By Alison Campbell 28/11/2019 20


As the rate of measles infection, and of deaths, continues to climb in Samoa, antivaccination activists infectious disease proponents seem intent on doubling down on their claims about vaccination. (Check pretty much any news-media FB post about measles & you’ll see exactly what I mean.)

Unfortunately, some of them have a greater reach than others. On a global level we have people like Andrew Wakefield, RFK Jnr (who visited Samoa earlier this year to promote his anti-vax message), & Del Bigtree . Here in the Pacific region we have people like Taylor Winterstein, who actively pushes an anti-vaccine message via social media and – for some odd reason – believes that having no relevant qualifications at all makes her well-suited to providing health-related advice.

Now, lots of folk don’t have a uni degree and by itself, that isn’t necessarily a problem; there are other ways to gain a lot of expertise. I defer to my mechanic, who has a trade qualification, when my car needs servicing, and to qualified electricians when I want some wiring done; they both know far, far more than I do about these things!

But despite Tay’s brave words, having no degree – no relevant qualification whatsoever – is not a virtue when claiming to offer health advice and “expos[ing] the corruption” behind vaccines (which are probably the most thoroughly-researched pharmaceutical product in history). It means only that she has no idea how to even begin doing the sort of research that she would need, let alone looking critically at claims made by other plague enthusiasts before sharing them with her followers.

So she’s happy to say that vaccination is “proving to be ineffective, dangerous, and making the virus more deadly” without offering a skerrick of evidence. Which would, I suppose, be difficult given that none of those claims are correct. As for claiming that the Samoan government is lying when it says that almost all the confirmed cases of measles are in the unvaccinated – Tay, logic is clearly not your strong suit. Here’s why, and why your message is so dangerous:

Up until very recently the first measles vaccination (MMR) was given in Samoa to children 15 months of age, so that they relied on herd immunity to protect them against the disease. (This was very recently brought forward to 6 months.) The overall vaccination rate for the country at the start of this epidemic was an appallingly low 40% for the first dose of MMR and 28% for the second. This means that many kids older than 15 months weren’t likely to be vaccinated either. And as of November 27, here are the number of infections and deaths in the various age groups:

View image on Twitter

Clearly measles is not a ‘mild childhood disease’, Tay. It isn’t now, & never has been.

Oh, and that claim you shared (& thus implicitly support) that the vaccines Samoan kids are now receiving come from India and are cheap & worse than useless? The bit about their origin is true. The rest, not so much. Did you even bother to check, or is your confirmation bias so strong that you think you don’t need to?

You’re also apparently ignorant of history. Samoa has suffered through other measles epidemics in the past. In 1893-94 around 1,000 people (of a total population of just 34,500) died of measles, which tore through the country after arriving on a ship from New Zealand (also discussed here). More than half of them were children. It’s notable that even back then, doctors recognised that having had a measles infection made people more susceptible to other infections (something that’s now identified as immune amnesia).

The message you are pushing is a foolish, dangerous one. (And one that will not win you any friends on arrival in Francewhere childhood vaccinations are compulsory in order for children to attend school.) It’s great to see major news outlets now picking up on it, and pushing back hard (also here). Hopefully the Samoan government will act as well.

The post advice about measles: when ignorance is definitely not a virtue appeared first on BioBlog.


20 Responses to “Advice about measles: when ignorance is definitely not a virtue”

  • Alison,

    The rate of flu vaccination among medical staff isn’t great.

    “All District Health Boards in New Zealand offer free influenza vaccination to staff. In 2012, approximately 48% of all employees received an influenza vaccination. This rate was a slight improvement from 2011 (46%) and 2010 (45%). Rates were highest among doctors (57%) and lowest among midwives (37%). Nurses (46%), allied staff (50%) and other employees (46%) had similar rates of influenza vaccination. Immunisation rates differed among DHBs, with the highest rates achieved in 2012 in Capital & Coast and Canterbury DHBs and the lowest rates in Taranaki and West Coast DHBs.”

    “Of those who did not receive an influenza vaccine, reasons included; no underlying medical conditions/healthy, fear of needles, perception that their risk of contracting influenza was low, belief that the vaccine is ineffective…Of those who would not be happy to receive vaccinations, reasons given included; preferring natural products, perception of low disease risk, wish to become more ‘holistic’ and concerns about adverse effects and the ongoing need for boosters…

    https://bpac.org.nz/BPJ/2012/December/upfront.aspx

    Do you have any objection to medical staff choosing not to be vaccinated?

