Thoughts on, and for, those trying to choose to vaccinate or not

By Grant Jacobs 20/05/2012

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 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 (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 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!)


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 – 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)

0 Responses to “Thoughts on, and for, those trying to choose to vaccinate or not”

  • “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.)”

    You may not like it, but it *is* proven effective in the field of social marketing. As atheists well know, they are criticized for “jumping” or “dissing” on persons merely by raising criticism of a subject (that some people adhere to). So Josh Rosenhouse checked out the science:

    “So far, he’s found that emotional appeals–like the famous ad showing an American Indian with a tear rolling down his face as he confronts pollution–work better than cognitive ones when it comes to persuading people to recycle. Emphasizing that “everyone else is doing it” also helps. (Emphasis Added)”

    I am not saying that a non-confrontational, non-judgmental method wouldn’t work statistically. And if it suits you personally, by all means go for it!

    But it seems confrontation and yes, social shaming by laughter and derisiveness to emphasize that “few are doing it”, works at least as well statistically. And criticizing others for doing something worthwhile for no other reasons that it doesn’t suit you is either uninformed or bigoted.

  • Torbjörn,

    To the first, I was writing with respect to them deciding to vaccinate or not. for that it does not good at all. Certainly for ‘winning’ a debate it might – after all debates are more “about” showmanship than the content.*

    Also: it’s not clear at that point, but I pick my battles, as it were. Some of this is touched on in my footnotes. Of the three groups of people I mention, I’d certainly jump on the first – but to “show them up” to the third group. Personally I don’t think it’s wise to jump on the third group, those not writing or only rarely speaking up. A key difference is who is open to new information and who is not. Those that are open to new information are better encouraged; those who’ve closed their minds, as it were, might be “shown up” to be working in an ideological way so that others can see that.

    * Suzanne Humphries repeated “demand” that I declare any conflicts of interest is perhaps a good example of showmanship. She points to that I’m a bioinformaticist (a computational biologist is more accurate to my own views but there’s a longish story behind that), but she has “overlooked” that word was preceded by ‘independent’. The “convenient” overlooking of that as an independent I’m hardly going to have a conflict of interest shows up how she’s just playing games.

  • I should add that my main concern here was to encourage those who are trying to decide to (politely!) seek out information from those with better backgrounds who might be able to help – and to obliquely encourage those with appropriate (current, professional) backgrounds and in a position to help to do so.

  • You have chosen the wrong example to raise your points because pertussis vaccine is a problematic vaccine. Bacteria strains have changed and immunity following vaccination is short lived-maybe 5yrs or less. Cocooning has been shown to not be effective and has been dropped in Australia. And esr rpt shows that 2/3rds to 75% of cases in nz are vaccinated.

  • a) no-one has ever claimed that vaccines are 100% effective, & b) in a population where the majority is vaccinated, & vaccines are not entirely effective, you would expect a proportion of those who come down with a vaccine-preventable disease to have been vaccinated. What is more interesting is the relative proportions. As a recent study shows (Schmitz et al, 2011), those children who are unvaccinated children have a much higher prevalence of vaccine-preventable infectious disease.

    Schmitz, R; Poethko-Müller, C; Reiter, S; Schlaud, M (2011). Vaccination Status and Health in Children and Adolescents: Findings of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) Dtsch Arztebl Int, 108 (7), 99-104

  • Grant, I also thought that Close-Up did a good job with the coverage of pertussis and vaccination. Objective, accurate and to the point.

    I suspected there would be an outbreak of less than objective “debate” from the anti-vaccination community, so the response to your even handed Facebook comment doesn’t surprise me.

    PaulS – from memory (I’m behind a firewall right now), the program mentioned the variation in bacterial strains, that immunity from the actual disease isn’t much longer than that from vaccination, cocooning isn’t always effective, and that ithe vaccine takes three doses (6 weeks, 3 months, 5 months) to be effective. I can’t remember whether it mentioned the boosters at 4 and 11 years because of the short-lived immunity or not.

    Close-Up did a good job.

  • PaulS – you’re making the same “mistake” people replying to me on the Facebook page did – berating me for things I hadn’t done. There’s nothing about any particular vaccine in my comments – I didn’t, to paraphrase your comment, “choose the pertussis vaccine as an example”. I wrote about the nature of on-line debate of the general kind seen in that Facebook page and in general terms how someone looking for information might better help themselves than read or get involved in the style of debate.

  • that may be the case alison but the discussion on the fb page grant is referring to centred around whooping coff and it is an accepted fact that the wc vaccine is not effective in part because bacteria strains have changed and in part because the vaccine immunity does not last more than 5 yrs or so.

