SciBlogs

Posts Tagged Vaccination

Vaccines Vs Pneumonia Darcy Cowan Jul 29

No Comments

One of the linchpins of the anti-vaccine movement is the attempt to muddy the issue with regard to vaccine efficacy. From this point various others follow; if vaccines are ineffective then large risks need not be shown – any risk at all makes being vaccinated an unwise choice. If vaccines do not perform their role then “forcing” people to vaccinate their children is unwarranted.

Lucky for them many of the diseases vaccinated against had the debut of their vaccine quite some time ago which makes it easier to cloud the issue as to causation: perhaps the disease was waning naturally, perhaps it was improved sanitation etc.

Lucky for us vaccine development continues and new vaccines get evaluated down the line to determine effectiveness. This gives us a more recent look how vaccines work and their impact on the population that is not as susceptible to these tactics.

For example, pneumonia is a risk for young children and hospitalisations in the US prior to 2000 hovered around the 1,200 per 100,000 mark. In  2000 a pneumonia vaccine was introduced into the vaccine schedule which targeted 7 of the 90 odd bacterial strains that cause the disease. Recently a study was published looking at the effect of the vaccine on incidence of hospitalisations. In particular the researchers were looking to see if the initial drop in hospitalisations seen in 2000 was holding steady considering the other strains that could fill the gap. They also looked at incidence of pneumonia hospitalisation in age groups other than infants (classed as <2 yrs old) to see if the vaccine was having any effects outside of the nominal target population.

I’m not sure if this expanded scope is normal for this sort of study but I gather that the older population tends to contract the disease from the young family members so this sort of cross population effect at least has a plausible mechanism in this case.

So what was found and why did I bring anti-vaccinationists into this?

Well, first off as was hinted above there was a significant drop in infant hospitalisations in 2000 (the year the vaccine was widely introduced) which continued to the end of the study period in 2009, as shown in this graph:

Oops, alt text here: you should really be seeing a picture. Sorry.

Incidence of Hospitalisation due to Pneumonia per year

In other words, the vaccine is doing it’s job. It’s hard to argue that there was a significant change in sanitation or general practice between 1999 and 2000 to account for the dramatic and sustained drop as seen. I would like to have seen the incidence prior to 1997 extended further in order to see what the trend for the previous 10 years was. However given that the purpose of the paper was routine surveillance, not to refute anti-vaccine proponents, that’s probably a bit much for me to ask. This 2004 study suggests that childhood incidence of pneumonia is around 3,500 cases per 100,000 (~35 per 1,000 as noted in the paper, adjusted here to give the same units as the current study) but does not specify how many of these would have required hospitalisation.

Secondly the study also found a significant drop in hospitalisations for older people as shown in this graph:

Alt text again, you should really get that looked at.

Pneumonia hospitalisations across age groups

So you don’t even need to receive the vaccine directly to get a benefit from it. That’s already well known but it’s nice to have an instance graphed out like this.

As I started this article, if you can throw doubt on the effectiveness of vaccines then arguing follow up points becomes much easier. A corollary to this is that if people are unaware of the facts around vaccine efficacy they will be unable to counter the miss-information and will either be persuaded by it or fail to effectively argue with those who have been already persuaded.

With this in mind I offer the above as further ammunition for those who come up against anti-vaccine arguments at home, at work or as you potter around the wilds of the internet.Enhanced by Zemanta

Previous Articles on the topic of vaccines:

IAS Complaint Part 1

IAS Complaint Part 2

IAS Complaint Part 3

IAS Complaint Part 4

Defending The Term “Anti-Vaccine”

The Legitimate Risks of Vaccines

Filed under: Medicine, Sciblogs, Science, skepticism Tagged: Health and Medicine, Pneumonia, Science and Society, Vaccination

Vaccines Vs Pneumonia Darcy Cowan Jul 29

No Comments

(I’m going to do my first post on the topic of vaccines since our resident expert joined us, I feel like I’m stepping on toes – Sorry Helen :))

One of the linchpins of the anti-vaccine movement is the attempt to muddy the issue with regard to vaccine efficacy. From this point various others follow; if vaccines are ineffective then large risks need not be shown – any risk at all makes being vaccinated an unwise choice. If vaccines do not perform their role then “forcing” people to vaccinate their children is unwarranted.

Lucky for them many of the diseases vaccinated against had the debut of their vaccine quite some time ago which makes it easier to cloud the issue as to causation: perhaps the disease was waning naturally, perhaps it was improved sanitation etc.

