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I’d like to blend two general lines of thought: what those seeking information about vaccination on-line want but might be unable to (easily) find on-line and what the science (writing) community might do to meet that.

Recently I wrote a comment on the Facebook page of local documentary programme Close Up, suggesting that people might be better ask rather than argue or ’say ‘how it is’’ over something they don’t have the background to to judge in the end.[1] I wrote this in part because many internet ’debates’ seem to degrade to something that seems pretty pointless to me.

Surely the sensible thing for those sincerely wanting to make a decision is to talk with an appropriate background, what typically happens for other things in daily life. But how do you do this for vaccine or other health issues – particularly on-line?

Before I dip into this, let’s distinguish three groups of people.

There are the few who actively promote and champion ’alternative’ thinking as their daily business, as it were, such as Suzanne Humphries or organisations such as the IAS and their overseas equivalents. I’m not addressing my thoughts to or ‘at’ these people.[2]

A second group would be those outside this ‘hard-core’ group but who write occasionally on on-line forums repeating what they’ve read elsewhere. They’re similar to the third in some respects, but presumably holding their opinions more tightly and consequently expressing their opinions and so being ‘visible’ to others on-line.

The third are those that are not ‘visible’ in these ’debates’ – readers, some of who may be trying to make a decision one way or other. They may feel too cowed to speak up, especially with the tendency of some to sling mud around.

I’m primarily interested in the third group and to lesser degree the second.[3]

From day to day when we lack background knowledge in a subject we seek out people with appropriate background and ask them. It’s why I’ve been using tradesmen examples for comparison in my comments there – it’s the same deal, more-or-less.[4]

I wrote ’I know you want to decide for yourself–we all do’. They’re not something I actively seek out, but on and off I’ve seen these noisy internet ’debates’ for a number of years. Well, many years actually, but in more years I’ve been trying to also pay attention to what might be the underlying reasons why people opposing medical practice are writing. A common concern by many opposing various health issues (etc) seems to be wanting to make their own decision.

Fair enough, but -

I can’t see that jumping on people is helpful to anyone. (Including those doing the jumping on; they’re not really gaining anything by ‘dissing’ others.) Hence my grump about the nature of these on-line ’debates’. They’re mostly pointless, as the participants lack the background to resolve the issues properly.

Insisting that what, say, Hilary Butler, Suzanne Humpthries or IAS and similar groups or people have written ’must’ be right won’t help them make a decision either – it’ll block them from seeing if these claims are right or wrong.

To make a decision you need to do the ‘usual’ things.

One would be to make sure where you are getting advice from is sound. It’s got the classic catch-22 that if you don’t know the field, it’s like trying to sort out the good tradesman from the fly-by-nighter from their advertisement. (We’ve all been there!)

Qualifications can be one indicator that someone is likely have an appropriate background – tradesmen have trade certificates and professional organisations for this. It’s not a complete guarantee; people also have to use knowledge properly. A few people will move on, fall out of practice (e.g. retirement) and some will even go ’off the rails’. Unfortunately these latter people in particular can be prominent on-line. The up-shot is despite that it is the quality of the argument presented should be what matters, we’re all pretty much forced to consider who is writing first as a practical matter. Checking past history and current practice can help.[5] (A catch, of course, is that you need to be able to judge their past history; more on this below.)

A common gripe by those opposing medical practice is independence of advice or opinion. Some take this further, playing a conspiracy card – alleging doctors, governments and companies are in cahoots and whatnot.

If you want an independent source of information on the science, one good source might be research scientists with experience in the relevant field and experience in communicating the science. For independence – research scientists at universities and most research organisations speak for themselves and their field. (It’s common lack of understanding that sees some people lump research scientists in with companies and label them as biased.)

If you want someone you can ask questions to, rather than ‘just’ read a (static) website options are thin on the ground. Relatively few scientists offer to help on-line or in general public settings. It’s something that people in the science communication area have talked about a lot. Most scientists simply haven’t the time to spare, they’re already wearing too many hats; many simply aren’t inclined to for a range of other reasons.

Whatever the reasons, a result is that most of the sound material on-line is limited to ‘static’ websites with information, like those at the older version of the immune.org.nz website, rather than interactive sites where discussions take place. (The new version has a discussion forum; it’ll be interesting to see if this can contribute in a useful way.)

A flip side to this is that the few sites that have those with a good background are outnumbered or less visible that those that noisily championing unsound ideas.

In some respects this is inevitable: specialists of any kind are fewer in number than those not a specialist in their field – it’s the nature of the beast, why they are ‘specialists’ – and compounded by the lack of time (or whatever) that makes their presence in on-line forums a rarity. (There are notable exceptions such as virologist Vincent Racaniello’s blog.)

Aside from that, many scientists prefer academic discussions, preferring engaging discussion to noisy ’debate’ with people who are unfamiliar with the details. Frustrating for those seeking information maybe, but there’s more in it for the scientists in many ways.

