Jun 06 2008

Drinking the Anti-Vaccine Kool-Aid

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Comments: 59

It’s not enough to mean well. You have to get the science right.

I believe that Jim Carrey and Jenny McCarthy mean well. They think they are saving the world from greedy corporations, corrupt government, and arrogant doctors. In their minds they are enlightened saviors, leaders of a “green” army alerting the rest of us to the dangers of toxins and the malfeasance of those in charge. Yesterday they lead a “green our vaccines” rally in Washington DC to help save the world.

But it’s not enough to mean well. Carrey and McCarthy get the science terribly, hopelessly, and tragically wrong. In fact, meaning well is part of what makes them dangerous. They display that toxic brew of arrogance and self-righteousness, combined with the power of celebrity to do real damage.


They are self-righteous because they think that only they and their group mean well. Like all conspiracy mongers, they readily and eagerly believe that the faceless “powers that be” are evil. They believe that doctors have abandoned (as Jenny McCarthy claimed in her speech at the rally) their oath to “do no harm.” They believe that people in government are so corrupt they will knowingly condemn millions of children to autism in order to avoid inconveniencing their buddies in “Big Pharma.” (Carrey also throws in the myth that restless leg syndrome is a made up diagnosis by Big Pharma – so I guess he only has to care about diseases that touch him personally, or does he think that all drug treatment is a conspiracy.)

They are arrogant because they believe that they know better than scientists – indeed than “science” itself. McCarthy warns us that science has been wrong before, as if that is some big insight. She wants us to trust her mommy instinct over hard evidence. Carrey predicts that the future will vindicate his claims and anyone who disagrees with him will be viewed as a flat-earther. He wants us to trust anecdotal hysteria over hard scientific evidence. In fact they are both perplexed as to why those evil scientists won’t just accept their low grade bad evidence and why they insist on believing all that carefully collected scientific evidence. They just don’t get it.

Meaning well does not excuse the harm they are doing. They lack the humility to consider that perhaps the science is complex and they better work harder to understand it, or at least understand why the scientific community disagrees with them (rather than just leaping to the self-serving conclusion that they must be smarter and more ethical than all those scientists). They lack the intellectual honesty or diligence to correct their egregious factual errors. They lack the wisdom to see that just assuming the other side is evil is a recipe for dangerous ideological extremism.

Jenny McCarthy has the gall to chastise doctors for failing their oath to do no harm. Meanwhile she and Jim Carrey have thrown that caution to the wind. They and their antivaccinationist buddies are doing demonstrable harm – as evidenced by the resurgence of vaccine-preventable diseases in recent years.

Others have done an excellent job at outlining all the factual errors in the “green vaccine” propaganda, but I want to highlight a few here.

Too Many Too Soon

This is the primary slogan of the rally; the phrase marchers are chanting as they move herd-like down the streets. They claim that children are getting too many vaccines too soon. Carrey, for example, harps on the point that 20 years ago children received 10 vaccines and now they get 36 in the routine schedule. He fails to note, however, that even though the number of vaccines have increased, the total number of antigens in those vaccines have decreased (due to improved vaccine technology). So children are getting less of an antigen challenge today than 20 years ago.

Also – there is no evidence nor any reason to believe that the vaccine schedule is unsafe or that the number or timing of vaccines is too great. This is just a convenient assumption. They throw out numbers as if they have some scientific or empirical meaning, but they don’t. Where is the evidence that 20 vaccines is safer than 36, or that spreading them out more reduces any side effect?

There is evidence that delaying vaccines leaves children vulnerable to those diseases longer and increases the incidence of vaccine-preventable diseases. First do no harm.

It’s The Toxins

It’s easy to scare people with “toxins” – it’s difficult to understand the research and that everything is a toxin – toxicity is all about dose and risk vs benefit. McCarthy loves to rattle off he list of supposed toxins in vaccine. The problem is – she gets the science completely wrong. She says there is still mercury in childhood vaccines, but she is wrong, or at least grossly misleading. Mercury has been removed from the routine vaccine schedule – those 36 vaccines do not contain any significant mercury. Some versions of the flu vaccine still do, but these are optional.

How does she deal with this inconvenient fact? She refers to the fact that some of these vaccines still contain “trace” amounts of mercury – left over from the manufacturing process. These trace amounts are truly trace – an insignificant dose that no honest, thinking, and informed person could think is toxic. But don’t confuse McCarthy with these facts. Instead she throws out the deliberately misleading propaganda that these trace amount are higher than the safe levels for drinking water. This is deliberately misleading – safe levels for a one-time dose is different than safe levels in drinking water which someone could consume large quantities of every day for years. If children were given 10 vaccines every day for years, she might have a point.

If the mercury in vaccines were linked to autism, as she amazingly still claims, then (as toxicity is all about dose) when the mercury-containing thimerosal was removed from vaccines by the end of 2001 (even if small amounts remained) this dramatic decrease in the dose should have been followed by an equally dramatic decrease in the supposed toxicity (autism) – but this decrease never happened. Autism rates have continued to climb without the slightest blip. Any honest person with the slightest understanding of science recognizes that his has killed the mercury hypothesis.

Mercury is the failed toxin of the anti-vaccine movement, so they have moved on to other toxins. McCarthy is still claiming that vaccines contain antifreeze and ether – they don’t. This is simply a lie, probably based in extreme chemical scientific illiteracy. She has been called on this nonsense, but has not changed her tune. So add intellectual laziness vs dishonesty to her list of sins.

