One of the persistent themes of this blog is that expertise matters. This is not to say the experts are always right (sometimes they disagree with each-other), and there is also a range of expertise, and different kinds of experts can have different biases and blind spots. But all things considered, someone who has formal expertise on a specific topic is likely to know much more about that topic than someone who has read about it on the internet.

Further, most people underestimate the amount of knowledge that exists on a topic, and therefore the vast gulf of knowledge that exists between them and the experts. In fact, the more someone knows about a topic the more they understand how much is known, and the more humble they tend to be with respect to their own knowledge. The flip side of this – people who know little tend to overestimate their relative knowledge – is an established psychological phenomenon known as the Dunning-Kruger effect.

Operationally Dunning and Kruger found in their study that the lower someone performed on a test of knowledge, the greater the gap between their perceived knowledge and performance and their actual performance. At around the 80th percentile and above, people tend to underestimate their relative knowledge. Below that point they tend to increasingly overestimate it, and everyone thinks they are above 50%.

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Anti-vaccine nonsense is relentless, and spreads through social media like a measles virus in an upscale private California school. Therefore we need frequent skeptical booster shots.

I will usually decide to take on a topic if I see it spreading or if fellow skeptics aren’t sure what the deception is. A story is sending up red flags, but a more expert eye is needed.

Pretty much every word in this headline is wrong or deceptive: Harvard Study Proves Unvaccinated Children Pose No Risk.

First, there is no study. This is not in any way about some new study or research, but simply an article by an anti-vaccine crank, Tetyana Obukhanych. Further, her connection to Harvard seems tenuous and it’s not even clear what her current academic status is. And most importantly, she uses cherry picked, irrelevant, and incorrect information to make her case.

But she appears to be the new darling of the anti-vaccine movement, so let’s take a deeper look. Continue Reading »

We have an anti-vaccine president. One of my concerns about Trump the candidate was that one of his most consistent positions over the years was blaming vaccines for the alleged autism epidemic (there isn’t one, by the way). Once elected it did not take long for this to manifest as a policy priority. In January Trump met with RFK Jr. to discuss him heading an Orwellian commission on vaccine safety and scientific integrity.

At a recent meeting with educators, Trump continued to express his false belief in a “tremendous increase” in autism:

“Have you seen a big increase in the autism with the children?” Trump asked Jane Quenneville, the principle of a Virginia public school that specializes in special education. Quenneville responded that she had.

Trump continued: “So what’s going on with autism? When you look at the tremendous increase, it’s really such an incredible — it’s really a horrible thing to watch, the tremendous amount of increase. Do you have any idea?”

“The autism?” Really? Continue Reading »

This is what happens when you compromise your academic and professional integrity in order to embrace a popular fad. The Cleveland Clinic, which is historically an excellent medical institution, has the Cleveland Clinic Wellness Center, which is a center of so-called “alternative” medicine.

Such centers are a Trojan horse. They are sold to naïve academics as providing “patient centered” warm and fuzzy symptomatic treatments. Meanwhile they are really centers for pseudoscience and health fraud. They use the respected names of venerable institutions to legitimize nonsense.

The Cleveland Clinic now has to face the PR nightmare of allowing the foxes into the henhouse (actually they built a new henhouse just for the foxes).

On January 6th Dr. Daniel Neides, Medical Director and Chief Operating Officer of the Cleveland Clinic Wellness Institute, published an anti-vaccine screed on the institution’s blog. The article is full of typical anti-vaccine misinformation, and is a serious embarrassment to the Cleveland Clinic. It will also embolden the anti-vaccine movement, who can point to the article to make vaccines seem controversial and convince more confused parents not to vaccinate their children.

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Dr. Bob Sears is a Capistrano Beach pediatrician who is famous for opposing mandatory vaccinations and the current CDC vaccine schedule. He has promoted his alternate vaccine schedule, which spreads out the vaccines much greater than the standard schedule. This has made him a darling of the anti-vaccine movement, an expert who supports part of their narrative (specifically, “Too many too soon” and parental choice).

Recently the Medical Board of California filed a complaint against Sears for “gross negligence.” There are three counts, the first for recommending a 2 year old patient not receive any further vaccines because of apparent reactions to previous vaccines. The complaint alleges:

Respondent was grossly negligent and departed from the standard of care in that he did not obtain the basic information necessary for decision making prior to determining to exclude the possibility of future vaccines, leaving both patient J.G, the patient’s mother, and his future contacts at risk for preventable and communicable diseases.

The complaint also alleges that Sears failed to adequately assess the patient after a head injury with complaint of headache, and also that he failed to keep adequate records by not filing the letter excusing the patient from vaccines in the chart.

The Standard of Care Continue Reading »

This has been a typical saga, one we have seen played out many times. An organization (company, institution, etc.) provides a venue for an irresponsible anti-science article, speaker, or film. There is then a public outcry that the venue is being exploited to promote pseudoscience. The organization initially defends their decision, then reconsiders. The author, speaker, director then cries “censorship.”

It’s a predictable script.

Recently the Tribeca Film Festival announced its list of movies it will be screening this year, and among them was Vaxxed: From Cover-Up to Catastrophe, a movie perpetuating the idea that the Center for Disease Control (CDC) is covering up data that shows a link between the MMR vaccine and autism.

