Monthly Archives: March, 2014

International Vaccine Terrorists

The United States suffers from a well funded celebrity supported anti-vaccine terror campaign. This campaign commonly using internet based media to disseminate fear. Most objections to vaccines are pseudo-scientific fabrications, deceptions or magnification of known problems. Anti-vaccine proponents use internet media to disseminate cherry picked evidence, statistical manipulation, and occasionally outright deception. The overriding theme is fear. Purposeful fear for the express purpose of minimizing or dismissing evidence that does not conform to their world view. Fear mongering that is inaccurate, false, or infers hyper-inflated concerns about vaccines. It is a methodological attack to blunt the message that vaccines have clear benefit and few dangers. The most effective methods are emotional narratives and massaged statistics.

I would call anti-vaccine writings and publications a terror campaign. A terror operation that is expressly designed to provoke a fear response. Anyone that attempts to point out the facts is immediately dismissed as a big pharma shill, corporate apologist or government disinformation agent. In the general media there has been a small amount of push back against this disinformation. Still I see regression of vaccination rates in the United States and elsewhere. The US states Kansas and Alaska lead for overall poor vaccination rates but the numbers are stable. California and Washington are states that have lost the most ground (percentage wise).  Other countries have experienced decline in vaccination rates as well. Countries that suffered outbreaks like Australia and Great Britain. I thought Canada seemed to be exempt until I came across data showing a measles outbreak in Canada.

There has been a significant decline in Canadian vaccination rates. Especially in British Columbia. Recently 200 cases of measles in British Columbia. The combination of declining vaccination rates and disease outbreaks demonstrate the negative impact of Anti-Vaccine propaganda in Canada. Fear(even fabricated untrue fear) is a powerful motivator.

It Should be noted that below are some images that people may find slightly disturbing proceed at your own discretion.

The prolific writings of well known anti-vaccine crank Joel Lord has been instrumental in British Columbia. He is the leader of a disinformation campaign based in Vancouver Canada. The group that he leads calls themselves the “Vaccine Resistance Network” or VRM. Joel Lord runs the VRM website from his home.

The VRM mission statement.

“a grass roots, non-profit organization striving to empower communities around the world with the means of self sufficiency, while determined to expose vaccine fraud & pharmaceutical industry malfeasance.”

VRM does “research” at least what they call research-VRM Study

Real research has to be scientific in structure to actually answer any question. Calling something research does not make it so. VRM is looking for known autism cases to determine if vaccines cause autism. Case studies are research starters not a method to determine answers. Plus this question has been answered. Answered by very rigorous scientific methods. Vaccines don’t cause autism period, the end. Despite constant medical monitoring, well structured research, and 20 years of evaluation, there is no credible evidence of autism being cause by vaccines.

Well structured analyses show that unvaccinated children have exactly the same incidence of autism that vaccinated children do. For ideologues facts are irrelevant or lies. So VRM goes forward with “research” in an attempt to confirm what they already know to be true. That is not science that is self confirmation. Plus case studies can provide compelling narratives. Narratives that can be twisted confirm an  overall narrative of government/big pharma conspiracy. Case studies is not science and it is not research. It is a fishing expedition. A fishing expedition for the express purpose of producing compelling propaganda narratives.

Lets take a look at the damage that anti-vaccination has done.

In 2005, 81.4 per cent of kindergarten-age children in B.C. had received the five-in-one vaccine. Which provides protection against whooping cough, tetanus, polio, diphtheria, and haemophilus influenzae.

By 2012, that rate had dropped to 75.5 per cent – meaning about one in four children hadn’t been vaccinated. Concerns about vaccine safety in the 1980s prompted officials to set up Impact, the Immunization Monitoring Program Active. Which looks at every single reported case of vaccine adverse reactions in 12 hospitals across Canada. Plus possible adverse reactions including admissions to neurology wards. They monitor 1500 cases of reported illness from vaccines in B.C. a year. Yet there is no evidence of any problems.

These stats are often attacked as proof as the complicity of medical professionals in a conspiracy. A conspiracy that is in itself an impossibly complex fallacy.

The connection between autism and vaccines has been thoroughly debunked by a range of studies, scientific groups and world health organizations. Including the Public Health Agency of Canada, the World Health Organization, the Mayo Clinic and the American Centre for Disease Control.

Beyond the consensus, there is new research showing that autism is detectable before children even start to get vaccines. To logically maintain the Anti-Vaccine mindset there are only two valid options.

1. That there is a world wide conspiracy including; all branches of public health, teachers, governments(some who actively hate each other), and Physicians. That medical doctors of all walks, and thousands of peer reviewed journals are ignoring or actively hiding the truth. That all these millions of people are ok with giving kids brain damage.

