healthcare workers

The ethics of mandatory participation in vaccine trials 1

Mandatory vaccination is a reality in many countries including in Australia where members of the military, students of mainstream medicine and employees at hospitals in NSW have no option but to accept vaccines or lose their jobs. The AVN is absolutely opposed to forced vaccination because vaccines are neither 100% safe nor is it 100% effective and therefore, it is not the government’s right to insist that people be vaccinated or vaccinate their children if they don’t think it is in their best interest. No government has the right to force a citizen to accept something that may make them ill or even kill them.

Even more chilling however is the idea of mandating that someone participate in a trial of an experimental vaccine. Making someone become a guinea pig or offer up their child for that purpose without the right to say no goes against everything our democratic government should stand for and the idea that a journal of medical ‘ethics’ could even suggest such as thing as a possibility is shocking. To read the original article, reproduced here for the purpose of research and critiquing, please click here.

In recent decades there has been a distressing decline in the numbers of healthy volunteers who participate in clinical trials, a decline that has the potential to become a key rate-limiting factor in vaccine development. …As a result, the risks of developing a health intervention that would benefit the whole population are carried disproportionately by some of society’s most poor and vulnerable. This is a situation few would judge to be fair or ethical.

It really is amazing how “ethics” works in medicine. It isn’t right that one group of people is poisoned so to fix the problem we need to ensure that more groups of people are poisoned to even out the burden. When the people during the French Revolution called for equality did they really mean it to be applied this way?

Compulsory involvement in vaccine studies is one alternative solution that is not as outlandish as it might seem on first consideration.

That’s the problem. There are plenty in the medical profession who wouldn’t consider this to be outlandish. And it is why we should be truly frightened.

Mandatory involvement in vaccine trials is therefore perhaps more akin to military conscription, a policy operating today in 66 countries. In both conscription and obligatory trial participation, individuals have little or no choice regarding involvement and face inherent risks over which they have no control, all for the greater good of society.

Yes. It is more akin to military conscription than organ donation. It is akin to something else too. Slavery.

Indeed I think it would be good to compare mandatory vaccination to both these ideas. Firstly, they are all justified as necessary evils for a greater good – the need to break a few eggs to make an omelette. Secondly, none of them ever actually produce the omelette.

The justification for conscription is that you can have more people fighting for your cause then you otherwise would which should help in the defence of a nation (I will be kind here and assume that conscripts will be used for this purpose even though for the most part historically they are used in aggressive pursuits rather than defensive ones). However, there is a fundamental problem. People who are conscripted don’t actually want to be there. How can you trust a soldier who would rather be smoking weed or diving under the nearest cover in order to protect himself from getting shot than he would to brave enemy fire and haul several wounded men to safety? Such people are more of a liability than they are a help and it was the great economist Milton Friedman who pointed this out (although many had no doubt made a similar argument previously). Conscription doesn’t work because while you can force people to take a plane to some faraway country you can’t force them to care about the cause – or their fellow soldiers. Of course that is not to say that all conscripts are terrible soldiers but they are – all else equal – vastly less reliable than those who want to be there.

So conscription sounds like it should work for the greater good but it simply doesn’t.

Slavery has also been justified as being necessary for the economic development of a country. The reasoning was that even though it wasn’t particularly fair on the slaves there was simply no choice for a developing economy. The simple economic argument is that slaves do work for a below market wage and hence you can “extract” more production without having to place a financial burden on employers. But, just like conscription, the argument was based on a false premise. Slaves only have an incentive to avoid getting beaten and so the work they will do will be only at this level – not a skerrick more. Generally speaking they can’t be promoted or rewarded with more money so they just do the bare minimum and never take any initiative nor do they have any means or incentive to save and invest in productive capital themselves or attempt any sort of entrepreneurship. Why would they? Consequently, slavery actually reduces production all else equal.

Obviously some people gain from slavery (ie slaveholders) but the majority of people lose (when you take into account the welfare of the slaves themselves). The economy as a whole does more poorly then if the workers are free.

Ideas that are justified “for the greater good” invariably only mean the greater good of scoundrels and this is precisely what we would get with mandatory vaccination. The assumption is that vaccines are effective and acceptably safe. Just like the assumption was that conscripts would care about fighting people they had never met in South-East Asia or that slaves would have just as much incentive to work as free labourers. All of these assumptions are wrong. But it is no accident. Sure those who believe in vaccinations – just like those who believe in slavery – do genuinely believe they are in the right, but their beliefs are inextricably linked to their own self-interest. They believe in vaccinations because it is in their best interests to do so. There is no point providing them with counter-arguments because you are asking them to recognise that not only is their pay-packet unjustified but their actions unconscionable.

As ever, then, the debate boils down to a consideration of the “greater good” or the “lesser evil.” A key consideration is the risk benefit ratio—risk to the individual volunteer balanced against the benefit to society. Society is unlikely to accept compulsory recruitment to a trial for a vaccine against the common cold if the vaccine causes severe complications in vaccinees. Increase the severity of the disease in question, however, and compulsory recruitment becomes a more palatable option.

An odd wording really. Almost as though the authors wish for the disease to be more severe so their dream of compulsory vaccination can become a reality. But that is probably just the paranoid in me.

In 2009, initial speculation regarding the H1N1 “swine flu” pandemic set mortality estimates high. In Mexico where the outbreak started, authorities closed public and private facilities [11], putting the interests of society above those of the individual. Although millions of people were infected worldwide, mortality rates were quickly revised downwards [12], and a successful vaccine mass-produced [13]. But consider if this had not been the case.

You got that? The only reason that H1N1 didn’t kill billions of people was because of the heroic efforts of the medical authorities and the glories of coercive government action. It wasn’t because the whole thing was completely overblown and these same authorities were simply scaremongering to offload some vaccines and play out their totalitarian fantasies.

The fundamental principles of medical ethics—beneficence, nonmaleficence, respect for autonomy, and justice—are, as always, conflicted on this issue.

They are the fundamental principles of medical ethics? Well I was way off then.

Justice would reason for the fair treatment of all, supporting mandatory enrollment to help ensure that the risks of developing an intervention that could benefit all are equally borne by all.

No. Justice would state that those who seek to profit from these concoctions and especially those who seek to force them upon us should be the sole people to be the test subjects. There is no need for case controlled trials or any sort of statistical shenanigans All that has to happen is for someone to show that even in extremis there is no way these concoctions could hurt anybody. The obvious first cab off the rank could be the mandatory vaccination guru Paul Offit. He claims that 100,000 vaccines given to a child in a single day would be a walk in the park so one can only presume he can’t wait for the honour of proving this to us himself. Those who believe in vaccine safety but make slightly less grandiose claims should at the very least take a weight-adjusted dose of the entire infant vaccination schedule of their respective countries.

But they won’t. Just like slavery advocates were never slaves themselves or conscription advocates generally keep their own sons out of harm’s way those who justify their actions by referencing some greater good are invariably cowards and hypocrites.

Respect for autonomy, on the other hand, would recognize and maintain the right of individuals to self-determination and their corresponding right to refuse a medical intervention. The Universal Declaration of Human Rights upholds the rights, dignity, and freedom of individuals and the need to protect people from “arbitrary interference” [14]—principles that would inevitably be compromised by mandatory enrollment in vaccine trials. Health services depend absolutely on the public’s confidence and trust—compromising on respect for autonomy would undermine this fundamental premise and launch us on a precarious slippery slope that may be difficult to climb back up.

Well I guess we should be thankful for small mercies that at least the authors haven’t gone all the way down the rabbit hole.

A more palatable and realistic option is a policy of “mandated choice.” In this case individuals would be required by law to state in advance their willingness to participate in vaccine trials [15]. The advantage of this system is that it could identify a large cohort of willing volunteers from which participants could be recruited rapidly without jeopardizing individual autonomy. It would encourage an open, noncoercive philosophy for tackling societal challenges without compromising individual freedom or public trust in the health care system.

Ostensibly this is probably a reasonable suggestion. However, it is unlikely to work out in such a benign manner. As I have said, vaccine creators and proponents are the obvious candidates but they are all hypocrites and cowards. So if even they refuse to partake why should anybody tie themselves in like that without a massive incentive to do so? Obviously such a proposal would, initially, go nowhere and hence, lead to a call for the government to provide ‘incentives’ to people to participate. Now, again this could be my paranoia, but I suspect that this is exactly what the authors expect to happen – that the government would make people an offer they couldn’t refuse to be part of the guinea pig group. Of course, this would just lead us back to the old problem: if the government were to entice people with say extra welfare payments we would still be getting much the same socio-economic group of volunteers as we do currently and which the authors say troubles them so.