  • grant it’s unfortunately you conclude i made a mistake. i haven’t berated you and i agree there is no mention of wc on this blog. what i was commenting on was simply that the example you used was a discussion on wc.

  • PaulS,

    As I’ve already explained I did not “choose the pertussis vaccine as an example” (never mind “You have chosen the wrong example”); you’ve just admitted as much yourself. You made a mistake, so what? – it happens, just live with it.

    You jumped in with what you wanted to it to be ‘about’ (stuff about whooping cough), placing it on me, but I hadn’t written about it at all – the same mistake those replying to me there did. Aside from that it’s holding me to something I never wrote, it’s besides my point and drives away from what I did write about.

  • PaulS,

    Grant started the discussion with an approach to providing information about vaccination. He’s expressed this more eloquently than I could and I completely agree with his approach. He merely said that Close-Up had done a good job with coverage of the whooping cough epidemic.

    Your initial comment made me unsure whether you had seen that episode, because the negatives you mentioned were all covered as well as the positives.

    They covered the actual illness in infants, that infants can die of the disease. They covered the short duration of immunity following whooping cough infection. They told how adults who had whooping cough as children are no longer immune and can get it again. They told how on average one person with the disease infects fifteen others.

    Grant was right. Close-Up did a good job.

  • PaulS that may be the case alison but the discussion on the fb page grant is referring to centred around whooping coff
    and whooping cough is one of the vaccine-preventable diseases mentioned in the paper I cited.

    and it is an accepted fact that the wc vaccine is not effective in part because bacteria strains have changed and in part because the vaccine immunity does not last more than 5 yrs or so.
    Bacterial strains change – so do the vaccines. On the issue of immunity: ‘natural’ immunity isn’t particularly long-lasting either, waning between 4 & 20 years after infection & illness ( Rather than an argument against vaccination, this is surely a case for vaccination and subsequent regular boosters,

  • alison, the bacterial strains used in the wc vaccine haven’t changed. aprt from the flu vax i’m not sure any other vaxxines change the strains. grant said, ‘I wrote a comment on the Facebook page of local documentary programme Close Up, suggesting that people might be better ask rather than argue’ and yet he and others jump down peeplz throats as soon as their mantra is challenged.

  • alison the re-emergence of wc is not a simple case of more is best. there are lots of reasons put forward for the re-emergence of wc.

    Immunity in vaccinated individuals wanes quickly… 4-5 years is commonplace
    Some authors suggest that the reason for the observed re-emergence is an increased awareness of waning immunity by health professionals which allows for disease diagnosis

    a cohort effect where the increase in incidence is more profound in specific age groups
    a vaccine batch with low efficacy used in some countries, eg canada
    an absence of a booster dose in some countries eg Australia. On the other hand, in The Netherlands, field studies show the evolution of the bacteria as the cause for pertussis re-emergence where mass vaccination for more than 50 years determined a genetic modification of the parasite, now less affected by the immunity produced following vaccination

    The development of new diagnostic methods such as pcr that are more sensitive and specific is also suggested as a reasonable explanation for the re-emergence of pertussis and other diseases. in fact pcr can give false positives for many diseases as there is a difference btwn having a bug as a commensal and having the disease.

    Many countries have very high wc vax rates but still have an emerging problem. more is not necessarily better. cherry picking referenses is eazy to make a case.. the answer is working smarter not working harder

  • PaulS

    You wrote: “and yet he and others jump down peeplz throats as soon as their mantra is challenged”

    – don’t troll please. I am extremely busy and will be for the next several months. As consequence I will be taking a very short view to trolling, most likely either putting any trolls on full moderation on short notice or simply kicking them off. You’ve been warned now, right? (I didn’t ‘jump down’ anyone, I didn’t even ‘oppose’ anyone: see my full comment quoted in the footnotes, nor I write on whooping cough [or any vaccine or disease] – as you said yourself, so I could hardly be presenting a ‘mantra’ about vaccines, etc. that was challenged. Furthermore, given the poor arguments presented there [esp. by ‘group one’ members] I’d hardly feel challenged by them!)

    Your claim about abandoning cocooning is worded in a way that would mislead, by the way. It’s still being advocated. They are not perusing ‘mandating’ it in the sense of making it obligatory. The suggestion to do it stands; I believe in the USA the advice for cocooning and/or vaccinating adults is ‘formal’.

    Some of the other things you are saying aren’t quite right, either, but I haven’t time to deal with them.

