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It might even be funny if Maher weren’t serious.

Bill Maher, well-known American comic, has been widely criticised for this anti-vaccine sentiments and statements.

He was awarded this year’s Richard Dawkins Award, awarded by Atheist Alliance International, honouring an outstanding atheist. The conflict of these has resulted in a fair amount of discussion.

Two days ago (Sunday 15th Nov) Bill Maher posted on his blog what he proports is a “considered” view of his position on vaccines, in what appears to be a move to counter what he believes was a misuse of his remarks on twitter to the effect that those who take vaccines are idiots.

Let’s look at what he says….

I’ve haven’t time to focus on the detailed science–perhaps it’s just as well we don’t really have too!–my focus will be more on the basic logic of what he says. (I have a day job…)

Personally, I think he should stick to being a comic. Unless his blog post was meant to be satire… I’ll take it as being serious; nothing in it seems funny-haha to me.

I’ve presented this as a running commentary as I haven’t time for anything more substantial.

I haven’t quoted every bit of his blog post, but most of it, as there’s simply too much of it. This is long enough as it is!

In infuriatingly, I discovered after I wrote the material below that this has already been covered, in a sense. It seems that his blog post is a re-hash of words from his final show for the season, which Orac has already dissected. At great length, as is Orac’s style. If you play the video at Orac’s blog and read his take on this, you’ll see how much of a re-hash it is. Sigh. But seeing I’ve written it, I’ll put it up all the same… One more voice can’t hurt, right?

What I’ve written is my own, not from Orac’s words.

Anyway, on with the show. Maher writes:

I do this because there is obviously a lot of curiosity about this subject of vaccines — it comes up in every interview I do these days, and I’ve been finding that people, including doctors, are privately expressing a skepticism that is still not very prevalent in public. I feel like I’ve become a confessor for people who want someone to be raising questions about vaccines.

He wants anecdotes to rule over evidence?

But I don’t want the job.

Cut the crap out. Playing the line that he’s the reluctant hero isn’t going get my sympathies. You don’t spend time writing an extensive post on a blog unless you wanted to. I know that from experience, right? :-) (OK, maybe he had staff do it for him, same deal.)

I agree with my critics who say there are far more qualified people than me – its just that mainstream media rarely interviews doctors and scientists who present an alternative point of view.

Good on them for not spending time on unsupported views, I’d say. Balance should be about if views have substance backing them, not “equal time on air”.

There is a movement to stop people from asking any questions about vaccines — they’re a miracle, that’s it, debate over.

Wow. Conspiracy theories this early in his post? There is no movement to stop people asking questions. Most scientists I know would prefer that people did ask questions because the evidence-based answers strongly favour taking vaccines. If there is a “movement” it’s to look at the evidence, not anecdotes from famous people. (Like himself, of course.)

I don’t think its that simple, and neither do millions of other people. The British Medical Journal from August 25 says half the doctors and medical workers in the U.K. are not taking the flu shot — are they all crazy too? Sixty-five percent of French people don’t want it. Maybe its not as simple as the medical establishment wants to paint it.

There is a simple answer he doesn’t didn’t give: laziness. Laziness is a human thing, after all… we’re all guilty of it. Boring “ordinary” answer I know, but boring ordinary answers are often the right ones; exotic conspiracy answers are a fetching and entertaining, but unrealistic… (to be polite).

The point I am representing is: Is getting frequent vaccinations for any and all viruses consequence-free?

I’d say he’s confused on two points. Firstly, that we have vaccines for “all” viruses. We don’t. Vaccines cost a hell of a lot of money and research time to develop. Priority is placed on addressing things that matter. More emphasis is placed on the likes of smallpox or polio than the common cold.

Secondly, there is an strong element of the old “too many vaccines are bad” anti-vaccine canard here. It’s nonsense. You get far more exposure to “nasties” all the time than all the vaccines combined.

I feel its unnecessary and counterproductive to try and silence people with condescension. Michael Shermer wrote me an open letter and felt I needed to be told that “vaccinations work by tricking the body’s immune system into thinking that it has already had the disease for which the vaccination was given.” Thanks, Doc, I thought there might be a little man inside the needle. Yes, I read Microbe Hunters when I was eight, I have a basic idea how vaccines work.

Hilarious. First try play the high moral ground card, then do exactly what you say you don’t to someone. Surely Maher can see how condescending he’s being? Well… it reads that way to me…

Maher might want to consider that Dr. Shermer wrote as he did because Maher’s statements so lacked substance that they carried the impression that he needed to be reminded of the basics.

He makes some excuses for not presenting his full story on his show, which I’ll leave aside. He excuses twitter as a very informal “place”, then writes of his tweet:

But apparently it’s taken very seriously, because there was Scott Pelley on 60 Minutes asking the Secretary of Health and Human Services what she thought about the fact that “Bill Maher told his viewers anyone who gets a flu shot is an idiot.”

He protests that “It was twittered, [...]“. True, but he’s a famous man. I’ve every sympathy for famous people who are hounded for silly quotes, but he must know his remarks anywhere are going to be used. That’s not the fault of twitter. Pointing at twitter isn’t an excuse. (Point at the context of the conversation, maybe, but he doesn’t do that.)