In short, the only likely effect of this proposal is that trials would be funded by taxpayers rather than pharmaceutical companies. And, this may well be the paranoid in me again, but I strongly suspect that this is precisely where the authors want this to go.

But perhaps most importantly, as a society we need to evaluate our perception of vaccination. Any successful vaccine program by its very nature takes a once-feared illness out of the public eye.

That is actually true in a sense. The definition of “success” for a vaccine is when the disease is relabelled and even though the number of people who suffer from the same symptoms stays the same (or increases) the original disease label is taken from the public eye to be replaced with a bunch of new conditions or increases in others. The only exceptions to this are things like influenza for which even the epidemiological evidence doesn’t show a protective benefit from vaccination – and still the doctors tell us to take them! Remember what I said previously about how it doesn’t matter what data you show them – even if it is their own? They will never accept that their pay-packets are unjustified, let alone that their actions are unconscionable.

This means that the benefits of immunization become forgotten while side effects in small numbers of individuals fill the headlines. It is all too easy for sensationalist and unfounded stories such as that claiming a link between the MMR (measles-mumps-rubella) vaccine and autism [16] to instead take root in society’s collective psyche.

Note the hypocrisy. Suggesting that we should split the MMR up before further research is done is “sensationalist” but claiming the whole world needed to take a poorly tested vaccine (H1N1) because a few unrelated people suffered flu-like symptoms is calm, rational policy-making.

Ultimately such a crucial public health intervention as vaccine development may become devalued—and only revalued once a drop in vaccination rates leads to resurgence of severe disease.

We can only hope! I don’t know why they are so concerned though – manufacturing panic is their greatest talent. Well, other than the sheer chutzpah to turn around and accuse us of ‘scaremongering’ – they certainly have that in spades too.

Perhaps lessons can also be learned from organ donation, where apathy and ignorance may be as much to blame for low donation rates as conscientious objection. If a concerted effort were made to increase public awareness of the success of vaccination, the potential of novel vaccines to improve global health drastically, and the important contribution that individuals can make by volunteering for studies, perhaps mandatory enrollment would not even need to be consider

Yes I suppose. One thing I have always noticed about vaccinations is that very few people have ever heard about them or their astonishing success rates. Clearly more children need to be told about them at school and government websites need to stop downplaying their benefits and the media need to be more one-sided when they are covering the risks vs the benefits…. I’m sorry, but do we live in the same world? Who the hell hasn’t been brainwashed from the day they were born about the miracle of vaccines? I remember in 3rd grade sticking 50 cent coins (it might have been 20 cents) on to a board at school because each one of those coins was going to save a child from measles apparently. I can’t imagine my upbringing was significantly different in that respect to anybody else’s.

The thing is though, that there are a significant and growing group of people on this planet who have been able to recover from this brainwashing. It isn’t easy of course. Most people find it extremely difficult to imagine that something they have been taught from the day they are born and backed by very serious government appointed experts who are particularly adept at using big esoteric words could possibly be wrong. It usually starts from making an observation that the great minds of the medical world swore was only a one in a zillion shot ie a severe reaction after a vaccine. But for many it branches out into reading about the completely farcical data that the so-called vaccine miracle is predicated on.

Indeed, it is probably the fact that the vaccine data is so appalling that holds it all together. Joseph Goebbels famously said that the bigger the lie the more credible it will be. Nobody ever thinks that somebody (particularly somebody in authority) would deny the bleeding obvious so the massive lies, ironically, go by with the least scrutiny. The type of evidence used to demonstrate the efficacy and safety of vaccines wouldn’t be acceptable to a Year 10 maths student if it was used to support anything other than this most sacred of cows.

For example, how do they get away with not using real placebos in their safety trials but other vaccines? How do they get away with ignoring the fact that deaths due to infectious disease had all but disappeared from Western countries long before vaccines for those diseases had been invented let alone become widely used? How do they get away with using notification data in place of incidence data? How do they get away with claiming that “you never see any more polio victims” when, according to government data, rates of physical disability have actually risen since the polio vaccine? How do they get away with claiming that the diphtheria and pertussis vaccines are worth their weight in gold when hospitalisations due to respiratory conditions are a dime a dozen despite a near universal vaccination rate? How do they get away with claiming that these toxoid vaccines will promote herd immunity when they don’t even aim to prevent the bacteria? How did they get away with claiming that small pox was eradicated when no mere mortal could have possibly known such a thing? How do they get away with multiplying a completely made up number (rates of measles deaths in developing countries) with another completely made up number (efficacy of vaccine in preventing measles deaths) by a real number (number of measles vaccines given) and use this to “prove” that the measles vaccine saves millions of lives? It truly is extraordinary the extent of the fraud. But the majority of people find it almost impossible to believe that so many intelligent and respected people could get it oh so wrong. After all, if it is obvious to us vaccine critics, then surely it must be obvious to the experts who must have subsequently given adequate explanations for them right? Now if only someone could find these damned explanations.

Article review by Punter

Measles deaths in Africa Reply

The following article is by Greg Beattie, author of Vaccination: A Parent’s Dilemma and the more recent Fooling Ourselves on the Fundamental Value of Vaccines. This information and the graphs included are excerpted from Mr Beattie’s latest book. It demonstrates very clearly that a true sceptic will not necessarily believe in headlines such as “Measles deaths in Africa plunge by 91%” without seeing the proof of those claims. Question everything – accept nothing at face value – that is the credo of the true sceptic.

Man is a credulous animal, and must believe something; in the absence of good grounds for belief, he will be satisfied with bad ones.
Bertrand Russell

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If you are not one to follow the news, you may have missed it. Others will have undoubtedly seen a stream of good-news stories over the past five years, such as:

Measles Deaths In Africa Plunge By 91%[1],[2]

There have been many versions on the theme; the percentage rates have changed over time. However, the bodies of the stories leave us in no doubt as to the reason for their headlines. Here are some direct quotes:

In a rare public health success story on the world’s most beleaguered continent, Africa has slashed deaths from measles by 91 per cent since 2000 thanks to an immunization drive.

An ambitious global immunization drive has cut measles deaths…

Measles deaths in Africa have fallen as child vaccination rates have risen.

These stories represent a modern-day version of the belief that vaccines vanquished the killer diseases of the past. There is something deeply disturbing about the stories, and it is not immediately apparent. The fact is: no-one knows how many people died of measles in Africa. No-one! Not last year and not ten years ago.

I will repeat that. No-one knows how many measles deaths have occurred in Africa. So, where did these figures come from? I will explain that in this blog. In a nutshell, they were calculated on a spreadsheet, using a formula. You may be surprised when you see how simple the method was.

We all believe these stories, because we have no reason to doubt them. The only people who would have questioned them were those who were aware that the deaths had not been counted. One of these was World Health Organisation (WHO) head of Health Evidence and Statistics, who reprimanded the authors of the original report (on which the stories were based) in an editorial published in the Bulletin of the WHO, as I will discuss shortly. Unfortunately, by then the train was already runaway. The stories had taken off virally through the worldwide media.

Overview

First, an overview of the formula. The authors looked at it this way: for every million vaccines given out, we hope to save ‘X’ lives. From that premise, we simply count how many million vaccines we gave out, and multiply that by ‘X’ to calculate how many lives (we think) we have saved. That is how the figures were arrived at.

The stories and the formula are both products of a deep belief in the power of vaccines. We think the stories report facts, but instead they report hopes.

The nuts and bolts

Hardly any of the willing participants in spreading the stories bothered to check where the figures came from, and what they meant. That was possibly understandable. Why would we need to check them? After all, they were produced by experts: respected researchers, and reputable organisations such as UNICEF, American Red Cross, United Nations Foundation, and the World Health Organisation.

However, I did check them. I checked because I knew the developing world wasn’t collecting cause of death data that could provide such figures[3]. In fact, it is currently estimated that only 25 million of the 60 million deaths that occur each year are even registered, let alone have reliable cause-of-death information[4]. Sub-Saharan Africa, where a large proportion of measles deaths are thought to occur, still had an estimated death registration of only around 10%[5] in 2006, and virtually no reliable cause-of-death data. Even sample demographic surveys, although considered accurate, were not collecting cause-of-death data that allowed for these figures to be reported. Simply put, this was not real data: the figures had to be estimates.