  • Ross,

    I’m a DHB employed doctor, fully vaccinated, and encourage all of my colleagues to get the influenza vaccine each year.

    A couple of points:
    1. The DHBs appear to only record those employees that they administer the vaccine to, missing those employees who get vaccinated by their own GP. GPs often are administering the vaccine several weeks before the DHBs and some people prefer to get the vaccine as soon as possible.
    2. Your reference is seven years old and probably does not reflect the current state of the DHBs. (Personal survey of my colleagues this winter – all doctors vaccinated, 20-30% by their own GP).

    My personal response if you asked me the question: *****, yes. Of course I object to medical staff choosing not to be vaccinated.

  • Yes, Ross, I emphatically do object to medical staff choosing not to be vaccinated. They are working in close contact with people who are already unwell, & should not be willingly setting themselves up to be potential flu vectors. The flu vaccine isn’t perfect, but it’s certainly better than nothing.

  • Alison

    You may object to medical staff being vaccinated but they have their reasons, which presumably you respect. Of course, it does suggest that if medical staff have good reasons not to vaccinate, non-medical staff may also have good reasons not to vaccinate.

  • Ross, Dr. Campbell very obviously doesn’t object to medical staff being vaccinated. It seems pretty clear to me that she encourages it, in fact.
    Without out a legitimate medical reason, medical staff have no good or respectable reason for not being up to date on vaccines. If you don’t support science, you don’t belong in the medical field.

    • Lovely to see you hear, AltPan. Now that I’ve approved your first post, you won’t be held up by moderation in future.

  • Ross, pretty much the only reason not to vaccinate is a medical contraindication. I would find it hard to respect a medical professional I was dealing with if it turned out that they had chosen not to vaccinate for flu or other VPDs for any other reason, given the significant negative impact this could have on their patients. Especially if they had also chosen not to wear a mask.

  • “You may object to medical staff being vaccinated but they have their reasons, which presumably you respect. Of course, it does suggest that if medical staff have good reasons not to vaccinate, non-medical staff may also have good reasons not to vaccinate.”

    Lets pull that apart.

    “You may object to medical staff being vaccinated but they have their reasons…”

    Having a reason is not the same as having a valid reason supported by the science, or even by common sense. I, for example hate needles with a passion and avoid vaccination, injected pain relief, and accupuncture except where it is obviously required. This precludes all accupuncture, but means I grit my teeth and look the other way when giving blood, being vaccinated, or on those odd occasions when I need pain relief at the point of a needle. None of my prevarication makes logical sense (except the accupuncture bit), and it fails the common sense bit too since my delaying tactics often make the pain worse or increase my risk of illness.

    “…which presumably you respect.”

    Thats a wild assumption by you. Why would any medical professional respect the irrational reasons of a fellow professional when those irrational reasons put patients at risk?

    “Of course, it does suggest that if medical staff have good reasons not to vaccinate…”

    Classic question-beg there.

    “…non-medical staff may also have good reasons not to vaccinate.”

    Non-medical staff housed in a separate building with no patient contact perhaps could go with thier personal beliefs however irrational they might be. Anyone circulating in a hospital, doctor’s surgery or other health provider where at-risk patients might be exposed to them, refer to my earlier comments. Allowing these people to conscientiously object to rational public health precautions would be akin to allowing food handling staff to be exempt from washing thier hands if they had a “reason” of any sort including denial of germ theory.

  • Ross, pretty much the only reason not to vaccinate is a medical contraindication. I would find it hard to respect a medical professional I was dealing with if it turned out that they had chosen not to vaccinate for flu or other VPDs for any other reason, given the significant negative impact this could have on their patients. Especially if they had also chosen not to wear a mask.

    Alison,

    Medical staff, like the general population, can get the flu despite being vaccinated. And as the quote I provided at the beginning shows, there clearly are multiple reasons why medical staff aren’t getting vaccinated. You can demonise them if you wish, but that shows a certain zealotry which is unbecoming of a health professional.

    I don’t know about you but if I get the flu I refrain from going to work.

  • Ross, as both Ashton & I have said, there are valid reasons not to vaccinate (medical contraindications), & then there are others. I respect the former.

    People with flu are infectious before they are symptomatic (as is the case for measles).

  • further to Alison’s pithy and on point reply and with my HR Manager hat on, calling in sick rather than taking active steps to avoid infection by vaccinating is shifting the cost of your personal decision to the employer – you are in effect socialising the cost of your decision ot not be vaccinated.

