homeopathy were effective.

jane,

A kid with a respiratory infection who is very active and has no fever is, firstly, not likely anywhere near sick enough to warrant ominous threats about “hoping “it’s not tooo laaaate”, and secondly, probably doesn’t have a bacterial infection at all so doesn’t “need” and won’t benefit from an antibiotic.

Anecdote alert, but I never had fevers. In fact, one of my ruptures occurred because the school nurse refused to let me go home because I didn't have a fever. Apparently that meant it wasn't bad enough. And it usually happened over the course of a few hours. Active, and went to school in the morning.

I am NOT saying all kids should be put on abx for ear infections, most absolutely do not need them and it contributes to resistance problems. However, a trip to the doctor to find out when pain starts can be a good idea. In fact, olive oil would have caused me much more damage, on top of having an ear canal swimming with Streptococcus. And when's the cut off? Days? Weeks? How long do you let a "nagging" infection go?

On more than one occasion, the mother showed up with the five unvaccinated children (ages toddler to second grader) into the waiting room and to the front desk. She didn’t call or put masks on the kids. One of those times, she brought in the children because SHE HAD TAKEN THEM TO A CHICKENPOX PARTY AND THEY WERE FEVERISH.

So she took them to a pox party where they were infected, then brought them in to a paediatrician's office that had immune compromised patients.
What is this I don't even...

@Shay - his mother-in-law is a nurse practitioner.

AnObservingParty:
"Weeks of bronchitis without antibiotics…it terrifies me how much these kids are suffering with things so easily treatable/preventable."

It terrifies me too. I frequently had bronchitis and other respiratory tract infections as a child, and it's miserable enough with the help of modern medicine! You know you're sick as a child when you don't even enjoy hearing the doc saying you shouldn't go to school this week, because you're just too tired to care.

My children's pediatrician has a separate waiting room for well-children, but they check-in at the same front desk, use the same doors (into the office and into the back section with the exam rooms) and only have one drinking fountain in the front. Then I think about veterinarians that have an entrance for dogs and an entrance for cats so they never cross paths...

Perhaps pediatricians need to follow this model and have an entrance for non-vaccinators and a separate entrance for fully-vaxed/relying-on-herd-immunity-due-to-vaccine-contraindications...

I had measles, mumps, chickenpox, and rubella as a child. I distinctly remember getting the polio vaccine in Cleveland when I was very young. My dad had polio, without sequelae, fortunately - you can bet we were getting the vax! I recall sitting in our doctor's waiting room with kids in leg braces.

Do these Nonthinkers vaccinate their children against polio? Tetanus?

A recent article at Slate discussed parent's irrational fears, and including some discussion of vaccines.

http://www.slate.com/articles/health_and_science/medical_examiner/2014/…

A nice quote regarding oh-so-scary vaccine indredients: The formaldehyde “added” to an infant’s body through vaccines is equivalent to adding a slice of American cheese to the top of a stack of 35 Hummers."

@brian

Some of the readers of that article might be interested in this post.

his mother-in-law is a nurse practitioner.

Really? And her specialty is pediatrics?

A number of the "RI Regulars" posted comments on this recent Daily Beast article about pediatricians who refuse to care children whose parents refuse vaccinations:

http://www.thedailybeast.com/articles/2014/01/30/the-real-reason-pediat…

Our old friend Dr. Bob Sears has a list of hundreds of "vaccine friendly" doctors and if you scroll down to California, you'll find Dr. Jay.

http://www.askdrsears.com/topics/health-concerns/vaccines/find-vaccine-…

If I had a young infant, I would be interviewing pediatricians to find who have instituted a strict vaccination policy. My babies were precious to me and I wouldn't want to expose them to deliberately non-vaccinated children, within the confines of a pediatrician's waiting room.

lilady @47 -- yowza. That Daily Beast article seems to have drawn all the usual suspects -- yourself and a few other rational voices against a baying horde of thermonuclear-grade stupid.

The great, great Charles Pierce -- who many know as a sometime "Wait, Wait, Don't Tell Me" panelist, and others know from his excellent politics blog on Esquire.com -- wrote a fine book entitled "Idiot America", about how in many circles, passionate belief has become as valued as actual knowledge. Recommended. He's actually an astute analyst, as well as often being hilarious.

Oh man! I just bought you a ticket for this, Orac?
Now who am I going to go with!!!

https://www.facebook.com/photo.php?fbid=10152112822072933&set=a.4921716…

So sad I don't live in NJ anymore...

A poster on "The Week" is saying that there is no link between the rate of vaccine exemptions and the vaccine rate, and that vaccine rates are not actually dropping. Lilady, maybe you can weigh in?

Responding to a few thoughts up-thread...

How do parents make the time off from work to look after kids ailiing from VPDs?
Perhaps they should check with the swelling ranks of parents of kids with vaccine induced autism.

Pro-vaxxers such as Offit are fighting the good fight?
And a highly profitable one to boot!

Seriously guys --just curious --when you make your spiels, are you not anticipating these rebuttals? (Hee hee hee)

Since vaccines don't induce autism, you have no point, Gerd, except for the one on your tin-foil hat.

And Derg weighs in to show, again, how totally stupid he is....thanks Derg...the thread was too highbrow, you needed to drop the IQ level a bit by showing up.

#4 Ren

"So, no, the people who get fired from practices for not doing the bare minimum to take care of their children are not “thinkers”. They’re sheep."

No, they are wolves adorned as sheepish things.
Bringing five unvaccinated kids straight from a "pox party" into a waiting room full of sick people is an aggressive act, using disguised aggression. It's sorta like the woman who proudly recalled the number or rear end accidents she'd caused by adopted a calculated strategy of slamming her brakes on full force when traffic bunches up a quarter mile ahead. Her "rationale" was that there's be an accident behind her, thus she would not herself get rear ended. Provided she doesn't repeat that in front of a judge there's nothing the law will do about it.

Same deal with the chickenpox, measles and HIV carriers who gleefully spread virus around to the "weak, genetically defective" individuals who "need to be thinned from the herd".

They are not victims, they are attacking your patients in a way calculated to leave themselves untouchable.

@52 ... and no sooner do I mention thermonuclear-grade stupid ...

As far as chicken pox parties, if it was 30 years ago and the vaccine hadn't been invented yet, and I had a generally healthy child who'd reached the age of nine or ten without catching it, I MIGHT contemplate deliberate exposure, just to prevent a more serious adult case later on. Of course, there IS a vaccine, so it's still dumb as shit.

And why would you bring your kid to the doctor for suspected chicken pox? Doctor's not going to do anything unless complications crop up.

@Chris @notation My child now 45 did well on his vaccine schedule. I am not against vaccines but I had read this about the HiB at 2 months.
"Scientists" and "Mds"among you please feel free to debunk. www.thinkingmomsrevolution.com/whats-really-behind-peanut-allergy-epide…
( I've heard all the negativity about this website, please do not be redundant, snarky even though I know you will be severely tempted )

"notation" and I could use some help here, with a couple of persistent trolls (I've just taken on "Emery" with a comment about vaccination rates and links).

http://theweek.com/article/index/257110/the-worrying-rise-of-the-anti-v…

@anon, Orac has already discussed this bunch and far more effectively than I can. If you would rather believe TMR than the CDC, I know all I need to know about you.

I'll snark if I wish. If you don't like it, tough.

Yet another case of organic being used by quacks. Organic seems to be the starter quackery that leads to homeopathy and all other quacktastic modalities.

lilady and Dorit ought to read the link anon just posted---sounds like the baloney Key Lime Pi was barfing up on Mother Jones.

@ Judy:

Just in case you didn't know:
'Fearless Parent' was founded by LKH and TMR's MacNeil - Brogan joined in later- and is featured on PRN ( internet radio)
Gracious! The woo doth clump together in heaps.

If you actually go, see if you can take notes.

Seriously guys –just curious –when you make your spiels, are you not anticipating these rebuttals? (Hee hee hee)

What "rebuttals"? Don't you have an awful backlog of these to provide on the last thread that you ran from with your tail between your legs?

anon: Sorry I'm going to get snarky here. If you don't like my tone...tough. Find yourself another blog to post your ignorant comments.

Peanut oil was investigated as an adjuvant on volunteers who participated in studies, fifty years ago. No vaccine containing peanut oil was ever licensed by the FDA for use in the United States:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130368/

More snark...

Here, for your perusal, photographs of children infected with the invasive and deadly H. influenzaie bacterium. The infant's gangrenous left hand was amputated after the photograph was taken.

http://www.immunize.org/photos/hib-photos.asp

In the context of firing patients, it is perhaps worth reiterating Gerg's self-described attitude when dealing with physicians:

[F]rom time to time I do get prolonged colds with coughing, sneezing, running nose, but never a fever....

Usually at my mother-in-law promptings (old people can be such hypochondriacs) I will sometimes go the doctor for these bouts. And, after waiting in the waiting room for an eternity, putting up with the unpleasantness of fellow sick patrons, uncomfortable chairs, really out-dated magazines, etc, I am then ushered in the doctor’s office where I have to wait another eternity. Feeling impatient and checking that they way is clear, I will further kill time by weighing myself or checking my blood pressure.

Eventually the doctor will grace me with his presence: ‘Hi there Mr. (insert Greg’s last name) — what brings you here today?’ I am tempted to mock him and ask, ‘what do you think?’–but I will behave.

After explaining that I have a cold, he runs me through the whole check-up gamut: ‘Open your mouth — cough- breathe–let me examine your eyes.’ And finally, after finishing this routine, he tells me that it looks like I have a bad cold. Aghast, I wonder why he gets paid good money for this.

A nice quote regarding oh-so-scary vaccine indredients: The formaldehyde “added” to an infant’s body through vaccines is equivalent to adding a slice of American cheese to the top of a stack of 35 Hummers.”

Heh, that's my line. Glad to see it put to such good use.

@ Denice

"If you actually go, see if you can take notes."

If I actually go, I'll bring along some cyanide capsules with me. And I did not know about the history of Brogan and TMR.

I do know she and Sayer Ji wrote a woo-filled piece on why vaccines aren't Paleo on Greenmedinfo. It sounds like a parody by The Onion. Seriously, you can't make this stuff up. The problem is that her MD and good credentials give the woo some unwarranted gravitas.

This Thinker has a remarkably healthy child who eats well and is developing normally with no learning disabilities or developmental delays.

When I try to imagine myself describing a friend's baby this way, my mind just hits a wall.

I think of the babies I know socially as people. With, you know, personalities.

They always sound like they're talking about collectibles or something when they mention their kids: (Near mint, no shelf wear, learning disabilities or developmental delays.)

Freaks me out.

@anon - yeah, what has been said above. Peanut oil is not and has never been utilized for a vaccine on the US Pediatric schedule....anyone that says otherwise is lying.

In fact, as far as I can see, I've only suggested it was the result of a phobic, whiny temperament, and/or a hysterical overreaction to the sigh of flyers, and/or a compulsion to rage at women.

Ann: They always sound like they’re talking about collectibles or something when they mention their kids: (Near mint, no shelf wear, learning disabilities or developmental delays.)

Freaks me out.

Yeah, I think that's a side effect of having a type A personality and giving up the career. They obsessively measure the kids, and implode when the kids don't measure up.

And I'm going to assume that second comment was supposed to be on another thread where the 'Void Troll" lurks. My condolences. I'm staying away from that thread; it's bad for my blood pressure and worse for my tooth enamel. I hope Orac bans that creepy rapist soon.

@ Judy:

Unfortunately, you're correct: an MD makes their woo appear more feasible - ALTHO' remember that these people scoff often at doctors and other professionals who AREN'T anti-vax. Brogan has appeared at PRN as a guest of their chief honcho, been published at various anti-vax and altie sites like GMI. LHK has been cycling around anti-vax world for the past few years, editing a book with Mary Holland, working with Focus Autism; she and MacNeil hosted a book signing at last year's Autism One with Jennifer Margulies, another 'fearless parent'.

Thus, these folks run in very small circles of closed mindedness: everyone knows everyone else and enables one another EXCEPT when there's war - as in Jake vs Blaxill.

Oops. Wrong screen and thread.

This is not my night.

"remember that these people scoff often at doctors and other professionals who AREN’T anti-vax."

In other words, 99.9999% of professional. And Brogan isn't just a contributor at Greenmedinfo......she is the "medical advisor," right below Sayer Ji himself. So she is blameworth for all the anti-vaxx on that site......and their endorsement of chemtrails too, I guess. I have yet to find a medical conspiracy which that site doesn't endorse.

http://www.greenmedinfo.com/blog/evidence-atmospheric-aerosol-spraying

A dandy tweet from Brogan on Monday. (The link is just to a two-year-old Christina England piece that is noteworthy solely for her praise of Lowell Hubbs in the comments.)

"Several bottles of yummy wine lay interspersed among their mostly green, mostly raw, mostly organic food fest."

Eating organic foods and not vaccinating to avoid alleged "toxins" then imbibing in copious amounts of alcohol, which is a known toxin and carcinogen. Irony must be the Thinking Moms Revolution.

Gregger, did you even bother to read what Orac wrote? In his post, he says:

[V]accines can be money losers for pediatricians. Indeed, a study from three years ago by athenahealth found that in almost half the cases, payments for vaccines weren’t enough to cover the cost of storing and administering them.

So why did you say @52:

Pro-vaxxers such as Offit are fighting the good fight?
And a highly profitable one to boot!

Here's one interesting fact for you. Dr Jonas Salk, the guy who created the inert polio vaccine used in most of he world, never patented it. If he had, he would have earned some $7,000,000,000. That's right, seven BILLION dollars. Yet to you, vaccinators are all about the money.

As children, my husband and I had measles and chickenpox. Our children were vaccinated against MMR, but caught chickenpox and survived, though our son had a skin infection during the course of his illness. Nowadays there are vaccines for just about every conceivable childhood illness under the sun. We live across the hall from a lovely lady who had polio as a child, and who now lives with Post-Polio Syndrome. Vaccinate or not? They should visit with our neighbour and listen to what she has endured during her lifetime. No child, anywhere, should have to go through what she has endured!

So why did you say @52:

Pro-vaxxers such as Offit are fighting the good fight?
And a highly profitable one to boot!

Very likely because of this. You don't think he actually reads the posts, do you?

@ Narad: Just above The Troll's comment is the comment from Emery who has been posting dumb analyses on blogs, about parent refusals to vaccinate completely, or those who opt out of select vaccines.

Emery is rather fixated on the varicella vaccine, which, of course, is a benign childhood illness.

Andrew Wakefield patented a vaccine and set up a company to exploit the patent, and it turned out to be made of milk.

@ zetetic0 #77

Eh, maybe the wine is organic, too. Makes it alright.

But indeed, ethanol has a very good creed as a neurotoxin.
It's also not too bad as a solvent for both water-soluble and fat-soluble chemicals. That's why wine/spirits/whisky connoisseurs bring their own glass to a tasting event, and don't use soap to wash it, to avoid mucking up the beverages' flavors. Or so I was told by one.

With the amount of wine the "Thinkers" seem to put away, I wonder what their thoughts on foetal alcohol syndrome are?

On the other hand, I would like see at least some acknowledgment of the side effects that vaccines can cause. I am not speaking of autism, but of the fevers, muscle aches and tremors you can get from them. These are my own experiences, I don't have children, yet medical personnel have all dismissed them as not from the vaccine. If a child told me that is how they made them feel, I would believe them. And, no, I am not advocating against vaccines. I am advocating for honesty from healthcare providers and I don't think it serves anyone to dismiss real side effects in the effort to get everyone on board for vaccination.

I guess ethanol's okay because it's "natural".

Eh, maybe the wine is organic, too. Makes it alright.

Don't forget that fermenting everything is all the rage. My recollection is that the unpasteurized Synergy brand kombucha could be coaxed up to 3% ABV with "improper" storage.

Orac: Sorry about your keyboard. Though, it could have been worse, you could have laughed so hard the coffee came out your nose;-)

Mike @ 61: Here's a slogan for you: 'Organic is the gateway placebo.' Though, I will admit that I've eaten some organic carrots, tomatoes, and spinach, and found them delicious.

There's one part of organic farming that we should all support, which is the requirement that antibiotics never be used as livestock growth promoters or added to their feed, but only be used on individual animals that are diagnosed with a relevant disease by a proper veterinarian.

I see no harm in MDs saying as much to their patients, particularly those who have a tendency to be wooed by woo. 'Yoga is good for exercise, organic veggies taste good, and organic meat isn't helping grow resistant bugs. By the way, please come in for a flu jab this year.' The patient sees that their doctor approves certain things that are part of the patient's worldview, so the patient is more willing to listen in return.

#85 AnnB

you seem to have had experiences on a different planet. Doctors are required to make you aware of the potential side effects of a treatment, drug companies are required to write them down for you. If you choose to ignore the literature accompanying the shot then surely that is your issue. However I would suggest that if you have had this experience in real life you register a formal complaint against the Dr involved for not informing you of potential side effects.

@AnnB:

I am not speaking of autism, but of the fevers, muscle aches and tremors you can get from them.

The first two ARE acknowledged. But I have to admit, tremors is a new one for me. How did the vaccine cause the tremors?

Seems like it's all over the Net that pharma' service announcements (PSA) are not changing the anti-vaxxers minds and could be backfiring.

So after you shills devote so much time and energy supporting pharma' scaremongering propoganda, they are still taking their cues from Dachel and Meleck? If I were pharma, I would fire all your arses -- Lawrence included, and he should be the first to go.

@Julian

Gregger, did you even bother to read what Orac wrote? In his post, he says:

[V]accines can be money losers for pediatricians. Indeed, a study from three years ago by athenahealth found that in almost half the cases, payments for vaccines weren’t enough to cover the cost of storing and administering them.

Those poor pediatricians!

Julian, in addition to convincing those TMs that vaccines had nothing to do with their kids' autism, why don't you encourage them to throw a few dollars their pediatricians way to cover the extra costs? I suggest you even personally crash their headquarters and make this pitch. Let me know how it turns out! (Hee hee hee.)

@Narad

Although it's not my style to follow or participate in any other topic here that's not related to autism, I, nevertheless, came across this gem from Delysid describing you....

You are so unbelievably pompous that you don’t even realize that your comments usually make no sense. Your favorite tactic (besides childish mockery) is go off into irrelevant obscure topics in a laughable attempt to demonstrate your intellectual superiority. You are like a dweeby and depressed Dennis MIller.

I think he has you pegged perfectly. Aiming for the stars with your attempt at earth of this world wit is resulting in it being lost to us earthlings.

#93 --'Aiming for the stars with your attempt at out of this world wit is resulting in it being lost to us earthlings'

"Some Galilean olive oil with a dab of Thieves (for an ear infection) and she was good to go."

This mom would be right at home in Jay Gordon's pediatric practice (he prescribes mullein oil and garlic along with homeopathic remedies for ear infections):

http://drjaygordon.com/faq/medicalconcerns/earinfections

I recently debated the issue of pediatricians refusing to see vaccine refusers with a pediatrician on another board (this is someone who is pro-vaccine but tries to accomodate delaying and refusing parents). His take was that there is virtually zero risk of kids with vaccine-preventable diseases infecting others in the waiting room, and that pediatricians who discharge parents from the practice over vaccine refusal are irresponsible slackers.

Which made me wonder who among the pediatrician(s) who post here will drop non-vaccinating parents and their kids (I don't recall hearing Dr. Hickie's position on the matter)? Are pediatricians who discharge antivax parents "dumping" on the rest of the profession?

@Derg - taking the words from someone who freely admits to conversing with beings from other dimensions through the habitual use of mind-altering drugs isn't really helping your case.....

As to your former comment, I guess I must be finally getting under your skin....good to know.

DB @95 -- Hearing that "Dr. Jay" uses homeopathic medicines makes me want to start grading the premed basic physics course that I teach much more severely.

When I saw the title of the post, I expected it to be about The Pediatrician To The *Stars*. But I guess he's not so much versus the D-K effect as pro the D-K effect.

“Whaaaaaat did you just say?” We all rubbernecked, saucer-eyed and slack jawed in her direction; our delicate sips turning into large lapping gulps.

What a thoroughly unpleasant group of people. Note: lapping out of a wine glass is not the recommended way of drinking wine.

Greg is, as usual, both deliberately offensive and incoherent:

"Big Pharma propaganda is ineffective, so pharma shills should be paid less." Wouldn't it make more sense to hire some pharma shills to push the "propaganda"?

"Vaccination is an enormously lucrative conspiracy against the public. Oh, wait, it's actually a money loser. Okay, then pediatricians should go beg people who hate them for more money. Hee hee hee." Yeah, that makes all kinds of sense.

@ Dangerous Bacon: The San Diego measles outbreak was determined to be caused by Dr. Bob Sears' deliberately unvaccinated seven-year-old patient, who acquired measles during a trip to Europe and returned to expose and infect patients in a doctor's waiting room. (The doctor's waiting room was not Dr. Sears waiting room):

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e222a1.htm

I confronted Dr. Sears on the Ho-Po...he was not pleased:

http://scienceblogs.com/insolence/2012/03/27/dr-bob-sears-vs-seth-mnook…

Dr. HIckie, I believe, has instituted a policy in his practice to not accept new patients whose parents refuse vaccinations. He has also notified the parents in his practice, who refuse to vaccinate, to find another practice, for their children.

lilady: "@ Dangerous Bacon: The San Diego measles outbreak was determined to be caused by Dr. Bob Sears’ deliberately unvaccinated seven-year-old patient, who acquired measles during a trip to Europe and returned to expose and infect patients in a doctor’s waiting room. (The doctor’s waiting room was not Dr. Sears waiting room):"

I pointed this out in the other thread, and still got the "well, it's a nearly zero risk" answer from the pediatrician (apparently, if the CDC hasn't documented other cases, they must never have happened).

I pointed this out in the other thread, and still got the “well, it’s a nearly zero risk” answer from the pediatrician (apparently, if the CDC hasn’t documented other cases, they must never have happened).

I used my google, keying in "measles transmission health care facility", to find this report from the WHO. Does it "count" if the transmission of measles occurred in Sydney Australia? :-)

http://www.wpro.who.int/wpsar/volumes/03/4/2012_OB_Hope/en/

@ Dangerous Bacon: Tucson Arizona...measles transmission in hospital Emergency Room waiting room:

http://jid.oxfordjournals.org/content/203/11/1517

Way to miss the point with your comment @92, Gregger. I was pointing out that your claim of vaccine profiteering @52 was incorrect.

More ammunition for Dr. Bacon:

http://www.ncbi.nlm.nih.gov/pubmed/24280280

Vaccine. 2013 Nov 24. pii: S0264-410X(13)01504-1. doi: 10.1016/j.vaccine.2013.11.005. [Epub ahead of print]

A global perspective of vaccination of healthcare personnel against measles: Systematic review.

Fiebelkorn AP1, Seward JF, Orenstein WA.

Abstract

Measles transmission has been well documented in healthcare facilities. Healthcare personnel who are unvaccinated and who lack other evidence of measles immunity put themselves and their patients at risk for measles. We conducted a systematic literature review of measles vaccination policies and their implementation in healthcare personnel, measles seroprevalence among healthcare personnel, measles transmission and disease burden in healthcare settings, and impact/costs incurred by healthcare facilities for healthcare-associated measles transmission. Five database searches yielded 135 relevant articles; 47 additional articles were found through cross-referencing. The risk of acquiring measles is estimated to be 2 to 19 times higher for susceptible healthcare personnel than for the general population. Fifty-three articles published worldwide during 1989-2013 reported measles transmission from patients to healthcare personnel; many of the healthcare personnel were unvaccinated or had unknown vaccination status. Eighteen articles published worldwide during 1982-2013 described examples of transmission from healthcare personnel to patients or to other healthcare personnel. Half of European countries have no measles vaccine policies for healthcare personnel. There is no global policy recommendation for the vaccination of healthcare personnel against measles. Even in countries such as the United States or Finland that have national policies, the recommendations are not uniformly implemented in healthcare facilities. Measles serosusceptibility in healthcare personnel varied widely across studies (median 6.5%, range 0-46%) but was consistently higher among younger healthcare personnel. Deficiencies in documentation of two doses of measles vaccination or other evidence of immunity among healthcare personnel presents challenges in responding to measles exposures in healthcare settings. Evaluating and containing exposures and outbreaks in healthcare settings can be disruptive and costly. Establishing policies for measles vaccination for healthcare personnel is an important strategy towards achieving measles elimination and should be a high priority for global policy setting groups, governments, and hospitals.

Perhaps they should check with the swelling ranks of parents of kids with vaccine induced autism.

And the evidence that vaccines induce autism would be what exactly, greg?

Oh, that's right--you don't have any.

Unfortunately, you’re correct: an MD makes their woo appear more feasible

Always good to remember what they call the student who graduated dead last in his class at medical school.

"Doctor".

@ JGC:

AND if they can't get an MD, they'll get a PhD - in anything!- including the kind you get through mail order. They like the sound of 'doctor'- it helps sell woo.

AnnB: " I would like see at least some acknowledgment of the side effects that vaccines can cause. I am not speaking of autism, but of the fevers, muscle aches and tremors you can get from them."

They are listed in the Vaccine Information Sheets that legally required in the USA to be given with each vaccine. From that website:

Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccinations.

If you are an American, you have no excuse for not reading them. If you live outside the USA, you are given a pass, but you are welcome to read them from the CDC website.

@ Helianthus:

re: organic wine.
They have it! It is made by Frey ( the vineyards, not the g-d). I've also read that itis 'biodynamic'- whatever that means.
( see website- Frey Vineyards).

So much mental masturbation between these "Thinkers".

@Julian
Now that I have your attention, I want to revisit your claim that there is no autism increase, just better detection.

So, I suppose we can all agree that there are no bio-markers for autism diagnosis. That leaves us with just its outward symptoms for detection. And, with autism, we are talking about the repetitive actions and gestures that go with the condition.
Afterall, other mentally retarded individuals have characteristic poor language and social skills.

Spelling things out, Julian, this would mean that tthroughout human history, everyone missed that a distinct segment of the mentally retarded population were sticking their fingers in their ears, hand flapping and head banging! In fact, it took Kanner only recently (1940s) to identify these people! And, since then, scientists and clinicians are getting really better identifying these distinct mentally retarded individuals who are sticking their fingers in their ears, hand flapping, and banging their heads. They are getting so good at identifying them, that they are reporting record cases of the condition yearly.

Now Julian, you take issue with me dismissing you as naievely stupid for buying into the no-link claim. But, If you really believe in the preceeding nonsense, how am I so wrong for chalking your thinking up as highly moronic?

You can't fire someone who has hired you. These doctors are simply quitting on their patients. Doctors quitting will allow parents to see how useless pediatricians are in general and how unnecessary well baby visits are specifically. Quit if you like, but since these doctors are discriminating against certain people it is appropriate that the medical profession has their state granted monopoly removed. I'm sure anyone can over prescribe antibiotics as well as they can.

@Sid - I'm surprised you aren't all for this. I mean, isn't exactly what Libertarians want? Giving businesses complete freedom to do what they please & associate with whomever they want?

@Orac' peanut gallery

The San Diego measles outbreak was determined to be caused by Dr. Bob Sears’ deliberately unvaccinated seven-year-old patient, who acquired measles during a trip to Europe and returned to expose and infect patients in a doctor’s waiting

Unvaccinated people don't cause measles outbreaks. The measles does. Not vaccinating is a non- action. Non- actions are not causative. The child did not aquire the measles. Aquire agiain implies an act of aquiring on the child's part. No such action took place. The child was infected without his knowledge by the measles. Finally he did not expose and infect. The poster again makes the error of conflating acts of God with concious acts. People are under no obligation to risk their health to protect others from acts of God

Yes, lawrence, just get rid of that medical monoploy part and I'm fine with it

No one is blaming the kid, as you very well know, you under-educated sorry excuse for an alleged human being.