Lucky for us vaccine development continues and new vaccines get evaluated down the line to determine effectiveness. This gives us a more recent look how vaccines work and their impact on the population that is not as susceptible to these tactics.

For example, pneumonia is a risk for young children and hospitalisations in the US prior to 2000 hovered around the 1,200 per 100,000 mark. In  2000 a pneumonia vaccine was introduced into the vaccine schedule which targeted 7 of the 90 odd bacterial strains that cause the disease. Recently a study was published looking at the effect of the vaccine on incidence of hospitalisations. In particular the researchers were looking to see if the initial drop in hospitalisations seen in 2000 was holding steady considering the other strains that could fill the gap. They also looked at incidence of pneumonia hospitalisation in age groups other than infants (classed as <2 yrs old) to see if the vaccine was having any effects outside of the nominal target population.

I’m not sure if this expanded scope is normal for this sort of study but I gather that the older population tends to contract the disease from the young family members so this sort of cross population effect at least has a plausible mechanism in this case.

So what was found and why did I bring anti-vaccinationists into this?

Well, first off as was hinted above there was a significant drop in infant hospitalisations in 2000 (the year the vaccine was widely introduced) which continued to the end of the study period in 2009, as shown in this graph:

Oops, alt text here: you should really be seeing a picture. Sorry.

Incidence of Hospitalisation due to Pneumonia per year

In other words, the vaccine is doing it’s job. It’s hard to argue that there was a significant change in sanitation or general practice between 1999 and 2000 to account for the dramatic and sustained drop as seen. I would like to have seen the incidence prior to 1997 extended further in order to see what the trend for the previous 10 years was. However given that the purpose of the paper was routine surveillance, not to refute anti-vaccine proponents, that’s probably a bit much for me to ask. This 2004 study suggests that childhood incidence of pneumonia is around 3,500 cases per 100,000 (~35 per 1,000 as noted in the paper, adjusted here to give the same units as the current study) but does not specify how many of these would have required hospitalisation.

Secondly the study also found a significant drop in hospitalisations for older people as shown in this graph:

Alt text again, you should really get that looked at.

Pneumonia hospitalisations across age groups

So you don’t even need to receive the vaccine directly to get a benefit from it. That’s already well known but it’s nice to have an instance graphed out like this.

As I started this article, if you can throw doubt on the effectiveness of vaccines then arguing follow up points becomes much easier. A corollary to this is that if people are unaware of the facts around vaccine efficacy they will be unable to counter the miss-information and will either be persuaded by it or fail to effectively argue with those who have been already persuaded.

With this in mind I offer the above as further ammunition for those who come up against anti-vaccine arguments at home, at work or as you potter around the wilds of the internet.Enhanced by Zemanta

Previous Articles on the topic of vaccines:

IAS Complaint Part 1

IAS Complaint Part 2

IAS Complaint Part 3

IAS Complaint Part 4

Defending The Term “Anti-Vaccine”

The Legitimate Risks of Vaccines

Filed under: Medicine, Sciblogs, Science, skepticism Tagged: Health and Medicine, Pneumonia, Science and Society, Vaccination

Anti-Vaccine Charity, No More Darcy Cowan Nov 07

No Comments

Last year I wrote a series of posts[1] around the Charitable organisation Immunisation Awareness Society and a complaint I had made to the Charities Commission. The Thrust of these posts and the complaint was that the Society does not fulfill the requirements of a charity and should be removed from the register. The effect of this is that they would also be stripped of their tax exempt status.

This indeed was my main goal. There are innumerable groups out there that I don’t agree with but you get that in a wide and varied world. In the case of the IAS though the speech they engage is is effectively publicly subsidised via the tax exemption, this should mean that they are constrained in what they can say. At the very least it should mean that they must present the facts undistorted by ideology.

Yesterday I found out that the Charities Commission agrees with me. In a decision handed down late last month they determined that the IAS does not qualify for charitable status and removed them from the charities register.

So, I guess you could say – I won.

It the words of one of my colleagues it also shows that one person can make a difference. Clichéd but true.

Reading through the Charities Commission decision it seems they focused on two things:

1. The biased nature of the information provided by the IAS and;

2. The political nature of their campaigning for a change in public policy.

This makes sense given the requirements that the Commission need to fulfil to determine whether an organisation meets the requirements to be a charity. Even so I’m a bit disappointed that there was no focus on the factual inaccuracy of and misrepresentation in the materials published by the IAS.

The decision does seem to skirt this line though when stating that  “Overwhelmingly, the information on the website argues that vaccination is ineffective and dangerous” the inference being that is view is incorrect as well as being biased. Even so, none of the language of the report actually states this outright (that I can see).

