Having recently discovered a veritable Library with Doctor Moon of antivaccine misinformation and quackery known as Modern Alternative Mama's blog, Facebook page, Twitter feed, and YouTube channel, I couldn't resist taking one more drought from the same well. It is, after all, almost Christmas, and truly, as far as the blog is concerned, the discovery of Kate Tietje, a.k.a. Modern Alternative Mama, was an early Christmas gift that could not but be opened immediately. Besides, with Christmas coming up in a couple of days, after today I plan on taking a brief blog break until Friday, with the possible exception of a recent recycled & tweaked post (to make it more...Insolent) from my not-so-super-secret other blog that I'd like to expose to a greater world. Merry Christmas and Happy Holidays!
So what am I referring to? Well, it's not as old as the post I deconstructed yesterday, but it's just as nonsensical. Worse, it's a listicle, a particularly annoying link-baiting form of post that generally irritates the heck out of me for its obviousness. On the other hand, most listicles are not as long as this, rarely going above 10 items. It's entitled 15 Things We Need to Stop Saying in the Vaccine Debate, but it might as well be titled 10 Things I Hate About You, the "you" being pro-science pro-vaccine advocates of science, medicine, and skepticism who regularly criticize the antivaccine movement; you know, bloggers like yours truly. Many are straw men, misrepresentations—I'm not sure if intentional or otherwise—of what those of us who counter what antivaccinationists say. Others are science-free ignorant rejections of science along the lines of Tietje's toddler-like attitude of, "I'm not going to vaccinate and you can't make me."
First off, I will say that I actually agree with one item. I don't think that any but rare trolls on "our" side ever say something this stupid, but it wouldn't surprise me if now and then the odd obnoxious git on "our side" says something this monumentally stupid. I'm referring to item #1: “You don’t love your children if you don’t vaccinate.” I've never said it. I don't recall ever having heard anyone anywhere associated with promoting vaccination and countering the pseudoscience, anti-science, and general misinformation of the antivaccine movement actually say such a thing or seen anyone write such a thing. However, I don't reject out of hand that on some rare occasion, someone might have said something. If that's the case, sure. Knock it off. Antivaccinationists love their children too. They might so misinformed or have such denialist tendencies that they willingly (some enthusiastically, like Tietje) leave their children unprotected against vaccine-preventable diseases, but they think they are doing what is best for their children.
Item #2 is "Shame on you." Tietje is clearly very unhappy that some try to use shame to persuade antivaccinationists to vaccinate. While I am ambivalent about the use of shame against the antivaccine movement, my reason is more one of practicality (it probably doesn't work) than because I think it's wrong (or, as Tietje puts it, "rude") to try to shame an antivaccinationist. If a parent is "on the fence" or potentially persuadable, shame is not the first tool that should be pulled out of the armamentarium, although parents who are on the fence are the ones for whom shaming might have some effect. So I don't rule it out entirely. On the other hand, when I encounter someone like Tietje, who is beyond persuading and regularly delivers Mount Vesuvius-like lava flows of burning stupid, I have no problem with telling her she should be ashamed of herself. She won't listen, but she's not the intended audience. The "on the fence" contingent is.
Next up:
#3: “You’re putting your child at risk.”
There is no way to eliminate all risk. Choosing to vaccinate is a risk (an immediate one). Choosing not to vaccinate is a risk (a future one). Getting out of bed in the morning is a risk. Anything at all places your child at risk.
This "logic," such as it is goes beyond Vesuvius-like eruptions of burning stupid and straight into supernova explosions. "Anything at all places your child at risk"? Seriously? Why not, then, fail to use child car seats and then later seatbelts? After all, seatbelts can cause serious injury. Unlike the case for vaccines, we know that people suffer seatbelt injuries. But when weighed against the number of people saved, there's no contest. Buckled up and (if small enough, secured in a car seat), a child in a major car crash has a much higher chance of surviving and a much lower chance of suffering serious injury than unbuckled. One could easily use Tietje's "logic" not to do anything at all ever to prevent disease, injury, or other adverse outcomes. Heck, why get term life insurance? If you're reasonably healthy and not over 60 or 70, your chances of dying in the next decade are pretty small. Take the chance! Or what about health insurance? Why use it if you're younger than middle-aged? Your chances of serious illness are pretty low if you're young and healthy?
The key is that not all risks are created equal. Some are more than others. Getting out of bed is a minuscule risk, for example, compared to getting in your car and driving in traffic. Also, the risk of vaccine-preventable diseases is low right now because vaccine uptake, overall, is high, albeit with the exception of areas populated by know-nothings like Tietje who don't vaccinate. If more people didn't vaccinate, that risk would increase, which brings us to:
#4: “You’re putting MY child at risk. You should vaccinate to protect babies/elderly/immunocompromised.”
This is really two separate arguments. First, if you believe that not vaccinating places your vaccinated child at risk, then why do you trust vaccines? If they work, then you don’t have anything to fear. Second, babies, the elderly, and immunocompromised people are at risk (potentially) from anyone who is sick. Whether they are vaccinated or not, and no matter which illness they have. It’s up to the parents of those people (or the people themselves) to protect them, not ask everyone around them to do it.
Finally, we don’t ask others to make medical decisions that could be risky to benefits ourselves. We each make the medical decisions we feel are right for us, and take on the risk we feel comfortable taking. We can’t, and shouldn’t expect, to control what others do.
This is basically a rehash of her self-centered arguments from the previous post of hers that I discussed, the one that basically says, "I won't vaccinate and you can't make me." As I discussed then, the primary reason to vaccinate isn't to protect other children or to protect the immunocompromised. Those latter two groups are additional reasons that vaccination is important, but, above all, vaccines protect the child who is vaccinated. Secondary, but important, benefits are to protect other children through herd immunity and those who can't be vaccinated. Most parents who don't vaccinate realize that they are not upholding their part of the social contract and tend to be at least a little conflicted about it. Antivaccinationists as militant as Tietje harp on this issue because likely, deep down, they know they are acting as parasites whose children's protection against vaccine-preventable disease depends upon the parents who do vaccinate.