The parents and the so-called pediatrician made conscious acts with their decision not to have the child vaccinated. Don't try to pass human stupidity and arrogance off as an act of God..

And when I was in sales, there were a number of times when I "fired" a client - when it reached a point where there wasn't a point in continuing the relationship.

Looks like poor sid is jealous that the wizard didn't give him a brain--just some hemorrhoids with a few ganglionic cells wired to his mouth.

@LW
I didn't say you should be paid less for your shilling duties. You should all be fired -- shown the door! Don't put words in my mouth, LW! You are all doing a piss poor job at countering Dachel. Pharma provides one propaganda article and she starts with her links....

'Vaccine courts pay out for autism'? Interesting! 'There is a movie, The Greater Good, telling both sides of the debate'? Maybe I will check it out!

Seriously -- what don't you guys understand about doing everything to keep the sheeps contained that you just are not getting? Geez -- incompetence!!

You can’t fire someone who has hired you.

It is generally accepted that you can sue for divorce, but you can't sue for marriage.

Beside, as has been noted, why would a parent want a pediatrician who wants to, in the parent's mind, poision the child.

"Unvaccinated people don’t cause measles outbreaks. The measles does."

That's got to be one of the stupidest comments I've seen on here yet.

"You can’t fire someone who has hired you."

Oh, I spoke too soon. This is even dumber. Of course you can.

Not vaccinating is a non- action. Non- actions are not causative.

Not stepping on the brakes is a non-action. Non-actions are not causative. Ergo, if Sid is driving down the freeway and does not apply the brakes when the car in front of him stops, the ensuing accident is not his fault. Momentum caused the accident, so please don't conflate acts of God with acts of stupid.

(BTW, Sid, inaction that results in the harm of others is called "negligence".)

“Unvaccinated people don’t cause measles outbreaks. The measles does.”

That’s got to be one of the stupidest comments I’ve seen on here yet.

You're new here, ain't ya? Sid is capable of much more stupid than that comment. That only measured 2.4 mega-stupids on the Sid-O-Meter. I've seen him go all the way to 11MS.

Offal...I'm not going to do your research. Try using your google fu skills, to check out avoiding a charge of "Patient Abandonment", when a pediatrician dismisses a patient from a professional practice.

You should have opened the links that I provided to "Dangerous Bacon", which detail the many cases of vaccine-preventable-diseases, which have been transmitted to infants and children, who are too young to have received the primary series of vaccines...or who have valid medical contraindications...or who are undergoing immune-suppressing treatments, for cancer, rheumatoid arthritis, etc.

<blockquote.You can’t fire someone who has hired you.

Which argues only that characterizing being asked to leave a pediatrician's practice because your choices regarding vaccination are placing other patients at risk of infection as "being fired" is inaccurate.

These doctors are simply quitting on their patients.

No, they're protecting the health of those other patients in the practice that have confidence in the physicians medical advice. What I can't understand is why--since you clearly don't trust the quality of the pediatrician's medical advice--you would want to remain his patient in the first place.

Quit if you like, but since these doctors are discriminating against certain people it is appropriate that the medical profession has their state granted monopoly removed.

By what argument is discriminating on a rational basis inappropriate, Sid?

Non- actions are not causative.

So if I fail to stop at a red light and instead drive through an intersection and strike another car, I didn't cause an accident? After all, all I've done is commit a 'non-action' by not stopping my car.

People are under no obligation to risk their health to protect others from acts of God.

What evidence demonstrates that receiving the MMR vaccine according to the recommended vaccination schedule places one's health at greater risk than remaining vulnerable to infection? Be specific.

Dang.. See Todd got there first.

I like that whole 'non-actions' are not causative thing. Maybe Sid should commit the non-action of failing to file a tax returns, and when called before the IRS explain why he can;t be held liable for a non action.

That only measured 2.4 mega-stupids on the Sid-O-Meter. I’ve seen him go all the way to 11MS.

And remember, the Sid-O-meter mega-stupid scale is like the Richter scale: logarithmic.

So after you shills devote so much time and energy supporting pharma’ scaremongering propoganda, they are still taking their cues from Dachel and Meleck?

It's pretty clear that the only possible effects Dachel's robotic efforts can have are (1) publicly demonstrating that she cannot respond when challenged and (2) being banned from sites for spamming and having her comments deleted, which seems to happen with some regularity.

You, on the other hand, having repeatedly been caught in outright lies, would be a dream come true as a public antivaccine crusader.

Anyway, since you're on about costs, perhaps you missed another item in the same issue of Pediatrics:

"Analyses showed that routine childhood immunization among members of the 2009 US birth cohort will prevent ∼42 000 early deaths and 20 million cases of disease, with net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs, respectively."

I expelled the non-vaccinating families from my pediatric practice in Tucson because of a whooping cough outbreak in my practice area. I will not have an unvaccinated child with florid pertussis coming into my waiting room (which had happened) and infecting in my waiting room either a newborn too young to be vaccinated or an immune compromised child, such as one who has had an organ transplant or is on chemotherapy for leukemia. If Sid and Greg are too stupid to understand this, that is their damn problem. And those two are about as dumb as those "thinking moms", who are about as smart as a sack of hammers.

Quit if you like, but since these doctors are discriminating against certain people it is appropriate that the medical profession has their state granted monopoly removed.

This is directly analogous to claiming that someone's being declared personal non grata at every bar in town is an argument against liquor licenses.

^ "persona"

How could we ever forget Offal's other endeavors...such as promoting the mailing of varicella infected lollipops between non-vaccinating parents?

http://www.bbc.co.uk/news/magazine-15647434

Offal also "debated" Dr William Shaffner, an infectious diseases specialist/professor at Vanderbilt University School of Medicine, on BBC Radio Overnight. Too bad, that broadcast isn't available now; Dr. Shaffner wiped the floor with him.

Gregger @111:

Spelling things out, Julian, this would mean that throughout human history, everyone missed that a distinct segment of the mentally retarded population were sticking their fingers in their ears, hand flapping and head banging!

Given that: for centuries it was believed that a lot of illnesses were caused by demonic possession; that psychology and psychiatry are relatively recent fields in medicine; that the mentally disabled were locked away and their symptoms weren't closely studied; that Tourette's and Down's Syndromes were only described in the 19th century; and that weird behaviours could be dismissed as eccentricities, why should this be unlikely sounding or even surprising?

And...speaking of vaccines and children, the lead article in the most recent MMWR offers more evidence in favor of vaccinating kids against the flu.

"After the regulation took effect, vaccination rates among Connecticut children aged 6–59 months increased from 67.8% during the 2009–10 influenza season to 84.1% during the 2012–13 season. During the 2012–13 influenza season, among all 11 EIP surveillance sites, Connecticut had the greatest percentage decrease (12%) in the influenza-associated hospitalization rate from 2007–08 among children aged ≤4 years. Additionally, the ratio of the influenza-associated hospitalization rates among children aged ≤4 years to the overall population rate (0.53) was lower than for any other EIP site."

Unvaccinated people don’t cause measles outbreaks. The measles does.

Likewise, restaurant workers who don't wash their hands after using the toilet don't cause foodborne illness via the fecal–oral route, the pathogens do.

Good luck with that, Sid.

Oh, I spoke too soon. This is even dumber. Of course you can.

notation, you clearly weren't here for Thingy.

Ah, there are benefits to being late to the party, I see.

@Narad

We should be on the lookout for those nefarious pathogens.

And, with autism, we are talking about the repetitive actions and gestures that go with the condition.
Afterall, other mentally retarded individuals have characteristic poor language and social skills.

Nice touch. Let us not forget Gerg's claim about his profession.

You missed Didymus, too. Count your blessings.

One of those times, she brought in the children because SHE HAD TAKEN THEM TO A CHICKENPOX PARTY AND THEY WERE FEVERISH. I wish I was joking.

Reminds me of Agatha Christie novel "The Mirror Cracked" where a famous actress kills a woman who many years earlier infected her with rubella and caused her child to be born with brain abnormalities. The woman had known she was sick, but wanted to get the autograph so badly, she put some make up on and went to the event and years later boasted about it.

The lady that brought her infected kids is very similar to that woman.

A. In this specific case, the parents acted: they took a non-vaccinated child to an area with measles.
B. As the example demonstrates, the distinction between action-non-action depends on the time frame in which you examine the events and on the purpose for which you do it - for example, fi someone is cooking, are they cooking, or are they not driving? People are rarely completely passive. In this case, the purpose is to assign blame and consequences to a human choice. The choice is not to take a precaution against a disease. Whether or not there should be consequences is a human policy choice. But saying this is just the start of the discussion. We need to ask: does the non-action justify any response? And if so, which response? Mandating action? Criminal penalty? Etc'. Others have already brought several great examples for actions we punish. Let me give you a few that directly respond to your "act of God": several states have laws that make it illegal for people with certain conditions to drive without taking medication to prevent dangers from the conditions (e.g. epilepsy and medication against seizures); if you have TB and refuse treatment you may be quarantined.
Before you say "this is about moral and not law", the justification for those choices is a moral one: when your choices - including your choices not to act - put others at risk, there are moral grounds for the public's representatives to take steps against you.

lilady: "You should have opened the links that I provided to “Dangerous Bacon”

Thanks for the links, but why is my username in "quotes"? It's like I'm not real or something. :(

Can you prove you're real?

You can’t fire someone who has hired you.
I don't know why Sid is contributing this correction here. Wouldn't it be better addressed to TMR, where the claim to have been “fired from Dr.*" was reported?

@ kitty:

"Reminds me of Agatha Christie novel “The Mirror Cracked” where a famous actress kills a woman who many years earlier infected her with rubella and caused her child to be born with brain abnormalities. The woman had known she was sick, but wanted to get the autograph so badly, she put some make up on and went to the event and years later boasted about it."

(Because I have an immense repository of totally useless minutiae and trivia)

I believe that "The Mirror Cracked" novel is based on the life of movie star Gene Tierney and her daughter Daria:

http://en.wikipedia.org/wiki/Gene_Tierney

"Tierney married twice, first to Oleg Cassini, a costume and fashion designer, on June 1, 1941, with whom she eloped. Her parents opposed the marriage, as he was from a Russian-Italian family and born in Europe.[10] She and Cassini had two daughters, Antoinette Daria Cassini (October 15, 1943 – September 11, 2010)[11] and Christina "Tina" Cassini (born November 19, 1948), born after their first divorce.

In June 1943, while pregnant with Daria, Tierney contracted rubella (German measles), likely from a fan ill with the disease.[10] Daria was born prematurely in Washington, D.C., weighing three pounds, two ounces (1.42 kg) and requiring a total blood transfusion. The rubella had caused genetic damage: Daria was found to be deaf, partially blind with cataracts, and had severe mental retardation. She later was institutionalized for much of her life.[10]"

@ Dangerous Bacon: Sorry for the quotation marks; I know you are real. :-)

kitty: "Reminds me of Agatha Christie novel “The Mirror Cracked” where a famous actress kills a woman who many years earlier infected her with rubella and caused her child to be born with brain abnormalities"

That was based on what really happened to Gene Tierney though Ms. Tierney never sought revenge (note the link is to a 35 year old article):

Soon disaster followed disappointment. She caught the German measles during a World War II USO tour, and because she was pregnant at the time the consequences were devastating. Gene carries permanently the scars of the day, more than four years later, when she placed her daughter Daria in a school for the mentally retarded. "The emptiness inside me was like a cave," she says. "She was a sweet little girl, with golden curls and soft skin. Physically she looked just like any other 4-year-old. I cried for Daria and I cried for me until I didn't know where the tears came from." Now 35, Daria still has the mind of an infant and is confined to an institution in New Jersey. (More than a year after the little girl was born, Gene was approached at a party by a former woman Marine who said they had met at a USO canteen two years earlier. The woman added that she had been quarantined at the time with the measles but had sneaked out to see Tierney anyway. "I just had to go," the woman gushed innocently. "You were always my favorite." Stunned, the actress said nothing.)

I am biased toward the genetic component in longevity and immune response. My grandmother had a sister who lived to 102. She was one of the original homesteaders to Oregon, she had 4 children 1 of which died in infancy, 2 lived to 99, the third 103. Truly amazing! They did not juice, nor were they vegans.

notation - Thingy's most infamous line was that children know to stay on the sidewalk and not in the dirt.

lurker: Though, I will admit that I’ve eaten some organic carrots, tomatoes, and spinach, and found them delicious.

I've spent many happy hours at farmer's markets.

JF: Don't forget that Greg thinks autistic people spend their life in stasis.

notation: Link to Thingy's infamous sidewalk quote. She was given the name "Thingy" because of the combination of her 'nym, Th1Th2, and the Seuss characters that caused chaos: Thing1 and Thing2.

@Dorit as I have explained to you countless times not vaccinating places no one at risk. It there was no extant risk there would be nothing to vaccinate against. Why you still cannot comprehend this is beyond me.

As to your driving analogy, we have an awarness of a condition - seizures - and we have an act - driving- so there is no connection to existing without taking evey vaccine that is recoomended nor is there one to going about normal activities because there is a chance you are infected. Your example could be connected to something such as drunk driving but certainly not the vaccination issues I've raised

Yes, if there was no extant risk there would be nothing to vaccinate against. So bleeping what?

If there was no extant risk, we wouldn't need to protect low-lying coastal areas from flooding.

In both cases, there is a risk and a decent, responsible person does not deliberately increase other people's risks. You don't get to destroy protective dunes to improve your view of the ocean and defend yourself on the grounds that if someone else's house floods, you won't be personally carrying the water in.

Vaccine-preventable diseases, like hurricanes, are known risks that exist in the world we live in. In your fantasy-land, it's somehow never your fault if other people are injured or killed.

Why do you want the right to kill other people's children?

@Dorit as I have explained to you countless times not vaccinating places no one at risk

I've read all your explanations since a few years and I'm not convinced, so prove it that not vaccinating put no one at risk.

Alain

Vicki, the person who posted above is not a decent responsible person. He does not care.

He chose his 'nym as an affront to someone who is a decent responsible person. Let us just say that Mr. "Unvaccinated people don’t cause measles outbreaks." is a despicable person. And an idiot.

A bit late to the party, but

People are under no obligation to risk their health to protect others from acts of God.

Am I my brother's keeper?

Also, thanks Himself God has a strong back. With all the responsibilities people like you keep dropping on Him instead of assuming them. All God did (if He really did anything) was to set loose a few bugs on Earth. If we are too lazy to protect ourselves against them, it's not His fault.

If you were seeing a bear cornering the toddlers from the family next door to you, I guess you would follow your principles and let the bear have his snack. After all, the bear deciding to come around is an act of God (nothing to do with the garbage bags you left outside), and you cannot be held responsible for not acting.

Ann: I had a few further thoughts on the children as objects thing. I've noticed that among middle-class/ low-upper class parents, parenting has more or less evolved into a competitive sport.
In certain circles, if you don't have the Baby Einstein DVDs prepped and ready to go a month from birth, the right baby-carrier, organic baby furnishings and pacifiers, don't have the preschool picked out, and aren't prepared to breastfeed until kindergarten, you might as well not bother to bring the kid back from the hospital. (I exaggerate, but not by much.)

#89 @incitatus

You complete me! Seriously though, you helped prove my point. I do get looked at like I am from another planet when I tell healthcare personnel that I get flu-like symptoms from vaccinations. [2 MMRs = cold sweats, high fever, muscle aches all over, fatigue but no headaches, upper respiratory anything, and it passes in 2 days. Both were before the law went into effect and 1 was given in basic training; a place where they don't care about informed patients. HepB similar symptoms. 2x TD boosters not as severe as MMR].

All I have ever been told is I may get mild soreness at the injection site and/or a mild fever. Vaccines hit me hard and when I tell them this, I am not believed. Also, I wouldn't report a healthcare worker for this as I can handle it with them myself.

#90 @Julian Frost How did the vaccine cause the tremors?

Thanks for asking. I don’t know how. Perhaps you can tell me. The tremors I refer to were from TD boasters. Just had one several months ago. My muscles shivered intermittently starting in biceps and down to thighs. If I had a fever, I would have blamed that because it felt like what accompanies fevers. Lasted approx.3 days.
#108 @Chris …you have no excuse for not reading them.

I worked in hospital pharmacies for 13 years so inserts and leaflets are not new to me. But, I appreciate you provided the information to others. The patient info did not cover the severity of my reactions (please see first paragraph in this comment) nor did it make my providers believe my reaction when I told them.

Yet another foolish statement from Greg:

Spelling things out, Julian, this would mean that throughout human history, everyone missed that a distinct segment of the mentally retarded population were sticking their fingers in their ears, hand flapping and head banging!

The autistic have always been with us. I shudder to think what they have suffered throughout history, when they and other mentally ill or disabled people were simply classified as "lunatics" and abused or treated as objects of entertainment.

These historical descriptions of Bethlem Hospital in London contain some interesting accounts. In 1522 Thomas More remarked that “thou shalt in Bedleem see one laugh at the knocking of his own head against a post”. In 1710 the travelling German scholar Von Uffenbach arrived at Bethlem and among the delusional patients he observed, other male patients (note the gender), “not mad but only deprived of their wits or simple”. In 1760 Thomas Brown wrote, of Bethlem:

Some were preaching, and others in full cry a hunting. Some were praying, others cursing and swearing. Some were dancing others groaning. Some singing, others crying, and all in perfect confusion. A sad representation of the greater chimerical world!

How many of these people were suffering organic or functional psychoses, how many severely autistic? How many other individuals with milder autism simply went unnoticed? We don't know, but I see no reason to believe that autism was any less common then.

What about later, in the 20th century? At least mental hospitals had ceased to be regarded as a suitable venue for an amusing day out; instead they became places people vaguely dreaded and avoided. I have mentioned here before my visits to a UK hospital for the 'mentally handicapped' in the late 70s and early 80s, that had hundreds of residents with mental disabilities of varying severity. Even those living in the village a couple of miles away (I lived there myself for a few years) had little idea they even existed, though they were aware of the mentally ill patients there.

In Autism: A Social and Medical History by Mitzi Waltz (p97 onwards is worth a read) I read:

John Clements, today a well-known specialist in the area of autism and challenging behaviour, was a young, idealistic psychology student in the late 1960s. He was shocked to learn whilst training at the Maudsley Hospital in London that there were thousands of 'lost souls' in huge facilities ringing the capital. Identified only as having learning difficulties or mental health conditions, many of them were people with autism.
[...]

Ely Hospital was a Welsh hospital for the 'mentally handicapped', the subject of a damning report in 1969 that helped start much-needed reforms:

Another thing missing from Ely was an understanding of autism. 'There was this notion of autism - I knew about Michael Rutter's work and Lovaas's work' Clement says. 'But the general perception in a place like Ely was... that autism didn't really exist, it's for middle-class families who can't face the fact that their child is mentally handicapped and can't come to terms with it.' As noted earlier, this skewed class dimension of autism diagnosis was based largely on the descriptions that had been set out by American clinicians like Kanner and Bettelheim, who had emphasized the idea that autistic children were mostly born to educated, high-achieving parents. 'No one at Ely was diagnosed as autistic,' Clements states, [but] 'when I look back, the place was stacked full of people with autism - stacked full. All with very severe learning difficulties as well, but it was not a concept that was prevalent for us at all.'

Similar reports came out around the same time in the US and in other countries, and reforms followed. I have no doubt that autistic people were among those that were locked away from public sight for decades.

So, it isn't surprising that we now see far more people with autism and other mental disabilities (differing mental abilities?), since just a few decades ago they were being essentially imprisoned away from public view and institutionally abused. One of the men mentioned in the book I quoted above, who had been at Ely Hospital for 30 years, had all his teeth removed, not because they were rotten but because it saved the staff the effort of cleaning them and saved on dental bills. I find it hard to express how angry that makes me feel.

I have no trouble believing that autism rates are exactly what they were even hundreds of years ago; severe autism, which is much easier to diagnose consistently, appears to be stable at about 1 in 1,000. The other 90% of individuals with milder autism might not have been noticed at all a few hundred years ago, or were just thought odd or 'simple'. In some cultures there may have been powerful motivations to learn to behave neurotypically. When the only diagnosis available was 'mental retardation' which came with free social stigma, who would seek a diagnosis for their child unless they really had to?

" as I have explained to you countless times not vaccinating places no one at risk. It there was no extant risk there would be nothing to vaccinate against. Why you still cannot comprehend this is beyond me."

Well, the problem is that that's not true. To start with, not vaccinating a child places that child at higher risk of catching a disease. The risk of disease exists before we vaccinate; but vaccinating reduces it, just as putting on a seatbelt reduces the risk of an accident - a risk that exists independently of the existence of a seatbelt.
Since most of the disease we vaccinate against can be transmitted to others, leaving yourself at higher risk of them means you're more likely to transmit them to others. If you left your child at risk, that child is also more likely to transmit them to others.

If you've left your child unprotected and then taken that child to an area where the disease is prevalent, you are exposing that child to the risk of it, and others your child may come across to the risk of transmission. Maybe a good analogy would be that if you did not teach your child how to swim and then threw him in a lake, you are actively exposing the child to a risk of drowning.

I hope that's clearer.

My source for Autism Stats-
www.cdc.gov/ncbddd/autism/data.html

@dedicated lurker (I love your moniker, BTW) "Thingy’s most infamous line was that children know to stay on the sidewalk and not in the dirt."

Jesus wept.

Sid the putz: "Dorit as I have explained to you countless times not vaccinating places no one at risk. It there was no extant risk there would be nothing to vaccinate against. Why you still cannot comprehend this is beyond me."

She's not the only one. Maybe it's because what you're farting about makes no sense whatsoever.

@anon,
That's probably the best source for accurate statistics on autism. But, keep in mind that an increase in the number of people diagnosed with autism may not reflect a true increase in the number of people who are autistic.
There are several articles at Science Based Medicine that explain the factors that contribute to the increase such as this one:
http://www.sciencebasedmedicine.org/social-factors-in-autism-diagnosis/

And, those statistics are for ASDs, which include autism as a subset.

True. I just hope that the stats do not increase.

ie. Based on the current diagnostic criteria there should be no increase unless they add more vague criteria.

@ anon:

The criteria were recently changed ( DSM 5) which should lead to a decrease in diagnoses. Jon Brock ( Cracking the Enigma blog/ last year) discussed some early studies showing this effect.
OBVIOUSY some people will say it is an attempt to cover up the truth.

notation - I picked it because I lurked on this blog for ages, and when I first commented I figured I'd only do it once or twice. Didn't really work out that way.

@dedicated: which, as far as I can see, is all to the good. :)

@Denice- Thanks -found the link crackingtheenigma.blogspot.com/2014/01/the-evolution-of-autism-comparing-dsm.html

www.crackingtheenigma.blogspot.com/2014/01/the-evolution-of-autism-comp…

I have explained to you countless times not vaccinating places no one at risk

By "explained" Sod means "I made a demonstrably false statement with no evidence whatsoever to back it up and then whined because I got my ass handed to me on a platter. Again."

AnnB: "The patient info did not cover the severity of my reactions (please see first paragraph in this comment) nor did it make my providers believe my reaction when I told them."

I am sorry you are so affected by vaccines. Imagine what would happen if you had a full blown infection.

What you need to provide your symptoms to VAERS, and do tell your primary medical care professionals. If you are in certain heath maintenance organizations it would get noted in the Vaccine Safety Datalink system.

Some people have immune issues which cause vaccines to cause more than the average reaction. It happened to one man's son with the OPV, so he campaigned to switch to the IPV (John Salamone).

Shay: Actually Offal's stance is perfectly understandable. Like almost every other libertarian, he doesn't think other people are real. Therefore, infectious diseases don't matter, because they only kill off non-player characters (everyone who isn't him.)

PGP: how do one's children fit into this equation? Real or unreal?

Dorit: Most libertarians don't have kids. But I'd have to say the kids are probably 'unreal.' At best, they're property. And I'm basing this off libertarians I've had the misfortune to run into on the net. Thankfully, I've never encountered one personally.

I don’t know why Sid is contributing this correction here. Wouldn’t it be better addressed to TMR, where the claim to have been “fired from Dr.*” was reported?

Perhaps he was just confused, given his lack of familiarity with being employable. Or lack of familiarity with firearms, which readily demonstrate what the word actually means.*

* I'll leave out the Proto–Indo-European part.

Your example could be connected to something such as drunk driving but certainly not the vaccination issues I’ve raised

Jesus Christ, Schecter, try to keep your own "argument" straight: Not sobering up is a "non-action." "Non-actions" are "non-causative." Drunk driving therefore does not cause automobile accidents.

Offal had a blog post devoted to him and his posts about influenza vaccine.

http://thepoxesblog.wordpress.com/2013/08/02/the-callousness-of-some-pe…

Good grief, there's a non-vaccinating parent on his FB page who asked for advice before taking a young child to the Philippines. The parent was told by other posters that vaccines are not going to protect the child:

http://www.nbcnews.com/health/health-news/measles-uptick-u-s-linked-phi…

Oh Gregger, you know how you are constantly arguing that autism is a modern condition caused by vaccines?
Well, I was just on Cracked, and oh, the timing is just too awesome.
http://www.cracked.com/article_20905_5-brain-disorders-that-started-as-…
Item topping the list? Autism Made Hunter-Gatherers Hardcore Survival Machines
So much for recent.

Has anybody noticed that the new star columnist on the anti-vax website has acknowledged three generations of autistic behaviour in his own family - and that's before he gets to his son?

"Now before I get started let me say although I see heredity at play in our family my Grandfather, Father and myself fall into the "just a little different" category and have never been diagnosed formally as being on the autism spectrum. I would say we all were autism level 0. The category of those that can contribute without assistance but are on the outside of the social mainstream."

@Julian

Hey Julian are you there? Julian are you listening? 'Hello. Hello. Anybody Home? Think, Mcfly!'

Julian, autism is a freakin, stinkin disability. There is nothing evolutionary advantageous about autism. If tomorrow, if the vast majority of neurotypical parents were to stop looking after their autistic kids, those kids would die: not being able to fend for themselves and satisfy their survival needs --die! That would leave a few high functioning autistics to reproduce and continue their lineage, and not having enough social skills to get laid, their numbers will take another serious hit. Perhaps a few will fu€k, and have kids, Julian. And, assuming their kids are autistic, Julian, the pattern will repeat itself with the vast majority of the low functioning ones dying off, and less and less high functioning ones reproducing.

Don't believe me, Julian? Check the long history of evolution, which shows organisms with deleterious traits following this precise pattern towards extinction.

Julian, don't get me wrong -- I don't mean to be crass. Just thought I would continue to spell things out.

@Julian

Julian, further to my argument that autistics (including high functioning ones) often face a serious challenge with reproducing, perhaps I will use you as a case study. Please feel free to answer the following questions, although you are not obligated to do so.....

Julian, are you married? Do you have kids? If not, Julian, do you have a girlfriend? Julian have you had many girlfriend in the past? Cutting to the chase, Julian, over your lifetime would you say that getting laid has been a challenging endeavour?

Again Julian, please understand that I don't intend to be mean and disrespectful. I am just trying to establish a point in the straightest way possible.

please understand that I don’t intend to be mean and disrespectful. I am just trying to establish a point in the straightest way possible a born odious jerk, more earwax than brain.

FTFY.

@Derg - stop lying...of course you intend to be mean and disrespectful.

@ Jeff1971:

I certainly did.
There are other references around blogs like AoA and TMR that cause me to wonder about familial patterns.
Not to mention the way that some of them- based on their writing- appear to think.

So in a few words, how are people with ASDs different than people without them?
I'll wait while you go over the answer in your head.

Now how does that explain the current situation on this thread?
I hope you see my point.

Now guys, wait a minute, I believe Greg just say something interesting.