I was curious as to how the estimates were arrived at, so I traced back to the source—an article in The Lancet, written by a team from the Measles Initiative[6]. After reading the article, I realised the reports were not measles deaths at all. They were planning estimates, or predictions. In other words, they represented outcomes that the Measles Initiative had hoped to achieve, through conducting vaccination programs.

Don’t get me wrong. We all know that planning and predicting are very useful, even necessary activities, but it is obvious they are not the same as measuring outcomes.

The title of the original report from the Measles Initiative reads, “Has the 2005 measles mortality reduction goal been achieved? A natural history modelling study.[7] The authors took one and a half pages to explain how natural history modelling applied here. I will simplify it in about ten lines. I realise that in doing so, some may accuse me of editorial vandalism, however I assure you what follows captures the essence of the method. The rest is detail. If you are interested in confirming this, I urge you to read the original article for that detail. Here we go… the formula at the heart of the stories:

My interpretation of the Measles Natural History Modelling Study

  1. Open a blank spreadsheet
  2. Enter population data for each year from 2000 to 2006
  3. Enter measles vaccine coverage for each of the years also
  4. Assume all people develop measles if not vaccinated
  5. Assume vaccination prevents 85-95% of measles cases
  6. Calculate how many measles cases were ‘prevented’ each year (using the above figures)
  7. Calculate how many measles deaths were ‘prevented’ each year (using historical case-fatality ratios)

There, simple. As you can see, this is a typical approach if we are modelling,for predictive purposes. Using a spreadsheet to predict outcomes of various plans helps us set targets, and develop strategies. When it comes to evaluating the result of our plan however we need to go out into the field, and measure what happened. We must never simply return to the same spreadsheet. But this is precisely what the Measles Initiative team did. And the publishing world swallowed it—hook, line and sinker.

As mentioned earlier, WHO Health Evidence and Statistics head, Dr Kenji Shibuya, saw the problem with this method. Writing editorially in the Bulletin of the WHO, under the title “Decide monitoring strategies before setting targets”, Shibuya had this to say[8]:

Unfortunately, the MDG[9] monitoring process relies heavily on predicted statistics.

…the assessment of a recent change in measles mortality from vaccination is mostly based on statistics predicted from a set of covariates… It is understandable that estimating causes of death over time is a difficult task. However, that is no reason for us to avoid measuring it when we can also measure the quantity of interest directly; otherwise the global health community would continue to monitor progress on a spreadsheet with limited empirical basis. This is simply not acceptable. [emphasis mine]

This mismatch was created partly by the demand for more timely statistics …and partly by a lack of data and effective measurement strategies among statistics producers. Users must be realistic, as annual data on representative cause-specific mortality are difficult to obtain without complete civil registration or sample registration systems

If such data are needed, the global health community must seek indicators that are valid, reliable and comparable, and must invest in data collection (e.g. adjusting facility-based data by using other representative data sources).

Regardless of new disease-specific initiatives or the broader WHO Strategic Objectives, the key is to focus on a small set of relevant indicators for which well defined strategies for monitoring progress are available. Only by doing so will the global health community be able to show what works and what fails.

In simple terms, Shibuya was saying:

  • We know it is difficult to estimate measles deaths, but
  • You should have tried, because you attracted a lot of interest
  • Instead, you simply went back to the same spreadsheet you used to make the plan—and that is unacceptable!
  • If you want to make a claim about your results, you need to measure the outcomes and collect valid data
  • Until you do, you cannot say whether your plan ‘worked’

Unfortunately, by the time Shibuya’s editorial was published, the media had already been trumpeting the stories for more than a year, because the Measles Initiative announced its news to a waiting media before subjecting it to peer-review. So, without scientific scrutiny, the stories were unleashed into a world hungry for good news, especially concerning the developing world. The result… the reports were welcomed, accepted, and regurgitated to a degree where official scrutiny now seems to have the effect of a drop in a bucket.

The question of who was responsible for this miscarriage of publishing justice plagued me for a while. Was it the architects of the original report? Or was it the robotic section of our media (that part that exists because of a lack of funds for employing real journalists) who spread the message virally to every corner of the globe, without checking it?

One quote which really stands out in the stories is from former director of the United States Centers for Disease Control (CDC).

“The clear message from this achievement is that the strategy works,” said CDC director Dr. Julie Gerberding

What strategy works? Is she talking about modelling on a spreadsheet? Or, using the predictions in place of real outcomes? More recent reports from the Measles Initiative indicate the team are continuing with this deceptive approach. In their latest report[10] it is estimated 12.7 million deaths were averted between 2000-2008. All were calculated on their spreadsheet, and all were attributed to vaccination, for the simple reason that it was the only variable on the spreadsheet that was under their control. And still there is no scrutiny of the claims. Furthermore, the authors make no effort to clarify in the public mind that the figures are nothing but planning estimates.

No proof

Supporters of vaccination might argue that this does not prove vaccines are of no use. I agree. In fact,let me say it first: none of this provides any evidence whatsoever of the value of vaccination. That is the crux of the matter. The media stories have trumpeted the success of the plan, and given us all a pat on the back for making it happen. But the stories are fabrications. The only aspect of them which is factual is that which tells us vaccination rates have increased.

Some ‘real’ good-news?

General mortality rates in Africa are going down. That means deaths from all causes are reducing. How do we know this? Because an inter-agency group, led by UNICEF and WHO, has been evaluating demographic survey data in countries that do not have adequate death registration data. These surveys have been going on for more than 50 years. One of the reasons they do this is to monitor trends in mortality; particularly infant, and under-five mortality.

Although the health burden in developing countries is inequitably high, there is reason to be positive when we view these trends. Deaths are declining and, according to the best available estimates, have been steadily doing so for a considerable time; well over 50 years.

One of the most useful indicators of a country’s health transition is its under-5 mortality rate: that is, the death rate for children below five years old. The best estimates available for Africa show a steady decline in under-5 mortality rate, of around 1.8% per year, since 1950[11]. Figure 1 shows this decline from 1960 onward[12]. It also shows the infant mortality rate[13]. Both are plotted as averages of all countries in the WHO region of Africa.

Figure 1. Child mortality, Africa

This graph may appear complex, but it is not difficult to read. The two thick lines running horizontally through the graph are the infant (the lower blue line) and under-5 (the upper black line) mortality rates per 1000 from 1960 to 2009. The handful of finer lines which commence in 1980, at a low point, and shoot upward over the following decade, represent the introduction of the various vaccines. The vertical scale on the right side of the graph shows the rate at which children were vaccinated with each of these shots.

The primary purpose of this graph (as well as that in Figure 2) is to deliver the real good-news. We see a slowly, but steadily improving situation. Death rates for infants and young children are declining. I decided to add the extra lines (for vaccines) to illustrate that they appear to have had no impact on the declining childhood mortality rates; at least, not a positive impact. If they were as useful as we have been led to believe, these vaccines (covering seven illnesses) would surely have resulted in a sharp downward deviation from the established trend. As we can see, this did not occur.

In Africa, the vaccines were introduced at the start of the 1980s and, within a decade, reached more than half the children. The only effect observable in the mortality rates, is a slowing of the downward trend. In other words, if anything were to be drawn from this, it would be that the introduction of the vaccines was counter-productive. One could argue that the later increase in vaccine coverage (after the year 2000) was followed by a return to the same decline observed prior to the vaccines. However, that does not line up. The return to the prior decline predates it, by around five years.

With both interpretations we are splitting hairs. Since we are discussing an intervention that has been marketed as a modern miracle, we should see a marked effect on the trend. We don’t.

The WHO region of Africa (also referred to as sub-Saharan Africa) is where a substantial portion of the world’s poor-health burden is thought to exist. The country that is believed to share the majority of worldwide child mortality burden with sub-Saharan Africa is India, in the WHO south-east Asia region. Together, the African and South-east Asian regions were thought in 1999 to bear 85% of the world’s measles deaths[14]. Figure 2 shows India’s declining infant and under-5 mortality rates, over the past 50 years. Again, the introduction of various vaccines is also shown.