Orac discusses the content of the movie in detail, but here is a quick summary. The movie is produced by Andrew Wakefield, the disgraced struck-off British doctor who published a study in the Lancet claiming evidence for a connection between MMR and autism. The paper was later retracted and found to be fraudulent.

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The Disneyland measles outbreak has the anti-vaccine movement on the ropes a bit. As I and pretty much all of my colleagues at Science-Based Medicine have predicted for years, once previously contained infectious illnesses start to seriously return, public opinion will shift against the anti-vaxxers.

We are seeing more mainstream stories like this one, Mom: Family that refused vaccination put my baby in quarantine, from CNN, and this one, Vaccine deniers stick together. And now they’re ruining things for everyone, from the Washington Post. As I mentioned in my earlier post, The Onion also nailed it with this satire, I Don’t Vaccinate My Child Because It’s My Right To Decide What Eliminated Diseases Come Roaring Back.

Of course, the cranks are unmoved. Their position is not based on a rational assessment of the evidence, and therefore evidence will not move them from their perch. What they have been doing is repeating tired anti-vaccine tropes. Unfortunately they are getting some exposure from residual false balance in the media.

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Part of the scientific approach to knowledge is to integrate information at various levels. It’s important to get the tiny facts correct, but you also have to put those facts into progressively broader and deeper frameworks. Theories are informed by facts which in turn make sense only in the context of the theory.

I try to take this approach with topics on this blog, by not only spending time addressing specific facts but also trying to see the big picture. For example, Mary Tocco, who is an anti-vaccine activist, was recently given space for a guest column on Michigan Live. I will go through and deconstruct her specific claims, but it’s also helpful to view her article in the broader social context.

Tocco is part of Michigan Opposing Mandatory Vaccination, or MOM (how can you not love “mom”). In her article she writes:

“The authors labeled Michigan Opposing Mandatory Vaccines an anti-vaccine group. Our organization is about protecting parental right to choose whether or not to use vaccines as a method of health care for themselves and their children.”

From this one paragraph we can see many of the threads currently weaving through culture. The big picture is that there is an ideological struggle going on between those who take a science-based worldview and believe that rational regulations should be based on the best science available, and those who wish to promote some other agenda that is not science-based.

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From time to time celebrities publicly discuss their opinions on scientific topics, and the results are usually not pretty. I have discussed previously the folly of Jenny McCarthy, for example, in using her dubious celebrity to promote anti-vaccine nonsense. Now The Donald has joined the ranks of people who are mostly famous for being famous who feel their celebrity gives them license to pontificate publicly about complex scientific issues. Trump told a Fox News audience that he strongly believes vaccines are causing the increase in autism diagnosis. He based this upon his scientific training, thorough reading of the relevant scientific literature, and consultation with experts – no, I mean based upon his casual observation and naive assumptions. Hey, he has an anecdote.

Here is the core of his rant:

“I’ve gotten to be pretty familiar with the subject. You know, I have a theory — and it’s a theory that some people believe in — and that’s the vaccinations. We never had anything like this. This is now an epidemic. It’s way, way up over the past 10 years. It’s way up over the past two years. And, you know, when you take a little baby that weighs like 12 pounds into a doctor’s office and they pump them with many, many simultaneous vaccinations — I’m all for vaccinations, but I think when you add all of these vaccinations together and then two months later the baby is so different then lots of different things have happened. I really — I’ve known cases.”

OK, it’s easy for a lay person to get caught up in a complex scientific question and get overwhelmed by information from one side. If you naively watch Loose Change, for example, without being familiar with the whole 911 conspiracy thing you might be led to believe there is something sinister going on. That’s how propaganda of that sort often works – overwhelm your audience with factoids, distorted and cherry-picked information, and apparent correlations and weave them into an emotionally compelling story. If you listen to just one side of any scientific debate you will probably be convinced that that side has a strong and perhaps even iron-clad case. Only when the other side has an opportunity to make their case do you see how the information you were given was systematically biased in one direction.

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One of my goals in writing for this blog is to educate the general public about how to evaluate a scientific study, specifically medical studies. New studies are being reported in the press all the time, and the analysis provided by your average journalist leaves much to be desired. Generally, they fail to put the study into context, often get the bottom line incorrect, and then some headline writer puts a sensationalistic bow on top.

In addition to mediocre science journalism we also face dedicated ideological groups who go out of their way to spin, distort, and mutilate the scientific literature all in one direction. The anti-vaccine community is a shining example of this – they can dismiss any study whose conclusions they do not like, while promoting any horrible worthless study as long as it casts suspicion on vaccines.

Yesterday on Age of Autism (the propaganda blog for Generation Rescue) Mark Blaxill gave us another example of this, presenting a terrible pilot study as if we could draw any conclusions from it. The study is yet another publication apparently squeezed out of the same data set that Laura Hewitson has been milking for several years now – a study involving macaque infants and vaccinations. In this study Hewitson claims a significant difference in brain maturation between vaccinated and unvaccinated macaque infants, by MRI and PET analysis. Blaxill presents the study without noting any of its crippling limitations, and the commenters predictably gush.

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