Tag Archives: Vaccines

More on Vaccination

Cross-posted.

One issue that I am fairly militant about is vaccination. Vaccines are arguably the greatest invention in human history. Vaccines made smallpox, a disease that slaughtered billions, extinct. Polio, which used to maim and kill millions, is on the brink of extinction. A couple of weeks ago, Rubella became extinct in the Americas:

After 15 years of a widespread vaccination campaign with the MMR (measles-mumps-rubella) vaccine, the Pan American Health Organization and the World Health Organization announced yesterday that rubella no longer circulates in the Americas. The only way a person could catch it is if they are visiting another country or if it is imported into a North, Central or South American country.

Rubella, also known as German measles, was previously among a pregnant woman’s greatest fears. Although it’s generally a mild disease in children and young adults, the virus wreaks the most damage when a pregnant woman catches it because the virus can cross the placenta to the fetus, increasing the risk for congenital rubella syndrome.

Congenital rubella syndrome can cause miscarriage or stillbirth, but even the infants who survive are likely to have birth defects, heart problems, blindness, deafness, brain damage, bone and growth problems, intellectual disability or damage to the liver and spleen.

Rubella used to cause tens of thousands of miscarriages and birth defects every year. Now it too could be pushed to extinction.

Of course, many deadly diseases are now coming back thanks to people refusing to vaccinate their kids. There is an effort to blame this on “anti-government” sentiment. But while that plays role, the bigger role is by liberal parents who think vaccines cause autism (you’ll notice we’re getting outbreaks in California, not Alabama). As I’ve noted before, the original research that showed a link between vaccines and autism is now known to have been a fraud. Recently, we got another even more proof:

On the heels of a measles outbreak in California fueled by vaccination fears that scientists call unfounded, another large study has shown no link between the measles-mumps-rubella vaccine and autism.

The study examined insurance claims for 96,000 U.S. children born between 2001 and 2007, and found that those who received MMR vaccine didn’t develop autism at a higher rate than unvaccinated children, according to results published Tuesday by the Journal of the American Medical Association, or JAMA. Even children who had older siblings with autism—a group considered at high risk for the disorder—didn’t have increased odds of developing autism after receiving the vaccine, compared with unvaccinated children with autistic older siblings.

96,000 kids — literally 8000 times the size of the sample Wakefield had. No study has ever reproduced Wakefield’s results. That’s because no study has been a complete fraud.

There’s something else, though. This issue became somewhat personal for me recently. My son Ben came down with a bad cough, a high fever and vomiting. He was eventually admitted to the hospital for a couple of days with pneumonia, mainly to get rehydrated. He’s fine now and playing in the next room as I write this. But it was scary.

I mention this because one of the first questions the nurses and doctors asked us was, “Has he been vaccinated?”

My father, the surgeon, likes to say that medicine is as much art as science. You can know the textbooks by heart. But the early symptoms of serious diseases and not-so-serious one are often similar. An inflamed appendix can look like benign belly pain. Pneumonia can look like a cold. “Flu-like symptoms” can be the early phase of anything from a bad cold to ebola. But they mostly get it right because experience with sick people has honed their instincts. They might not be able to tell you why they know it’s not just a cold, but they can tell you (with Ben, the doctor’s instinct told him it wasn’t croup and he ordered a chest X-ray that spotted the pneumonia).

Most doctors today have never seen measles. Or mumps. Or rubella. Or polio. Or anything else we routinely vaccinate for. Thus, they haven’t built up the experience to recognize these conditions. Orac, the writer of the Respectful Insolence blog, told me of a sick child who had Hib. It was only recognized because an older doctor had seen it before.

When I told the doctors Ben had been vaccinated, their faces filled with relief. Because it meant that they didn’t have to think about a vast and unfamiliar terrain of diseases that are mostly eradicated. It wasn’t impossible that he would have a disease he was vaccinated against — vaccines aren’t 100%. But it was far less likely. They could narrow their focus on a much smaller array of possibilities.

Medicine is difficult. The human body doesn’t work like it does in a textbook. You don’t punch symptoms into a computer and come up with a diagnosis. Doctors and nurses are often struggling to figure out what’s wrong with a patient let alone how to treat it. Don’t cloud the waters even further by making them have to worry about diseases they’ve never seen before.

Vaccinate. Take part in the greatest triumph in human history. Not just to finally rid ourselves of these hideous diseases but to make life much easier when someone does get sick.

Mathematical Malpractice Watch: Torturing the Data

There’s been a kerfuffle recently about a supposed CDC whistleblower who has revealed malfeasance in the primary CDC study that refuted the connection between vaccines and autism. Let’s put aside that the now-retracted Lancet study the anti-vaxxers tout as the smoking gun was a complete fraud. Let’s put aside that other studies have reached the same conclusion. Let’s just address the allegations at hand, which include a supposed cover up. These allegations are in a published paper (now under further review) and a truly revolting video from Andrew Wakefield — the disgraced author of the fraudulent Lancet study that set off this mess — that compares this “cover-up” to the Tuskegee experiments.

According to the whistle-blower, his analysis shows that while most children do not have an increased risk of autism (which, incidentally, discredits Wakefield’s study), black males vaccinated before 36 months show a 240% increased risk (not 340, as has been claimed). You can catch the latest from Orac. Here’s the most important part:

So is Hooker’s result valid? Was there really a 3.36-fold increased risk for autism in African-American males who received MMR vaccination before the age of 36 months in this dataset? Who knows? Hooker analyzed a dataset collected to be analyzed by a case-control method using a cohort design. Then he did multiple subset analyses, which, of course, are prone to false positives. As we also say, if you slice and dice the evidence more and more finely, eventually you will find apparent correlations that might or might not be real.

In other words, what he did was slice and dice the sample to see if one of those slices would show a correlation. But by pure chance, one of those slices would show a correlation, even there wasn’t one. As best illustrated in this cartoon, if you run twenty tests for something that has no correlation, statistics dictate that at least one of those will show a spurious correlation at the 95% confidence level. This is one of the reasons many scientists, especially geneticists, are turning to Bayesian analysis, which can account for this.

If you did a study of just a few African-American boys and found a connection between vaccination and autism, it would be the sort of preliminary shaky result you would use to justify looking at a larger sample … such as the full CDC study that the crackpot’s own analysis shows refutes such a connection. To take a large comprehensive study, narrow it down to a small sample and then claim the result of this small sample override those of the large one is ridiculous. It’s the opposite of how epidemiology works (and there is no suggestion that there is something about African American males that makes them more susceptible to vaccine-induced autism).

This sort of ridiculous cherry-picking happens a lot, mostly in political contexts. Education reformers will pore over test results until they find that fifth graders slightly improved their reading scores and claim their reform is working. When the scores revert back the next year, they ignore it. Drug warriors will pore over drug stats and claim that a small drop in heroine use among people in their 20’s indicates that the War on Drugs is finally working. When it reverts back to normal, they ignore it.

You can’t pick and choose little bits of data to support your theory. You have to be able to account for all of it. And you have to be aware of how often spurious results pop up even in the most objective and well-designed studies, especially when you parse the data finer and finer.

But the anti-vaxxers don’t care about that. What they care about is proving that evil vaccines and Big Pharma are poisoning us. And however they have to torture the data to get there, that’s what they’ll do.

Monday Linkorama

  • Whooping cough is making a comeback. Oh joy! Thanks, anti-vaxxers.
  • The obesity rate has leveled off. Not that I expect the Nanny Staters to admit this. I suspect we’ve simply reached our natural maximum.
  • The CDC needs to stay out of social engineering. They seem to keep finding was to make problems seems much worse than they actually are.
  • I am just so glad to see the company behind those creepy King ads is down for the count. Let’s get rid of all the ad agencies.