Earlier in the thread, and in the previous one on vaccines, he keep asking where all of these autistic children were, before industrial times and vaccination.
Example from #111 above:

Spelling things out, Julian, this would mean that tthroughout human history, everyone missed that a distinct segment of the mentally retarded population were sticking their fingers in their ears, hand flapping and head banging!

But recently, he just said:

If tomorrow, if the vast majority of neurotypical parents were to stop looking after their autistic kids, those kids would die: not being able to fend for themselves and satisfy their survival needs –die!

I believe he just answered his own question.

BTW, Greg, you overlook a little detail in the transmission of autistic genes: even assuming that autistic people don't reproduce (and in wedding-arranged societies, it doesn't really matter that one of the spouse is not talking much), the siblings may also carry the deleterious genes without expressing them.
With a single recessive gene in cause, the 2 parents have to be carriers to see affected children, but statistically only 1 out of 4 children will be double recessive and thus affected; 2 out of the 3 other children will be like their parents, dominant/recessive carrier. Now, if 2 or more genes are in cause, and only a few specific combinations lead to autism, many of us can be carrying half of the genetic payload responsible for autism, never to be seen unless we mate with the right person...
If the evolutionary pressure is not too high, the genes may stay in the population for a long time. Like, the whole of human history.

Also *de novo* variation.

-btw- as your friendly early warning system, I must report that there are two interesting, not OT, posts today:

- Cia Parker tells stories about our own Dorit and hepB ( @AoA)
- TMR announces that the Establishment is in trouble, because it awakened the Mommies. Eeew.

We should call the Mommies "Zommies".

@DW 189, For the latter: http://xkcd.com/1013/

Uh oh....John D. Stone "might be" fixated on Dorit.

"Autismmom

I am absolutely sure that having been turned into the main propaganda arm of the vaccine industry we should continue to monitor and report on Dorit Reiss.

John

Posted by: John Stone | March 07, 2014 at 09:45 AM"

Jeff: Has anybody noticed that the new star columnist on the anti-vax website has acknowledged three generations of autistic behaviour in his own family – and that’s before he gets to his son?

Yeah. The mind boggles at the amount of self-hatred he'd have to have to write at AOA. It bothers me a bit more than CIA Parker's gobshite about having autism. (Also the attempted white knighting at work bothers me.)

@PGP - yeap, autism certainly isn't genetic....unless you count all of these families with multiple generations of autism....morons.

Don't forget all the other ills that are supposedly caused by vaccines.
In my family, my brother and father developed asthma (though brother grew out of it,) and although I'm the only one diagnosed with ADD, I'm pretty darn sure that my dad and possibly one of my grandparents have it- and both my sibs have some ADD traits.
I went to a school with a lot of ADD/ADHD students, and I also noticed that a lot of the parents seemed to have some form of it themselves, though they were almost certainly never diagnosed. Dyslexia is also known to run in families- in fact, I'm surprised no one has ever argued otherwise.

Must say, looks like April will be another challenging month for you guys...

'How long can we expect them to turn it all blue without asking why'?

@ PGP:

I wish your brother well.
One of my crea... (ahem!) _gentlemen_ also "grew out of asthma" at 12 or so only to have it come roaring back at age 50.

Leaving aside the obvious fact that Gerg is continuing his usual pattern of running away from his original "point" immediately upon its being challenged....

If tomorrow, if the vast majority of neurotypical parents were to stop looking after their autistic kids, those kids would die: not being able to fend for themselves and satisfy their survival needs –die!

This is true of all children, moron. At least this saves the trouble of wasting time dissassembling the rest of the idiocy.

And once again, Gregger shows he doesn't read the data we provide for him.

Julian, autism is a freakin, stinkin disability. There is nothing evolutionary advantageous about autism.

If you had bothered to click through to the Cracked post, you would have read:

[Autistics]were able to efficiently operate alone; the time and effort that others spent socializing and drawing crappy stick figures on cave walls were instead channeled into things like tracking, getting to know the terrain, and other Rambo stuff...
[Autistics] are also known to engage in repetitive activities like stockpiling food and supplies, a useful talent in a world where your survival depended on those exact things. Since they were strong, skillful, and well-fed, their lack of social skills presumably wasn't much of a hindrance when it came to procreation, either.

Nothing evolutionarily advantageous to autism, eh?
Cracked links through to an article from Science Daily.
The paper referred to in the Science Daily article is Jared Edward Reser. Conceptualizing the autism spectrum in terms of natural selection and behavioral ecology: The solitary forager hypothesis. Evolutionary Psychology, 2011; 9 (2): 207-238.

Narad - maybe Gerg is that person who wrote that child neglect shouldn't be a crime if the kid can crawl outside to find new parents.

Cracked links through to an article from Science Daily.

Full paper here (PDF).

Jared Edward Reser. Conceptualizing the autism spectrum in terms of natural selection and behavioral ecology: The solitary forager hypothesis. Evolutionary Psychology

It was nice of the people who dream up evo-psych Just-So stories to print them in a specialised journal, where they are easier to ignore.

that person who wrote that child neglect shouldn’t be a crime if the kid can crawl outside to find new parents.

That was Delysid, citing Rothbard and the Mises Institute. The Reductio ad Adsurdum argument just doesn't work on some people. When they realise that their theoretical principles lead inevitably to a logical corollary which is batsh!t insane, rather than reconsider the principles, they prefer to reject reality and preach the virtues of batsh!t insanity.

Dedicated lurker: No, that was the void troll who posted a link to that screed, though I imagine Gerg and Sid not-so-Vicious would agree.

DW: My little sis grew out of migraines too- go figure. Li'l bro is doing pretty well for himself, and no signs of the asthma reoccurring. Now if we could only find his darn pet.

Looks like Julian chimed in, but conspicuosly missing from his comment was info pertaining to his 'studliness'. Folks, who here still doubt my wisdom? Julian, and other autistics are likely not. To breed. They will not pass on their 'supposed' autistic genes. And yet, even with their reproduction problem, autistics are still here, and if anything, their numbers are increasing! How could this be?? HHMMMNN!

child neglect shouldn’t be a crime if the kid can crawl outside to find new parents.

I spent some time trying to make sense of the intellectual contortions on show in Rothbard's Mises-Institute columns. As far as I could tell, a fetus is supposed to be an unborn child, i.e. a free and autonomous moral agent (because this axiom is easier than accepting degrees of agency). Therefore the mother is not bound to supply the fetus with nutrients and oxygen, and if human physiology allowed her to cut off that supply by an act of will, it would be legal. An abortion, however, involving an act of violence,* is murder and warrants the attention of what minimal legal system exists in the libertarian utopia.
Abandoning a baby is OK, because once it is born, finding food and warmth is the baby's own responsibility.

* Presumably an abortion obtained using ergotamine to cut off blood to the placenta would be legal, but I did not pursue the reasoning that far.

@herr doktor bimler

HAHA! You are the one who doesn't seem to understand the reductio ad asurdum logical fallacy. "We need laws or else there will be chaos!"

If we don't have laws against child neglect than society will insanely neglect children, IMMA RIGHT?

It is quite ironic how Orac's Insane Asylum loves to bring up the Dunning-Kruger effect will laughably oblivious to its direct relevance here.

We are scientists therefore we are geniuses about our political opinions as well!

The paper referred to in the Science Daily article is Jared Edward Reser. Conceptualizing the autism spectrum in terms of natural selection and behavioral ecology: The solitary forager hypothesis.

I remember that paper now, from 3 years ago. It talks about "social morays". The journal's peer-review and proof-reading standards are such that an entire paragraph is repeated.

I just consider everyone here as an academic elitist who espouse collectivism because it is impossible to keep track of the mishmash of arrogant hypocrisy and paradoxical political beliefs being spouted here, but please herr doktor bimler remind again of your personal thoughts on abortion/neglect/abuse.s

There have been periods in our history when child abuse and neglect were extremely common, and they certainly happen today. If you're trying to say there is no need for laws against child abuse or neglect, you are very wrong.

Greg's dribble is never-ending, it seems.

the pattern will repeat itself with the vast majority of the low functioning ones dying off, and less and less high functioning ones reproducing.

Not for the first time, I find myself questioning Greg's claims that he works with those with mental disabilities. Anyone believing that "low functioning" autistics require social skills to "get laid", cannot possibly have any experience in this area. The sexuality of those with severe mental disabilities is rarely talked about, but causes a lot of problems, not least unwanted pregnancy.

@Dorit

You seem to have the very naive belief that laws stop things from happening.

Liberals are funny. Let's make a a law and then pat ourselves on the back for solving the problem.

Herr Doktor Bimler @203, 206 -- It sounds as if there are some folks who would view Swift's A Modest Proposal as being a perfectly fine way for the free market to take care of a social problem.

HDB @ 208 -- -- It sounds as if there are some folks who would view Swift's A Modest Proposal as being a perfectly fine way for the free market to take care of a social problem.

@ herr doktor bimler:

Eels on facebook? What next!

@ Krebiozen:

I doubt it myself.
When you counsel people surprising things 'come out'.

@palindrom

Yes, you are totally correct! Eating children is a long established libertarian belief!

Palindrom @212 has repeated a paragraph to see who notices.

Greg, I'm not answering your questions about my sex life because they are inappropriate.

And creepy.

I just consider everyone here as an academic elitist

That's a curious rationalization of your own glaring inadequacies, since elitism should be a good thing in the imaginary dynamics of the imaginary State of Nature.

who espouse collectivism because it is impossible to keep track of the mishmash of arrogant hypocrisy and paradoxical political beliefs being spouted here

If you think back, you may recall that you started shrieking about everybody being a "collectivist" promptly after your AGW "analysis" fell flat (which was long before I bothered with you). You are literally unable to cipher out just how you could come to be universally negatively regarded, so you simply fall back on a laughably ill-designed broad brush.

Even better, here you cough up your explanation: "Everybody" "espouses collectivism" "because" you can't keep track of things. Well done.

Looks like Julian chimed in, but conspicuosly missing from his comment was info pertaining to his ‘studliness’.

Conspicuously present in yours is another flight from criticism of another idiotic premise.

Folks, who here still doubt my wisdom? Julian, and other autistics are likely not. To breed.

And this is what's left, neither more nor less than the undefended assertion, yet again, that ASD = "mental retardation," which itself doesn't even support the "conclusion."

Gerg, do everybody a favor, and put some effort into being the village idiot: explain, in your own words, what a "gene" is.

If we don’t have laws against child neglect than society will insanely neglect children, IMMA RIGHT?

Since society already does that at an alarming rate, I don't think removing the laws against it will make it go down, no.

dedicate lurker,

Since society already does that at an alarming rate, I don’t think removing the laws against it will make it go down, no.

I have come across libertarians who believe that laws are the main cause of crime, that "prisons are built with the bricks of the law". I'm not sure if this is a misunderstanding of the obvious (i.e. if there are no laws there are no crimes), or a weird variety of magical thinking. In Delysid's case I suspect the latter. If you convince yourself that the tyranny of government is to blame for all ills, and that if we didn't have a government everyone would behave responsibly, it all makes sense, I suppose.

#173 @Chris "I am sorry you are so affected by vaccines. Imagine what would happen if you had a full blown infection."

Nope. I don't ever want to see a full blown infection, but that's what the vaccine is for then, right? ;-)

Thanks for the sentiment, especially on this thread; I see it can get a little hot in here. And, thanks for the additional information about reporting.

@Dorit

You seem to have the very naive belief that laws stop things from happening.

You know, D., all it takes is a trip to W—pedia to get a leg up about whether anybody has lately seriously considered the "deterrent effect" (PDF) rather than, say, naively asserting that it doesn't exist at all.

AnnB @158 Here is a reported reaction of tremors-www.jnnp.bmj.com/content/63/2/258.full

www.jnnp.bmj.com/content/63/2/258.full

HDB @216 -- I figured you'd notice!

Have a fine weekend!

AnnB @158 Here is a reported reaction of tremors-www.jnnp.bmj.com/content/63/2/258.full

That's substantially more than "my muscles shivered intermittently starting in biceps and down to thighs," and it's not a "reported reaction."

@Delysid, 212:
If you want to say that laws do not enforce themselves and that just having a law is not enough, that's certainly true. For example from this context, we still have more child abuse and neglect than we should. But:
A. As pointed out by Narad, in his inimitable style, we do have some literature that suggests that deterrence works, however imperfectly.
B. Challenging as it is to enforce a law that is on the books, enforcing a law that is not on the books is even harder. Passing the law is a necessary first step.

You seem to have the very naive belief that laws stop things from happening.

How can you believe this is true when we have actual concrete data to the contrary?
https://www.ncjrs.gov/App/abstractdb/AbstractDBDetails.aspx?id=206023

Oh wait, this is social science so the data and analysis don't matter, or something. It's just like how every climate model is false because they're complicated!

“Autismmom
I am absolutely sure that having been turned into the main propaganda arm of the vaccine industry we should continue to monitor and report on Dorit Reiss.
John
Posted by: John Stone | March 07, 2014 at 09:45 AM”

John Stone and his ilk have "been turned into the main propaganda arm of the vaccine industry"? And therefore should be monitoring and reporting on Dorit Reiss?

That's what he wrote, anyway. 

 What does the vaccine industry have against Dorit Reiss?

Not enough to deny vaccines to me or my family, I hope.

It's surprising how few libertarians advocate the abolition of laws against theft and squatting and usurpation of property (onviously such laws are useless, because owners are still being robbed).

Correction:
J Neurol Neurosurg Psychiatry 1997;63:258-259 doi:10.1136/jnnp.63.2.258
Severe but transient parkinsonism after tetanus vaccination
http://www.jnnp.bmj.com/content/63/2/258.full

Oh wait, this is social science so the data and analysis don’t matter, or something. It’s just like how every climate model is false because they’re complicated!

Like women?

@anon - thanks for the link. It is interesting, yet sad, read.

@Narad - I'm glad I didn't suffer that much, but I don't get your point.

@Narad – I’m glad I didn’t suffer that much, but I don’t get your point.

The point is that anon went scrounging around and came away with nothing more than a lone case report that has no meaningful similarity to the symptoms that you described and that also, while dancing around the issue, purports to offer an example of causality by exclusion.

Krebozien: I’m not sure if this is a misunderstanding of the obvious (i.e. if there are no laws there are no crimes), or a weird variety of magical thinking.

Well, like I said upthread, to most libertarians, everyone except them is an NPC- a non-person. Therefore, if a libertarian murders someone, it shouldn't count, as they acted against a non-person and the laws make the murder into a crime.

AnnB, there is a reason that I take (drag) the two college aged kids who live at home to get their influenza vaccine just before the weekend, and when they do not have major projects or exams in classes the following week. Every few years an influenza vaccine will knock me down for a couple of days.

You seem to have the very naive belief that laws stop things from happening.

Well, I'm not the first to say that some people are alive only because it's illegal to kill them.

http://bit.ly/1kDrU0V

Greg, #205, March 7, 2014:

Looks like Julian chimed in, but conspicuosly missing from his comment was info pertaining to his ‘studliness’.

As if it were any of your business, or anybody else's.

Folks, who here still doubt my wisdom?

Do I actually need to raise my hand? I would conjecture that few who have read your nonsense has any doubts about your lack of wisdom. After all, the arrogance of your "Justified True™ Belief" epistème does not signal 'wisdom' to anyone who deals with reality.

Julian, and other autistics are likely not. To breed.

My children, grandchildren, and (due later this year) great-grandchildren might also disagree with you.

They will not pass on their ‘supposed’ autistic genes. And yet, even with their reproduction problem, autistics are still here, and if anything, their numbers are increasing! How could this be??

Perhaps your quandary has to do with the True™ Beliefs that you cling to, and the discrepancy between your True™ Beliefs and reality.

Chris,

Every few years an influenza vaccine will knock me down for a couple of days.

Are you sure? I wonder how often someone coincidentally gets a mild viral infection at the same time as a vaccine and the latter gets the blame for the symptoms. The CDC say that only 1 in 100 people get a fever after an influenza vaccine (though headache and joint pains are more common), and I would guess that being "knocked down" for a couple of days is even rarer.

I only started getting a flu shot a few years ago, but I haven't noticed any effects at all. No pain, no sore arm, no fever, nothing. The only vaccine I ever remember having any side effects was typhoid (which is live attenuated IIRC): I felt very strange that afternoon and went home early from work. Even that I now wonder about; it could have been entirely unconnected, or even psychosomatic.

Similarly I believed I was allergic to penicillin for a couple of decades because I broke out in a rash once, my doctor jumped to precautionary conclusions and it stayed in my medical records. Recently my GP suggested giving penicillin another go, and I found I can take it and its relatives without any problems. That presumably means the rash was due to something else, perhaps the infection that was being treated.

My point is that the post hoc fallacy bites sceptics too.

I've gotten the flu shot for over 10 years. No effect whatsoever.

Krebiozen @ 242: I tried that CDC link and can't find anything about what percentage of people get a fever after a flu vaccine; not that I doubt you, but I was hoping it would clarify whether some people are more likely than others to have that reaction. That is, if two people get vaccinated, and one of them gets a fever afterwards, is that one more likely to get a fever from the following year's flu vaccine?

Krebiozen @242 --
I don't think reports of flu shot reactions are due to coincidence.

I have had no illness this season except maybe for a week-long cold, but the evening after I got my flu shot I felt distinctly under-the-weather -- slightly feverish, a bit achy. It went away within a day, unlike a 'real" illness, and never bothered me much. It was listed as a possible side effect on the handout I was given. I'm almost sure it was a real side effect, because of its short duration, the fact that I seldom get sick, and its close match to the symptoms on the handout.

My wife works in health care and many of her co-workers had similar experiences with their mandatory (and-it's-a-good-thing!) flu vaccinations.

I only started getting a flu shot a few years ago, but I haven’t noticed any effects at all. No pain, no sore arm, no fever, nothing.

Maybe I'm a delicate flower or something, but I had a couple of days' sore arm from Fluzone. Dtap was worse.

Similarly I believed I was allergic to penicillin for a couple of decades because I broke out in a rash once, my doctor jumped to precautionary conclusions and it stayed in my medical records. Recently my GP suggested giving penicillin another go, and I found I can take it and its relatives without any problems.

I take pains to highlight something similar when the topic comes up: I was sent off into the world with the admonition that I was "allergic to erythromycin." Given that nobody seems to have any evidence of this, I can only assume that it's some sort of residue from overzealous allergy testing when I was a kid.

The SSLR from sulfamethoxazole was cute, though.

@Narad - It's ok. I can understand a rare side-effect as that. The story may not show causality, yet it is something that happened to someone at one point in time and I can read it without prejudice. To me, it doesn't hurt to exchange factual information.

@Chris - well, thank you for acknowledging this, although I am sorry it lays you out.

When I suffer, I mostly get the same response as @Krebiozen. One, twice maybe three times a coincidence, but not every time I get a vaccine. I am aware of many side effects, but I can take Augmentin on an empty stomach with no issues, and I once took Zaleplon and it had zero effects. I remember hoping that if it wasn't going to make me sleep, that I would at least hallucinate. Not that I wanted to get high because I don't enjoy high, but so that I would know that I actually had ingested something. I also get endoscopys and colonoscopys without sedation or pain meds with no issues; I am not the reactive patient.

My point is that people are different and not every one responds the same way to the same medication. Recently a psychiatrist wrote a reply to a comment of mine that was so beautiful, it was almost poetic http://real-psychiatry.blogspot.com/2014/03/can-you-trust-your-physicia….

I wasn't commenting on vaccines specifically there, and if those here would like me to bring it back to vaccines, I will, and ask, who is making the bigger sacrifice? The person who gets vaccinations but doesn't experience any side effects or the person who feels like hell after getting them, but gets them anyway.

Delysid:

Yes, you are totally correct! Eating children is a long established libertarian belief!

Well, according to your libertarian convictions, what would you inherently object to if such a transaction took place?

For all those that wrote of their reactions to vaccines, I guess I'm not as much of a minority patient as I had thought.

@Narad - Yes, Septra hit me hard too. Hives that connected into wheals as large as saucers. Ended up in the ED in the middle of the night for those.

I again had no ill effect luckily from the Tdap but my granddaughter did from the DTap, fever and crankiness but it was gone after 1 day.

@Narad – It’s ok. I can understand a rare side-effect as that. The story may not show causality, yet it is something that happened to someone at one point in time and I can read it without prejudice. To me, it doesn’t hurt to exchange factual information.

No, it doesn't hurt, as long as there's a context within which to understand it. "Tremor" isn't a monolithic category, so dredging up a case of extrapyramidal symptoms carries baggage that I don't think anon took into consideration.

@Narad - point taken.

Sorry everyone misunderstood, but I saw "transient" meaning he fully recovered from this awful experience. It was quite severe but he did recover. I thought it would be viewed in this context.

Ann,

That's an easy question: obviously those of us who tend not to have side effects from vaccines are making little or no sacrifice. All getting a flu shot costs me is ten minutes of my time. Therefore, those of us for whom it's easy should be particularly diligent about getting vaccinated, in part for the sake of herd immunity.

Krebiozen: "I wonder how often someone coincidentally gets a mild viral infection at the same time as a vaccine and the latter gets the blame for the symptoms."

The last time was when I got the H1N1 in a combo influenza just a year after I had had an H1N1 single vaccine. I just assumed that it was an immune response to the second dose.

It has only happened a couple of times. But with college pressure I want to minimize sick days for the kids living at home (the rule is that we only pay tuition, a job is required to move out). Plus fever and malaise are listed as side effects. Something one does not need during mid-terms or finals.

I can't do anything for the one who does not live at home. I just leave him text reminders, one included a bribe, but that does not work. He works with kids so he is always being exposed to something. Last year he called us because he was very sick, and his dad took him to an emergency department.

This month he is cutting back his hours to finish out school, and actually have time to find a "real" job. He could never go to the college's career centers job workshops because he was at work. Hopefully he will be exposed to fewer pathogens.

When I got a TD back in high school my arm ached for days. When I got a DTaP a few years back they injected me in the shoulder, which was a lot less painful.

My "worst" reactions were with the 3 doses of hepatitis B vaccine; my arm ached for days, but I had no systemic reactions.

I found this about solicited reactions from various age groups, post vaccination with Fluzone seasonal influenza vaccine:

http://www.rxlist.com/fluzone-drug/side-effects-interactions.htm

Vicki,

Krebiozen @ 242: I tried that CDC link and can’t find anything about what percentage of people get a fever after a flu vaccine;

Sorry, that's because I made a mistake and misread the page somehow - it's the adenovirus vaccine that results in a fever in 1 in 100 recipients. Mea culpa.

However, this study found a lower incidence of systemic side effects (which includes flu-like symptoms) in those receiving influenza vaccine as compared to those receiving placebo. I find it interesting that more than 40% of placebo recipients reported systemic side effects that must surely have been either a coincidence or a nocebo effect of some sort.

A quick browse through some other studies found similar results i.e. local reactions (sore arm etc.) are relatively common, but not systemic reactions are rare. These are older studies, so it's possible perhaps there are more side effects with more modern vaccines.

Oops - ^ "but systemic reactions are rare".

Looks like Julian chimed in, but conspicuosly missing from his comment was info pertaining to his ‘studliness’. Folks, who here still doubt my wisdom? Julian, and other autistics are likely not. To breed. They will not pass on their ‘supposed’ autistic genes. And yet, even with their reproduction problem, autistics are still here, and if anything, their numbers are increasing! How could this be?? HHMMMNN!

Why is it that every time that Dreg posts something, I'm reminded of an episode of South Park:

http://www.youtube.com/watch?v=_H8XqA7WyLI

Why is it that every time that Dreg posts something, I’m reminded of an episode of South Park:

Funny, he always brings Beavis and Butthead to my mind.

Perhaps Derg should direct his questions at his AoA fan club, who are the ones that keep talking about how they have multi-generational autistics in their families....including Ms. Parker, for instance.

I would love to see how they would react to Derg's question on breeding.

Somewhat OT -

Greg and other disease advocates have asked 'where were all the autistics in the past?'. Part of the answer is here.
http://www.cnn.com/2014/03/08/us/mississippi-unmarked-graves/index.html…

The asylum drew residents from across the state, people who were committed for a variety of ailments. Many, according to records, were institutionalized for years.

When residents died, few were claimed by families. Experts believe poverty may have also played a role -- families could not afford to retrieve and transport the bodies.

As a result, many were buried in unmarked graves in an area of the property believed designated as the asylum cemetery.

I generally have a mild reaction to any vaccine (fever, aches) but I'm used to that now since it happens every time and with every vaccine I've ever gotten. And I don't forgo the vaccine just because of them. I may delay them if I have an activity happening that I need to be 100% for, but I won't skip them entirely.

Greg has no clues and I'd really like to give him some quarters.

@ Lawrence:

I think it's interesting that he chose Julian upon whom to heap his load of stereotypes and to subject to insensitive prying questions: Julian *sounds* like a younger guy. I think that a few older, self-identified autistics/ people with AS mentioned having children/ grandchildren. And Alain est Francais ( and you know the stereotypes about them!) so it was Julian by default. Forrtunately, Julian knows to regard the message from whence it came.

So maybe the creature has more than one stereotype about people with ASDs: earlier, he displayed his overly histrionic views about those with more severe conditions and now, he's on AS.

Oddly, a few women commenters have mentioned that they wouldn't be surprised if their husbands would test as AS. Also there may be some data on the male children of (male) engineers being more lkely to display autistic traits.

Also his views on how autism spreads genetically are rather 'precious'.

Everyone except Greg understands that the reason one uses the term "Autism Spectrum Disorder" is that there is a spectrum, so it is entirely possible for traits at one end of the spectrum, and even quite a ways across it, to be neutral or beneficial to survival or reproduction, even though traits at the other end are damaging to survival or reproduction.  It is not at all a reach or special pleading to suggest that alleles for "autistic-like behaviors" could be maintained in the population even if those with autism never reproduced at all (see: sickle-cell anemia). 

Moreover, genes can be pleiotropic. If autism is, indeed, related to the immune system, then possibly there are alleles which improve immune function and also produce traits on the spectrum; in the days before modern medicine and sanitation, the fact that the person didn't die in infancy of disease would outweigh the fact that s/he was not exactly neurotypical.

I apologize if these points have been made by others. I have been busy and am trying to catch up on comments.

From the TMR blog:

"This Thinker has a remarkably healthy child who eats well and is developing normally with no learning disabilities or developmental delays."

It sounds like she's talking about one of those Tamagotchi things kids used to have back in the 90s. Weird.

AnneB,

I wasn’t commenting on vaccines specifically there, and if those here would like me to bring it back to vaccines, I will, and ask, who is making the bigger sacrifice? The person who gets vaccinations but doesn’t experience any side effects or the person who feels like hell after getting them, but gets them anyway.

To me that seems a very odd way of looking at things. What does it have to do with sacrifice? To me it's about taking a calculated risk to reduce your chances of getting sick and infecting someone else. Coming out of the clinic with a substantially lower chance of getting flu seems like a bonus to me, not a sacrifice.

No one knows for sure if they will be one of those that react badly or not, but we all know that we have reduced our chances of getting far more unwell, and have carried out a social duty by reducing our chances of infecting someone else.

It's possible you are one of those 40% that would have reported systemic effects from a placebo shot; maybe you will be surprised to find the shots you have from now won't affect you at all. I would still get the flu shot, even if it did make me sick with " fevers, muscle aches and tremors". Truthfully, I have no way of knowing if the shot I get later this year will knock me sideways, or even give me anaphylactic shock or Guillain Barre syndrome, though I can get an idea of the risks I am taking by looking at the pack insert. It does seem to me a risk well worth taking, one far smaller than the risk many people take every day driving their car, for example. To extend the analogy, would reading about those who were trapped in a burning car by a jammed seat belt put you off wearing one?

Sorry about the extra "e" I added to your name above Ann.

