What makes me angry about not vaccinating

I get annoyed when people say they don’t vaccinate their kids. I don’t think they are stupid or ignorant, but I do wonder why they’d make that choice. However, it’s not simply not vaccinating kids that bothers me. There are people whom I love dearly who may never vaccinate their children. It hurts me that I haven’t found a way to encourage them to let go of the fear, or suspicion, or whatever it is that keeps them from doing it, but I am not going to let go of those people as a friend. It’s not the not vaccinating that makes me angry, though that choice is on the wrong side of the risk equation. What makes me angry is the lying.

There are people who lie to me about vaccines because they’ve gotten information from some prominent person whose celebrity is built up on their willingness to misrepresent the purported harms of vaccination. I see board-certified doctors perpetuating confusion– not clearing up but rather confusing simple issues– in order to have their followers confused about vaccination and vaccine preventable disease. These doctors answer legitimate questions about safety with ambiguity and head-patting: “whatever you think is best. You’re the parent.”

I see politicians who can appeal to the streak of suspicion that many of us have about the government, and who can leverage that against a worried parent until it feels like there’s no one to trust on this topic except, maybe, that same parent-oriented doctor who won’t advocate for the choice that really, truly helps the child, which is undeniably vaccination. Instead, that doctor will advocate for the parent’s right to feel comfortable in whatever choice they make, regardless of where they’ve gotten their information, and regardless of how well they’ve understood it. Politicians and celebrity doctors are telling us it’s great to put our egos and our fears before the health of our children. That makes me angry.

Then there are the stories that we make up to say this is actually better for the child. I comforted myself with lies when I chose not to vaccinate. I said my unvaccinated child was healthier because he wasn’t vaccinated. I said it was those people who vaccinate that were causing more problems with stronger, mutant viruses that would eventually become resistant to vaccines. I believed things that were made up, or based on wild speculation, rather than using a conservative, reasoned assessment of the available science.

Not vaccinating children upsets me, because vaccines are such a safe way to protect children from sometimes serious diseases. Vaccines are safe for people without contraindications. The risks of vaccines are understood and there is ongoing research in vaccine development that will make vaccines even safer. Even in admitting that vaccines can be made safer, they are already far, far safer than infection from the wild virus or bacteria. This preventive medicine has been used for a very long time because it works. Over the years, the technology has become masterfully precise in stimulating immunity without causing illness.

Lying about vaccines, and government conspiracies involving vaccines, is what make me angry, not just upset. We can have a discussion about vaccination even if you disagree with the practice, but if your position involves conspiracies about corruption, bought out politicians, or adulterated vaccines, and you don’t have evidence to support what you’re saying, then you’re bearing false witness and stoking fear. It’s not just me who finds that kind of behavior objectionable. It goes against Christian morals and even secular ethics. It’s wrong.

To me, the vaccination issue is an issue of life. As a steward over my children, I am called to protect their lives diligently, not just passively. Diligence means seeking out ways to make them safe while serving Him. I won’t lock them away and try to protect them from every danger in life, because that would interfere with our ability to serve God as a family. However, something simple, like vaccinating them against disease, does nothing to hinder our service, and in fact opens up possibilities for us to do more with less risk of harm to ourselves or others. It is not about being sequestered away and protected from all risk, but simply protecting our kids from unnecessary risks that do not serve Him.

On this point I am reminded of the unvaccinated Amish missionaries who went to the Phillipines and brought measles home to their community last year. They created a relatively large outbreak that was finally ended about 3 months after the initial infection, because over 8000 people in the community rushed to vaccination clinics to receive the MMR. The missionaries’ intent was to serve God. Was the outcome of 350+ persons infected with measles, and postponed community worship services, really worth it? Vaccination was a simple way that their service trip could have served him to the fullest, without putting others in danger.

When the confusion and ambiguity and wild suspicion is whittled away, it is clear that vaccination is effective and safe. Vaccines prevent disease. Vaccination enables healthier lives. There are fears that arise in us, especially those of us who have heard stories of vaccine injury. Some of us may be tempted to saturate ourselves in those stories, with what I’d warn could be a kind of morbid lust, such that demands a a Christian truly examine their motives. Reading horror stories is not the same as extending compassion to those who have been hurt. We need to set aside these fears and set aside our egos, and look with clarity at the issue at hand. A prayerful decision needs to be made for the health of our children, with their future service to the Lord in mind, should they follow the Christian way.

Vaccine tragedy in Mexico due to improper handling

As I suspected when I first heard that the accident was due to “external contamination”, the tragedy in Mexico appears to have been due to Staph. species bacterial contamination on the outside of the vial, or on the hands of someone involved in the process of administering the vaccines. I was mocked for making the statement “sounds like someone didn’t wash his hands” but that’s exactly what it sounds like– perhaps a little oversimplified. No, you do not have to handle the needle to transfer bacteria, simply handling the baby and not following hygiene protocol would be enough to give the bacteria entry into the skin.

