IAS Complaint Part 4: Anti-Vaccine Impact in New zealand

By Darcy Cowan 14/10/2011 175


Finally in the series of extracts from my IAS Charity complaint, I give a brief look at the impact of anti-vaccine information in New Zealand. I also bring together information from other parts of the complaint that have not been covered in the extracts so far.

Impact of Anti-Vaccinationist Misinformation in New Zealand

Maintaining a high level of vaccine coverage is important for reducing the probability of disease outbreaks and to limit the spread of disease in the community. Diseases (often) spread due to contact between infected and uninfected individuals. If the uninfected individual has partial protection from the disease due to immunisation then the disease will spread with more difficulty. This is often referred to as “Herd Immunity”.

Herd immunity does rest on several assumptions, one of which is that immunised individuals are spread evenly throughout the population. If pockets of unvaccinated individuals develop then diseases can gain a foothold in that part of the population and spread outward – even to vaccinated individuals. If parents in a community are convinced by the IAS information not to vaccinate their children then an in-road for disease is created and outbreaks can occur. As such this would constitute a detriment to both children and the wider community – in direct contradiction to the IAS stated charitable aims.

New Zealand has struggled to reach recommended vaccination levels in the past with the coverage rate in 2005 being only 77% at two years of age1. With such low rates of vaccine uptake in the population there is a risk of vaccine preventable disease outbreaks occurring in the population and putting children’s lives at risk. In fact this is happening now with the measles outbreak in Auckland. Health officials have linked this outbreak to lowered vaccine uptake attributable to anti-vaccine misinformation2.

Vaccine coverage for a disease such as measles needs to be at approximately 90% or greater in infant populations to prevent epidemics3. Despite a focus on increasing coverage since earlier this century and improving coverage since the 2005 survey New Zealand still only sees an average of 85% vaccination coverage in this age group, with some areas dropping as low as 75%4.

In 2004, just prior to the Vaccine Coverage survey, a study was performed to see what reasons parents gave for not vaccinating their children5. The results of the study found that many of the parents interviewed made a decision not to vaccinate based on perceived risk of the vaccines. The risks cited were common anti-vaccinationist misunderstandings, including linking vaccines to autism and the belief that children’s immune systems are weakened by immunisations.

While almost all of the study participants consulted their GP for vaccination information, this source was seen as biased. In fact many of the ’Pro-vaccine’ sources were considered biased and parents expressed interest in information provided by groups outside the ’medical establishment’ indicating distrust of medical advice on this topic in general. The Immunisation Awareness Society was explicitly listed as a source of information by 76% of survey respondents, along with Naturopaths and Homeopaths (43% and 48% of respondents respectively).

The Immunisation Advisory Centre is sufficiently concerned about misleading anti-vaccination claims that they have included a page dedicated to rebutting this information on their website6.

Conclusion

The IAS dispute that they are ’anti-vaccine’ both in their Charity ’Rules’ (3. Beliefs, subsection C7 and through comments on their website. This claim rings hollow though when the actual content of their writings is examined. Therefore it is important to look at the effective output of the ideologies, philosophies and stance of the charity rather than their explicit statements.

In regard to IAS staff and members, belief that they are acting in the public interest, belief that their materials constitute an educational resource and belief that they are in fact doing the right thing are not enough. I have no doubt that the founding members, the officers and members of IAS sincerely think that they are provide a public service and that their interpretation of the scientific facts is the correct one. This however only affords them the right to be respected as individuals and for their views to be given fair hearing, it does not constitute a right to charitable status and does not exempt their views from criticism.

The IAS has shown through their materials that, despite protestations to the contrary, their views are anti-vaccine. This entails that their views are factually and scientifically incorrect, that they have an agenda to reduce or stop vaccinations being performed and that through this their actions may translate into serious harm for individuals, the community and the public at large. The IAS currently enjoys charitable status, as such they are exempt from taxation on their income. This amounts to a government subsidy of anti-scientific and potentially harmful views.

————————————————————————————————-

One last point, I am pretty clear to paint the IAS as anti-vaccine. They themselves deny this label, as mentioned above. But then I have a bias don’t I? Well, heres a link to a website that has the opposite bias, they list the IAS as on of their “100+ Great Anti-Vaccination Information Links“, I’d say that;s telling.

Footnotes:
1. NZ Vaccine coverage survey 2005
http://www.moh.govt.nz/moh.nsf/pagesmh/6028/$File/national-childhood-immunisation-coverage-survey2005.pdf
found on:
http://www.moh.govt.nz/moh.nsf/indexmh/national-childhood-immunisation-survey-2005

2. Stories covering the Aucland Measles outbreak:
http://www.stuff.co.nz/marlborough-express/news/5220199/Immunisation-rate-of-refusal-growing
http://www.nzherald.co.nz/immunisations/news/article.cfm?c_id=461&objectid=10553617
http://www.stuff.co.nz/national/health/5222511/Measles-outbreak-likely-to-spread

3. Predictive model for Measles Outbreaks. Coverage at 15months should be >90%
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810912/pdf/10813154.pdf

4. Immunisation Coverage report 2010:
http://www.immune.org.nz/site_resources/Professionals/Research/2010_Immunisation_coverage_report.pdf
Found Here:
http://www.immune.org.nz/?t=603

5. Study looking at reasons NZ parents give for not vaccinating:
http://www.nzma.org.nz/journal/117-1189/768/

6. IMAC website with anti-vaccination rebuttals:
http://www.immune.org.nz/?T=938

7. Charities Register page for IAS:
http://www.register.charities.govt.nz/CharitiesRegister/CharitySummary.aspx?id=17c102eb-e79c-de11-9604-0015c5f3da29

Filed under: Medicine, Psychological, Questionable Techniques, Sciblogs, Science, skepticism Tagged: anti-vaccine, antivax, IAS complaint, Science, Science and Society, Vaccine, vaccine ingredients, Vaccines


175 Responses to “IAS Complaint Part 4: Anti-Vaccine Impact in New zealand”

  • Hi Darcy,

    Just wanted to lend another voice of support. Such a worthy project, and glad that you’ve dedicated so much time an energy and done such a good job of it.

  • Thanks guys, sometimes feels like I’m stumbling in the dark with this stuff. Hopefully the Charities Commission also thinks I’ve argued my case adequately.

    As always any inaccuracies, spelling mistakes and bad grammar are mine, any corrections appreciated.

  • Darcy, you say, “Vaccine coverage for a disease such as measles needs to be at approximately 90% or greater in infant populations to prevent epidemics3.”

    Ref 3 you label, “3. Predictive model for Measles Outbreaks. Coverage at 15months should be >90%
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810912/pdf/10813154.pdf

    The title of that article is actually, “Predicting and preventing measles epidemics in New Zealand: application of a mathematical model”

    I read the article… can you post the quotes that refer to;

    1. herd immunity
    2. Vaccine coverage for a disease such as measles needs to be at approximately 90% or greater in infant populations to prevent epidemics

    Thanks
    Ron

  • Ron, why don’t you take positive action, rather than negative?, e.g. positively test for yourself if the paper lacks in the ways you suggest.

    (BTW, The second looks trivial – read the conclusions.)

  • Ron, listen to Grant. Page 5 of the PDF if you are having difficulty.

    Could you explain why you are linking herd immunity with this particular reference? Could you post the quote where I imply that herd immunity is explained by this paper.

  • Grant, the whole point of providing references is not to make a paper or statement or comment look authoritative, but to enable readers to undertake due diligence and check the references to determine the credibility of the argument.

    I checked that reference and it does not support what is claimed… it does not mention herd immunity… nor does it provide any evidence to support the claim that Vaccine coverage for a disease such as measles needs to be at approximately 90% or greater in infant populations to prevent epidemics3.

    In fact I have never seen ANY science to support that statement… it seems that people forget that the word ‘herd’ relates to the total population… otherwise they would call it ‘calf-immunity.’ If infants get infected by adults then vaccinating infants will not stop the spread of the disease… it will only (hopefully) protect the individual.

  • Darcy, in the preceding paragraphs you refer directly to herd immunity… the statement ‘Vaccine coverage for a disease such as measles needs to be at approximately 90% or greater in infant populations to prevent epidemics’ is a description of herd immunity, n’est pas? Is that not what you were inferring?

  • Yes the preceding paragraphs were a quick run down on herd immunity. That reference was for coverage levels.
    One is an explanatory concept the other is recommended levels.

  • Ron,

    You implied (stated?) that the paper didn’t offer support for “Vaccine coverage for a disease such as measles needs to be at approximately 90% or greater in infant populations to prevent epidemics”

    I briefly looked it up (skimmed only). Here is one direct quote, from page 283 (the 5th page of the paper, as Darcy was saying):

    “Coverage at 15 months of age needs to increase to 90% (or more), and effective opportunities for catch-up immunization are also required to be certain of success.”

    Similar statements are expressed in more general modelling terms within the paper (i.e. more closely related to the context Darcy raised it).

  • Grant, that is a statement of opinion… it is not referenced.

    I am aware of vaccination rates well over 90 percent with epidemics/outbreaks of measles so such a rate in a very small percentage of the herd provides zero certainty.

    I would have thought that a person critiquing someone with an opposing view… especially if they were purporting to represent the good guys (science) would use referenced primary sources of evidence, not unreferenced opinion some 12 years old.

    NZ’s coverage for MMR is measured at 24 months, not 15 months… the vaccine hasn’t even been scheduled to be given till 15 months so its totally impossible to have 90 percent coverage at 15 months.

    Interestingly, the WHO reported New Zealand vaccination coverage in 1997 as over 99 percent!!!! I doubt anyone would believe that “credible” source.

  • Grant, that is a statement of opinion…

    It’s a recommendation that follows from their work, a conclusion, as you must know. Not an unsubstantiated opinion.

    It is not referenced.

    No research paper makes circular references!

    I would have thought that a person […] some 12 years old.

    Ad hominem, empty dismissal, etc; I’m stopping reading there.

  • Darcy, thank you for rising the issue of herd immunity. I’ve taken a solid look at the nascence of the belief as a result.

    I started with your reference number 3… I googled and found some references which referred to an earlier Tobias paper in the NZMJ. [1]

    That paper references an earlier paper which says that Morbillivirus is very highly transmissible and mathematical models predict that coverage 0f at least 93% of each birth cohort will be necessary before effective herd immunity results.

    The reference given is “Directly Transmitted Infectious Diseases: Control by Vaccination”. Roy M. Anderson; Robert M. May. Science, New Series, Vol. 215, No. 4536 (Feb. 26, 1982)

    It’s an interesting read… it opened my eyes to the way herd immunity was developed and is argued today… The theory in the paper states it is predicated on life-long protection from vaccination and 100 percent effectiveness of the vaccine… neither of which are true which means the mathematical models are null and void… n’est pas?

    Any thoughts?

    [1]
    N Z Med J. 1987 May 27;100(824):315-7.
    Measles immunity in children: the 1985 national immunisation survey.

    Tobias M, Scadden J, Clements J, Patel A.

  • Ron – The conclusions I quoted are from the author’s work; the reference you’re pointing at is background. (I’m not interested in debating this.)

  • mmm… so their calcs are that with an effective vaccination rate of 80 percent they will get herd immunity? (90 percent efficacy; 90 percent uptake) Even when the vaccine’s effectiveness wanes after a few years???? The herd theory was predicated on near 100 percent of children over the age of about 5 being immune due to natural infection, 100 percent vaccine effectiveness and lifelong immunity… Grant, there is a BIG difference… Tobias’s work also showed that the introduction of vaccination resulted in a lot more older children not having circulating antibodies… an interesting paradox, n’est pas?

  • In the interests of grammatical accuracy, Ron, it’s “n’est-ce pas”.
    A pedant’s work is never done …

  • Carol, French was never strong subject of mine, but if you google n’est pas you’ll see I’m in good company… Given this is not a peer reviewed blog I’m not particulalry bovered… 🙂

    However, when I need a gramma checka or spill cheka I’ll keap yu in mynd.

  • No Darcy, I’m saying that if you believe in Herd Immunity, if it works, then it requires 100 percent vaccine effectiveness and lifelong immunity to work… Neither of these are true for any vaccine that I’m aware of and it is known that immunity from measles vaccine wanes over 5-10 years.

  • Herd immunity, if it works, occurs over time… it is predicated on the WHOLE herd having immunity, not just the calves… when it was first developed as a theory nearly 100 percent of people over the age of 5-6 were immune from measles which meant that in theory only the preschoolers needed protection to achieve the firebreak…. since the introduction of measles vaccine more and more teenagers lost their immunity due to shorter protection spans from the vaccine… Tobias did a series of studies measuring antibodies in the 1980’s to show that… he comments on it in his c1987 paper… referenced above

  • Thanks for the clarification. At the risk of misrepresenting your point again I’ll try to summarise: Herd immunity may not work but if it does we need a more effective vaccine and immunisation programme to take advantage of it.

    That sounds good to me too. Sorry if I’m oversimplifying but I’m attempting to get to your core point without clouding the issue too much. Thanks for your forbearance.

  • Darcy, assuming Herd Immunity works in practice, and it makes total sense that it SHOULD, then 95 percent (or whatever) of the HERD (not one sector of the herd as is being promoted by the MOH at present, ie 18-24 months old) need to be immune for the fire break to be effective…

    At present we don’t have the tools to be able to achieve that…

  • Thanks Ron, what tools do you suggest to increase vaccination levels and vaccine effectiveness to the required levels? Would you say that this is a technological (vaccine production – better antibody response etc), educational or legislative issue?

    Thanks.

  • Darcy, all good questions.

    You could also add philosophical and ideological issues to that.

    The question needs to be asked, ‘why’ at all?

    Certainly legislation only breeds dissent and martyrs.

    The technology is not there to produce vaccines with a broad enough or specific enough immune response that will last the distance.

    Measles was a relatively mild disease that was demonised simply to try and get the masses to buy into the vaccine programme.

    Two good reads relating to power and politics and manipulation of evidence and minds can be found in

    Epidemics, panic and power: representations of measles and measles vaccines
    Kevin Dew, Victoria University of Wellington, New Zealand

    Child Immunisation: Reactions and Responses
    to New Zealand Government Policy 1920-1990.
    by Alison Suzanne Day

    I can email copies if you can’t find them.

  • I don’t think so Darcy… Drew, in particular, articlates his assessment of why IAS was formed and who its member were… in the context of this blog that is very pertinent and very much on-point. Demonising opponents may have washed in the cold war era… I suggest that it is not technology that needs to change, but mind-sets…

    Read Drew then I’d appreciate your comment.

  • “Measles was a relatively mild disease”

    Ron, how do you define “mild”? Are the hospitalisations happening in the current epidemic because of a “mild” disease? Being a mild disease, do you think we no longer need to vaccinate against it?

  • It is off point when the target here is not specifically measles but vaccination in general. Don’t allow the specific example to become the issue itself.

  • Darcy, the problem with this is that each vaccine is unique… there is no ‘one size fits all.’

    Measles vaccine is unique if only for the fact that it can’t be given to infants… Each vaccine has to be accessed on its merits… so therefore using measles as an example is very relevant… more so given the fact that the MOH has just changed the schedule to 12 and 14 months… dropping the 4 year dose. Doesn’t make sense to me when the main problem is other people losing immunity and spreading the disease.