There was also an additional point touched on that merely providing information does not in and of itself “advance education”. In other words to be an educational charity you actually have to actively educate people, not simply act as a repository of information – otherwise every private citizen with a decent library or informational website could become a charity.

Finally, in my personal 15 minutes of fame, the Commissions decision has been reported in the Dominion Post – complete with a quote from me. Not my most eloquent moment but it’s close enough to the point I wanted to make that I’m fairly happy.

[Edit: Thanks goes to commenter Hemlock for sharing the IAS response to this news]

——————————————————————————————————————-

1.  And here they are in all their tedious glory:
https://scepticon.wordpress.com/2011/10/11/anti-vaccine-charities-is-there-any-quality-control-on-charities/

https://scepticon.wordpress.com/2011/10/11/ias-complaint-part-1-thimerosal-in-your-vaccine-no/

https://scepticon.wordpress.com/2011/10/12/ias-complaint-part-2-gardasil-horrors-horrific-reasoning/

https://scepticon.wordpress.com/2011/10/13/ias-complaint-part-3-vaccine-ingredients-not-so-bad-really/

https://scepticon.wordpress.com/2011/10/14/ias-complaint-part-4-anti-vaccine-impact-in-new-zealand/

https://scepticon.wordpress.com/2011/10/17/defending-the-term-anti-vaccine/

https://scepticon.wordpress.com/2011/10/18/the-legitimate-risks-of-vaccines/

Enhanced by Zemanta

Filed under: Medicine, Sciblogs, Science, skepticism Tagged: Health and Medicine, IAS complaint, Science and Society, Vaccination, Vaccine

Anti-Vaccine Charity, No More Darcy Cowan Nov 07

108 Comments

Last year I wrote a series of posts[1] around the Charitable organisation Immunisation Awareness Society and a complaint I had made to the Charities Commission. The Thrust of these posts and the complaint was that the Society does not fulfill the requirements of a charity and should be removed from the register. The effect of this is that they would also be stripped of their tax exempt status.

This indeed was my main goal. There are innumerable groups out there that I don’t agree with but you get that in a wide and varied world. In the case of the IAS though the speech they engage is is effectively publicly subsidised via the tax exemption, this should mean that they are constrained in what they can say. At the very least it should mean that they must present the facts undistorted by ideology.

Yesterday I found out that the Charities Commission agrees with me. In a decision handed down late last month they determined that the IAS does not qualify for charitable status and removed them from the charities register.

So, I guess you could say – I won.

It the words of one of my colleagues it also shows that one person can make a difference. Clichéd but true.

Reading through the Charities Commission decision it seems they focused on two things:

1. The biased nature of the information provided by the IAS and;

2. The political nature of their campaigning for a change in public policy.

This makes sense given the requirements that the Commission need to fulfil to determine whether an organisation meets the requirements to be a charity. Even so I’m a bit disappointed that there was no focus on the factual inaccuracy of and misrepresentation in the materials published by the IAS.

The decision does seem to skirt this line though when stating that  “Overwhelmingly, the information on the website argues that vaccination is ineffective and dangerous” the inference being that is view is incorrect as well as being biased. Even so, none of the language of the report actually states this outright (that I can see).

There was also an additional point touched on that merely providing information does not in and of itself “advance education”. In other words to be an educational charity you actually have to actively educate people, not simply act as a repository of information – otherwise every private citizen with a decent library or informational website could become a charity.

Finally, in my personal 15 minutes of fame, the Commissions decision has been reported in the Dominion Post – complete with a quote from me. Not my most eloquent moment but it’s close enough to the point I wanted to make that I’m fairly happy.

[Edit: Thanks goes to commenter Hemlock for sharing the IAS response to this news]

——————————————————————————————————————-

1.  And here they are in all their tedious glory:
https://scepticon.wordpress.com/2011/10/11/anti-vaccine-charities-is-there-any-quality-control-on-charities/

https://scepticon.wordpress.com/2011/10/11/ias-complaint-part-1-thimerosal-in-your-vaccine-no/

https://scepticon.wordpress.com/2011/10/12/ias-complaint-part-2-gardasil-horrors-horrific-reasoning/

https://scepticon.wordpress.com/2011/10/13/ias-complaint-part-3-vaccine-ingredients-not-so-bad-really/

https://scepticon.wordpress.com/2011/10/14/ias-complaint-part-4-anti-vaccine-impact-in-new-zealand/

https://scepticon.wordpress.com/2011/10/17/defending-the-term-anti-vaccine/

https://scepticon.wordpress.com/2011/10/18/the-legitimate-risks-of-vaccines/

Enhanced by Zemanta

Filed under: Medicine, Sciblogs, Science, skepticism Tagged: Health and Medicine, IAS complaint, Science and Society, Vaccination, Vaccine

Get Your Up-To-Date Vaccine News Darcy Cowan Oct 19

No Comments

Thanks to my recent single-minded posting I’ve stumbled across this resource that pulls together news and blog posts on vaccines and anti-vaccine topics.