But, come on — it was a twitter from a comedian, not a treatise in the New England Journal of Medicine, that’s not what I do.

is immediately followed, opening the next paragraph, with:

I’m just trying to represent an under-reported medical point of view in this country, [...]

You can’t have this both ways. You both say that you don’t do that and then say that you do. Either you know your stuff or don’t. You can’t represent something you don’t understand. No-one can.

If you don’t know medicinal science how can you “represent [a ...] medical point of view”?

But someone needs to be representing the point of view that says the preferred way to handle flus is to have a strong immune system to begin with, and getting lots of vaccines might not be the best way to accomplish that over the long haul.

Two things here. To the first part, note the hidden assumption that implies “without vaccines”. Yes, it’s good to have a healthy immune system, but that says nothing about not having vaccines. (He’s also mixes the flu’ specifically with vaccines in general throughout.)

To the second part, he’s back at the “too many vaccines” canard, again.

In addition, my audience is bright, they wouldn’t refuse a flu shot because they heard me talk about it, but if they looked into the subject a little more, how is that a bad thing? If they went to the CDC Web site and saw what’s in the vaccine — the formaldehyde, the insect repellent, the mercury — shouldn’t they at least get to have the information for themselves?

Ignore him playing the reluctant saviour again (cue the violins, etc.). But the false claims about the vaccines, ouch.

Like I said at the onset, I haven’t time to go in the science in details. I’ve got work to attend to, like most people.

There’s a “standard” thing denialists of all kinds do: make many claims quickly knowing each claim will take a long time to refute, much longer than the time to make the false claims in the first place. Unfortunately, as a practical ploy it’s a winner. It’s always quicker to make false claims than correct them. But let me make a few quick points:

Formaldehyde is a natural substance that’s also in our own bodies… in far larger amounts naturally than are in the vaccines.

“the insect repellent”–huh? Bizarre claim. Orac has dug this out and covered it well. Note that to resolve this claim he had to reach for rense.com, a very bizarre website that is basically a grab-bag of conspiracy theories of all kinds.

“the mercury”. By this he, no doubt, means thimerosal. This is a well and truly over-played claim, see my earlier post on this. This should be a closed case now without silly sods still trying me out that this is relevant. There are trace amounts of thimerosal in a small number of vaccines (most don’t have any). Your body can (slowly) clear thimerosal and at these amounts there is no issue. The far larger source of mercury, in a form that is more of a health issue, is from people’s diet, e.g. sea fish.

And if you have a compromised immune system and can’t boost it naturally, as in poor countries where the children are eating dirt, then a vaccine can be a white knight — bravo!

Err, an in Western countries too. Compromised immune systems aren’t limited to poor nations.

Does the polio vaccine have the power to prevent children from getting polio, and did it indeed do just that in the 1950s? I believe it does, and it did. But polio had diminished by over 50 percent in the thirty years before the vaccine — that’s a pretty big fact in the polio story that you don’t often hear and which merits debate. It may be the case that the vaccine should have been used anyway to finish polio off, but there are some interesting facts on the other side.

Dumb argument. Just because a disease is being suppressed doesn’t mean that the disease organism has gone away, unless humans are the only host for that disease. Take away the thing suppressing the disease and it’ll come back. That particular “experiment” has been done many times with consistently the same result: remove the vaccine, the disease returns.

So yes, I get it, we learned how to trick our immune systems. And maybe sometimes, you gotta do it. But maybe the immune system doesn’t like being tricked so many times. Maybe we should be studying that instead of shouting down debate.

Back to the “too many vaccines” canard. Sounds as if this is all he has. And who is he to be advising what to study if he points out he doesn’t know medical science?!

Someone who speaks eloquently about this is Barbara Loe Fisher, founder of the National Vaccine Information Center. I find her extremely credible, as I do Dr. Russell Blaylock, Dr. Jay Gordon and many others, but I shouldn’t have even mentioned them because I don’t want to be “the Vaccine Guy”!! Look it up yourself, and stop asking me about it — I’m already the Religion Guy, and that’s enough work!

The “National Vaccine Information Center” is well-known as an anti-vaccine movement with a (likely intentionally) misleading name. Repeatedly exposed as such on-line (see Science-based Medicine).

I’m not familiar with Dr Blaylock, but see Science-based Medicine for exposés on Dr Gordon, or try Respectful Insolence.

60 Minutes has done two pieces on swine flu within a month. The first one introduced us to a high school football player named Luke Duvall who, we were told, was the picture of health, and then got hit by the flu so bad he was in the hospital at death’s door. But later in the segment we learn that Luke had staphylococcus pneumonia along with the flu. Was that staph bug in him when he got hit by the flu? Its not clear from the reporting, but since every other kid on both football teams got the flu, as well as the cheerleaders … ahem … and all of them got over it just fine, then it seems quite possible that Luke had a co-existing infection, and that’s why his experience with H1N1 was so different.