Parenting when you are autistic: Autistic Parenting is one excellent source; there are others. For example, I continue to learn from Brian R. King, LCSW. (I added his credentials because "Brian R. King" is a relatively common name.)

Moreover, genes can be pleiotropic.

Next you're going to wind up doing something silly like trying to explain penetrance to him.

Next you’re going to wind up doing something silly like trying to explain penetrance to him.

Uh ... no. There's silly -- like explaining percentages to Didymus -- and there's really silly -- like explaining anything at all to Greg. I was just commenting for any lurkers who might think his argument made sense.

#268 @Krebiozen

I was waiting to get called on the sacrifice thing and you didn't disappoint. I commend you actually.

No, it isn't about being noble at all, that is only something I console myself with when those around me act like I make up the fact that vaccines bother me. And I still don't think it is the placebo effect. I could give you more examples such as the fact that I have been in two drug studies or the fact that I have a rare condition known as dermatographia (doctor diagnosed), but there is no way I can prove to you that I have a pretty good handle on the whole placebo thing. In addition, I am just as aware that you can someday have a bad reaction, as that someday they may change something in the vaccines and I may not be bothered by them at all.

No, my main desire was just to stop people like me from being dismissed for symptoms we feel after getting a vaccination, and to temper the "I know what is best for you" thinking on both sides of the debate. Perhaps, if the crappy feelings were acknowledged drug companies might be "inspired" to create a better vaccine, instead of insisting that severe side-effects are just a problem in some people's heads.

I have my own car example, one that doesn't really map to vaccines because immunization affects others, but one with the same idea that I am trying to get across. It is the subject of mandatory air-bags. I was a Consumer Reports subscriber when it came out about how great air-bags were and how many lives they would save. I was cautious about them, not the least of which was that they were expensive, but more so by the thought that they were pushing them to be mandatory. Well, we found out how air-bags worked out for those that are short or not yet tall like kids. If they had been a little more thoughtful in testing them or how they rolled them out, maybe brain injury for those in these demographics would have been discovered before insisting that everyone us them. Of course, they have improved since then, but I can't believe that engineers did not have at their disposable the ability to test crash test dummies not the size of a full grown man at that time. They just didn't bother.

For your seat belt example, I wear my seat belt all of the time, always have, even knowing it could trap me in the car in a fire or underwater. What my take on this is, build a better seat belt that can release in those circumstances.

This just made me think of another ludicrous thing. I volunteered at local community hospital last summer and they had trouble with their main lobby automatic sliding doors. The doors would frequently not function by either opening and closing constantly or by not opening at all until someone waved their arms at them like a fool until they finally opened. Yet, I found it curious that there was no provision for the doors to work without being electronic, except for the dead-man switch for emergencies which only locked the doors open all of the time. And, the only people that could "fix them" (or not) were those dispatched from a company an hour away. What genius thought this type of set up would be a good idea, I don't know.

So much for my rants. Here's to better vaccines for all of us!

AnnB -- Your post gives me an opportunity to re-tell an amazing true story.

Some years back, a woman in my area was driving two kids to school on a route that passed through a covered bridge. It was wintertime.

In the bridge, she got tangled up on some new planking that had been installed, which threw her car through the side of the bridge -- much like the accident in "Beetlejiuice". The car turned over in the air and landed on its roof in the icy-cold creek below.

Fortunately for her, two medical residents were in the following car. They instantly jumped in the river and got the kids out. But it took a while to get the woman out, and all that time, her head was underwater. Once they got her free, they splayed her out on the bottom of the car and started life-saving measure. She'd been under for well over 5 minutes minutes, they figured, so there was no chance, but still ....

After a few moments, she sputtered back to life -- a night in the hospital for observation and warmup, and she was .... fine!

It was the mammalian diving reflex! The water was so cold that it kicked in, and she survived without any sequelae.

Later, someone wrote a letter to the editor of the local paper railing against seat belt laws, because, you know, you could drown if you were trapped in a submerged car.

This woman, bless her, wrote in saying that was exactly what happened to her -- and pointing out that given how her car had landed upside down, she would probably have been killed without her seatbelt.

or the fact that I have a rare condition known as dermatographia

What leads you to think that dermatographism is rare?

AnnB,

No, it isn’t about being noble at all, that is only something I console myself with when those around me act like I make up the fact that vaccines bother me.

I don't think you are making anything up, and no one I'm aware of is claiming that reactions to vaccines never occur. However, I do know that it is very easy for us to fool ourselves where drug reactions are concerned; it's how human brains work. Even assuming that you are correct in assuming that the vaccines you have received were responsible for your symptoms, I still don't understand why you have to console yourself at all. I assume the "fevers, muscle aches and tremors" you experience after a flu vaccine are far less severe than flu itself, which can put you in the hospital or even kill you. Isn't that a good trade-off? If the reaction is worse than flu itself, i.e. you are debilitated for weeks, then I could understand you avoiding the vaccine. The same goes for other vaccines.

And I still don’t think it is the placebo effect.

Maybe it isn't and maybe it is. It's very hard to tell on an individual basis and the truth is you don't know for sure. What do you make of the study I cited? It found that:

192 (35.1%) individuals who received influenza vaccine complained of one or more systemic side effects compared with 75 (42.4%) who received placebo (difference -7.3%; 95% CI -15.6 to 0.9%; p = 0.10).

Don't you think every one of those 75 people who experienced systemic effects after the placebo would have been convinced that they had received the vaccine and that they had experienced side effects to it?

I could give you more examples such as the fact that I have been in two drug studies or the fact that I have a rare condition known as dermatographia (doctor diagnosed),

I don't see what having been in drug studies or having dermatographia have to do with vaccine reactions. I had dermatographia as a child (I remember my friends playing tic-tac-toe on my arm), as did my daughter. She also appeared to react to MMR with fever and flu-like symptoms; her doctor ordered separate vaccines for her second dose (this was in the UK pre-Wakefield), but even that reaction, if it was a reaction, was far milder than either measles, mumps or rubella. Even with such a reaction, vaccinating her was a no-brainer, I thought it was wonderful that she didn't have to suffer these diseases as I and her mother had.

but there is no way I can prove to you that I have a pretty good handle on the whole placebo thing.

Having a pretty good handle on "the whole placebo thing" doesn't make us immune to cognitive biases. Look through the literature at the number of people who are convinced they have food allergies, or are sensitive to electromagnetic emissions, but who react just as strongly to placebos. We all have these biases. A couple of decades ago I was convinced that the large doses of vitamin C I was taking protected me from colds and flu. Now I'm equally convinced I was fooling myself.

No, my main desire was just to stop people like me from being dismissed for symptoms we feel after getting a vaccination, and to temper the “I know what is best for you” thinking on both sides of the debate. Perhaps, if the crappy feelings were acknowledged drug companies might be “inspired” to create a better vaccine, instead of insisting that severe side-effects are just a problem in some people’s heads.

I don't think the "crappy feelings" some people experience after vaccination are psychosomatic (though maybe sometimes they are - some people are highly suggestible), I think they are often due to a coincidental viral infection.

As for severe reactions, how could anyone possibly insist that these are "just a problem in some people’s heads"? A serious adverse drug reaction is something that (from the FDA website) causes death, is life-threatening, causes substantial risk of dying, requires hospitalization, causes
disability or permanent damage, causes a congenital anomaly/birth defect or otherwise requires medical or surgical intervention. These reactions are not psychosomatic.

When we look at the data, and see that these severe reactions are just as common in those that don't receive the vaccine, we can conclude that any association with the vaccine is probably coincidence, or that severe reactions are so rare we cannot detect the association. Some serious reactions do occur, of course, but are very rare. In these cases we need to balance the risks against the benefits of the vaccine. For example, there is an increased risk of narcolepsy and Guillain Barre after some flu vaccines, but the risk of these disorders after flu is even greater. Even the Urabe mumps vaccine, which was withdrawn in the UK for causing aseptic meningitis, is far safer than getting mumps.

I think you are mostly attacking a straw man, as severe reactions are very rare and are certainly not ignored, vaccines are constantly under surveillance for increased risk of adverse events, those with unacceptable risks are withdrawn, and drug companies are constantly working on improving vaccine safety and efficacy.

You are correct. Severe reactions was the wrong term. Severe would be like the reaction in the story that anon linked me to. It is only severe compared to the stated literature and what others tell me they experience. Surprisingly, muscle soreness at the injection site is not something I normally experience.

The mention of the drug trials was only to make you aware of the fact that I am well apprised of the placebo effect, and yes, even in myself. I mentioned dematrographia because it may have something to do with my being particularly sensitive to things. I am also prone to allergic rashes, the most recent one continued for almost a year and it was only resolved with ultra low doses of doxepin. Again, I am admitting that I may be an unusual case because I am hypersensitive.

It would be a straw man argument if I was arguing against vaccines, which I never have done. I have even gone out of my way to get a vaccine. I enrolled one of the drug studies specifically to get the HepB vaccine because I couldn't get it paid for by my employer. They wouldn't cover it unless I had patient contact, and I was told the same thing about medical insurance coverage. I didn't verify this with my insurance company as I found the HepB study soon after.

I get my immunizations, and never with the fear of the illness in mind, so comparing the reaction to the actual illness is entirely lost on me. I get vaccinations because they are the prudent course of action even though they make me miserable for a few days; crappy being a relative term. I can tell you that the way I felt after the Measles vaccines was as severe as any flu I have ever experienced.

The vast majority of the time I am told that what I experience is not a reaction to a vaccine even though it repeats itself in history every single time I receive an immunization. And this occurs after the fact. I don't go in to my doctor complaining how bad vaccines make me feel. I tell them the symptoms after I have already had them. Then I am told it is the placebo affect; I might as well be told it is psychosomatic. That is a judgement call on others part, just as it is on mine that it is not, but I have to go with my experience on this because that is what I know.

The fact that others say that you can not get substantial flu-like symptoms from a vaccine, I would say is much more limited thinking that saying that it is a possibility. Like I said, if a child told me that a vaccine made them feel sick and they had a high fever and malaise directly after each vaccine, I would believe them. There would be no reason not to; it wouldn't change the need for a immunizations, but it might be a bit more compassionate.

I read KevinMd.com frequently. Up until late last night, I had not read any of the articles on vaccines. However, I was reminded of a quote from one of the pediatrician's when writing my most recent comment here.

"I come from the days of seeing 4 to 6 kids a month with temperatures of 102 to 104 following the original DTP vaccine of three decades ago. The much improved vaccine production methods that have reduce (sic) that same number to within a whole year have of course been the reason that most subsequent vaccines were much more innocuous from their inception."

You can find the complete comment here http://www.kevinmd.com/blog/2014/03/failure-vaccine-messages.html#comme…

@Krebiozen - My apologies. I was much harder on you in my comment than your comment warranted. It isn't you; it is just that you touched on a raw nerve of mine from the constant denial I experience in my "real" world interactions.

@276 "She also appeared to react to MMR with fever and flu-like symptoms; her doctor ordered separate vaccines for her second dose (this was in the UK pre-Wakefield), but even that reaction, if it was a reaction, was far milder than either measles, mumps or rubella. Even with such a reaction, vaccinating her was a no-brainer, I thought it was wonderful that she didn’t have to suffer these diseases as I and her mother had."
What diseases? Did you have measles? and Rubella and Mumps? I had rubella, mumps and chicken pox- annoying and mild. Also why are they not making a separate pertussis vaccine? Look at the stats for diphtheria. How is an infant going to contract this? Fear mongering on both sides of the vaccine wars.

anon @280 -- Fortunately, most cases of mumps, rubella, and measles were (or, unfortunately, are) fairly mild. But in many cases they have terrible consequences. Measles can be fatal.

@276 No I didn't want my child to suffer that's why he was vaccinated. My daughter-in-law choose a different schedule for her daughters. Pediatricians who allow another schedule are
NOT anti-vaccine.

anon: "Also why are they not making a separate pertussis vaccine?"

Because it is easier to give a child one injection instead of three.

anon: "Look at the stats for diphtheria. How is an infant going to contract this?"

There are these large metal things you see in the sky every so often. We call them airplanes. People use them to fly all over the world, and sometimes they bring infections. Just like the diphtheria that killed an unvaccinated woman in Australia a couple of years ago.

More information:

Diphtheria in the former Soviet Union: reemergence of a pandemic disease.
Successful Control of Epidemic Diphtheria in the States of the Former Union of Soviet Socialist Republics: Lessons Learned

If we went with your opinions that could happen here. Why should we allow diphtheria to come back?

How about tetanus? It is in the soil outside your house. Do you want to skip that vaccine. There is a little boy in New Zealand who is learning how to walk again after getting tetanus last year.

"Let me set the scene for you..."

What the author wrote sounded like a parody. It really did...you can't make this stuff up I guess.

@280 Look at the stats for pertussis-something is clearly wrong and it's not the unvaccinated who are to blame.
Here is the press release from the FDA. 
"This research suggests that although individuals immunized with an acellular pertussis vaccine may be protected from disease, they may still become infected with the bacteria without always getting sick and are able to spread infection to others, including young infants who are susceptible to pertussis disease."
 www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm 

AnnB,

I can tell you that the way I felt after the Measles vaccines was as severe as any flu I have ever experienced.

Seriously? The worst flu I had I was unable to get out of bed for over a week, and was off work for a month. If you have a more severe reaction than that then I can understand why you are concerned.

The vast majority of the time I am told that what I experience is not a reaction to a vaccine even though it repeats itself in history every single time I receive an immunization. And this occurs after the fact. I don’t go in to my doctor complaining how bad vaccines make me feel. I tell them the symptoms after I have already had them. Then I am told it is the placebo affect; I might as well be told it is psychosomatic.

Perhaps you should change your doctor. I find it hard to believe that any doctor would tell a patient that their adverse drug reaction wasn't real. That's potentially very dangerous.

The fact that others say that you can not get substantial flu-like symptoms from a vaccine, I would say is much more limited thinking that saying that it is a possibility.

It's a possibility, of course, particularly from live vaccines. Who claims that vaccines can't cause such symptoms? I wonder about the flu vaccine, because clinical trials find no difference between vaccine and placebo, but not others.

Like I said, if a child told me that a vaccine made them feel sick and they had a high fever and malaise directly after each vaccine, I would believe them.

Personally I prefer to use a thermometer to determine if a child has a fever, but I see your point.

There would be no reason not to; it wouldn’t change the need for a immunizations, but it might be a bit more compassionate.

This is what I don't understand. How would this compassion manifest itself? When I have been warned about possible vaccine side effects I have been told to rest, take acetaminophen and drink plenty of fluids, consult a doctor if it gets worse of persists i.e. treat it as a viral illness. If you are asking for my sympathy then you have it. I know I'm lucky that I don't apparently react to vaccines, I'm glad I don't and I'm sorry you do. You have my sympathy if you feel rotten whatever the reason.

I don't understand the relevance of the comment about DTP. Doesn't that show that vaccine manufacturers are responsive to adverse reactions, as I wrote?

Don't worry about being hard on me, I can handle it ;-)

www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm

Fevers after vaccination is a quite well-researched subject. It's one of the ways in which bogus claims of reactions to, for instance, MMR can be detected. No component of MMR can cause an immediate fever, or indeed anything at all (excepting anaphylaxis, I guess).

anon,
It looks like others have covered my main points, but anyway...

What diseases?

Measles, mumps and rubella, that MMR protects against.

Did you have measles? and Rubella and Mumps?

I'm in my 50s so yes. I was very sick with measles as a child, and have memories of spending weeks in a darkened room. Mumps was nasty too. I contracted rubella as an adult, and was moderately sick for a couple of weeks, which made me miss an important interview (I didn't want to travel and possibly expose pregnant women). It would have been very nice to exchange those for a couple of nights of fever and fitfulness, as my daughter suffered.

I had rubella, mumps and chicken pox- annoying and mild.

Aren't you lucky? I've ridden in a car driven by a drunk driver and nothing happened to me. I was lucky too.

You must know that rubella used to cause many cases of congenital rubella syndrome each year, that mumps can cause deafness, sterility and meningitis. I was utterly miserable with chicken pox, which can also kill, and causes shingles later in life which is also very unpleasant. I wish that the UK would introduce a varicella vaccine as the US has.

Surely you aren't foolish enough to think that just because you had an easy time everyone else does?

I see you omit measles as I guess you are aware that 500 children a year that used to die of measles every year in the US, and of the 8 deaths, 27 cases of measles encephalitis, and 1,482 cases of pneumonia we have seen in the 30,000 cases of measles we have had in Europe since 2010.

Also why are they not making a separate pertussis vaccine?

Because combining vaccines increases vaccine uptake. Isn't one shot better than three?

Look at the stats for diphtheria.

Why do you think there is so little diphtheria in the US? It has a 10-20% death rate, and before vaccination there were more than 125,000 cases and 10,000 deaths each year. If vaccination was stopped, why wouldn't the same thing happen again? Please don't tell me that improvements in hygiene prevent airborne diseases like diphtheria.

How is an infant going to contract this?

What a very silly question. This is a disease that still kills thousands of people every year on a planet that has tens of thousands of flights globally every day. Have you ever met anyone from outside the US (or wherever you live)? All you need is one tourist with diphtheria sneezing over an unvaccinated child.

Fear mongering on both sides of the vaccine wars.

Sometimes fear is rational, and it makes sense to make people aware of dangers, especially when they are so easily preventable.

#288 283 Diphtheria
Incidence Rate: approx 1 in 272,000,000 or 0.00% or 1 people in USA This is not a 3rd world country
www.rightdiagnosis.com/d/diphtheria/stats.htm#medical_stats
Worrying about diphtheria would almost classify one as OCD.

@anon 286,
That's a very interesting press announcement, because it shows the process of science-based medicine at work.
That is, SBM develops a treatment, or better yet a prevention like vaccines, for a disease or condition like pertussis.
It tests to see if that works and is safe.
Then the treatment/prevention is made part of standard practice and implemented as widely as feasible.
SBM also looks for unforeseen or previously undetected problems. When it finds them, it evaluates how bad they are and responds appropriately. It also looks for a better treatment/prevention.

For a slightly old review article, please read this:
http://www.cdc.gov/mmwr/preview/mmwrhtml/00048610.htm

The old whole cell pertussis vaccine was effective, though perhaps not as effective as we'd like. But it caused too many severe side effects. So, the acellular pertussis vaccine was developed. It caused a lot less side effects, but was effective enough at preventing and limiting the spread of the disease.

Both versions have the problem that several shots are required to get sufficient immunity in young children. Also, the immunity wanes a lot sooner than we'd like, so a vaccine that gives longer protection would be good. Until then, we have to get regular boosters, which is another reason why the pertussis vaccine is bundled with tetanus and diptheria.

The link you provided shows a new problem with the current vaccine. So, it's yet another reason why we need a better pertussis vaccine and also why as many people as possible should be vaccinated against pertussis for their own protection.

SBM is looking for a way to maximize the benefit and minimize the harm, such as adverse side-effects or a hidden way to spread the disease.

The way suggested by those who emphasize the harm and ignore the benefit, that is to not vaccinate, would take us back to incidence and mortality rates like those in the 30's.

And, in places where a lot of people react to their fears by refusing to vaccinate, we are already seeing significant outbreaks of pertussis and babies who are too young to be vaccinated yet are dying as a result.

Kreb: Personally I prefer to use a thermometer to determine if a child has a fever, but I see your point.

I tend to have days where my temperature runs *really* hot. Not feverish, just very warm. I think a vaccine might cause some feelings of heat, and I tend to be a bit lethargic after any appointment because my anxiety levels skyrocket and I need a day to recover. So, yeah, I'd be a bit wary of attributing 'fever and malaise' to a vaccine reaction.

anon, why do you want diphtheria to return? If you had read the two papers I posted you would have learned that a combination of an anti-vaccine movement and a change in government that resulted in an interruption of vaccination caused diphtheria to return. This resulted in thousands of kids actually dying.

So, as a non-epidemiologist you are suggesting that we not vaccinate for diphtheria. Since diphtheria does not care about national borders and is not extinct, it will return.

Why do you want diphtheria to come back to the USA?

anon,

This is not a 3rd world country [...] Worrying about diphtheria would almost classify one as OCD.

Are you aware that there are literally millions of visitors to the US every year from countries where diphtheria is more common? For example, there were 2,525 cases of diphtheria in India in 2012, and it killed 3 children there last year. There were 600,000 visitors to the US from India last year. There were thousands of cases in Indonesia, hundreds in Iran, Lao and Nepal, and dozens of cases in Bangladesh, Pakistan, Somalia, Sudan, Thailand and Vietnam too. Many people travel to and from those countries on business and on vacations all the time.

Not vaccinating one's child against a horrible disease that kills thousands in countries in the developing world every year, when you live in a country that gets millions of visitors from those countries constitutes negligence, in my opinion. Why would anyone take even a small risk of their child getting such a nasty infection when the vaccine is so safe?

There were tens of thousands of cases in the former USSR a couple of decades ago, because of a fall in vaccination coverage. If enough people adopt your attitude in the US, I have no doubt the same thing will happen.

#293 India is not a good example
"Malnutrition is more common in India than in Sub-Saharan Africa. One in every three malnourished children in the world lives in India"
www.unicef.org/india/children_2356.htm

#285 @Krebiozen - Glad to know I can pick on you :) I wasn't offended that you added an "e" to my name either.

Seriously? The worst flu I had I was unable to get out of bed for over a week, and was off work for a month."

The day after receiving the measles vaccine, temp was running 101/102 temps, cold chills, shivering, felt like a truck hit me. Could not go to work and stayed in bed. Symptoms were largely gone after 2 days, and by 4th day I felt fine. Go figure. In the basic training, I don't know how I functioned, but I was a lot younger then, and there you push through a lot, a strong fever being the least of your worries. I have never had a flu, even the Russion flu or mono (don't know which) that ever lasted over 7 days. Curious a flu lays you out so much, but not the vaccine.

I wonder about the flu vaccine, because clinical trials find no difference between vaccine and placebo, but not others.

I have never gotten the flu vaccine so I can't speak to a personal reaction. Haven't gotten it as I don't fit the demographic, and I remember years when it was rationed.

Perhaps you should change your doctor.

Yes, I wish my doctors were better to me, but a middle age women doesn't get much validation in the office. A couple of years ago, walked into urgent care in a lot of pain (for me) and the doctor was going on about sprains and how this one spot of tenderness (not pain) earned me an x-ray, but you know sometimes the little hairline fractures don't show up until the next day, blah, blah, blah. After the x-ray, he came in the exam room and said "I don't believe you" twice. And then said, "You have 2 fractures; I don't believe you walked in here on that leg." Trimalleolar fracture to be exact, with a plate, 6 screws and a TightRope. This is only one instance; I won't bore you with more, but there is a reason I stated that I get dismissed in my "real" life. It doesn't help me that I downplay my symptoms, I am not the hysterical type or wanting to appear like one. I think next time I should try being a screaming, crying hot mess.

Per your earlier comment What do you make of the study I cited?

Now I will be judgmental. I have a pretty strong constitution (broken leg example again - I went to work that morning [and sat luckily] and worked for over three hours while I waited for urgent care to open); I largely view those that get reactions from placebos as histrionic whiners or it is coincidence. But, I am open to being wrong about myself, strong constitution or no.

Personally I prefer to use a thermometer to determine if a child has a fever, but I see your point.

Ha,ha! I meant an actual fever ID'd by a thermometer. I didn't think it needed explanation as kids generally say that they are "hot" not that they have a fever, yet it was my poor grammar that made my statement FUBAR,

You have my sympathy if you feel rotten whatever the reason.

This is compassion, and I sincerely thank you.

"I don’t understand the relevance of the comment about DTP. Doesn’t that show that vaccine manufacturers are responsive to adverse reactions, as I wrote?"

This and so much more! Getting better vaccines really is the only reason to speak of adverse reactions with the exception of sharing or showing compassion.

#287 @Jeff1971 - I am sorry I am not always concrete (see fever above) in my language and this weekend has been particularly challenging.

I do not get an immediate fever. It occurs the next day and depending on the vaccine it lasts for two to four days.

@anon,
Diphtheria is not scurvy or rickets.
It is not prevented by having the correct nutrient in your diet.

Can you cite a study that demonstrates otherwise?

Or are you just looking for something else to pretend that following your suggestion won't bring back this horrible disease?

anon: #293 India is not a good example

Anon, why do you want diphtheria to return to the USA?

If it happened in Russia and Ukraine, which are not third world countries, it could happen in the USA.

Here are those papers, just click and read:

Diphtheria in the former Soviet Union: reemergence of a pandemic disease.

From that one:

lthough all of the Newly Independent States were affected, three quarters of the more than 140,000 cases (Table 1) and two thirds of the more than 4,000 deaths reported since 1990 (1-3) were reported by the Russian Federation.

Explain why you want that to happen in the USA.

@Krebiozen The worst flu I had I was unable to get out of bed for over a week, and was off work for a month.

You have my sympathy as well. I can't imagine enduing a flu for a month.

AnnB,

I largely view those that get reactions from placebos as histrionic whiners or it is coincidence.

No wonder you reacted like that to the suggestion you might be mistaken about your vaccine reactions! I would never dismiss someone's placebo reactions as histrionic whining, any more than I would tell dismiss a phobia or depression. Perhaps you need to develop a little compassion yourself ;-)

@ Krebiozen:

Totally OT but-
Any foxes around lately?
( there's one at the south end of the park who likes cat food)

anon,

#293 India is not a good example
“Malnutrition is more common in India than in Sub-Saharan Africa. One in every three malnourished children in the world lives in India”

I suppose there was a huge outbreak of malnutrition in the former USSR in the 1990s.

In 1994, at least 20 imported cases of diphtheria were reported in countries in Europe, including Bulgaria, Finland, Germany, Norway, and Poland. This demonstrates the potential for the diphtheria epidemic in the NIS to spread to neighboring countries in Europe, the Middle East, and Asia. Although no cases have been directly imported into the United States, CDC has received reports of two cases of diphtheria among U.S. citizens who reside in or who traveled to the NIS, and considers the epidemic to pose a risk for importation into the United States.

This report underscores the importance of maintaining high levels of diphtheria immunity among the total populations of the United States and other countries, regardless of whether international travel is planned.

Denice,

Any foxes around lately?
( there’s one at the south end of the park who likes cat food)

They seem to have recovered from what we suspect was someone poisoning them a couple of months ago - there were several reports of people finding dead foxes in their back yards. The mothers are out of their dens now, and we expect to see kits in a month or two. Chicken scraps are our vulpine friends' staple, but they get leftovers and dog biscuits too.

Krebiozen

I would never dismiss someone’s placebo reactions as histrionic whining, any more than I would tell dismiss a phobia or depression.

I appreciate that in you! Are you an MD?

Point taken! My statement was somewhat tongue in cheek, and I knew I was being judgmental. In person, I show compassion for everyone as I don't know if it is real or placebo, either way the symptom is the same. However, I confess that compassion fatigue does set in when I see the power of suggestion in full swing in the same individual over and over, and I do my best to get over it.

#301 actually there was poverty in the former states- www.unece.org/fileadmin/DAM/ead/pub/041/041c7.pdf

AnnB,
I think you have been unlucky with the doctors you have encountered. I have run into a few idiots too, but they have been the exception, thankfully.

You have my sympathy as well. I can’t imagine enduing a flu for a month.

My boss wasn't impressed, as you might imagine. I had been fighting a giardia infection for ten years (long story), had lost a lot of weight and was very run down at the time. The flu itself lasted a couple of weeks, I lost even more weight, and it was another couple of weeks before I could walk more than a few yards without feeling ridiculously fatigued. I remember a friend of mine dragged me out for a drink the night before I went back to work and a woman in the pub told me I looked like I had AIDS, which was nice.

I also had trouble getting my hepatitis B titers to an adequate level, despite repeated vaccinations. In the end I got an exemption - as I didn't work directly with patients it was only me at risk. I later found out I have abnormally low IgG subclass levels and an elevated IgE (I have no idea why yet), which means I may have a form of hypogammaglobulinemia; I'm seeing an immunologist about this next week actually.