Next up is #5: “Mothers in third world countries would be grateful to have vaccines.” This is a bit of a straw man in that I don't recall anyone ever having said this, but Tietje's response is astounding, namely that these mothers would be grateful to have clean water, plentiful food, access to medical care, and a safe place to live, ranting, "A person literally cannot live without safe water. People can and do live without vaccines all the time." Yeah, perhaps so, but their chances of getting sick and dying from vaccine-preventable diseases are much higher without vaccines. Many will live, but a lot will die as well. Just because it's possible to live without vaccines does not mean it's desirable to do so. Tietje, however, doesn't see it that way:
Plus, those mothers in the third world don’t have any way of doing research. They don’t have access to information. All they know about vaccines is what they’re told. If doctors come into their villages and say, “You need these. They’re amazing. They’ll save your child’s life.” Of course they are going to want them! They don’t have access to another viewpoint!
Except that, sadly, many such populations are prone to a different sort of antivaccine fear mongering, such as claims that the tetanus vaccine is a secret plot to sterilize their girls. Tietje then exults in her ability to "have access to science and information, as well as the ability to make my own decisions about my family’s medical care." Too bad her access to the Internet leads her to major Dunning-Kruger effect action:
#6: “You just don’t really understand science or you would vaccinate.”
This is so unnecessary. It’s an elitist point of view. The only way that a person would opt out or disagree is if they’re too stupid to get it? No.
There are parents on both sides who might have made a choice because they didn’t look into the facts much — maybe their friend or their doctor told them to, so they just went along with it. But there are lots of people who’ve done incredible amounts of research and have come to a careful conclusion.
Saying that their research “doesn’t count” because they don’t have a science background is just insulting — and wrong. People are smart enough to do their own research. They truly are. A piece of paper that says so makes no difference. (Plus, there are lots of doctors and other medical professionals who question vaccines or don’t vaccinate! And they clearly understand the science.)
No, it is not "elitist" to say this. It is a simple and accurate pronouncement of Tietje's lack of understanding of science and how little antivaccinationists understand vaccine science. Moreover, Tietje's research actually doesn't count, as much as she tries to claim that it does, because, based on its content, it is obvious that it comes from dubious sources spouting pseudoscience and misinformation (which she parrots). A key feature of the Dunning-Kruger effect is that a person suffering from the effect is ignorant about a subject but thinks she is not, indeed might even think she has become an expert in it. In other words, Dunning-Kruger involves a massive overestimation of one's understanding of a topic or competence at a task, which is in marked contrast to true experts, who tend to underestimate their knowledge and competence. In Tietje, the Dunning-Kruger gets to the point where she thinks her University of Google knowledge trumps the knowledge of physicians and scientists (see item #7, which I won't discuss but flows from this item). To understand medicine, immunology, vaccine science, and infectious disease requires a lot of research. As I've described many times, frequently it is the intelligent, college-educated people, some even with advanced degrees, who are prone to Dunning-Kruger, because they grossly overestimate their ability to "pick up" an unfamiliar subject on their own.
Quite frankly, I've concluded based on perusing her writings that Tietje herself is too stupid to get it. I could be wrong, but, if I am, certainly her writings won't disabuse me of that conclusion. However, it's a straw man to say that we argue that people don't vaccinate because they're too stupid. Again, the "best" (i.e., the most effective) science denialists are usually the ones who are the most intelligent, the ones with advanced degrees. Denialism is not a product of lack of intelligence, although, as Tietje shows, there are clearly exceptions.
Next up is #8: “Just walk through a graveyard and see all the babies that died 100 years ago because we didn’t have vaccines.” According to Tietje, this isn't because of lack of access to medical care, emphasizing "There are a whole bunch of reasons why babies died more frequently 100 years ago, most of which are not related to vaccines." She even throws in the intellectually dishonest "vaccines didn't save us" trope. Here's the problem. It's easy to find examples to refute this. Polio killed and paralyzed many thousands throughout the 1940s and the 1950s, many in cities. Does Tietje think polio victims didn't have access to medicine and clean water? Of course they did. It wasn't until after the introduction of the Salk polio vaccine that polio incidence and mortality plummeted. Ditto haemophilus influenza type B (Hib), which was killing children until 20 years ago. Pediatric medical care was quite sophisticated then, and these children also had access to clean water, but Hib incidence and death didn't plummet until after the vaccine was introduced.
I'm getting tired now, and the rest of her items are a grab back of typical antivaccine tropes. In one, she pontificates that if someone dies of a vaccine-preventable disease, there's no guarantee that the vaccine would have prevented that:
But. There’s no guarantee that vaccines would have prevented the death or injury. Vaccines themselves don’t come without risks (yes, people can and do die from vaccination, too). I understand it’s really hard if you know someone personally who was disabled or killed by an illness, but this is a purely emotional reaction, not a scientific one.
An emotional reaction? Not a scientific one? Irony meter overload. Again. Seriously. There's never any guarantee, but the person's chances of never acquiring the infection would have been far higher if that person had been vaccinated. No vaccine is 100% effective; expecting 100% efficacy is the Nirvana fallacy.
Tietje also regurgitates the "#CDCwhistleblower" myth in her post:
#14: “Vaccines do not cause autism. End of story.”
Ah, not quite. Or, well, not at all.
It’s recently come out that a key study that the CDC used to “disprove” a link between vaccines and autism was falsified. Statistically significant data was omitted from the results. That data showed a 340% increase in autism among African-American boys when they received the MMR prior to 36 months of age, instead of after. One of the lead researchers, Dr. Thompson, admitted this in a public statement.
It’s also true that a number of other studies show links between ingredients in vaccines and autism, or similar neurological disorders.
These other "studies" tend to be of very poor quality and performed by scientists who have drunk the antivaccine Kool Aid. I've spent a lot of time deconstructing many of these studies. As for the "CDC whistleblower" thing, no, no, no, no, no, no, no, no, no.
Next:
It’s also true that we’ve done very few studies on the link, the studies have been (generally) poorly designed, and that we have never done a vaccinated vs. unvaccinated study. This question is far from settled, but from the evidence we do have (scientifically and anecdotally)…we can say, yes, vaccines do cause autism.