Figure 2. Child mortality, India

And again, vaccines do not appear to have contributed. Mortality rates simply continued their steady decline. We commenced mass vaccination (for seven illnesses) from the late 1980s but there was no visible impact on the child mortality trends.

In a nutshell, what happened in the developed world is still happening in the yet-to-finish-developing world, only it started later, and is taking longer. The processes of providing clean water, good nourishment, adequate housing, education and employment, freedom from poverty, as well as proper care of the sick, have been on-going in poor countries.

I would have loved to go back further in time with these graphs but unfortunately I was not able to locate the data. I did uncover one graph in an issue of the Bulletin of the WHO, showing the under-5 mortality rate in sub-Saharan Africa to be an estimated 350 in 1950[15]. It subsequently dropped to around 175 by 1980, before vaccines figured. It continued dropping, though slower, to 129 by 2008[16].

The decline represents a substantial health transition, and a lot of lives saved. When cause-of-death data improves, or at least some genuine effort is made to establish credible estimates of measles deaths, it will undoubtedly be found they are dropping as well. Why wouldn’t they? This is good news, and all praise needs to be directed at the architects and supporters of the international activities that are helping to achieve improvements in the real determinants of health. In the midst of all the hype, I trust we will not swallow attempts to give the credit to vaccines… again.

I am not confident, however. I feel this is simply history repeating itself. Deaths from infectious disease will reach an acceptable “low” in developing countries, at some point in time. And although this will probably be due to a range of improvements in poverty, sanitation, nutrition and education, I feel vaccines will be given the credit. To support the claim, numerous pieces of evidence will be paraded, such as:

Measles Deaths In Africa Plunge By 91%

We need to purge these pieces of “evidence” if we are to have rational discussion. The public have a right to know that these reports are based on fabricated figures.  Otherwise, the relative importance of vaccines in future health policy will be further exaggerated.


[1]    Medical News Today 30Nov 2007; http://www.medicalnewstoday.com/articles/90237.php

[2]    UNICEF Joint press release; http://www.unicef.org/media/media_41969.html

[3]    Jaffar et al. Effects of misclassification of causes of death on the power of a trial to assess the efficacy of a pneumococcal conjugate vaccine in The Gambia; International Journal of Epidemiology 2003;32:430-436 http://ije.oxfordjournals.org/cgi/content/full/32/3/430

[4]    Save lives by counting the dead; An interview with Prof Prabhat Jha, Bulletin of the World Health Organisation 2010;88:171–172

[5]    Counting the dead is essential for health: Bull WHO Volume 84, Number 3, March 2006, 161-256 http://www.who.int/bulletin/volumes/84/3/interview0306/en/index.html

[6]    Launched in 2001, the Measles Initiative is an international partnership committed to reducing measles deaths worldwide, and led by the American Red Cross, CDC, UNICEF, United Nations Foundation, and WHO. Additional information available at http://www.measlesinitiative.org

[7]    Wolfson et al. Has the 2005 measles mortality reduction goal been achieved? A natural history modelling study; Lancet 2007; 369: 191–200 Available from http://www.measlesinitiative.org/mi-files/Reports/Measles%20Mortality%20Reduction/Global/Wolfson%20Lancet2007_Measles_Mortality_Reduction.pdf

[8]    Kenji Shibuya. Decide monitoring strategies before setting targets; Bulletin of the World Health Organization June 2007, 85 (6) http://www.who.int/bulletin/volumes/85/6/07-042887/en/index.html

[9]    MDG – Millennium Development Goals, to be discussed shortly in this chapter.

[10]  Dabbagh et al. Global Measles Mortality, 2000–2008; Morbidity & Mortality Weekly Report. 2009;58(47):1321-1326 http://www.medscape.com/viewarticle/714345

[11]  Garenne & Gakusi. Health transitions in sub-Saharan Africa: overview of mortality trends in children under five years old (1950-2000);  Bull WHO June 2006, 84(6) p472 http://www.who.int/bulletin/volumes/84/6/470.pdf

[12]  If you perform a ‘google’ search for ‘infant mortality rate’ or ‘under-5 mortality rate’ you will locate a google service that provides most of this data. It is downloadable in spreadsheet form by clicking on the ‘More info’ link.  http://data.worldbank.org/indicator/SH.DYN.MORT/countries/1W-US?display=graph :Vaccine coverage data is available from the WHO website http://www.childinfo.org/files/Immunization_Summary_2008_r6.pdf

[13]  Infant mortality rate is “under-1 year of age” mortality rate.

[15]  Garenne & Gakusi. Health transitions in sub-Saharan Africa: overview of mortality trends in children under five years old (1950-2000);  Bull WHO June 2006, 84(6) p472 http://www.who.int/bulletin/volumes/84/6/470.pdf

If male superheroes posed like female superheroes

Offit vs Salisbury: Mock Battle of the Titans 2

Image: What if Male Avengers Posed Like Female Avengers? by Coelasquid

The following is a critique written by John Stone, the UK Editor of Age of Autism. John has written about two very recent articles contained in a regular feature of the British Medical Journal called Head to Head. This section is supposed to provide a place where two opposing viewpoints can each have their say on a medical issue for the purpose of balance and fairness. Since there are two articles involved, we have chosen to forego the plunger / Einstein rating and just go ahead with the critique. You can read David Salisbury’s ‘against’ compulsory vaccinattion viewpoint by clicking here and Paul Offit’s ‘for’ compulsory vaccination viewpoint by clicking here. We give full attribution to the British Medical Journal for these pages and present them here for research and critiquing purposes only.

Mock battle of the Titans: Offit and Salisbury dispute over compulsory vaccination in British Medical Journal

There’s always been a small lobby for mandatory vaccination in the UK. The last time it was brought up as a high profile public issue in 2009 – driven by former British Medical Association president Sir Alexander Macara –  it came to grief as 5 panellists on BBC TV’s Question Time declared that, though MMR was quite safe (of course as politicians and journalists, they had all carefully studied the science), they did not think it should be compulsory (perhaps also secretly reflecting, as well-informed citizens, on whether they really wanted their children or grandchildren to be forced to have it after all). The following year, a motion was defeated at the BMA in debate led by the GMC panel chairman at the Wakefield hearing, Surendra Kumar, who also of course sat on two licensing authority committees but had not disclosed that fact.

The ideological differences between the UK’s ‘immunisation’ supremo, David Salisbury, and the pope of vaccination, Paul Offit, are perhaps rather slight: Salisbury bought into Offit’s 10,000 vaccine doctrine http://www.ageofautism.com/2011/10/best-of-age-of-autism-paul-offit-and-the-milgram-experiment.html , and so their current  head to head in BMJ is, of course, completely about tactics, and ensuring compliance over however many vaccines they want your child to have. As the exchange indicates Salisbury is fairly cautious about the politics of such a departure in the UK, as he might also be about the legal ramifications.

As the recent MMR case in Italy has shown, the main defence was not that MMR did not cause the injuries (including symptoms of autism) but that the parents, not the government were responsible as the vaccine was not mandatory http://childhealthsafety.wordpress.com/2012/05/09/italy-court-holds-mmr-vaccine-causes-autism-ii-initial-english-summary/ .  Such a move might also lead to scrutiny of the United States National Childhood Vaccine Injury Act of 1986 and its consequences where, apart from anything else, billions of dollars have quietly been paid out in compensation. In contrast, compensation in the UK is derisory and is paid out on the whim of civil servants (most years now there are no payments at all).

Moreover, Salisbury’s greatest tool of compliance is the multivac (several vaccines given in one shot). Hence perhaps the kerfuffle over Andrew Wakefield’s suggestion for single vaccines instead of MMR in 1998. At the time, this was still an option for families on the UK programme. Wakefield’s call for single vaccines was the reason for their immediate withdrawal less than 6 months later.

In both 1998 and now – the multivac was the future, with the schedule gradually being ratcheted up, most often without any public discussion. The next instalment in the UK is likely to be a 6 in 1 vaccine which for the first time will include Hepatitis B administered in conjunction with a seventh vaccine – Meningitis C. The first of these shots will be given at two months of age.