    “cherry picking referenses is eazy to make a case” – you’re welcome to tell Suzanne or Hilary that too – point being, if you must make statements like these, apply them equally. Dismissing things out-of-hand, as you are, isn’t too good either y’know. People will press single papers – you can’t realistically expect people to offer a full literature survey each time they make a comment! The problem is how people present references – accurately representative of the overall picture or selectively choosing or ‘framing’ a reference to ‘support’ a view that is contrary to the current best understanding of the issue. In the latter the person’s opinion is driving the selection and the reference is there a ‘prop’ and used a way that doesn’t represent what the overall literature shows.

  • in a fb post grant said ‘ The Immunisation Advisory Centre (IMAC) is a nationwide organisation based at the School of Population Health at The University of Auckland.’ He just cut and paste off their website. If he was neutral and wanting to contribute to an infrmed discussion he would have said that imac was set up by the moh and is funded by the moh and farma companies to promote vaccination so it can not be seen as independent, unbiased, or even objective although it sites research that shows the whole cell wc vaccine had 36 percent efficacy whch i guess means mst teenagers and adults that were vaccinated thght they benefited whn they ddnt.

  • Please note my article was to encourage those who are trying to make a decision to ask, not for people (like “PaulS”) to push views.

    Similarly, I mentioned that despite the saw that arguments should stand on it’s merit (useful in an academic context, but my context was pragmatic) it’s useful for a reader not familiar with the subject to know the writer’s background; purely as an example, they’d have no idea of PaulS’ background meaning that they’d be best to let his comments pass.

  • grant i’m pleased you don’t jump down peoplz throats and get angry and stuff. your very moderate and measured response to my posts is surely an example of exemplary openmindedness and rationality.

  • Hi Paul,

    You’re moving to straight-out trolling: you’ll be moderated now. (You’ve loaded your own meaning on to want I wrote, misrepresenting it to throw mud at me, incorrectly. Your claims are misleading, too.)

  • Stuart,

    Just while I remember & have time –

    The “lazy” way to offer a link in most blogs is simply to put the link (URL) itself into the text; the blog software will recognise it’s an URL, provided it has ‘white space’ at each end, and turn it into an active link for readers.

    To place the ‘under’ text, use

    <a href=”your-URL”>the text</a>

    where ‘your-URL’ obviously should the URL and ‘the text’ is, well, the text that has the URL ‘attached’ to it.

    (Now let‘s see if my HTML entity characters come through so that the example doesn’t get mangled…!)

  • Thanks, Grant, I’m always forgetting that href= trick. This time I have got organised & put it on my whiteboard 🙂

  • Thanks, Grant. Learning HTML has always been on my “to do” list, but I’ve never really found the time. 🙂

  • Stuart, I could do a very short (and lazy!) post covering the very basics as used in writing comments, which is limited to basic styles (italics, bold), links and perhaps quotes. (The later differs a bit from one blogging platform to another.) Not sure many people from my readership would want it or not, though.

  • Grant, I’ll eventually get around to learning HTML, especially if I continue commenting. In the meantime I’ve followed Alisons’ example and saved the href= trick in a text file on my desktop.

    Again, thanks.

  • Stuart, that is an opinion piece with cherry picked research. Look at this cochrane review. if the bacteria has morphed since the introduction of acellular vaccines then studies done before the bacteria morphed will show higher efficacy. The australian and norwegian studies suggest that the wc vaccine needs new bugs.

  • PaulS – you seem to be dismissing out-of-hand, suggesting you aren’t interested in engaging with material; your response suggests you haven’t noted the key point of the article Stuart linked to, e.g.


    “So, has B. pertussis managed to mutate its pertussis toxin, Prn and FHA proteins to the point where the immunity induced by the vaccine versions of them is seriously impacted, making our current estimates of aP vaccine efficacy wrong?

    Well, no.”

    (I’m wondering if you even read it.)

  • PaulS,
    Please read the article. It uses that Cochrane review as one of its primary references and interprets the results correctly.

  • Grant,
    Purely by coincidence, the sort that we humans like to fit into patterns, I encountered someone with pertussis yesterday.

    I don’t know what my immune status is, but it’s probably very low (last booster during university years). Since I don’t want transmission of pertussis to be on my conscience I’ve already sought out and received the DTaP to try to prevent transmission.

  • Please don’t insult me; it makes for antagonism, not good healthy scientific debate. Of course I read the article which is hardly definitive. I’ve read widely and only formed opinions about pertussis following that reading. All my children and grandchildren are fully vaccinated so I am not anti vaccination. But it doesn’t take long to realize that the problm with the pertussis vaccine is not about vax/antivax. See cid(dot) “vaccine effectiveness was 65.6% (95% confidence interval, −35.8% to 91.3%; P = .092).”

    Ask any statistician how one should interpret a result with a CI crossing zero and a P=0.092. Even Nikki Turner would say that shows it doesn’t work.

