May 09 2017

More Anti-Vaccine Pseudoscience

ObukhanychAnti-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.

The False Argument from Authority

It is perfectly legitimate to refer to an actual consensus or even predominance of expert opinion, which is adequately based on evidence, as a reason for holding an opinion. I will listen to what most physicists who work in quantum mechanics have to say about the quantum wavelength and what the real implications of the double-slit experiments are. If you want to disagree with the experts, you seriously better show your work.

Scientific authority, however, never rests in a single individual, because individuals can have quirky opinions.

Further, it is common to exaggerate the credentials of an alleged expert when you want to use them as an authority to promote an ideological opinion. That’s propaganda 101.

Obukhanych is promoted as a Harvard trained PhD immunologist. Superficially this sounds like she is an authority on vaccines. However, a more thorough look at her academic history tells a different story. Skeptical Raptor did a thorough investigation and found that Obukhanych seemed to be little more than a post-doc. She is listed on 10 scientific publications, only one as first author, none as corresponding author, and none on vaccines specifically. She does not appear to have any current academic affiliations.

I also have to point out that basic science researchers do not necessarily have a good working knowledge of clinical science or clinical practice. That is a common source of “crankery” – either clinicians who do not understand basic science, or basic scientists who do not understand the science and practice of medicine.

None of this means that her opinions are wrong. They need to be taken for their inherent value. What it does mean is that it is misleading to promote her as an authority.

We also have another way of assessing her immunology chops. She wrote a book,  Vaccine Illusion: How Vaccination Compromises Our Natural Immunity and What We Can Do To Regain Our Health. She self-published this book on Kindle, which likely means she could not find a publisher interested in it.

Harriet Hall has already done a thorough deconstruction of the book, which reveals a number of things. Obukhanych doesn’t really have a good grasp of immunology, and/or is a horrible science communicator. As Harriet points out, this is her definition of immunology:

“…a science that studies an artificial process of immunization – i.e., the immune system’s response to injected foreign matter. Immunology does not attempt to study and therefore cannot provide understanding of natural diseases and immunity that follows them.”

This is pure nonsense. Immunology studies all aspects of the immune system and how it responds to a number of challenges, from infection to foreign bodies to tissue transplantation. Her definition seems distorted specifically to create the false premise that immunologists study vaccines but not natural immunity resulting from disease.

This, in my opinion, makes Obukhanych a crank, that she is willing to distort the science to that degree in order to promote an ideology. Read Harriet’s review to see how much utter nonsense and pseudoscience fills her self-published rant.

Cherry Picking and Logical Fallacies

Obukhanych tries to build a case for the position that vaccines are not that useful, vaccine refusal is a reasonable position, and not getting vaccinated is not a threat to the public health. To say that her arguments are not compelling would be an understatement.

In her recent article she claims:

People who have not received the vaccines mentioned below pose no higher threat to the general public than those who have, implying that discrimination against non-immunized children in a public school setting may not be warranted.

This is both wrong and misleading. She refers to the inactivated poliovirus vaccine, tetanus, and Hepatitis B. Let’s take tetanus first, for at least with this one the basic claim that tetanus is not a communicable disease is correct. The purpose of the vaccine is to prevent serious illness when contracting tetanus from a puncture wound. This vaccine is not intended to prevent community spread, so pointing out that it doesn’t is pointless.

Most importantly, this says absolutely nothing about the vaccines that are designed to prevent community spread. This is like saying, you know seat belts do not prevent crashes. I don’t see why regulations require seat belts when they do not lower the risk of getting in a crash or protect other people on the road.

Her claim about the IPV is simply wrong. Using only this vaccine you can eliminate polio from a population. Using this and the other polio vaccines we are on the brink of eradicating polio from the world. We would have done so already if not for anti-vaccine fearmongering.

She also misses the point on Hep B. This is a blood-borne illness, so you can’t catch it from casual contact. You can spread it through small cuts, sexual contact, mother to child, and through sharing needles. So having immunity does limit its spread. The reason we give it to babies is because they are vulnerable, if they contract it they are almost guaranteed to have lifelong health consequences, and vaccinations have reduce child infections by 82%.

She then talks about the “measles paradox” and completely misinterprets its implications.

Measles research scientists have for a long time been aware of the “measles paradox.” I quote from the article by Poland & Jacobson (1994) “Failure to Reach the Goal of Measles Elimination: Apparent Paradox of Measles Infections in Immunized Persons.” Arch Intern Med 154:1815-1820: “The apparent paradox is that as measles immunization rates rise to high levels in a population, measles becomes a disease of immunized persons.”

This is a common anti-vaccine trope. The notion is that in a highly vaccinated population, most people who contract measles were vaccinated. This is a great example of misusing statistics, or just pure innumeracy. The non-responder rate for the measles vaccine is about 5%. So if a population is mostly vaccinated, there can be more non-responders than unvaccinated. Therefore there will be more infections among the vaccinated.

This is entirely the wrong way to look at the numbers, however. What you really want to know is the relative risk of becoming infected between vaccinated and unvaccinated, and the data is clear that being unvaccinated carries a dramatically increased risk of being infected with measles.

Further, her analysis ignores herd immunity. An outbreak will be limited and won’t spread if most of the population is immune. The unvaccinated reduce the percentage of the population that are immune, and below some point (around 90-95%) herd immunity is not sufficient to prevent a large outbreak.

Herd immunity also stops infections like measles from becoming endemic, meaning that they are always in the population just moving around from outbreak to outbreak. We eliminated endemic measles in the US through vaccines, but it has not been eradicated from the world and so can continue to be imported. If vaccine refusal climes, however, it can become endemic again.

Obukhanych does not give a thorough analysis of vaccine epidemiology, but rather cherry picks only those bits of information that she can use to create a false impression that serves her anti-vaccine ideology.

She further tries to argue that vaccines are riskier than claimed. She cherry picks one Ontario an misinterprets it:

It is often stated that vaccination rarely leads to serious adverse events. Unfortunately, this statement is not supported by science. A recent study done in Ontario, Canada, established that vaccination actually leads to an emergency room visit for 1 in 168 children following their 12-month vaccination appointment and for 1 in 730 children following their 18-month vaccination appointment (see appendix for a scientific study, Item #5).

Here is the study. There was an increase in ER visit, but not in hospitalizations. The increase in ER visit was mostly due to a viral rash, which is not a serious adverse event. There was also an increase in febrile seizures, 20 per 100,000 children vaccinated. Febrile seizures are a self-limiting condition, and weren’t serious enough to warrant hospitalization.

She also ignores benefit in her argument. These were increases right after vaccination, but medical interventions are judged based upon risk vs benefit, so have to also consider how many ER and hospital visits were prevented by vaccines preventing infectious disease.

Conclusion

Obukhanych appears to be the perfect storm of anti-vaccine pseudoscience. She has superficially impressive but ultimately thin credentials, and she makes what sounds like a scientific argument but to anyone with any real knowledge of vaccines or immunology they are cherry picked, logically-challenged, and misleading.

She is likely to be a permanent fixture in the anti-vaccine movement, however, because she is exactly what they want – an anti-vaccine crank to lend the illusion of credibility to their propaganda.

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