There’s more, of course, mostly covered already by me and other science bloggers – but the nonsense never goes away. There is no autism epidemic -the increased diagnosis rates are caused by expanding diagnosis and increased surveillance. The Hannah Poling case was not an admission, as Carrey and McCarthy both claimed, by the government that vaccines can cause autism.

Conclusion

It is ironic that Carrey and McCarthy worry so much about toxins when they have drunk so deeply and carelessly of the toxin-laiden anti-vaccine Kool-Aid. They mean well, but in the self-righteous and arrogant way that witch burners meant well. They are inside the self-contained world of the conspiracy theorist – and just like the world of The Truman Show (actually a decent movie starring Jim Carrey) it’s all fake, and there is no apparent way out. They are buried under a pile of ideological propaganda and they don’t have the scientific chops to dig themselves out, nor the humility to listen to those who do.

Carrey and McCarthy would be just another couple of sad cranks, except their celebrity gives force to their delusions. They are now the poster children for the phrase – It’s not enough to mean well. You have to get the science right.

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59 responses so far

59 Responses to “Drinking the Anti-Vaccine Kool-Aid”

  1. Oracon 06 Jun 2008 at 8:15 am

    Indeed.

    Antivaccinationists have descended over at my blog because I had the temerity to show the hard, photographic evidence that their “Green Our Vaccines” and “Too Many Too Soon” slogans are nothing more than a disingenuous ploy to move the goalposts and that Jenny McCarthy and Jim Carrey are now cranks extraordinaire spouting bad science mixed with paranoid conspiracy theories.

    The mercury hypothesis was a serious tactical error on the part of antivaccinationists. It was a hypothesis that made a testable prediction, namely that removing thimerosal from childhood vaccines should result in a decrease in autism prevalence within 5-10 years. (Autism is usually diagnosed between ages 3-5.) Well, it’s been nearly seven years since the thimerosal was removed and guess what? Autism prevalence hasn’t fallen; it’s still rising, the same thing that was observed in Denmark, Canada, and other countries that removed thimerosal before the U.S. did. That’s about as strong epidemiological evidence as there is that mercury in vaccines does not cause autism, or, if it does, it would have to be in a truly tiny number of “susceptible’ individuals. That’s why antivaccinationists won’t make that mistake again, which is why the vague appeal to “toxins” or to “too many vaccines.” Meanwhile Jenny says she want’s “safe” vaccines while she says in interviews that if she has another child she will never vaccinate.

    One point you’ve overlooked is that, although Jenny and Jim may mean well and have honestly come to believe their propaganda, they are useful idiots for others who may not mean so well. I’m talking about the quack industry known as the “biomedical movement” that has grown up around autism, starting with chelation therapy to “remove the mercury poisoning” from vaccines to hyperbaric oxygen chambers, to diets, to supplements, to…whatever. If people accepted that vaccines did not cause autism, the financial interests of this movement would be very much in jeopardy. They’re also useful idiots for the hard core antivaccinationist movement that is opposed to mass vaccination programs on general principle.

  2. DavidCTon 06 Jun 2008 at 8:56 am

    Sadly this has become a public relations issue. Being right scientifically is not enough. Being right on the science was not enough to save Dow Corning from financial disaster once “toxins” from breast implants became a “woman’s issue”.

    The issue has become one of “protecting children”. With constant repetition in the media even the stupidest idea can seem credible. The horrors of dead and disabled children who suffered from vaccine preventable diseases are just forgotten.

    I wonder how many parents who want to avoid the homeopathic dose of mercury in vaccines, will still serve their children a tuna sandwich. Perception and actual risks are often very distorted.

  3. ellazimmon 06 Jun 2008 at 9:10 am

    Just out of curiosity: Dr Steve have you ever been approached by a representative of any drug company flunky and asked to endorse a medication that does not have sound research backing it up? Do you know of anyone who has?

    I was just wondering where the idea of “Big Pharma” came from in the first place. I like the movie The Fugitive with Harrison Ford a lot but I never really took the drug trials scam part seriously.

  4. Fifion 06 Jun 2008 at 10:30 am

    DavidCT – With all due respect, there are very good reasons why women (and people of colour) may question the accuracy and good intentions of chemical manufacturers, medical researchers (particularly those associated with industries that sell products) and and even their doctor sometimes.

    Certainly things have gotten a lot better as more women have gotten into medicine but there’s still a long way to go. And let’s face it, the chemical industry is hardly up there as a the most ethical of industries and, like cigarette manufacturers, they can’t be trusted to be honest or ethical, particularly if it’s at the expense of profits.

  5. daedalus2uon 06 Jun 2008 at 11:14 am

    Fifi, that is true of all industries. The people pushing the anti-vax hysteria are selling things too. Wakefield was planning on selling his alternative to measles vaccine. The Geiers are selling chelation, Lupron treatments and witless testimony. David Kirby is selling books. Jenny McCarthy is selling stuff too. People are told they need supplements by the people selling them. Someone sold all those tee shirts.

    As far as I know, Dr. Novella isn’t selling anything related to vaccines. His research is in neurology. Orac isn’t selling anything related to vaccines. His research is in cancer.

    Those who advise against chelation make nothing by doing so. Orac doesn’t make anything by telling people liver and colon flushes are useless (I presume, maybe the great and secret toilet paper lobby is secretly funding him. Is that the reason for his fascination with enemas?)

  6. Oracon 06 Jun 2008 at 11:22 am

    Being right on the science was not enough to save Dow Corning from financial disaster once “toxins” from breast implants became a “woman’s issue”.