Not everyone, obviously. Certain people are more at risk than others. But just like we say that cigarettes cause lung cancer (even though many people who smoke do not develop lung cancer), vaccines cause autism.
Wow. This is some major misunderstanding of epidemiology. Yes, many people who smoke don't get lung cancer, but the relative risk of lung cancer associated with smoking is so high that it has been easily detected many epidemiological studies. In fact, we frequently say that "correlation does not equal causation," but when the correlation is as strong between something like smoking and a disease like lung cancer, it's hard not to infer causation, particularly given that causation has been supported by multiple other lines of evidence and it's impossible to do a randomized controlled trial of smoking versus no smoking to nail down causation absolutely.
In marked contrast, there are no high quality epidemiological studies that demonstrate that vaccines are associated with a detectably increased risk of autism. Quite the contrary. As I've described more times than I can remember, every well-designed large epidemiological study looking at the question has failed to find a statistically significant link. Tietje is, quite simply, wrong. As for the "vaxed versus unvaxed" study, it's not the panacea that antivaccinationists think. They always either deny the unethical nature of doing a randomized "vaxed versus unvaxed" study and/or greatly underestimate the expense and difficulty of doing an epidemiological "vaxed versus unvaxed" study.
I'm tired now and have to get to work. (I did part of this last night and the rest in the early morning, before work.) As I've shown, Tietje's torrent of antivaccine misinformation is truly epic. Feel free to add your own responses, particularly to items I "neglected." And Merry Christmas and Happy New Year! I'll be back with new material on Friday. Probably. It depends on the amount of celebration that goes on the next two days.
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The argument that better food, healthcare and sanitation caused the drop in vaccine-preventable diseases is particularly irksome to someone who, like me, was born in the 1950's. Guess what? We had clean water (and indoor toilets! I didn't routinely have to dig my own lavatory facilities until I joined the Marines).
We had safe, healthy food -- in fact my diet as a child was probably healthier from a sugar/fats intake standpoint, as my mother was a Depression baby and was trying to raise seven kids on an assistant professor's salary so we rarely had desserts and never had sodas/sweets except at holidays.
And we had a family doctor, annual checkups, the whole 9 yards. Are there people out there who honestly think that middle-class families in the US in the 50s and 60s were living in squalor?
Like Shay, I'm from that age group and my family was/ is semi-posh; I was probably what anti-vaxxers would call dangerously over-vaccinated ( because of lost records** - by parents AND doctors, school/ university in farflung locales) and I later worked with clients with compromised immunity.
The other day I had a conversation with two of my slightly older cohorts and discovered that - unlike them- I had only two VPDs: chickenpox ( which was not much) and measles ( which was so horrible that my recall is based on others' recollections, not my own- that month is nearly a blur to me). I believe that I had influenza twice ( age 12 and 40-something) but wasn't ever tested.
And unlike anti-vaxxers' expectations, I haven't been sick frequently, I have only very minor allergies and I'm the near reverse of autistic ( according to ASQ)
** my birth certificate ( a copy) looks as tho' my mother printed it up herself by hand.
About #6:
Some anti-vaxxers turn that on its head by insisting that THEY have the True Science (tm) and the True Facts (tm). I listen to endless slipshod reasoning courtesy of PRN that encourages doubting SBM and substitutes instead work by AJW, Lucija T, Blaylock and various others.
THEY have science on their side.
Also, IIRC, her better hygiene hypothesis kinda breaks down completely in the case of polio. Improved living conditions actually led to more severe cases of polio, since people were being exposed later in life, rather than as infants.
Can't believe Orac has missed this little gem.
Might come as a bit of a shock to Tietje, now that the perspex box with the fairy lights inside (how seasonal!) is on her case, she wont know what hit her.
@ Fergus:
She is target-rich- calls herself 'MAM' and her last name mean similarly in Dutch.
What's a reliable source for stats on injury and death due to vaccines? HRSA? http://1.usa.gov/1zfC3Dd
They hygiene hypothesis as put forth by antivaccinationists is so intellectually dishonest that as an epi it completely offends me. Yes, if you model the curves you can see a slight drop off and leveling of disease incidence with the advent of modern sanitation but it was by not means a cure. They also seem to conveniently "forget" to put in where the vaccine was widely released when suddenly the curve takes a sharp plummet. Since most of the time that is decades after the advent of modern sanitation it is intellectual dishonesty to the extreme to say that suddenly (and coincidentally right around the time the vaccine was introduced) modern sanitation saved us all from the scourge of measles (or insert VPD of choice). Happy Holidays Orac and enjoy your vacation.
Lava fans may want to check out Erik Klemetti's blog "Eruptions" on Wired; there are at least three major lava flows going on right now, Holuhraun in Iceland (biggest lava eruption in Iceland since the 1780s), Fogo in the Cape Verde Islands, which has eaten several villages so far, and the seemingly endless eruption of Kilauea. Klemetti links videos -- how can one not love videos of lava? Vesuvius itself doesn't produce that much lava -- it's mostly pyroclastic flows.
Any and all would be apt similes for the torrents of burning stupid under discussion.
Al the best of the season to the various regulars -- hopefully I'll have some good stupid jokes for you in the new year!
Unless that involves public schools, of course.
I'm sure those of us that suture wounds (me occasionally, others maybe daily) here have always wondered if we've proven that sutures are safe and effective. I mean, really--has anyone every done a "sutured versus non-sutured study": http://thespudd.com/its-time-for-a-sutured-vs-unsutured-study/
I am a mother of a vaccinated 7-year old and a non-vaccinated 2-year old. Some of my relatives call me irresponsible and accuse me of performing an experiment to my children's expense. But to me it is evident, that the outreaching effects of vaccination aren't even close to be known. You can't dissesct a body into that close and permanent to litterary follow the substances through the body. some stay there for good. therefore I choose to wait with vaccination. of course there is a profit to vaccination, considered epidemically. and I am glad for the grace of "late birth", that letal diseases aren't that often encountered in the society I live in. and of course should polio vaccins be available immediately and sufficiently in regions where it is reported. nevertheless I sense as a mother an inner aversion against any invasive act to the body, that is not necessary, but often enough due to scientific curiosity and to pharmaceutical-industry-interests, and not to hippokratic service to humankind.