    In the last decade the schedule has dropped from 11 yrs to 4 years to 14 months… what does that say about the science and politics of the vaccine?

  • “the main problem is other people losing immunity and spreading the disease.”

    Rubbish. The main problem is unvaccinated people catching the disease and then passing it on.

  • Ron Measles is an example the issue is vaccination. I’m not advocating a one-size-fits-all approach other than higher immunity in the population will slow the spread of disease.

    Do you have any comment on this or is this discussion over?

  • of why IAS was formed

    Their argument as to why they formed isn’t key (it could be bluster, after all): what is important is what they do, their actions.

    I don’t know who this Drew character is, but IAS say they were founded by Hilary Butler. If the articles by Hilary Butler that Michelle Rudgley of IAS held up as ‘evidence’ in her response to my article are anything to go by, what Hilary—and hence IAS—is trying to do is not ‘educational’.

    (As an aside, according to MOH, the majority of measles cases occur in unvaccinated people; taken simply this would suggest people not vaccinating is a large (the larger) part of the issue.)

    In the last decade the schedule has dropped from 11 yrs to 4 years to 14 months… what does that say about the science and politics of the vaccine?

    That they’re trying to protect the most vulnerable ages.

    Let’s use that to bring it back to the wider issue Darcy was trying to point out. Sound education would include vulnerability in the very young, etc. Education would explain why the decision was taken rather than just ‘hit on’ it. Once honestly presented, then it might be critcised.

    Preemptively dismissing the decision, illustrates that the approach is not intended to educate, but to push a preset agenda, i.e. biased activism rather than education. (And I would add, unsound activism.)

  • Grant, rather than label an informed and respected academic as ‘a [ ] character, I suggest you get his article and read it… it is very sound and extremely well referenced.

    Darcy, I totally agree… higher immunity in the community would slow the disease. The problem is that vaccination for measles actually lead to LOWER immunity in the community… at least according to Tobias when he looked at the immune status of over a thousand people.

    Vaccination and immunisation are not synonyms… nor are vaccinate and immunise.

    Darcy, I totally agree with your comment… Herd immunity does rest on several assumptions, one of which is that immunised individuals are spread evenly throughout the population. If pockets of unvaccinated individuals develop then diseases can gain a foothold in that part of the population and spread outward – even to vaccinated individuals.

    Reading Tobias’s article highlights the fact that vaccination changed the demographic of those who were not immune… a large percentage of teenagers and adults became susceptible to measles BECAUSE of their vaccination… thereby nullifying the herd theory that only vaccinating 95 percent of toddlers who achieve herd immunity… it is dumb policy for the MOH and IMAC to promote that as anyone without a tertiary education, even dumb mums, knows it not only has no scientific basis, but the science says otherwise.

    Grant, read Dew’s paper… he articulates well the MOH’s problem… it’s called credibility.

  • Grant, rather than label an informed and respected academic as ‘a [ ] character,

    I wasn’t insinuating, just writing informally. You try too hard jump on every slight opportunity you can to ‘colour’ other’s writing by twisting the meanings of what they’ve written. Best to look for the innocent ordinary meanings first.

    (BTW, trailing ellipsis are readily read as insinuating; you might want to not use them. It’s bit rich for you to be pointing at me if you’re writing like that, y’know!)

    I suggest you get his article and read it…

    I’m unlikely to have time, but if you want people to read this, you’ll want to supply a link to it or reference it.

  • Grant said, “I’m unlikely to have time, but if you want people to read this, you’ll want to supply a link to it or reference it.”

    I did… see above… I’ve emailed it to you and Peter… maybe Peter can put it on the site somewhere… it’s an important paper in understanding the dynamics of humanity and politics relating to the push/resistance of vaccines…

  • “(BTW, trailing ellipsis are readily read as insinuating; you might want to not use them. It’s bit rich for you to be pointing at me if you’re writing like that, y’know!)”

    Sorry Grant… I’m only 59 and hadn’t been made aware of that before…

    Wikipedia notes… “In reported speech, the ellipsis is sometimes used to represent an intentional silence, perhaps indicating irritation, dismay, shock or disgust. This usage is more common amongst younger, Internet-savvy generations.[citation needed]

    In poetry, this is used to highlight sarcasm or make the reader think about the last points in the poem. “This is a Happy Warrior, This is he…”

    In news reporting, it is used to indicate that a quotation has been condensed for space, brevity or relevance.”

    I guess it’s take your pick… anyone could be offended if they wanted to be… Guess I’m excused as I’m not young and internet-savvy…

    🙂

  • I did… see above…

    You misspelt his surname (e.g. Drew, in particular, articlates) so that searching for ‘Drew’ led to no citation.

    I’ve emailed it to you

    You’ve been told—many times—not to write to me privately. Your pestering me this way lead to me insisting on this.

    The abstract & link to subscriber access is available on-line.

    Sorry Grant… […]

    I have to say that lot seems a rather childish way to acknowledge you were implying negative meanings! (i.e. insinuating)

    Just my opinion, but it’s more constructive to just present whatever it is you want to say.

  • Grant, you are a master at pedantic… sure, I mispelled Dew’s name a couple of times… but not in the reference…

    If you want to argue science, then read the science… I’m not bothered with point scoring… I’ll leave that to ‘experts.’

  • Ron,

    On topic, first (putting this to the top for other’s sakes):

    Before your comment above I considered putting up the one paragraph in that article referring to IAS and explaining why it’s not news to me as a post sometime in the weekend (if I found time and interest). I wrote the essence of that long paragraph myself earlier in one sentence (in a comment after Darcy’s post after this one). You can’t leave out the (false) ‘evidence’ that is held up ‘against’ MoH, etc., it’s part of the same picture – Darcy wote about some of this in his article above.

    Off-topic:

    All I did was try explain so you’d understand, there was no need to try point-score off it.

    Certainly, sending me a private message nagging me shows you have no respect for other’s wishes. You now have four weeks furlough against you on my blog (1×2 + 1×2). Don’t write to me personally.

    then read the science…

    Others have no obligation to read what you put up really—they’re your interests in the end of the day and they may not share an interest in them, or think them worth discussing.

    Just kidding, and do lighten up: I note Dew’s work is actually sociology, not science 😉

  • Grant, you say, “Just kidding, and do lighten up: I note Dew’s work is actually sociology, not science ;-)”

    Firstly, school playground antics don’t do your cause any favours… do I look bovered that you might spit the dummy and take your ball home and not let me play? This isn’t even your blog… LOL… can’t you hack being sent an email with an important document attached? Peter can confirm their was nothing rude in it as he was copied in…

    As for you comment about Dew’s work is actually sociology, not science… you demonstrate that you do not understand humanity… science is one aspect of life… it should not be considered a religion. Dew’s whole point is that the more people get bullied and pushed by power and politics the more they’ll question and resist. Dew’s evidence is that demonising previously mild/moderate diseases to create fear in the hope that people will queue up to inject their kids IS about sociology, and the use of the science of fear… the more they do it the more they will immunise a sector of society against vaccinations… what a paradox.

  • Grant, for the benefit of others… I sent you two emails… one only contained the Dew paper as an attachment… copied to Peter Griffin.

    The second simply said, “Read the science if you want to discuss science…”

    Now that is harassment warranting public chastisement?????????????????? Grant, you don’t do your cause any good whatsoever when you spit the dummy over someone using an email that is on your website.

    You need to engage the evidence… that’s what science is about. Instead you try to win arguments and make points using non-evidence based methods… how paradoxical is that??

    Engage Dew’s paper… and Day’s for that matter… don’t just write them off or ignore them as inconvenient truths.

    ABSTRACT from Dew’s paper… “In anglophone countries, there have been increasing efforts to vaccinate the total population. A number of strategies have been employed in order to achieve this goal, including compulsory vaccination before children
    can attend school (USA); financial incentives to general practitioners and other vaccinators to achieve vaccination targets (UK); and, in New Zealand, a system known as mandatory choice. The New Zealand system involves education
    centres being co-opted into the medical domain to encourage parents to vaccinate their children. In order to promulgate such strategies, ‘vaccinepreventable’ diseases, vaccines, parents of unvaccinated children, and the children themselves are represented in particular ways. This paper examines the
    last three ‘epidemics’ of measles in New Zealand and the way in which the campaigns to prevent these epidemics represented the disease and other agents. Drawing on Foucault’s concepts of governmentality and bio-power,
    the paper explores the linkages between disease representations and the state.
    KEYWORDS bio-power; governmentality; immunizations; measles; vaccinations

    His introduction connects to the study…

    Introduction
    The portrayals of diseases and of treatments are important elements in conflicts between the state, the medical profession, individual practitioners and consumers. This study explores the ways in which an infectious disease, measles, and the ‘prophylactic’ medical treatment for this disease, measles
    vaccination, have been represented. It draws on a Foucauldian analysis to explore issues of governmentality, risk and the surveillance of the population, and suggests that the contemporary ‘regulatory’ environment will favour increasing efforts by the state to impose conformity to its policies,
    relying on a duties of citizenship discourse to foster this conformity.

    However, countervailing elements exist, particularly where there is a dissonance between, on the one hand, the ways in which health promotion campaigns portray disease and vaccinations and, on the other, the lived experience of the populace.

    As Day points out, the only way the vaccinators could get people to want the measles vaccine was to follow New Yorks strategy of demonising measles and portraying it as worse than the public’s perception of it.

    Grant, that’s using sociology to argue science, n’est ce pas?????

  • Here’s an extract from Dew’s ‘sociology’ paper… tell readers that this is not relevant to the vaccination debate…

    “In the 1985 epidemic, two deaths due to measles were recorded and reported in the media, and in the 1991 epidemic, four deaths were reported. The public presentation of the issue is that the problem, and cause of death, arise from not being vaccinated. If we look at the issue more closely we can see that the picture is far more complicated.
    Of the two children who died during the 1985 epidemic, one had a non- Hodgkins lymphoma and was on chemotherapy, and although having already been immunized, the child caught measles and pneumonia followed. The other child had a mucolipidosis and developed a secondary bacterial infection (Butler, 1991). In both cases the media reports attributed death to measles, and not to pneumonia, bacterial infection, chemotherapy, lymphoma or any other cause. In other words, the statistics compiled for media consumption are constructed and processed within pre-existing interpretative frameworks (Bloor et al., 1987). These frameworks posit mono-causal explanations where the disease is an evil and the vaccine is a good.”

  • And where did they catch measles from, Ron? The lymphoma child’s life was ended prematurely because of measles. This is a prime example of how we must protect our most vulnerable members of society, e.g. those with compromised immune systems. Are they not worth it?

    The pockets of unimmunised people that exist in our community allow these out-breaks to occur which increase the chances of this type of thing happening. And of course death isn’t the only or even the main risk from measles, as you well know.

    And how ironic that you call foul on the case above being attributed to measles when it wasn’t very long ago that you insinuated deaths and serious outcomes to the MeNZB vaccine. Remember the car crash victim? Could have been the vaccine you claimed. Perhaps the child was irritable from the jab and caused the driver to pay them too much attention leading to a crash. That was the longest bow I’ve ever seen drawn.

    And let’s not forget that you are now on record as calling measles a “mild” disease.

    > “Measles was a relatively mild disease”
    >
    > Ron, how do you define “mild”? Are the hospitalisations happening
    > in the current epidemic because of a “mild” disease? Being a mild
    > disease, do you think we no longer need to vaccinate against it?

  • Simon: +1. There’s a story on page 3 of today’s DomPost about a young Wellington woman who most definitely didn’t think her bout of measles was ‘a relatively mild disease’ during her three days in Wellington hospital.
    Ron is also on the record as claiming that he is “not anti-vaccine”.
    Tui Billboard-grade irony here.

  • “You need to engage the evidence… that’s what science is about”

    Er, Ron, many of us here are actually working, publishing scientists ourselves, and the last thing we need is a lecture from you about what science is about.

  • “Remember the car crash victim? Could have been the vaccine you claimed. Perhaps the child was irritable from the jab and caused the driver to pay them too much attention leading to a crash. That was the longest bow I’ve ever seen drawn. ”

    It was actually a teenager driver who had just had the MeNZB vaccine… The datasheet itself stated, “Dizziness has been very rarely reported following vaccination. This may temporarily affect the ability to drive or use machines.”

    So, Simon, your long bow is not so long, is it? I never said it WAS the cause, I simply pointed out that it was discounted by defenders of the faith without due consideration…!

    The comments about children dying from measles having stuffed immune systems were not mine… they were Dews… and he was pointing out that these deaths were being used to scare parents of healthy kids to get their kids vaccinated as, to use a 60’s cold-war term, “The [bad/nasty] Russians were coming to get you!!!!!

    Ordinary people see through scaremongering sooner or later… the more it is used to gain a short term benefit the more long term harm it does as it creates distrust…

    As for your comment, “Are they not worth it?” In modern society, if we spent unlimited amounts on all causes of death the country would soon be bankrupt… Cost benefit analyses help us put our efforts into those areas giving greatest return… at a societal level, spending tens of millions of dollars trying to, maybe, save one life is not good value for money… that’s just the way it is.

  • Carol, “Er, Ron, many of us here are actually working, publishing scientists ourselves, and the last thing we need is a lecture from you about what science is about.”

    Maybe so, but what many scientists don’t understand is that science sits within a human world… science is not sterile… scientists need to realise that they have to get buy-in… and that means engaging with society… that was the point of my comment to Grant… he can’t discount a paper because it was written from a sociology point of view… besides, is there not a discipline called social-science?

  • Well, that is undisputable. I have no problem with science existing in a societal context. But it seems to me that you yourself are blind to the evidence-based approach by relying heavily on one or two papers that suit your ideological bias (such as Dew/Drew/whoever) and ignoring the weight of evidence from the overall literature. Close parallels with climate change denial – they like to see themselves as contrary free thinking sceptics, but, er, not so much.

  • Carol, you’ve just used an article in today’s DomPost to support position…

    “”Measles is like the flu on crack,” she says. The Victoria University student, 19, should know – she was the first person in Wellington to become infected during the current outbreak.

    http://www.stuff.co.nz/dominion-post/news/5832909/Wellington-student-tells-of-measles-terror

    Firstly, I’ve never had crack so I can’t comment on that aspect of the report.

    Secondly, over 200 bacteria and viruses cause hyperpyrexia and myalgia, so that is not a reason for pushing a vaccine.

    Thirdly, the story says she got it from her brother, and that she was vaccinated early during an outbreak in Brisbane over a decade ago… presumably her brother was also vaccinated…
    Then it says, “She picked up the infection from her elder brother, who unwittingly passed it on while he was visiting from Auckland. A few days after returning home, he was diagnosed with measles and spent a day in Auckland Hospital.

    Miss Lyme was born in Brisbane during the 1991 measles epidemic, and so was vaccinated about six months earlier than usual. Public health officials believe that made the immunisation less effective as she got older. ..”