Poor logic. You’re telling us to ignore people and let them suffer because they have other conditions that affect the outcome? Conditions they can’t conveniently “just not have” when the flu’s around. “Staph” is a pretty common infection, after all.

He’s also leaving out that some people without underlying conditions got seriously ill. Sounds like what the chiropractor tried to say. As I wrote there:

The studies noted above indicate at least one quarter of serious ill patients had no underlying health condition, possibly more.

Back to Maher:

By the way, when Scott Pelley asked the government spokesman about the fact that only one percent of people who get the flu find it to be anything other than a typical, mild flu, the answer was an analogy to seatbelts, that “only 1 percent of people riding in a car will be in an accident, but you don’t want to take a chance on being that 1 percent.”

That went unchallenged, which is sad, because what a horrible analogy! I would think vaccines containing many different dicey substances shot directly into the bloodstream have a slightly greater chance of secondary effects than a piece of fabric lying across your waist. Maybe if you had to swallow the seatbelt this would be a good analogy.

No, the analogy Maher gives is truly horrible, mainly because it simply leaves out the actual numbers. Firstly he tries the emotive “many different dicey substances shot directly into the bloodstream”. Leaving aside his mistake that vaccines are not “shot directly into the bloodstream” (but muscle), he’s still overplaying it by leaving out that the dose matters. The tiny amounts of these things in vaccine are insufficient to cause any harm.

Then there’s the actual rate of serious affects subsequent to vaccination which are much, much lower than 1 in 100. Hell, if they were that high, they wouldn’t past early pre-clinical trials, never mind reach the market. (They’re measured to units of 1 in 10,000,000 and generally occur at those sorts of frequencies.)

While we’re on the subject of bacteria, let me say clearly I understand germ theory also — I believe they also covered that in Microbe Hunters — nor have I ever said I was a “germ theory denier.” What I’ve been saying is that Western medicine ignores too much the fact that the terrain in which bacteria can thrive is crucial and often controllable, which shouldn’t even be controversial. I don’t care what Louis Pasteur said on his death bed — it was probably, “Either the curtains go or I do” — that’s not the point!

Nice try, but your body is crawling with bacteria (your body has roughly ten times the number bacterial cells in & on it as human cells) and many (if not most) bacterial infections are opportunistic. You couldn’t control them if you tried. Sure, you can reduce your odds of infection, but not eliminate them. The easiest way to think of this, is think of the likes of getting a splinter in you gardening (or whatever), or eating food that later proved dodgy.

And it’s precisely because I am a Darwinist that I fear the overuse of antibiotics, since that is what has allowed nasty killer bugs like MRE to adapt so effectively that they are often resistant to any antibiotic we can throw at it. There are consequences to vaccines and antibiotics. Some people want to study that, and some, it seems, want to call off the debate.

Vaccines cannot be directly compared to antibiotics like this. They are two very different things. This is a straight-forward attempt to play on people’s fears then introduce a false comparison to imply an association that is not there.

Instead of setting up this straw man of me not understanding germs or viruses, let’s have a real debate about how much we should use vaccines and antibiotics. Of course it’s good that we have them in our arsenal, but isn’t the real skeptic the one who asks if these powerful but toxic methods do harm to what actually is a a very good defensive system, the one you were born with?

He seems to be setting up rather a lot of straw men himself! Debates are no good: they’re not about discussing evidence, they’re about winning over the audience. Issues like these cannot be decided by opinions, his included, they can only be solved by evidence-based studies and for things he mentions, there is a lot of evidence already.

Also, I have never said there was a medical conspiracy.

He did earlier in the very same blog post (see above).

Do pharmaceutical companies want to cure diabetes or do they want to sell diabetes drugs and equipment? Well, they sure do sell a lot these days, and the food companies are what make that possible. Read David Kessler’s book about the deliberate way food companies use salt, fat and sugar as foodcrack to get people literally addicted to eating bad food and too much of it. Is that a conspiracy? Only if you define corporations putting profit ahead of human health as conspiracy. The fact that Americans will do anything to each other for money is not a conspiracy, it’s a scandal.

Interesting perhaps, but this has nothing to do with vaccines.

Irrelevant stuff about American health care omitted. (Not of interest to me.)

He bangs on about advertising, big money, etc. with pharmaceutical products. Well, OK; but isn’t what matters is the evidence behind the claims, not all this?

“[...] and for the record, I have a naturopath doctor and I have a Western doctor.”

Methinks there’s the nub of the problem. He’s been “drinking the woo too deeply”, as Orac is fond of saying. I’d suspect his naturopath is a good salesperson.

Ms. Fisher said “If we want to create a society that is dependent on shots for immunity — the same way we are getting dependent on prescription drugs, antibiotics, and surgery — this is the path we should keep going down.”

Well, I suppose we could go back to the days that serious infectious illnesses were common, by dispensing with the prevention of them…

I don’t think its “anti-science” to pause and consider that point of view.

Of course it’s anti-science. He doesn’t even start to consider the science point of view right throughout his article, despite all his hand-waving excuses that he’s looked at them!