Or…..

2. That a small well funded dedicated group of Anti-Vaccine enthusiasts lack the medical knowledge to understand the nuances of vaccines, public health, and neurological disorders That they dismiss any evidence that doesn’t conform to their world view becasue the have an emotional attachment to a child suffering from autism. That human nature makes it difficult to understand that bad things can happen with no active culprit, and that we can be powerless to stop some medical issues. Additionally that the belief has become a cottage industry for some that results in significant personal power and money.

There is no credible evidence that there is a conspiracy. The best evidence of a conspiracy was a fabricated study done by a doctor that wanted to sell a competing MMR vaccine. The researcher who published the original paper in a prestigious medical journal, The Lancet, had an undeclared financial conflict of interest, a British medical board found. The study was recalled, while the author, Dr. Andrew Wakefield, was barred from practicing medicine.

It is human nature to believe what we see, hear and often self confirm. Anti-vax proponents seem unable or unwilling to understand what the medical data means. They continue to promote this agenda despite proof that autism precedes vaccines. When evidence derails their worldview the parameters change to continue to fit a square peg in a round hole. Actions consistent with ideology, and confirmation bias, not facts.

The outbreak in Canada is just another example of how a fantasy based belief system is placing us all at risk. A vocal minority should not dictate our public health. They should not be able to set back huge gains made in pediatric infectious disease over the last 50 years.

Do we really need to see kids dying of polio, diphtheria, and whooping cough? Do we need to see deformed infants due to rubella again, or deafness due to mumps? Do we want the fear mongering to overcome good public health. Success narratives lack emotion “My kid grew up happy and healthy with vaccines”. The absence of disease is not scary and emotion provoking. Difficult to fight ideological fear attacks with simple facts. It is difficult to blunt emotional narratives with”Here is the Data”.

Worse honest physicians and scientists cannot give the type of definitive answers that anti-vaccine proponents offer. An Ideologue will always give the same answer”Yes Vaccines are toxic and harm children”. A good medical professional will give you an honest answer. Even the best medical treatment has a very tiny risk. Vaccines are one of the best medical treatments we offer, and the small risks are rare and well known. The problems are no great mystery. The diseases they protect children from are monstrously dangerous.

The answers are simple for me and my children. Vaccines do have some small risks. Sending my kid to school is risk, driving in car is a risk, letting him jump on the bed is a risk. These are risks most kids can live with. Would I let my child talk to random strangers, play with a gun, ride his bike on highway, have a pet rattlesnake? No I would not because the risks are too high/too deadly.

Vaccination risks are snall risks that kids can live with. The disease they protect your children from are not something they can live with.

United States Pediatric Disease Annual Mortality Prior to Vaccines.

Polio: 20,000 cases paralytic polio

Polio

Mumps: 450 deaths from mumps 1 in 20,000 cases became deaf permanently.

Mumps

Hib: 600 deaths from Haemophylus influenzae b, thousands with loss of limbs and brain damage.

Hib Meningitis

Pertussis(Whooping Cough):9000 deaths plus 200,000 sickened

Pertussis victim

Rubella: 2100 neonatal deaths and 11,000 miscarriages. Of the survivors 20,000 were born deaf, blind, microcephalic(profoundly developmentally delayed) or all.

RUBELLA

Diphtheria: 15,000 deaths a year.

Diphtheria

Tetanus: 1100 deaths per year. 

Smallpox: Estimated 300 million in the 20th century. In 1967 15 million dead.

Smallpox

My point is not to terrorize you. It is to show you that anti-vax proponents own the compelling narratives, because of vaccines are effective. If the children at your kids school suffered from outbreaks like they did 70 years ago the anti-vax movement would be limited to a crank category. It is my desperate hope that we do not need to have children die in large numbers before parents can come to their senses?

Anti-vax proponents try to twist the numbers from the pre-vacccine era but the facts are the facts. Just talk to your, mother, father, grandma, grandpa, or someone who lived prior to World War II. Ask them what happened to brothers sisters and friends. Ask the about Polio outbreaks, whooping cough deaths, or quarantines due to measles. It will be an eye opening experience.

Prior to public health child mortality rate was 17%, after vaccines 0.7%.  The numbers I quoted are US specific. Most of the developed world shares similar numbers. Wherever there are vaccines available kids live. Anywhere vaccines are unavailable or limited kids die. Imagine the number of people who wouldn’t be alive today without vaccines. Prior to vaccines and antibiotics world population was about 1 billion. Just about the time vaccines became into world wide use the population went from 2 billion to about 7 billion. Life expectancy went from 48 to 74. This was not an accident. Vaccines are simply the most effective infectious disease treatment ever. In 25 years antibiotics may be worthless, but vaccines will still be just as effective.