    Indeed it wasn’t. However, even though science has shown that breast implants don’t cause auto-immune disease, cancer, or any of the other systemic syndromes that were attributed to them, they are not without problems. Those problems are primarily local in nature, such as implant rupture, scarring, capsular contraction, etc.

  7. Steven Novellaon 06 Jun 2008 at 11:42 am

    I agree that no industry should be trusted where there are millions or billions of dollars to be made. That is why I favor tight regulation of the drug industry – and that is pretty much what we have. There are many problems, including the fact that the FDA is underfunded, but many of the problems with conflict of interest, etc. are being weeded out. It will never be perfect, but I think an honest and non-ideological assessment of the whole situation is that it works pretty well.

    The supplement industry is a different matter – it is almost completely unregulated and is a complete nightmare. It is funny, though, that the anti-Big Pharma conspiracy theorists never mention that.

    The point of good research is that it is performed in such a way that bias and conflict do not influence the results (which includes independent replication and peer review). Again – such influences will never be zero, but they can be made to be smaller than the effects we are looking for.

    For the record, I am a salaried academic with no financial ties to vaccines or any other medical modality. The same is not true, as others have pointed out, of many of the anti-vaccinationists.

  8. bigjohn756on 06 Jun 2008 at 12:10 pm

    About how long will it be before we will start to see the un-vaccinated children begin to suffer and die from preventable diseases?

  9. deciuson 06 Jun 2008 at 12:18 pm

    Yet more airheaded celebrities abusing their popularity for promoting dangerous nonsense. As if being a clown were the intellectual equivalent of possessing a higher education.

  10. Fifion 06 Jun 2008 at 12:30 pm

    Actually I’m not calling into question the doctors who contribute here (and I’m a bit surprised at the knee jerk reaction as if I am!). I’m just pointing out that medicine and science have not always served women and people of colour well and have been downright unethical at times due to sexism and racism, and obviously corporations are in the business of making money and then making more money for shareholders. They game requires ever increasing profits, often at great cost to the environment and people’s health. Historically corporate interests often win out over human ones. To me this isn’t an issue of conventional medicine vs CAM – it’s to do with the nature of corporations and profit, something I personally think mixes very poorly with medicine. It’s pretty obvious that if supplement manufacturers can influence the government to pass laws that don’t take into account public safety then so can hugely powerful and wealthy corporations of any nature. I’m not sure why anyone would trust politicians in one area and then not the other! Now that sounds like a trust bias that’s not based on evidence!

  11. Steven Novellaon 06 Jun 2008 at 12:40 pm

    Fifi wrote: “It’s pretty obvious that if supplement manufacturers can influence the government to pass laws that don’t take into account public safety then so can hugely powerful and wealthy corporations of any nature. I’m not sure why anyone would trust politicians in one area and then not the other! Now that sounds like a trust bias that’s not based on evidence!”

    I’m not sure what you are referring to here. There is no trust bias – it all should be properly regulated. It’s just a fact that DSHEA has de-regulated supplements to the favor of industry and detriment of public health.

    Historically the sexism and racism of our society and culture were reflected in medicine as well. As sexism and racism decline, they decline in medicine also. I don’t think anyone disputes that. If anything, science and academia has been ahead of the curve on such things – not a reason to generally distrust science.

    Right now there are more women than men in medical schools, and in 20 years female doctors will outnumber male doctors.

  12. deciuson 06 Jun 2008 at 12:46 pm

    Fifi,

    watch out for the genetic fallacy.

    It is true that corporate interests have in many cases trampled over public health and -generally speaking- I share many of your concerns. However, the issue at hand has to be addressed on the basis of the empirical data available. Since many independent and state-funded studies have already been carried out, we are faced with a scenario that differs drastically from -say- one where a pharmaceutical company is attempting to push on the market a dubious product by concealing part of the relevant research.

  13. Fifion 06 Jun 2008 at 12:53 pm

    I entirely agree about good research but as is often discussed here not all research is good research. It’s also foolish to ignore the cultural biases that have historically influenced medicine and research. To do so is to simply become the other side of the good/evil medicine coin which totally ignores the real life complexity in favor of fantasy. Clearly that’s the antithesis of what this blog intends to do so I think it’s just as important to point out when someone on the pro-EBM side says something ignorant or disparages people as being stupid when their concerns are not at all stupid or “hysterical”. After all, corporations routinely suppress science that doesn’t serve their commercial purpose….as has been discussed here.

  14. Steven Novellaon 06 Jun 2008 at 1:01 pm

    But, Fifi, there is no credible evidence that that has happened IN THIS CASE. There have been many independent studies that collectively very reliably show no link between autism and vaccines.

    The epidemiological data (the same data used to initially claim a link) shows no change after removal of thimerosal. There are no corporations involved in this data – it’s in the public record.

    McCarthy’s chemical illiteracy is not a matter of anyone’s greed – or even having to believe anyone. The ingredients are listed – it is simply a propaganda lie that vaccines contain “ether” or “antifreeze.”

    “Too many too soon” is made-up and scientifically flawed.

    My problem with your comment is that you are applying it in this specific case when there is no application to any of the specific criticisms I leveled at Carrey and McCarthy. It is an attempt on your part, in my opinion, to poison the well with a vague and broad brushstroke about corporate malfeasance and sexism in medicine, etc.

    I supported my position with detailed points referring to not only this specific claim but these specific people. You should do the same.