It uses a cool functionality of Scoop.it to collect posts which are then “curated” by a real person (hate those obviously fully automated ones that often ping my posts).

Vaxfax monitor is a Scoop.it site, which means the curator specifies keywords and the software trawls Twitter, Google, Digg and Youtube to generate content that matches the keywords. Once this is done the output is offered to the curator to vet. The posts that are retained through this process are published to the main site while those that don’t make the cut are discarded.

The curator of this feed is a poster who goes by the handle anarchic_teapot. Regarding anarchic’s chosen Nym I took this from the about page:

“My handle was chosen entirely at random, so don’t read anything political, social or ironic into it. I have no connection with the Anarchist Teapot Collective, or the coder using the handle anarchic.teapot (with a period, not a hyphen). I’m pretty certain I used the name first, though.”

I contacted anarchic_teapot to get a bit more information about the process involved in putting this feed together and to get a feel about the person behind the page and for why this resource is important.

[Scepticon] Where abouts in the world are you based?

[anarchic_teapot] I live in France, surrounded by sunshine, wine and cheese. And lots of other stuff that’s bad for my diet.

[Scepticon] The agregator uses keywords to collect content, is there any way to get random stuff you’ve noticed into it?

[anarchic_teapot] It’s also possible to scoop stories directly off the Internet, using a browser widget. In fact, the 3 main aggregators I use: paper.li, scoop.it and newsvine now all offer this service.

[Scepticon] What’s the difference between those services?

[anarchic_teapot] Scoop.it will publish each article immediately it’s validated. You choose any tags and which sites you’re going to publish to. It’s useful for getting breaking news out the door, but does require a lot of time curating. Another drawback is that it can mean a lot of tweets going out, and I don’t like flooding the intertubes, out of respect for my long-suffering readers. I want to keep them!

Paper.li does quite a good job of finding keywords, and you can pick the regularity at which it’s updated. At most, you’ll have two tweets a day.
The (big) disadvantage is that you can’t remove unwanted content until after an update.

Newsvine doesn’t send out tweets, although I suppose it would be easy to send your personal RSS feed through a service like Twitterfeed for that. On the other hand, it does allow comments, so you can get a discussion going. You can also write quite a lengthy post about the article you’ve seeded, as they call it. However, you have to go find your content for yourself; it won’t go looking for you. Although you *will* be warned if Newsvine thinks someone has already seeded the same story.

[Scepticon] Once the stories are gathered what happens?

[anarchic_teapot] Every time I check the feed, I have up to 100 stories that I can either discard, block the source (porn sites, bots, or other minor noise) or decide to publish. I try to keep Scoops recent (past 2-3 days) and from reliable sources. I also try to keep repetition down.

[Scepticon] Why did you feel the need to create such a resource, what do you see as the goal of aggregating all this stuff in one place?

[anarchic_teapot] I suppose the need comes from not having enough time to check major news sources regularly, and nobody to do it for me. I’ve always been one to let the computers do the spadework. Putting it all in one place gives me the chance to spend more time sifting through the dross. There is a lot of dross. I have some absolute doozies lined up for future blogging.

At the same time, to see so much quackery being sold so hard scares me.
It keeps me motivated, and I understand why others are so implicated in the struggle for science too.

[Scepticon] What is the criteria for inclusion, do you simply include those things you already agree with?

[anarchic_teapot] Well, it’s all a bit subjective, as things have to be when you’re playing editor (I hate the word curator, that’s for museums) to any sort of publication. As a rule of thumb, I try to keep to stuff that’s informative, not too technical – I’m not the health professional in the family – and of immediate use. I had to think about announcements of potential breakthroughs (HIV and malaria are currently doing the rounds) but decided it would be quite enough to deal with currently available vaccines.

[Scepticon] What is the main focus, news stories that demonstrate harm of anti-vaccine views or information about vaccines themselves?

[anarchic_teapot] Both, really. For reasons of space, I try to avoid localised reports, unless the story is of wider relevance (e.g. a clinic offering free shots probably won’t make it, but an outbreak of mumps may). I occasionally throw in some of the nastier antivax stuff, well flagged as such, in the hope that someone better qualified than me will pick it up and pillory them.