Think about it, and do not let fear mongers put your child at risk.

Parents in the western world, for the most part, don’t ever have to live with the agony of watching their child die from a preventable disease. In some third world countries it is a far fetched dream to have their children vaccinated.

This isn’t the “age of Autism”(about 1.13% of children suffer with autism spectrum disorder). It is the age of life. A childhood free of terrible and deadly infectious disease.

Canada needs to get on the ball, and we all need to minimize this deadly nonsense.

As a additional opinion I feel that anti-vax proponents blame parents of autistic children. Telling them that a big bad drug company made their child autistic. Indirectly telling them that they failed to do the proper research. That they are at fault for allowing this to happen to their kids. As I said before criminal terrorism.

References:

http://www.cdc.gov/vaccines/stats-surv/nis/tables/12/tab02_antigen_iap_2012.pdf

http://www2.aap.org/immunization/families/autismwakefield.html

http://www.pbs.org/fmc/timeline/dmortality.htm

http://vaccineresistancemovement.org/

http://bc.ctvnews.ca/b-c-vaccination-rates-drop-amid-misinformation-campaign-1.1744379

Advertisements

Was Walt Disney a Misogynist ?

9 months ago I wrote a post about the pop culture perception that Walt Disney was anti-Semitic. Since I wrote the original post, the movie Saving Mister Banks (a biopic about Disney) was released. The movie and the promotion brought this topic back into the public eye. On the surface the antisemitic claims sounded convincing. They did not hold up to close scrutiny. Claims made by a former employee lacked supporting evidence. Most of the other evidence is circumstantial and contradictory. There is good evidence showing that Walt Disney wasn’t focally antisemitic. Other ex-employee’s have come out strongly in favor of Disney’s reputation. Disney hired a multitude of Jewish staff and actors.  Disney had more Jewish actors on staff than any other studio, including studies owned by Jewish moguls like Warner. Notably he was the first person to cast a well known Jewish actor to play Santa Claus (Ed Wynn in babes in toyland.)

In my Opinion, the Antisemitism claims about Disney are overblown, post-hoc, and lack convergence in the evidence. You can read a more thorough analysis in the original piece. Was Walt Disney an Anti-Semite?

Saving Mr. Banks is a movie about Walt Disney and the creation of the movie Mary Poppins from a female author’s book. As the movie has been promoted the attention has resurfaced. Actress Meryl Streep in a public discussion about the movie put forth a less known but equally dogmatic rumor. Namely that Walt Disney was a Misogynist. Given my experience with the Anti-Semitic charge, I decided to turn a skeptical eye to this rumor and see what the evidence is.

The recent claims by Actress Meryl Streep give a good overview of claims of misogyny by Walt Disney.

“calling the late animator a “hideous anti-Semite” who “formed and supported an anti-Semitic industry lobby”.

“And he was certainly, on the evidence of his company’s policies, a gender bigot,” she added, before quoting a letter he wrote to an aspiring female animator in 1938.

“Women do not do any of the creative work in connection with preparing the cartoons for the screen, as that task is performed entirely by young men,” it read.

She went on to quote Disney’s colleague Walter Kimball, who apparently said that his boss “didn’t trust women or cats” Variety reports.

Streep did, however, throw a little water on the fire by adding: “There is a piece of received wisdom that says that the most creative people are often odd, or irritating, eccentric, damaged, difficult. That along with enormous creativity comes certain deficits in humanity or decency.”

Here is a copy of that letter.

The Letter

The origin of the letter is unique. It was part of the estate of Mrs Ford. Found by the family and made public after her death. I will take it on face value as genuine. It was not written by Walt personally, as was claimed by Streep.

Secondly Streep claimed that Ward Kimball, one of Disney’s original animators, was quoted as saying Disney didn’t trust women.

I will start with the second claim first. Did Ward Kimball make the statement “didn’t trust women or cats.” Yes he did. Although it took me a lot of searching to find out if it was an actual quote. I had to go to Ward’s biographer  to get the answer.