Until now, and quite remarkably, our Joint Committee on Vaccination and Immunisation have resisted the introduction of an infant Hepatitis B vaccine, presumably on the reasonable grounds that only in very distinct and identifiable cases were infants at risk from the disease. Now, it just looks as if it will be tacked on to a product that everyone is expected to have http://www.ovg.ox.ac.uk/sites/default/files/6COM.pdf . This replicates the situation in 1988 when giving a mumps vaccine to infants was against previous medical advice. One thing is clear, it was wrong to give Hep B before, so it is not clear why this product is now being developed in partnership with the NHS.

The other factor in the UK is that the possibility of suing the manufacturers if anything goes wrong is completely theoretical. While in principle it exists, it lies in the discretion of a highly politicised body, the Legal Services Commission, which even blocked a legal suit against Merck over Vioxx despite successful litigation in the US. The protection of the civil law is really only there for the very few people who can afford it.

The moral perhaps is that while we are being leant on in the UK by the Department of Health and the National Health Service to vaccinate our children, the risk is all ours, and that’s the way the British government needs it to remain. I certainly won’t be voting for mandatory vaccination in BMJ’s present poll, but my motives will be somewhat different from those of David Salisbury.

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Media fear campaign – ABC Catalyst, 17 May, 2012 20

This program is rated 4 plungers. If I could have rated it lower, I would have. 

Back in December of 2011, I was contacted by a producer at Catalyst, an ABC ‘science’ show, about being involved in a program they were planning on vaccination to air early in 2012 (I was told at the time that it would be about March). They wanted to speak with the parent of a child who had passed away as a result of a vaccine and I spoke with several but none of them were willing to deal with the ABC after watching some of their coverage of this issue. Neither was I. Time has shown that we all made the right choice!
The scientific definition of a catalyst is a substance that increases the rate of change (like an enzyme) by causing a chemical reaction without actually being changed itself.

Last night, ABC TV’s science program, Catalyst, featured an 11-minute segment on the vaccination issue called Danger Zones which demonstrates why calling this show ‘Catalyst’ was extremely appropriate. It shows that the media, the government and the medical community have not been changed in any way despite the large quantity of readily-available scientific information on the known dangers and ineffectiveness of vaccines.

Despite this lack of change on their part, they will hopefully be a ‘Catalyst’ for change through their complete and utter disregard for science, the truth and the tens of thousands of Australian families whose children have been permanently injured by a procedure they insist on calling safe for everyone.

Those dirty unvaccinated hippies

The premise of the program was that vaccination needs to be maintained at levels of 95% in order for diseases to die out, and the doctor / journalist who presented the show focussed on Byron Bay as an example of what can happen when people stop vaccinating. The implication is that because Byron Bay has a lower rate of vaccination then the rest of the country (a ‘fact’ that is thrown around quite often, depending upon what point is being made at the time. Sometimes it is Byron Bay; sometimes North Sydney; sometimes Perth), the rest of Australia is now in the 5th year of a record-breaking whooping cough epidemic.

These figures on the incidence of disease by local government area seem to be a closely-held secret. I have had many discussions with the Department of Health where I asked to be shown this data but they won’t provide it unless I tell them what I want to use it for. What are they afraid of? They seem to provide this data easily enough to media pundits but hold it back when speaking with anyone who they think might use it for purposes they don’t approve of – like being critical of policies which these same figures show are not working.

We do know, thanks to a year’s worth of correspondence back and forth between Greg Beattie and the Department of Health and Aging, that there is no evidence available to show the whooping cough vaccine  has done anything to reduce the rate of infection in Australia during the current epidemic. When looking at the age groups which would have been most recently vaccinated – those aged between 0 and 4 years old – fully vaccinated children were far more likely to get the disease then the unvaccinated. Seventy-five percent of those who were diagnosed with pertussis (whooping cough) were fully vaccinated; a further 14% were partially vaccinated and only 11% were unvaccinated (including an unknown percentage who were too young to be vaccinated).

Whooping cough is rife in every country where vaccines are administered and vaccination rates have never been higher. So the medical community – which has long had a reputation for spinning a failure into a success – has decided that instead of blaming an obviously ineffective vaccine, they will blame those who haven’t been vaccinated for the occurrence of disease in the supposedly protected population. Only those who are not thinking would believe that sort of garbage and yet, the majority of the medical community and their pals in the media seem to fit that bill perfectly.

What will it take to convince them?

The vaccine is failing. Don’t take my word for it. We currently have more cases of whooping cough per capita then at any time since 1953 when the vaccine was introduced for mass use in Australia. Let me say that again another way. In 1952 when we had no mass vaccination for whooping cough, the incidence was lower than it is today with close to 95% of children vaccinated.

The same situation is being seen in the US where a large study of  the 2010 pertussis outbreak in North America showed that those most likely to get whooping cough were fully vaccinated children between the ages of 8 and 12 years old.

We have a real belief that the durability (of the vaccine) is not what was imagined,” said Dr. David Witt, an infectious disease specialist at Kaiser Permanente Medical Center in San Rafael, California, and senior author of the study. Witt had expected to see the illnesses center around unvaccinated kids, knowing they are more vulnerable to the disease.

“We started dissecting the data. What was very surprising was the majority of cases were in fully vaccinated children. That’s what started catching our attention,” said Witt. (http://blog.imva.info/medicine/whooping-cough-vaccine-failing)

The most recent estimates for ‘protection’ from whooping cough if you are vaccinated is three years. But immunity from infection lasts for between 30 and 80 years!

The vaccine is failing our children and the government and the media in conjunction with mainstream medical organisations are doing their best to point the finger of blame at the unvaccinated rather than accepting that it is the vaccination that is the cause of this outbreak and the fully vaccinated who are its victims.

Those dirty hippies!

There was no mention of the fact that the AVN is based on the Far North Coast of Australia during this show (though we are not in Byron Bay), but several montage scenes showing the AVN’s website, images of a seminar I had conducted in SA several years ago and the backs of people’s T-Shirts saying Investigate Before You Vaccinate (what a concept!) were prominent throughout this program.

The idea that a small group of unvaccinated people on the North Coast of NSW can infect the rest of the country even though they are fully vaccinated is one that would require a complete suspension of both thought and logic. Apparently, the ABC is able to do both those things – but is their audience?

Every single person who was interviewed on the streets of Byron Bay was dressed like a hippie (OK, I have nothing against hippies having been one myself throughout high school and University) and it is obvious that the intention was to show that hippies are the ones who are not vaccinating and we all have to hate hippies while the ‘average’ Australian – personified by the many babies we see during this show screaming in their mother’s arms while needles were stuck into their body – were doing the right thing and keeping the community safe.

Vaccines not only protect you, they protect your community. And that’s why immunisation can be called altruistic.

The REAL intention of trying to differentiate between hippies (who supposedly haven’t been vaccinated) and middle-class Australians (who have) is to foment hatred and fear towards those who have made a decision that goes against the mainstream. They are the ones to blame for your child’s illness – not the vaccines you gave to your children, thinking they would stay safe though they then got the disease anyway. It isn’t your fault. It isn’t your doctor’s fault. It isn’t the government’s fault. It’s all the fault of those dirty hippies!

Of course, the Australian government’s own studies have shown time and time again that the average person who chooses not to vaccinate their children is older, from a higher socio-economic status and highly educated. We certainly find that to be the case amongst the membership of the AVN from our own surveys. Not hippies after all – just very well-informed and concerned parents. Go figure.

One thing that would be interesting to know is the rate of autism, asthma and juvenile diabetes in areas with low levels of vaccination as opposed to those with high vaccination complaince. I wonder if we will ever see Catalyst cover this story?

Anti-choice propaganda and nothing more

The fact is that shows such as this do nothing to advance the vaccination debate or to help parents make a decision that is right for their families. In fact, they do the exact opposite by relying on fear and propaganda and not using any information whatsoever. There was not one real statistic; not one medical journal study; not one truly informative piece of information given out in the entire program. Pretty surprising when you think that this is supposed to be a science program.

I take that back. There WAS one study shown and that was the 1998 case series by Andrew Wakefield et al that was retracted from the Lancet. The doctor / journalist sat on a rock by the sea holding up the paper with a big red “RETRACTED” stamped across the page. Due to the recent High Court (UK) victory by one of Wakefield’s co-authors, Dr John Walker-Smith, it is very possible that this retracted article may be reinstated at some point in the future. In addition, what is known is that there have been many published articles since 1998 which have verified and expanded upon Wakefield’s original hypothesis that vaccination may have some bearing on the development of autism and gut issues in children. But this unscientific and unbalanced report never looked at any of that.