The teapot also admitted to using the generated content prior to publishing as a means of keeping an eye on the shall-we-say “less reasoned” content out there. I believe the term used was “Stupidity detector”, turning these gems into the bases of blog posts.

One of the things that I am grateful the anarchic for is the attempt to keep the feed from turning into an agglomeration of random crap.As noted earlier, I often get pingbacks from sites that have linked to my posts (and sometimes published portions of them) that when I check are simply grabbing everything with a keyword with in filtering, even to the point that the main purpose of a page is 180o opposed to what I’ve written but presents my content as if it’s in line with the site’s philosophies.

According to the teapot:

“The nice thing about Scoop.it is that you don’t *have* to publish anything.”

Ah, how refreshing.

Enhanced by Zemanta

Filed under: Interviews, Medicine, Sciblogs, Science, skepticism Tagged: anti-vaccine, antivax, Health and Medicine, Science, Science and Society, Vaccination, Vaccine

Defending The Term ’Anti-Vaccine’ Darcy Cowan Oct 17

6 Comments

I have spent some time recently labelling the IAS as anti-vaccine. They themselves categorically state that they are not anti-vaccine. Who am I to say that I’m right and they are wrong?

Well, nobody really. I can’t read their minds, although if I could would that change anything? All anyone can do is examine their output, and that of others, and try to make a determination as to whether it is more consistent with an impartial, or simply safety concious, approach to vaccines and vaccination or an anti-vaccine stance.

I hope that my previous posts have demonstrated that the IAS in particular produces anti-vaccine rather than balanced vaccine safety material.  The mission of the IAS is to cast doubt on the safety and efficacy of vaccines not to educate responsibly about the real concerns and limitations of vaccine use. If this was their aim they could do a much better job. Look at the articles produced on their website and you will see many that promote the “dangers” of vaccinations, try to discredit health campaigns and generally aim to undermine public confidence in vaccines.

An organisation concerned about vaccine safety and promoting responsible use of vaccines might write about reducing wide-scale vaccination in favour of targeted vaccination of at risk populations. Perhaps They would also try to work with health authorities to examine ways in which vaccine production can be improved (better production techniques might avoid allergy issues mentioned below), or ways in which the distribution of vaccines can be made more effective and thereby reducing the need to preservatives that are thought by them to be harmful.

It is important to note that someone can be concerned about the safety of vaccines while not being anti-vaccine at the same time. I alluded to this above, but there are legitimate safety issues surrounding vaccine use and vaccines should indeed be closely scrutinised prior to mass roll-out via safety and efficacy trials and post roll-out via surveillance systems and doctors reports. It is a valid complaint that procedures are not always carried out effectively.

Sometimes though they are carried out quite effectively and in a follow-up post I will look at a couple of examples of this. The trouble is that often when a “danger” of vaccines is reported more coverage is given to the sensationalistic claims than the eventual explanation. Also (perhaps because of this) these claims have a tendency to hang around and affect public sentiment long after the coast is clear from a safety standpoint.

As I mentioned there are real risks associated with vaccine use, there are known side effects that can have implications for the health of a small number of vaccine recipients. One of the more obvious being allergic reactions to the vaccine ingredients. Those with egg allergies are urged to use vaccines cultured via chicken embryos with caution and may be unable to receive the vaccine at all. There can be other serious and not so serious or transitory side effects for specific vaccines and effects that are general to vaccines (such as redness, soreness, syncope etc).

As such there are a variety of non-histrionic ways that vaccine safety can be discussed, without impugning the general safety of vaccines. Likewise reasonable conversations may be had regarding relative efficacy of vaccine preparations against the myriad of infectious agents that we are exposed to as well as discussions about cost effectiveness of mass vaccination for low incidence infections.

Serotype replacement (or replacement disease) is another issue that can be raised. As infectious strains are targeted by vaccines there is the possibility that other strains that were less important in the pathology of disease become more prominent once the “Top Dog” has been removed.

Encouraging the production and research into more effective vaccines that give better or more long lasting protection could also be a fruitful line of approach. Perhaps we could focus on immunogenicity, better adjuvants would give a vaccine the ability to provoke a stronger immune response, possibly with fewer antigens – as has already been achieved with modern vaccines. If vaccines are improved in this way then there will likely be more local reactions with the inclusion better adjuvants. This again is a reasonable discussion to have.

The lack of large RCTs on all vaccines and the challenges of working around this (for example ethics prohibit withdrawing a measles vaccines then trying a new one against a placebo). The types of studies required or currently used to give us the appropriate information to act upon is something that we can all try to resolve together.