“As the family-approved biographer of Ward Kimball, I’m tickled to see Ward quoted in a public venue. But it also pains me to see Ward’s words taken out of context to serve someone else’s personal agenda. I’ve read thousands of pages of Ward’s writings, including his personal diaries, and I can say unequivocally that Ward never felt Walt Disney ‘didn’t really like women.’ In the quote, Ward claims that Walt was suspicious of women, but I don’t know the context of that statement. And guess what, Meryl doesn’t know the context either. That’s the entirety of the quote published in Neal Gabler’s biography of Walt Disney, stripped of all its original nuance and meaning. We can only assume that there was something that Kimball said that preceded and followed his soundbite-worthy statement. The fact that Kimball listed both women and cats in the same sentence suggests that he was being playful and facetious, a reflection of his personality. He would have likely cringed to see someone misappropriating his comments to attack a man whom he deeply respected and admired.”

Another Kimball Quote:”We thought we were always going to be 21 years old. We thought we would always be putting goldfish in the bottled drinking water, balancing cups of water on the light fixtures, changing the labels on cans of sauerkraut juice. We were 21 years old, Walt was 30, leading the pack. Working there was more fun than any job I could ever imagine.”

In my opinion the woman and cats quote is probably meaningless as evidence of misogyny. Given the cat reference it was probably tongue in cheek humor. A humorous comment about his boss. Someone that he had a long, productive, and playful relationship with.

The letter is fairly compelling evidence that Walt Disney’s studio had discriminatory practices related to  hiring women in the creative department. I have no reason to doubt the veracity of the letter. It is inconsequential that the letter came from a woman’s office.

Did Disney studios have misogynistic hiring practices in the 1930’s?

Answer: in my opinion, Yes. Even without the letter I would have said, yes.

Prior to WWII the country was suffering from crushing depression a large percentage of men were out of work. Women only made up about 26% of the workforce at the time. That workforce grew to 50% during WWII and immediately fell when the soldiers returned home. Fairly clear evidence of generalized sexist hiring practices in the US at that time (Misogynistic that it is). Cultural mores in the US placed women out of the workforce. Men were considered the bread winner. The letter is an indictment of Disney Studios. Evidence that Disney studios, like many companies at the time, were sexist. Culturally it fits the problems of the time. What this says about Walt Disney personally is murky. He had the power to treat women with an equal rights/equal pay agenda. It would have made him unbelievably progressive for his time. The fact that the studio sent a misogynistic letter to a female applicant does not say anything about Disney’s personal beliefs. It is emotionally provoking and suggestive, but not really good evidence of Disney’s attitude towards women? I am not ignoring the letter. There is some very good evidence to the contrary.

In 1938 Retta Scott was hired by the Story Department at Disney studios. She was assigned to the Bambi project. When Walt Disney saw her sketches he  personally assigned her to animate scenes in the movie. She was the first female animator at the studio. She was the first because Disney personally put here there. That is the same period that the letter arrived at Mrs. Fords house.

Retta Scott wasn’t the only female animator for long. Disney moved her onto other movies and he added another iconic female Disney animator, Mary Blair. Mary became a instrumental artist at Disney studio’s. She toured the world for FDR’s Good Neighbor policy. She traveled on this tour with Walt, his family, as well as several members of Disney’s staff.  After that tour she worked several package films, and on two partially animated features — Song of the South and So Dear to My Heart. The early 1950s were a busy time for the Disney studios, with an animated feature released nearly every year. She was art supervisor on several Disney films. Even after she retired from Disney studios he asked her back to do iconic art work at Disney theme parks. Tomorrowland, and it’s a small world where her designs can still be found.

Hardly the actions of a Misogynist with negative attitudes about female artists.

So very much like claims of antisemitism I see a lot of show, but no go. Little or no direct evidence to support claims of Misogyny. Facts that will not stop the misogyny claims from being circulated and certified as Disney dogma.

I always recommend getting your history from historians, not movies, and certainly not from celebrities. If you see something from either of those two sources you have good reason to be skeptical.

References:

http://www.dailymail.co.uk/news/article-2541292/Walt-Disney-grandniece-Meryl-Streep-right-Disney-racist-misogynistic.html

http://www.hollywoodreporter.com/news/was-meryl-streep-correct-calling-669589

http://en.wikipedia.org/wiki/Mary_Blair

http://en.wikipedia.org/wiki/Retta_Scott

http://en.wikipedia.org/wiki/Ward_Kimball

Should Pregnant Mothers Avoid Tylenol?

Could Tylenol be linked with neurodevelopmental disorder, Attention Deficit Hyperactivity Disorder?

A recent study in The Journal of The American Medical Association Pediatrics (JAMA Pediatrics) has suggested a link between ADHD in children and mothers taking Tylenol while pregnant. This has been widely covered by the news media. The study is a correlational statistical evaluation. Of course correlation is not causation. Yet the study has been widely reported as an open ended question. Should pregnant mothers taking Tylenol be worried that they are giving their child ADHD? Given what is known about ADHD I found the premise improbable. I decided to take an intensive look at this research and try to tease out the facts.