Chris @11 -- of course, if you're a physician with a small wound in an easily accessible place on your body, you can always suture self.
Well, Jo, you must be pretty torn when your children get scratched by a rose thorn, or puncture their foot on a hidden twig or somesuch. What to do? Is that a natural invasive act? Will you take your chances with natural tetanus? Genuinely interested how you extrapolate your natural mommy aversion senses.
Jo: " of course there is a profit to vaccination, considered epidemically."
Oh, do please tell us! Show us how Big Pharma gets less profits when we have to treat diseases instead of preventing them. As a a parent of someone taken to the hospital due to a now vaccine preventable disease, I would really love to know how much more cost that vaccine would have been compared to the ambulance ride and hospital costs. Please provide the verifiable economic data to show vaccines are more costly than treating diseases, something like this:
Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009
"and I am glad for the grace of “late birth”, that letal diseases aren’t that often encountered in the society I live in."
News flash! That is because most of the people around you vaccinate their children. Have you thanked your responsible neighbors for protecting your younger child by vaccinating their families? Really, you should.
In the mean time, it seems there have been a few cases of SSPE in Germany. Here is a German language video of one child.
How come my comments with the links to the very wonderful "Just the Vax" blog do not even appear?
One of the bloggers there is German, and she has several posts of the problems with kids getting sick in Germany.
Shay @1
This person born in the mid 50s attended a one room school for grades 1 through 3 which had outdoor toilets. We had to stand the outhouses back up after Halloween. However, I only had to walk about a half mile to school and it was not uphill both ways.
I got a smallpox vaccination in that school and it didn't take, so I am glad that smallpox has been eliminated.
My mom's throwing this link around facebook: http://vactruth.com/2014/12/12/10-reasons-not-to-vaccinate/
I know there's stuff out there to refute all the points, but I'm curious if anyone has done a direct point by point smackdown on this piece of feces like Orac has done here for another list.
Mom is a scary example of crank magnetism. YEC, fundamentalist Christian, Organic Vegan, Essential Oils Using, Vaccine Denying, GMO's Cause Cancer nurse.
A friggin' nurse. >.<
Have you had the unfortunate experience of reading her book yet? It's fairly awful. I managed my way through it (for science) and wrote about it here: http://www.insufferableintolerance.com/a-practical-guide-to-sticking-to…
She has also penned a post entitled “Rejecting Modern Science“ of which I attempted to refute (http://www.insufferableintolerance.com/rejecting-modern-science-why-the…). MAM is pretty vile and I rarely use that term. She's proudly wilfully ignorant, arrogant and has unfortunately wrangled her way into a position of authority for mothers.
Off topic, but is anyone else wondering about the photo that accompanied this and yesterday's article? Bare hands, a ring, and worst of all, it appears the left thumb and forefinger are touching the needle. Isn't this a disregard of sterile technique?
I wish Jo would look at the relative risk of vaccinating vs. failing to do so. And do a decent search for the lack of association between vaccines and autism. The question of tetanus is a good one, and I hope she answers it. She'll feel terrible if the child becomes deaf as a consequence of getting measles, or sterile from the mumps... Why is that not a factor in her decision? While railing about vaccine side effects, they often ignore disease side effects, thinking measles just means a rash and not hospitalization for meningitis or pneumonia. Self deception is truly sad. Does Jo think the older child was vaccine-damaged?
" However, I only had to walk about a half mile to school and it was not uphill both ways."
At least admit that it was in the snow.
Shay @22
In the winter it was in the and through the snow as I walked across a hayfield.
My grandma used to knock over the outhouses on Halloween. She also hid a live snake in the schoolteacher's desk once; I think she was personally responsible for driving away several teachers.
Re. 'You don't love your kids if you don't vaccinate.'
OK, we should knock it off with that.
But how about this?: 'Sure you love your kids, even if you don't vaccinate them. But just because you love them, doesn't mean your judgement is so smart. You'd love your kids even if you gave them packets of cigarettes for Christmas, and that wouldn't be very smart either. Next question.'
Cloudskimmer: The position of the vaccine administrator's fingers certainly do appear to be touching the needle and the picture doesn't portray proper technique for administering a vaccine via the subcutaneous route, or the intramuscular route:
http://www.immunize.org/catg.d/p2020A.pdf
OSHA does not require use of fresh clean gloves to administer vaccines. Hand washing or alcohol-based hand cleaner is required:
https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIV…
Orac wrote:
I'm going to argue that statement is problematic, argue for the effectiveness of shame. Part of that argument is that while Ignorance or stupidity are not shameful in and of themselves, denialism fueled by selfishness flying in the face of established fact and the principles of logic —“I’m not going to vaccinate and you can’t make me" — is shameful indeed. I'll return to how that works for fence-sitters after attempting to add a voice in chorus to Orac on just how denialist Modern Alternative Mama actually is. You can skip to the break below to get right to the shame argument if you like.
To me, a sign of medical denialism is when even I — totally averse to statistical calculation, and with but a thimbleful of knowledge of the science — can see the fallacies sticking out like nasty compound fractures.
"There is no way to eliminate all risk." Therefore risk is always present. Therefore the mere presence of risk cannot be a determinant in the variability of health problems. As we know from valid empirical data health problems vary, that "all risk cannot be eliminated" is meaningless even if true.
"We don’t ask others to make medical decisions that could be risky to benefit ourselves." Yes we do, in that we fail to demand medical insurance be outlawed, and also by our own participation reinforce a pooling-of-risk that allows insurance companies to demand patients make medical decisions that benefit the bottom line of insurance companies.
"We each make the medical decisions we feel are right for us, and take on the risk we feel comfortable taking."
I should just laugh hysterically, but for the record, the under-or-uninsured are not comfortable, and kids who get pertussis/measles etc. aren't making their own medical decisions.
"Saying that their research “doesn’t count” because [people doing it] don’t have a science background is just insulting — and wrong. People are smart enough to do their own research. A piece of paper that says so makes no difference."
