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[Update: those looking for a breakdown of the IAS article, it’s in the Appendix.]

The suggestions they make are appalling.

I was tempted to add to the title ’, does this really help anyone?’

Seriously: is encouraging people to be defensive in a tit-for-tat fashion using potted answers really helpful?

I have seriously mixed feelings about writing this sort of thing. On one hand I’d much rather be examining some interesting science. I’ve a lot of that lined up. One out recently is how a rare aggressive thyroid cancer syndrome dominantly found in children of older men is likely to be caused by mutations accumulating in sperm, possibly through germline selection.[1] But I hate to let things like this article on the IAS website stand unanswered. And it’s Friday. There’s always that excuse.

The Immunisation Awareness Society (IAS) has come under question here on sciblogs for it’s advocacy of anti-vaccine stances under the guise of a charitable organisation (see under ‘Related articles’) and for remarks offered to journalists.

This post is on the long side (given how busy I am) so allow me to offer equally busy souls a condensed take before elaborating.

IAS claim to offer an ‘informed choice’. It’s a common among some people and groups who oppose vaccines to claim that they are, for want of a better term, ‘pro-choice’ when all they write is ‘anti-’. IAS reads that way. In order to be true to offering informed choice, information presented should be sound and presented fairly without pushing a particular viewpoint. This article from IAS does none of these. My key objection isn’t even the individual errors [which I’ll address later], bad as they are, but the larger thing of taking a totally negative oppositional approach. If they sincerely want to take vaccine issues forward don’t ‘tell people what to say’, as their article does–that’s the rote evangelism of overbearing ideology–instead investigate what they believe is true using sound sources and present their arguments to open discussion. My challenge for them [is] to live up to what they claim to represent.

My encounter with this particular story starts at another site, the Facebook page of Vaccine Free Families in New Zealand.

(A word to the wise. I am not encouraging people to hassle this group. If you must offer comments there, please be polite. I would encourage people to instead offer their responses here.)

Over there a reader started a game, in their words:

’Ok time for a little game. Im going to post a few common comments which are said by pro vaccine or unaware families and I want to see what your response would be if this was a face to face situation. I want to see what ammo you keep in your mind, your go to facts rather than the “its my family, my choice” kind of answers which are perfectly fine I just want to know what facts you can pull out of your brains quickly….no googling!!’

This developed as a series of questions, listed below, with readers of the Facebook page writing in answers. Whatever you think of these questions and their responses, they provide a useful sample glimpse into some of the beliefs / thoughts that some of those that oppose vaccines have.

Here are the questions asked:

Q: “oh you dont immunise? Arent you worried your kid will get real sick and die?”

Q: “dont you know theres a measles epidemic at the moment!”

Q: “”oh well you know you cant put your kid into school if their not up to date with their jabs.”

Q: “You know that whole Vaccines cause autism thing was a fake right”

Q: “So your kids will spread all these diseases around and give them to those unable to be vaccinated and with low immunity” (There were not many replies to this one.)

Q: “But if you dont immunise then your not protecting the rest of the countries children thru herd immunity, thats just selfish”

Much of this really lies in the replies rather than the questions, which are riddled with misunderstandings and errors. I’d offer a sampling of the replies and address the concerns raised, but there’s rather a lot of them and my time is (very) limited. Maybe in a later article.

To my real target, the IAS.

They put up a similar series of questions where they offered their readers ‘ready answers’:

People find themselves in a variety of situations where the topic of vaccination comes up. Often people who have chosen not to vaccinate cannot remember facts and figures to give others or think of what to say. Don’t let this stop you from speaking up.