Acetaminophen

Tylenol(AKA Acetaminophen and Paracetamol) is a widely used over the counter as a pain medicine. In my opinion it is just about the safest pain reliever available. Like all medicines it has known risks. It commonly causes liver failure due to overdosing, both accidentally and intentionally( Suicide Attempt). The most common source of overdose is taking multiple over the counter medicines. People are unaware that Tylenol is often an ingredient in many cold and flu remedies. They fail to read the boxes and end up overdosing themselves. If you have a normally functioning liver and you limit yourself to 2-3 grams per day it is probably the safest medication that you can take bar none. It is given to newborns and pregnant mothers. So it is quite a surprise that there is correlation between ADHD and intra-partum tylenol dosing.

The Actual Research:

“Acetaminophen Use During Pregnancy, Behavioral Problems, and Hyperkinetic Disorders”

Layman’s Synopsis- It was a large Danish study. Involving 64000 children and their mothers. They had multiple lines of evaluation. Parent response questionnaires, the danish hospital registry, and ADHD medication prescriptions were all tracked. At least half the mothers took tylenol while pregnant. They found a signficant correlation with first trimester usage of tylenol, and frequent dosing throughout all three trimesters with higher rates of ADHD. They tried to control for maternal inflammatory disease, infection during pregnancy, the mother’s mental health problems, or other potential confounders.

There are problems with this study but I think they did a reasonable evaluation. One question that plagues me is, why did they look at this aspect of ADHD? In the abstract they cite concerns over Tylenol and hormone regulation. Sure there are some theoretical models that predict that problem, and some high dose animal studies that duplicate that. They are making a complicated and precarious assumption to even come up with this study. They make two complicated assumptions to look at this. Namely that hormone changes from Tylenol affect brain development and that in turn relates to ADHD. They are drawing a lot of lines together that do not have a solid foundation. In my estimation the only true link is the reverse. They looked at Tylenol because it is one of the few drugs thought to be relatively safe intra-partum(pregnant) therefore widely taken. Even that doesn’t answer my question. Out of all the neurodevelopmental issues in childhood why is ADHD the one that is correlated with Tylenol? That makes me suspicious of an agenda but it does not invalidate the work.

There are real problems with their methods. Self reporting tools are a consistent problem with ADHD or Hyper kinetic disorder studies. Although they used a standardized tool, its benefit as a diagnostic tool is weak. Also tracking prescriptions as a measure of disease incidence(frequency) is also problematic. Ritalin in particular can be over utilized and has been criticized as being used as a diagnostic tool. Meaning, I give your kid Ritalin and he/she gets better therefore he/she has ADHD. Successful medication treatment is not truly a comprehensive way to diagnose this condition. ADHD is a behavioral disorder which by its nature is a very difficult diagnose even in expert hands. Using ADHD medication prescriptions as a method for determining prevalence of ADHD is very flawed.

The study tried to control for maternal mental health issues. Their methods were self reporting, intra-partum eval, and statistical controls. This is a relatively weak control for a large confounding variable. Research clearly shows that there is a genetic/environmental link in ADHD. How much is environment and how much is genetic is unclear. One thing is clear, home parental mental health is a large variable to exclude and this study has not done that very stringently.

My final significant objection is statistical. Although using large numbers is very good to generalize results, it causes a problem. The P value to big to fail problem. Meaning, with a very large sample, the standard error becomes extremely small, so that even minuscule distances between the estimate and the null hypothesis become statistically significant. TO laypersons- The more subjects you have the more likely you will produce a statistical anomaly that falsely positive.

So am I ready to call BS on this bit of widely reported research?

No I am not. It has some very compelling evidence. It was a large study and even though there are a lot of confounding variables, they did a reasonable job trying to control them.

The most compelling evidence is in the dose dependent response. Seeing a correlation with dose and disease is fairly compelling. Although compelling in is not causation. It is a argument to do more research. It is not compelling as a basis for deciding drug safety. Especially given decades of safe use and the complete uncertainty about the causes of ADHD.

This is not a study that should be creating the type of fear mongering I have already begun to see on the naturopath/Alt.Med crank blogs and websites.

This study is interesting, and it is strong enough to recommend a more controlled and focused study. It is not impossible that Tylenol is some how affecting brain development, and that the exposure results in long term behavioral issues. It is just improbable.