    The Cochrane review by Zhang et al 2010 included 4 RCTs (Trollfors B et al 1995; Anonymous 1988, Greco D et al 1996; Gustafsson L et al 1996) in the assessment of absolute efficacy of aP vaccines against severe pertussis in children. (In part, the same RCTs were also included in the systematic review by Jefferson T et al). Zhang et al concludes that all multi-component aPs provided high level of protection against pertussis: Thus, Greco D et al (1996) reported 84 % efficacy for both of the 3-component aP vaccines used; Gustafsson L et al (1996) found 44% efficacy for a 2-component vaccine, and 78% efficacy for a 5-component vaccine, whereas Stehr K et al (1998) reported 79% efficacy of a 4-component aP vaccine.

    Note that those studies were done approximately 20 years ago, before the acellular vaccine was widely used. The bacteria has mutated somewhat since then and protection quickly wanes as noted in research out of Norway. They note problems are not so apparent where vaccination was stopped in 1979 for a couple of decades.

    A good media report summing up the different thinking of experts is one published in San Diego in 2010.

    Is Whooping Cough Vaccine Working?

    Just how much protection the vaccine provides is up for debate among researchers.

    “The studies have a range of effectiveness but most of them fall 80 – 90 percent effective,” says Tom Clark, a scientist with the Centers for Disease Control in Atlanta.

    “That’s wrong,” according to Dr. James Cherry, a professor with UCLA, referring to Clark’s statement. Cherry has been studying whooping cough for 30 years.

    “Vaccine efficacy is not an absolute measure,” says Dr. Fritz Mooi, a scientist with the Netherlands Center for Infectious Disease Control.

    Mooi says he can’t put a number on vaccine efficacy.

    All three researchers are world authorities with different views on how well the vaccine works. And whether it’s contributing to one of the largest pertussis outbreaks in California – and in other outbreaks around the world.

    Mooi says there have also been examples of vaccinated children developing whooping cough in Ireland.

    “I think we are seeing that everywhere where vaccinated children whom you would not expect to see get infected, get infected nevertheless.”

    Mooi says the vaccine was developed for an older strain of whooping cough. He says the newer strain makes more toxins and puts increased pressure on our immune system. That can lead to illness despite immunization.

    “Fritz Mooi is a brilliant scientist but when he tries to put epidemiology with it he screws up.” Cherry says referring to Mooi’s theory.

    Cherry believes current vaccines aren’t as good as the ones used prior to the mid-nineties, but they’re safer and have fewer side effects.

    “We gave up something for decreased reactions: we gave up efficacy.”

    Cherry says ideally we need new vaccines, but the current vaccines – if used more frequently – especially in older kids and adults, could prevent the spread of whooping cough.

    Several sources, including the official Journal of American Pediatrics, show Dr. Cherry received speaking fees and research funds from pharmaceutical companies which produce the pertussis vaccine.

    “I think we have to be honest and try to find out what’s happening.” Mooi says.

    Mooi believes researchers need to develop new vaccines. But he says the idea that the disease may be mutating and out-smarting current vaccines has been ignored by many public health officials

    “That’s not good science and that’s not good public health.”


  • PaulS,
    You challenged me to read a Cochran report that was fully referenced, referred to, and dissected in the article that I referred you to. Is it any wonder that Grant and myself questioned whether you had read the article?

    The Cochran reports are available in full to me. That one does not say what you think it says.

  • Stuartg,
    Thanks for the link above about the scientific evidence on evolution of whooping cough. It was sad to read again how Meryl Dorey of the AVN attacks those who have described their bad experiences with whooping cough. It amazes me how groups who complain about being victimized by pro vaccine people are incredibly vicious in THEIR victimization of those who are pro vaccine.
    But then that is a common tactic of those who do not have science on their side – they substitute their lack of evidence with personal attacks, emotional manipulation and conspiracy “theories”

  • PaulS,
    Please don’t take this as antagonism. I’ve had a little more time to read the opinion articles and papers you referrenced. Most of them I’ve read before.

    I think that a realistic summary is that you have found articles and papers that suggest there may be a theoretical problem with the acellular pertussis vaccine.

    The article I supplied is more recent, with references to later research (yet still includes some of the references you used…), and can be summarised as the theoretical problems are not found in practice.

    Current thinking seems to be that since we can’t find a problem with acellular pertussis vaccine in practice then we continue with previous advice; it remains current advice. Nevertheless, it’s worth keeping an eye out in case purely theoretical ideas do arise in practice.