    Now that is interesting because the MOH has just changed the schedule considerably at what risk? Most of the cases are in older kids… not younger ones… Vaccinating babies at 12 months hasn’t been the norm because science says it’s not a good time to vaccinate them… the MOH is going to do a 12m/14m regime… what evidence is there to support that? They intend to drop the 4 year dose… yeah, right, as if! Especially when the evidence is saying that kids vaccinated at 15m and 4 years should get another dose at 11-12 years and probably also as adults…

    Tobias note in their 1987 paper that 15 percent of teenagers had no immunity because of the fact that measles vaccine immunity was short lived… He says they would be near 100 percent protected at that age if they hadn’t been vaccinated…

    That’s the problem… herd immunity was predicated on 100 percent effectiveness and life long protection, neither of whic is the case…

    Does me saying what the science shows make me anti-vax???? I would have thought it made me pro-science…!

  • The point remaining, of course, that you ignore the weight of evidence from scientific and medical orthodoxy while claiming to be keen on a scientific and evidence-based approach.

  • Maybe so, but what many scientists don’t understand is that science sits within a human world

    Scientists are parents too. They’re not robots.

    that was the point of my comment to Grant… he can’t discount a paper because it was written from a sociology point of view

    Misrepresenting me – I didn’t discount the article. What I did was try to lighten things up (because you’re lowering the tone) with a friendly joke playing on your ‘asking’ me to discuss science, when the article you pointed to wasn’t. I spelt out that it was a joke to lighten things. But you just have to rework it to be something else. Silly.

    besides, is there not a discipline called social-science?

    Word games and point-scoring like this are why I’ve ceased to be involved.

    Just quickly reading back, as I see that you have several times misrepresented me earlier to put them right:

    can’t you hack being sent an email with an important document attached?

    You sent the document, I told you firmly not to email me, you followed that with a personal message some time later—a silly attempt to goad off this forum—then I placed the furlough. I did explain what prompted the furlough earlier. No-one should have to accept unsolicited mail after they have (repeatedly) advised the person to cease.

    Engage Dew’s paper… and Day’s for that matter… don’t just write them off or ignore them as inconvenient truths.

    If I do, I’ll write it on my own forum, as I indicated earlier. (Just my opinion, but you’d do better to not try bully people to read something but try make it interesting to them.)

    I didn’t write it off, either—misrepresenting me again: in fact, I wrote that I’d said as much myself and might look at it further. I also pointed out that it doesn’t mean that the (false) ‘evidence’ used in anti-vaccine arguments can’t be overlooked, as is part of the same issue.

    Skipping down to your latest:

    herd immunity was predicated on 100 percent effectiveness and life long protection, neither of whic[h] is the case

    The first models might well have simplistic (I don’t know but it seems reasonable), but to suggest current modelling work is ignorant of less than 100% effectiveness is silly.

    I would have thought it made me pro-science

    If you represented the science accurately and in its correct context, maybe – but you too frequently don’t.

    Anyway, I’m off 🙂

  • I’ve checked official surveillance reports and it appears that the Wellington student was kept in an isolation unit for quarantine purposes and was not admitted to the hospital for treatment. The reports say the case was confirmed but no-one was admitted to hospital.

    That suggests that she was not seriously ill… her fever and aches may have been severe, but they appear not to be serious.

  • For goodness sake, Ron, if you want to win the battle of hearts and minds for your anti-vaccination jihad you are in the wrong forum.

  • Carol… the simple point I’m making is that science is not black and white. The pros and cons of vaccination can not be summed up with one paper… there is no one size fits all… you put up an anecdote as evidence of the seriousness of modern measles, and yet a mother whose child’s life is decimated within an hour or two of a vaccine is emotional when she blames the vaccine… her emotion is based on a lack of understanding of statistics and chance… her situation is argued to be an anecdote…

    I’m not trying to convince anyone of anything… other than looking beyond the stated… references are given in science papers to enable people to verify the facts for themselves… I checked official sources to verify a statement in a newspaper… the official sources provide contrary evidence to the proposition posted on this blog by a science advocate…

    If scientists critically evaluated evidence rather than simply accepting some professor God’s word as gospel then science would have a much easier job communicating and engaging with the general public… especially when ordinary people have access to more evidence than most medics ever delve into.

  • I’ll just note here that the young Wellington student has a different version of events to yours.
    Otherwise I really can’t be bothered to try and get the last word.
    Have a good weekend.

  • >> “And how ironic that you call foul on the case above being attributed
    >> to measles when it wasn’t very long ago that you insinuated deaths
    >> and serious outcomes to the MeNZB vaccine.”
    > “So, Simon, your long bow is not so long, is it? I never said it WAS the cause, I simply pointed out that it was discounted by defenders of the faith without due consideration…!”

    And the irony passes you by.

    > “The comments about children dying from measles having stuffed immune systems were not mine…”

    But you posted them. People may not know some of the consequences of not immunising. They can be shocked to discover there are people who are extremely vulnerable. This is but *one* reason to get almost total vaccine coverage.

    > “spending tens of millions of dollars trying to, maybe, save one life is not good value for money”

    You’ve been told many times that it is not.just.about.saving.lives. You continue to ignore this.

    > “…measles vaccine immunity was short lived… He says they would be near 100 percent protected at that age if they hadn’t been vaccinated…”

    We know that the vaccine’s immunity is short lived compared to the actual disease. With all your quotes you seem to be suggesting that not vaccinating is the way to go.

    Earlier:
    > the main problem is other people losing immunity and spreading the disease.”
    Rubbish. The main problem is unvaccinated people catching the disease and then passing it on. N’est-ce pas?

    And let’s not forget that you are now on record as calling measles a “mild” disease.
    > “Measles was a relatively mild disease”

    How do you define “mild”? Are the hospitalisations happening in the current epidemic because of a “mild” disease? Being a mild disease, do you think we no longer need to vaccinate against it?

  • Ah, medical orthodoxy… the font of all things true and evidence based? Being an EBM advocate I went to look up the measles vaccine (seeings we’ve focussed on that in this thread.

    “How do you know if one healthcare intervention works better than another, or if it will do more harm than good?”

    “Cochrane Reviews are systematic reviews of primary research in human health care and health policy, and are internationally recognised as the highest standard in evidence-based health care. They investigate the effects of interventions for prevention, treatment and rehabilitation. They also assess the accuracy of a diagnostic test for a given condition in a specific patient group and setting. They are published online in The Cochrane Library” at
    http://www.cochrane.org/cochrane-reviews

    So what do they say about the measles vaccine?

    Interestingly, they concluded, “We could not identify studies assessing the effectiveness of MMR that fulfilled our inclusion criteria even though the impact of mass immunisation on the elimination of the diseases has been largely demonstrated.”

    http://www2.cochrane.org/reviews/en/ab004407.html

    So I asked the authors why they included a non-edidence-based statement about the impact of mass vaccination which is not their norm… the key authored replied that the inclusion “even though the impact of mass immunisation on the elimination of the diseases has been largely demonstrated” was not written by the authors but was a political inclusion by others…

    I asked him what the evidence for the inclusion was and he replied, ‘politics.’

    It’s called medical orthodoxy…

    So what is an evidence-based kind-a-guy supposed to do? Ignore the evidence, or go with the politics?

  • David… I do it often… as an EBM advocate I am regularly review the evidence and adjusting my position accordingly… I’m always willing to change/amend my thinking in light of new evidence…

  • Ron, you did assert a couple of weeks ago that measles is a mild disease. This is not what the Cochrane summary concluded (Alison linked to it back on that other thread). Are you willing to change/amend your thinking here?

  • Darcy, can you cut and paste where I said measles was a mild disease? The evidence you linked to does not support me making that statement.

  • Ron, this is what you said.

    “Measles was a relatively mild disease that was demonised simply to try and get the masses to buy into the vaccine programme.”

    It took me less than two minutes to locate it using Darcy’s link.

  • Alison Day’s thesis…”Chapter Six demonstrates the shift in focus for immunisation from the perceived ‘killer’ diseases, such as diphtheria and polio, to the commoner childhood illnesses of measles and rubella. To try and persuade parents to have their children immunised, the Health Department began to publicise the more serious side-effects of these socalled
    ‘mild’ illnesses. Campaigns were conducted elsewhere, such as in the United States where, from 1963 to 1968, 20 million doses of measles vaccine were given out.53 The measles vaccine did not have such an auspicious start in New Zealand, due
    to events in Britain, when serious side-effects from the vaccine in a few children halted the British measles immunisation programme. As New Zealand was about to use British vaccine the programme was put on hold. Resulting ambivalence by the
    Health Department towards the vaccine meant it was now introduced through the family doctor instead of a school campaign. Levels of acceptance were, therefore, correspondingly low. This was also the period where the rising cost of visiting the doctor for immunisation had begun to affect levels. By making immunisation free in 1972 it was hoped that more parents would consent to have their children immunised.”

  • “The two polio vaccines together were effective enough to virtually
    eradicate polio from New Zealand by 1962 and diphtheria was reduced by immunisation to the very occasional case. Nonetheless, the measles and pertussis vaccines were much less effective and epidemics still occurred despite quite extensive immunisation over a long period. However, the results of non-immunisation were clearly evident. In 1978 there was a serious pertussis epidemic in Britain after several years of low immunisation uptake. Similarly, in the United States more cases of
    measles began to occur after the measles immunisation programme had its funding cut. In New Zealand in the late 1980s an epidemic of meningococcal meningitis A was controlled by immunisation and the use of the hepatitis B vaccine halted the spread of the disease in schools. Consequently, for most vaccine-preventable diseases immunisation was regarded by the Health Department and health professionals as an effective measure although its efficacy did vary for each vaccine. Therefore, notwithstanding the input made by of a range of other factors, immunisation has appeared to have made an important contribution overall to the declining child morbidity and mortality rate for infectious disease over the second half of the twentieth century in New Zealand.”

    Day, Alison (2008) Child immunization: reactions and responses to New Zealand government policy 1920‐1990. PhD thesis (history), University of Auckland.

  • “Therefore, notwithstanding the input made by of a range of other factors, immunisation has appeared to have made an important contribution overall to the declining child morbidity and mortality rate for infectious disease over the second half of the twentieth century in New Zealand.”

    So does this mean the apparent contribution is based on “appearance” not evidence.

    Of course, if the polio diagnostic criteria used before the polio vaccine was introduced were still used today, there would still be a dozen or so serious polio cases in NZ children every year… only now they call it AFP and nobody cares… globally there has been an unpublicised dramatic rise in AFP cases (100,000 cases a year now compared with 10,000 cases a decade ago) as the decline of polio has been widely publicised.

  • Ron, what exactly was the point of your copy-and-paste-cepades?

    AFP is caused by multiple organisms including poliovirus, are you attempting to attribute all cases to polio?

    Your word-games are becoming tedious.

  • Hi Darcy, before polio vaccine was introduced all AFP was attributed to polio… afterwards, not only was the definition of polio changed, but testing was introduced… all negative polio paralysis cases got redefined as AFP (acute flaccid paralysis.)

    One point is that it is easy to make claims and counter claims… the reality is that measles wasn’t the evil it’s been cast as… and clinical ‘polio’ didn’t disappear as claimed… although it had waned considerably prior to the introduction of the polio vaccine.

    Anti-anti vaccine folk would be able to argue/discuss issues much more persuasively if they focused on evidence and not focused on pre-determined positions.

    Have you seen the fact that the USA CDC has quietly backed off their claims about flu vaccine efficacy/effectiveness? They are in a corner and realise they are losing the credibility argument by continuing to claim that flu vaccine a very effective when they know it’s not.

    Arguments should be based on evidence, not per-determined arguments.

  • > the reality is that measles wasn’t the evil it’s been cast as

    Ron, you’re down-playing these diseases. Measles is a serious disease. Are you claiming it is mild again?

    > clinical ‘polio’ didn’t disappear as claimed

    Polio is a serious disease. Your word games are down-playing this serious disease as well.

    > Have you seen the fact that the USA CDC has quietly backed off their claims about flu vaccine efficacy/effectiveness? They are in a corner and realise they are losing the credibility argument by continuing to claim that flu vaccine a very effective when they know it’s not.

    I’d be interested in seeing where they claimed the flu vaccine is very effective. The figures “released” are all from existing studies. Where is the news here?

    All this makes one wonder how much sympathy you really do have with the anti-vaccine rhetoric.

    Polio has been wiped out in New Zealand and around almost the entire world. Measles vaccination is very effective as evidenced in the latest outbreaks amongst mainly unvaccinated individuals. The flu vaccine isn’t great but it is better than nothing. Improved vaccines are certainly required.

  • Simon, with regards to risk and policy issues there are two axes… one is societal risk and the other is individual risk.

    If you are talking about societal risk, then one needs to take into account the big picture and benefit versus cost versus lost opportunity… using the MeNZB vaccine campaign, for example, spending 200-250 million dollars to save two-three lives is a gross waste of resource from a big picture/societal point of view. Whilst those 2-3 deaths are tragic for the individual, arguing that “any amount of money spent saving a life is worth it” is an irrational and emotive argument… especially if one is spending the best part of $100 million to save a life as occured with the MeNZB vaccine.

    On the other hand, an individual who has just lost a loved one to a bacteria or virus for which there is a vaccine then it is logical that they would advocate wide use of the vaccine, regardless of cost… Two recent examples of individual loss driving demands for universal risk solutions are the case of the medical student who died from Men C (in part due to poor medical care) and the case of a child who drowned in an unfenced stream… it would be crazy to expect every drain/stream to be fenced simply because of the cost/benefit.

    By way of example… about 600 New Zealanders die each year under the age of 20… if $100 million was spent saving each of those lives that would equate to $60,000 million, or $60 billion per year… obviously no sane person would consider that rational risk management, and yet that’s the equivalent New Zealand spent saving a life from Meningococcal disease.

    Measles is a disease that is mild for the vast majority of sufferers. For the vast majority it is a nuisance… at a societal level it is a very mild disease… at an individual level, for a very small minority it can be a serious illness… as can the common cold, pimples, and a host of other illnesses.

    Simon, if you had a spare $200 million what would you spend it on? A vaccine for very small benefit, or more efficient means of providing warm and dry homes for the poor with significant proven health benefits?

  • On a societal level measles isn’t trivial. Even for a ‘mild’ case the child will still be ill for several days – days when they’ll need to be at home & in the care of their parent(s). This means that their parents will need to take time off work, & given the amount of sick leave most can access, at least some of that time will be unpaid leave. Either way, the parent isn’t at work doing the day job that they’re paid for, resulting in a loss of productivity for the firm involved (or for the self-employed individual). Add the costs of that up for multiple cases of measles (or any of the other childhood diseases that you persist in describing as ‘mild’) & the societal costs may not be all that trivial.

    You’re also forgetting the lifetime costs of long-term disabilities caused by some of these diseases (yes, including measles). The lifetime costs of caring for someone severely disabled by, say, meningitis, is very definiitely not trivial (one detailed calculation is here:http://www.meningitis.org/assets/x/53379 ) – & a cost that can be considerably reduced by widespread vaccination. Incidentally, it’s not just ‘the poor’ who die of or are disabled by meningitis; the young man you mention is a case in point.

  • Alison, how would you compare the costs of measles sequelae versus, say, the costs of sequelae of car accidents, accidents in playgrounds, child abuse, asthma, survived ‘drownings’, etc, etc…

    Risk and policy decisions should be based in where society gets the best value for money, not who can gain the ear of the media and pull heart strings using emotion and rhetoric.

    Science reveals that the vast majority of measles casualties recover uneventfully… scientists would have us believe that it is a feared disease that causes mayhem and carnage in society… as Grant said, you can trust the science, not the scientist.