It is improbable because ADHD and other Hyper Kinetic disorders are not a single source disease. There seem to be many environmental, and genetic links. It is a improbable chain of reasoning to say that Tylenol affects brain development intrapartum, and that the change is long lasting, and that it results in specific behavioral changes years later with no other discernible cognitive effects.

Improbable not impossible.

So when you have a weak study correlating(not causing) a complication from a medication used in pregnancy, you always take a look at it. You do not jump to blanket warnings or label changes, especially if the drug has a generational history of safety. I recommend you look at this using a Bayesian anaylysis (in my opinion far more accurate). You will see that this study cannot possibly outbalance the prior evidence of safety. More research is needed to define if this is even a problem.

A common argument would be to err on the side of caution, but that can have unintended negative consequences as well.

Mothers may falsely believe that Tylenol is dangerous. Causing everyone to start thinking that taking OTC NSAID’s are safer. Hysteria could easily develop and people would start avoiding Tylenol  for all pediatric conditions, not just pregnant mothers. NSAID’s are not dangerous either, but clearly they have a higher risk profile for the very young compared to Tylenol.

Plus, blaming a mother’s need for a pain control medication in the past may result in maternal guilt over a child’s current problems. By assuming that Tylenol caused a child’s ADHD you are pointing at the mother, as the cause. Resulting in many negative secondary effects for a family dealing with a behavioral disorder. You are making current and future pregnant women struggle with severe pain without any medication options.

Just a few ways reactionary fear could damage people. All to “err on the side of caution.”

Rule of thumb for pregnant moms. There is a chance that everything you do may affect the future development of your child. It is not limited to medication. That is a very heavy responsibility, so take it seriously. Don’t go it alone, and don’t fall for the naturalistic/alt med fallacy. Medications are tested and researched. Yes we find the occasional proverbial “warts” on the treatment. At least we are looking. What you don’t see in the Alt. med research is any indication of any problems. They expect you to assume that everything they do is perfectly safe because it is “Natural”.  Utter nonsense, no treatment is perfectly safe.

My advice for pain control. Avoid medications if you can, not just Tylenol, all medications. Try to use massage therapy, and physical therapy to deal with most general pain complaints. Check with your OB before taking any treatment. Never take any supplement, vitamin, or medicine unless it is under you OB doctor’s direct advice. Always take the smallest dose for the shortest time. Stay away from untested/regulated/and poorly researched alternative medicine. I can tell you what the risks are for your baby with proven medical care. I cannot even guess what the risks are with Alt. Med. Please don’t treat a pregnant mom like she is a selfish murderer because she took some Tylenol in front of you. Tylenol and its generic versions are still the safest pain treatment that can be offered to a pregnant mommy. Pregnant mothers, do not under any circumstances take a Non Steroidal Anti-Inflammatory like OTC ibuprofen. That medicine has proven risks to your unborn child.

Most risks for pregnant women are well known. Some are overblown fear mongering. This study is interesting, but as tool to determine cause and effect it is useless. Warnings that you may hear about Tylenol and ADHD amount to no more than Fear Mongering and are not medical science.

References:

http://archpedi.jamanetwork.com/article.aspx?articleid=1833486#Abstract.

http://www.tylenol.com/safety-dosing

http://www.cdc.gov/ncbddd/adhd/facts.html

http://www.cdc.gov/pregnancy/

DisclaimerThis post is my personal opinion, it does not reflect the opinion of: my practice, my partners, hospital affiliations, Brian Dunning or my academic affiliations. It is for informational/educational purposes only. It is not intended to replace personal medical evaluation and discussion with your healthcare provider.

Deadly Flu Vaccine and the Bizarro World View.

A skeptoid writer brought to my attention to a webpage about the flu vaccine. After reading the blog post I found myself thinking about the TV show Seinfeld. Specifically a few lines from the episode called The Bizarro Jerry. Where the comeidian Jerry Seinfeld says “Superman’s exact opposite, who lives in the backwards Bizarro world. Up is down, down is up, he says hello when he leaves, goodbye when he arrives“.

This article was written by Bill Sardi. He is a well known anti-vaccine/conspiracy crank and has tons of ludicrous posts. It is not surprising that he can take data about influenza in California and twist it in Bizarro like fashion to suit his quack ideas. Not surprising at all. I think it is a wonderful demonstration of how self motivated reasoning can come up with the exact opposite of reality. 

Lewis Carroll’s Mad Hatter

Lets take a little trip down the “Rabbit Hole”, and reveal the difference between logic and motivated reasoning.