  • Stuartg, if the wc vaccine is so good and vaccination rates so high why are there so many problems with wc? There is a great deal of evidence that the vaccine is not too flash, strategies such as cocooning don’t work and that the bugs are morphing… eg

    Background: Pertussis incidence has been increasing for the past two decades in Norway, as in much of
    the highly vaccinated world. The greatest increase is in teenagers, although the most severe cases occur
    in infants. A teenage booster is recommended globally, largely with the aim of reducing infant incidence.
    However few countries have implemented the booster, and almost no data have been published on its
    utility in preventing infant cases. We aim to assess the duration of vaccine-induced immunity, and the
    possibility for a teenage-booster vaccine to protect infants in Norway.
    Methods and findings: We used a unique data set that merged case reports with a national vaccine registry
    from Norway, 1996–2010, to assess age- and cohort-specific hazards of infection. We also developed and
    implemented a likelihood-based method for estimating the duration of immunity, taking into account
    age-contact data relevant for pertussis transmission. The risk of infection in thirteen-year olds increased
    nearly four-fold, however the hazard in infants did not significantly change. The seasonality of cases
    in pre-school-aged children differed from that of school-aged children. The introduction of a childhood
    booster vaccine provided indirect protection for unvaccinated members of the cohort, but little protection
    to neighboring cohorts. Additionally, we found evidence for increasingly rapid infection after three doses
    of vaccine, potentially caused by significant and heterogeneous loss of immunity. An estimated 15% of
    vaccinated individuals lost their immunity within five years after vaccination.
    Conclusions: Immunity induced by the acellular pertussis vaccine prevents both disease and transmission,
    but is short-lived and heterogeneous. The age-mixing patterns lead to little contact between teenagers
    and infants. Therefore, while a teenage booster vaccine campaign would likely provide strong protection
    for cohorts of teenagers, it would provide little protection for infants…

    4. Discussion
    The epidemiology of pertussis in Norway has been changing
    over the past 15 years in that there is (1) increasing incidence,
    (2) a shift in age distribution toward cases in teenagers, and (3)
    a decrease in the long-term protection provided by the vaccine.

    J.S. Lavine et al. / Vaccine 30 (2012) 544– 551

    When experts can’t agree why should mum and dad parents be expected to take the word of so-called scientists who have no expertise in what they are talking about. Science is made to look stupid and is frowned upon when these same scientists then call parents ignorant if they look at the evidence for themselves and conclude that no-one really knows.

  • PaulS,

    You appear to have answered your own question.

    “If the wc vaccine is so good and vaccination rates so high…” “…estimated 15% of vaccinated individuals lost their immunity within five years…” “…few countries have implemented the booster…”

    You have pointed out that immunity rates are not high because the booster vaccinations to maintain immunity are not being given. Not giving the boosters means that vaccination rates are NOT high.

    You appear to be using the terms “scientist” and “expert” interchangeably. Please don’t, because they aren’t interchangeable in this case.

    To me, scientists are the group that have developed the vaccine and have produced theoretical papers raising potential problems with the vaccine.

    The experts here are the clinical epidemiologists and immunologists who actually use the vaccines and then monitor how well the vaccines work in practice.

    “When experts can’t agree…” They do agree. Worldwide, with only minor changes between countries.

  • ““When experts can’t agree…” They do agree. Worldwide, with only minor changes between countries.”



    “I think we have to be honest and try to find out what’s happening.” Mooi says.

    Mooi believes researchers need to develop new vaccines. But he says the idea that the disease may be mutating and out-smarting current vaccines has been ignored by many public health officials

    “That’s not good science and that’s not good public health.”

    The article shows its an expert/scientist dogfight.

  • What should a parent make of this?

    A team of Australian scientists studied samples taken from patients in four states and found the new strain of the bacteria now accounts for 84 per cent of whooping cough cases.

    Among the recent victims was a five-week-old baby boy who died in an Adelaide hospital 18 months ago.

    Adults can get whooping cough too, although they have a better chance of beating it.

    Professor Lyn Gilbert, who is the director of the Centre for Infectious Diseases and Microbiology at Sydney’s Westmead Hospital, says the strain is breaking through the protection of vaccines.

  • PaulS,

    You acknowledged my articles makes no mention of whooping cough or the (particular) vaccine yet you’re still pushing your own interests.

    As I’ve already noted, my article was about a better approach for those that have yet to decide to help themselves better and how science blogs might help. It was not to offer a place for those with particular views, such as yourself, to parade them. It’s never polite to roll into someone’s space and push your own conversation. Thus, it’s rather rich of you to point at others – you know perfectly well you are pushing your own interests.

    (As an aside, see my ‘About’ page: “I would like to encourage friendly and open discussion.” Debate ≠ discussion. As I wrote earlier, debate is ‘about’ showmanship and ‘winning’. Part of discussion involves taking on the other person’s offerings – something you do not appear to be willing to do.)