  • It was – and can be again – a “feared disease that causes mayhem and carnage in society”, in the absence of vaccination.

    So – are you in favour of discontinuing most of the standard childhood vaccinations?

  • Also, every year this country spends a very large amount of money in attempts to minimise the effects of car accidents (driver education, installing crash barriers, straigthening & otherwise dealing with ‘problem’ roads, etc), playground accidents (changing the nature of playgrounds & the surfaces kids may land on), drownings, etc. Why is it OK – in your book – to do this, but not to attempt to minimise the impact of meningitis, measles, & other vaccine-preventable diseases?

  • Alison, measles was not a feared disease like polio was… the ‘fear’ perception was, as pointed out in Alison Day’s thesis, promoted by vaccine mongers to try and get parents to buy into the vaccine.

    Your question about discontinuing most of the standard childhood vaccines is a good one, and perhaps illustrates the one-size-fits-all modus operandi of the vaccine industry.

    Personally, I am of the opinion that each vacine should be considered on its merits… not bundled up with everything that moves.

    A benefit of circulating measles virus is that, in theory, it should infect non-immunised and cause natural immunity and therefore created herd immunity (if such a utopic state occurs.) In theory immune rates should them exceed 90 or 93, or 95 or whatever the rate de jour is required to attain herd immunity.
    For some strange reason it hasn’t burnt itself out… why not?

    An aspect of continued emotive push of mass vaccination not considered by officialdom is the fact that it not only wears thin, but it chips away at the credibility of the whole concept of multiple repeat mass vaccinations being required to eradicate certain diseases…

    In short, I certainly don’t believe in vaccination for vaccination sake, although i is a good business model.

  • Ron, I agree Alison’s question was a good one. It was also directed at you personally and yet again you’ve danced around giving a direct answer.

    you were asked “are you in favour of discontinuing most of the standard childhood vaccinations?”

    Well, what is your answer?

  • Darcy, I did answer Alison’s question… “Your question about discontinuing most of the standard childhood vaccines is a good one, and perhaps illustrates the one-size-fits-all modus operandi of the vaccine industry.

    Personally, I am of the opinion that each vacine should be considered on its merits… not bundled up with everything that moves.”

    What don’t you understand about that???? It would be unscientific to try and evaluate all of the vaccines on an all or nothing basis don’t you think?

  • uh,huh. I thought the words “relatively mild” were straight forward. Turns out I was wrong.

    OK a slightly different track, on the merits, which vaccines are useful to keep in the schedule?

  • And he’s off, using someone else’s blog to push his barrow… (I keep suggesting he go to wordpress.com and get his own, etc.)

    Ron,

    I agree with Darcy, you are persistently walking around what others have raised, diverting to other things.

    Measles is a disease that is mild for the vast majority of sufferers.

    Simon, if you had a spare $200 million what would you spend it on? A vaccine for very small benefit,

    In the second you are trying to frame the answer with an assertion; you’re presuming the answer in the question.

    Neither are the issue.

    The issue is if the population would be better with the vaccination program than not.

    For it to be vaccination or some another thing, you presume that the vaccine programme has no or little economic value of it’s own in your question (again effectively framing an answer in the question).

    While I’m writing, if anyone wants a quick summary of the basics on measles, including typical rates of serious affects, one source is this page at IMAC.

    not who can gain the ear of the media and pull heart strings using emotion and rhetoric.

    You have been a problem in this way in your past. I find it truly ironic and rich of you to write this.

    To bring this back on topic – IAS is fine example of this problem, wouldn’t you say?

    What don’t you understand about that????

    What I (and to my reading Darcy and Alison) from this is that you have avoided Alison’s question. (You also use it as an opportunity to try ‘imply stuff’ of the “the vaccine industry”, a straw-man phrase.)

    Your reply to Alison is empty in that it doesn’t actually say anything, really. It’s like a politician making noises 🙂

    It make general noises in the direction the question ‘should all vaccines be treated as a group, a whole’, but Alison didn’t ask that. She asked “are you in favour of discontinuing most of the standard childhood vaccinations?”

    How about a simple list with yes/no to each?

    To help you, these are recommended childhood vaccines on the IMAC website: http://www.immune.org.nz/?t=571 (They list seven.)

  • Alison, I have not commented on car accidents, playgrounds etc… However, I would look at risks and benefits and put limited resources where they would have most impact. Spending $200-$250 million to prevent at best 2-3 deaths (and related ongoing harm) was a, in any language, a gross waste of valuable resource…

    I would undertake risk assessments and establish those areas where spending a dollar would make the most impact to society. In other words, prioritise. If individual vaccines stacked up then I’d have no problems funding them on a case by case basis. I think Pharmac provides a useful model in this regards. Although not perfect by any means, they also have a humanitarian fund whereby some (lucky) individuals get disproportionate funding for treatment/mitigation of rare disorders.

    An example of work I’ve done for a variety of clients around the globe can be seen here. http://tinyurl.com/8ayxkxp I’ve recently updated this. I haven’t included deaths related to vaccine preventable diseases because they never featured in the selection of risks I looked at. But based on my more than decade involvement in risk and policy work, I’d certainly have reducing medical injury on a priority list.

  • Darcy asks, “OK a slightly different track, on the merits, which vaccines are useful to keep in the schedule?”

    Darcy, as a scientist you would know that such a question couldn’t possibly be answered off the top of one’s head without undertaking an in depth risk/benefit analysis.

    The CDC has just downgraded its views on the flu vax in the face of irrefutable evidence it was overly optimistic in its assessment of the flu vax.

    You’ve asked a very good question… have you ever taken the time to answer it yourself? Without doing so, it is impossible to make an objective assessment of the pros and cons of any vaccine.

    Have you attempted to answer that question yourself?

  • Ron,

    You seem very determined to avoid answering the question!

    Darcy’s question is just the same as Alison’s and mine, really, just asked in the affirmative, e.g. which of the vaccines listed would you say ‘yes’ to?

    I ‘unbundled’ the different vaccines for you, so your objection to Alison about this is not an issue now.

    Without doing so, it is impossible to make an objective assessment of the pros and cons of any vaccine.

    Then how can you offer that “A vaccine for very small benefit”?

    More importantly: are we to take it that you have done no risk analysis on childhood vaccines that can give a definite answer?

  • Spending $200-$250 million to prevent at best 2-3 deaths (and related ongoing harm) was a, in any language, a gross waste of valuable resource…

    On the basis of the figures in the paper I linked to earlier, you’d need to prevent ‘only’ 20 people being severely disabled by the meningitis vaccine & you would be cost-neutral. Actually it would be less than that because the figures given were in pounds sterling & the exchange rate doesn’t favour NZ$.

    Why measles doesn’t ‘burn itself out’ in NZ? This may help you with the answer: As part of national and hemispheric initiatives, the United States established a goal to eliminate indigenous transmission of measles by the year 2000.[1,2] Before measles vaccines were licensed in the United States in 1963, more than 500,000 cases occurred each year.[3,4] Today, several decades later, the number of measles cases is at an all-time low of 100 cases reported in 1999, and surveillance data suggest that indigenous transmission has been interrupted in each year since 1996, suggesting that measles is no longer an endemic disease in the United States.[5-12] However, the importation of measles from other countries, coupled with susceptible populations of both infants younger than the age of routine vaccination and young adults, potentially threaten sustained elimination of endemic measles.[10-13] Moreover, measles epidemics are cyclic; an outbreak will occur when a sufficient level of susceptible persons is reached. – from Hutchins et al, 2001. The orignal is on Medscape http://www.medscape.com/viewarticle/408098 but subscription is free.

  • Also, on the issue of measles not being feared in the same way that polio was… The WHO website tells us that

    Measles is a highly contagious, serious disease caused by a virus. In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year.

    It remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. An estimated 164 000 people died from measles in 2008 – mostly children under the age of five.

    Measles is caused by a virus in the paramyxovirus family. The measles virus normally grows in the cells that line the back of the throat and lungs. Measles is a human disease and is not known to occur in animals.

    Accelerated immunization activities have had a major impact on reducing measles deaths. From 2001 to 2011 an estimated one billion children aged 9 months to 14 years who live in high risk countries were vaccinated against the disease. Global measles deaths has decreased by 78% from 733 000 in 2000 to 164 000 in 2008
    http://www.who.int/mediacentre/factsheets/fs286/en/

    A disease that can be characterised as one of the leading causes of child mortality globally – in part due to the fact that many infants remain unvaccinated in some parts of the world – is likely to generate fear of the disease in thsose parts of the world where the risk remains high.

    ANd in my previous comment – I should have said prevent only 20 people being severely disabled through use of the meningitis vaccine (ie the vaccine is protective). Late at night; I should leave off posting!

  • Alison the meningitis costs you linked to are based on a worse case hypothetical person, nevertheless based on an amalgam of real persons. Fortunately very few people have long term sequelae from meningitis as described… Having said that, the costs are relative, and would be similar for people brain injured from falls, near drownings, MVA’s, viscous assaults, etc, so it would be irrational to argue that this provides justification or preference for any particular form of prevention/treatment for any particular ‘disease.’

    In NZ the standard ‘cost’ of a death used to decide priorities for roading (by way of example) uses a figure of about $3.5 million.

    “The total social and economic cost of all injuries in New Zealand, at June 2008 prices, is conservatively estimated to be approximately NZ$9.7 billion, with a range from $7.4 billion to $13.6 billion, depending on the economic value attributed to a human life. Of the $9.7 billion, 53% is attributed to the human cost. The three highest cost areas are motor vehicle traffic crashes, suicide and falls, which account for approximately 63%
    of the total costs of all injuries. The six priority areas account for 84% of the total social and economic costs of all injuries. ”

    NOTE: their use of the term injury relates to physical injury, not disease caused injury.

    See full NZ Injury Prevention Strategy report (Five-year Evaluation The costs of injury in New Zealand and methods for prioritising resource allocation) … it’s a good read… references Milne who did the mENZB economic impact assessment which was full of assumptions which mostly proved overly optimistic (Barb & I pointed that out in our 2005/2006 meningococcal gold rush series as did the Cantuerbury University Hons student who was blackmailed to remove her thesis from public purvue
    http://www.nzips.govt.nz/documents/Report4.pdf

    As for the medscape paper you referred to… it shows nothing objective… only a claim that the ongoing downslide of measles cases was due to the introduction of the vaccine. As occured in NZ with the MeNZB vaccine, the disease was on the wane before the introduction of the vaccine… and continued its downhill slide unabated.

  • Alison, I’m not a follower of Mike Adams… I do, however, follow the CDC… Overselling Flu Vaccine Effectiveness Risks Undermining Public Health Credibility … read this…

    http://www.psandman.com/col/fluvax-effectiveness.htm

    I find it paradoxical that Blogs and Tweets have become the new font of all things true and scientific… and Bloggers and Tweeters have become the nouveaux “experts,” don’t you?

  • Nor am I a follower of Mike Adams – if you read the post I linked to, you’d see a thorough examination of the claims (actively promoted by Mr Adams) that the CDC has admitted the ‘ineffectiveness’ of the flu vaccine.

  • I for one am concluding that Ron is unwilling to answer the question. (Among several others he is ‘overlooking’.)

    My interpretation of this is that he is unable to answer the question, that he has no data on which to make a definitive decision on that matter.

    All he is doing, and seems to be able to do, is raise hypothetical “objections” – i.e. present a standard (anti-vaccine) ‘concern trolling’ approach.

  • As for the medscape paper you referred to… it shows nothing objective… only a claim that the ongoing downslide of measles cases was due to the introduction of the vaccine. As occured in NZ with the MeNZB vaccine, the disease was on the wane before the introduction of the vaccine… and continued its downhill slide unabated.

    To my reading Ron is presenting pre-determined conclusions, ones he has been offering for years.

    This quick take on this issue is fun:

    http://www.iayork.com/MysteryRays/2009/03/05/on-measles-vaccination-and-capitalism/

    I find it paradoxical that Blogs and Tweets have become the new font of all things true and scientific… and Bloggers and Tweeters have become the nouveaux “experts,” don’t you?

    Well, I find it paradoxial that Ron resorts to this rather than reading the article!

    Regards bloggers and tweeters –

    People’s expertise depends on the person and their experience, not the communication medium they are using.

    While it’s clear Mike Adams’ experience and expertise on this topic is questionable (at least we can all agree on this), some bloggers and tweeters are established experts. They include, for example, one of this year’s Nobel Prize winners in Physics, tenured full professors (I personally know several) and so on. I doubt these people are “nouveaux “experts”” – they were experts long before they took up blogging or tweeting.

    My reading of it is that the unstated point Alison was making was that ‘even Mike Adams acknowledges this’.

  • Hi Alison, Mike Adams has nothing to do with this discussion…I have read his posts on occasions but have no interest in most of what I have read…

    The CDC as recently as June 2011 had this pseudo-science on their website… “Overall, in years when the vaccine and circulating viruses are well-matched, influenza vaccines can be expected to reduce laboratory-confirmed influenza by approximately 70% to 90% in healthy adults <65 years of age. "
    http://web.archive.org/web/20110623063932/http:/www.cdc.gov/flu/professionals/vaccination/effectivenessqa.htm

    They changed it a few days before the Lancet article was published to "For example, in an observational study of people 50–64 years of age, the vaccine was 60% effective in preventing laboratory-confirmed influenza among otherwise healthy adults 50–64 years of age, but only 48% effective among those who had high-risk medical conditions…"

    In other places it still makes the claim that "Past studies have shown that in years when the vaccine viruses and circulating viruses are well-matched, the vaccine can reduce the chances of getting the influenza by 70%-90% in healthy adults. The vaccine may be somewhat less effective in elderly persons and very young children,…"
    http://www.cdc.gov/flu/professionals/vaccination/virusqa.htm

    They make no mention of the Cochran reviews meta-analysis which found that the flu vaccine sucked…

    Coming back to cost/benefit… how far would $200 million go in reducing deaths from the 500 or so suicides each year?

  • 1st Principles… Grant recently posted a link to a blog as evidence relating to the use of vit C…
    https://sciblogs.co.nz/code-for-life/2011/10/08/whooping-cough-and-media-balance/

    He links to
    https://sciblogs.co.nz/guestwork/2011/11/10/vitamins-myths-facts-use-and-misuse/

    Go read the opening gambit…

    “When it comes to using vitamins to supplement diets, there’s a wide gap between what science says and what many consumers believe.

    A recent study, for instance, established that some 52% of the Australian population takes some form of complementary medicine, with over a third of this number taking vitamin pills.”

    Now go look at the reference provided to support this “scientific fact” (click on ‘recent study’ in article.)
    The full astudy can be found here…
    http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2011.00745.x/pdf

    Can someone enlighten me where this paper provide any factual evidence to support the statement “A recent study, for instance, established that some 52% of the Australian population takes some form of complementary medicine, with over a third of this number taking vitamin pills.”

    The title of the blog is, “Vitamins: Myths, facts, use and misuse”

    I guess the opening gambit was the myth…? Am I wrong?

  • Hi Darcy,

    Personally, I’m not so much bothered as finding this a bit silly.

    Not only is his comment wide of the topic here, it’s also wide of both my article and the comment I added to the comment thread that follows it, referring to the guest post on vitamin supplement use. (The article itself does not link to the guest post.)