Bill Sardi published the web article “The Flu Death Trap” on March 5 2014 (Although it is referenced at the bottom I am not directly linking since I do not want to enhance his readership in any way). He hits the usual highlights for the anti-vax crowd fear mongering and anti-corporate warnings, the standard fare. He does deliver it with a twist. Using statistics that demonstrate the risks of poor vaccination rates, he then cherry picks them to “prove” how the flu vaccine is deadly. Not a revolutionary approach in the Anti-Vax crowd. Just another good demonstration that arguing with the Anti-Vaccine crowd is pointless. Bill has devised an interesting maze of illogical thinking to explain deaths from Influenza. Artfully dancing around the real findings to fit his world view.

“There just has to be a reason for the unusual rash of flu-related deaths in California.  Even after the peak of the flu season has passed and a steep decline in hospitalizations signaled the flu season was almost over, reports of flu-related deaths keep coming in. If public health authorities know the reason for these deaths they certainly aren’t saying anything.”

I believe the term “Flu related Deaths” is self explanatory but lets continue to explore his thinking.

“California mandates all health insurance plans must go through a health exchange and that puts many of the preventive health services mandated by the Affordable Care Act into play including free flu shots — not even copayments. But ironically the number of flu deaths in California this season has skyrocketed 17-fold, from 14 deaths last year at this time to 243 deaths, mostly among adults age 25-64 years of age.And long past the date when hospitalization rates from the flu peaked in mid-January, flu-related deaths soared to 302 in news reports dated March 1, 2014.”

This is a complete misrepresentation of the facts and it omits the most significant findings. Yes there has been a prolonged and severe flu season in California as well as the Northeast. Yes there have been an increase in deaths compared to last year. He is trying to draw a link with the vaccines and the deaths. I will address his very purposeful massaging of the data to produce the opposite of what the data really indicates.

Influenza always changes from season to season. Comparing single season data is not useful, especially when we are still in the collecting phase. These deaths are assumed from the Flu but the final data may be much different. For arguments sake lets assume that the deaths are all related to Influenza. First of all with a few minor exceptions all the deaths were in un-vaccinated individuals. The few exceptions had severe complicating health issues. Almost all of the deaths in the 25-65 age group had complicating health issues of some kind. Respiratory, Auto-immune conditions, organ transplant, and coronary conditions. Older people have had fewer problems with this disease. Not because they haven’t been vaccinated(his unspoken premise). Rather, it is believed that this H1N1 strain is similar to one that afflicted that generation when they were young. So they have had this strain of Flu before and have some protection now. People who have had the pandemic H1N1 supplement 3 years ago seem to be better protected as well. That is why the age curve seems unusual this year. Nationwide, Flu deaths are down this year. It is only when you select for California do you see this anomaly of increase. I would point out that the health care initiative he derides has slightly increased vaccination rates in the northeast (traditionally higher than California), with a subsequent decline in flu fatalities all ages.

That does not stop Bill from determining the opposite.

“By this time last year only 34 flu-related deaths had been reported among adults under age 65.  A total of 106 deaths in that under-65 age group were totaled by the end of the 2012-13 flu season.  So one wonders if the total flu-related deaths in California will rise over 1000 by the end of the flu season. Is a so-called “hot-lot” flu vaccine to blame?  Or is the vaccine failing altogether?  Given that any revelation flu shots aren’t working or may be attributed to raising flu-related mortality, one can anticipate public health officials will be less than forthcoming.  They are the guardians of the vaccine industry.”

He goes straight to the Anti-Vax playbook. Draws unsupported conclusions, and poisons the well, “one can anticipate public health officials will be less than forthcoming.  They are the guardians of the vaccine industry.

Nice, so when the officials point out that the vaccine is the best tool to blunt the disease they are corporate shills. Bill doesn’t stop there. He then tries the gish-gallop approach to support his conclusions and further fear monger about the vaccine. That may work in a public debate but in writing it just doesn’t work. I will break down this nonsense one piece at a time.

“Consider the fact a toxic flu vaccine administered under a newly announced nursing home vaccine campaign resulted in so many preventable deaths in 1993 that the life expectancy in the U.S. declined for the first and only time since the 1918 flu pandemic.  This fact remained hidden till this journalist pored through reports published in Morbidity & Mortality Reports to uncover this hidden vaccine catastrophe.   Is a repeat of the same underway?”

Just an allusion to another ridiculous article he wrote pro-porting that an uptick in death rates in the US coincided with a new flu vaccine in 1993. Long story short, 1993 was the peak mortality for the AIDS epidemic. The death of so many statistically young people skewed the data for average life expectancy. There was a sharp rebound beginning in 1996 when anti-viral therapy became wide spread. Whatever he “Pored Through“, obviously was not the facts.