The real victims

Almost immediately after the show ended, I was contacted by one of our members. This woman who I have known for many, many years and who has been kind enough to allow me to stay with her and her family in Sydney several time when I was down there on AVN business, has a grown son who was permanently brain damaged by his shots. I have never seen her get angry or impatient with anyone. Not until last night, that is. Here is her message to me:

Hi Meryl,

Did you see Catalyst tonight? It was on vaccination and was nothing more than an advertisement for vaccines. It was disgusting and so one sided. I have just written to the ABC in disgust.

You see, it’s all fine and good for Robert Booy to say that vaccine reactions are rare:

But they’re minor and they go away quickly. Rare side effects are something in the order of one hundreds of thousands. An allergic reaction, for example.

but this mother knows better. Her son’s reaction hasn’t gone away in close to 25 years. Her family is one of the ‘rare’ unlucky ones. Or is it?

How many of you reading this now have a family member who was seriously affected by vaccines? In my own family, I can count over 10 people who have had serious and, in some cases, ongoing issues because of vaccination. And when I give a seminar and ask the audience to raise their hands if they know of someone who has been badly affected by vaccines, it is rare to see less than 80% of those in the room not raise their hands.

Is it really rare for people to react to vaccination or is it simply rare for that reaction to be acknowledged?

For those families who have gone through vaccine hell, last night’s program was more than propaganda – it was a sign of the lack of respect and recognition given to them in their day-to-day struggle with a situation that only happened because they were ‘altruistic’ and did what they were told was for the good of society. Now, society wants nothing to do with them. In fact, society wants to pretend they don’t exist.

It is supposed to be our ABC but apparently, the ABC belongs to the highest bidder. The real losers are the children of Australia, their families and the truth.

If you would like to write to Catalyst, you may do so using the information and form found here – http://www.abc.net.au/catalyst/contact/default.htm

by Meryl Dorey

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Pushing Buttons… 85

The moderator apologises for a serious error. I uploaded an older version of this blog which did not include all information. This has now been fixed and again, I apologise to both Epiphany who wrote this blog post and to our readers for not having the correct information here from the word go. MD

I came across a blog the other day called ”Which button would you click?”  In it is the typical pro-vaccine scenario of having to choose between pushing a button that kills 1 out of 1,000 children (the supposed rates of death by disease) while the other button kills 1 out of 1,000,000 children (the supposed rates of death by vaccine reactions).  At the end of the scenario, the question is posed “which one would you click?”

The blogger’s response is “it’s a no brainer”, and in some ways, he is correct. It does take absolutely no brain power to follow the advice of most mainstream medical and scientific professionals, but it does take brain power to actually look at the historical data on mortality rates of supposed vaccine preventable diseases yourself and see whether vaccines really do save lives.

So let’s look at the first button, if we do not vaccinate will 1 out 1,000 children die?

“Experience of the last two centuries indicates that infectious deaths fell to a small fraction of their earlier level without medical intervention, and suggests that had none been available they would have continued to decline, if not so rapidly in some diseases.”

Professor Thomas McKeown in “The Role of Medicine”

If we look at the mortality rates in Australia pre-vaccine for most childhood diseases, you will see that there was already a 90-99% decline before most vaccines were introduced and the same decline in diseases like Typhoid and Scarlet Fever for which no vaccine was ever used in Australia. (please note: the following graphs are taken from the e=book, Fooling Ourselves on the Fundamental Value of Vaccines by Greg Beattie)

How is that possible you ask, if vaccines did not save us from disease what else could it possibly be?

“In the now developed countries, mortality due to tuberculosis, measles, whooping cough, typhoid fever, diarrhoeal diseases and many other infections began to fall long before the responsible microbial agents had been identified and before specific measures of control or treatment were known. This decline – much greater than anything achieved since through the use of vaccination and antimicrobial drugs – paralleled the improvement in general living conditions. Microbes and the diseases caused by them prosper, therefore, only in environmental conditions favourable to them.

Dr Moises Behar said in his report to the World Health.

I have actually asked a vaccine advocate in an online debate before, “What evidence do you have to show what percentage of lives saved historically comes from vaccines, and what percentage of lives saved are from improved living conditions?”. Funnily enough, they had no answer.

Over and over again, we are told that vaccines save lives and unvaccinated people are putting everyone’s lives at risk, but where is the evidence of this?  Now when I say evidence, I don’t mean estimated lives saved based on estimates of vaccine coverage, efficacy, and the population, I mean actual numbers of real people who have been saved from death because of being vaccinated.  The answer – is that there is no evidence, you cannot actually prove that vaccines save lives. You can only prove that it causes the body to produce antibodies to the vaccine virus and bacterial particles, so if vaccines are not proven to save lives, then is it really a “no brainer” to push that second button?

Now let’s look at the second button, do only 1 out 1,000,000 children die from adverse vaccine reactions?

“ The Advisory Committee on Immunization Practices (ACIP) states, “VAERS data are limited by underreporting and unknown sensitivity of the reporting system, making it difficult to compare adverse event rates following vaccination reported to VAERS with those from complications following natural disease”

“ Since follow-up is not conducted, it may be argued that some reports may not be attributed to or associated with vaccination and therefore the true rate of adverse events is essentially unknown. Nevertheless, adverse reactions reported in VAERS have typically been shown to be only 5% or 10% of the true rates.”

Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR); Prevention of Varicella Updated Recommendations of the Advisory Committee on Immunisation Practices. May 28, 1999; 48 (RR06): 1-5

 So if the true rate of adverse events is essentially unknown, how can doctors in all honesty say that the rate is 1 in 1,000,000?   Maybe it is just me, but I would think having a true rate of adverse reactions would be a priority, especially when parents are being pushed harder and harder to vaccinate their children and themselves everyday by the government, medical and scientific organisations and the media.

To further demonstrate the supposed catastrophic results that can occur when vaccination rates decline, this blog includes a graph purporting to show that pertussis rates and deaths went up in Japan when the vaccination coverage declined.  What this graph does not include though is that the original reasons for stopping the use of this vaccine was concerns due to 37 infant deaths linked with the DTP vaccine itself! The fact is, pertussis is a cyclical disease that tends to peak every 2 to 5 years.  One very interesting thing to come from this period of time is that when Japan started vaccinating again, they changed the age of vaccination to 2 years old. As a result, something startling happened! Japan jumped from 17th to first place for lowest infant mortality in the world!

This was also seen in England in 1975, when the media reported a link between brain damage and vaccination. Parents stopped vaccinating and the overall infant mortality rate plummeted, but when vaccination rates started increasing again, MacFarlane in 1982 noted;

“The postneonatal mortality fell markedly in 1976, the year in which a sharp decline in perinatal mortality rate began. Between 1976 and 1979, however, neither the late nor the postneonatal mortality rates fell any further. Indeed, the postneonatal mortality rate increased slightly among babies born in 1977″.

A much more telling pertussis graph to include would have to be the one for the whooping cough epidemic here in Australia. It started with over 4,000 cases in 2007; 14,000 cases in 2008; 29,000 cases in 2009; 34,000 cases in 2010; and 38,000 cases in 2011. So obviously, going on the previous graph, there must be low vaccination rates, right? No wait…the vaccination coverage rates for infants under two is 94.9% and the under 5yr rate is 90.7%.  It certainly doesn’t seem like high vaccination rates equal, less whooping cough now does it? ( http://www.medicareaustralia.gov.au/provider/patients/acir/statistics.jsp#N1002D)

In Conclusion:

We have button  number 1 where there is no concrete evidence that vaccines have saved lives. Instead, we are left with fears based on historical rates of disease incidence and death.  We don’t even have any evidence that, were we to stop vaccinating,  diseases would return to the rates we had before living conditions were improved, let alone to seeing 1 in 1,000 die.

With button number 2, the true rates of adverse reactions are essentially unknown. At the very best, a maximum of between 1 and 10% of reactions are reported. (Personal communication with Dr John McEwen, formerly of ADRAC)  So the 1 in 1,000,000 figure for children dying from vaccine reactions is, once again, just a guess.

 So where does this leave us?