    Neither has anything to do with the number of people taking vitamin pills. If Ron has a question over that, surely the person to ask is the author of the guest post? (Best to make it polite, though.)

    (My article was an examination of statements made by Michelle Rudgely to media; i.e. no relevance there. (Michelle Rudgely is the spokesperson for IAS.) My comment referred readers to the guest post as that post pointed to a study on use of vitamin C to [unsuccessfully] treat the common cough; i.e. no relevance to my article or comment there either.)

  • My point is that people defending an evidence-based position should do their homework and front up with evidence… not get excited about what someone else posts and use it as evidence… medicine is predicated in many aspects on getting something in print three times so that it becomes set in stone…

    The fact is that what was touted as scientific evidence was no better/worse than what they were trying to be critical of… no attack… just critique…

  • Ron,

    not get excited about what someone else posts and use it as evidence…

    Now this really is silly. (I routinely provide follow-on links in my comment threads as a courtesy to readers to so that they can connect with [sometimes tangentially] related material that might interest them.)

    The basis of evidence is not that it’s in print, but the data and testing that is being presented.

    I’m closing my interest in this, as it seems a long way from what Darcy would like covered here.

  • > Ron:
    > Measles is a disease that is mild for the vast majority of sufferers.
    > For the vast majority it is a nuisance… at a societal level it is a
    > very mild disease… at an individual level, for a very small minority
    > it can be a serious illness… as can the common cold, pimples, and a
    > host of other illnesses.

    The common cold is a mild disease, measles is not. Just because a disease is mild in some people does not mean a disease can be classified as mild.

    The latest outbreak (in mostly unvaccinated by the way) resulted in about 20% of identified sufferers being admitted to hospital. By anyone’s definition (except, it seems, Ron Law’s and the IAS) that is a serious disease.

    Do not also forget that measles can cause other complications like encephalitis and miscarriage, even the ultimately fatal SSPE. Perhaps even as many one in a thousand measles cases result in death from what I’ve read. At that rate there would be 4000 deaths every year in New Zealand. That is many billions of dollars to use the example of car death “cost”.

    Don’t forget that the MMR vaccine also protects against mumps and rubella, both also potentially serious diseases worth vaccinating against.

    So Ron, please stop referring to measles as mild, relatively mild, societally mild, insignificant or whatever other term you can come up with to downplay it. You appear to be deliberately minimising the impact of the disease for what? I honestly can’t work it out.

    Measles vaccination is a fantastic cost effective tool for reducing and hopefully even eliminating a serious disease.

  • Ah spit, got carried away with my figures. 1 per 1000 deaths would apply to each year’s cohort, which is about 60,000 I think, so about 60 deaths per year, not 4000.

  • Simon says, “Perhaps even as many one in a thousand measles cases result in death from what I’ve read. At that rate there would be 4000 deaths every year in New Zealand.”

    Unbelievable…

    Then Simon says, “Ah spit, got carried away with my figures. 1 per 1000 deaths would apply to each year’s cohort, which is about 60,000 I think, so about 60 deaths per year, not 4000.”

    Again, unbelievable…!

    According to official NZ death figures from the Ministry of Health (then Department of Health) there were an average of 5 deaths per million population in NZ from 1940 to 1960… An average of 16 per year in the 1930’s, 5 per year in the 1940’s and 4 per year in the 1950’s… a drop of 75 percent in the decades pre vaccine… dropping further to 2.3 in the 1960’s… which included epidemic years in 1963, 1965, 1967, 1969. Vaccination against measles was introduced in New
    Zealand in 1969,

    Simon, can you show readers any scientific reference documenting 1 in 1,000 of an entire cohort in a developed country has/would die from measles if unvaccinated?

    In developed countries, such as New Zealand, measles was not so common in infants in the pre-vaccine era… it spread once children started school… with few deaths relative to other causes of death… the last ‘bad’ year for deaths in NZ was 1938 with 163 deaths (105 per million).

  • Ron,

    I believe previously pointed readers in one of Darcy’s comment threads (i.e. including you) at the CDC’s accounts of what would happen if vaccinations stopped. For measles, it includes:

    “As many as three of every 1,000 persons with measles will die in the U.S. In the developing world, the rate is much higher, with death occurring in about one of every 100 persons with measles.”

    I haven’t time to dig this back to scientific references (I have other things to do), but you should be capable of following the lead provided yourself should you wish to confirm it.

  • And I remember commenting earlier, with data from the World Health Organisation – earlier in this thread, I think – that the mortality & morbidity rates for measles are much higher in the developing world. This is due in part to difficulties in getting those most in need, vaccinated.I don’t remember you addressing that point at the time, Ron.

  • Don’t you just love scientists’ ‘Google a reference’ approach to finding evidence?

    The CDC’s PINK book says, “Before 1963, approximately 500,000 cases and 500 deaths were reported annually, with epidemic cycles every 2–3 years. However, the actual number of cases was estimated at 3–4 million annually.”

    http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf

    And you’d have readers accept the same organsiation’s unsubstantiated claim that, if there were 3-4 million cases per year (as estimated) then there would have been 9,000-12,000 deaths.

    Would the real death rate please stand up?

    In the 60’s/70’s there were 50,000 deaths a year in the USA… and has been declining steadily since…

    The CDC also says the incidence of lightning-related deaths has decreased since the 1950s with about 100 deaths per year… do they attribute the decline to vaccination?

    We don’t live in the past… do we live in fear of the black plague returning????

  • Alison, there are a plethora of disease in the developing world that relate directly to suck nutrition, suck housing, suck sewage systems and suck water… and the WHO’s and rich countries answer to all of that is? Spend billions on vaccinating…

  • Don’t you just love scientists’ ‘Google a reference’ approach to finding evidence?

    Sarcasm is not helpful, nor in my opinion does it make you or your cause look good – especially if you aren’t doing any better yourself. (Look at yourself before accusing others, etc. You asked for the references and google is just a tool – criticising someone for using a tool is silly.

    What would be poorly would be using unsound sources or figures in a misleading or incorrect way, such as the word games you play with the CDC figures. They only said the case rates are likely to be underestimated; this isn’t saying that the death rates are likely to have been underestimated. You have manufactured ‘conflicting’ numbers in death rates by assuming the same rate of cases-to-deaths — that’s your assumption, not theirs.

    Note my point in offered the CDC sources was offering it as a lead that you might follow, not as an end in itself, a point I made clear. Your reply suggests you prefer tit-for-tat rather than try find the source of their claim. If so, I can’t see constructive value in helping you, but while I remember I also recall having seen a research or review paper offer rates of between 1 and 3 per 1000, depending on the country or survey used; I haven’t time to dig that up either but as this is your interest you might look for it.

    Excusing the housing, sanitation, etc. conditions in developing countries doesn’t make the mortality rates in those countries go away. I fail to see why people should ignore ‘those’ countries through dissing them. There are also internationally-funded development projects in those countries, not just vaccination efforts. In some countries development efforts are slow and hampered by local issues (e.g. war zones, extreme politics). These efforts cost billions too. By assisting the health of the people, people are more able to focus on their environment, jobs, etc, than the ill health of their children, etc.

    Regards the black plague – the disease is still with us, it’s just that modern antibiotics easily cope with the disease organism and modern living arrangements mean fewer cases are seen.

  • “Note my point in offered the CDC sources was offering it as a lead that you might follow, not as an end in itself, a point I made clear. Your reply suggests you prefer tit-for-tat rather than try find the source of their claim.”

    Please explain how you prove a negative… the fact is you quoted an unsubstantiated reference… not only that, but your source contradicts itself in it vaccination bible… the Pink Book…
    You can’t hide deaths… they either come from the hospital or end up in the morgue… and each has a death certificate… the chances of anyone dying from the measles and not being certified are much much lower than the vast majority who get measles and don’t end up in hospital… in the 40’s-50’s I doubt measles was a notifiable disease and even if it was we know that only few were reported.

    In NZ in the 90’s with a high degree of vigilence it was estimated that as many as 40,000 children got the measles with 6-7 deaths… that’s a death rate of about 1:6-7,000, or 20 times fewer than the unsubstantiated figure you quoted.

    In the 50’s-60’s there were approximately 4 million births per year… if 90 percent of those were infected, a reasonable assumption based on serology studies, then that is were the CDC get their estimates of 3-4 million cases per year on average… if only 500,000 were reported, this means only 12-15 percent of cases were reported…

    My point is that people who claim to be science bloggers should base their comment on science… not on random statements and present them as fact. Google is a brilliant tool… it means that unqualified people have access to basically the same information as experts… one of the reasons I adopted first principles and spend hundreds of hours following references and references of references to the source of the Nile is because more often than not references are cherry picked and represented to make a case… they are often taken out of context, and the source is often an unsubstantiated comment in a letter or editorial that gets presented as fact and given credence.

    An example is your reference substantiating the uselessness of vitamin C… the reference you gave was not evidence… it was a blog which actually made a false claim… the paper it cited did not say vitamin C was useless… in fact it said the opposite, and it stated that further studies were warranted.

  • Please explain how you prove a negative…

    I didn’t suggest you do.

    I said those figures are without reference from the onset myself – I pointed to a lead; what’s the value in trying to make it more than that? If you don’t want to chase up on the leads, fine – but don’t point at me for your unwillingness to do that. Trying to manufacture an argument and foist it on me is a bit much.

    it means that unqualified people have access to basically the same information as experts…

    If they are open-access, yes, but that people can access the material, doesn’t mean they’ll do well with it or by it. The expertise needed to make accurate and meaningful sense of the science is important too.

    Those with preheld agendas (like those in the anti-vaccine ‘movement’) frequently misread or misinterpret scientific articles. This is one of the reasons that IAS stands badly when looked at from an ‘education’ stand-point.

    An example is your reference substantiating the uselessness of vitamin C

    That is not an example of ‘googling references’. I pointed to a study mentioned in a guest post on this forum as a courtesy for my readers (partly to encourage them to read other’s writing here). As I pointed out earlier, I commonly offer (sometimes tangentially) related follow-on reading for my readers in many of my posts. They’re links for my readers to follow up or not as they’d like to.

    If you have a problem with the claim, isn’t the person to ask the one who made the claim? (I’m not that person.)

    the reference you gave was not evidence

    (You’ve also ‘re-worded’ what I wrote, but I’m overlooking this as I’m not interest in tit-for-tat.)

    You appear to be using Darcy’s forum to take potshots at me, ignoring or ‘re-wording’ what I have written. As a consequence I’m left feeling there isn’t much value in further replies. In any event, as a practical matter, I have other things I’d rather be doing.

  • Ron, read what I said; as many [as] one in a thousand measles cases. It’s a fair assumption that almost everyone got measles pre-vaccination so another fair assumption is that a number close to each birth cohort got measles in any one year (most get it after starting school but a good proportion before).

    Using your figures, the “bad” year of 1938 with 163 deaths had a death rate of around 5 per 1000 (approx 30,000 births/year). A “good” year, let’s take your average of 2.3/m in the 60s (almost 6 deaths per year over a popn of 2.5m), gives 0.1 per 1000.

    So a low year would have a death rate of 10/100,000 and a bad year would be 500/100,000. In today’s population that would be 6 to 300 deaths per year. Admittedly the deaths would be lower given improved housing, medicine, hospital care etc so let’s look at a recent outbreak in New Zealand. In 1991 there were 6 deaths out of a reported 10,000 cases. That’s a rate of 0.6/1000 and that’s in a modern setting.

    Now of course there would be more cases in 1991 than reported. One estimate I’ve seen is 30,000. This would lower the rate to 0.2/1000. I know you don’t like to use unconfirmed cases in your figures so I’m sure you wouldn’t want to include those extra 20,000.

    A birth cohort of 60,000 and no vaccination would result in most of that number suffering from measles in a year. The expected number of deaths each year could be from 12 to 36. Maybe in a “good” year the number would be lower than 12 and maybe in a “bad” year the number would be more than 36. I don’t know if 1991 was a good year or a bad year. Perhaps it was a “bad” year and the number of deaths was high at 6 (out of 10,000 to 30,000 cases). Perhaps it was a “good” year and the number of deaths could have been at the high end and closer to the “as many as 1/1000” figure.

    So, using the figures you supplied we find that my rate is quite believable even if at the high end. I did say “as many [as] one in a thousand”, not exactly 1/1000.

    So back to your claim of measles being a “mild disease”. Measles kills 0.2-0.6/1000 people in New Zealand (a developed country) even with a vaccination programme, hospitalises 20-60/1000 and makes a whole heap more quite sick. So with no vaccination we would have, each year, 12-36 deaths and 1200-3600 hospitalisations and much misery. All this for a disease preventable by a simple vaccination.

    Do you still hold this on par with the common cold and pimples?

  • Simon, it doesn’t work like this… “Using your figures, the “bad” year of 1938 with 163 deaths had a death rate of around 5 per 1000 (approx 30,000 births/year). A “good” year, let’s take your average of 2.3/m in the 60s (almost 6 deaths per year over a popn of 2.5m), gives 0.1 per 1000.”

    If measles wasn’t circulating for 3-4 years then the cohort accumulates… there was an average of 12 deaths associated with measles (not necessarily caused by measles) per year between 1930 & 1969 inclusive… an average of about 40,000 births per year over that time giving a death rate of 1 per 3.3 thousand cases… somewhat fewer than the claimed 3 per 1,000. ie, the 3 per 1,000 figure is inflated x10… and keep in mind that most of those deaths were not directly caused by measles.

    As a matter of interest, we don’t live in the past… Occasional epidemics continued to interrupt the trend towards lower death rates among children in the mid twentieth century. For example, a measles epidemic in 1938 contributed to increased infant and child deaths. Although only 19 infant deaths were directly attributed to measles (Statistics Department, 1938), the disease made infants and young children more susceptible to diarrhoea, enteritis and respiratory diseases.

    So the death rate in the 21st century should be somewhat less than in the mid twentieth century. This would be in part due to better living conditions and health care, and part due to the reduced virulence of measles as noted in the 60’s PRIOR to the introduction of the vaccine…

  • > As a matter of interest, we don’t live in the past

    Which is why I gave the 1991 figures. Regardless of “cohort accumulation”, there were about 6 deaths out of 10,000 cases (30,000 if you include the estimate – would you?). The rate would be 0.6 (or 0.2) per 1000 (I never said 3/1000).

    If, say, you add up the cohorts of 3 years you get 180,000. Applying the 1991 rate to that figure you could have, in an epidemic year, 36 (108) deaths. I think you can work out how stretched the hospitals would be in that year with all the thousands of extra admissions.

    Yeah, just your everyday “mild disease”. Are 36 deaths acceptable to you, Ron, given there is an effective vaccine available?

  • Simon… someone else claimed 3 deaths per 1,000… and we don’t live in the past… the last time there were 30 deaths in NZ was well over half a century ago and two decades before the vaccine was introduced.

    Again, we don’t live in the past… we do learn from it… one thing we know is that the measles virus was becoming less virulent even before the vaccine was introduced.

    36 deaths is a hypothetical number in 2011… how many kids die each year from other preventable causes?????

  • Simon,

    Regards the measles death-to-case rate (DCR), this reference may be useful:

    http://jid.oxfordjournals.org/content/189/Supplement_1/S69.long

    From the abstract:

    “Overall the death-to-case ratio was 2.54 and 2.83 deaths/1000 reported cases,”

    I’m just passing the reference on for those who might wish to consider it (e.g. you) – I don’t have time to read past the abstract & a skim of the introduction myself.