So, our different experiences with vaccines and infections may well be due to individual differences, as you first suggested. However, I still think the safety profile of modern vaccines is excellent, and would still get an annual flu vaccine even if I reacted as you did to MMR.

@280 Look at the stats for pertussis-something is clearly wrong and it’s not the unvaccinated who are to blame.
Here is the press release from the FDA.
“This research suggests that although individuals immunized with an acellular pertussis vaccine may be protected from disease, they may still become infected with the bacteria without always getting sick and are able to spread infection to others, including young infants who are susceptible to pertussis disease.”
www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm

squirrelelite, I think you're giving anon too much credit for ability to follow the conversation honestly. He/she is taking an article that talks about the effects of one vaccine vs. a different vaccine, and hallucinating the idea that it somehow says the effects of a third option, not using any vaccine, is therefore proven blameless when it comes to the spread of the disease!

Anon, a few years ago, a 22 year old woman from Australia caught diphtheria while on vacation and died.
Your insinuation that good nutrition is enough to protect against diseases is wrong.
Boneheadedly wrong.

anon @305:
actually there was poverty in the former states

If the presence of poverty and malnutrition is the explanation for outbreaks of diphtheria, I can't see how the US is supposed to be safe.

HDB,
I too find it strange that some people seem to believe that the US is a special place where people are so well fed and cared for that infections like diphtheria could never return, even if vaccination were stopped, or that there is some magic barrier that kills off pathogens in travelers to the US mid-flight.

Do they really think that people in France, for example, where measles came roaring back a few years ago, leaving hundreds with encephalitis or pneumonia, are in worse health than the average American? Did they ever hear of the Mediterranean Diet?

Even odder, it is often the same people who claim that a combination of the Standard American Diet and conventional medicine are destroying people's health, and at the same time seem to think Americans are so healthy that vaccines are not necessary to prevent the infectious diseases other nationalities are vulnerable to.

Please continue -I love the extrapolations to my comments.

@anon: so when you said at #290 that the US is not a third world country, at #295 when you quoted from UNICEF that malnutrition is more common in India than in Sub-Saharan Africa, when you claimed at #305 that there was poverty in the former soviet states, at no time were you trying to say that good nutrition is sufficient to protect against diphtheria?
You love the extrapolations to your comments? How about acknowledging that we've correctly stated your opinion?

I worked as a caseworker in the late 60's-80's. I saw a good deal of "tranche de vie". There were problems with sickle cell anemia, cirrhosis, ambulatory schizophrenia, congenital abnormalities, blindness from diabetes, cancer, PTSD from returning Vietnam vets.
I don't remember any health alerts about VPDs during this time. (I do have a phobia about germs)
Just my experience.

#312 3 children died from diphtheria in India.
India has a population of 1.2 billion.

Krebiozen,

I wish you well with your health. It is isn't easy to navigate within healthcare especially for less prevalent or lesser known conditions. I am glad you are seeing an immunologist to discuss it. Take care of yourself.

@anon: so when you said at #290 that the US is not a third world country, at #295 when you quoted from UNICEF that malnutrition is more common in India than in Sub-Saharan Africa, when you claimed at #305 that there was poverty in the former soviet states, at no time were you trying to say that good nutrition is sufficient to protect against diphtheria?
You love the extrapolations to your comments? How about acknowledging that we’ve correctly stated your opinion?

#312 3 children died from diphtheria in India.
India has a population of 1.2 billion.

Which had already been noted. The closest you came to making a point is the opposite of what you were asserting.

Shall we look at the data? Increasing DPT3 coverage from 10% to 70% led to a decrease from about 600,000 cases per year to as few as 1100. Do you think these things might be related?

I did get squeamish about the client with active TB.

I don’t remember any health alerts about VPDs during this time

One explanation for the lower concern for VPDs in the late 60s-80s would be If vaccination rates were higher then.

Anon, why do you want diphtheria to return to the USA?

I don’t remember any health alerts about VPDs during this time.

And you've never had the flu, and childhood diseases were a walk in the park, and therefore none of this silliness about actual facts is of any consequence. Got it.

#Chris -a better question would be "why are you against BigPharma accountability as to the safety of vaccines?"

No, anon, I want to know why you want diphtheria to return to the USA.

What do you have to gain by reducing the protection against diphtheria by not vaccinating for it, so it can return?

#30[2] actually there was poverty in the former states

Which has quite a few outliers if one compares the tables in your own source, which its not at all clear that you bothered to examine, with the incidence map in the MMWR that Krebiozen provided. Were you "looking at" the GDP data? Do you think this might, I dunno, correlate with public health infrastructure? Did you bother to look for population density maps? Did you think about this at all?

#Chris -a better question would be “why are you against BigPharma accountability as to the safety of vaccines?”

You left out the part about the big honking danger signal in nearly a century's worth of vaccinating against diphtheria that makes this something other than a sorry attempt to change the subject.

#Chris I want to know why I can't get a separate pertussis vaccine if I don't know if I am a carrier since I had the Tdap and it has a lesser dose of pertussis vaccine. (In case my daughter-in-law has another child. Her 2 are vaccinated.)

I have concluded that "anon" simply does not understand that diphtheria is dangers and will return if we stop vaccinating against... or that he wants it to return.

So, anon, why do you want diphtheria to return?

anon, have you kept up with your Td boosters every ten years?

Because the tetanus boosters always contained diphtheria, because there always a threat of someone getting from a traveler. What part of that do you not understand?

The Tdap is just the same booster but with added pertussis. Why should Big Pharma get more profits by producing different variations like Tt, d, Td, p, etc. and not just these three: Td, Tdap and DTaP?

Do you want Big Pharma to make more money? Or do you just not understand that diphtheria is dangerous and if vaccination is reduced it will come back.

I have concluded that “anon” simply does not understand that diphtheria is dangers and will return if we stop vaccinating against…

I have concluded that anon has extreme difficulty forming coherent points. This is starting to resemble the Robert O. Young routine when it started complaining that no attention was being paid to an old case of misconduct by some random, retired New York obstetrician.

I sincerely doubt that anon read the several links on the 1990s diphtheria epidemic posted in the last few hours. Also he seems to have no idea that a Td booster is recommended every ten years:
http://www.cdc.gov/vaccines/vpd-vac/tetanus/who-vacc.htm

Tremor from DTAP (DAPTACEL) 2005
www.patientsville.com/vaccines/dtap/tremor-dtap-daptacel-2005.htm

Ooooh, anon has posted one case report. That ends with "patient recovered." So what? What does that have to do with the four million children born each year, which means that over ten million doses of DTaP are given each year. That is one reaction in tens of millions of doses.

As an adult you would get the Tdap. So what does that one case report has nothing to do with your question.

So what is more dangerous, anon: the DTaP vaccine or diphtheria, tetanus or pertussis infections. Provide something more coherent than a random URL.

Speaking of Big Pharma, who gets to pay for the increased incidences of diphtheria, tetanus and pertussis by not vaccinating? How much cheaper is it to put a kid on respiratory support for several days than it is give them the DTaP series, and later a Tdap booster?

Will is not cheaper, and more than money is saved by vaccinating: Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009.

What they did:

A hypothetical 2009 US birth cohort of 4 261 494 infants over their lifetime was followed up from birth through death. Net present value (net savings) and benefit-cost ratios of routine childhood immunization were calculated.

What they found out:

Analyses showed that routine childhood immunization among members of the 2009 US birth cohort will prevent ∼42 000 early deaths and 20 million cases of disease, with net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs, respectively. The direct and societal benefit-cost ratios for routine childhood vaccination with these 9 vaccines were 3.0 and 10.1.

Ooooh, anon has posted one case report.

It's a VAERS excerpt. Anon is now simply ignoring everything it's said and trying to circle back to AnnB's report, the truth of which nobody questioned in the first place.

It is like anon is doing a Sir Brave Robin, but running around in circles instead of away.

I'd be more worried about MRSA- How's BigPharma's research going?

I’d be more worried about MRSA- How’s BigPharma’s research going?

Why? Despite the white-bread hype, S. aureus in fact disproportionately affects the developing world and the socioeconomically disadvantaged (PMID 23043704).

Do you want somebody to whomp up a vaccine to follow your amuse-bouche of aP?

anon, when was your last tetanus booster?

And I don't care about what you are worried about (though you can follow what is happening in bacterial infection research by listening to This Week in Microbiology).

Now, what is better for a baby to get: the DTaP vaccine or a diphtheria, tetanus and pertussis infection?

Provide some scientific documentation to support your answer, not a random URL nor some other unrelated comment.

#336 Statistics:
According to the CDC an estimated 10,800 deaths in the U.S. each year are caused by staph, 5,500 of which are linked to MRSA.
www.cnn.com/2013/06/28/us/mrsa-fast-facts/

I am relatively "new" to the blog--08/2013. I recently saw that Thingy had returned under a new nym. She was quickly outed and Orac banned her again. What did she do that she was banished? I am curious because there are a few other trolls that can be exceptionally repulsive at times that are not banned which I understand considering their comedic value.

#336 Statistics:
According to the CDC an estimated 10,800 deaths in the U.S. each year are caused by staph, 5,500 of which are linked to MRSA.

And? You completely skipped the part about waiting for a vaccine. These are people who are already sick, like the malnourished Sitting in Darkness.* Hell, if you can distance yourself from the entire "Third World," you can certainly get past this blip on the radar, given your proven dominance over the infectious agents you've already swatted away like flies.

Surely you're not saying that you don't give a shıt unless it's something that you perceive as a personal threat through an amateurishly polished lens, right?

anon, I asked you a question. Answer it:

Now, what is better for a baby to get: the DTaP vaccine or a diphtheria, tetanus and pertussis infection?

Provide some scientific documentation to support your answer, not a random URL nor some other unrelated comment.

Scilicet: "What did she do that she was banished?"

Incredible stupidity is one reason. The reason for her last banning escapes me, but she is infamous in thinking that toddlers know enough to stay on sidewalks.

By the way, anon, I will ask you about the relative risk between the DTaP and the infections it is designed to protect for each time you post from now on. So go find those scientific cites to tell us which is safer: the vaccine or the three diseases.

Chris my granddaughters are vaccinated with the Dtap and my son also. Why are you asking these inane questions? That's all they have to offer now. I suggested it would be great if they had a more effective pertussis vaccine since the link I posted suggested an adult who was vaccinated with the Tdap could spread pertussis to the unvaccinated neonate.

I recently saw that Thingy had returned under a new nym. She was quickly outed and Orac banned her again. What did she do that she was banished?

Keep in mind that it's also been banished from mothering[.]com (probably twice). If there's a short story that captures it in full fruit, I don't have it. Basically, its whole trip boiled down to ritual purity. And it pretended to be a nurse and would ramble on about the version of immunology that lived between its ears until it would fall back on profound monosyllabic replies. "Next" saw frequent rotation.

Then it would run away and start all over with the same tape, which is why there was an attempt to deploy a crude computational model, the Th1Th2bot, which IIRC tended to best Th1Th2 at its own game. I believe this is the origin of the phrase "barking up the wrong squirrel."

I suggested it would be great if they had a more effective pertussis vaccine since the link I posted suggested an adult who was vaccinated with the Tdap could spread pertussis to the unvaccinated neonate.

While simultaneously complaining that you couldn't procure bare aP in a practically indecipherable clause chain:

I want to know why I can’t get a separate pertussis vaccine if I don’t know if I am a carrier since I had the Tdap and it has a lesser dose of pertussis vaccine.

Define "carrier." Or just answer the "inane" question, already.

#345
"Because the current vaccine appears to suppress symptoms, vaccinated but infected people can be carriers of pertussis without knowing it and thus unwittingly pass it on in the  community. The original vaccine trials, the authors note, didn’t screen vaccinated participants who were symptom free for infection and thus overlooked this possibility"
www.forbes.com/sites/emilywillingham/2013/11/26/government-funded-study…

Anon, what is better for a baby to get: the DTaP vaccine or a diphtheria, tetanus and pertussis infection?

Also, anon, when was your last tetanus booster before you got the Trap?

Just answer these questions.

As I recall Thingy was banned for accusing the parents of disabled children of causing their children's disabilities by deliberately 'infecting' them with vaccines. If memory serves she was particularly obnoxious to lilady about this.

@ Jeff1971:

"Fevers after vaccination is a quite well-researched subject. It’s one of the ways in which bogus claims of reactions to, for instance, MMR can be detected. No component of MMR can cause an immediate fever, or indeed anything at all (excepting anaphylaxis, I guess)."

That's really interesting. Would you happen to have a reference or two for this? My google-fu is pretty weak and I've not been able to turn anything up. I'm not saying I don't believe you, or anything. It'd just be nice to have a reference bookmarked next time I come across an anti-vaxxer claiming the MMR shot gave their kid a fever. Cheers.

I find it interesting the way the antivaccine movement twist and turn about the pertussis vaccine. It was the incidence of side effects that led to the replacement of DTP with DTaP, and now the same people who complained about the side effects are complaining about a lack of efficacy and waning immunity.

DTaP is about 85% effective at preventing whooping cough i.e. severe pertussis but 'only' about 70% effective at preventing infection altogether, including the mild cases that anon is so concerned about. Since pertussis is almost as contagious as measles (R0 = 12-17) with a herd immunity threshold of 92–94% even full vaccination and up-to-date boosters may not be able to eliminate the disease entirely, but it can reduce its incidence dramatically, as we have seen.

I think the answer might be maternal or neonatal immunization to protect babies from infection. People not vaccinating their children can only make the situation worse.

Because the current vaccine appears to suppress symptoms, vaccinated but infected people can be carriers of pertussis without knowing it and thus unwittingly pass it on in the community.

That is not a definition. How long do you think you can be a "carrier" for?

anon and anyone else who is interested, should read Seth Mnookin's blog and how Barbara Loe Fisher used a documentary film to become the grande dame of the anti-vaccine movement:

http://blogs.plos.org/thepanicvirus/2012/09/13/the-whole-cell-pertussis…

"....In the days after “Vaccine Roulette” aired, Thompson’s employer provided callers with the phone numbers of other people who’d also called looking for more information about negative information regarding vaccines — and in doing so, helped create the modern-day anti-vaccine movement. Among the parents who met in the days after the airing of “Vaccine Roulette” was Barbara Loe Fisher, who soon formed a group with the Orwellian moniker the National Vaccine Information Center.

At the time, Fisher was a former PR professional who’d become a full-time housewife after she’d given birth to her son Chris four years earlier. When “Vaccine Roulette” aired, it had been more than a year since Chris had started displaying symptoms of what would eventually be diagnosed as a range of developmental disorders. I wrote about Fisher’s reaction to Thompson’s broadcast in my book:

← Twitter awesomeness: I get schooled in genetic sequencing
Poetry by Scott Lentine about life on the autism spectrum →
The whole cell pertussis vaccine, media malpractice, and the long-term effects of avoiding difficult conversations
By Seth Mnookin
Posted: September 13, 2012

Seventy years-ago, a pioneering American scientist named Pearl Kendrick combined killed, whole cell pertussis bacterium with weakened diphtheria and tetanus toxins to create the first combination diphtheria-pertussis-tetanus vaccine. It was an almost instantaneous success: In 1934, six out of every 100,000 Americans died of whooping cough. By 1948, that figure was less than one in 100,000; by 1960, there were fewer than ten cases of the disease per 100,000 residents.

In the coming decades, there were reports about complications from the whole-cell pertussis vaccine. This was not surprising: while whole-cell vaccines can be both effective and safe, their use of the actual contagion as opposed to an isolated component mean they are among the crudest of all vaccines. The whole-cell pertussis vaccine could cause febrile seizures, high fevers, and even fainting — reactions which are understandably scary for parents but which typically have no long-term effects. (My younger sister ran an extremely high fever after her first DPT injection, which she received in the late 1970s.) There were also unconfirmed reports — of brain damage, comas, even paralysis — which to this day have never been verified.

Fast-forward to April 19, 1982, when WRC-TV, the local NBC affiliate in Washington, DC, aired a special titled “Vaccine Roulette.” The report, hosted by Lea Thompson, was an example of scare-mongering at it’s worst: Throughout the hour-long show, Thompson featured heart-breaking interviews with parents who described how their children had been left in near-comatose states after receiving a vaccine that was mandatory for public-school children in the vast majority of states. These were augmented by what turned out to be inaccurate statistics, cherry-picked quotes, and risible falsehoods about some of the “experts” Thompson used to support her thesis that the “medical establishment” was “aggressively promot[ing]” a vaccine while willfully ignoring “the consequences.” It also presented parents’ recollections as fact — and, as we know from countless studies, memory is imminently fallible. Those doctors and public health officials who disagreed with Thompson, on the other hand, were subjected to hours of grilling. (One AAP official said that over the course of a five-hour interview, Thompson asked the same question, “repeatedly in slightly different ways, apparently to develop or obtain an answer that fitted with the general tone of the program.”) When Thompson, who won an Emmy for the show, was asked about her errors, she said the grousing was simply coming from “doctors [who] are miffed because they have to talk to their patients now.”

In the days after “Vaccine Roulette” aired, Thompson’s employer provided callers with the phone numbers of other people who’d also called looking for more information about negative information regarding vaccines — and in doing so, helped create the modern-day anti-vaccine movement. Among the parents who met in the days after the airing of “Vaccine Roulette” was Barbara Loe Fisher, who soon formed a group with the Orwellian moniker the National Vaccine Information Center.

At the time, Fisher was a former PR professional who’d become a full-time housewife after she’d given birth to her son Chris four years earlier. When “Vaccine Roulette” aired, it had been more than a year since Chris had started displaying symptoms of what would eventually be diagnosed as a range of developmental disorders. I wrote about Fisher’s reaction to Thompson’s broadcast in my book:

It wasn’t until she saw Thompson’s broadcast that the pieces fell into place. The reactions that Thompson described—convulsions, loss of affect, permanent brain damage—were, Fisher realized, identical to those experienced by her son. Suddenly, Fisher remembered in meticulous detail what had happened one day eighteen months earlier, when Chris had received the final dose of his DPT vaccine:

When we got home, Chris seemed quieter than usual. Several hours later I walked into his bedroom to find him sitting in a rocking chair staring straight ahead as if he couldn’t see me standing in the doorway. His face was white and his lips slightly blue, and when I called out his name, his eyes rolled back in his head, his head fell to his shoulder and it was like he had suddenly fallen asleep sitting up. I tried, but could not wake him. When I picked him up, he was like a dead weight and I carried him to his bed, where he stayed without moving for more than six hours, through dinnertime, until I called my Mom, who told me to immediately try to wake him, which I finally did with great difficulty. But he didn’t know where he was, could not speak coherently and couldn’t walk. I had to carry him to the bathroom and he fell asleep again in my arms and then slept for twelve more hours.

It’s an incredibly moving story, and one that Fisher has told to congressional panels, federal committees, and state legislatures, and at national press conferences for more than twenty-five years. In all that time, she’s almost never been questioned about the specifics of her narrative—and there are parts that, if nothing else, certainly are confounding.~ Fisher, as she told an Institute of Medicine (IOM) Immunization Safety Committee in 2001, is “the daughter of a nurse, the granddaughter of a doctor, and a former writer at a teaching hospital” who viewed herself as “an especially well-educated woman when it came to science and medicine.” How was it that her only response to finding her unresponsive son displaying symptoms associated with heart attacks, strokes, and suffocation was to carry him to bed and leave him alone for six more hours? And if Chris’s reaction to his fourth DPT shot was so severe that it transformed an ebullient boy into a sluggish shell of his former self, why had he been fine after receiving the first three doses?

Shortly after the formation of Dissatisfied Parents Together, Fisher founded the National Vaccine Information Center. Since then, she’s played an essential role in organizing a movement that’s targeted the press, politicians, and the public in equal measures. The result has been a steady erosion of vaccine requirements and a steady increase in the percent of the population skeptical of vaccine efficacy...."

Is it any wonder then, why I and others question CIA Parker who claims her own ASD was caused by a DPT vaccine she received at three months of age? Parker also claims her daughter's autism was caused by a hepatitis B vaccine birth dose, based on what she calls a prolonged "encephalitic cry" immediately after she was discharged from the hospital, yet Parker never brought her child to any emergency room for an evaluation to determine if, in fact, her self-diagnosed "encephalitic cry", was indicative of a serious, indeed deadly, encphalitis/encephalopathy?

anon: There is no separate aP vaccine available, so why won't you answer Chris' question about Tdap booster vaccination, to protect yourself and to protect infants and children who have valid medical contraindications for receiving DTaP vaccine?

I suppose anon would demand a single antigen mumps vaccine which is not available for post-exposure prophylaxis and refuse a MMR vaccine, if his child was a close contact of a child who is part of an outbreak of mumps in a fully immunized group...in spite of the fact that a third MMR vaccine has been recommended by the CDC, State and local health departments to contain and end a mumps outbreak in a fully immunized population.

http://contemporarypediatrics.modernmedicine.com/contemporary-pediatric…

Gee, I hadn't noticed that the Dachelbot is now disclosing that she's getting paid:

The daily media update is sponsored by Lee Silsby Compounding Pharmacy and their OurKidsASD brand

@ Narad:

I noticed that.
I'm sure that her reportage would never be influenced despite the fact that it's sposored by a supplement company.

SPONSORED

She denied being paid on at least one article I've seen.

"John Stone
Thank you, John. And NO, I"m not paid for what I do." http://www.wor710.com/media/podcast-the-john-gambling-show-johngambling…

You'll have to scroll down some. I screenshot it.

She denied being paid on at least one article I’ve seen.

Five'll get you ten that the weaseling out is that compiling the articles is "sponsored," not the actual spamming of them.

There are malnourished children in the United States, for that matter. Hunger isn't just a third world problem, although I'm not surprised to see another iteration of the blantant classism that seems to go hand in hand with a lot of antivax, organic, "green" lifestylers.

In anecdata, I often feel awful for a few days after a vaccine, but my fibromyalgia means a lot of things can throw me off my precarious balance for a few days, so it's pretty moot to me personally if it's a vax reaction, a hormonal shift, a drop in barometric pressure, or stress. On the other hand, since I'm used to feeling crappy, there's no particular disincentive to get a vaccine that protects me from a much more debiliating illness, or prevents me infecting anyone else.

Is that Stone spreading his smears again? He really is such a nasty creature.

In other news, Kent Heckenlively is back at AoA...shilling for his new book, written by Judy Mikovits. More blogging material for Orac, perhaps?

http://www.ageofautism.com/2014/03/kent-heckenlively-book-debut-plague-…

Oops ^ Heckenlively and Judy Mikovits are co-authors of that new book.

I've been reading Cia Parker's latest missive over on AoA on Hep B and why Dorit is wrong.
I thought I'd mention it, seeing as how we are discussing DK.
It is a wonderful demonstration, speaking as I do as one who witnessed the Mother Jones stupid in all it's malignant glory.
http://www.ageofautism.com/2014/03/how-the-cdc-and-dorit-reiss-hyped-ri…

Heckenlively and Judy Mikovits are co-authors of that new book.

It's hard to see that as anything else but a cynical exercise in merging two disparate (though equally committed) groups of evidence-deniers.

lilady @352 -- That's a long post; please allow me pull out the remarkable paragraph in the middle, in which you quote Barbara Low Fisher describing the day her son supposedly had his vaccine reaction:

When we got home, Chris seemed quieter than usual. Several hours later I walked into his bedroom to find him sitting in a rocking chair staring straight ahead as if he couldn’t see me standing in the doorway. His face was white and his lips slightly blue, and when I called out his name, his eyes rolled back in his head, his head fell to his shoulder and it was like he had suddenly fallen asleep sitting up. I tried, but could not wake him. When I picked him up, he was like a dead weight and I carried him to his bed, where he stayed without moving for more than six hours, through dinnertime, until I called my Mom, who told me to immediately try to wake him, which I finally did with great difficulty. But he didn’t know where he was, could not speak coherently and couldn’t walk. I had to carry him to the bathroom and he fell asleep again in my arms and then slept for twelve more hours.

Holy. Crap.

If that had happened to my kid at that age, we would have been on our way to the ER instantaneously, if not sooner.

The mind boggles.

Lilady, who is Kent Heckenlively?

(I'm also reading up the entries about him here as we speak).

All of CIA Parker's "efforts" have paid off. See the Cp 7 Element on the revised Periodic Table Of Vaccine Rejectionism:

http://encyclopediaantivaccinemovement.blogspot.com/search?updated-min=…

who is Kent Heckenlively?

He has his own entry at the Encyclopedia of American Loons:
http://americanloons.blogspot.com/2013/10/755-kent-heckenlively.html

Oh boy.
I read Dorit's link to the comments
( as well as recent AoA articles).

These people haven't been in such a scatterbrained frenzy' collective hissy fit since they perseverated upon Brian Deer.

Take a bow, Prof R!
You have reached the upper stratosphere of the antivaxxers' enemies list:
"Almost as bad as Brian".

And fond of Nazi analogies, by Orac's various entries on the topic. How inappropriate.

I liked The Poxes' new post on that: http://thepoxesblog.wordpress.com/2014/03/08/1676/

#372 was about Mr. Heckenlively. Sorry. Now I'm going to go write.

It’s hard to see that as anything else but a cynical exercise in merging two disparate (though equally committed) groups of evidence-deniers.

It was hard not to noticed that Heckenlively's self-advertisement failed to note that even Mikovits conceded that XMRV was simply a contaminant. It seems like a lot of them didn't get this memo.

However, they've merged before.

Oddly enough, I worked with Kent H, just as he was first encountering the Wakefield fraud. He seemed like a considerate, concerned parent, keen to help his daughter via reasonable means (he was very pleased at how she was doing with music therapy). Such a shame he went down the rabbit hole.

Heckenlively has blogged on AoA about XMRV before...many times:

http://www.ageofautism.com/legal/

Looks like everyone's favorite reporter is longer at CBS...

http://talkingpointsmemo.com/livewire/sharyl-atkisson-right-wing-heroine

However, they’ve merged before.

Ah, I miss those days of 'Peak XMRV', when you could log into ERV's blog each day expecting to find new details of research malfeasance.
I had assumed that Judy Mikovitz would sink gracefully back into obscurity after the retractions and the faked results, but evidently she is the Sarah Palin of virology.

Looks like everyone’s favorite reporter is [no] longer at CBS…

"Stonewalled: One Reporter's Fight for Truth in Obama's Washington"

"PLAGUE – One Scientists’ Intrepid Search for the Truth about Retroviruses, Chronic Fatigue Syndrome, Autism, and Other Diseases"

At least somebody knows how to write a subtitle, and it isn't Skyhorse.

One Scientists'

Did anyone else notice that error? So much for "scientific".

Coming soon to Amazon.com; the extraordinary scientist's intrepid blah, blah, blah. In the meantime, Amazon has both editions of Keri Rivera's book and Teri Arranga's book.

http://www.amazon.com/Plague-Scientist%C2%92s-Intrepid-Retroviruses-Syn…

“PLAGUE – One Scientists’ Intrepid Search for the Truth about Retroviruses, Chronic Fatigue Syndrome, Autism, and Other Diseases”

Perhaps there should be a sub-subtitle...."and how her search ended in tears, ignominy, ridicule and jail time."

More on Skyhorse:

It is the project of Tony Lyons IIRC and the vastest, reekingest sinkhole of printed woo on the planet. Lyons has a child with autism and his ex ( who has an Icelandic patrronymic name which I forget) wrote a book about "finding" her lost child- who, I suspect ,was in close proximity all of the time.

Other luminaries' work published here include, AJW, LKH and Holland, the TMs, KIm S etc. And last and certainly not least, Lyons gave Mr Null his own 'publishing company' and a deal to print dozens of titles by him and his friends in the next few years. Many with include book-and-film deals.