Where all concerned parents should be: looking at ALL the information available, weighing the pros and cons and hoping that we make the best possible choice for our families.  Whatever that choice may be, it should always be in the hands of the person or persons taking the risk.

by Epiphany

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Justifying mandatory vaccination 78

The following is a critique of the article, The Clinician’s Guide to the Anti-Vaccinationists’ Galaxy from the journal, Human Immunology. This article is still in press and has not yet been published though it is ready for publication once the journal has formatted and done their final copy-editing. We give full attribution to Human Immunology and post this article here for research and critiquing purposes only. The author of this critique is HPS and we will be seeing much more of this person on the REAL Australian Sceptics blog in the coming months.

Sceptical Rating for the article reviewed: Four Plungers

Another day – another attempt by some doctors to justify the mandating of vaccines. They can’t win on arguments so instead, they resort to force. This paper is kind of weird in the sense that it wants to give doctors an easily-referenced guide to combating the concerns of parents. Apparently, the authors seem to feel they will blow all away with their brilliance and irrefutable logic while at the same time, claiming that ultimately, mandating vaccines is the way to go.

Now the first point to note is at the end of the article where we find out that the authors, Poland and Jacobson, are not exactly disinterested observers. They both work for Merck amongst other vaccine-related activities.

Of course, they are entitled to make their case irrespective of whether they have a vested interest or not. Nonetheless, given these interests, one would hope that they wouldn’t make the mistake of filling this piece with smears, insults or attempts to persuade people using themselves as some sort of authority.

The claims:

First claim: Vaccines saved many millions of lives.

Now as far as I can tell, this cannot be backed up with any evidence. The site, Vaccines Did Not Save Us – 2 Centuries of Official Statistics, seems to debunk this notion as well as any other. If vaccines saved lives, it is hard to find evidence for this in the actual data. Most ‘data’ that demonstrates any life-saving ‘miracleness’ is in the form of projections that take assumptions about how many lives a doctor thinks that, for instance, the measles vaccine will save and multiplies that by the number of measles vaccines handed out. Now some might think that was a ridiculous thing to offer up as evidence given that the authors could come up with any number they like, but presumably that must be our ‘anti-vaccinationist’ brains not being able to understand science like these authors can.

Second notion – the eradication of smallpox.

I have to ask. How did the World Health Organisation (WHO) know that the smallpox virus was eradicated? How could they have known something that no mere mortal possibly could? Did they test every human on the planet to make sure that none of them were ‘asymptomatic carriers’? Did they test every rock, tree, piece of dirt, etc to ensure it wasn’t hiding there? How did they know it was gone? Since smallpox was declared to be eradicated, there have been sporadic outbreaks which  local doctors have put down to smallpox. Then, when the WHO or similar organisations come in, they simply wave their hands and say “Well it couldn’t have been smallpox, could it? It doesn’t exist anymore.” So it seems to be just a self-fulfilling prophecy.

On a related note, did anybody worry about fatal chickenpox 250 years ago? Samuel Johnson’s dictionary suggests that no such condition had ever been reported. It would seem then that the concern for fatal/severe chickenpox is a more modern thing. In particular, and I suspect not coincidentally, after the introduction of the smallpox vaccine. Too many people who had been vaccinated still getting the pox and still dying from it. Some of the reputable medical textbooks at the time actually instructed doctors to use vaccination status when making their diagnosis. Still, that is probably just me not understanding enough about the scientific method and the peer-review process and thinking that there might be an investigator bias in these things. We all know that investigator bias doesn’t exist at all.

So the whole smallpox eradication looks pretty shaky. Of course, Poland and Jacobsen would counter by saying that they are caused by different viruses – but even if that’s true, how could doctors have known which disease was caused by which virus in 1800? I’m pretty sure that electron tunnelling microscopes weren’t in significant use back then. And how often do we test pox victims for the smallpox virus today? Or even in the mid 1970s?

Third point – the efficacy of vaccines

Their next point about the general efficacy of vaccines is similar to the smallpox one. And my retort is the same. In epidemiology the ‘double’ in randomised double blind placebo controlled trial is not there to help the phrase roll off the tongue better. Epidemiological evidence is always subject to bias if the doctors know you have received a particular treatment. This renders it nigh on worthless for trying to prove that the treatment works unless this bias is either quantified retrospectively or controlled for in the original trial (ie with a ‘double’ blinding).

I could list all the so-called vaccine success stories subject to this bias but I will just put polio out as an example. How many cases of crippling/paralysis that had no trauma-related cause in the Western world were under the banner of something other than polio before the vaccine? Virtually none it would seem. Later on, children with crippling/paralysis could have Guillian Barré, non-polio enteroviruses, coxsackie and a plethora of other conditions. Many of these labels didn’t even exist before the vaccine or were thought not to cause paralysis and yet today, they make up virtually all of the acute flaccid paralysis (AFP) cases. (AFP is a sort of ‘basket’ into which all diseases which are clinically indistinguishable from paralytic polio are gathered together.) This would be fine of course if AFP cases as a whole had fallen significantly. Alas, no such luck as the following paragraph will illustrate.

India is slated as soon to be ‘polio-free’. But what does this mean? Well if you look at the World Health Organisation’s website for India, you will see that even though AFP has risen in the past 16 years (since they have been counting), almost all of these cases have been dumped into the non-polio type. Apparently that makes it alright. You see, doctors couldn’t find a particular protein in the stools of these individuals so they declared them not to have polio (there were zero non-polio AFP cases in 1996 and 16 per 100,000 in 2011).

Now you might think that most parents wouldn’t really care too much about proteins in stools when they have a paralysed child to concern themselves with, but again, that is coming from an ‘anti-vaccinationist’ who doesn’t understand the glories of peer-review and the scientific method. If I did understand those things like our great doctors, I would understand that paralysis is no big deal. It’s the little protein in the stool that matters.

Next point – The Super-Bowl effect

The next point the authors make is some anecdotes (I thought ‘real scientists’ didn’t use them?) about some people getting rashes after a Super Bowl game. It seems reasonable that the entire country would be in a blind panic over such serious phenomena. I mean some of those people might have missed a couple of days work. Catastrophic. Not like those lucky souls in India who are paralysed but who have had the incredible stroke of good fortune to have been found not to have had the polio virus in their stools.

The authors acknowledge that there are real side effects to vaccines but of course, they are extremely rare. What do these scientists tell themselves at night? That hundreds of thousands of parents all around the world all got their children vaccinated and then subsequently decided to become part of a vast global conspiracy to bring down vaccinations for no apparent reason?

At least that is what I assume these ‘scientists’ must think. After all, vaccinations are the only product whereby people ignore the stories of those who actually had experiences of them when ascertaining their safety. Imagine if thousands of people walked into the Toyota headquarters and explained that when they pressed the brakes on their Camrys nothing happened and, in response, the Toyota executives came out with a bunch of graphs and ‘experts’ who told them that it was all in their imagination and that they had no intention of recalling and double-checking their cars.

We might also be people who are innumerate (which presumably includes people who think that the double in double blind trial actually means something), or have low cognitive skills. This is quite strange really given that in the Western world, those who question vaccinations are almost invariably among the more educated and better paid, but never mind.

Still we all reject the ‘scientific method’ and the peer-reviewed literature. But what about peer-review literature that calls into question vaccine safety or efficacy? Well all peer-review is equal but some peer-review is more equal than others I guess.

Is there a scientific method to their madness?

And just what is the ‘scientific method’. We hear about this a lot but no one ever really categorically defines what binds say medicine with astrophysics. The randomised double-blind placebo controlled trial (RDBPCT) is considered the gold standard of epidemiology but I can’t imagine how such a technique would be of any use in understanding how stars form. But what do I know? I think peer-review is nothing more than a euphemism for appealing to authority and its main purpose is to protect academic guilds from clandestine thoughts. Now that’s ‘otherworldly and alien’ for you.

And is statistical evidence the best we have in medicine anyway? For those who have studied some economics, you would know that the concept of ‘revealed preference’ has primacy in determining human beliefs. If I say I want to live an ascetic existence in order to win popularity but surround myself with precious jewels and iPods, then fair to say I don’t want an ascetic existence at all. My behaviour is the guide to my true beliefs – not my words. Nothing particularly revolutionary about this and most reasonable people would simply think that was a statement of the bleeding obvious (most sound economics is).

Put your money where your beliefs are

So how about this for true beliefs? Babies are smaller than adults, so their ability to withstand doses of various substances without harm would be significantly less.