    Judging from the abstract this appears to use data for both vaccinated and unvaccinated, but “Overall, 90% of deaths reported to the NIP occurred in persons who had not been vaccinated against measles.” (The detailed results might be broken down somewhere in the paper.)

    The DCR reported may be (v. likely to be) on the high side to whatever extent (I don’t have time to dig the extent out) as the intro. suggests an epidemic occurred during the survey period, but the intro. also refers to a DCR of ~1 death in 1000 cases the 1950s.

    The introduction offers a brief & readable outline what has been said elsewhere, that while the death-to-case ratio did not alter markedly with introduction of the vaccine, the number of cases (and deaths) did.

  • Grant said, “Regards the measles death-to-case rate (DCR), this reference may be useful:

    http://jid.oxfordjournals.org/content/189/Supplement_1/S69.long

    From the abstract:

    “Overall the death-to-case ratio was 2.54 and 2.83 deaths/1000 reported cases,””

    Previously he had said… “As many as three of every 1,000 persons with measles will die in the U.S.”

    Grant, you have rightly pointed out that there were 2.54 and 2.83 deaths/1000 REPORTED cases,””

    Given that most cases are not reported, the CDC (and you) are wrong to claim that “As many as three of every 1,000 persons with measles will die in the U.S.”

    Such a statement is unscientific and indefensible…

    Did it register that only one person actually died of measles?????

  • we don’t live in the past… we do learn from it

    Ron, 1991 is not the distant past. The death rate was about 0.2/1000. Applying that to your accumulated cohort would give a terrible year of 36 deaths and many thousands of hospitalisations. It seems you want to take us back over 50 years. Are my figures “unbelievable…!”?

    This is a serious disease. I’m still trying to understand why you trivialise it. Why Ron?

  • Grant, did you read the bit… “Reported measles death—1996. The only acute measlesassociated
    death reported to either system between 1993 and
    2000 occurred in New York City in 1996. The patient was a
    38-year-old black woman with a history of congestive heart
    failure, chronic obstructive pulmonary disease, and diabetes
    who presented to an emergency department in respiratory distress.
    She was intubated but had cardiac arrest and died. She
    had no history of fever, rash, or exposure to a measles case…

    The diagnosis of measles is uncertain in the death reported
    in 1996, because there was no history of rash or fever and no
    known exposure. Giant cell pneumonia has multiple causes,
    and false-positive results from polymerase chain reaction tests
    are fairly common…”

    In other words, even the CDC doubts it was due to measles…

  • Simon, I’m not trivialising anything… simply putting it in context…

    There are 500+ suicides in NZ every year and we sweep them under the carpet… no discussion in media because politically correct bureaucrats think they know best… yet we spend millions on vaccines that have no evidence that they work…

    Now, before you say that’s not true, I’ll return to Grant’s post of a link to a blogger who used a Cochrane Reviews study to show that vitamin C was useless… the Cochrane study made no such conclusion… in fact it said there was reasonable evidence that vitamin C was a useful prophylaxis… and recommended further study… the Cochrane reviews found ZERO studies that demonstrated that measles (MMR) vaccines worked… so why the double standards?

    Grant has just posted a link to a CDC study showing the gradual decline in case fatality for measles (suggesting reducing virulence) and yet when I make that statement people jump down my throat…

    The MARCH 30, 1963 BMJ noted “Fortunately measles is a much less serious disease than it was thirty years ago, a fact that is borne out by the observations of several practitioners reported elsewhere in this issue… The disease is a nuisance to the patient, inconvenient to parents, family doctors, and hospitals staffs, and some of the complications, such as encephalitis, continue to be severe…”

    For the vast majority of cases, measles is a nuisance to the patient… inconvenient to parents, doctors and hospitals… and in some (read very few) complications can be severe… that was 1963… treatments have progressed somewhat since then… even Professors from Auckland advocate multiple high dose vitamin A treatments… but no doubt sci-bloggers would disagree…

    The authors concluded that vitamin A megadoses appear effective in reducing mortality from measles in children under two years old and have few associated adverse events.

  • FWIW I realise it’s only a newspaper article, not a scientific study…

    “If a child is admitted to hospital with measles, we give them a treatment of vitamin A,” he said.

    http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=9006061

    One in every 10 Auckland infants is growing up with Third World-type vitamin deficiencies.

    A four-year study led by paediatrician Cameron Grant, of the Starship children’s hospital, has found that 12 per cent of Auckland toddlers aged from six months to two years do not have enough vitamin A, a deficiency that causes blindness in more than 250,000 children in developing countries each year.

    Ten per cent of the Auckland infants – despite living in a country with bountiful sun and outdoor space – do not get enough vitamin D, a substance the body makes when it is exposed to sunlight. The study also found a quarter of Auckland infants have too little iron in their blood.


    ‘We suspect that if we are finding these micronutrient deficiencies in a proportion of children, it implies that there are probably other micronutrients that are also deficient, and we suspect they may be having adverse effects on children’s health,” said Dr Grant.

    Vitamin A deficiency was not common in developed countries, but it was a problem in the developing world and because some of New Zealand’s infectious diseases epidemiology mirrored that, the doctors decided to study vitamins also.

    Dr Grant also leads a study on Auckland’s rate of childhood pneumonia, which is five to 10 times higher than in the United States. The high rate of such diseases was due partly to increasingly overcrowded houses in the past 10 to 15 years, and variable access to family doctors, he said. But it now seemed that illness also stemmed partly from poor diet.

    Imagine if we spent the millions we spend pushing unproven vaccines on dealing with the issues noted by Professor Grant…

  • Ron,

    My comment was addressed to Simon not you. I wrote earlier, I only provided a lead and I’m not interested in tit-for-tat as you clearly are. (i.e. I’m not interested in ‘conversing’ with you as it seems there is nothing productive to be gotten from it.)

    You seem to be nitpicking to dismiss, rather than trying to learn to get an understanding. If you look positively I suspect you’d find that the DCR will fall to the order of magnitude of 1 in 1000 once the various factors are considered.

    For example, just because the work is based on reports, doesn’t mean you get to dismiss it entirely out-of-hand. (It may well be that at that time that is all the data anyone had, or that for what they are trying to do—exploit comparing two systems—it’s what they have to work it.)

    Such a statement is unscientific and indefensible…

    Did it register that only one person actually died of measles?????

    As I wrote earlier: “Sarcasm is not helpful, nor in my opinion does it make you or your cause look good […]”

    In fact, you’ve goofed badly.

    Look at the first sentence of the description of that you quoted: “The only acute measles-associated death reported to either system between 1993 and 2000 occurred in New York City in 1996.”. The period from which the DCRs are calculated was 1987-1992, as noted in their abstract and throughout the paper.

    If you had read more carefully, or even just read properly at all IMHO, you’d have seen that the one case you refer to was *after* the period of their study (that is, the period they determined the DCRs, etc.) and after the introduction of a ramped up vaccine campaign – i.e. it illustrates how effective that ramped-up vaccine campaign was.

    My distinct impression is that you have jumped in trying to throw something at me with having properly read was is there, let alone understand it.

    To me this serves to illustrates or reveals that you are not really interested in trying to find out what is right, just in pushing a pre-set agenda.

    Coming back to the topic—IAS—this is the type of thing that makes the ‘education’ efforts by IAS non-educational. By jumping onto things that at a glance look support a pre-held agenda, ‘information’ is presented that is wildly out of context.

  • Simon, I’m not trivialising anything… simply putting it in context…

    Yes, you are trivialising it. You keep saying measles is a mild disease, you rate it alongside the common cold and pimples, you hand wave away deaths from complications to measles and you keep ignoring the deaths from 1991.

    yet we spend millions on vaccines that have no evidence that they work
    the Cochrane reviews found ZERO studies that demonstrated that measles (MMR) vaccines worked

    Now you are being disingenuous, Ron. You know what the Cochrane review was designed to look for and you know the many published studies that show the gulf in cases between vaccinated and unvaccinated people in the now all too common outbreaks.

    The vaccine works and here you are implying it doesn’t. The endemic spread of measles can be halted in this country but it’s going to difficult when people like you and the IAS do everything you can to downplay the seriousness of it and the effectiveness of the vaccine.

    So, are 36 deaths “unbelievable…!”?

  • Readers should mentally delete “serves to” from the penultimate paragraph of my previous comment.

    Darcy: thanks for fixing the link in my earlier comment.

  • Grant, I guess I got sucked in by the title of the paper… “Acute Measles Mortality in the United States, 1987–2002” I’ll get back once I’ve worked out how 1996 doesn’t fit within this range…

  • Simon, your 36 deaths are hypothetical…

    Of course they’re hypothetical but they are based on the recent 1991 experience. Remember “we don’t live in the past… we do learn from it”.

    Are you hand-waving away the near certainty of deaths and hospitalisations again? It seems like it. Let’s not forget that you are implying that the vaccine doesn’t work from your previous posts (“no evidence they work”, “ZERO studies”).

    So if the deaths and hospitalisations and permanent damage of a large measles epidemic are merely hypothetical, should we stop vaccinating against measles now?

  • Simon says, “Let’s not forget that you are implying that the vaccine doesn’t work from your previous posts (“no evidence they work”, “ZERO studies”).

    So if the deaths and hospitalisations and permanent damage of a large measles epidemic are merely hypothetical, should we stop vaccinating against measles now?”

    How paradoxical that on another sciblog contributed to by others on here, vitamin C therapy is rubbished because there have been no double blind controlled studies to show that it works… why the double standards with measles vaccine? There are no double blind controlled studies to demonstrate it works… the stench of hypocrisy…

  • Ron, are you seriously suggesting that a double blind controlled study of the measles vaccine be undertaken? How on earth would you ethically design such a study? Remember, we know that the measles vaccine works from the many published studies that show the gulf in cases between vaccinated and unvaccinated people.

    So should we stop vaccinating against measles?

  • Simon… absolutely such studies should be done… if only to allow people like me to put our minds at rest…!. If the vaccine is so good and measles is such a public health issue then what have vaccine proponents got to lose… a definitive study would put the scientific findings that there is no good evidence that they work to rest.

    How could it be that vaccinated/unvaccinated studies show the vaccine works… simple… take a child ith measles-like rash and cough to the GP… the gp notes they have been vaccinated so diagnoses something else… the gp notes the child hasn’t been vaccinated and diagnoses measles… it’s as simple as that… have seen that work both ways with my own eyes…

    Would you stop the prescribing of Pamol/paracetamol to babies when we know that it causes more harm than good?

  • absolutely such studies should be done

    Can you think of an ethical way to do it? I can’t. Why would you do a study like that when we already know the vaccine works?

    a definitive study would put the scientific findings that there is no good evidence that they work to rest

    There is plenty of good evidence it works.

    How could it be that vaccinated/unvaccinated studies show the vaccine works…

    Please review the latest measles outbreak data.

    Would you stop the prescribing of Pamol/paracetamol to babies when we know that it causes more harm than good?

    I don’t prescribe Pamol/paracetamol to anyone.

    So should we stop vaccinating against measles?

  • Simon says, ”
    Can you think of an ethical way to do it? I can’t. Why would you do a study like that when we already know the vaccine works?”

    Simon, over ten thousand high dose IV vitamin C doses are used in treatments in New Zealand evry year by medical practitioners… based on their clinical experience, they swear by it… over 500,000 IV doses are prescribed in the USA each year… again, registered medical practitioners swear by its effectiveness… and yet scibloggers claim their is no evidence it works and that Alan Smith’s dramatic rise from the death bed was put down to co-incidence ‘because there is no evidence it works.’

    The Cochran Reviews, the gold standard in evidence-based medicine could find no reliable evidence to support claims of measles vaccine efficacy… why? Simple, because none exists.

    Why do you claim it does exist when it doesn’t???? I thought you were an advocate of evidence-based medicine/science…

  • Ron asked, “Would you stop the prescribing of Pamol/paracetamol to babies when we know that it causes more harm than good?”

    Simon responded, “I don’t prescribe Pamol/paracetamol to anyone.”

    Simon, I never said you did… I asked, “Would you stop the prescribing of Pamol/paracetamol to babies when we know that it causes more harm than good?”

    I didn’t ask if you would stop prescribing Pamol/paracetamol …

  • Ron,

    Simon asked after (measles) vaccine testing, not vitamin C.

    What I find interesting about your discussion with Simon is the extent that you offer ‘support’ based on anecdote or ‘argument by authority’ (with the fallacies these involve), dismiss out-of-hand what doesn’t seem to appeal to you, not engage with what is presented to you, make suggestions without offering support for them, and so on.

    It raises a question to me of why you are trying so hard to dismiss the measles vaccine. (You did something similar to the pertussis vaccine on my blog.) The simplest answer, to my mind, would be that you oppose vaccines and are trying to justify your views to yourself.

    “no evidence they work”, “ZERO studies”

    As Simon was saying, there are studies and evidence that show vaccines to work. There are more forms of evidence than just DBRCTs (double-blind randomised controlled trials). The paper I cited earlier would be one contributing example. By ‘contributing’, I mean that while it may not stand on it’s own—most science works by looking at all the evidence taken together—it does offer support that vaccines are effective. That there was only one not-confirmed death from measles, as you cited to me, was an indication of success of a re-vamped vaccination program as I pointed out earlier. (The number of cases is a more appropriate measure, though.)

    I find your thinking about modelling or projections a bit paradoxical. Isn’t the sensible thing to do try project ahead? You seem to want to only use past figures, but then also slate using past figures at the same time.

    The Cochran Reviews, the gold standard in evidence-based medicine could find no reliable evidence to support claims of measles vaccine efficacy… why? Simple, because none exists.

    I (strongly) suspect you’re being misleading. If they reported a lack of evidence (I haven’t time to read the review itself), I would imagine they’ll be noting a lack of double-blind random controlled trials. This would not say there was (your words) “no reliable evidence to support claims of measles vaccine efficacy” – it would say that there lack that particular type of evidence.

    I’d also add that Cochrane studies are not without their issues.

    More generally (i.e. not directly at you, but just a general observation): one thing that can be ‘lost’ in anti-vaccine proponents pushing their case is that in Western countries vaccination programmes for common illnesses are (often/usually) more about keeping the disease down, maintaining low levels, trying to prevent them coming back. It’s a different thinking than for the situation than in the developing countries where the focus is on trying to get the disease levels down.

  • “As Simon was saying, there are studies and evidence that show vaccines to work. There are more forms of evidence than just DBRCTs (double-blind randomised controlled trials).”

    This demonstrates gross hypocrisy and double standards… RDBPC studies are exactly the standard scibloggers such as yourself use to measure the efficacy of treatments such as vitamin C, and dietary supplements and yet you are a denier when it comes to promoting pet medicines such as vaccines… the bottom line is that measles vaccines have not been demonstrated to work using robust scientific methods… the fact that pharmaceutical companies are reluctant to undertake them when they have ample opportunity, such as in Africa, suggests they don’t want to take the risk. To their credit, they did start one with influenza vaccine, but quickly abandoned it (so they wouldn’t have to publish the results) when they realised the vaccine was 100 percent ineffective because a different flu strain was circulating…

    Grant, if RDBPC studies are the standard you use to try to discredit common treatments such as high-dose IV vitamin C, (as you did recently on another blog) then, as a scientist, you have to be consistent and apply the same standard to pet treatments, otherwise you’ll be rightly tagged as being biased.