Oh right. ....Scientists'....

I think today's TMR post really fits the topic of this post too. http://www.donotlink.com/e1h

I'm sorry for this pediatrician.

Skyhorse-
Here is a flagrant example of what they publish.
www.skyhorsepublishing.com/book/?GCOI=60239107008290&amp;
Horrors!

I find it interesting the way the antivaccine movement twist and turn about the pertussis vaccine.

It's interesting a lot of ways. What problems do they think actually come from the DTaP vaccine? As far as I know, no one has ever actually said anything specific.

Remember when the MMR hubbub came about, it was the "my baby got the MMR vaccine and BOOM! autism!" As I've noted before, that, in itself, is not wrong, and is absolutely justification for looking for a connection. So that is what was done, and, if you look properly, the answer is no, there is no connection between getting the MMR vaccine and autism.

And here's where it gets goofy. So after having ruled out the MMR/autism connection, the anti-vaxxers jump to DTaP. So maybe it's DTaP then?

However, the problem with that is that it doesn't follow at all. No one has actually ever associated DTaP with any specific issue. But it must be a vaccine, right? So let's go after DTaP.

So publshing Darwin makes being a go-to house for getting your personal hobby horse woo into print perfectly fine and dandy?

anon, the reason Skyhorse gets our derision is because they published Callous Disregard, Wakefield's book length whine fest. Perhaps they publish a more than a century old out of copyright book for something that might actually sell.

Now, please try to answer my questions honestly:

What is better for a baby to get: a DTaP vaccine or a diphtheria, tetanus or pertussis infection? Provide verifiable scientific documentation to support your answer.

Also, when was your last tetanus booster before you were told to get a Tdap?

I haven't seen this movie, but am seriously considering it.
http://www.rogerebert.com/reviews/afternoon-of-a-faun-tanaquil-le-clerc…
It tells the story of Tanaquil le Clerq, a great ballerina who declined to take the Salk vaccine in 1956 and got polio.

If the mother described in that scenario is so combative with a pediatrician and so certain about her "research", why doesn't she find a "vaccine-friendly doctor"?

Dr. Bob Sears has a list of hundreds of doctors, who, like Sears and Dr. Jay Gordon, pander to these ignorant pugnacious mommies.

@ squirrelelite: Here's the Wikipedia entry on Tanaquil le Clerq.

I think I mentioned that I was reading "The Immortal Henrietta Lacks" who died from metastatic cervical cancer 60 years ago and whose cell line (HeLa) lives on in laboratories around the world.

At the end of the book, I learned that a small amount of her cancerous tumor was tested and found to be HPV 18 strain, which along with HPV 16 strain is responsible for > 70 % of cervical cancer. (Protection from both strains is contained in Gardasil vaccine).

Omitted Tenaquil le Clerq entry:

http://en.wikipedia.org/wiki/Tanaquil_LeClercq

@palindrom366

Holy crap indeed. I'm not a parent (yet! crosses fingers), but yeah, total ER trip. It is totally bizarre to me that these parents who are so "thinking" and more concerned than thou don't think that kind of condition is ER worthy.

@ Jubilee

If it makes you feel any better, I've often wondered if the parents who tell these kinds of stories aren't simply exaggerating the severity of the incidents in hindsight. Especially those who claim that they know their kids immune systems were "overloaded" because they got progressively sicker after every shot - surely if that were true they would have stopped taking their kids to get them.

Other luminaries’ work published here include, AJW, LKH and Holland, the TMs, KIm S etc.

They also have an extensive catalog of JFK conspiracy books, as well as Jerome Corsi's new volume on how Hitler escaped Germany and his older one on how the government is covering up the Nazi discovery of "abiotic oil."

Thanks palindrom; I managed to garble that link from Seth Mnookin

No one ever questioned Barbara Loe Fisher about what she reported as her son's reaction to a vaccine...and it served to start her on a long and profitable career.

CIA Parker, tells that same old, same old story about her child's "encephalitic cry" and HER diagnosis of her child's "vaccine-induced-encephalopathy". Does she think that bullsh!t story will jump start a new career for her?

Thanks for the link, lilady.

I see she wrote a cookbook!
I'll have to try to find that sometime.

@Marry Me, Mindy

What problems do they think actually come from the DTaP vaccine?

The DTaP/Tdap nonsense stems from the days of the whole-cell pertussis vaccine. Here's a thorough history of the pertussis vaccine from DTP to DTaP. Short story: there were concerns of AEs following whole-cell pertussis immunization, but it didn't really take off until a documentary full of stories, but short on science, aired: Vaccine Roulette. That's what triggered Barbara Loe Fisher to become active and blame the DTP for her child's neurological condition.

@SarahA.

Yeah, there's surely some hindsight mental reorganization. It's just--I went with my brother to the ER with my little niece last fall after she had a febrile seizure and we were out the door within five or six minutes of her being unresponsive. (And she is absolutely fine--I had lots of febrile seizures as a tot, so while it was scary, we had at least a little sense of what it looked like.) I just can't imagine waiting hours with a kid totally unresponsive and with bluish lips, or just tucking them into bed.

Skyhorse-
Here is a flagrant example of what they publish.
http://www.skyhorsepublishing.com/book/?GCOI=60239107008290&amp;;
Horrors!

Here's anon's syllogism:

1) This publishing company publishes one book which is not bullsh!t.
2) (unstated)
3) Therefore there is nothing wrong with anything the company publishes.

I would lurve for you to tell us what goes in 2), anon, really I would.

2)This publishing company publishes other books which are not bullshit.
3)This publishing company publishes books which are bullshit.
4)This is called freedom of the press.
If any issue arises there are courts in which to sue.
5)Unfortunately what maybe legal is often unethical or immoral.

#400
2)This publishing company publishes other books which are not bullshit.
3)This publishing company publishes books which are bullshit.
4)This is called freedom of the press.
If any issue arises there are courts in which to sue.
5)Unfortunately what maybe legal is often unethical or immoral.

#400
2) This publishing company also publishes bullshit.
3) This is called freedom of the press.

Freedom of the press does not mean freedom from criticism.

There is a difference.

By the way, you have not yet answered my questions:

What is safer for a a baby to get: a DTaP vaccine or an infection from diphtheria, tetanus and pertussis?

And when was your last tetanus booster before you were told to get a Tdap?

anon,
You need to learn what a syllogism is to understand what Antaeus is getting at. This is a very useful tool to unpick the deductive reasoning we use to figure out what is true, or not. It can often reveal errors in our thinking, where we have made unwarranted assumptions or made leaps of faith.

You don't have any bloody idea how a syllogism works, do you, anon? I'm also starting to think you have no idea how civilized discussion or common courtesy work, either. Here's a free hint: Don't go trying to drag the discussion off-track just because your ideas are being shown for the indefensible trash they are.

I think it's time we introduce you to the practice of the ultimatum question. The way it works is, we ask you a question, and if you make three comments on this or any other thread without answering, you are treated as having assented by default to an answer you will probably find unfavorable.

The question is this: "In what way is anything that's been said about Skyhorse in this conversation debunked or even put in different context by the observation that they publish one legitimate book which happens to be in the public domain?" Choosing not to answer means your answer will be taken as "It doesn't have any relevance at all; I was merely attempting to disrupt the conversation by demanding attention for that book as if its existence meant something."

I don’t want to be a tone troll, but sheesh, sometimes you guys are difficult to engage. I think you are dismissing anon out of hand and missed a really important opportunity to learn something. And based on the recent findings that your message and/or delivery may actually be backfiring, this would be an area that I would be actively evaluating if I were you… Diplomacy ain’t for everyone.

I will try to briefly summarize the study that Anon was referring to up-thread, it is actually very interesting, informative and both relative to this discussion as well as some things that were unclear in our previous discussion (leaving the cult of anti-vaccinationism and alt-med.)

A recent study published in PNAS (anon provided the press release for this study) developed a non-human primate model of whooping cough. I will do a quick breakdown of the study so those that are interested can understand and think critically about the implications.

1. Baboons were vaccinated with the normal infant series of DTaP or inactivated whole cell pertussis vaccine wP.

2. These two sets of baboons as well as naïve (non-vaccinated, non-infected) and convalescent (previously infected) sets of baboons were exposed to D420, a B. pertussis clinical isolate that causes severe infection in humans and baboons.

The convalescent animals showed no evidence of colonization or infection upon re-exposure. Whereas the naïve animals experienced colonization and eventual clearance 30 days after exposure. Now, what is interesting is that the aP vaccinated baboons showed slightly slower colonization pattern, equivalent peak levels of colonization, but clearance was slower than the naïve baboons, with clearance around 35-40 days. The wP animals experienced a similar pattern of colonization as aP vaccinated animals, but clearance was on the order of 18-20 days.

Although the vaccinated animals showed evidence of colonization, they did not have any outward symptoms (asymptomatic.) This indicates that the aP vaccine is effective at limiting the symptoms of disease, but not colonization by Bordetella pertussis.

Next, the research group probed the ability of transmission to the aP vaccinated animals as well as the ability of the aP vaccinated animals to transmit the bacteria to naïve hosts. First, the two aP individuals and a naïve animal were co-housed with a directly challenged unvaccinated host, which resulted in indistinguishable peak levels and colonization patterns in both the naïve and vaccinated animals. Next, the researchers placed two aP vaccinated animals that were challenged with D420 in a housing setup with two naïve hosts, which resulted in the naïve hosts contracting the bacterial infection and coming down with full-blown whooping cough.

These are very important findings as they alert us that the most likely suspects of transmission may well be the aP vaccinated population as they can carry the bacteria for a long time (35+) days without symptoms, but with the full capability of transmitting disease to a naïve host.

So to further clarify this thought, let’s say you have two kids, one has been vaccinated with the aP vaccine, the other child was not vaccinated (he has a crunchy mommy). These two kids were both exposed to someone that has whooping cough, so if we extrapolate the findings from this non-human primate model to humans, we would assume that both children are colonized similarly with B. pertussis. Now, crunchy kid has full blown pertussis and is in bed coughing to the point of throwing up (I had it when I was 13 and this is what I remember), whereas, non-crunchy kid is non-symptomatic, so he is out at school, goes to his sports activities, a birthday party, to the grocery store with mom, etc, etc… all the while crunchy-kid is at home in bed.

Which kid is going to transmit the infection to more people?

@Narad

I will try to answer your question re: “carrier” to the best of my ability.

Based on the findings I presented above, I think it is safe to say that one could be a carrier for 30-40 days, even if you have been vaccinated. I remember from my Med Micro text book that Bordetella pertussis is a transient normal flora of humans, but there was no indication as to how long this transience persisted.

One thing I would be interested in is a longitudinal follow up of the aP vaccinated baboon cohort. My curiosity would be whether the aP vaccinated individuals that have been exposed to the clinical isolate D420 that went through the colonization and clearance indicated in the results, upon re-exposure, if they have a similar pattern of colonization and clearance or one that more closely resembles the convalescent cohort.

This is important because technically if it is the former, then the definition of carrier could be expanded to an indefinite time frame depending on exposure of that individual to other carriers.

What’s interesting is the paper that pD cited (not this thread, but the other I referred to) re; “locking in” of CD8 T-cells could help us to understand if this programming phenomenon is plausible. Kreb, was the only one who commented on that paper, but I got the feeling he didn’t read it, because I came to a different conclusion than he did based on what I read.

This is a long post already, but there is a lot more I would like to write about (immunological details of why this is happening), seeing as this is a perfect example to help explain why and how a vaccine can provoke qualitatively different immune responses vs. infection or even different formulations/combinations of the same vaccine, a topic that seems to be unclear to commenters here. This would also be a good time to help explain how vaccines may differ from normal antigenic exposure and how they can persistently modulate innate immunity (heterologous effects). If people are interested in this discussion, I will elaborate, but I won’t waste my time if no one cares.

hope this helps!
skeptiquette

Freedom of the press is totally irrelevant here. No one is saying Skyhorse cannot publish what it chooses, and even if one of us were, we are not the government. But the choices a publisher makes absolutely goes to its credibility and its positioning, in good ways and bad ways, and one book that is an outlier either way doesn't disprove a general trend.

@skeptiquette 407,

Any thoughts on my comment 291?

anon is a puzzling case, because occasionally they (she?) say something that sort of makes sense.

But, some of the comments like 19 are just references with no statement of what they think about what they are linking to.

And others, like the whole diptheria sequence starting at 280, indirectly argue against vaccination without quite being willing to come out and say so.

And there's a lack of response to short direct questions.

So it can get a bit frustrating after a while trying to fiigure out just what anon is trying to tell us, or progress from simple comments into a conversation.

Hi squirrelelite,

Actually, your response at 291 was very well written and on point!

Sorry if I lumped you in, it's hard to keep track of everything people say.

I would only argue that your last paragraph may not be fully accurate (but partially):

And, in places where a lot of people react to their fears by refusing to vaccinate, we are already seeing significant outbreaks of pertussis and babies who are too young to be vaccinated yet are dying as a result.

The increase in incidence of whooping cough may be a result of both waning immunity due to issues with the vaccine (as you mention) as well as this new found phenomenon that I have mentioned. I think that your paragraph reads that this increased incidence is caused by people not vaccinating due to fears, which can't be ruled out. However, I would argue that it is too early to pin the cause on the decision to not vaccinate, and that in doing so SBM credibility takes a hit because it looks like we are latching on to something that is expedient to our way of thinking vs. objectively evaluating the evidence (which in this case is just coming in.)

Thanks for pointing out your rational response, I missed it earlier.

Skeptiquette

You're welcome, skeptiquette.

I think my comment sort of got lost in the flood, which can happen easily enough.

I agree whooping cough is difficult to blame exclusively on refusal to vaccinate because of the lower effectiveness of the vaccine. And, most scientifically aware reports are very tentative about that.

But, a lower vaccination rate certainly doesn't help.

I guess my point was that it is almost more logical to blame the resurgence of whooping cough on the aP vaccine rather than vaccination refusal, because the aP vaccine allows for one to be a carrier without any overt symptoms, thus increasing the likelihood of passing it on to others in the community (i.e. non-vaccinated infants)

Which is why I was trying to explain ( a while ago) how misguided and difficult it would be to try to take legal action against someone who refused vaccination and allegedly transmitted the disease agent to a vulnerable citizen.

Am I the only one who came to these conclusions based on the available evidence?

Skeptiquette,
I'm late to reply to this, but anyway:

What’s interesting is the paper that pD cited (not this thread, but the other I referred to) re; “locking in” of CD8 T-cells could help us to understand if this programming phenomenon is plausible. Kreb, was the only one who commented on that paper, but I got the feeling he didn’t read it, because I came to a different conclusion than he did based on what I read.

I assume you mean:

Acute neonatal infections ‘lock-in’ a suboptimal CD8+ T cell repertoire with impaired recall responses

I did read it, and I didn't see how it related to pD's claims that an early immune insult could disrupt neurodevelopment. I still don't. This paper is essentially about how early acute infections can affect the immune system in mice. It found that a neonatal acute replicating viral infection led to a muted immune response to the same pathogen in adults. I don't believe neonates are given attenuated viral vaccines, or that you could extrapolate from an acute infection in mice to a live vaccine in humans even if they were.

What were the different conclusions you came to and why? If you are suggesting that this study shows that early vaccination might make an adult less able to respond to the pathogen they were vaccinated against, I agree, it does raise that theoretical possibility, but I see no evidence of it in humans, and this wasn't what pD was arguing.

I did write a longer response to your suggestion that aP may be responsible for the increase in pertussis, rather than a fall in vaccine uptake, but decided against posting it. In short, I think you may be right; the possibility of asymptomatic people spreading the infection is not a new idea.

I think we should learn from this that putting unpleasant but temporary adverse effects of the cellular pertussis vaccine ahead of efficacy was a serious mistake. It would have been better if we had stuck with the whole cell vaccine.

I'm curious. Are you in favor of bringing back the whole cell pertussis vaccine? What about vaccinating pregnant women or newborns? Both these solutions would alleviate these problems, with the only problem being the incidence of unpleasant but temporary adverse reactions.

I've been wondering the same thing - if it'd be feasible to bring back the whole-cell vaccine at this point. Were the side effects really significantly worse than those for other vaccines? I know at least some of the cases of seizures and such that got a lot of publicity later turned out to be due to preexisting genetic conditions.

Sarah A,

Were the side effects really significantly worse than those for other vaccines?

Yes, this recent study found that local, systemic and febrile reactions were more commonly observed in infants who received DTwP vaccines than in those who received DTaP vaccines: 9·09% vs 0·85% for local reactions, 12·12% vs 1·00% for systemic reactions, and 26·26% vs 2·58% for febrile reactions, all P<0·001. I'm not sure what the distinction is between "systemic" and "febrile" reactions - I don't have full access from my current location. That's quite a large increase in distress for both child and parents.

However, I don't think the evidence shows that the long-term or permanent sequelae were any worse, despite considerable hysteria about this possibility. Some cases that were initially ascribed to the wP vaccine were subsequently found to be due to Dravet syndrome. I'm most familiar with what happened in the UK, where it was stated in the House of Commons in 1974 that "between 1,000 and 2,000 children in the UK had suffered irreversible brain damage as a result of the vaccine". Subsequent research found this was not true, but not before, understandably, vaccine uptake fell, there were large outbreaks, and dozens of children died unnecessarily.

Is a fever in more than 1 in 4 and a sore arm in 1 in 10 worth the increase in efficacy the wP component might confer? I don't know. One serious problem in assessing the efficacy of pertussis immunization is the cyclical nature of the disease. I wonder how much this has skewed the results of efficacy trials of both wP and aP. This, along with the possibility of aP resulting in more asymptomatic patients, reported mutation of pertussis to become vaccine-resistant and the spread of parapertussis make this a complex and confusing area.

BTW, a couple of things in my first reference above caught my eye, that I should have know but didn't: firstly that aP was first used here as a booster, as the wP is too immunogenic. The second was that pregnant women were immunized here in 2012 as part of a program to address unexpected increases in pertussis incidence.

There seem to be a number of different possible approaches to these problems, but I don't envy any public health authorities trying to figure out which have the best risk-benefit ratio and are most cost-effective.

#415 Krebiozen,

This is a great summary of the differences b/t the two. I am going to "borrow" it for my discussions with others. Thx!

AnnB,
Glad to be of assistance. One change I would make to what I wrote is to remove my speculation about cycles of pertussis outbreaks affecting clinical trial results, as I don't think that's true. I do think the cyclical nature of pertussis outbreaks can mislead us into thinking something has recently gone wrong, when it hasn't. Whooping cough has an approximately four year cycle with two years of lower incidence and two years higher, and there are large variations in different peaks and troughs, so it can take a while to see the results of changes in vaccines and schedules. It's another factor that makes it hard to see what's going on.

I would also add that I believe another reason the wP was replaced with the aP is that the former contained thimerosal and the latter didn't.

Lastly I see that Tdap immunization is already recommended for unvaccinated pregnant women in the US. This will provide newborns with some maternal pertussis antibodies, which should protect them until they are vaccinated themselves.

I did read it, and I didn’t see how it related to pD’s claims that an early immune insult could disrupt neurodevelopment. I still don’t.

That’s probably because he never used this reference to support the claim that early immune insults could disrupt neurodevelopment, but rather used this reference to support the claim that the timing of an immune challenge is important to consider when discussing the impact of early-life immune challenges.

This was in response to your assertion that antigenic challenges do not generally cause immune dysfunction or dysregulation; they are part of normal immune function.

See below:

Kreb: Antigenic challenges do not generally cause immune dysfunction or dysregulation; they are part of normal immune function.

pD: Your assertion is at odds with a great amount of literature when developmental timeframe is taken into consideration.

Here is an example of this:

Acute neonatal infections ‘lock-in’ a suboptimal CD8+ T cell repertoire with impaired recall responses (PLoS Pathog. 2013 Sep;9(9):e1003572. doi: 10.1371/journal.ppat.1003572. Epub 2013 Sep 12.)

Kreb: That’s not an example of an antigenic challenge causing immune dysfunction, it’s an example of a less robust immune response by neonatal primary CD8+ T cells to an acute infection (not a vaccine) as compared to adult memory T cells, in mice. This less robust neonatal response is “outgrown by the adult primary response”.

pD: What might account for the fact that only the treatment group showed differential immune capacities in adulthood, if, indeed, antigenic exposure was not causing persistent immune dysregulation? Do you suppose the treatment group also got broccoli.

Kreb: A less robust response to a specific antigen that neonatal primary CD8+ T cells were previously exposed to does not constitute, “persistent immune dysregulation”. I fail to see even a tenuous connection to your hypothesis.

So, I based my comment off the above exchange. I see pD attempting to explain how timing is important when it comes to an immune challenge and using the cited paper as a supporting reference.

Quick breakdown of this reference:

1. A set of neonatal mice were acutely infected with vaccinia virus expressing the gB-8p peptide (VACV-gB, i.p.) which is the immuno-dominant epitope of Herpes Simplex Virus-1 (HSV-1.)
This strategy was used because:

“In this way, we were able to mimic neonatal vaccinations with live viral vectors and preferentially prime the neonatal T cells that were available in early life.”

Vaccinia virus is the active component of small pox vaccine and is a good vector for vaccination against other pathogens (such as HSV-1 apparently).

2. A set of adult mice were given the same immune challenge (vaccinia virus with HSV-1 expressed peptide.)

3. Both sets were then re-challenged with HSV-1, this is NOT the same pathogen.

kreb: “It found that a neonatal acute replicating viral infection led to a muted immune response to the same pathogen in adults”

emphasis kreb.

I think this point needs to be clarified. The animals were acutely infected with vaccinia virus (the active component of small pox vaccine) that expressed the immunodominant protein of Herpes Simplex Virus, therefore making vaccinia a live viral vector for the peptide of interest. Then they were re-challenged with HSV-1, NOT vaccinia.

4. The mice that were vaccinated as neonates had a different immune response to the HSV-1 challenge than the mice that were vaccinated as adults. Timing of vaccination was important and this is evidenced by the impaired/dysfunctional recall response of the mice that were infected as neonates.

“kreb: “What were the different conclusions you came to and why? If you are suggesting that this study shows that early vaccination might make an adult less able to respond to the pathogen they were vaccinated against, I agree, it does raise that theoretical possibility, but I see no evidence of it in humans, and this wasn’t what pD was arguing.”

So the conclusions I came to were:

1. pD properly used this reference to support his contention that the timing of an immune challenge can cause persistent or long-term immune dysfunction or impairment.

This is further confirmed by the authors themselves:

“Here, we demonstrate how the developmental stage of the host at the time of vaccination or primary infection can alter the composition of the long-lived memory CD8+T cell pool, as well as their ability to respond to subsequent infections.”

2. I see the altered composition of the long-lived memory T cell pool and impaired recall response as an example of persistent immune dysfunction that is directly attributable to the timing of the immune challenge.

3. Yes, I also came to the conclusion that it is theoretically possible that the timing of an immune challenge (vaccine) in humans could dictate the resultant immune response when re-challenged. I agree that we can’t just extrapolate these results in animal models to humans, but I do think that these results offer insight and hypothesis generating material.

I will get to the pertussis stuff next. It offers a good example of persistent immune modulation from vaccination and how qualitatively different immune responses affect outcomes.

Skeptiquette,

2. A set of adult mice were given the same immune challenge (vaccinia virus with HSV-1 expressed peptide.)

3. Both sets were then re-challenged with HSV-1, this is NOT the same pathogen.

Perhaps my sloppy language is to blame, but my point is it's the same antigen whether it's produced by GM vaccinia or by HSV-1. This isn't some generalized immune dysfunction caused by early infection as I thought pD was implying.

I see the altered composition of the long-lived memory T cell pool and impaired recall response as an example of persistent immune dysfunction that is directly attributable to the timing of the immune challenge.

I think labeling this as immune dysfunction is a big stretch; it's a muted immune response to a specific antigen as compared to an adult response to that antigen, that's all. It certainly isn't the sort of dysfunction that could even theoretically affect neurodevelopment as far as I can see. Of course our immune systems respond differently at different ages, this is well known, and is largely the basis of the vaccine schedule. The fact that, "vaccination or primary infection can alter the composition of the long-lived memory CD8+T cell pool, as well as their ability to respond to subsequent infections”, is the basis of immunization and is hardly a surprise.

I still don't see what you and pD are getting at. It looks to me as if you are desperately looking for some way that vaccination might cause immune dysfunction in a way that affects neurodevelopment leading to autism, when we have no direct evidence for this at all. You are looking for an explanation for something we have no reason to believe occurs.

Have I missed something?

Just one more thing, briefly. A muted immune response isn't necessarily dysfunctional. There are lots of antigens we don't want to react to. For example, it may be a good idea not to mount a full-scale immune response against an antigen that a newborn is exposed to; it may be something in the environment the child has been born into.

Krebiozen:

I still don’t see what you and pD are getting at. It looks to me as if you are desperately looking for some way that vaccination might cause immune dysfunction in a way that affects neurodevelopment leading to autism, when we have no direct evidence for this at all. You are looking for an explanation for something we have no reason to believe occurs.

It does seem to be putting the cart in front of the horse. They keep try to find a way that vaccines cause autism, when there does not seem to be any real evidence that autism is caused by vaccines.

Plus, there is the Htrae leap that the immune reaction from a vaccine would be greater than that of a full blown infection.

I remember (and have since forgotten), when the CDC approved acellular pertussis vaccines for all 5 doses of pertussis-containing-vaccines. Prior to 1997, the first three doses of whole cell petussis vaccines were given and acellular pertussis vaccine was approved by the CDC for the fourth and fifth doses, only.

http://www.cdc.gov/mmwr/PDF/rr/rr4607.pdf

Tdap booster vaccines are recommended for all pregnant, for all of her pregnancies, even if her pregnancies are close together.

Oops "Tdap booster vaccines are recommended for all pregnant ^ woman, for all of her pregnancies, even if her pregnancies are close together."

lilady, have you seen this one?

gianelloni.wordpress.com/2014/03/14/thanks-pharma-you-created-the-anti-vaccine-movement/

The comments alone (which appear to be heavily moderated) make me want to bang my head on the wall and simultaneously vomit.

I've already seen that blog...a perfect example of the Dunning-Kruger effect. :-)

lilady,

Tdap booster vaccines are recommended for all pregnant, for all of her pregnancies, even if her pregnancies are close together.

You're quite right, of course. I missed that in the recommendations I linked to at #417, but I now see this has been the ACIP recommendation for every pregnant woman, regardless of vaccination status, since 2012.

To maximize the maternal antibody response and passive antibody transfer and levels in the newborn, optimal timing for Tdap administration is between 27 weeks and 36 weeks of gestation, although Tdap may be given at any time during pregnancy .

This, or neonatal vaccination, is effective in baboons, but it's too early to say if it is effective in humans, especially since vaccination uptake is low; I was unable to find figures for the US, but in the UK uptake of Tdap in pregnancy is around 50-60%. Increasing this seems to me to be the best way of closing that 2 month window of vulnerability to pertussis in neonates.

It's reassuring to me that after blundering around the literature to see what the most rational response to increasing pertussis incidence might be, I find that this is precisely what public health authorities both the US and UK have already implemented.

I recommend this way of readin that blog: http://rbutr.com/http://gianelloni.wordpress.com/2014/03/14/thanks-phar… =D

@Antaeus Feldspar
Reading that blog makes me think of all the wrong arguments I see in it. It really is terrible. Yes measles is an innocent disease not worse than common cold. Well, tell that to the parents of a 8 moth old child that landed in a hospital in The Hague, because it got measles from an unvaccinated child in daycare. The 8 month old was to young to get vaccinated. Alas all articles are in Dutch, so I won't add links to the story.

Renate -

What did you think of the rebuttal linked in the upper right corner?

I think it sums up nicely what I would like to say and more.