All these things are such that reasonable people may disagree and we should be able to marshal evidence based (rather than emotive) arguments to discover the optimal us of vaccines in society. To my reading of the IAS, their output appears limited to vitriolic and divisive attacks on health authorities and other informational agencies, vilification of pharmaceutical companies, fearmongering over the alleged dangers of vaccination and downplaying the risks of infectious diseases.

Where we start treading into anti-vaccination territory is when we start to become entrenched in a view that sees vaccination as an evil unto itself, perpetrated in the name of profits by immoral pharmaceutical companies and carried out by unethical doctors who are either ignorant dups or willing accomplices. Those who take this stance may make all of the reasonable arguments that I outline above but also be resistant to evidence that contradicts their views and committed to a general non-vaccine outlook.

In discussing this it is very difficult to convey the range of views that may be represented. Obviously we all exist on a spectrum – from fully pro-vaccine to recalcitrant anti-vaccine. It can also be very difficult to determine the views of people in conversation. I prefer to err on the side of caution and assume people are generally well intentioned and open to evidence until proven otherwise.

One of the defining characteristics of the anti-vaccination crowd, it seems to me, is the hyping of dangers far beyond what the evidence supports. As can be seen in some of the attacks on vaccine ingredients, lists of ingredients are given and scary information accompanies them with the toxicological effects of these compounds on living organisms. In these cases  though the dose is often ignored. Dose response is one of the corner stones of medicine and the dose makes the poison. Drink large quantities of formaldehyde and you’re in trouble, but in the tiny doses found in vaccines your body can easily handle it. as noted in a previous post our bodies actually make formaldehyde as part of normal metabolism and the amount found in vaccines is far smaller than that made by the normal process of living.

When it comes down to the bottom line – Vaccines work, and they actually perform that holy grail of CAM, “boosting” the immune system and allowing the body to heal itself. Not in some vague, feel good alternative medicine way but in real objectively measurable and observable ways. Your immune system is primed to react to infectious agents in such a way as to reduce the amount of time that it takes for an effective immune response to be mounted against the pathogen.

With this priming your body can fight off infections much more efficiently and this translates into keeping us healthy, or reducing the severity of diseases. While we can debate the finer points of vaccine safety and efficacy in the end we have a system that works and has saved many lives. I see that as a win.

[for more on this topic see this post from David Gorski of Science-Based Medicine published last year]

Enhanced by Zemanta

Filed under: Alternative medicine, Medicine, Psychological, Questionable Techniques, Sciblogs, Science, skepticism Tagged: anti-vaccine, antivax, health, IAS complaint, Immunization, Science, Science and Society, Vaccination, Vaccine

Vaccines and Autism — Media Report Card Darcy Cowan Sep 15

4 Comments

Just got sent this link by the irrepressible Aimee, a “Not great” article about the Vaccines vs Autism “Debate”.

Here’s my Media Score Card for this article:

Much rubbish, a few good points. I give her a C-.

‘vaccinate at any cost’ = Strawman
Court decisions =/= Science
Incomplete knowledge = No knowledge = Fail
Anecdote =/= Good Evidence
“acceptable risk” argument simplifies risk/benefit assessment = Fail
“Teh Toxins” = Fail
Injection = Unnatural = Fail
“canaries in the coalmine” = Fail.   Can someone say “Mommy instinct”?

Respectful discussion = Win
Pro-information = Win
Complex topic = Win.

All-in-all a reasonable person sucked into the Vaccine -> Autism perspective.

Pity.

Enhanced by Zemanta

Filed under: Medicine, Sciblogs, Science, skepticism Tagged: Alternative medicine, Autism, health, media, Mental health, Neurodevelopmental, Science and Society, Side Effect Debate, Vaccination

Vaccination Awareness Week Round-Up Darcy Cowan Nov 05

No Comments

There’s still officially one more day of Anti-Vaccine Awareness Week (two really, as it’s an American idea) but here’s a round up of the posts anyway. While I know there are lots of great in-depth posts around the blogosphere on this the following list has been restricted to NZ posts to keep the local flavour. The posts are in roughly chronological order.

The University of Auckland Library at Tamaki Library blog Misinformation spread about HPV vaccine

Me Anti-Vaccination in NZ

Scott at Imperatorfish They Can’t Vaccinate Against Tin-Foil Hat Syndrome

Michelle at Skeptics In The Pub Vaccines: The actual facts (well, the links to some anyway…)

Alison Campbell at Bioblog on polio

Michelle at Skeptics In The Pub More facts about vaccines….