    The standards you and Simon are applying to defend the measles vaccine are the same as naturopaths, herbalists and others apply to defend naturopathy, herbalism and the like. You are in fact defining vaccines in the same terms as a traditional medicine… which I find quite ironic.

  • Oh, and should we stop vaccinating for measles based on the lack of double-blind randomised controlled trials found for the Cochrane review (in your opinion)?

  • “…based on the lack of double-blind randomised controlled trials found for the Cochrane review (in your opinion)?”

    Simon, is this evidence of being a denialist? Are you suggesting the the Cochran Reviews actually found evidence that the Measles vaccine works?

  • Simon says, “One word, Ron – ethics. Look it up.”

    Simon, I’ve just had a good laugh… thank you!

    Now, as an advocate of ethics, can I assume that you have been slamming DHB’s who, last year, allowed six people to die from complications of the flu without giving them the opportunity to try proven safe high-dose IV vitamin C?

    Given the billions of dollars being spent on unproven treatments, such as measles vaccines, don’t you think that ethics mandates proper scientific trials to demonstrate that those dollars are being well spent???? Why are RDBPC studies required for high-dose IV vitamin C being given to people written off by medics as destined for the morgue, and not required for substances injected into perfectly healthy children who have a very small chance of being adversely affected by the disease they are supposed to be protected from????

    This from the BMJ… IMAC and their supporters pull out the “ETHICS” card whenever they are standing in evidential quicksand… read this… then Jefferson’s article… and note that Jefferson is the lead author of the measles Cochran Review which couldn’t find any reliable scientific evidence relating to measles vaccine effectiveness.

    “In his 28 October review of the available literature, Tom Jefferson finds that there is a “large gap between [influenza vaccination] policy and what the data tell us.”[1] What the
    data tell us, he writes, is that the inactivated vaccines have
    “little or no effect on the effects measured” and the comparative
    evidence is insufficient to demonstrate the vaccines are safe.

    Jefferson’s results are consistent with previous epidemiological
    reviews of the effects of influenza vaccination. A 2005 National
    Institutes of Health review of over 30 influenza seasons “could not correlate increasing vaccination coverage after 1980 with declining mortality rates in any age group” and concluded “observational studies substantially overestimate vaccination benefit.” [2]

    Annually, public health agencies in the US and UK launch massive campaigns aimed at convincing doctors of the importance of influenza vaccination. Is this necessary? Safe and effective interventions for diseases that truly pose a threat to morbidity and/or mortality are unlikely to be controversial. It is interesting to note here that not only is the evidence supporting the safety and effectiveness of influenza vaccination lacking, but there are also reasons to doubt conventional estimates of the mortality burden of influenza.

    As I have documented previously, [3] the mortality
    data is a mess–over the period in which CDC statistical modeling of flu-associated mortality has estimated an 80% rise in deaths, officially recorded flu deaths have dropped 30%. Complicating this is the fact that influenza-like illness is not only indistinguishable from influenza, but far more common, leading to unrealistic expectations of influenza vaccination.

    The policy questions raised by these reviews are crucial to answer. While it is often said that influenza poses a serious burden to health, influenza vaccines impose their own particular burden–to the tune of billions of dollars annually. If policy is going to be driven by evidence, this requires us, first of all, to consider the evidence.”

    References:

    Jefferson T. Influenza vaccination: policy versus evidence. BMJ 2006;333:912-915. (also online)

  • Ron,

    I would be very suprised if anyone here believes that DBRCT are the only source of reliable evidence.
    Under the right circumstances DBRCT are considered to be the best way of removing bias on the part of the subjects involved and those running the experiment, however it is not always ethical to use DBRCT which is what I think several others have been trying to tell you.
    Let me give you an example. Say a researcher wants to demonstrate that folic acid reduces the incidence of spina bifida. DBRCT would require giving some patients a placebo and others folic acid. Because there is already strong evidence that folic acid reduces the occurrence of spina bifida then such an experiment would be considered unethical (and no researcher would hopefully even suggest such a study).
    On the other hand DBRCT are considered appropriate when there is little evidence to support whether a drug/vitamin has effect. This is why it is used in the case of new drugs (where there is no previous evidence) or for supplements where as well as there being little evidence either way, the probable effect of being on the placebo has limited health consequences.
    Historically DBRCT trials are quite interesting for in the case of diseases such as cancer and AIDS, the DBRCT trials have often been ended early because when the drug has been shown to be effective, patients on the placebo have exerted political pressure to receive the actual drug. This in itself represents some ethical challenges.
    What others here have been trying to argue is that because vaccines are considered to be effective – to run a trial of placebo vs vaccine is unethical.

    Luckily there are other ways to gather evidence about drugs and treatments when ethics makes the DBRCT unusuable.
    These include observational studies. For example, because the use of vaccines is voluntary in most countries, then observational studies to follow those who choose to vaccinate and those who do not could produce useful data. For example, I think it was in Denmark(?) where they compared the rate of autism in vaccinated and unvaccinated populations and found it was the same, suggesting that vaccination has no role in the development of autism.
    Observational studies do have issues around trying to keep bias out but they can be quite effective if they are designed properly.

  • Here is the summary of the Cochrane review by Tom Jefferson that you are referring to

    “Measles, mumps and rubella are three very dangerous infectious diseases which cause a heavy disease, disability and death burden in the developing world. Researchers from the Cochrane Vaccines Field reviewed 139 studies conducted to assess the effects of the live attenuated combined vaccine to prevent measles, mumps and rubella (MMR) in children. MMR protects children against infections of the upper airways but very rarely may cause a benign form of bleeding under the skin and milder forms of measles, mumps and rubella. No credible evidence of an involvement of MMR with either autism or Crohn’s disease was found. No field studies of the vaccine’s effectiveness were found but the impact of mass immunisation on the elimination of the diseases has been demonstrated worldwide.”

  • This demonstrates gross hypocrisy and double standards…, etc.

    No, but it does suggest in the end you would rather attack people than look or understand.

    (I’m also still left wondering why you are trying so hard to dismiss the measles vaccine by word games, smearing others, etc., rather that try look to the evidence that is there.)

    While I can empathise with people wishing that they could control their own lives (this seems a key underlying basis of anti-vaccine protest), there is little excuse for simply attacking others in a straw man ‘us-vs-them way. It’s not productive and entirely negative.

    One of the ironies of attacking scientists is that of all people involved they are in the best place to help. (I mean here scientists independent of the companies selling the products.) Attacking them won’t help your cause.

    But on what I did write:

    I only wrote that there is more evidence than just DBRCTs. I also wrote “most science works by looking at all the evidence taken together” – you need look at all the evidence. You’re setting up ‘failure’ artificially by ‘insisting’ on only one kind of evidence. Different problems require different approaches. Some things simply aren’t suited to be tested via DBRCTs; ethical issues can be one reason.

    You seem to have ‘overlooked’ that I have previously pointed you to a vaccinated v. not study that has been widely summarised on-line (there are other shorter summaries). You also don’t seem to want to even try find substantive material such as this. I’m not saying either study is this last word—science rarely rests on single studies and I’ve only spared less than a minute on searching—what I’m pointing at is why won’t you even make an effort.

    I didn’t “try to discredit common treatments such as high-dose IV vitamin C”, I wrote that a poem presented conclusions without backing them and I didn’t in fact say anything about DBRCTs or not in doing that either—you’ve placed those words in my mouth. Readers can verify for themselves. Nor are vaccine “pet treatments,”—they’re not my treatments, but the medical community’s.

  • Michael, with the greatest of respect, the evidence regarding the benefits of folic acid supplementation before/during early stage pregnancy reducing NTDs by some 75-80 percent came from RDBPC studies and the Cochran Reviews have undertaken a [positive] meta-analysis. The fact is that despite the emerging evidence, there are 10,000s of thousands of disabled people born with NTDs because denialists ignored the evidence until the clinical studies had proven its effectiveness… even then a major debate took some time to effect change… even in NZ the MOH drags the chain by only promoting 800ug doses (only available from pharmaceutical companies) despite the evidence showing the benefits at 400ug per day. The MOH’s chain dragging is based on their belief that vitamin supplements don’t work and that supplement companies are dodgy… even though the vast majority of supplement companies manufacture under similar GMP standards to pharmaceutical standards and no evidence of harm or dodgy product.

    Talking of dodgy, you are obviously not aware that the lead author of the Denmark study has been charged with fraud by the CDC and others over that work and others… the case may well make Wakefields payments of 5 pound to kids at a birthday party seem like kindergarten stuff…

  • Michael, at last… someone actually is starting to look at the evidence… Note: “No field studies of the vaccine’s effectiveness were found but the impact of mass immunisation on the elimination of the diseases has been demonstrated worldwide”

    They found no evidence to demonstrate that it works….

    Now, why don’t you email Tom and ask him who put the saving grace comment, “but the impact of mass immunisation on the elimination of the diseases has been demonstrated worldwide” into the study report… he will tell you that it was not the authors, but the editors added it because the study would have otherwise caused distress amongst the vaccine industry… so much for the Cochran Reviews being independent and maintaining high standards… I can give you his email if you can find it… I’ve already had that conversation with him…

  • Ron,

    Regards your remark “Talking of dodgy, you are obviously not aware that the lead author of the Denmark study has been charged with fraud by the CDC” I recall that it has been widely pointed out that he was not the lead author, that he was charged with financial fraud, not scientific fraud, and, if I recall correctly, that this financial fraud was unrelated to the paper in question.

    Note in particular how your complaint does not revolve around looking at the science of that work, but attacking an author. (There were several authors.) Wakesfield’s work fails.

    You’re simply not checking before making claims. Isn’t that being dodgy?

  • Grant, why do you discredit high-dose IV vitamin C… why do you rely on Cochran Reviews (and, I might add, refer readers to a blog that makes totally false claims about the Cochran Review, which did, in fact, find evidence of efficacy regarding vitamin C use) when it suits you and dismiss them when it doesn’t?????

    Look at the MeNZB fraud… the number of deaths was plumetting BEFORE the vaccine was rolled out, yet before/after rates are used to say the vaccine worked…

    IMAC used Sth American studies to demonstrate that the MenB vaccine there worked… same… the vaccine was introduced on the downward slide of an ongoing natural decline… and claimed the post vaccine decline was due to the vaccine…

    Take a look for yourself…
    http://img.scoop.co.nz/stories/images/0502/eb5f2dc2a6eaccffc1f2.jpeg

    Look at the ongoing decline in menB deaths in NZ amongst under 20s and tell readers that the vaccine had a noticable impact…

    Look at figures 3 & 7…
    http://www.surv.esr.cri.nz/PDF_surveillance/MeningococcalDisease/2010/2010AnnualRpt.pdf

    Now tell me that this shows the MeNZB vaccine makes a difference. Even Sumner Burstyn & I projected, based on MOH data, that even if the MeNZB vaccine worked it would at most prevent 1-2 death per annum… the MOH offical post campaign estimate was about 3 in total…

    The problem with observational studies, and post-hoc studies is bias, bias, bias… hence the need for credible studies which have never been done…

  • Grant, you are amazing!!!

    Wakefield was one of was it 12-13 authors?????? wasn’t he????

    Thorsen was one of the principle researchers in the autism study… are you saying that commiting fraud to the tune of over a million dollars doesn’t affect the credibility of one’s work??????

    AMAZING>>>>!!!!

    A Danish autism researcher allegedly bought a home, a Harley and a Honda by fraudulently billing a CDC grant program for more than $1 million, federal prosecutors said today.

    Prosecutors said this afternoon that a federal grand jury had indicted Poul Thorsen, 49, on 13 counts of wire fraud and nine counts of money laundering in connection with the scheme.

    Thorsen, working as a visiting researcher, got the Atlanta-based U.S. Centers for Disease Control and Prevention to award $11 million in grants to the Danish government from 2000 to 2009. The grants were designed to study the relationship between autism and exposure to vaccines, between cerebral palsy and infection during pregnancy, and between childhood development and fetal alcohol exposure.

    Thorsen moved to Denmark in 2002 and became a principal investigator under the grant. Prosecutors said he subsequently submitted at least 13 fraudulent invoices, ostensibly for services performed by a CDC lab, for work that was never performed.

    The money was deposited in an account at the CDC credit union that Danish authorities believed was under the control of the CDC. Thorsen actually controlled the accounts, and he used the money to buy a house, a Harley Davidson motorcycle, Audi and Honda vehicles and numerous cashier’s checks, prosecutors said.

    Thorsen was part of a team in several highly publicized studies that discounted any possible correlation between autism and childhood vaccines. Critics of those studies — most notably Robert F. Kennedy Jr. in articles on Huffington Post and elsewhere — have cited the Thorsen investigation as a sign that the research cannot be trusted. Others note, however, that Thorsen was never the lead researcher on any of those studies.

    Emory University’s Rollins School of Public Health listed Thorsen among its new faculty for 2008-09. He is no longer affiliated with the university.

  • Paul Thorsen… news release from the U.S. Attorney’s office in Atlanta: [now keep in mind he’s innocent until proven guilty… and to think that wakefield has never been indicted in any court, as far as I know,… only in the medical establishments courts set up to defend the integrity of a pillar of medicne…

    AUTISM RESEARCHER INDICTED FOR STEALING GRANT MONEY

    Thorsen Allegedly Absconded With Over $1 Million

    ATLANTA, GA – POUL THORSEN, 49, of Denmark, has been indicted by a federal grand jury on charges of wire fraud and money laundering based on a scheme to steal grant money the CDC had awarded to governmental agencies in Denmark for autism research.

    United States Attorney Sally Quillian Yates said of the case, “Grant money for disease research is a precious commodity. When grant funds are stolen, we lose not only the money, but also the opportunity to better understand and cure debilitating diseases. This defendant is alleged to have orchestrated a scheme to steal over $1 million in CDC grant money earmarked for autism research. We will now seek the defendant’s extradition for him to face federal charges in the United States.”

    “Stealing research grant money to line his pockets, as Poul Thorsen stands accused of here today, cheats U.S. taxpayers and will simply not be tolerated,” said Derrick L. Jackson, Special Agent in Charge of the Atlanta Region for the Office of Inspector General of the Department of Health & Human Services. “HHS/OIG will continue to work closely with our law enforcement partners to bring these criminals to justice.”

    Reginael D. McDaniel, Special Agent in Charge of the Atlanta Region for Internal Revenue Service Criminal Investigation said, “Today’s global economy demands a high-level coordinated approach by multiple agencies and authorities in the investigation of financial crimes. While schemes often become more sophisticated over time, fortunately, so do our investigative techniques. IRS Criminal Investigation is proud to have shared its hallmark expertise in following the money trail in the scheme alleged in this indictment.”