Absolutely 100% correct, and science absolutely agrees — which means this point is a straw-man, irrelevant to the claim "anti-vaxers understand science because they do research" for which it is offered in support. The premise of science is that validity of results depends on methods applied, which anyone is potentially capable of following, if only by accident. Research counts or doesn't count depending on whether the research meets tests X, Y, Z, not the researcher. Hedy Lamarr's estalished credentials were limited to her ability to be the source of the most smokin' hawt photographic images of a woman known to Western Civilization when she invented (along with musician George Antheil) frequency-hopping spread-spectrum technology. Meanwhile, lots of folks with pieces of paper that say PhD, have cranked out research that proved to be piffle. This isn't really Dunning-Kruger because experts can make the same mistakes as amateurs. Anti-vaxers really don’t understand the specific bits of science that matter. That doesn't mean they're too stupid to get it. It means not getting it is all that matters, regardless of what or how much 'research' they've done.
"We’ve had major advances in medical science that allow us to treat diseases differently so they’re NOT deadly anymore."
Umm, Kate, you're missing an 'as'. You know it's supposed to be there. It's "not AS deadly anymore." It's not an everybody dies or nobody dies dichotomy. There are things called "odds".
Anyway, this one's my favorite:
You might miss the larger logical fallacy one while facepalming manglings of fact, e.g. 'reports of death from vaccines' =/= deaths from vaccines. But pretend everything she said is TRUE: thousands have been permanently damaged from vaccines; reactions are more common than even trained Doctors know; and severe complications from VPDs occur at very low rates. That would prove exactly nothing. You can't compare raw numbers to percentages. The incidence of 'reactions' says nothing about the incidence of 'permanent damage'. And 'permanent damage' could include results that are trivial compared to 'severe' complications. I don't need to have a science degree, or be as smart as Hedy Lamarr to see the BS here — in this case language skills sufficient to teach High School English will do. Those very, very rare 'severe complications' could still be vastly higher in number than equally severe 'permanent damage', depending on the size of the relevant domains being considered and the actually frequency of occurrences expressed as percentages.
Never mind that "children who have died or been permanently damaged by vaccines" would have to exclude autism, the un-named elephant in the room, since no one knows what causes autism, or even if autism is a unified thing with any uniting causal factors — an actual disease — as opposed to a description of a fairly wide range of similar traits, any of which could have an unspecified number of causes.
See, the High School English teacher knows "Vaccines do not cause autism," is ambiguous wording, ripe for what logicians call an 'equivocation fallacy.' It could mean 'Vaccines are never a causal factor in any single case of autism" which would be false (because it's a negative) but insignificant because it would not establish "Vaccines have ever been a causal factor in a single case of autism." Or it could mean "Vaccines are not a measurable causal factor in the general incidence of autism." Which is unquestionably true, as to claim otherwise, you first of all would need to demonstrate a consistent pattern of correlation across a statistically significant number of reproducible at least reasonably well designed studies, not just one fraud and one easily debunked interpretation of tortured data.
••••••••••••••••••••••••
Which brings us back to Orac's thought about shame, which I fear is also, alas, both too absolute and too ambiguous at the same time. The question is not whether shame is the first tool grab, but how useful a tool it is. The question is not whether that tool should be pulled, but in what way it might best be used —who gets the shame under what conditions.
So, to start with a no-brainer: shaming parents for questioning vaccine safety — for being fence-sitters instead of having already gone to the science and figured it out for themselves — is stupid, immoral, counterproductive and must be TOTALLY avoided at all costs. But 'shame' is not just something you've earned or not in the present. It's something that can and will fall on you, and super-glue itself to your heart, if you do bad things, no matter how good your intent. Your ignorance is not shameful. But if you hold onto it against reason, morality and compassion... shame will surely follow.
Of course, I don't know if/how such an approach would work with Jason and Tanya Fencesitter, and I'm just tossing out ideas for discussion. (I don't imagine a chat with a PCP would necessarily be the most effective or efficient way to deliver such a message, for example). I've tried to be as manipulative as all hell, but honestly so. I want to scare the bejeebers out of Jason and Tanya with the PROSPECT of shame, without shaming them in the least in the here and now, and presenting them with the face of compassion for THEM — not just kids — instead. Because, really, they ARE vulnerable too, potential victims of MAM-mania with psychological consequences I don't want to even begin to think about. So I want them to think about the fact they don't want to face bearing those consequences either.
There's some 'science' in my example I'd guess they don't teach in med school: the power of identification is an established and well-researched principle in communication and persuasion. The folks at Texas Children's appear to have engaged highly-skilled professionals — the booklet is a STORY not a study; it's UNTOLD so there's no shaming the reader for ignorance going in; it's full of pictures of individual people; everyone has a name, and the names are used as chapter titles. Names take ideas out of the abstract and make them concrete. Thus, I have my imaginary talk-to-the-Fencesitters employ names at every possible opportunity.
The Untold Story opts for restraint instead of going as hard for the gut as it might have. It could have included parents who had refused or delayed immunization and are now mourning the loss of a child to VPD. You know such folks exist. The authors obviously felt it was unwise to go there directly, and better to let the readers figure the connection out for themselves. So there's probably an argument my hypothetical pushes them too hard in that direction.
A question I'm asking myself, though: if I had permission would I use the Baltimore pediatrician's name? Would I make 'him' concrete? He's my shame-scare, the one who should have known better, the one whose ignorance or inattention cost the Palmers the best chance to save Breanne's life. Is he best left to a vague imaginary? Or would I name him if I could? Would I attach a picture of a face trying to look stoic but worn by remorse to the name?
I wonder what physcians and sbmers feel about the Palmers' story being included in the booklet, becoming Told, since it hinges on the failure of an sbm practitioner. I think it's actually a good thing they included that, because if parents accepted the authority of their individual doctors, if they distinguished between the credence attached to an M.D. and some 'doctor' of vitalism or some righteous Warrior-Mom-Knows-Best Facebook club, they probably wouldn't be fence-sitters in the first message. The message they need to hear is, in fact I think, the message of science: anybody can be wrong. Science isn't about a single expert, even when that expert is a schooled and rigorous in that expertise as any individual can be. It's about crowd-sourcing in a community of qualified experts. It's about meticulously checking the results, doing the work again, results so reproducible the experts reach consensus. One pediatrician can be wrong. 50,000 warrior mom's can be wrong. 5,000 pediatricians charged to double-check the work? I doubt it.