  15. deciuson 06 Jun 2008 at 1:07 pm

    Yeah, Steve, but I spotted the logical fallacy first. :-)

  16. Fifion 06 Jun 2008 at 1:09 pm

    decius – I wasn’t discussing autism here, just responding to DavidCT

    “Sadly this has become a public relations issue. Being right scientifically is not enough. Being right on the science was not enough to save Dow Corning from financial disaster once “toxins” from breast implants became a “woman’s issue”.”

    I found this dismissive and seemingly ignorant of why women may have been suspicious of Dow. (Or why people of colour in the US may have their fears that seem irrational but aren’t actually if one looks historically at some of the “experiments” carried out on Black and poor people.) The multinational corporations that create and sell pharmaceutical and chemicals are just as involved in the public relations aspects of any of these kinds of issues – and into making them into media circuses.

    My point about “trust bias” is that corporations of all kinds throw money at government to try to minimize the costs and their liability, and maximize their influence and to think that the pharmaceutical industry – despite the laws on the books they don’t always follow – is no less profit driven or ethical. DavidCT seems to have a trust bias to me.

  17. Fifion 06 Jun 2008 at 1:52 pm

    And obviously my bias leans towards not trusting corporations or government to be unbiased or outside of the influence of all kinds of well shod interests ;-) Government isn’t exactly the friend of science or EBM, particularly in the US!

  18. Fifion 06 Jun 2008 at 2:33 pm

    Dr Novella – Yes but I wasn’t talking about or responding to this particular case and DavidCT was talking about another case. Really, you’re singing to the choir about autism and I have no desire to “poison the well” (though I must say that analogy is a bit close to drinking the kool-aid to me to swallow comfortably) or confuse the issue regarding autism.

    I’m slightly saddened and disappointed that you perceive my response and bringing up these issues to be some form of trolling or an attempt to poison your well when I wasn’t even the one who threw the other examples into the well to begin with.

  19. Fifion 06 Jun 2008 at 2:39 pm

    You’re also ascribing to me a position on autism I don’t hold.

  20. DevilsAdvocateon 06 Jun 2008 at 3:02 pm

    How wonderful it’s been to be a male without color. Nobody ever screws us.

  21. Fifion 06 Jun 2008 at 3:11 pm

    That’s not what I said DevilsAdvocate, poor white men get screwed too (they’d be part of the poor I mentioned, traditionally used in the system as cannon and factory fodder). However they haven’t had to contend with quite as much institutionalized and legally sanctioned prejudice as women.

  22. Fifion 06 Jun 2008 at 3:14 pm

    As a white woman who had access to education, proper nutrition and of having the good luck to be born who I am and in the position I was born in, I recognize and understand the my own privilege.

  23. DevilsAdvocateon 06 Jun 2008 at 3:22 pm

    If we extrapolate your premise – that any agency or entity who has behaved unethically before ought never be trusted again – I’d have to wonder whom you do trust, since virtually every such agency or entity has behaved thus at some point. I can’t speak for the rest of posters here, but to me you appear to be reiterating a redundancy, and off-point as well.

    Dr. Novella has asked.. well, I just C&P what he posted:

    “I supported my position with detailed points referring to not only this specific claim but these specific people. You should do the same.”

    With all due respect, I could do without your history lessons, coming down, as they seem to, from the mountaintop of Righteous Indignation, shared with us I guess because you think us unaware of it all. It’s more than a bit insulting. Were you aware that black people were once enslaved in America? No, really. (Sort of like that).

    Do you have anything specific, as Dr. Novella asked?

  24. Eximious Joneson 06 Jun 2008 at 3:29 pm

    I guess I’d like to know how pharmaceutical products should be researched, manufactured and sold — if not by corporations then by what? Limited partnerships? Even if the shares of all such firms were, by law, privately-held how would that improve anyone’s trust in corporations? Just what sort of organization or business entity should these companies be? Dr. Novella has already noted that, in the U.S., these firms and their products are heavily regulated. I’m not sure what else can be done on the corporation front, here. To have such a broad distrust of all corporations isn’t very different from the mindset of these misguided celebrities. We have government agencies here whose function is to keep a tight grip on these companies. It’s not perfect, but I’m not sure what alternative there is.

  25. Fifion 06 Jun 2008 at 3:36 pm

    Devil – I’m not disputing Dr Novella’s position on autism. How many times do I have to say this (apparently over and over again). Clearly not everyone here is up on their history and considering your “white guys have it rough too” comment apparently you aren’t either and don’t particularly acknowledge (or perhaps just can’t see) some of the prejudices within our social systems. If you think that racism and sexism no longer exist, you’re clearly living in an ivory tower. That said, these things are changing and people who do practice EBM no longer consider homosexuality an illness or choice and so on. My comments are no more insulting that David’s were but I guess you didn’t notice.

    I don’t see the point of pointing out the historical sexism and racism within medicine if as you say you’re already aware of it. Racism in medicine may have its roots in slavery but it certainly lasted in to much more recent history, as has sexism. You’re only personally responsible if you’re perpetuating it so there’s no need to be a defensive white guy unless you are.

  26. Steven Novellaon 06 Jun 2008 at 3:37 pm

    Fifi,

    Sorry if I confused your response as to my blog entry rather than another comment.

    I am not ascribing any position regarding autism to you nor have I questions your dedication to EBM.

    My real point is that references to past bad behavior of an entity like the government or industry is problematic – the people, culture, and laws are all different now.

    I agree that we should be skeptical (as you might imagine) and really it comes back to my original point – in the end all that matters is the science. Whether or now implants caused inflammatory disease does not at all depend on how women have been treated historically by male dominated institutions – it depends entirely on the scientific evidence.