Me A Side Benefit of the ‘Flu Vaccine — Reduction in Heart Attacks

Michael Edmondsat Sciblogs Guest Work ’I’m not a Scientist but …’; Dissection of an antivaxxer’s argument

Alison Campbell at Bioblog chelation quackery around vaccination

Grant Jacobs at Code for Life Immunisation, then and now

Alison Campbell at Bioblog homeopathic vaccinations — fail

The next couple are not specifically about vaccination but I think are worth a mention:

Grant Jacobs at Code for Life If presenting a claim on a popular issue

Megan Leask at Southern Genes This Week in Science History: 1-11-10

If anyone knows of a post I’ve missed then please feel free to add it in the comments.

[Edit] One more – Alison @ Bioblog vaccination & smallpox

For those of you interested in the international posts, blogger Liz Ditz has done an awesome job collating all of the posts here:

The Big List of Reality-Based Vaccine & Infectious Disease Blogging

Enhanced by Zemanta

Filed under: Alternative medicine, Medicine, Sciblogs, Science, skepticism Tagged: antivaccinationist, antivaccine, antivax, Health and Medicine, HPV vaccine, Infectious disease, Influenza vaccine, New Zealand, Science, Vaccination, Vaccine, Vaccine controversy

A Side Benefit of the ‘Flu Vaccine — Reduction in Heart Attacks Darcy Cowan Nov 03

4 Comments

ResearchBlogging.orgIt’s a bold claim, that being vaccinated for Influenza will protect you against having a heart attack or Myocardial Infarction (MI). Well according to a study published last month in the Canadian Medical Association Journal that could well be the case.

The study, “Influenza vaccination, pneumococcal vaccination and risk
of acute myocardial infarction: matched case—control study
“, included 78,706 individuals over the age of 40 in an attempt to determine whether and how much of an effect the vaccine had on MI. The results showed that the vaccine was associated with an almost 20% reduction in risk of MI compared to the unvaccinated population.

My first thought when I read this was that those individuals who get vaccinated might engage in other activities that would lend themselves to reducing risk of MI, healthy eating habits, regular exercise etc. The so called ’healthy user’ effect. This study attempted to control for this sort of confounding factor by using matched controls with similar risk factors. In particular they performed two further analyses that I think comfortably undermine this interpretation of the results.

First they compared the timing of the receipt of the vaccine, ie early or late in the ‘flu season. Second they looked at subjects who had been vaccinated with the pneumococcal vaccine as a comparison. In the first case there was a greater reduction in risk for those who had received the vaccine early in the season, 21% compared to only 12%. In the second case they found no protective effect for those who had received the pneumococcal vaccine. It seems unlikely that the subjects of the study would vary their healthy habits in precisely the ways they would have to in order to see these results as being independent of the vaccine itself.

An interesting aspect of this kind of epidemiology though is that simply looking at the raw numbers there is a greater incidence of MI in the vaccinated group compared to the unvaccinated group. This is an artefact of how the vaccines are administered clinically. Those patients who have greater cardiovascular risk are also the patients who are more likely to be recommended for vaccination. It’s like noticing that people who buy antiperspirant tend to have sweatier armpits than those who don’t*. Those who are prone to sweaty armpits will likely tend to be those who will buy and use antiperspirant, to accurately gauge effectiveness you would have to control for this factor.

Tying this into the anti-vax focus of this week, one of the claims I’ve seen is that the flu vaccine is useless as it is based on strains that were around the previous season (Here via IAS). This is distressingly simplistic thinking. This paper shows that the vaccine is far from useless, in fact the most benefit was found within ‘flu seasons. If there was no effect of the vaccine on the current ‘flu season strains then the study would not have shown the protective effect that it did. Once again the anti-vax crowd (and by extension the altmed crowd as there tends to be overlap) has shown their inability to grasp the nuance of the situation.

There is a gradation of effect when a vaccine does not exactly match the wild strain, the interaction of antigens and antibodies is more complicated than you might suppose. Changes in the antigen (mutation of the virus over the ‘flu season) mean that antibodies may bind less tightly and therefore have a reduced effect but that is not the same as no effect.

To sum up, health is a complicated thing. Many factors are inter-related and in order to get the whole picture we sometimes have look at things from an unusual perspective. Vaccinating for the ‘flu can reduce your risk of heart attack, who knew? But, we should also be wary that we are keeping things within the realm of plausibility. Infection does cause inflammation which can plausibly effect heart function**. This does not mean it’s valid to blame the Wi-fi at your local school for your vague aches and pains.***

Footnotes:

*To make up an example.