But I propose that all the scientific consensus in the world won't persuade non-scientists unless they understand the thing the consensus is about in human, personal, emotional terms — what it means for THEM as feeling subjects. If the prospect of shame can be leveraged for that, I say go for it.
I also invite comment on a tactic that came to me in writing this, which I fancy to be rather inspired (if I do say so myself): mediating the voice of medicine debunking the anti-vaxers through the voices of truly thinking parents. Parent-to-parent, translating the science-talk into parent-talk (with all the proper citations, natch.) It strikes me that a couple celebrities could be enlisted as interrogators along with the 'regular folks' for the PR value (which might be considerable). Thoughts?
Happy Boxing Day.
Sadmar @27: Brilliant. Just super. 'The prospect of shame/guilt' and what you said about translating science to parent-speak. YES. And it's less manipulative than the vast majority of major media. Win/win solution.
Sadmar@27: Fantabulously unethical. Sets off all the "FIND A NEW DOCTOR" alarms. I vaccinate my kids, and if I got anything like that brochure, I would be on the hunt for a new pediatrician.
When I take my kid to a doctor, whether it's a well-child or a sick visit, and my doctor suggests a course of action, I want them to make a recommendation. Do absolutely not give me this bullshit about how you're giving me all the information and letting me make the choice, because my first, my VERY FIRST question is going to be "what do you advise me to do?" And that's not because I'm an ignorant sheep who doesn't research or ask questions or care to understand. It's because I pay the doctor to be the expert on this. I have a master's degree and a professional license in a field of my own. It is my job to make informed recommendations to my clients. It is my doctor's job to make informed recommendations to me.
Also, I really don't want to have things explained to me by people who didn't understand it themselves, but grilled some people who did until they thought they maybe understood it. I'll sit here in the office and the person who actually understands can dumb it down for me right there on the fly, and I can ask the questions *I* have. Including "is it a good idea to give our baby, with an ear infection, a flu shot right now at the pediatrician we're seeing about an acute issue while on vacation, or does it make more sense to wait and get it at our next WCV, from the doctor at home?" I take flu pretty seriously, but I'd go with the doc at home, personally - and I'd think the next WCV (never far off for a child under 18 months) was soon enough for a second opinion.
Sending people home with a reading list (if it has 21 pages it is not "short"), and instructions to make another appointment is a great way to lose them to follow-up, and assure they get no vaccinations at all.
I haven't heard of Breanne Palmer, but I'm guessing the story is that she didn't get a flu shot from that pediatrician in Baltimore, and then she died of the flu. Poor baby, but not exactly a casualty of the anti-vaccine movement if, as I suspect, her parents chose to have the physician they saw for an acute issue stick to the acute issue, and defer preventative care to their usual pediatrician.
Lurker: The problem is that while most anti-vaxxers love their kids, that love is conditional. As soon as the kid becomes imperfect (read disabled) the love goes away. Makes me really wonder if any of these high-strung anti-vaxxers could raise a deaf or a blind child- or if they'd drive out to the nearest cornfield. And we obviously have ample proof of how anti-vaxxers are failing at raising their autistic children.
Ok, so moderation didn't like my last comment. I'll try again.
Lurker: The problem isn't that anti-vax advocates don't love their children. The problem is that their love is conditional. We've all seen what happens when high-strung people end up with autistic children or children with learning disabilities/mental retardation. They tend to start shortchanging the kids, trying "cures" on them, or deliberately sabotage the children. The damage these people could do to a kid that's gone deaf or blind or who developed brain damage is a big concern. And raising a disabled child in a Quiverfull family simply can't be done.
@PGP:
I know a family with more children than you have fingers that has a severely disabled child that they've raised just fine on a single salary. They're not Quiverful by any means, but you'd probably not see the distinction with their actual beliefs particularly meaningful. Consider your thesis disproven.
@PGP - Be wary of any claim that certain groups of people don't love their kids, or love them in a lesser fashion than they should. Those claims get thrown around a lot. (I didn't want my children's sex announced at ultrasound, because I preferred to wait until birth to find out. I don't love my kids. Since then, I have Not Loved my kids by having an epidural, sending them to daycare, using formula ever at all, CIO sleep training, public schools, every media choice I could even possibly make, and several things about nutrition.) As a parent, you don't so much learn to tune these accusations out as to treat them as red flags. You think anti-vaxers only conditionally love their children? Have a flag. We'll step around you like a landmine, whether or not we vaccinate.
I am rather high-strung myself. I know a number of other high-strung parents, in both vaccinating and non-vaccinating flavors. High-strungedness seems to me to be distributed generously among the population at large, no less likely in any one belief group than in the others. Plenty of high-strung parents make this personality trait work in their children's favor - being easygoing won't always get you what you need out of schools and health insurance companies.
I hope the Russians love their children too.
Just sayin'.
Elizabeth: "You think anti-vaxers only conditionally love their children? Have a flag."
You seem to think I'm pulling these ideas out of my orifices. Do some reading at Thinking Mom's Revolution, Age of Autism or other anti-vaccine websites, and tell me I'm wrong about those parents. I agree parenting is tough, and I usually try to be non-judgey, but in general, the anti-vax parenting community- or at least, the online parts of it, are pretty toxic and awful.
Just the stats: Can they get whatever devices the kid needs on a single salary? Or do they have to choose- glasses but not hearing aids, for example, or surgery vs. wait it out and pray? And how often do the other kids have to play caretaker when Mommy has another baby?
I'd say that's a fairly reliable source for statistics; however, it's important to not just look at statistics, but understand what they mean.
For instance, antivaxxers often cite the total amount paid out by NVICP over twenty-five years of the program's existence, but I've never seen one of them put that in the context of the much much MUCH larger figure of how many vaccinations were given over that time period. If you simply take that total payout figure and you DON'T put it in that context, you're being deceptive.
Regarding Elizabeth A. @ #27
"I vaccinate my kids, and if I got anything like that brochure..."
If she vaccinates your kids, she wouldn't get the brochure.