Here are some examples that may help:

  1. When you hear someone saying something incorrect about vaccination, simply say ’I used to believe that until I got more information — would you like to me to get you some more information?’
  2. When a doctor or nurse asks why you haven’t vaccinated, simply say ’I am open to vaccination but have not found any SCIENTIFIC evidence vaccination works — do you have any SCIENTIFIC proof?’
  3. When an elderly person tells you that polio was very bad and will return, simply say ’the official info states that polio was 90% gone before vaccination was widely used, so what got rid of the 90%?’
  4. When a well meaning friend or relative questions your decision, simply say ’I fail to see how injecting heavy metals, foreign proteins, multiple viruses and many toxic substances into a body all at one time can keep someone well, can you explain it to me?’
  5. When someone questions your responsibility as a parent, simply say ’I think a responsible parent investigates any procedure to be carried out on their child and does not simply following like sheep out of fear and ignorance, what do you think?’
  6. When someone says your baby will die if not vaccinated, simply say ’I would be more worried if I vaccinated as SIDS is most common at 2, 4 and 6 months — when vaccines are given. In Japan they stopped vaccinating young babies and the SIDS rate plummeted — isn’t that interesting?

This is followed by some general closing thoughts (with straw-man statements).

Rather than tackle these statements here (see the Appendix for that), what I’d like to do is put aside all the questions and their replies for a moment and look at the larger picture – the aims of IAS and it’s existence.

IAS-logo

They offer themselves as ’for an informed choice’, the motto (or slogan) in their logo.

What was presented in their Q&A is neither well-informed nor encouraging choice.

It’s not presenting information and examining it, but, literally in this case, telling people what to think.

If you read the IAS website, you will quickly learn that when they offer information it is usually inaccurate, unsubstantiated or out of context. You will also learn that they do not encourage free choice, as such, but rather encourage a particular choice–their favoured anti-vaccine view.

In Australia, the New South Wales Government Health Care Complaints Commission (HCCC) has issued a public warning about the Australian Vaccination Network (AVN) following complaints laid (PDF file), primarily from the Stop AVN Campaign. (Discussion on this, naturally, abounds. This warning was recently challenged in court;  one informal summary is offered on an Australian blog.[2])

The observations the HCCC notes of AVN are also true of IAS:

  • provides information that is solely anti-vaccination
  • contains information that is incorrect and misleading
  • quotes selectively from research to suggest that vaccination may be dangerous

(IAS probably do less of the latter as they rarely refer to the research literature at all.)

What IAS offer is quite a different thing to offering information and letting readers draw their own conclusion.

In order to genuinely advocate ’informed choice’–what they claim to offer–the information presented must be accurate, be presented fairly and the organisation should not push a particular view.

These oppositional question-and-answer games certainly do not do this.[3]

I would challenge IAS, rather than tell people what to say, to investigate what they believe is true using sound sources and present their arguments to open discussion.[4]

Appendix

Let me take each question and it’s reply and very briefly offer some comments. My replies are to the person defending their choice not to vaccinate:

When you hear someone saying something incorrect about vaccination, simply say ’I used to believe that until I got more information — would you like to me to get you some more information?’

What matters is if your information is sound; checking it against sound sources could be a start.

When a doctor or nurse asks why you haven’t vaccinated, simply say ’I am open to vaccination but have not found any SCIENTIFIC evidence vaccination works — do you have any SCIENTIFIC proof?’

What about your decision? Is that based on sound information?

Looking for proper evidence is indeed a good thing. You would be better to either ask an advisory service like IMAC or look up the scientific literature as these represent the medical science community. The sources I referred to earlier try condense the key points to something more readable.

When an elderly person tells you that polio was very bad and will return, simply say ’the official info states that polio was 90% gone before vaccination was widely used, so what got rid of the 90%?’

By all accounts the polio epidemics were indeed bad, but the idea that polio mostly declined before the vaccine were introduced is incorrect. A number of anti-vaccine sites seem to spread this particular myth. It’s usually based around pointing out a (gradual) decline in deaths then saying the number of cases fell, when they didn’t. (I recently learnt from experience that in a few cases the myth comes from leaving the Salk vaccine out of the picture.) The original data for polio cases in the USA over 1952-1962 can be found on the excellent History of Vaccines website.