Given this, any adult who claims the infant vaccine schedule is extremely safe should, assuming their words matched their true beliefs, have absolutely no qualms about taking a weight-adjusted dose of the infant schedule. And yet to this day, not one doctor, nurse, or any other vaccine-supporting individual has been prepared to put their money where their mouths are and actually do this. Now this simple fact tells us more than a million epidemiological studies. Indeed it simply isn’t possible for any statistical study to trump this fact. If vaccines were safe, its supporters wouldn’t think twice before doing this presumably simple challenge. But they never, ever do.

You see statistical studies are easy to rig. I can rig them to make vaccines look extremely dangerous. Vaccine supporters can rig them to make them look incredibly safe. That is the nature of statistics. An RDBPCT is hardest of all to rig, and yet, they still are. One of the more common methods is to use a non-inert substance instead of a placebo (so the new vaccine is being compared to something that most people wouldn’t assume was safe). Indeed, every single vaccine you have ever been given has been tested in this – what can only be described as fraudulent – manner.

Much harder to rig the results of taking the entire weight adjusted infant schedule.

So I won’t go too much into specifics of the safety aspect because, as I say, ‘scientists’ will come up with a bunch of cherry-picked data and I could do the same. But tellingly, they won’t put their money where their mouths are.

The authors try and make out that vaccines are incredibly safe because the number of antigens are much less than they used to be. Firstly, all that tells us is that in terms of the antigens, newer vaccines are presumably safer than previous vaccines but not necessarily safe. Secondly, last I checked, antigens weren’t the only component of a vaccine. The reason that there are less antigens is because it is cheaper to produce vaccines with less antigen but more aluminium (which increases the immune response). Now, replacing antigens with aluminium may in fact be safer but for the authors not to admit that this is the reason that there is less antigen now illustrates the deception at the heart of this paper.

They mention the pre-licensure studies as proving that everything is fine. Now remember what I said a couple of paragraphs ago about using a non-inert placebo? Well this is where this whole thing comes into play. They will give one cohort the new vaccine and another cohort another substance, be it the old vaccine, a completely different vaccine or, in some cases just aluminium (Merck’s study of Gardasil, for example). So, let us say the previous DTP vaccine resulted in the deaths of 10 out of every 10,000 recipients and the new one results in 9 out of every 10,000 recipients. Based on their definition of safety, the new vaccine will be declared safe! Indeed, the headlines will talk about it reducing mortality compared to a placebo!

Of course, what the newspapers or doctors will never volunteer is that the placebo wasn’t what you thought it was – ie a completely inert injection (such as saline). Instead, it was something that you would never consider to be inert. The information isn’t hidden – you can read the study – but of course only a fraction of people ever do that. They just trust that their doctors will have done so and more importantly to internalise that information in a manner that isn’t self-serving.

It’s there in black and white

What’s interesting though, is that the pharmaceutical company will write up in their package insert every single adverse event that happens in both cohorts. Because the health bureaucrats will approve the vaccine on the basis that it doesn’t do significantly more damage than the ‘placebo’, both they and the doctors will assure you that the chances of any of these adverse events are miniscule because they consider the relative chances to be the difference between the vaccine and the placebo. Since the placebo itself could have caused problems, this is nothing more than speculation – deception, actually. So the package inserts will often look scary for these vaccines but the doctors will assure you that the risks are tiny. They are wrong. The package leaflets written up by the pharmaceutical companies are in fact the only place to get any honest information on the possible side-effects of the vaccine.

Their spiel on Guillain-Barré syndrome (GBS) can be understood in that light now. If you look at package inserts for vaccines, GBS will crop up regularly. That’s because it happens in the pre-licensure studies. If it happens to both cohorts then it will be dismissed as ‘background’ levels (and won’t affect its approval) but will still be written up in the inserts as a possible contraindication or condition that should prevent you from taking the vaccine.

Now you should be starting to get an idea of the extraordinary deception that vaccine ‘science’ requires. When they say no link has been found, you can rest assured that no link was looked for. More than that, they had to cover their eyes in order not to see all the elephants in the room.

All they had to do was ask the parents for their stories and they would have had hundreds of thousands – perhaps millions of pieces of evidence. But they never do. Remember -many ‘scientists’ only use data that can be easily rigged. Imagine if there was a report written by a government body which detailed thousands of case studies of parents observing their children’s health falling apart after vaccines. If it were any other consumer item, this is exactly what would have been done.

Shonky use of statistics

I note that the paper’s reference on flu deaths caused by A/H1N1 used just the upper range number of 2 million years of life even though the study had a lower range of one sixth that. You would think that lower figures deserve mentioning but I have a sneaking suspicion that the authors don’t put the references there in the hope that everybody will chase them all up. Now you might say that 300,000 person years is still significant, but you have to understand the inconsistent and convenient use of methodologies here.

The authors of the referred study (Viboud et al) did not use actual lab confirmed numbers of A/H1N1 influenza to get their mortality data but an assumption that a certain percentage of pneumonia/influenza mortality must have been due to A/H1N1 (so-called Swine Flu) in the US. The inconsistency arises when you understand what has happened with the polio vs AFP data. Today, you can’t have polio unless it is lab confirmed whereas in the past, the diagnosis was made on clinical grounds (in other words, by using symptoms). This change in criteria makes the vaccine look more effective.

Here, Viboud et al are saying that we should ignore lab confirmed results and just make estimates as to how many people had A/H1N1. Again, this is done to make the vaccine look good – or to show that its implementation was worthwhile. Poland and Jacbosen took this paper’s wild speculation and assumed that the top range must be the correct one and put it out there as though it was an established fact rather than some epidemiologist’s self-serving fantasy.

Again, it is this sort of thing that is pervasive in the pro-vaccination camp. They regularly come up with speculative projections and then try to pass them off as established numbers.

“Public health officials hail routine vaccination as one of the top ten public health achievements of the 20th century [65], but anti-vaccinationists have successfully campaigned to block legislation for school and day-care mandates and other public health interventions designed to increase vaccination uptake.”

This statement reflects that it is these authors who are on another planet. Firstly, why would ‘anti-vaccinationists’ care about the opinions of public health officials when it came to vaccines? Isn’t questioning public health officials kind of a corollary – desired or not – of questioning vaccines?

Secondly, there are many people who absolutely love vaccines yet who still oppose school and day-care mandates. Or at least they say they do.

It obviously comes as a total surprise to our illustrious authors that there are some people who think they should have the right to decide what gets injected into their bodies.

Anyway, what mandatory vaccine spiel would be complete without hurling abuse at Andrew Wakefield as though most people who question vaccines do so because of him? I can’t speak for others who question vaccines, but I have only a cursory knowledge of what Wakefield did and had never even heard of him before I made up my mind. Indeed, believe it or not, I had never even heard of the connection between vaccines and autism.

But what his story shows me is that when doctors tell me that they would happily admit to their mistakes if, indeed, it turned out that vaccines weren’t as great as they are made out to be, that is a complete lie.

The way Wakefield has been treated for doing no more than raising questions proves that doctors are far more concerned with protecting themselves than protecting patients. That is the moral to his story as far as I am concerned. I am not saying his science is flawed – it wouldn’t take much to be a million times better than an industry that compares its poisons to other poisons and then declares them to be safe – but it had nothing to do with my decisions. It does however demonstrate that vaccines are a sacred cow. A religion – not a scientific process.

“By being informed about the charges brought forward by anti-vaccine proponents, especially those of a quasi-immunological nature, clinicians can assist in providing data-driven information to health providers and the public, assist in research where data gaps are apparent, and provide data for the scientific basis for accepting or refuting claims of vaccine safety and function. The only rational way in which to proceed in devising individual and public health policy in regards to the use of vaccines requires high quality studies and resulting data, interpreted carefully and based on the scientific method.”

I personally would have thought this would require providing data that shows the real world efficacy of vaccines and wasn’t subject to the investigator bias.

It would also require the testing of these vaccines against actual placebos rather than non-inert substances.

But frankly, too much use of statistical mumbo-jumbo is how we got into this position of unyielding sides in the first place. So personally, I would prefer the time-honoured tradition of putting your money where your mouth is.

So some people (and I can think of no better candidates than the authors) need to take a weight adjusted dose of the infant schedule. Better yet, weight-adjust it and then multiply it by 5 times to show that absolutely no child – no matter how fragile – could possibly be harmed by these wonderful concoctions.

HPS.