"my VERY FIRST question is going to be 'what do you advise me to do'?"
Imaginary Dr. said: ...And because of what you’ve told me... You know my medical opinion... The Fencesitters didn't ask and the Dr. told them anyway.
"if it has 21 pages it is not “short”... I haven’t heard of Breanne Palmer... not exactly a casualty of the anti-vaccine movement..."
Elizabeth's brilliant critique of Untold Story, which she has not read, fits with her not-having-read my comment:
The Untold Story isn't just tossed out into the universe willy nilly. It's for fence-sitters who are deciding whether or not to have their children immunized. It's 44 pages, lots of photos, 15 pages of actual copy, just over 6,000 words. The Palmers are on p. 21. If you're pondering the wisdom of getting a flu shot for baby S., and the relevance of "she didn’t get a flu shot from her pediatrician and then died of the flu," escapes you, well then you'd be the kind of thoughtless parent too bothered to look over 15 pages of copy on a life-and-death issue for your child anyway.
"I suspect her parents chose to have the physician they saw for an acute issue stick to the acute issue and defer preventative care to their usual pediatrician."
I got that wrong (apologies to all). It was the Palmers usual pediatrician at home that declined to give Breanne the flu shot due to the ear infection. The acute condition on the trip to Maryland was the flu. The Baltimore pediatrician addressed the acute condition by prescribing antibiotics. Not being a Dr., I don't know what responsibility he has for sending home a 15-month-old with a fever of 101° from a viral infection with nothing but antibiotics, or if some other intervention could have saved her life at that point.
"I take flu pretty seriously, but I’d go with the doc at home, personally."
And since Elizabeth has not bothered to read The Untold Story, she has just retroactively sentenced Breanne Palmer to death.
"I really don’t want to have things explained to me by people who didn’t understand it themselves."
As Elizabeth is apparently too busy using her master’s degree and professional license to make informed recommendations to clients who have to take her expert opinion as the final word as they are too busy, bored or dumb to understand it themselves, she apparently takes an understanding of how vaccines work as over her head, and thus being incapable of being researched, checked and verified by a non-doctor, even under the guidance of a team of medical experts.
More crucially, Elizabeth remains clueless that the issue is not about HER, and what SHE wants. It's about doctors being able to persuade people who already know their physicians' opinion, and are already unconvinced by the mantle of expertise.
"I haven’t heard of Breanne Palmer, but I’m guessing the story"
Ignorance of Breanne Palmer does not keep Elizabeth from guessing, despite the link to the details being right under her nose, and by "guessing" she's I'm 'guessing' she's employing a figure of speech that means 'I'm pretty damn sure.' (If she was really just guessing I'd guess she would have clicked the link first.)
On this blog, Monday 12/29/14, a noob anti-vax blogger at dinnerforthought.com has been 'nominated' as Dunning-Kruger Rookie of the Year. Orac wrote of this fellow, "The arrogance of ignorance is strong in this one. Very strong. Worse, he’s proud of it." And here's Elizabeth making dinnerforthought.com-guy look like a rank amateur in boastful arrogant ignorance. But there's no Dunning-Kruger here. D-K demands at least a brief seminar at Google U. before bloviating. Elizabeth looked-up NOTHING before bloviating. About Breanne Palmer. Who's dead. Who spent the last days of her 15 months of life vomiting and burning with a fever of 107° as the virus attacked her heart and brainstem. Because her pediatrician didn't give her her flu shot. Because the pediatrician was misinformed about vaccines.
[i am rendered mute...]
@PGP:
If you're thinking along the lines of glasses and hearing aids, you're not thinking nearly disabled enough, but yes, she seemed to have everything she needed. I seem to remember them saying that she had to have surgery when she was quite small, but I can't say for sure. They were of a denomination that believes that God doesn't usually help people that haven't done all they can to help themselves, so they wouldn't be likely to take a pray and wait strategy. I'm not privy to the details of their daily lives, so I can't say if the other kids have to "play caretaker," but I can say they appeared to be well adjusted socially, not overstressed, and to be having their needs met.
@PGP. Do forgive me for believing that what you wrote might be representative of your overall point. Clearly, this has led us both into misunderstandings. If I had read your link, I would not have shared your own errors in regards to the story at the heart of the narrative, which would have saved us all some trouble. Perhaps you will accept this as a parable on the problems of taking one's understanding from someone who has taken their understanding from a third party - which is the heart of my objection to asking anyone to make a medical decision on the basis of information obtained from a document created by someone who questioned someone else about the issue.
Not being a Dr., I don’t know what responsibility he has for sending home a 15-month-old with a fever of 101° from a viral infection with nothing but antibiotics, or if some other intervention could have saved her life at that point.
That fever wouldn't warrant a whole lot of concern by itself. Without information about other symptoms that the baby in question may have been presenting, it's impossible to say what could or should have been done. I am not a pediatrician myself, so you are free to doubt what I say. "That fever isn't a concern by itself" is the response I have received from every conceivable source when it has been my child with the fever.
You seem to want to serve up a narrative that is (a) gigantic, and (b) nakedly emotionally manipulative, to parents with doubts. You would like to reject my rejection of this piece because of the fact that, since I already agree with your position, I wouldn't be subjected to it. It is therefore not about me.
I disagree that this is not my concern. I am the parent of small children, who go to school. I am also a cancer patient. That means that, sometimes, I have run children of my own back and forth to buildings full of other children, who may or may not be vaccinated, while immunosuppressed. I walk into those buildings every day during the school year, and wait with my kids for the opening bell. I live with the darling disease vectors, and there are limits to the effects of good hygiene. Our family delayed some vaccinations for our kids because my oncologist was concerned about my exposure to viral shedding during parts of chemotherapy. It is in my best interests for as many people as possible to vaccinate their children because my kids can't always be completely vaccinated, and because I can't always be either. Herd immunity is our best bet.
For that reason, I have opinions about the persuasive strategies used on parents who are reluctant to vaccinate. I want the strategies to actually work. I think they would be more successful if they weren't insulting. I think they would be more successful if they weren't nakedly emotionally manipulative - I see that you claim that the authors of The Untold Story exercised restraint in that area, and I even believe they exercised some, but in my opinion: not enough. The parts of the document quoted here are immensely emotionally manipulative.