    But I get you point – that it does explain why women may have distrusted the institutions that were relaying the science. That’s fair- to a point. Clearly in this case they were wrong and the institutions were right – the science has born that out. Again it gets back to the need to look carefully at the science and not let emotional arguments – even ones that have a point – color your conclusions.

  27. Fifion 06 Jun 2008 at 3:51 pm

    “I agree that we should be skeptical (as you might imagine) and really it comes back to my original point – in the end all that matters is the science. Whether or now implants caused inflammatory disease does not at all depend on how women have been treated historically by male dominated institutions – it depends entirely on the scientific evidence.

    But I get you point – that it does explain why women may have distrusted the institutions that were relaying the science. That’s fair- to a point. Clearly in this case they were wrong and the institutions were right – the science has born that out. Again it gets back to the need to look carefully at the science and not let emotional arguments – even ones that have a point – color your conclusions.”

    I agree entirely and I appreciate that you understand my point. I’m just trying to point out that sometimes people aren’t aware of the emotional or cultural bias they themselves bring to the table (as David seemed to be doing to me). Personally I’m quite surprised by some of the reactions to my initial post which seem to me to themselves to be coloured by emotion and leaping to all kinds of conclusions.

  28. Steven Novellaon 06 Jun 2008 at 4:08 pm

    The trigger finger is probably very sensitive on such blog posts as they typically rapidly become the target of antivaccinationists who, either subtly or clumsily, start throwing around conspiracy theories and using every dirty tactic or logical fallacy in the book. It tends to put everyone on “high alert.”

    This is a negative aspect of trolls – they make everyone else keep one eye out for troll-like behavior and then perhaps pounce too aggressively.

    In David’s defense I think you may have read too much into his original post. He never called anyone hysterical nor was he dismissive. He made a valid point – these issues were politicized in a way that trumped the science. Therefore an epidemiological question became a political issue about sexism. With vaccines and autism the science is being subverted, and the anti-scientific ideologues are trying to grab the PR high ground by saying they are all about protecting children. They’re not.

  29. Fred Cunninghamon 06 Jun 2008 at 4:10 pm

    A recent report on Medscape indicated a possible link between some cases of autism and shampoos containing pyrethrins. At this point there doesn’t appear to be enough evidence to end the war on cooties. Have any of the autism crowd picked up on this?

  30. Fifion 06 Jun 2008 at 4:39 pm

    Dr Novella – I do understand that people are defensive about these issues – and perhaps I was being defensive and this led to possibly misunderstanding DavidCT. It’s quite possible, I don’t harbor any illusions that I uniquely amongst humans am completely objective :-)

    I agree that issues of this kind become highly politicized and a media circus and the facts can get lost in people emotionally defending their territory and not listening to each other. However, if one desires to reach the general public then it’s worthwhile understanding why people hold certain beliefs rather than dismissing them as being irrational. I found putting “women’s issue” in quotation marks to be odd and the equating of women’s concerns as being the same as the interests of the anti-vaccination industry (which has a commercial agenda at the base even if it’s rolled out as activism) to be misguided (at best, dismissive at worst).

  31. deciuson 06 Jun 2008 at 5:01 pm

    If that were the case, the prediction could be made that among rasta people (at least in parts of Jamaica) there should be no case of autism. As I learned during a lengthy stay in the island, they unanimously shun shampoo in favour of hemp soap or other herbal cleaning agents.

  32. deciuson 06 Jun 2008 at 5:11 pm

    P.S.
    Fifi is no troll, that’s for sure.

  33. Fifion 06 Jun 2008 at 5:50 pm

    My apologies for diverting the focus of the thread. Quite honestly I didn’t think my comment would be such a big deal and I probably should have just refrained from posting on a busy day when I was distracted and not as thoughtful as I could have been.

  34. DevilsAdvocateon 06 Jun 2008 at 5:52 pm

    Of course Fifi is no troll, but I do tire of her repeating what is obvious to decent people with a modicum of education and/or intelligence, that sexism and racism continue.

    I wonder if she does not see that, in essence, she is playing social politics with these lectures to the choir on misogyny and racism.

  35. deciuson 06 Jun 2008 at 7:20 pm

    I think this bit of ado for nothing highlights the need for us who are aficionados to this most enlightening blog to get to know each other better, as to avoid misunderstandings of this slightly paranoid nature, which Steve perfectly described as “status of high alert”.

    Time should be enough in the long run, but perhaps we could find a more expeditious way, like introducing and describing ourselves or having the possibility to make one’s profile public.

  36. daedalus2uon 06 Jun 2008 at 7:38 pm

    It is unfortunate, but Fifi does have an excellent point. There is a persistent and pervasive anti-female bias in many human cultures; in just about every culture that I know enough about to be able to make a judgment. It is disturbingly high in every place it has been looked at.

    http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2005/06/28/000112742_20050628084339/Rendered/PDF/wps3618.pdf

    So much so that it is not an unreasonable default assumption to make that there is anti-female bias. Dr Novella is correct, as sexism and racism decline in the culture, it will decline in medicine too.

    This happens to remind me of a post I recently made elsewhere on the OJ Simpson verdict. I heard this from a commentator relating a conversation he had with Jimmy Carter a few days before the verdict. The commentator was worried about the violence that was likely when Simpson would be found guilty and Carter corrected him that OJ was going to be found innocent; saying that so many innocent black men have been convicted and executed that this jury will find him innocent. It was a backlash against the clear and obvious racism, bigotry, abuse and injustice that was pervasive in the LA police department and which was pervasive in US society for so long.