    It would be interesting to test (I’m not aware of case law around it yet) but if your employer provides free flu vaccinations and you refuse to take it up for other than medical reasons, there might well be a case to not pay sick leave if you later become infected with the vaccine-protected flu strain and take time off work.

  • Ross,

    Anecdotal (I know). Pithy (I know).

    Usually I get a cold several times a year – kids with colds do tend to cough in your face when they are brought into the ED at 3am with a runny nose, cough and sore throat for five days – but I haven’t had influenza since medical school.

    Maybe I don’t get influenza because I get the vaccine as soon as it is available? I usually go to my GP because they have the vaccine 3-4 weeks before my DHB gives it. Unfortunately, that means my DHB doesn’t record me as having had the vaccine.

    Most of my colleagues who see patients, usually including all of the doctors, get vaccinated before the ‘flu season starts. If we delay until the season ‘starts’ then we’d likely catch the virus from asymptomatic people carrying the virus before they became ill, and then pass it on to our patients before we became symptomatic ourselves.

    I have one colleague who has valid medical reasons not to be vaccinated. We tend to protect him/her from symptomatic patients, and hope that he/she does not get infected by asymptomatic patients/relatives.

    I let my thoughts be known about any colleagues who decline influenza (and any other) vaccinations without valid medical reasons.

    If I’ve got a cold, I’m not at work. Amazingly, this year is the only year I can recall not having a cold! (Roll on vaccines for the common cold…)

    There are valid medical reasons not to receive influenza and other vaccines. I respect them. They don’t include the FUD being advanced by antivaccinationist fearmongerers.

    By the way, if you have influenza, you are unable to go to work because you are too unwell. If you are able to go to work then you’ve got a cold, not influenza, but it’s still not appreciated by your colleagues when you spread it around.

  • calling in sick rather than taking active steps to avoid infection by vaccinating is shifting the cost of your personal decision to the employer – you are in effect socialising the cost of your decision ot not be vaccinated.

    I’d be interested in reading your submissions to your employer, and to the Government, where you advocate for non-payment of sick leave for those who choose not to undergo a flu vaccination. Do you mind sharing your submissions?

    You obviously missed the point that anyone can get the flu despite being vaccinated. Would you be creative and find another reason not to pay such individuals?

  • “calling in sick rather than taking active steps to avoid infection by vaccinating is shifting the cost of your personal decision to the employer – you are in effect socialising the cost of your decision ot not be vaccinated”.

    I’d be interested in reading your submissions to your employer, and to the Government, where you advocate for non-payment of sick leave for those who choose not to undergo a flu vaccination. Do you mind sharing your submissions?

    You obviously missed the point that anyone can get the flu despite being vaccinated. Would you be creative and find another reason not to pay such individuals?

  • “It would be interesting to test (I’m not aware of case law around it yet) but if your employer provides free flu vaccinations and you refuse to take it up for other than medical reasons, there might well be a case to not pay sick leave if you later become infected with the vaccine-protected flu strain and take time off work.”

    I imagine if that were tried in the health sector, many capable health workers would find alternative employment. The health sector can ill-afford to lose capable workers given the pressure it is under. It would be a very courageous – some might say foolish – employer that took such action. It could also be in breach of the Employment Relations Act.

    I doubt that good employers would enquire about whether someone has had a flu shot.

    https://www.stuff.co.nz/business/transforming-business/106377008/changing-workplace-unlimited-sick-leave-keeping-employees-more-honest-than-not

    • “I doubt that good employers would enquire about whether someone has had a flu shot.”

      Given that there is an economic cost to employers when staff are off sick, they probably should. (And yes, the vaccine isn’t perfect, but considerably better than nothing.

      You’re not seriously saying that health workers should be free to wilfully put patients at risk by refusing to keep their own vaccinations up to date, Ross?

  • “The health sector can ill-afford to lose capable workers given the pressure it is under. It would be a very courageous – some might say foolish – employer that took such action. It could also be in breach of the Employment Relations Act.”

    The medical/health sector can ill afford staff endangering patients. It would be foolish for medical centres to ignore staff putting patients at risk. Some would say it’d be in breach of medical ethics, if not laws.

  • Hi Ross.