I am the choir for this message, and you are preaching the message in a way that causes me to reject it. That suggests that you are doing something wrong.
Of course, it may not be you. It may be some other idiot who thinks that anti-vaxers respond well to condescension. There is nothing I love more in life than giant .pdf files full of folksy, good-humored guilt trips, so as soon as I am done with all the concerns that press on me more urgently, I will give your link all the consideration it deserves.
Justthestats: Okay, so they managed. Doesn't mean that the vast majority of evangelicals could, especially if they have to deal with someone with fetal alcohol syndrome or an autistic kid. Unlike the 'angels' with Down's or cerebral palsy, FAS kids and autistic kids don't get passes on behavior and often end up harshly disciplined. I'd also like to point at Sarah Palin's kid, Trig, who bears a name advertising his syndrome and never seemed to have the glasses or hearing aids he needed and was often hauled around, risking infection. Even though Palin is rich, she obviously couldn't afford everything he needed.
I'm actually very impressed with your friends. Did they win the lottery too?
Elizabeth: "It may be some other idiot who thinks that anti-vaxers respond well to condescension. There is nothing I love more in life than giant .pdf files full of folksy, good-humored guilt trips, so as soon as I am done with all the concerns that press on me more urgently, I will give your link all the consideration it deserves."
If the shoe fits.. I mean, anti-vaxxers don't tend to respond well to reason or facts so what else is left?Also, you mixed me up with Sadmar.
Why is it that the CDC itself has refused to address this information and to either refute it, or accept it as worthy of further concern and more studies?
What is a vaccine aluminum adjuvant made of? Aluminum, right? What is aluminum even in small amounts when placed in a liquid? It becomes a coagulant, and especially so within human blood, where you now as a result of that adjuvant, have non specific inflammation taking place, and a host of potential changes to go with that in red and white blood cells, and the immune complexes, etc. Can you squeeze a gulf ball through a water hose, even with enough pressure to burst the hose? How about if we are now talking about the microvascular territories of the human brain?
Dr. Andrew Moulden: Every Vaccine Produces Microvascular Damage
http://vaccineimpact.com/2015/dr-andrew-moulden-every-vaccine-produces-…
http://barbfeick.com/tolerance_lost/tolerance_lost/tolerance_lost__dr.h…
Andrew Moulden is a loon who doesn't know what he's talking about.
http://scienceblogs.com/insolence/2008/10/16/vaccines-cause-microvascul…
Oxygen, with a rapid ability to free radical itself at the drop of a hat; one of the most toxic molecules on the planet....
Iron .... holy crap, IRON ... the great electron raper of all molecules....
Never since the great book Alien have we seen a more toxic bloodletting.
@Orac - a dead, bi-polar lunatic who killed himself....the Vaccine Court laughed his "evidence" out of the Courtroom.
The CDC shouldn't respond to crazy people.
Gloating over someone committing suicide? That's pretty vile.
Stay classy, Lawrence. Stay classy.
@JP - merely stating a fact. His sister stated publicly that he was bi-polar & he committed suicide.
Please show exactly how stating a fact is gloating - and yes, it is also a fact that he was laughed out of the Vaccine Court as well.
JP, true. I was only going to mention that Andrew Moulden is no longer with us. The only explanation was "My brother was Bipolar and it was consuming his life. Drew committed suicide on Monday."
It is quite sad what havoc he caused in his family.
Now, Lowell is another matter. He is a long list of cluelessness.
@Lawrence:
Sure, those are all facts, but yes, sometimes stating facts can come off as gloating, especially when certain facts are irrelevent. Was he totally wrong when it came to his "scientific" theories? You betcha. Does that have anything to do with his having a psychiatric diagnosis or his manner of death? Nope, nope, nope.
Plenty of people have a documented mental illness and nevertheless manage to be awesome people, contribute to society, etc., etc. Lots of people who don't have psych. diagnoses believe wrong, stupid things, or are just awful people. The two don't have a whole lot to do with each other at all, as far as I can tell. In any case, people with bipolar disorder are generally perfectly lucid, except maybe during the most extreme parts of a manic phase, which are usually short-lived, if only because by the time things get that bad, somebody's getting arressted or involuntarily committed. Obviously, if people can manage their mental illness through medication, etc., their illness will have even less of an effect on their lives. The next time you go talking about "dead bipolar lunatics" in public, I'd think twice before doing so, because there just might be one or two (live ones) in your presence.
In any case, I wouldn't wish the pain of having a family member committ suicide on my worst enemy. Nor would I wish being so low that the only way out you can see is to off yourself on my worst enemy. I speak from experience on both accounts.
JP: "I speak from experience on both accounts."
The same with our family. So I have the greatest sympathy to his family.
It may or may not be gloating, but it certainly has the feel of an ad hominem.
My apologies if I came off in any way inappropriate.....It galls me that anyone would give this individual any credence (or make medical decisions for themselves or worse, their children) based on his "opinions."
I do feel for his family - but I have no such feelings for those that attempt to use these opinions to cause further harm.
I considered this, but the comment didn't have the characteristic prose manglings of that Lowell.
Why is it that the CDC itself has refused to address this information and to either refute it, or accept it as worthy of further concern and more studies?
If only the CDC would issue a statement refuting these claims, all the anti-vax numpties and conspiracy theorists would change their minds immediately!
AND speaking of anti-vax numpties...
today Jameson @ AoA instructs the faithful in the fine art of spreading falsehood... I mean, *advocacy*, listing the many ways one can use the social media to broadcast tales of woe and pseudoscience.
And wouldn't you know, our old friend, Greg, turns up and talks about the importance of speaking truth to power or suchlike. That is, addressing the 'hostile crowds" like us.
How did that work out for you, Dude?
one can use the internet/ social media
I expect he thinks he came out on top in that encounter. After all, people responded to his messages he was eventually banned (after asking specifically to be banned). Sounds like mission accomplished.
I kinda wonder what they would think if I told them about the time he degenerated into posting rape threats. But given that they're nasty awful people, I don't really want to know.