“Simultaneously health authorities are avoiding announcement of an outbreak of Reye’s Syndrome in California, caused after children with the flu use a fever-reducing medicine like aspirin.  They are calling these childhood cases “mysterious” when its limb paralyzing symptoms are obvious signs of Reye’s syndrome.”

At this point what caused the polio like cases is thought to be a virus. There is no evidence that this is some form of Reye’s Syndrome. Which is linked to a drug not a vaccine.

“Of the 405 reported cases of fatal or severe influenza (requiring hospitalization in an intensive care unit) influenza (Morbidity & Mortality Weekly Reports) as of Jan. 18, 21% had been vaccinated with the current vaccine at least two weeks prior to their diagnosis.”

This is an out and out lie or he has no ability to read the data. Out of the 405 reported cases only 28 had a known vaccination status. Of those 28 people only 6 had been vaccinated. That is 21% of 28 people not 21% of 405 people.

  • “Usually the very young (under 3 years of age) and the very old (over age 65) comprise most flu deaths, so the fact that 61% of hospitalizations were 18-64 years of age is of alarming concern.  Persons age 41-64 were 600% more likely to die of the flu than other age groups.
  • The very young and the very old have undeveloped and used-up immune systems.  But these presumably well-fed young to middle-aged adults don’t fit the typical mortality profile.
  • All cases for which complete records were available succumbed to the pH1N1 strain of the flu virus.”

As I pointed out above elderly had previous exposure to this strain, so age lowered risks with this flu. The majority of fatalities however were not “healthy”. I have no idea what his description “well-fed young to middle-aged adults” means. Morbid obesity is a risk factor for mortality not a prevention. The high rates in younger people is an anomaly, for the most part they were not “Healthy.” Not coincidentally, the high rates of unvaccinated adults in California are in the affected age group. Changing the bell curve to the middle follows the pattern of unvaccinated persons. Usually fatality leans towards the elderly because they have increased susceptibility and poor response to the vaccine. Not “used-up immune system.” Although the personal exemption rule has raised the risk for children in California, they still have high enough vaccination rates to prevent widespread outbreaks. It is true that the very young are at high risk for severe flu complications. Fortunately despite declining vaccination rates the number of flu related deaths have stayed stable. Probably due to sufficient herd immunity.

“Is it adult Reye’s?”

He donates a whole paragraph to this improbable and foolish concern that tylenol can somehow induce Reye’s syndrome in adults. It doesn’t, Reye’s syndrome is strictly pediatric and aspirin related. More useless comparisons and fear mongering. He doesn’t stop there.

“Flu shots administered from retail pharmacies rather than at doctors’ office and clinics is a relatively new practice and it places three mortal flu factors under the same roof – acetaminophen, sugar and the flu virus itself.”

Meaning less fear mongering. He call this the “deadly Flu Triad”. Up is down, Down is up again. Next is the Piece de resistance, of Bizzaro world.

“The very idea of giving a flu shot (a little bit of the flu itself) to sick high-risk (diabetic, overweight, asthmatic) customers who arrive at pharmacies and already have evidence of weak immunity and selling them a vitamin C-depleting drug (acetaminophen) at the same time may explain the current rise in flu-related deaths among adults younger than age 65.  Once hospitalized, these very ill now flu-sickened patients are likely to receive medications (steroids, acetaminophen) that further deplete vitamin C, leading to their early demise.”

There is zero reputable data linking vitamin C deficiency and flu virulence. It is an science-y sounding load of nonsense.

The facts of this data is apparent to me. A fairly virulent strain of the flu in California affected a younger population. Due to virulence, lack of vaccinations and co-morbid health issues there is a one year statistical bump middle age mortality. Isolated to one US state. The elderly were not affected as strongly due to a remote past exposure to a previous strain of the flu. Unfortunately kids still suffered deaths, at least no more than usual.

What this data says to me is that California needs to promote more Flu Vaccination clinics. That the strong anti-vaccine sentiment in the state of California is having a deleterious effect upon public health and stronger measures need to be taken. There is no evidence that a Deadly Flu Vaccine is being given. In fact the opposite is represented in the data. The best protection is the flu vaccine.

Like I said a Bizarro world, Down is Up, Up is Down. All I have to say is…..

Hello 🙂

Bizarro DC comics

References:

http://www.lewrockwell.com/2014/03/bill-sardi/the-flu-death-trap/

http://www.reuters.com/article/2014/02/01/us-usa-flu-california-idUSBREA1004820140201

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6307a

%d bloggers like this: