Tag: mmr

It’s not just about measles

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More from YLE: Your Local Epidemiologist. And they are still banging on about measles.

I (last) “banged on about it” here.
Great post, that. Just enough rant, balanced nicely with facts and an appropriate amount of sarcasm.

Anyway…

The latest newsletter from YLE has the same title as this post. That’s not coincidence – I copied it.

Because it makes a very good point:

It’s not just about measles. It’s about what measles represents.

As scientists, having worked and studied hard for many years to become experts in our fields, we need to remember that not everyone is like us. Some people studied hard to become mechanics or accountants or teachers. And what seems obvious to us, perhaps only seems obvious to us because of our studying and our expertise. Much like the reasons behind a broken engine will be more obvious to a mechanic, or the meaning of a balance sheet will be more obvious to an accountant. And also teacher… stuff. Probably.

The measles outbreak in the US (and in Europe); the reappearance of a deadly disease that we had completely under control in the developed world is every bit as terrifying as it is completely avoidable.

Measles is a canary in the coal mine. When measles reappears in a country like the U.S., it signals that something has gone seriously wrong. This is a disease we had essentially eliminated—thanks to one of the safest and most effective vaccines in the history of medicine. But the way things are heading, the U.S. is at risk of losing its elimination status this year. This is not just a failure to move forward—it’s the unraveling of decades of progress, representing one of the greatest public health achievements of our era.

It’s a massive failure, and it’s a huge indicator of the high level of mistrust in what is – objectively – clear and obvious, successful science. But as we see regularly in politics, when there is a vacuum of power – or the perception of such – then nefarious parties will take advantage and move in.

It’s because trust has, both due to failures of public health to reach communities and due to well-organized efforts to spread inaccurate information about vaccination, leaving many Americans’ heads spinning as they sort through the noise and figure out who to trust.

We shouldn’t have to keep telling the public just how well vaccines work and just how essential they are: the proof is all there in the data. But maybe we should still have been explaining those data to the public, because in the absence of that sort of communication, others have taken the baton, contorted it, and presented their alternate version to the relay running public.
And as a scientist, it’s both absolutely infuriating that these snake oil salesmen and grifters have peddled their constant lies and unfounded theories around vaccination, and thoroughly depressing that (some) people have looked at the evidence set out before them, and then chosen to believe these venomous blatherskites.

For many in medicine, the resurgence of measles, along with declining rates of routine childhood vaccination, is a concerning sign of what’s to come. If we’re losing ground on measles, we may soon be vulnerable to other vaccine-preventable diseases. Whooping cough cases are already rising. Polio, Hib, or even diphtheria may soon appear in our emergency rooms.

It’s shocking and it’s embarrassing. And YLE’s attempt at a measured response to this upcoming crisis:

…the road back to a world where this isn’t a challenge will not be paved with more facts, fear, or finger-wagging. It will be built, as it always has, through stories and relationships—one respectful, genuine, evidence-based conversation at a time.

is absolutely admirable, but also smacks of someone living in a Walter Mitty world.

Sure, it would be perfect if we had the time, the resources and the ability to talk to concerned, confused parents and families out there and explain to them why they should listen to us and not the other “opinions” on this. But firstly, we don’t have the capacity to do that, and even if we did, in this divided, polarised world, there’s no reason why they would take our word over the nice “doctors” with their brain worms, and their books and supplements to sell. And I say that because if the public could see through the lies and the clever manipulation of the anti-vax lobby, then they would surely have done so already and we wouldn’t be facing this disastrous situation.

This won’t get any better anytime soon.
In fact, without wanting to be pessimistic, I don’t see how it will get any better anytime at all.

What could possibly go wrong?

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The measles outbreak in the USA has now killed at least two people, including a 6 year old girl, and has infected at least 430.

430 might not seem like a huge number, but it’s worth remembering that even if infection doesn’t cause death, it can result in deafness, blindness and brain damage, as well as having other serious long-term effects.

And we’ve been through some of the reasons that this outbreak is happening. Indeed, the parents of the little girl that died gave an interview after her death in which they said that they remained strongly anti-vaccination. And while you can argue that that’s their right (sadly, it is), maybe for some context we should add another of the things they said in the same interview:

“The measles wasn’t that bad.”

That ‘s them describing the disease that just killed their daughter.

Absolutely terrifying. Not least given that they have 4 other kids.

Of course, one of the other reasons (other than religion) that measles vaccination has waned is Andrew Wakefield’s long-disproven link between MMR and autism.

A lie can travel half way around the world while the truth is putting on its shoes.

There are now many, many studies refuting Wakefield’s “work” – and it’s a horrible lesson in how incredibly damaging and dangerous spreading falsehoods can be.

It’s absolutely clear that Wakefield’s “study” was – at best – terrible science, and – at worst – completely fraudulent.

So it’s both weird and worrying that The Department of Health and Human Services in the US has decided to launch a study into… er… “the connection between immunisations and autism”, and even weirder and more worrying that [gosh] they’ve chosen a prominent anti-vaxxer to help run it.

David Geier has written several papers on the alleged dangers of vaccines in causing developmental disorders in children, several of them funded by the non-profit Institute of Chronic Illnesses (ICI), Inc.

The CEO of the Institute of Chronic Illnesses (ICI), Inc. is one David Grier.

He’s certainly never medically examined children even though he holds no medical qualification.

Grier and his father have long been grifting while pretending that there’s a link between vaccines and autism. They then tested and “treated” their patients at huge expense to the parents, while raking in money for representing them at (unsuccessful) legal hearings into their childrens’ disorders.

Anyway, he seems like the perfect guy to run an unbiased, objective, non-partisan study into this allegedly contentious and emotive non-issue.

What – I ask again – could possibly go wrong?

Why should we bother?

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Technology is the key to our advancement as a species.

We invent things using technology.
We improve them using technology.
We simplify processes using technology.
We overcome society’s problems using technology.

There’s a lot of work, a lot of brains and a lot of money that goes into developing these technologies so that they can benefit humankind.

And yet, sometimes all of that seems so very unappreciated.

And it does seem that parents are particularly unappreciative of the things that could literally save their child’s life.

Like the mother driving her squabbling kids home from school yesterday: both of them 8 or 9 years old and climbing around the footwell and passenger seat of her car – not a seatbelt in sight.

To the parents in Gaines County in Texas,

It seems that in this case, religious beliefs may have been a strong reason behind many of the (now 24) cases: all of whom *shock* are unvaccinated. Gaines Country has a high population of Mennonites, and all of the cases in Gaines can be linked to Mennonite schools. Traditionally, Mennonites reject “modern” technology (which would likely include vaccinations), which is all well and good until it backfires and a wholly preventable measles outbreak maims or kills their children.

According to this from MennoniteUSA.org:

Mennonites believe in simple living but express that simplicity in a spirit of stewardship and awareness of the needs of others rather than completely separating from society

But if I was the parent of a baby in Texas right now (the first MMR vaccination is at 12-15 months), I would be very worried. I certainly wouldn’t be thinking very kindly about the Mennonites and their alleged “spirit of stewardship and awareness of the needs of others” BS.

Look, religious or not, as parents we deserve to give our kids the best chance in life. And that should start with the right to health and life. Willfully ignoring or rejecting the proven technologies that we have developed to keep our children safe and well is tantamount to child abuse. As one commenter points out:

It’s difficult to have sympathy for an adult who refuses a vaccine and then gets the disease.
The children didn’t have a choice.

Yep. The children deserve better.
And everything they need is right there. It’s readily available.

They’re just not being used.

And that does raise the question: Why should we bother?

On Fracking and Vaccing 1

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No shortage of interesting stuff arriving on my desktop today, much of it (for some obscure reason) along the (shouldn’t really be, but because of irrational fears, still) contentious issues of Shale Gas Extraction via Hydraulic Fracturing and Vaccination.

Not together, you understand. That would be at best, unhelpful, and at worst, downright messy.

[Note, 500 words in: This is already getting too long; I’m going to split it into two posts]

The vaccination one first. It’s a post by Jed Lipinski on Slate and discusses the case for legal action against parents who choose not to vaccinate their children. Not, I hasten to add, specifically because of that choice, but because their unvaccinated child may then infect (and cause harm to, or kill) another child. The post is triggered by an episode of a popular American drama, but also refers to this paper by Caplin et al. which asks:

Is there a case for holding non-vaccinators legally liable for harm caused to others by their inaction?

It makes interesting reading.

As a microbiologist and a father of a child who has – by chance – just had her MMR booster and whose teacher is currently off school with Rubella, I would welcome action like this. And that’s not me being vindictive – it’s not because I don’t understand the reasoning behind parents’ who choose not to vaccinate their children:

Parents who don’t vaccinate their kids may have the most heartfelt reason in the world: fear for their own children’s safety.

But, as Lipinski goes on to say:

…the basis for that fear is simply unfounded, and their decisions are putting other kids directly at risk.

So this decision basically comes down to a lack of good education and a lack of understanding. But, putting myself in their position, without those things, it’s fairly easy to see why a parent might make that choice. I am regularly approached by reasonable, intelligent, sane parents who are still concerned as to whether they should vaccinate their children or not.
The attempts to educate parents such as these are clearly failing; either they are being swayed, to varying degrees, by irrational, unscientific arguments, or quite simply, they don’t want to learn – they’re not bothered.

The threat of legal action (unpretty though it is) might just be catalyst for making them sit up and take notice. Almost like having to sign an indemnity form ahead of some activity. Yes, sure you can make your own decisions, just be aware that you are also responsible for the consequences of those decisions. This is a good thing.

However, I imagine that the chances of this sort of law ever making it into reality are slim to zero. And even then, I don’t think that it’s as clear cut as the paper suggests:

Since epidemiologists today can reliably determine the source of a viral infection, the authors argue, a parent who decides not to vaccinate his kid and thus endangers another child is clearly at fault and could be charged with criminally negligent homicide or sued for damages.

There’s a clearly-explained, detailed hypothetical case (of Jinny and Michael) described in the paper, a timeline of events and tests that the authors conclude:

would provide a reliable case for causation.

and apparently:

Utilizing the scientific tools available today, it cannot be proven with 100 percent certainty that Jinny infected Michael with measles. Nevertheless, current scientific techniques could lead experts to state they believe that the preponderance of the evidence, with 95 percent certainty or better, that Jinny infected Michael.

I’m not sure I agree at all with that 95% figure and they don’t state where they got it from. In addition, this is a perfect, uncontaminated (hypothetical) case, and even then they can’t definitively prove causation. You’ll have to read the case to understand these questions in context, but: What if Jinny had caught measles from another – local – unvaccinated child, rather than having contracted it in Germany? The genotyping would be far less specific.
Or what if Michael actually has a life outside the daycare facility, where he may have had contact with other unvaccinated (and infected) children? Can his parents really say that he has had no contact with any other measles-infected child? Can they prove this? How?

Caplin et al. ask:

Can Science Link Jinny’s Measles Infection to Michael’s Death?

And even in this “perfect” case, I say that no, it can’t.
If I were a lawyer for the defence, I’d be counting my huge fee licking my lips at the plateful of ifs, buts and maybes and the side-salad of assumption.

So in summary, suing parents who don’t vaccinate their kids: Nice idea. Right idea. But never going to work.

Back to the drawing board.

[I’ll get the fracking stuff done later or maybe tomorrow – watch this space]

How things work

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A great letter in today’s Cape Times from John Walmsley of the Nuclear Institute rebuffing the concerns of opponents to nuclear power in the wake of the troubles at the Fukushima Nuclear Plant in Japan.

I’m trying to get hold of the full text, but there was one thing which I found particularly pertinent, especially while the fracking debate continues on this post.

This quote from the letter:

The anti-nuclear lobby will make alarming public pronouncements that will be quietly trashed by professional health organisations in the technical literature.

Brilliant. Because isn’t this the problem? It was the problem with MMR, where the experts repeatedly stated that there was no link to autism, but the anti-vax groups preyed on the public’s fear and exacerbated the effect of Andrew Wakefield’s lies.

And it still exists with the anti-fracking parties spreading fear through emotionally-laden misinformation to advance their cause.
It closes minds and it means that the real information – the important, factual information – is hidden from the general public. Which, of course, is the aim of these people.

In some ways, analogies can be drawn to the issue that troubles me around the media and their inaccuracies: namely that they can shout about a subject  on the front page – however inaccurate their claims may be – often igniting a bitter, yet worthless debate based on nonsense, but then get away with publishing a tiny correction at the bottom of page 19 two weeks later.