One consequence is that this leaves those with experience in the same general area of science, but who are not specialists in the specific niche area, picking up the slack. This is certainly better than coverage in the general media. It’s not so much that these scientists will get things wrong, so much as the time involved in verifying material can limit what is presented. (When you’re writing right on your niche you can, more-or-less, write off the cuff.)

If you ask politely you should find these people there are usually happy to help. The trick in these things, I find, is to express an interest in a friendly and polite way – just as you might ask a tradesman for suggestions. (Some authors mostly write articles and leave discussion for others.) Check that the writer’s background, of course, and that they are considered ’sound’.[6] One way is to check that they currently publish papers in quality research journals. (For biologists, searching on PubMed for their name is one approach to this. You’ll still have to check a few things like if the journals they have published in are sound, but it’s a start.)

Here’s a thought – one approach that saves some of this trouble is to use the better science writing communities, as they tend to avoid having members they consider ’dodgy’.

Other science writing communities (other than ours, that is) can be found via scienceblogging.org orscienceseeker.org. (I understand the blogs in scienceseeker are vetted, so most should be of a reasonable standard. I’ve listed some blogs in my Other Science Blogs page, but this is now badly out of date – feel free to try anyway!)

Not all these take on public health issues, of course. Readers are welcome to point out particular blogs by scientists (preferably currently active scientists) or quality science writers that cover public health issues.

I’ve compiled a few more reliable sources of medical information (not just on vaccination).

The CDC has a recent update on the use of pertussis vaccine. (The immune.org.nz is website likely to have a local equivalent.)

If you want to talk to a parent, you could try reading this parent’s perspective. (Her latest post has over 500 comments!)

Footnotes

I’ll admit this isn’t the topic I’d like to start resuming blogging on, I prefer science itself really, but a coincidence of events and scrap of ’free’ time in the midst of a mad rush has lead to it.

1. The documentary programme had presented coverage on the current whooping cough epidemic. I thought they did a pretty good job, but I was less impressed with the ‘debate’ on their Facebook page. Here’s what I wrote:

With the best of respect to those trying to “debate” this issue:

I know you want to decide for yourself–we all do–but if you lack the background it’s highly unlikely that you’ll be able to put different studies in their proper perspective. Goodness knows first-year Ph.D. students can struggle. We use specialists in every area of life for a reason!

By all means express whatever concerns you might have (fair enough!), but a smart amateur DIYer doesn’t try to tell an experienced builder how to do their job! You can *ask*, of course, and learn from them – it’s one reason why IMAC put up the pages on http://immune.org.nz/ – to summarise for others.

A number of people replied levelling various accusations at me, in particular that I was ’dismissing others’, a sort of defence by attacking.

I didn’t express a point of view on the subject itself (as some made out in reply), but how many were are approaching the subject.

Either way, I made what is (surely) be a straight-forward and fairly obvious point and bunch of people tried jump on me. It got me to thinking again why people are antsy about others replying at all and what people opposing (say) vaccines were really after.

2. One thing I find striking is just how few those behind the ‘pyramid’ of opposing various health issues really are.

It’s unkind to say this in some ways but the ‘core’ proponents are something of a lost cause. It’d be like expecting to turn around a committed creationist’s view in a few short comments on-line–it’s not going to happen. At best you might just put the seed of an idea in some heads, but you’d be lucky to do even that. A key problem is that people with ideologies oppose what ever you say by fait, they don’t consider what you’re saying. My feelings are that while you’re better to assist the third group (readers), people in this small subset are better shown up in the eyes of the other two categories, particularly the third.

You could split the ‘core’ group further; I’m inclined to treat the organisations separately from the individuals, but let’s lump them together for the purpose of this post. Similarly, different individuals will have different underlying motivations.

3. One thing I like the idea to keep in mind is when (nominally) replying to people in the first two groups is to in practice focus on trying to reach the third crowd, those who are only reading the discussion, through your reply to those that are writing. Aside from being a better target it has the useful side-effect of not focusing too hard on the person ‘in front’ of you.

4. You wouldn’t throw brickbats, ’demand’ answers or insist that what you heard ’from the neighbour’ to them in the way that some people do online. They’d most likely give you an odd look, shrug their shoulders and walk off!

5. For example (following the discussion on the Close Up Facebook page), and to cut a very long story short, ’information’ Suzanne Humphries, Michelle Rudgley, IAS, etc., have offered in the past is unsound; plenty of reason to be concerned that anything more they offer will be unsound too. This, of
course, brings up the same catch-22 I mentioned earlier if you lack the background – how to judge.

6. With regard to the discussion on the Close Up Facebook page, Suzanne Humphries gets ruled out here. Homeopathy in particular flies in the face of far too much well-established science. Nutshell: anyone who believes in homeopathy has moved far past science or sound critical thought.

Other articles on Code for life:

Campbell Live on influenza vaccines

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

Immunisation then and now

Do TED lectures need better vetting?

Homeopathy in NZ pharmacies revisited: Wartoff and more

Epigenetics overview (video)