    Your latest comment asks “What should a parent make of this?” – my article made the point that they have no way of easily deciding much of these things given that they (typically) lack the background to judge, hence the suggestions in the article. Your asking this is counter to the key point of what I wrote. It seems that not only have you not read the article Stuart offered, you have not taken on board my article above either!

    As for your cut’n’paste ‘debate’, it is an example of the problem I indicated in my article and why internet debates (note, not discussions) are pretty much pointless for parents wishing to make decisions. They do not inform them because readers (typically) lack the background to judge what is offered, as I noted.

    You cherry pick, but accuse of others of cherry picking. You slight others yet claim to be ‘offended’. When corrected, you ignore it. Your approach helps no-one, certainly not parents who are wanting to make a decision.

    For example in ‘quoting’ a “published in San Diego in 2010” (you don’t give the source) you have selectively excerpted to leave out any balance. ‘Missing’ from what you offered included:

    “When KPBS asked the CDC why it believed so many vaccinated people in San Diego county contracted whooping cough – nearly two out of three people – the agency provided a written statement. The CDC says statistically, higher vaccination rates increases the probability a sick person will have been immunized.

    The CDC says the data do not indicate the vaccine is ineffective.”

    SImilarly, the deputy public health officer was paraphrased as saying “He is also skepitcal about making assumptions based on the statistics.”

    But you left these out.

    Now lets look at that from a parents’ point of view. You have misinformed them by leaving out the full context. They’re not helped by that, in fact, unless they were alert to the possibility (and not all will) they are potentially worse off for it.

    Pushing a view in a debating manner does not help people decide, doubly so if you offer material out of context – then it is actively unhelpful to them.

    You are also (mis)representing material in your summaries, e.g. you write “When experts can’t agree” – but it has clearly widely been acknowledged for some time that the length of protection offered by the pertussis vaccine is medium-term.

    To write as you do misrepresents the state of play.

    Does that help parents trying to understand? No.

    Just to add to this, there is also work indicating that the ‘natural’ immunity (i.e. gained from infection) is not live-long, e.g. Duration of Immunity Against Pertussis After Natural Infection or Vaccination, for example:

    “A review of the published data on duration of immunity reveals estimates that infection-acquired immunity against pertussis disease wanes after 4-20 years and protective immunity after vaccination wanes after 4-12 years.”

    “Adults in the prevaccine era rarely presented with typical forms of pertussis.13 One study indicated that only 0.26% of a population of 20,405 persons had a second case of pertussis disease.10 It was therefore postulated that immunity from natural infection was close to lifelong.11,14 A more recent prospective study of household contacts in a largely unvaccinated population demonstrated that 33% of adult pertussis cases had a history of pertussis during childhood.11 Computer simulations of the prevaccine era by mathematical modeling estimate that, in 1940, everyone experienced pertussis as a child, 9% of the population had more than 1 typical pertussis episode, and the average adult experienced 2.6 cases of mild pertussis in his/her lifetime.15 The frequent occurrence of mildly symptomatic B. pertussis infections in adults refutes the previously held belief that infection-acquired immunity is lifelong.”

    Note how this last paragraph is trying to balance the different studies over time and draw a conclusion that explains things as best as we might understand it today. It’s a complete contrast to the polarised statements we’re seeing from you. This is more how science has to be done – bringing together the material – quoting this then but “what about this” is unhelpful and, taken on it’s own, is misleading.

    This bring me back to what my article was about (and what this thread really ought to be about not this sideshow about pertussis vaccination): ‘tit-for-tat’ debates/arguments like this are simply not helpful to parents. They do, of course, play into the hands of the scaremongering from the anti-vaccine proponents and groups because parents being unable to easily judge the material are faced with confusion. Put another way, in repeatedly offering “what about” the old FUD [‘fear, uncertainty and doubt] of groups with political or ideological angles on a subject is at play. It’s cheap and nasty – the sort of thing IAS and it’s ilk offer.

    Science can’t be taken in single papers (as PaulS is doing here, and Hilary did on the Facebook page). It has to be taken with an understanding of the background and with a (as best as is practically possible) view of all of the relevant research being done. Individual research papers will oppose eachother.

    So what is useful for parents, then? Rather than repeat my article – anyone interested can just read the original! 🙂 (Nutshell, opportunities to discuss with people with the appropriate background in a neutral setting – scientists writing via blogs are one possibility.)

    [Edited to fix link.]

  • PaulS,

    If I have a problem with the brakes on my car, I take it to a brake specialist. If the electrics of my house go wrong, I get an electrician. If the drains are blocked, I get a plumber. Following earthquakes I get a structural engineer and a geotech engineer to assess the safety of my house and land.