When a well meaning friend or relative questions your decision, simply say ’I fail to see how injecting heavy metals, foreign proteins, multiple viruses and many toxic substances into a body all at one time can keep someone well, can you explain it to me?’

Alison has told me that she wants to cover this one, so I’ll await her contribution. [Update: it’s here.] If IAS or you aren’t familiar with what enables vaccines to work, perhaps it’s best look to those that develop them, are responsible for vaccine safety or study immunology? As I was writing earlier, the better people to ask are those the represent the medical research community. IMAC, the CDC and my suggested sources are some possible starting points. (The claim of ’toxic substances’ and ’heavy metals’ is overplayed, as Alison will no doubt explain.)

When someone questions your responsibility as a parent, simply say ’I think a responsible parent investigates any procedure to be carried out on their child and does not simply following like sheep out of fear and ignorance, what do you think?’

The use of ‘fear and ignorance’ is replying to a straw-man, the person is quite likely quite happy with their decision. We all defer to experts in pretty much every area of our lives because we recognise that they know better than we do. My impression is that many ‘anti-vaccine’ parents feel they cannot trust those with better knowledge to represent their interests. I can sympathise (but not agree) with that, but reflecting your distrust onto others isn’t right or fair. (You might be better to investigate and learn why they are confident, perhaps?)

When someone says your baby will die if not vaccinated, simply say ’I would be more worried if I vaccinated as SIDS is most common at 2, 4 and 6 months — when vaccines are given. In Japan they stopped vaccinating young babies and the SIDS rate plummeted — isn’t that interesting?

Shame on IAS to repeat a well-established myth, although I have to say it is typical of what I have seen of their ‘information’. As the burden of proof lies with them, IAS should verify their own claim, but allow a few quick pointers.

IAS will need to clarify which vaccine they mean, but is likely to be the DTaP vaccine. The CDC has a brief explanation that the rate of SIDS if anything is somewhat lower amongst those who have taken a DTaP vaccination. (Some sites suggests this particular myth traces back to an error made by anti-vaccine proponent Viera Scheibner.) Note also that when Japan stopped the whooping cough (DTaP) vaccine, over the next 8 months they experienced approx. 13,000 cases of whooping cough as a consequence.

The questions are followed by some general thoughts, the first of which is:

Finally, if you cannot remember any of the above, no matter what someone is saying, simply ask ’can you prove that?’ This is the show stopper as vaccinators cannot prove anything they say in regard to vaccines being safe or effective. They are simply not safe and effective.

What matter is what you think.[5] If you choose not to take vaccines, it is for you to determine that choice is sound.

Later we read:

People who vaccinate can rarely answer any intelligent questions about vaccination.

To my judgement those replying to the questions on the VFFNZ Facebook page offer, to be polite, poor responses. If their responses are typical, then those that oppose vaccines do no better. I’m not really surprised neither ‘side’ does well at this, as few people will be well versed in the research literature involved. That’s why I suggested ’You would be better to either ask an advisory service like IMAC or look up the scientific literature as these represent the medical science community’ earlier.

What I do think is bad, though, is to think that you can speak more accurately on a subject than those who have spent many years studying it, on the basis of a few hours on the internet.

Skipping the next paragraph (it’s neither here nor there other than it stereotypes those who oppose vaccines and speak out as ’open and responsible’), we read:

A final word: People who vaccinate their children out of fear and ignorance do not have to justify their decision.

You don’t have to either, so stop thinking you do!

Actually this isn’t quite right. Lets put aside that the straw-man of ‘fear and ignorance’ being played again (as I mentioned early, many of these people will be quite happy with their decision). Those medical community are in fact obliged to justify the decision to offer the vaccines. Most people are aware of them, even if at a distance and in a vague sort of way. They know the medical community has control systems for these sorts of things. In that wider sense, the decision is justified and is obliged to be.