    I’m interested in this subject because, as a good employer, we recently DID ask all our employees to disclose their measles immunity status. We provided vaccination for free including transporting people to vaccination centres during work time. We excluded almost 35 people from work because they were either asymptomatic but exposed to measles and did not know their immunity status, or they were symptomatic. For those who were asymptomatic and quarantined, we paid for the entire two weeks above and beyond sick leave.

    We did all this to meet our obligations under the Health and Safety at Work Act. Our actions were supported by the union on site who encouraged staff to get vaccinated and to quarantine themselves if they had been exposed to measles. You can do this AND be a good employer. I’d argue you have to if you want to be a good employer.

    The step to asking about flu immunity is not that far and, in the event of a serious outbreak, we probably would take very similar action for very similar reasons.

    People at work will pass communicable disease. It can’t be avoided when you are in relatively close proximity for 8 or more hours a day. As a PCBU we are legally bound to recognise that and then put reasonable controls in place to minimise the risk to workers on our site. I argue that we have a responsibility to require staff to disclose their immunity status so we can control for it and minimise the risk to all our staff.

    Having identified people at risk of contracting an infection and potentially spreading it, what control should we put in place? We cannot practically isolate them. By law, we cannot just “wait and see”. A reasonable and practical approach is to vaccinate, and so we should do that where appropriate.

    The H&S@W Act Section 45 requires employees to take reasonable steps to protect their own health and the health of others at work. It requires employees to comply and cooperate with the employer in H&S matters. Refusal to get vaccinated when it is offered by the employer might (everything is testable) be seen as not meeting the quite firm direction of this section of the Act (it reads as “…workers must…”, not “…workers should…”).

    Paid sick leave is owned by the employer. It is paid to the employee in cases where the employee is medically unfit to work. There is no absolute right to it though – the employer can ask for proof of illness and can decline to pay where that proof is not forthcoming or, in the reasonable opinion of the employer, is insufficient.

    Taking the worker’s obligations under the H&S@W Act and the limited employer discretion around paid sick leave, it’s not a great stretch to not paying for sick leave where the employee opts to accept the risk of infection by choosing not to be vaccinated when the employer offers it.

    I take your point about the statistical fallibility of vaccines – it would be something I am sure would be considered in any case that might make it to a judicial process.

    In as much as I am ever likely to make a submission on the subject, thats it – and its provided with the absolute limit that it is solely my position, not that of my employer.

  • I have numerous problems with this push for vaccination; Why is the science not linked in these discussions? The claims are that vaccines are safe and effective. Give the links to the safety trials of each vaccine being discussed, showing the results of the vaccinated versus the fully non vaccinated. I have been unable to locate any research by the pharmaceutical industry that involved the ‘”Gold Standard” double blind placebo (saline injection or sugar pill) for any vaccines prior to licencing and going on the immunization schedule. How long were these studies, how big was the control group, what was the follow up and what substance was given in the control group? All the studies I have found to date involved control groups given either another vaccine or an adjuvant, not an inert placebo.

    So far I have seen the medical profession, who claim to base their knowledge on science putting forward emotional, circumstantial evidence, not science. Any discussion on science, need to link the research.

    • Hi Shirley – the science absolutely is linked in discussions at Sciblogs; you appear to want every single relevant paper to be linked in every single post, regardless of the focus of that post. .

      No safety studies? They most certainly exist – & must exist due to the nature of clinical trials. For example, for Gardasil (a trial that was double-blind & used both placebo & adjuvant controls): https://journals.lww.com/pidj/Abstract/2010/02000/Clinical_Trial_and_Post_Licensure_Safety_Profile.2.aspx

      I have been unable to locate any research by the pharmaceutical industry that involved the ‘”Gold Standard” double blind placebo (saline injection or sugar pill) for any vaccines prior to licencing and going on the immunization schedule – this makes me wonder what databases and search terms you were using. For example, the Salk polio vaccine underwent exactly the type of trial that you are calling for: https://www.ncbi.nlm.nih.gov/pubmed/14361811 You will find that this was the case for each vaccine prior to its first introduction.

      All the studies I have found to date involved control groups given either another vaccine or an adjuvant, not an inert placebo.
      If researchers are looking at the efficacy of a vaccine that is a variant on an existing vaccine, then the approach you describe is entirely justified. This is because the research question is not “is this vaccine better than placebo”, but “is this vaccine better than the existing version”. It would not be ethical to use a saline placebo in these circumstances, as that would mean exposing the placebo group to the risk of the disease itself. I’ve discussed this in another post.
      https://annals.org/aim/fullarticle/712939