    I am not an expert in any of these fields and do not try to usurp the authority of such experts.

    You have acknowledged that you are not an expert in the field of vaccination, yet all of your posts suggest that you are trying to challenge the experts (CDC, MoH, etc) as an equal or more than an equal.

    I have referred you to a measured, well referenced “opinion” from someone who could be considered one of the experts in the field. You have dismissed it out of hand but consider your own sourced, journalistic, opinions of higher veracity. You give the impression that you consider yourself to be more of an expert in the field than the author.

    It is obvious that no matter what evidence is presented to you that you have fixed ideas that are not going to be changed. You consider yourself better able to interpret the primary research and statistical analyses than the experts who have spent years if not decades working as the leaders in the field.

    Please consider the logic of your position.

    Since it is Saturday night, I’m now able to hand over my workload to one of my colleagues. I plan on a seafood risotto with a Marlborough pinot gris in the company of my wife.

    I wish you well.

  • grant jabobs shows a gross lack of understanding of humanity and how our society works. Thank god we don’t rely on experts like patrick kelley to decide guilt in child abuse cases. grant says; “Your latest comment asks “What should a parent make of this?” – my article made the point that they have no way of easily deciding much of these things given that they (typically) lack the background to judge, hence the suggestions in the article.”

    Society has so little respect for ‘rent-an-expert’ advocacy that we create juries of ordinary people to decide such important issues such as guilt and truth. ‘background’ can often result in prejudice.

    gc correctly claims that he didn’t mention wc in his blog, but he conveniently ignores that the context of the facebook community he was referring to was wc. gc complains about trolling on his blogs but is at the front of the queue in trolling on other peoples forums.

    gc, as mentioned all of my kids and grandkids are fully vaccinated. I don’t have a personal interest in this other than to point out and comment on hypocrisy and people with a mindset that tries to ridicule ‘anyone who makes a comment about vaccination that is different to mine is obviously anti-vaccination.’

  • stuartg ‘If I have a problem with the brakes on my car, I take it to a brake specialist. If the electrics of my house go wrong, I get an electrician. If the drains are blocked, I get a plumber. Following earthquakes I get a structural engineer and a geotech engineer to assess the safety of my house and land.

    I am not an expert in any of these fields and do not try to usurp the authority of such experts.’

    stuartg, do you not get a second opinion? Can I ask who makes the decision? A mechanic has no authority. neither has a plumber. In fact the chances are that a plumber you get out is not even a registered plumber. If you drains are blocked you need a drainlayer, not a plumber. geotech engineers have no authority. The decision-makers are none of these people. Vaccination proponents have no authority. Fortunately we don’t live in a police state. Ordinary people make decisions, not people with vested interests despite their expertise. Don’t rubbish these decision-makers if they don’t accept the car is not stuffed or the drain doesn’t need ripping up. Christchurch is a good example. Tonkin and Taylor never made any decisions about red zoning land. They just said it would cost a fortune to stabilise the land so that the council could put pipes back in the ground with a degree of certainty. Anyone could build a safe a and secure house in a red zone. Engineering solutions are always economic decisions.

    Don’t rubbish ordinary people who exercise freedom of choice by choosing an option you wouldn’t. that’s what freedom of choice is about.

  • PaulS

    After criticising the sources other contributors have used, I find it astounding that you would use the following yourself:
    Not only is a non scientific source, but the experts quoted are very careful to point out
    A spike in whooping cough cases MAY have been caused by a new strain of the bacteria that is resistant to existing vaccines, new research suggests

    \Before vaccinations against whooping cough it was a major killer, there were hundreds of deaths, he said.
    He says even where the vaccine does not prevent the bacteria, it still reduces its severity.\

    What we suspect, although it’s circumstantial evidence at this stage..

    I would have thought that any person who reads this article completely would get the impression that the vaccines still are effective in protecting those who have had them

  • Grant,

    Going back to your original question, where does the average person get good advice from in terms of vaccination?

    I have some difficulty answering this. I’ve more than three decades experience in the field, including managing infectious disease outbreaks, yet I would not consider myself anywhere near expert level. I know enough to understand the reasons why the teams of experts in the field give the advice that they do, and understand why it is the best level of advice available. I do not have sufficient knowledge to be able to challenge the advice or suggest alternatives. I’m not an expert.

    I note that many countries worldwide have set up independent advisory groups into vaccination. These groups are usually composed of the persons from that country with the greatest knowledge of infectious diseases, clinical epidemiology, immunology, pharmacology and population statistics. Together they can give advice on the individual vaccinations, appropriate times for them to be given and how to achieve the best results for the lowest cost for the individual countries.