    I think the not guilty verdict sent shock-waves through the LA police department and brought about changes that never would have happened if OJ had been found guilty. I don’t think that anyone had this as a conscious plan, but the OJ verdict probably did more to clean up the racism and discrimination in the justice system than a hundred well-meaning anti-racism activists could have done. It sent the very clear signal that business as usual wasn’t an option. That people in power (i.e. rich, law abiding mostly non-racist whites) had more to lose by tolerating the racist justice system status quo than by making the justice system non-racist.

    When “scientific sounding” arguments have been used to promote racism and sexism, it is not unreasonable for a skeptic (or people who believe themselves to be skeptics) to take those traditional cultural practices into account. Actual data always trumps inferences but when people don’t have access to the data or don’t understand the data those people can be manipulated to believe the bias or the reverse bias and not the facts. I think that is what killed Dow Corning. Not that Dow Corning had done anything wrong, but there were a lot of bad practices by the chemical industry. A lot of what got dumped on the chemical industry was really done by government, but the government has the ability to give itself immunity.

    Anti-big pharma bias is exactly what the anti-vaxers are trying to foment. Why; because they want to win. They can’t win on the facts, or on the logic, so they will win by getting the government to do what they want. How did the supplement industry get what it wanted? Not through facts and logic and controlled studies. They got it the old fashioned way by bribing politicians with campaign contributions and becoming politically active. The same way the Creationists are getting what they want.

    The recent dropping of charges in the Roy Kerry case

    http://www.theness.com/neurologicablog/?p=290

    may be (perceived to be) similar. There is the perception (true or not) that MDs won’t criticize other MDs. That incompetent MDs are allowed to continue to practice out of a sense of “professional courtesy”. I think some of the problem with that prosecution stemmed from high level politically active medical professionals declaring it to be a case of drug misidentification.

    I am not sure if all of these ideas actually hold together as a coherent comment. Desperate people do desperate things and don’t always behave rationally or in their best interests. They do things like drink the Kool-Aid (or Flavor Aid as in the Jonestown incident). It is unreasonable to expect desperate people to behave rationally. A desperate irrational mindset is exactly what many quacks, politicians, lawyers and every other non-scientist/non-skeptic tries to invoke in their opponents/collaborators.

  37. BAon 06 Jun 2008 at 9:33 pm

    DA: extinction of responding is often effective.

  38. superdaveon 06 Jun 2008 at 10:14 pm

    Orac, I have two degrees in biomedical engineering and I am getting a third…I really hope this “biomedical movement” you are referring is not going to be confused with real science and engineers who use a very similar term.

  39. Lonnie123on 07 Jun 2008 at 1:01 am

    Superbly written article Dr N. One might say that when it comes to Jenny and Jim, you should point a finger and yell “Liar Liar”

    I’ll save the laundry list of puns that could come out of his movie list (and her rap sheet as well), but suffice it to say that it is getting hard to stomach all of this stuff.

    The Larry King video was great in that it showed the MD’s know what they are talking about, and McCarthy is relying almost solely on “Mommy Instinct” and a smug grin about how doctors dont know anything. If only we could have seen the first 30 seconds of the show where she rode in on her white horse.

  40. Oracon 07 Jun 2008 at 12:10 pm

    Orac, I have two degrees in biomedical engineering and I am getting a third…I really hope this “biomedical movement” you are referring is not going to be confused with real science and engineers who use a very similar term.

    What can I say? That’s what the parents who think that using diet, chelation therapy, hyperbaric oxygen, etc. can cure autism are often called and sometimes call themselves.

  41. mr con 07 Jun 2008 at 2:14 pm

    http://home.iae.nl/users/lightnet/health/scheibner.htm

    SIDS and vaccines.

    Autism and vaccines.

    (NOY written by a celebrity)

  42. mr con 07 Jun 2008 at 2:14 pm

    not

  43. HCNon 08 Jun 2008 at 1:58 pm

    Third try:

    Viera Schneibner is a geologist, she has no medical training. Her efforts to pin SIDS not on child beaters but on vaccines is repugnant. In 1997 she was awarded the Bent Spoon Award by the Australian Skeptics. Here is (if it makes it this time, I am going to mung the URL) their report on her, vaccines and SIDS:
    skeptics.com.au/journal/1997/1_immunise. htm

  44. Oracon 08 Jun 2008 at 10:21 pm

    Indeed. One of the absolute vilest things any antivaccinationist has ever done is to attempt to claim that shaken baby syndrome doesn’t exist but rather is a misdiagnosis for vaccine injury. They even went so far as to try to use this argument to set a baby killing child abuser free.

  45. [...] as disingenuous as it gets. Like Steve Novella, I have no doubt that Jenny McCarthy and Jim Carrey mean well, but I agree that it’s not enough to mean well. There’s a famous saying that the road [...]

  46. Fifion 09 Jun 2008 at 9:45 am

    I’d like to apologize to anyone who finds this subject boring or a distraction from Dr Novella’s blog post. However, I’m bringing this up since part of what Dr Novell’s post is about is communication and it seems relevant.

    Devil – If I was preaching to the choir I’d be hearing an “amen” not being told I was stupid and it was personally insulting to you for me to bring up sexism or racism (or homophobia for that matter, or do you also believe that no MDs are homophobic now that EBM has shown homosexuality isn’t an illness or immoral choice?). Particularly since there seems to be some idea being floated that racism ended when slavery did (or sexism ended when women got the vote). It would be wonderful if everyone let go of their deep seated prejudices when science proved them to be baseless but this is no more true of doctors than it is of the general public. Things ARE changing as the prejudices have been acknowledged and confronted (and as more of the people in question become involved in the institutions in question).