** See http://www.sciencebasedmedicine.org/?p=6926

*** http://theness.com/neurologicablog/?p=2215

—-

Siriwardena AN, Gwini SM, & Coupland CA (2010). Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case-control study. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 182 (15), 1617-23 PMID: 20855479

Enhanced by Zemanta

Filed under: Alternative medicine, Medicine, Psychological, Sciblogs, Science, skepticism Tagged: Canadian Medical Association Journal, Case-control study, Health and Medicine, Influenza, Influenza vaccine, Myocardial infarction, Vaccination, Vaccine, Vaccine controversy

A Side Benefit of the ‘Flu Vaccine — Reduction in Heart Attacks Darcy Cowan Nov 03

2 Comments

ResearchBlogging.orgIt’s a bold claim, that being vaccinated for Influenza will protect you against having a heart attack or Myocardial Infarction (MI). Well according to a study published last month in the Canadian Medical Association Journal that could well be the case.

The study, “Influenza vaccination, pneumococcal vaccination and risk
of acute myocardial infarction: matched case—control study
“, included 78,706 individuals over the age of 40 in an attempt to determine whether and how much of an effect the vaccine had on MI. The results showed that the vaccine was associated with an almost 20% reduction in risk of MI compared to the unvaccinated population.

My first thought when I read this was that those individuals who get vaccinated might engage in other activities that would lend themselves to reducing risk of MI, healthy eating habits, regular exercise etc. The so called ’healthy user’ effect. This study attempted to control for this sort of confounding factor by using matched controls with similar risk factors. In particular they performed two further analyses that I think comfortably undermine this interpretation of the results.

First they compared the timing of the receipt of the vaccine, ie early or late in the ‘flu season. Second they looked at subjects who had been vaccinated with the pneumococcal vaccine as a comparison. In the first case there was a greater reduction in risk for those who had received the vaccine early in the season, 21% compared to only 12%. In the second case they found no protective effect for those who had received the pneumococcal vaccine. It seems unlikely that the subjects of the study would vary their healthy habits in precisely the ways they would have to in order to see these results as being independent of the vaccine itself.

An interesting aspect of this kind of epidemiology though is that simply looking at the raw numbers there is a greater incidence of MI in the vaccinated group compared to the unvaccinated group. This is an artefact of how the vaccines are administered clinically. Those patients who have greater cardiovascular risk are also the patients who are more likely to be recommended for vaccination. It’s like noticing that people who buy antiperspirant tend to have sweatier armpits than those who don’t*. Those who are prone to sweaty armpits will likely tend to be those who will buy and use antiperspirant, to accurately gauge effectiveness you would have to control for this factor.

Tying this into the anti-vax focus of this week, one of the claims I’ve seen is that the flu vaccine is useless as it is based on strains that were around the previous season (Here via IAS). This is distressingly simplistic thinking. This paper shows that the vaccine is far from useless, in fact the most benefit was found within ‘flu seasons. If there was no effect of the vaccine on the current ‘flu season strains then the study would not have shown the protective effect that it did. Once again the anti-vax crowd (and by extension the altmed crowd as there tends to be overlap) has shown their inability to grasp the nuance of the situation.

There is a gradation of effect when a vaccine does not exactly match the wild strain, the interaction of antigens and antibodies is more complicated than you might suppose. Changes in the antigen (mutation of the virus over the ‘flu season) mean that antibodies may bind less tightly and therefore have a reduced effect but that is not the same as no effect.

To sum up, health is a complicated thing. Many factors are inter-related and in order to get the whole picture we sometimes have look at things from an unusual perspective. Vaccinating for the ‘flu can reduce your risk of heart attack, who knew? But, we should also be wary that we are keeping things within the realm of plausibility. Infection does cause inflammation which can plausibly effect heart function**. This does not mean it’s valid to blame the Wi-fi at your local school for your vague aches and pains.***

Footnotes:

*To make up an example.

** See http://www.sciencebasedmedicine.org/?p=6926

*** http://theness.com/neurologicablog/?p=2215

—-

Siriwardena AN, Gwini SM, & Coupland CA (2010). Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case-control study. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 182 (15), 1617-23 PMID: 20855479

Enhanced by Zemanta

Filed under: Alternative medicine, Medicine, Psychological, Sciblogs, Science, skepticism Tagged: Canadian Medical Association Journal, Case-control study, Health and Medicine, Influenza, Influenza vaccine, Myocardial infarction, Vaccination, Vaccine, Vaccine controversy

Network-wide options by YD - Freelance Wordpress Developer