    We can compare the recommendations from different countries. For example, NZ, Australia, UK, Canada, USA, (France, Germany, Russia, Japan… if you’re comfortable with non English sites). Each country has its own spectrum of infectious diseases to deal with and their own methods of purchasing the vaccines. Each country strives to get the “best bang per buck” in its own way.

    You know, if we compare the advice from different countries, vaccination advice is surprisingly similar. Yes, there are differences, for instance some populations in NZ had 50% incidence of hepatitis B infection before teenage years, so there was a relative emphasis on that earlier than some other countries. If there was a hepatitis C vaccine, Japan would place heavy emphasis on that.

    In spite of the differences between countries, we are all human and all subject to the same infectious diseases. Ultimately, to reduce the impact of the diseases, multiple countries have independently arrived at very similar vaccination schedules. To me, that suggests that hundreds, if not thousands, of experts worldwide have developed these schedules after considering many options. None of these schedules are the result of a single person.

    The best and most accurate information available on vaccination tends to be on the web site of the health provider of the country that you are living in. It sounds strange to antivaxxers, but that information is usually sourced independently from the health provider themselves, for example CDC gives the advice and information but they aren’t the USAs health provider.

    In NZ I would start with the Ministry of Health website for information, USA I would go to CDC, Canada, Australia, UK… all similar.

    It may be a lame ending to a long post, but they really are the best and most accurate places to get information from.

  • I’ll try get back to this later – am very busy.

    PaulS: please try not to make others to have done things (said things) they haven’t. I haven’t said what you make out to have. (Also best not to mangle other’s names.) The analogy you’ve offered is an example of an incorrect viewpoint I’ve seen expressed many anti-vaccine forums; it’s actually partly why I wrote what I did in my article.

    Michael: Given the article Stuartg offered a while back PaulS seems to raising the same theme but without engaging with what been presented (AFAICT).

  • Stuartg – I’ll get back to you. Quick thought, for whatever reason I lead off my list of possible useful sources with the international sites; might have suggested people start with their local public health bodies as you suggest. (I haven’t read your comment through – just dropped down to the end!)

  • “Science can’t be taken in single papers (as PaulS is doing here, and Hilary did on the Facebook page). It has to be taken with an understanding of the background and with a (as best as is practically possible) view of all of the relevant research being done. Individual research papers will oppose eachother.”

    Bollix… whooping cough is not the same in NZ, Aus, Norway, US, or even in different age groups. If efficacy studies were done before the rollout of mass vax programmes and the bug morphs then obviously the earlier efficacy studies no longer apply. The scientific facts are that wc vaccine is not very effective, regardless of the results of efficacy studies. I don’t know hilary on whatever facebook page so i carnt comment on her posts. what I do know is that scibloggers commonly use even one off newspaper articles as scientific proof when it suits their cause.

    Grant’s blog highlights the folly of these sorts of exercises in trying to control human beings’ free choice… they more so-called scientists denigrate others views the more irrelevant they become to effecting change.

    As i said, all my kids and grandkids are fully vaccinated so why do you point the antivax bone at me just because i point out that this vaccine has not been/is not very effective at controlling this bug. its as if scibloggers inc’s manhood has been challenged.

  • PaulS – stop trolling, please. As I’ve already said, I’m very busy. When I have time I may elaborate, but you’re just putting words in my mouth that I haven’t said and pointing at your words.

  • So whenever someone disagrees or challenges you they get tagged as a troller… now that sure is walking the talk… Quote “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.)”

    Grant, why do you jump on anyone who shows your argument is like filo? How does that help anyone?

    If you want to ban me like you have others go ahead… it will make your argument look very authoritative. or not

  • PaulS,

    “I can’t see that jumping on people is helpful to anyone”

    Neither are snide comments or insults (e.g. Bollix)

    You might want to reflect on your own posts and the tone of them, if you a concerned about maintaining a civil and scientific conversation here

  • PaulS,

    “Whooping cough is not the same…”

    In that case, what is it? Let us know the correct name, with citations to show there has been appropriate name change when it has been identified as something else.

  • I’ve just noticed that the IAS, a local anti-vaccine organisation, has provided a fresh quick guide for new parents on finding vaccination information page on their website.

    I’m struck by how this page:

    – offers no books on vaccines that are not written by anti-vaccine proponents,

    – doesn’t point to any forums where discussion is open (the IAS forums are closed those without anti-vaccine views, creating an echo-chamber effect), never mind forums where research scientists active in the field write.

    They do point to PubMed, but realistically few parents can read what is there for themselves – the primary science literature is difficult to understand accurately without a solid background.