In the same sort of way, those that choose not to should really justify there decision too. After all it’s their families and the wider community that will be affected. Disowning responsibility entirely like this a bit irresponsible. Think how you’d be taken if you said ’I don’t have to justify keeping my kids clean because others do.’ You keep them clean because you know it’s the responsible thing to do. The medical community offers that advice. Now, why would the medical community turn their advice all upside down just for vaccines?

The IAS article closes with:

Be proud you have done the research and acted responsibly based on your new knowledge.

What research? Where is this ’new knowledge’? The IAS article doesn’t present any. That was one of my key criticisms of it – that it presents inaccurate information and doesn’t examine the information presented.

Knowledge isn’t about rote copying other’s words. It’s about understanding things, about testing ideas. That’s why I called for the IAS to ’investigate what they believe is true using sound sources and present their arguments to open discussion.’ It’s why science uses an approach of rigorous testing and discussion. It’s how we learn what still needs further work and what is sound. You’ll never get that from rote copying of other’s words.

Footnotes

1. Or Dravet Syndrome, which would be of more interest to those with an interest in vaccines.

2. My thanks to lizditz who helped with these links. The amount of time and energy Liz pours into combating ‘woo’ is impressive. It gets worse when organisations that (claim to) offer sound advice to families (say) host guest articles by the likes of AVN, as the Australian group BellyBelly has done. (I wrote several days ago politely suggesting that they take this page down, but they have not acted nor replied. It is difficult, to say the least, for them to claim to be offering good advice to families and also present this sort of wildly inaccurate material. Are we to be left to presume that they are content to be considered an unreliable source of information?)

3. See also a recent post by Alison on the issue of discussing issues with strongly-held views, here be dragons.

4. This page answers a few of the more common vaccine myths.

You might note that this is asking to be positive, in the sense of presenting material that moves things forward. It’s the reason, for example, that I feel reluctant writing these sorts of posts as I prefer to offer constructive material. It’s the reason that despite having written an long reply to the article Michelle Rudgley’s posted in response to my examining her statements to a journalist, I have not posted it. It was easy enough to show the claims she presented were unsound (if time consuming as I had to dig back to the sources), but to present it positively I’d have to also do what IAS hasn’t, essentially do their work for them: research each question, examine what is there and present a fair presentation of it. That would take an entire series of long posts to examine each issue in turn.

5. Let’s do a longer take on just this one. There are several errors here. One is captured in the cliché that ‘a lack of evidence is not evidence of a lack’. Or, put differently, it’s a logical fallacy to argue that ’if ‘Y’ cannot prove for ‘X’ is right, then ‘not X’ must be right’. For example, ’if Yvonne cannot prove the car was red, then the car must not be red’ is a nonsensical. IAS are arguing, or strongly implicating, that a (claimed by them) lack of proof of vaccines as being safe, is a proof of vaccines not being safe.

A second error is, of course, that ’as vaccinators cannot prove anything they say in regard to vaccines being safe or effective’ is a straw man statement – it’s not correct and seeks to dismiss out-of-hand.

A third, more subtle, issue hidden in this is that safety or effectiveness is not absolute but relative; vaccines are ‘more safe than’ or ‘sufficiently effective to make an acceptable difference’. By setting up absolute standards, you artificially set up a demand for absolute safety and absolute effectiveness. This demand for perfect safety, in turn, harks to calling for safety in terms of every individual, rather than looking at it from a population view. The correct question is if the population is better off, not if every single person is perfectly protected. What in the end matters is if the vaccines are (much) safer than the disease in the absence of vaccine and if the effectiveness is sufficient to deliver this benefit.

A few related articles on Code for life:

Reviewing Deadly Choices

Fact or fallacy, a survey of immunisation statements in the print media

Immunisation, then and now

Rubella, not a benign disease if experienced during early pregnancy