    I guess it comes down to our motivation for engaging here… If the motivation for reading and engaging regarding the topics discussed on this blog is to be able to discuss EBM and create understanding and reach the general public, then I’d think it would be worth listening and not dismissing something that is outside of one’s personal experience. If the motivation is just to make oneself feel superior, then just dismissing anything that doesn’t conform to the vision of superiority and righteousness that one holds and dismissing the concerns of others is the way to go. (This seems exactly the same kind of mindset that allows pseudoscience and woo to flourish to me – because it’s the same mindset of those who believe in and/or sell woo and also because it alienates those who are being insulted so prevents communication.)

    My motivation to participate here comes out of a variety of sources but one is that I see the miscommunication that goes on that does not serve EBM OR the general public well. I grew up around medicine and research and I work in communications and the arts (as a journalist, in PR and as an artist, and have also worked in a pain clinic) so my perspective is perhaps somewhat different than those immersed in practicing or teaching medicine (or engaged in research, though I have quite a few friends who are researchers so I’m not blind or deaf to their concerns and experiences). I make no claim to be an expert in EBM and am quite willing to admit when something is beyond the scope of my knowledge. That said I am probably more informed regarding the inner workings of advertising and media, and the history of propaganda, than many here. I was hoping to be able to contribute here (as well as learn) simply because I can see why the people around me and the general public tend to be so misinformed and I had hoped to make a small contribution to being part of a solution. Of course, it’s much easier to just dismiss people with differing perspectives as stupid or perhaps even “hysterical”.

    I assume that the majority of people who engage here regularly have good intentions (except for the obvious exceptions), just as McCarthy and Carrey probably have good intentions. As has already been noted, good intentions don’t always pave a road that takes us in the direction of our desired results and this is as true of people engaged in science and EBM as it is of those who fall prey to woo.

  47. daedalus2uon 09 Jun 2008 at 7:09 pm

    As a member of the choir let me shout out Amen and Hallelujah sister! ;)

    Understanding how one arrives at understanding are the most difficult things to understand. Very often people generate arguments and rationalizations post hoc for beliefs they arrived at quite non-scientifically.

    Fifi, I think you have a valuable contribution to make here, precisely because of your understanding of “other ways of learning”. I am not using the term “other ways of learning” in the pejorative sense that many in the EBM community use it, nor am I using it in defense of any woo-based practices. The fact is that virtually all people arrive at virtually everything they “know” by means other than science and evidence based methods.

    The anti-vaxers didn’t arrive at their beliefs by looking at reliable facts and deriving logical inferences from those facts. There is simply no way that they will abandon those beliefs via facts and logic.

    People arrive at beliefs by a variety of methods, often by being taught them by someone trusted, a parent, a friend, a teacher, a member of the clergy. Those beliefs are then very difficult for the individual to change even when they are wrong. A shared belief system produces a sense of community, a community that is lost if that belief is abandoned. One has to abandon not just the belief but the community that is defined by that belief.

    It is the essence of marketing to bring people to believe something without a chain of facts and logic. Sometimes the belief is of minor importance, such as whether a beer tastes great or is less filling. Some fads in science are like this, not based on facts and logic but on hype. The lobotomy for example.

    Even people who consider themselves scientists have beliefs that they consider to be “scientific” that were not arrived at through facts and logic. An example I like to use is the myth of homeostasis. An idea which is virtually universally believed but which has no theory or data to support it (because it is actually wrong); an idea which scientists who believe in it can’t talk about because it causes them cognitive dissonance.

    I think it is important to understand how people arrived at beliefs other than through facts and logic because only when those processes are able to be examined can the real and underlying motivations be understood. It is easy to see errors other people are committing it is much more difficult to see our own.

    As Fifi mentions, there is a tremendous inventory of unrighted wrongs that people feel have been inflicted on them. These perceived wrongs are easily co-opted by “leaders” and used to rationalize animosity toward a group. We saw this recently in the movie “Expelled” blaming the Holocaust on scientists and Evolution and in the blaming of 9/11 on Iraq. A strategy of many “leaders” is not to right those wrongs, but to use the anger and desperation created by them, to channel that desperation into achieving the “leader’s” goals. That can be the start of the descent into fascism as discussed in Naomi Wolf’s ten steps to fascism. Desperate people do desperate things, crazy things, things they would never do had they been non-desperate.

    I think a necessary part of the advancement of the EBM and SBM agenda is to reduce the amount of desperation in society. I think that is a large part of what I consider to be the “liberal” agenda. That is a large part of what I think is important to maintain any kind of civil society.

  48. massimoon 09 Jun 2008 at 10:20 pm

    I would like to read your comments again sometime fifi. what a lame misunderstanding.

    I’m just gonna lay back now and bang some mercury-tainted hypos into the back of my knee to get high the way only the autistic can get high.

  49. badrabbion 10 Jun 2008 at 11:38 am

    It is clear that FDA approval process of drugs, including vaccines, is comprehensive. But it is also clear that many medications prove to have untoward side effect that FDA trials have not properly vetted.

    So it is common for drugs to show evidence of untoward and unknown toxicity after their approval by the FDA.

    So now some mothers are coming forward and pointing out that their children are getting sick following vaccination. These mothers do not know what in a vaccine is causing this, or even that it is a vaccine. They are making a temporal observation. They call it, as Dr. Novella cynically pointed out “mommy instinct”.