And if Big Pharma would be so cynical as the Gianelloni family seems to think they are, they should thank the anti-vaccinationists for creating more diseases, which bring more profits than vaccinations.
b.t.w. I doubt they are that cynical.

Hi Antaeus,

It's hard to say how effective the rebuttal will be at changing people's minds...

It was well written, but the tone of it may come off as condescending, which directly inhibits the effectiveness of any message no matter how true it is.

This is a tough area: what strategies to use to deliver the message most effectively?

Something that I think needs to be considered ASAP amongst skeptics. I have a few ideas, but definitely something worthy of further consideration.

One thing that is clear is that we have to be sure to have all the facts straight and be open minded and this rebuttal failed on the former.

Fore example, It may be possible to contract measles from the vaccine, and it may be possible to transmit or shed the measles vaccine virus and for it to become an infection in another individual.

It is also possible for an outbreak's index case to be fully vaccinated, however, this is much, much more rare than the index case being an un-vaccinated individual.

Either way, I think it is important to be accurate, otherwise credibility can take a hit and the message can be ignored. often it is hard to be fully accurate, as information is changing quite rapidly these days.

I think labeling this as immune dysfunction is a big stretch; it’s a muted immune response to a specific antigen as compared to an adult response to that antigen, that’s all. It certainly isn’t the sort of dysfunction that could even theoretically affect neurodevelopment as far as I can see.

Maybe I am misreading you or something, but it still seems like you are unclear about the details and results of the study.

You do realize that both sets of mice that were challenged with HSV-1 were adult mice, right?

The muted response that you are talking about was in adult mice, not neonatal mice.

The muted response was only seen in the adult mice that were previously vaccinated during the neonatal timeframe, not the adult mice that were vaccinated during adulthood then rechallenged.

Of course our immune systems respond differently at different ages, this is well known, and is largely the basis of the vaccine schedule. The fact that, “vaccination or primary infection can alter the composition of the long-lived memory CD8+T cell pool, as well as their ability to respond to subsequent infections”, is the basis of immunization and is hardly a surprise.

I guess the results were surprising and novel to me. Why do you think that they would study and present results that are "hardly surprising"?

my feeling is that you are missing something.

Just one more thing, briefly. A muted immune response isn’t necessarily dysfunctional. There are lots of antigens we don’t want to react to. For example, it may be a good idea not to mount a full-scale immune response against an antigen that a newborn is exposed to; it may be something in the environment the child has been born into.

I agree that a muted immune response during the neonatal period may have advantages, but this is not what we are talking about.

Let's try it a different way.

Let's say that the immune response to HSV challenge of the mice that were vaccinated in adulthood = functional. Meaning they clear the infection and have a normal functional immune response to the HSV challenge.

Whereas the immune response to HSV challenge of the mice (adult) that were vaccinated as neonates = dysfunctional. Meaning they clear the infection more slowly and do not have as effective or functional response.

The precipitating factor here is the timing of vaccination/ infection.

I still don’t see what you and pD are getting at. It looks to me as if you are desperately looking for some way that vaccination might cause immune dysfunction in a way that affects neurodevelopment leading to autism, when we have no direct evidence for this at all. You are looking for an explanation for something we have no reason to believe occurs.

Have I missed something?

Probably not.

the syllogism that I constructed (and Antaeus revised) may help in understanding my position, but I am pretty sure you read it. If not, here it is.

A) Autism appears to be an immune mediated condition (at least in a subset of individuals)

B) Vaccines can modulate the infant immune system, including the innate arm of the immune system.

C) The immune system is a critical component of normal brain development.

D) Immune system dysfunction/disturbances during this critical period can have long lasting effects on behavior and cognitive functioning.

E) Therefore, we should explore the possibility of vaccines contributing to both the prevention and etiology of autism within this conceptual framework.

I guess it's just that I see evidence for A, B, C, and D so that leads me to E.

I will try to avoid bringing this stuff up anymore, as it is pretty tired out and boring (to you). Thanks for engaging me, though.

I may be just helplessly lost in a vast array of immunological details and somehow I see a pattern(it may be real or just a figment of my imagination) that others don't see. Either way, I still find interest in reading about these topics and may mention things occasionally.

skeptiquette,

I think labeling this as immune dysfunction is a big stretch; it’s a muted immune response to a specific antigen as compared to an adult response to that antigen, that’s all.

Maybe I am misreading you or something, but it still seems like you are unclear about the details and results of the study.

You do realize that both sets of mice that were challenged with HSV-1 were adult mice, right?

The muted response that you are talking about was in adult mice, not neonatal mice.

Yes, I read the study, and understood it. Do I really have to spell everything out in full? Perhaps I should have written:

it’s a muted immune response to a specific antigen by neonatal memory CD8+ T cells as compared to naïve adult CD8+ T cells' response to that antigen, that’s all.

The muted response was only seen in the adult mice that were previously vaccinated during the neonatal timeframe, not the adult mice that were vaccinated during adulthood then rechallenged.

Yes, I understand this, but but it is only to a specific antigen. Claiming that exposure to an antigen at a specific age causes "persistent immune dysregulation" makes it sound like the immune system is permanently damaged in some way. It isn't. There is just a muted response to the antigen the mouse was exposed to neonatally.

I guess the results were surprising and novel to me. Why do you think that they would study and present results that are “hardly surprising”?

Are you familiar with medical research at all? If you think that only research that is surprising and novel is published I suspect not. The vast majority of research I have been involved with has been confirming what is already expected to be true. Published papers that are surprising and novel are the ones that make the newspapers.

my feeling is that you are missing something.

My feeling is that you are reading something into this that just isn't there.

I agree that a muted immune response during the neonatal period may have advantages, but this is not what we are talking about.

You described this response as "impaired/dysfunctional". If it has advantages then it isn't impaired or dysfunctional.

Let’s say that the immune response to HSV challenge of the mice that were vaccinated in adulthood = functional. Meaning they clear the infection and have a normal functional immune response to the HSV challenge.

Whereas the immune response to HSV challenge of the mice (adult) that were vaccinated as neonates = dysfunctional. Meaning they clear the infection more slowly and do not have as effective or functional response.

That's just playing with semantics. If you define an adult unvaccinated response as normal then any vaccinated response that differs from that will be abnormal.

The precipitating factor here is the timing of vaccination/ infection.

Yes, I understand that. An immature immune system responds differently to a mature one. This is something we need to be aware of when planning vaccine schedules, or we may find a vaccine given too early will have unexpected effects later. Isn't this one reason we don't give live vaccines before the age of one when the immune system is more mature?

the syllogism that I constructed (and Antaeus revised) may help in understanding my position, but I am pretty sure you read it. If not, here it is.

I read it, and to me it reads like someone trying to rationalize a preconceived idea. Turning my nitpicking setting up to 11:

A) Autism appears to be an immune mediated condition (at least in a subset of individuals)

Autism is not an immune mediated condition in any sense of the term I understand. An immune mediated condition is something like an allergy or an autoimmune disease. Autism is a condition that may be caused by changes in cytoarchitectural and neuronal organization. There may be immune mediated processes involved in these changes, and some immunological anomalies are associated with autism, but that really isn't the same thing as it being an immune mediated condition. There are a lot of maybes in here, and it is by no means clear whether the immunological anomalies we see are a cause, an effect or the results of something that also causes autism.

B) Vaccines can modulate the infant immune system, including the innate arm of the immune system.

How do vaccines modulate the innate immune system? Live vaccines and some adjuvants stimulate the innate immune system, obviously, but 'modulate' implies they somehow modify or control it. I don't think they modulate the innate immune system any more than a natural infection does.

C) The immune system is a critical component of normal brain development.

Parts of the immune system may be involved in normal neurodevelopment. There is a lot of evidence pointing in that direction, but it really isn't clear yet. It certainly isn't clear that the kinds of changes in immune functions that vaccines can cause are the same as those that are involved in neurodevelopment.

D) Immune system dysfunction/disturbances during this critical period can have long lasting effects on behavior and cognitive functioning.

If by "this critical period" you mean the second trimester of pregnancy, and by "immune system dysfunction/disturbances" you mean a maternal rubella infection then I agree. I don't see any evidence for a further period of neurodevelopmental vulnerability post-natally, nor do I see evidence for vaccines being involved in these "dysfunction/disturbances". Why would vaccines create a more disrupting effect on neurodevelopment than the natural infections that human babies have been exposed to for millennia?

E) Therefore, we should explore the possibility of vaccines contributing to both the prevention and etiology of autism within this conceptual framework.

Is that really a syllogism? If so it seems very shaky indeed to me.

I guess it’s just that I see evidence for A, B, C, and D so that leads me to E.

I still see this as little more than, "autism may have something to do with the immune system, vaccines do something to the immune system, therefore vaccines may cause autism". It's a logical possibility, but I don't see any of the other dots I would need to see to connect this up the way you have. I could do the same thing with my broccoli hypothesis: "autism may have something to do with the immune system, broccoli contains immunomodulatory substances, therefore broccoli may cause autism". In both cases there is a glaring lack of supporting epidemiological and other evidence which, in the case of vaccines, people have been looking for for the past 15 years or more.

I will try to avoid bringing this stuff up anymore, as it is pretty tired out and boring (to you). Thanks for engaging me, though.

I wouldn't engage you unless it interested me too, or at least how you came to these conclusions interests me.

I may be just helplessly lost in a vast array of immunological details and somehow I see a pattern(it may be real or just a figment of my imagination) that others don’t see.

That's a human failing we all have to guard against.

Either way, I still find interest in reading about these topics and may mention things occasionally.

It would get pretty dull around here if everyone agreed about everything all the time ;-)

Yes, I read the study, and understood it. Do I really have to spell everything out in full? Perhaps I should have written:

You don’t have to spell everything out in full, you just have to in a way that is actually clear that you understand what it is you are talking about.

Sorry, the way you spelled things out made it unclear.

Are you familiar with medical research at all? If you think that only research that is surprising and novel is published I suspect not.

Of course I am familiar with medical research and realize that many publications are replicative studies or off shoots of other work. I gave the wrong impression with the sentence I wrote, I hope this is clarified.

Published papers that are surprising and novel are the ones that make the newspapers.

I disagree with this. There are constantly findings that are novel and surprising in all different disciplines that never get press, I would say this is the norm rather than the exception.

My feeling is that you are reading something into this that just isn’t there.

Ok. not sure what that is... since I have been very explicit.

You described this response as “impaired/dysfunctional”. If it has advantages then it isn’t impaired or dysfunctional.

Well, it could be advantageous as a neonate to have a muted response, but it may not be advantageous for that muted response to become “locked in.” Again we are talking about two different things here, the immune response of a neonate and that of an adult. It may be advantageous for the developing infant to have a muted response, but may be very disadvantageous to the adult to have this “locked in” muted response, as it translates to impaired immunity and slower clearance of that specific pathogen.

That’s just playing with semantics. If you define an adult unvaccinated response as normal then any vaccinated response that differs from that will be abnormal.

No, I was just describing the results from the study in a different way, one that I thought would make it more clear. I never defined an adult unvaccinated response as normal, I defined the adult vaccinated response as “normal/functional.”

Yes, I understand that. An immature immune system responds differently to a mature one.

Ok. But again that is not what was being compared. They were comparing the immune response of two different sets of mature mice to HSV-1 challenge.

Isn’t this one reason we don’t give live vaccines before the age of one when the immune system is more mature?

I don’t know, you tell me. Is that what the available evidence is telling you? Are there trials with live viral vaccines in infants that resulted in a situation where they were had an impaired response to the pathogen later in life that you are gleaning this from? (this is a serious question, I haven’t looked into it at all and am curious)

I always thought it was because there were safety concerns about using live viral vaccines in infants under one, but that may be just one part of a larger set of reasons.

A) Autism appears to be an immune mediated condition (at least in a subset of individuals)

Autism is not an immune mediated condition in any sense of the term I understand. An immune mediated condition is something like an allergy or an autoimmune disease. Autism is a condition that may be caused by changes in cytoarchitectural and neuronal organization. There may be immune mediated processes involved in these changes, and some immunological anomalies are associated with autism, but that really isn’t the same thing as it being an immune mediated condition. There are a lot of maybes in here, and it is by no means clear whether the immunological anomalies we see are a cause, an effect or the results of something that also causes autism.

Fair enough. Perhaps I was a bit over-zealous in my characterization of autism as immune mediated. I think what you have presented is a fair interpretation of the evidence; there may be immune underpinnings of various importance, but the direction of causality isn’t fully established.

On a side note, I did begin to organize the immune/autism research that I have looked at and have a doc going that I will post sometime (sorry Alain and MOB, I promised this a few weeks ago, I did start it at least...)

B) Vaccines can modulate the infant immune system, including the innate arm of the immune system.

How do vaccines modulate the innate immune system? Live vaccines and some adjuvants stimulate the innate immune system, obviously, but ‘modulate’ implies they somehow modify or control it. I don’t think they modulate the innate immune system any more than a natural infection does.

This is actually a growing area of interest, as it relates to the paradigm shift amongst immunologists of innate immunity having memory (trained immunity)

Here are a few references:

PMID: 17116347 – this one is very relevant as it shows persistent modulation of the infant cytokine response based on whether the infant received aP or wP and not just to re-challenge (in vitro of course) with pertussis antigens, but to general antigens as well.

Which is why the authors came to similar conclusions that I have espoused, such as:

“Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

With more specific wording in the paper to this effect:

The capacity to induce a Th1- or a Th2-type immune response seems to be linked to the intrinsic properties of the encountered antigens, and this is probably most important in infants, who do not yet have memory cells for these antigens. Factors amplifying early Th2 imprinting may skew subsequent immune responses toward Th2-polarized immune memory, whereas Th1-type cytokine-inducing antigens may antagonize such a Th2-polarized immune memory. The identification of the environmental factors that may orient the immune responses of infants toward a Th2 or a Th1 pattern may therefore be very important.

More PMID’s of interest: 23572484, 24352476, 23869409.

I will try to get to the rest of your post in the near future.

Cheers!

Fore example, It may be possible to contract measles from the vaccine, and it may be possible to transmit or shed the measles vaccine virus and for it to become an infection in another individual.

Show me a single documented case of measles disease due to either scenario.

@skeptiquette,

Ok.

Alain

the syllogism that I constructed (and Antaeus revised) may help in understanding my position, but I am pretty sure you read it. If not, here it is.

A) Autism appears to be an immune mediated condition (at least in a subset of individuals)

B) Vaccines can modulate the infant immune system, including the innate arm of the immune system.

C) The immune system is a critical component of normal brain development.

D) Immune system dysfunction/disturbances during this critical period can have long lasting effects on behavior and cognitive functioning.

E) Therefore, we should explore the possibility of vaccines contributing to both the prevention and etiology of autism within this conceptual framework.

It is very hard to believe you're attempting to act in good faith, skeptiquette, when we catch you telling falsehhods like this. I am personally very offended that you are treating me so shabbily, utterly ignoring everything I have to say and yet name-dropping me as if I had at some point sanctioned your determined wrong-headedness.

The above is not "the syllogism that [you] constructed (and Antaeus revised)". It is, word-for-word, the exact same text that you originally proposed to be a 'syllogism'.

Exactly where do you get off saying I "revised" it when it has not been revised one bit? When you in fact utterly ignored my pointing out serious problems with it, not least of them being that it isn't a syllogism because E introduces a new entity (namely, 'possibilities of factors contributing to both the prevention and etiology of autism that should be explored') that does not exist in any of the premises!

If you absolutely must LIE, skeptiquette, and tell everyone that the bundle of vaguely related ideas above is a 'syllogism' (false) which has been 'revised' (LIE), then at least do not tarnish my name by pretending I had any role in that non-existent revision-in-response-to-feedback. Tell people it was Gooby, the purple goblin in your head, who helped you 'revise'. That's far closer to the TRUTH.

Damn blockquotes.

And damn SCUMBAG LIARS.

@Narad

Show me a single documented case of measles disease due to either scenario.

Actually, I just stumbled across them after I read the blog that Antaeus linked.

They were PMID’s: 24439074 and 24330942 for the first claim.

They are documented case-studies.

From the first PMID: 24439074

A 23-year-old healthy man was given a measles vaccine, not rubella or mumps vaccine at the same time, on March 27, 2013, as part of an occupational health protocol; how-ever, he presented with a high fever (40C) at 18 days post-vaccination. At 20 days post-vaccination, a rash appeared on his trunk, legs, and arms. Koplik’s spots, a runny nose, and red eyes also were noted. Two days after disease onset, blood samples, a throat swab, and a urine sample were collected and tested for measles virus by reverse transcription-polymerase chain reaction. A sequence cor-responding to the measles N protein (533 bp) was amplified from the serum, peripheral blood mononuclear cells, and throat swab, and was identical to that of the genotype A virus (DQ345721). The subject had no history of travel before the vaccination or contact with patients with measles. Before vaccination, he tested negative for serum antibodies against the measles virus. Thus, he was diagnosed with vaccine-associated measles.

Also,

Clinicians should be aware of the possibility of vaccine-associated measles in both children and adults.

The other pmid is open access so you can read it and let me know what your thoughts are.

Regarding the second claim, I drew this from the pmid: 24330942

Where they stated:

Of note, only one case report of transmission from vaccine-associated measles has been identified [15,16].

And I haven’t gotten that paper, but I did find one other mention in another paper that makes me more skeptical of the claim. from pmid: 23543773 is this statement:

There is a case report suggesting the transmission of vac-cine strain between immunocompetent siblings, but the conclusion was based only on clinical presentation, with no laboratory confirma-tion of infection (11,12).

Here are the citations 11, 12 for your reference.

11. Millson D. Brother-to-sister transmission of measles after measles, mumps and rubella immunization. Lancet 1989;333:271.

12. Campbell AGM. Brother-to-sister transmission of measles after measles, mumps and rubella immunization. Lancet 1989;333:442.

Again, I did not say these scenarios were common, just possible. However, I will retract the second claim as there was no laboratory confirmation and it happened back in 89’ (practically prehistoric times when it comes to medical science)

I'm sorry Antaeus.

what I wrote was very poorly worded. Let me revise that to set the record straight.

the attempt at a syllogism that I constructed (and Antaeus revised, the revised version is not shown, just my original attempt) may help in understanding my position, but I am pretty sure you read it. If not, here it is.

etc. etc.

To everyone: I formally retract the statement I initially made and would like it to be replaced with what I have written above.

Let me suggest that instead of calling somebody a scumbag liar you could proceed more cordially, such as:

Antaeus: Hi skeptiquette, I noticed you referred to your attempted syllogism as my "revised syllogism" could you please correct your wording so as to clarify that.

me: Of course Antaeus, Im very sorry about that mistake, thanks for bringing it to my attention. I will correct the record for everyone to see.

As you are well aware, I don't have any track record of lying, actually quite the opposite--I am very forthright about being wrong or making a mistake and acknowledging those instances.

I don't think you understand my motivation. This isn't some life or death battle that I am going to get even remotely emotionally worked up about. I am trying to take these opportunities to learn something, through discussion with like minded people. That is really what I love about the internet; it's that I can have a conversation with kreb or anyone else, who lives halfway around the world, and learn new things, think of new avenues to explore, etc.

Im sorry that you got so upset, it certainly wasn't my intention.

The other pmid is open access so you can read it and let me know what your thoughts are.

Actually, they both are. Let me first note what the CDC has to say generally on the subject:

"During outbreaks, measles vaccine is administered to help control the outbreak, and in these situations, vaccine reactions may be mistakenly classified as measles cases. A small proportion of measles vaccine recipients experience rash and fever 10–14 days following vaccination."

PMID 24439074, Kurata et al.: They state that they found DQ345721. This seems a little weird, since that's CAM-70, whereas Japan uses the AIK-C strain, but I'm not competent to speculate further. They do not state whether they looked for parvovirus B19.

Taking Koplik spots as pathognomonic of measles disease proper (i.e., disregarding PMID 1401292, which I can't see anyway), this seems pretty solid.

PMID 24330942, Murti et al.: I'll go with the authors; highly suggestive, but weird as all get-out at 37 days, making speculation on some sort of immunocompromise not outside the question. Then again, if it's basically undetectable, it amounts to nearly the same thing.

I'm also unable to see PMID 15804301, "Vaccine-associated 'wild-type' measles."

So, OK, it seems possible.

This seems a little weird, since that’s CAM-70, whereas Japan uses the AIK-C strain, but I’m not competent to speculate further.

Interesting, thanks for looking into that. I'm not competent enough to speculate further either. Where is Prometheus when you need him... wasn't he really well versed in everything measles?

Taking Koplik spots as pathognomonic of measles disease proper (i.e., disregarding PMID 1401292, which I can’t see anyway), this seems pretty solid.

Ahhh, now I understand why they tested for parvovirus B19 in the canadian case study, it can present in a similar fashion.

I will look at PMID 15804301

Yea, possible but very rare.

skeptiquette,

Sorry, the way you spelled things out made it unclear.

Perhaps. You wrote:

You do realize that both sets of mice that were challenged with HSV-1 were adult mice, right?

To clarify what was done (from the study):

Neonatal and adult B6 mice were vaccinated with VACV-gB and challenged 6 weeks later with HSV-1. [...] Naive adult B6 mice were also infected with HSV-1 for comparison with the secondary CD8+ T cell responses.

A six week old mouse is equivalent to a human aged 3-4 years, not an adult.

When I wrote:

I think labeling this as immune dysfunction is a big stretch; it’s a muted immune response to a specific antigen as compared to an adult response to that antigen, that’s all.

The "adult response to that antigen" I was referring to was the naive adult response to HSV-1, as compared to the response in the six week old mice. I shall try to be clearer in future.

Published papers that are surprising and novel are the ones that make the newspapers.

I disagree with this. There are constantly findings that are novel and surprising in all different disciplines that never get press, I would say this is the norm rather than the exception.

How is what I wrote inconsistent with that? You implied that the results must be novel and surprising otherwise they would not have been published in a journal, which is not true. The vast majority of published research is neither novel nor surprising, to the layperson anyway, which is why it doesn't make the newspapers.

My feeling is that you are reading something into this that just isn’t there.
Ok. not sure what that is… since I have been very explicit.

The connections between the different elements in your 'syllogism', for example. I don't see them.

Well, it could be advantageous as a neonate to have a muted response, but it may not be advantageous for that muted response to become “locked in.”

Again we are talking about two different things here, the immune response of a neonate and that of an adult. It may be advantageous for the developing infant to have a muted response, but may be very disadvantageous to the adult to have this “locked in” muted response, as it translates to impaired immunity and slower clearance of that specific pathogen.

It may be or it may not be, we don't know, which is why I would argue against labeling it "dysfunctional" or "impaired". A newborn has just emerged from an environment where it was surrounded by foreign antigens; it had to mute its responses to its mother's proteins, this is quite normal. Developing a full adult immune repertoire is a process that takes a while.

That’s just playing with semantics. If you define an adult unvaccinated response as normal then any vaccinated response that differs from that will be abnormal.

No, I was just describing the results from the study in a different way, one that I thought would make it more clear. I never defined an adult unvaccinated response as normal, I defined the adult vaccinated response as “normal/functional.”

Maybe my sloppy language is to blame again. There are two different vaccinations being discussed here: VACV-gN and MCV-1. By "adult unvaccinated response" I meant the response, to the HSV-1, of an adult that was not vaccinated with VACV-gB as a neonate.

Basically I object to this 'locked-in' muted response being labeled as dysfunctional, abnormal or impaired. I think it may be a normal response to being exposed to large amounts of an antigen at a very early age. The implication of the language pD, and you, have used is that this study supports the idea that neonatal vaccines may somehow damage the immune system generally, including those parts that may be involved in neurodevelopment, possibly leading to autism, and I don't think there is any evidence that this is the case.

Yes, I understand that. An immature immune system responds differently to a mature one.

Ok. But again that is not what was being compared. They were comparing the immune response of two different sets of mature mice to HSV-1 challenge.

This is getting weird. If a neonatal mouse is exposed to large amounts of HSV-1 antigens (from a GM vaccinia infection), its immature immune system responds by muting its future responses to that antigen. That's the effect the study was looking at, an effect that is the result of an immature immune system being exposed to large amounts of an antigen.

Isn’t this one reason we don’t give live vaccines before the age of one when the immune system is more mature?

I don’t know, you tell me. Is that what the available evidence is telling you? Are there trials with live viral vaccines in infants that resulted in a situation where they were had an impaired response to the pathogen later in life that you are gleaning this from? (this is a serious question, I haven’t looked into it at all and am curious)

It's been a long time since I studies vaccine development, so I'm not sure of that specifically. There were trials of high titer measles vaccines that were found to lead to higher mortality rates than the regular vaccine, for example, and I remember reading of other unexpected effects of vaccines that have led to changes in timing, dosing and types of vaccine. There has been a lot of trial and error over several decades to get to the current schedule.

I always thought it was because there were safety concerns about using live viral vaccines in infants under one, but that may be just one part of a larger set of reasons.

Lack of efficacy as well as safety I think. Maternal antibodies persisting in newborns can interfere with a reaction to vaccines, for example.

I'll take a look at the effects of vaccines on the innate immune system when I have some time this weekend.

The problem is that those parents that refuse to have their children vaccinated are refusing to take part in the social contract that used to be followed in this country. I'm sorry but all children are equally valuable and your refusal to have your child vaccinated put other children at risk while at the same time depending on the 'herd immunity' for your child's health and safety. Perhaps you could move where no one is vaccinated and see how that works out for your child.

Regarding the question of vaccinating neonate mice and challenging them six weeks later, Krebiozen observes, "A six week old mouse is equivalent to a human aged 3-4 years, not an adult."

Yes, and they're also only six weeks old. A mouse is not a human being with every metabolic process sped up proportionally. If mammalian immune processes take a more or less fixed time to respond -- if the mouse immune system does not in fact respond thirty or so times as fast as the Hunan immune system -- then what this experiment may be telling us is the breath-taking revelation that an immune system responds a little differently a few weeks after initial exposure than it does on initial exposure.

2nd try:
skeptiquette,
You wrote:

vaccines may differ from normal antigenic exposure and [...] they can persistently modulate innate immunity (heterologous effects).

To which I replied:

I don’t think they modulate the innate immune system any more than a natural infection does.

I had a quick look at the papers you cited:
PMID: 17116347 which compared responses to wP and aP in infants, with the aP inducing a Th2-skewed reponse at 6 months (Th2 responses are unwanted allergic responses, Th1 are inflammatory i.e. the response you want from a vaccine) . This might suggest that, "vaccines may differ from normal antigenic exposure", however, this study found that, "the global Th2 bias observed in 6-month-old infants vaccinated with a Pa vaccine was normalized at 13 months". So this appears to be a transient effect.

PMID: 2357248 is about non-specific effects of vaccines. We know that measles vaccine and BCG protect against a number of other diseases, and that other vaccines may increase the risk of other diseases, such as DTP in developing countries. I don't think this is a property unique to vaccines, I see no reason to think this does not occur with early infection too.

PMID 24352476:

the innate immune system displays epigenetic memory of an earlier infection or vaccination, a phenomenon that has been named "trained immunity."

Again, this is an effect common to early infection and vaccination.

PMID: 23869409 again about training innate immunity, and again nothing to suggest a long term qualitatively different effect of vaccines on the innate immune system as compared to natural infection.

If anything these findings make it even more important to be sure children are vaccinated, as a natural infection early in childhood may have long-term consequences that are bound to be more severe than those caused by vaccination.

I don't see anything here that supports the idea that vaccines may somehow damage the immune system and lead to neurodevelopmental problems

I am in conflict with a non-vaccinating cousin who continually sends me articles such as the following link. My grand children are vaccinated, hers are not. Obviously, we are not scientists.
http://www.gaia-health.com/gaia-blog/2011-10-24/vaccines-may-be-fueling…

She also sent me this- (She is retired and has a lot of time on her hands)
http://www.ncbi.nlm.nih.gov/pubmed/18752390
Development of unilateral cervical and supraclavicular lymphadenopathy after human papilloma virus vaccination.