    According to United States Attorney Yates, the charges and other information presented in court: In the 1990s, THORSEN worked as a visiting scientist at the U.S. Centers for Disease Control and Prevention (CDC), Division of Birth Defects and Developmental Disabilities, when the CDC was soliciting grant applications for research related to infant disabilities. THORSEN successfully promoted the idea of awarding the grant to Denmark and provided input and guidance for the research to be conducted. From 2000 to 2009, the CDC awarded over $11 million to two governmental agencies in Denmark to study the relationship between autism and exposure to vaccines, between cerebral palsy and infection during pregnancy, and between childhood development and fetal alcohol exposure. In 2002, THORSEN moved to Denmark and became the principal investigator for the grant, responsible for administering the research money awarded by the CDC.

    Once in Denmark, THORSEN allegedly began stealing the grant money by submitting fraudulent documents to have expenses supposedly related to the Danish studies be paid with the grant money. He provided the documents to the Danish government, and to Aarhus University and Odense University Hospital, where scientists performed research under the grant. From February 2004 through June 2008, THORSEN allegedly submitted over a dozen fraudulent invoices, purportedly signed by a laboratory section chief at the CDC, for reimbursement of expenses that THORSEN claimed were incurred in connection with the CDC grant. The invoices falsely claimed that a CDC laboratory had performed work and was owed grant money. Based on these invoices, Aarhus University, where THORSEN also held a faculty position, transferred hundreds of thousands of dollars to bank accounts held at the CDC Federal Credit Union in Atlanta, accounts which Aarhus University believed belonged to the CDC. In truth, the CDC Federal Credit Union accounts were personal accounts held by THORSEN. After the money was transferred, THORSEN allegedly withdrew it for his own personal use, buying a home in Atlanta, a Harley Davidson motorcycle, and Audi and Honda vehicles, and obtaining numerous cashier’s checks, from the fraud proceeds. THORSEN allegedly absconded with over $1 million from the scheme.

    The indictment charges THORSEN with 13 counts of wire fraud and 9 counts of money laundering. The wire fraud counts each carry a maximum of 20 years in prison, and the money laundering counts each carry a maximum of 10 years in prison, with a fine of up to $250,000 for each count. The indictment also contains a forfeiture provision seeking forfeiture of all property derived from the offenses, including an Atlanta residence, two cars, and a Harley Davidson motorcycle. In determining the actual sentence, the Court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders.

    This case is being investigated by Special Agents of the Office of Inspector General of the Department of Health & Human Services and the Internal Revenue Service Criminal Investigation Division.

    Assistant United States Attorneys Stephen H. McClain and Michael J. Brown are prosecuting the case.

  • Ron,

    Grant, you are amazing!!!

    You are ignoring what people have written and choosing to slag them (i.e. me) and play word games. It’s distasteful and wrong-headed.

    Instead of cutting and pasting, why not try understand before making claims. See for example here.

    Sure he may have committed financial fraud, I said so earlier, but that doesn’t make the research wrong.

    What this thread has done, I think, is illustrate the extent you wish to push an agenda rather than look to substance.

  • Ron

    “They found no evidence to demonstrate that it works….”

    No, they found no field studies. Not the same thing at all.

    Also with the Wakefield paper the majority of the other authors withdrew their support for the paper quite quickly once it’s content was challenged. (A good example of what happens when senior researchers hook their names onto research they haven’t significantly participated in)

    With regards to the folic acid example, my mistake for not picking up that it was tested using a double blind approach by some researchers. However, do you have evidence that before these studies were carried out that there was reliable evidence that folic acid could prevent neural tube defects. I haven’t found any evidence in my initial reading around folic acid supplementation.

  • Teratogenic and neurological effects of folic acid deficiency, including association with spina bifida/NTDs dates back to the 50’s… it took over 40 years before the medical establishment accepted the benefits of folic acid supplementation in reducing NTDs… essentially, a whole generation of Dr Gods had to retire before the industry would/could accept that a simple dietary supplement could prevent such a debilitating illness.

    Two papers worth reading are a 60’s paper from Australia which references work published in 1960 regarding studies on rodents, and a lancet review in 2006 of the history of folic acid and B12 and related matters…

    The RDBPC studies were published 20 years ago…, 20 years after the issue was first raised; 400ug was established as the dose of choice for all mums and 4,000ug was used for mums who’d had a NTD baby previously… these doses were chosen because they were based on what was available… the 400ug dose has stood the test of time.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1059148/pdf/brjprevsmed00092-0030.pdf

    http://tinyurl.com/868hhjl

  • Michael, the 10 or so co-authors never recanted their involvement, nor the paper itself… only the interpretation… the paper was not retracted until recently when it became such a political issue. three authors never recanted anything… wakefield was one of them…

    The paper never claimed that measles vaccine caused autism… indeed, Wakefield, himself, has never ever been anti-vax. He is not even anti-measles vaccination as far as I’m aware… indeed, the infamous paper only became an issue when Tony & Cherrie Blair refused to say whether their son was vaccinated… assumption was he hadn’t… then the pro-vax media (and anti-vax folk) got onto it and fanned the flames both ways.

  • Wakefield, himself, has never ever been anti-vax.
    If this is the case, why does he associate with organisations that actively argue that vaccines are dangerous & parents should not vaccinate their children, such as Generation Rescue in the US? He’s certainly not arguing against them.

  • Alison,

    Wakefield was also in the line-up for a ‘vaccine safety’ conference in Jamaica, that according to left brain, right brain didn’t include any vaccine researchers but was sponsored by an anti-vaccine group.

    This meeting apparently also seeded the latest fuss about Wakefield. There he apparently passed the scoring notes for the biopsies from his Lancelet paper on to David Lewis… anyway if you haven’t already you can read one take of the story at Respectful Insolence or in the more formal take at Nature. (The original sources are cited within these.)

  • On another blog, https://sciblogs.co.nz/code-for-life/2010/08/23/vitamin-c-swine-flu-media-lawyers/

    Michael says,”Fred, The whole calcium score story sounds intriguing though I’m trying to work out what happens after 3 years if one’s plaque grows at 35% per annum. Medical research is a very challenging area in that the body is incredibly complex and to find causations of diseases (and also cures) one has to try and and control many variables and look for statistical patterns across a large group of people.
    Thus, while your health turnaround is a wonderful thing, without being able to compare it to the experiences of many other people within a trial which contols some of these variables it is hard to draw any scientific conclusions.
    I hope your good health continues.”

    So, Michael, why doesn’t this apply to the magical made around the use of vaccines?

  • Alison, my understanding is that Wakefield advocates the use of single component measles vaccine… as far as I’m aware he’s always been pro-vaccine. He can’t be responsible for others’ actions.

    Grant, are you suggesting that anyone who speaks at any conference is biased toward those promoting it? What an amazing thought… that would tag anyone who ever attended a medical conference as being in the pockets of pharmaceutical companies, and therefore automatically biased… how totally absurd!

  • Ron,

    Would a conference that has not a single speaker whose expertise is on the topic it claims to cover be unusual?

    If none of the speakers had backgrounds/expertise in the topic of the meeting but had aims consistent with the focus of the major sponsor, would the meeting stand a reasonable chance of being a sham that serves the sponsor’s aims by pretending to be about the advertised topic, but in fact being about the sponsors aims?

    (I note that you dropped my key point in your reply, misrepresenting what I wrote.)

    Would someone promoting their product in place of others on the market be possibly acting with self-interest?

    (Again you left out a key point.)

  • Grant asks, “Would someone promoting their product in place of others on the market be possibly acting with self-interest?”

    Are you referring to pharmaceutical companies???? :-))

  • Ron,

    From a 2007 Cochrane review looking a the the use of vaccines to treat influenza

    “Inactivated parenteral vaccines were 30% effective (95% CI 17% to 41%) against influenza-like illness, and 80% (95% CI 56% to 91%) efficacious against influenza when the vaccine matched the circulating strain and circulation was high,”

    Authors conclusions
    “Influenza vaccines are effective in reducing cases of influenza, especially when the content predicts accurately circulating types and circulation is high”

  • You haven’t answered the questions, but so be it.

    It seems to me that all you can do is taunt, evade, nitpick and play word games – i.e. act like a troll. You’re getting far too childish for me to continue with this.

  • Michael, why didn’t you refer to the 2010 Cochran Reviews????

    Authors’ conclusions
    Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.
    WARNING:
    This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274
    influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.”

    The 2007 review was in healthy adults, not the geriatric group targeted by flu vaccine proponents… there is no sound evidence it works to any significant degree in that age group.

  • Michael, by the way, I am not aware of any study showing influenza vaccine being used to treat influenza… I assume that was an honest mistake…? it happens…

  • unproven treatments, such as measles vaccines

    Here you go again, Ron. Why do you keep saying the measles vaccine is unproven? It’s as if the only research you can see is the Cochrane review of MMR effectiveness and safety. You should read Michael Edmonds’ post about appropriate use of DBRCTs again.

    The vaccine has been very successful since being introduced. For example, endemic transmission was arrested in the USA, outbreaks affect the unvaccinated in hugely higher numbers than vaccinated and outbreaks are generally caused by imported measles.

    I’d be very interested in what explanation you have for why measles is a long way down the road to being wiped out.

    And I guess I’ll try this question again: Should we stop vaccinating against measles?
    And this one: How you would ethically design a suitably powerful gold standard study of the measles vaccine?

    (By the way, the vaccine isn’t used to treat measles. An honest mistake I assume. It happens)

  • Ron

    “Michael, why didn’t you refer to the 2010 Cochran Reviews?”

    Um, because we have already discussed that, repeatedly

    “Michael, by the way, I am not aware of any study showing influenza vaccine being used to treat influenza… I assume that was an honest mistake…? it happens…”

    Take it up with the authors of the Cochrane Review then – it was a direct quote, which should have been obvious from the quote marks.

    “WARNING:
    This review includes 15 out of 36 trials funded by industry”

    Oh dear, the “it’s all a conspiracy” gambit?

  • “””WARNING:
    This review includes 15 out of 36 trials funded by industry”

    Oh dear, the “it’s all a conspiracy” gambit?””

    That was actually a quote by the authors… imagine if the studies had been about a herbal medicines, undertaken by herbal manufacturers and published in herbalist journals… they’d be discounted forthwith by scibloggers due to research/selection/publication bias.

    It is well proven that conspiracies are alive and well when it comes to big business sponsoring/controlling/ghost writing ‘scientific’ research… the MeNZB vaccine is a classic… Professor Lennon, the principal researcher, complained bitterly about not having access to data to verify results she signed off.. in fact she was not even aware of results in studies presented to the MOH for licencing the MeNZB vaccine.

  • Vaccines for preventing influenza in healthy adults
    Jefferson T, Di Pietrantonj C, Rivetti A, Bawazeer GA, Al-Ansary LA, Ferroni E
    Published Online:
    July 7, 2010

    “Over 200 viruses cause influenza and influenza-like illness which produce the same symptoms (fever, headache, aches and pains, cough and runny noses). Without laboratory tests, doctors cannot tell the two illnesses apart. Both last for days and rarely lead to death or serious illness. At best, vaccines might be effective against only influenza A and B, which represent about 10% of all circulating viruses. Each year, the World Health Organization recommends which viral strains should be included in vaccinations for the forthcoming season.

    Authors of this review assessed all trials that compared vaccinated people with unvaccinated people. The combined results of these trials showed that under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms. Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations. Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited…”

    Vaccine studies are canned when it is obvious that teh circulating flu virus does not match the vaccine… this scews meta-analyses in favour of vaccine effectiveness.

  • With respect, Michael, I can’t see where you’ve included the words related to treating influenza with vaccine in “quotes” and I’ve searched the 2007 Cochrane Reviews and can’t find such a quote…

    Can I assume the outcome of the discussion of the 2010 Cochrane Reviews was that the review was much less favourable to the vaccine’s effectiveness, and therefore quoting the 2007 review demonstrates selection bias?

  • Ron, the 2007 review from which I took the quote is readily accessible here
    http://www.ncbi.nlm.nih.gov/pubmed/17443504

    I had however missed that the 2010 review replaces this review. The 2010 review is less positive about the influenza vaccine but does state
    “In the relatively uncommon circumstance of vaccine matching the viral circulating strain and high circulation, 4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms” signifying that there are challenges in matching the strains in the vaccine with the strains in the circulating virus. They do however conclude that ” Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost.”

    The warning you noted is interesting but if the authors suspect the data provided by some sources was unreliable I wonder why they did not remove the data, which is fairly standard for Cochrane reviews.

    This debate seems to be going around in circles – I would suggest that each vaccine has to be judged on its own merits and that the limited use or results of one vaccine does not mean that all vaccines are flawed. Double blind experiments are not appropriate or ethical when previous observation tells us that it might be effective (e.g. measles, mumps etc).

  • Michael,

    I haven’t time to read this stuff (also why I haven’t written any articles on my blog of late), but for the influenza vaccines I’d want to understand what they are using to represent the ‘average’ or ‘typical’ effect, as much more than other vaccine targets influenza has variation from season to season. (As you know each year has a new tailored vaccine to different strains is developed; you would expect results to vary from year to year with this.) Suffice to say that simple averages may not represent what is happening very well, so I’d want to understand carefully what they are using and the statistical implications. (I have no time to look into this myself.) You’d also want to consider if the outcome of a ‘poor’ vaccine is linear or not with respect to coverage & cases. Off-hand I have no idea how well the Cochrane approach deals with seasonal variation and non-linear responses and the like; it may be better suited to the ‘classic’ drugs with a ‘fixed’ target.

  • Michael said, “I would suggest that each vaccine has to be judged on its own merits and that the limited use or results of one vaccine does not mean that all vaccines are flawed.”

    Absolutely… that’s the point I’ve been making right through… blanket embracing of all vaccines as panacea is not only unscientific, it is totally illogical…

    Michael said, “Double blind experiments are not appropriate or ethical when previous observation tells us that it might be effective (e.g. measles, mumps etc).”

    This is a totally false argument… if it was true, you would be supporting the use of selenium and folic acid supplements to prevent certain cancers, homeopathic treatments, etc, etc… the hole point of RDBPC studies is because ‘observations’ are full of bias… experts swear that their personal experience/observations are correct and proof of efficacy/effectiveness… RDBPC studies are design to remove doubt… but we know that even with these bias can be introduced when negative studies are abandoned and never reported and only positive studies are published.

    Why should $150 million plus have been spent on a large RDBPC study testing selenium supplements when not only had observational studies, but also RDBPC studies had demonstrated they prevented approx 50 percent of cancer deaths?????

  • Michael, I’ve read and text searched the 2007 cochrane review… I can not find the quote regarding the use of influenza vaccine as a treatment for influenza. Can you cut and paste it?

  • Absolutely… that’s the point I’ve been making right through

    I disagree. (Strongly.)

    What you have done is nit-pick with meaningless objections, then when faced with substantiative answers “taunt, evade, nitpick and play word games.”

    the [w]hole point of RDBPC studies is because ‘observations’ are full of bias

    So? Why RDB(P)CTs are used is not an argument against what Michael wrote. It’s also not an argument saying that any other kind of study is worthless. Essentially you’re setting up a false antecedent. You’re played this line before and it’s been explained to you before, too. You also seem to be just ignoring what he, and others, have pointed out several times now, and for that matter that people have pointed out to you for years. (See my previous point.)

    Why should $150 million plus have been spent on a large RDBPC study testing selenium supplements when not only had observational studies, but also RDBPC studies had demonstrated they prevented approx 50 percent of cancer deaths?????

    Why don’t you go and find out? An out-of-hand dismissals doesn’t make there a lack of reason.