    I agree that celebrities, with their stupidly simplistic interpretation of science, tend to complicate the issue. At the same time, it appears (and I have not researched the subject, but I am commenting on appearances) that the science has not been work out either.

    It seems to me that incidences of Autism must be compared with a population of vaccinated versus vaccine naive population. Obviously the latter control group must be in every other way similar to the vaccinated group.

    It seems to me that the only way to do this is to have a prospective randomized study in the US, comparing the incidence of Autism amongst vaccinated and unvaccinated children. The latter study would not be unethical as the unvaccinated group would be protected by herd immunity. Also, the study should not take too long to complete, as the hypothesis of development of autism following vaccination stipulates that that autism occurs within months or short years following vaccination.

    If such a study has not be done, then by “motherly instinct” it should be done!

  50. HCNon 10 Jun 2008 at 12:25 pm

    badrabbi said “It seems to me that incidences of Autism must be compared with a population of vaccinated versus vaccine naive population. Obviously the latter control group must be in every other way similar to the vaccinated group.”

    There have been lots of epidiological studies of that sort done in several countries that have not seen any real evidence that vaccines cause autism. Some of them:

    Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links with Immunizations
    Authors: Fombonne E, Zakarian R, Bennett A, Meng L, McLean-Heywood D
    Source: Pediatrics, July 2006, Vol. 118(1):e139-e150

    The Incidence of Autism in Olmsted County, Minnesota, 1976-1997
    Authors: Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Jacobsen SJ
    Source: Archives of Pediatric and Adolescent Medicine, January 2005, Vol. 159(1):37-44

    No Effect of MMR Withdrawal on the Incidence of Autism: A Total Population Study
    Authors: Honda H, Shimizu Y, Rutter M
    Source: Journal of Child Psychology & Psychiatry, Online Early Release

    Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta
    Authors: DeStefano F, Bhasin TK, Thompson WW, Yeargin-Allsopp M, Boyle C
    Source: Pediatrics, February 2004, Vol. 113(2):259-266

    Association Between Thimerosal-Containing Vaccine and Autism
    Authors: Hviid A, Stellfeld M, Wohlfahrt J, Melbye M
    Source: Journal of the American Medical Association, October 1, 2003, Vol. 290(13):1763-6

    Thimerosal and the Occurrence of Autism: Negative Ecological Evidence from Danish Population-Based Data
    Authors: Madsen KM, Lauritsen MB, Pedersen CB, et al
    Source: Pediatrics, Sept. 2003, Vol. 112(3 Pt 1):604-606

    Prevalence of Autism and Parentally Reported Triggers in a North East London Population
    Authors: Lingam R, Simmons A, Andrews N, et al
    Source: Archives of Disease in Childhood, August 2003, Vol. 88(8):666-670

    A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism
    Authors: Madsen KM, Hviid A, Vestergaard M, et al
    Source: New England Journal of Medicine, November 7, 2002, Vol. 347(19):1477-1482

    And there is a review of some of the literature here:
    http://pediatrics.aappublications.org/cgi/content/full/114/3/793

  51. daedalus2uon 10 Jun 2008 at 12:38 pm

    badrabbi, the study would be unethical. It would violate the declaration of Helsinki.

    http://www.wma.net/e/policy/b3.htm

    Those in the placebo side of the study are receiving no benefit by being in the study, only risk of harm.

    What would you use as the placebo vaccine? Vaccine without antigen but with aluminum? If there was no immune response, it would be easy to tell who was vaccine and who was placebo.

    How many cases of autism in each group would be enough to have good statistics? How big does each group have to be in that case? At a cost of a few thousand per participant, the cost of the trial becomes quite large.

  52. badrabbion 10 Jun 2008 at 8:32 pm

    HCN; Thank you, I will check the studies and get back to you.

    Daedalus2u; I do not think that the study would be unethical. The benefit to the control group may be the possibility of being spared a complication. The placebo can be a subQ saline injection. If there was no immune response, only a antibody titer can determine who got the vaccine and who did not. We would not expect the naive vaccinated subjects to develop infectious disease as they would be protected by herd immunity. As for the statistics, I would assume that a statistician would have to stipulate an apriori null hypothesis. So, we would assume that taking the vaccine makes it, say 30% more likely to develop Autism. If so, the statistician would have to determine the number of patients who would need to be enrolled in order to detect a 30% difference as being statistically significant. These kinds of studies go on all the time in clinical medicine. What’s the issue?

  53. HCNon 10 Jun 2008 at 9:55 pm

    The issue is that we already know that the MMR, the Hib, the IPV, and the DTaP protect from some very nasty diseases. If you decide that to just satisfy the curiosity of some people who do not understand the science to do a study where a large chunk of children are not protected from measles, mumps, Hib, pertussis, tetanus and others… You are denying those children protection, and if they do not know that, it is unethical.

    Then compare that kind of study with research like this:
    http://archpedi.ama-assn.org/cgi/content/full/160/3/302

    With measles being so easily transmitted (one child coming back from Switzerland caused an outbreak of at least 11 more cases!, three of them babies too young to be vaccinated), it would not be ethical to withhold medical protection.

  54. HCNon 10 Jun 2008 at 10:05 pm

    “We would not expect the naive vaccinated subjects to develop infectious disease as they would be protected by herd immunity.”

    If a bunch are NOT vaccinate, then herd immunity has been eroded. It has been eroded enough that about dozen babies each year die from pertussis, and outbreaks of diseases to occur. Plus there is no such thing as herd immunity with tetanus.

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