Ok, Thanks for looking those over.

Do you think that it would be worthwhile to more thoroughly look at the effects of various vaccinations and/or combos of vaccines on the innate immune system? (i.e. large scale prospective studies)

This is basically where I stand. It would make sense to me to do these types of studies. The results could be used in a number of subsequent studies, but at the very least we would have a bunch more data to better understand both safety and efficacy of current vaccines.

Thanks,

Skeptiquette

skeptiquette: I don’t think you understand my motivation. This isn’t some life or death battle that I am going to get even remotely emotionally worked up about. I am trying to take these opportunities to learn something, through discussion with like minded people.

No, we understand your motivation all right. You are anti-vax to the core, and keep pretending the studies haven't been done. All I ask is that you quit weaseling around. Stop pretending you're 'on the fence,' no one is fooled by that act.

PGP,

lol... No, you obviously and evidently do NOT.

If I were anti-vax to the core, as you promulgate, why would I have had my kids vaccinated?

that may be a tough one to answer, but, please answer that question.

Prospective studies looking at the innate immune responses of infants after the normal pediatric vaccine schedule have not been done. Why do you think the authors of the study (2007) I cited above said:

“Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

Also, PMID: 19423079 is interesting in that it explores how inflammation from a vaccine (typhoid) can alter brain activity and connectivity in an adult resulting in mood changes.

Specifically:

Inflammation-associated deterioration in total mood was also associated with a marked decrease in activity within amygdala, a region central to processing emotional information from faces. Connectivity analysis also showed that inflammation-associated mood change modulated the connectivity between sACC and arMPFC, a region activated when thinking about others, and with right STS and amygdala, regions implicated in processing social/emotional information from faces. These changes might under-pin the marked reduction in social behavior associated with acute sickness, possibly reflecting an internal self-reorientation of attentional focus (9) and the heterogeneity of symptoms associated with inflammation-associated mood change.

So, I ask myself, what happens when a one day old infant or a two, four, six or twelve month infant gets a vaccine, what type of inflammatory response occurs? What is the magnitude and duration of the inflammatory response? Are there changes in activity and connectivity in brain regions that are implicated in empathy and social/emotional processing (like we see from above study or other important changes)? If changes do occur, how long do they last? How does this inflammatory response differ among individuals? i.e. how does genotype, how do other developmental (prenatal) occurrences impact this response?

You can call that “a just asking questions ploy” or “weaseling”, I just call this critical thinking and trying to fill voids in our collective ignorance. IF you have answers to those questions or could point me in the direction where I can find answers, then just do so. From what I can tell, we do not have data to answer these questions, hence large scale prospective studies are warranted.

Wouldn't you rather be armed with more information rather than less when trying to counter the anti-vaccine movement... Sometimes I think that you wouldn't.

@LW

Regarding the question of vaccinating neonate mice and challenging them six weeks later, Krebiozen observes, “A six week old mouse is equivalent to a human aged 3-4 years, not an adult.”

I don't really know why Kreb announced this. I never made any claim that a six week old mouse is the equivalent of an adult human. I though it was more of an FYI announcement.

There were three groups of mice in the study:

1. Neonatal mice that were vaccinated/infected that were 1wk old. These mice were then rechallenged 6-8 weeks later, making them 7-9 wk old adult mice.

2. There was an unvaccinated adult group challenged at 8-12 weeks.

3. There was a 8-12 week adult group that was vaccinated and then rechallenged 6-8 weeks later, making them 14-20 weeks old.

Skep: I disagree with this. There are constantly findings that are novel and surprising in all different disciplines that never get press, I would say this is the norm rather than the exception.

Kreb: How is what I wrote inconsistent with that? You implied that the results must be novel and surprising otherwise they would not have been published in a journal, which is not true. The vast majority of published research is neither novel nor surprising, to the layperson anyway, which is why it doesn’t make the newspapers.

I did imply that the first time around, but clarified it with this statement:

Of course I am familiar with medical research and realize that many publications are replicative studies or off shoots of other work. I gave the wrong impression with the sentence I wrote, I hope this is clarified.

WRT the question of "how is what I wrote inconsistent with that?"

that being:

There are constantly findings that are novel and surprising in all different disciplines that never get press

by press I mean written about in newspapers.

what you wrote being:

Published papers that are surprising and novel are the ones that make the newspapers.

Aren't those two statements entirely contradictory/inconsistent?

You are saying that if a published paper reveals findings that are surprising or novel that there will be some sort of story or recognition of that in the newspaper, right?

Whereas, I am saying that if a published paper reveals findings that are surprising or novel there is a better chance that it will go unnoticed (norm vs. exception).

Am I missing something?

WRT to vaccines and the natural infections that they protect against:

It always seems to be brought up the the infection can also cause inflammation or from Krebs recent analysis that it can also modulate the infant immune system, but I guess I have never understood the logic that if the infection can do "it" or worse, then we don't need to understand or study how vaccines may be able to do "it."

To me this is just faulty logic.

This recent abstract that I read was completely in line with how I perceive this.

PMID: 24514081

Part of the abstract from above PMID:

...The risk of onset or relapse of CNS demyelination following infections against which the vaccines are aimed to protect, is substantially higher and the benefits of vaccinations surpass the potential risks of CNS inflammation. This does not in any way exempt us from“learning” the lessons taught by the reported cases and searching new and safer ways to improve vaccination techniques and increase their safety profile.

Does this position make sense to others?

skeptiquette,

Why do you think the authors of the study (2007) I cited above said:
“Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

Did you miss what I wrote above? This study found that the Th2 response observed had disappeared by age 13 months.

Nope, didn't miss it.

Did you miss what the authors concluded?

“Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

There was an early modulation, right? TH2 skewed response through 13 months, right?

So, somehow you know if and/or what the long term consequences of this are?

Please share.

skeptiquette,
This probably isn't worth pursuing but I find your position baffling regarding these two statements:

There are constantly findings that are novel and surprising in all different disciplines that never get press (by press I mean written about in newspapers).

And

Published papers that are surprising and novel are the ones that make the newspapers.

To which you responded:

Aren’t those two statements entirely contradictory/inconsistent?

Not at all. The logic seems crystal clear to me. The only papers that get attention in the press are those with surprising or novel findings. That doesn't mean that all papers with surprising or novel findings make the newspapers, of course they don't. However, papers without findings that are in some way surprising or novel, or controversial are very unlikely to get attention from the media. My point was that the papers we see discussed in the press are in no way representative of the thousands of papers that are published every day.

You are saying that if a published paper reveals findings that are surprising or novel that there will be some sort of story or recognition of that in the newspaper, right?

No, not necessarily.

Whereas, I am saying that if a published paper reveals findings that are surprising or novel there is a better chance that it will go unnoticed (norm vs. exception).

Where do you get that idea from? That's the very opposite of what I see in practice. A quick Google of today's medical news finds:
1. An argument about 2 studies on statins in the BMJ that found, "statins did not reduce mortality and that side effects meant they did more harm than good".
2. Difficulty getting pregnant could be due to stress.
3. California doctors speed up Valley fever diagnosis.
All of these are novel or unexpected, aren't they?

The important point is that you can't claim that a paper has unexpected results just because it exists or has been published in a journal. That did appear to be your argument at #473 when you wrote, "Why do you think that they would study and present results that are “hardly surprising”?"

I just skimmed that follow up study and they do not mention the need for large prospective studies.

So, are you thinking that since they found the Th2 skewing to be transient, they no longer are concerned with large prospective studies?

I understand what you are saying if this is the case.

Gotcha.

This was just a misunderstanding. I understand your position now.

Thanks.

I am in agreement with you.

skeptiquette,

“Large prospective studies would be warranted to evaluate the possible long-term consequences of this early modulation of the cytokine responses in infants”

There was an early modulation, right? TH2 skewed response through 13 months, right?

So, somehow you know if and/or what the long term consequences of this are?

Please share.

The first study found a change in Th1/Th2 ratio, the second study explored this effect further, finding that it did not persist, that, "the global Th2 bias observed in 6-month-old infants vaccinated with a Pa vaccine was normalized at 13 months".

I see no reason to expect a temporary change in Th1/Th2 ratio to have long-term consequences. Do you?

Sorry, cross-posted.

I am really not sure. The immune system during developmentally sensitive time frames is something we are just starting to understand.

I am a bit more cautious than you, and would say that until we have prospective studies examining this, we cannot say one way or the other.

skeptiquette,

WRT to vaccines and the natural infections that they protect against:

It always seems to be brought up the the infection can also cause inflammation or from Krebs recent analysis that it can also modulate the infant immune system, but I guess I have never understood the logic that if the infection can do “it” or worse, then we don’t need to understand or study how vaccines may be able to do “it.”

To me this is just faulty logic.

I don't think it's about logic, I think it's a difference in approach. There are a million things that it would be interesting to research in depth. The problem is deciding which are the most potentially fruitful areas to look at.

I think it's best to look at the data to see what isn't adequately explained by our current understanding, and focus our attention there. I don't see what data it is that might be better explained by a "vaccines cause neurodevelopmental delay" hypothesis than our current models. I don't see any data that supports the hypothesis, and I see quite a lot of data that isn't consistent with it.

Just because something is logically possible doesn't mean it is a promising possibility to follow. If early post natal infection or vaccination was an important cause of neurodevelopmental delay, I would have expected to see very much more developmental delay in the pre-vaccine era and in the developing world, when exposure to infection was and is far greater than in the US. I would expect vaccination to reduce the incidence of these conditions, and I'm not at all convinced we have see any significant changes at all, certainly not in severe autism, for example.

@Krebiozen -

A few (very few) thoughts:

Does the observance of a six month change in cytokine profiles based on vaccine type give us any insight into the broccoli analogy? Presumably the infants in the first study had a lot of *other* things happening during the months following last ap/wp vaccine, but those other insults didn't turn the vaccine type into noise, as you might expect if there were millions of other things also modeling the immune milieu. (?) How should we fit this data into a model that assumes vaccination cannot modify immune systems characteristics other than generation of antibodies?

I see no reason to expect a temporary change in Th1/Th2 ratio to have long-term consequences. Do you?

Again, I think we probably disagree on the right application of the precautionary principle, but my thoughts on this question is that if our outcome measure is neurodevelopment, we might want to express great skepticism at the notion that because we can't conceive of a mechanism, there must not be one. Worse, we have mechanisms by which change can be affected.

Consider briefly some of the studies I referenced previously on microglial participation in neurodevelopment. Those cells, the microglia, are known to change morphology as a function of immune signaling in the periphery. So, *if* we are modifying what that peripheral signaling looks like, and *if* that signal manifests centrally as changes to microglial morphology, how might this affect the ongoing participation of microglia in brain formation? While there are plenty of *ifs* there, I don't think we are nearly clever enough to understand this question and the fact that our existing analysis is based on very imprecise animal models doesn't make me feel any better, if anything, it makes me feel like we are a lot dumber about what's happening than we might want to be.

The development of the brain during infancy is a time of once in a lifetime operations; you get one chance to perform the synaptic pruning that occurs between late gestation and two years of age. There are lots of players interacting all at once; it isn't like a game of solitaire you can leave for a few months and then come back and pick up on. This is why I get a little bit worried with the idea that because a change in the immune backdrop appears transient, that therefore, it cannot be having an effect. You might reply that you think it is unlikely such a change could be occurring, and you may be right, but it is only within the past five years we have even begun to realize microglia could be participating in neurodevelopment at all. Ten years ago if I were to suggest the immune system played any part in brain formation you'd probably have had the same level of skepticism toward that idea.

You might also consider the work that has been done regarding the apparent training of microglia into different states when challenged during critical timeframes. PMID 22322212 is a good review of this.

OK!

pD,

Again, I think we probably disagree on the right application of the precautionary principle, but my thoughts on this question is that if our outcome measure is neurodevelopment, we might want to express great skepticism at the notion that because we can’t conceive of a mechanism, there must not be one. Worse, we have mechanisms by which change can be affected.

Briefly, as I'm not saying anything new, we have mechanisms by which it is very remotely conceivable that vaccines might have some effect on neurodevelopment, I agree. However, I'm not aware of any evidence whether epidemiological or mechanistic, that suggests that they are having any effect. There is a lot of evidence which, taken in its entirety, argues strongly against any such thing happening.

When there is no evidence to suggest something is happening, why look for mechanisms by which it might happen? Isn't this the essence if tooth-fairy science?

You mention the precautionary principle, but no one in their right mind is arguing that vaccines do more harm than good. I think the precautionary principle supports making sure vaccine uptake is as high as possible, and to continue post-marketing surveillance to detect any possible adverse events due to vaccines. Unless and until such adverse events are detected, digging about looking for possible ways in which they might be caused seems to me to be a waste of time and energy.

pD's there-might-be-a-mechanism-even-if-we-can't-conceive-of-one reminds me of arguments currently used by anti-GMOers.

These folks and antivaxers increasingly share much in common, notably FUD-spreading on the grounds that we can't know all the possible ramifications of immunization or genetic modification of foods, therefore it is imperative to be very worried about engaging in either activity (even when it is demonstrated that they are beneficial, have an excellent safety record and there is no plausible reason to think they might be doing the Bad Things detractors believe they are).

Both groups have also taken to epigenetics in a big way. When you can't otherwise make your case, wave your hands about what horrible things could be happening to our genomes years down the line due to vaccines or GMOs (but don't be concerned about the effects of infectious diseases or non-GMO foods).

skeptiquitte: If I were anti-vax to the core, as you promulgate, why would I have had my kids vaccinated?

Possibility 1: You're lying.
Possibility 2: Kid 1 was fine, kid 2 has something (ADD, dyslexia, maybe some form of spectrum thing, asthma or allergies) that you're desperately trying to blame on something, anything, other than your own genes.
Possibility 3: You're a troll pretending not to be one. I personally favor this, since you're really selling the bubbly cheerleader act.

Just to demonstrate how starting with a hypothesis and then looking for evidence to support it can be very misleading, I have decided to do just that with my broccoli-autism hypothesis. I don't believe this hypothesis is correct, but I wanted to show how you can find evidence to support almost any hypothesis you care to formulate.

Broccoli and other brassicas as a possible cause of autism spectrum disorders
We know that the immune system may play an important role in neurodevelopment, for example PMC3059681. Disruption of normal immune processes could theoretically interfere with neurotypical development, leading to autism.

My hypothesis is that potent modulators of the innate immune response system present, in broccoli are readily absorbed (PMID: 17164373) by weaned infants and are very probably present in breast milk of mothers that have consumed brassicas. These immunomodulatory chemicals may interfere with neurodevelopment by suppressing andrgogens and inhibiting the apoptosis of cells that is an essential part of neurodevelopment.

From Wikipedia:
"The 3,3'-Diindolylmethane found in broccoli is a potent modulator of the innate immune response system with anti-viral, anti-bacterial and anti-cancer activity. Broccoli also contains the compound glucoraphanin, which can be processed into an anti-cancer compound sulforaphane, though the anti-cancer benefits of broccoli are greatly reduced if the vegetable is boiled. Broccoli is also an excellent source of indole-3-carbinol, a chemical which boosts DNA repair in cells and appears to block the growth of cancer cells."

PMID: 12665522
"Using fluorescence imaging with green fluorescent protein androgen receptor and Western blot analysis, we demonstrated that DIM inhibited androgen-induced androgen receptor (AR) translocation into the nucleus. Results of receptor binding assays indicated further that DIM is a strong competitive inhibitor of DHT binding to the AR. "

This androgen-blocking property may be related to the striking gender differences in autism, by blocking androgens during normal neurodevelopment. PMID: 21359227 found that retinoic acid-related orphan receptor-alpha (RORA) regulates conversion of estrogen to testosterone:

In addition, we demonstrate that RORA transcriptionally regulates aromatase, an enzyme that converts testosterone to estrogen. We further show that aromatase protein is significantly reduced in the frontal cortex of autistic subjects relative to sex- and age-matched controls, and is strongly correlated with RORA protein levels in the brain.

PMID: 11294972 tells us that DIM in broccoli can affect aromatase activity .

DIM can also affect inflammatory cytokines PMID 18156398:
3,3'-Diindolylmethane suppresses the inflammatory response to lipopolysaccharide in murine macrophages.
" Downregulation of NF-kappaB and AP-1 signaling may be one of the mechanisms by which DIM inhibits inflammatory responses."

This downregulation of inflammatory cytokines at a time of neurodevelopmental sensitivity could prevent the normal pruning of neurones, and account for the extra white matter seen in autism.

PMID: 18840677 found suppression of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced nitric-oxide synthase 2 expression in astrocytes by a novel diindolylmethane analog protects striatal neurons against apoptosis. This supports my hypothesis that maternal or infant ingestion of broccoli during windows of neurodevelopmental sensitivity inhibits the pruning of neurones.

There is also epidemiological evidencethat supports my hypothesis:
"Americans consumed 2 billion pounds of broccoli in 1998. On a per capita basis, this works out to about 8 pounds, which is 34 percent higher than in 1990 and nearly 3 times the 1980 level. "
Autism diagnoses have increased in parallel with broccoli consumption - see http://twitpic.com/dzce0w .

I hope my point is clear.

So, pD and skeptiquette, why are your hypotheses that link vaccination to autism more compelling than my broccoli-autism hypothesis?

Possibility 1: You’re lying.

Im not lying, but It's your choice to believe me or not. I don't care.

Possibility 2: Kid 1 was fine, kid 2 has something (ADD, dyslexia, maybe some form of spectrum thing, asthma or allergies) that you’re desperately trying to blame on something, anything, other than your own genes.

Nope, wrong again. All kids are fine, with no ADD, Dyslexia, Spectrum, or asthma or allergies. (but Im probably lying, right?)

Possibility 3: You’re a troll pretending not to be one. I personally favor this, since you’re really selling the bubbly cheerleader act.

from Wiki:

In Internet slang, a troll (/ˈtroʊl/, /ˈtrɒl/) is a person who sows discord on the Internet by starting arguments or upsetting people,[1] by posting inflammatory,[2] extraneous, or off-topic messages in an online community (such as a forum, chat room, or blog), either accidentally[3][4] or with the deliberate intent of provoking readers into an emotional response[5] or of otherwise disrupting normal on-topic discussion.[6]

I don't seem to fit into any of those descriptions... but I would like the opinions of others that may see this differently.

What the hell do you even mean by "bubbly cheerleader"?

This just seems to be another shining example of how your assumptions and categorization are not in-line with reality.

This chart from the CDC shows 12 doses by 4 months old.
http://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
Look at the contents of these vaccines. Look at the vaccine load at 2 mos.
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipi…
PCV13 at 2 mos. -What the ? casamino acids, yeast, ammonium sulfate, polysorbate 80, succinate buffer, aluminum phosphate, soy peptone broth.
And only 1 vaccine out of the 6 recommended at 2mos.
As I said my children were vacinated years ago on a different schedule with no protests from parents that I could remember.
Where is the science behind this huge increase in doses?

@anon - there is plenty of science behind it, if you'd care to look - even the CDC has a very clear explanation as to how the vaccine schedule came about....also, scared of ingredients?

Perhaps you should do some research on those ingredients and the quantities in which they are used - a good place to start is:

http://antiantivax.flurf.net/

Your fears are completely unfounded....and back in the day, kids were exposed to thousands of more antigens from old vaccines than they are today. Science does indeed march on.

skeptiquite: What the hell do you even mean by “bubbly cheerleader”?

Basically, you type like you're twelve, and the Miss Polly Sunshine act is both annoying and stolen from the (un) thinking moms. No one who's hit 20 uses 'lol' in anything outside of texts.

*Your*- long day and no spellcheck.

anon,

As I said my children were vacinated years ago on a different schedule with no protests from parents that I could remember.

My son was caught up in a pertussis outbreak in the UK in the late 80s. He couldn't be vaccinated for medical reasons, but the outbreak itself was caused by a vaccine scare. Spread by rumor and hysterical media reporting, the belief that the pertussis vaccine caused permanent brain damage led to a dramatic reduction in vaccine uptake. Immunity fell below the herd immunity threshold and thousands of children were infected, hundreds were hospitalized and dozens died. My son was lucky to get away with a few weeks in the hospital coughing until his lips turned blue.

A few years later large studies exonerated the vaccine. All those children suffered and died needlessly, because of antivaccine hysteria, essentially.

So, when someone like you tries to tell me that things were just fine in the good old days, I have to laugh (in a rather bitter way, to be honest).

BTW :

casamino acids, yeast, ammonium sulfate, polysorbate 80, succinate buffer, aluminum phosphate, soy peptone broth.

As a biomedical scientist, none of those ingredients look in the slightest bit noxious to me, in fact most sound very nutritious (my local Japanese restaurant does a fine soy peptone broth, though they call it miso soup). I would happily swallow or be injected with a few ml of any of them.

More on Skyhorse

Hey, they have a new title coming up!

So anon, do provide scientific documentation to support your answers to the following questions:

What is safer for a baby: PCV13 vaccine or a bacterial pneumonia, meningitis or bloodstream infection?

What is safer for a baby to get: DTaP vaccine or a pertussis infection?

What is better for a baby to get: Hib vaccine or a haemophilus influenzae type b infection?

What is better for a baby to get: rotavirus vaccine or a rotavirus infection?

What is better for a toddler to get: varicella vaccine or a chicken pox infection?

What is safer for a toddler: the MMR vaccine or a measles infection?

#482 I am sorry about your son. I never tell parents not to vaccinate. I am not an MD nor am I a scientist. But I read what MDs have to say, like many parents who are not scientists. I cannot evaluate this following link but he makes his case. My granddaughter had a very high fever with the DTap and behaviorial issues afterwards, but she is fine now. http://www.nvic.org/Doctors-Corner/Aluminum-and-Vaccine-Ingredients.aspx
#484 My grandaughter got the DTap-
You are asking absurd questions again.

@Anon - I don't think those questions are absurd at all - what is safer, the vaccine or the infection?

But I read what MDs have to say, like many parents who are not scientists. I cannot evaluate this following link but he makes his case.

Palevsky also insists that peanut oil is used in vaccines and badly embarrasses himself in the process. If you're going to skulking around for antivax gibberish and then say "I can't evaluate it, but MD! MD!", then you're simply being intellectually dishonest.

Come on, anon. You brought the PCV13 vaccine and its scary ingredients. One of which is used in ice cream. Obviously you would never ever feed your grandkids ice cream.

So which would you prefer a grandchild to get: the PCV13 vaccine or the bacterial infections it prevents? Give us an answer, not an excuse.

#487 What I do know are my biases, which are only my opinions and not facts.( I am glad that I am not a pediatrician.) I would never tell any one not to vaccinate. I found the following-
"In 1964 Merck produced the adjuvant 65-4 that contained up to 65 percent peanut oil plus Arlasel A, aluminum stearate, and other ingredients with 13-fold higher levels of antibodies than previous vaccines. During the 1970s and 1980s peanut oil became a common practice and ingredient in vaccines." Heather Fraser in her 2010 book, The History of the Peanut Allergy Epidemic.

@ Narad:

Holy crap!
I suppose that that new title further supports my thesis that Sky Horse indeed prints material not even fit for wrapping fish.

I've had a very long day but staying up and linking to that made it all worthwhile.

http://www.smartvax.com/?option=com_content&view=article&id=73
"In 1964, Merck announced that it had patented a revolutionary peanut oil vaccine adjuvant.  This news was reported in 1964 and 1966 in The New York Times[10] with follow up in medical literature through the early 70s. Merck’s Adjuvant 65-4 provoked such high levels of antibodies – 64 times higher than the same vaccine in an aqueous solution — that any vaccine to which it was added could produce many years worth of immunity. Was this potency safe?  A 1973 WHO report co-written by Adjuvant 65-4 inventor Maurice Hilleman found the use of peanut oil was relatively safe if properly injected to avoid “severe adverse reactions”.[11] But the safety of the adjuvant was challenged by others including D. Hobson in the Postgraduate Medical Journal (March, 1973).  Hobson documented the power of this adjuvant to sensitize recipients to vaccine proteins. This adjuvant created allergies."

“In 1964, Merck announced that it had patented a revolutionary peanut oil vaccine adjuvant....

Thank you for proving my point about intellectual dishonesty. Now show me the part where it was ever used in a licensed vaccine. Would you like a hint?

Oooh, a book! By Heather Fraser, MA, BA, B.Ed... none of those are scientific. And another Skyhorse published book. Really?

We are not interested in your opinions, but just the facts. When you present us with nonsense, you will be asked questions that you need to support with actual citations. Not books by biased parents.

As I recall, the last time I actually suffered going through Fraser on G—le Books, she basically conceded the point. Nice to know that Anon had the copy-and-paste right at her fingertips, though.

I've seen prior posts by "anon" lying about peanut oil in licensed vaccines. Anon and the others who get their vaccine information from AoA, the NVIC and whale.to, have never been able to show us documentation that peanut oil was ever used in an FDA licensed vaccine:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130368/

Well, there is a PubMed link:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192090/

It is an ad.

anon, answer the question: Would you rather a grandchild get the PCV13 vaccine or one of the several bacterial infections it is designed to prevent?

Also, do you also make sure none of your grandchildren get anything with yeast? No bread? No pizza? Wow.

No pizza and ice cream parties at your house.

Why would they be able to run an ad that even remotely looks like an article, including the URL? It reminds me of internet advertising that appears to be an article or the copy being stuck in the middle of the article; so blatantly deceiving that they have to advertise that they are an advertisement.

Why would they be able to run an ad that even remotely looks like an article, including the URL?

PubMed Central simply takes in Canadian Family Physician wholesale, and the journal runs publisher announcements. You can see the entire TOC for this issue here.

Wow.

There are some busy bees posting here this evening, aren't there?

A swarm of them, seemingly.

How nice.

In books, or work, or healthful play,
Let my first years be passed,
That I may give for every day
Some good account at last.

I ain't posting but if I where, it would be at the assh*le who is calling someone or everyone an imbecile.

Alain

Oh, and I lost faith in humanity.

Alain

#495 lilady- the link you provided stated "A comparison was made of the antibody response and subjective reactions to zonally-purified influenza vaccine in aqueous suspension and in peanut oil adjuvant 65-4. Both preparations contained 700 CCA units of A/Aichi/2/68, and 300 CCA units of B/Mass/1/71. Subjective reactions were recorded by asking the volunteers to complete a record daily for 5 days. Pain at the injection site was recorded by 64 per cent of the recipients of the oil adjuvant vaccine compared with 35 per cent of the aqueous recipients, but local redness was more frequent after aqueous vaccine.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2130368/
Was this not FDA approved?

Was this not FDA approved?

You didn't even bother to read the paper, did you? Or notice the title of the journal?

#492 See #502
"Adjuvant emulsions-
"This class includes oil in water or water in oil emulsions such as FIA, Montanide, Adjuvant 65, and Lipovant17. The mechanism of action of adjuvant emulsions includes the formation of a depot at the injection site......
"Adjuvant 65 offers the advantage over the mineral oil used in IFA(57, 58, 59) that it can be metabolized(23).
http://www.nature.com/icb/journal/v82/n5/full/icb200475a.html

#503 Narad didn’t even bother to read the paper, nor notice the title of the journal.

anon: That link I provided to you was for A-65 adjuvant, which was tested on volunteers during the 1960s-1970s. It was never, ever, ever, used in an FDA licensed vaccine.

You should ask Heather Fraser why that peanut oil based adjuvant wasn't approved by the FDA as a vaccine adjuvant.

Look at this. A Federal Regulation about the required listing of all ingredients (culture media, excipients...and adjuvants) in every biological manufactured in the United States. (Vaccines are biologicals, "anon").

http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?C…

Would you like Narad to interpret the Federal Code for you?