According to the Mexican government agency IMSS, the species found was Staphylococcus hominis, a very common bacteria that colonizes human skin. It can cause severe sepsis in newborns. The antibiotic resistant strain is transmitted by healthcare workers, but it is not clear which strain was found in the infants in Chiapas. The bacteria was also isolated from the children, and their clinical symptoms were consistent with an infection from this bacteria.

They concluded that the infections were a result of handling and administration, since the vaccines were apparently properly stored and the vials themselves were not contaminated.

A Former Off-Grid, Homeschooled Child’s Thoughts on the Naugler Family

Breckinridge, KY — Started reading about this today and it is just appalling. Coming from a few years of “homesteading” experience (homesteading-lite), having a background in natural resources and land management, and being a CASA volunteer, this situation strikes me on so many levels. This is probably the best summary of the REAL issues that can be observed at the Naugler family homestead just by looking at the pics. I’m glad this author chose to focus on the pond because that was one of the first things that stuck out to me as well. The pond is a scummy, open pit sitting just a few hundred yards away from the family’s tent (12 people living in a tent!!). It is clearly a health and safety hazard, but in one interview the mom explains its condition as being “green” due to “letting it go back to nature” or something. Degraded conditions do not spontaneously improve. The ignorance– and I say that honestly, not intending to hurl insults– of this family makes this situation totally unsafe for children. It’s one thing if adults want to live backcountry style in a situation like this (and I wouldn’t mind the camping, minus the poor land stewardship), but it’s another thing entirely to have a very large family with babies and toddlers living like this.

This just hurts my heart… and being supportive of large families, and homeschooling and homesteading and off-the-grid living, I feel in a way sort of responsible to point out why this is so wrong. It’s probably readily apparent to most people. To some, the problems may not be so clear, especially if you generally support some of the marginalized choices this family has made. But this is not ok. It’s just not.

Keeping things neat and tidy on a farm/homestead with kids is not easy and it doesn’t always have to look pretty, but it does have to be safe.

It is not necessarily even about poverty. The family has received tens of thousands of dollars in gifts from people who support and clearly care for them, but so far it is unclear whether that money will actually be used to clean up the property and invest in a real dwelling in order to have their children returned to them.

From the article:
“This has been framed as a “off the grid” issue. It is not. “Off the grid” does not mean, by default: dangerous, filthy, ignorant of basic food preparation and safety, anti Government and anti documentation. “Off the Grid” living can be done safely, cleanly, and in full compliance with all local laws and regulations (in many states). I know. I lived it.

This has been framed as a homeschool issue.

It is not.

Kentucky has very open homeschooling laws. It’s legal. Heck, “un-schooling” is legal there too.

The children were taken because it was unsafe. VERY unsafe, not because they were homeschooled.”

Homeschoolers Anonymous

CC image courtesy of Flickr, Paul Jerry.

The following post is written by Gary. The author’s name has been changed to ensure anonymity. “Gary” is a pseudonym. Also by Gary on HA: “The Deep Drone of Unseen Cicadas” and “Hurts Me More Than You: Gary’s Story”.

To begin with I would like to state several things.

1. I do not know the Naugler family. I have never met them. All of the following observations are based solely from the information this family posted, publicly, on their blog and public Facebook page.

2. Much of the “information” being spread about the internet in regards to this family is clearly, factually incorrect. This can be seen through simple observation of posts on the family’s public Facebook page and blog.

Most of the information people are referencing is based only from the first few photos and/or posts on the family’s blog and Facebook page. For instance, the cover photo…

View original post 2,640 more words

A mock catch-up schedule for an unvaccinated 5 year old

Let’s say you chose not to get your child vaccinated while s/he was an infant, and now you’re considering enrolling them in a public school where certain vaccines are required. You may be terrified at the thought of your child receiving all of those vaccines at once, but rest assured, the catch up schedule for a 5 year old is nothing to fret over. The following work up is based on the Louisiana Department of Health and Hospitals Immunization Schedule and it will vary depending on your location and your pediatrician’s office. However, since this schedule makes the process more clear than even the CDC’s published catch up schedule, I’m going to use this one as an example.

This assumes the use of MMRV and Pediarix, two combination vaccines that can be used for children up to 7 years old and which most offices will probably stock because they significantly reduce the number of injections needed (reducing the risk of administration error, as well). I will include some notes at the end.

So this is how it goes:

First visit: 2 shots (+2 optional)

DtaP-IPV-HepB, MMR-Var, (+HAV, flu)

1 month later

2nd visit: 2 shots (+1 optional)

DTaP-IPV-HepB, MMR-Var (+flu)

1 month later

3rd visit: 1 shot

DTaP

6mos later

3rd visit: 1 shot (1 optional)

DTaP-IPV-HepB, (HAV)

That’s it. 4 visits, 9 months, 6-10 shots (6 required for school). Now your child meets all of the requirements for kindergarten and is protected from up to 9 illnesses that could lead to serious complications, or spread to others for whom these illnesses might be deadly.

There are some factors that can increase the number of shots. For example, if you have already started some vaccination series with an incompatible vaccine, then it may not be possible to finish the series with Pediarix. There is a preference among some practitioners or parents, as recommended by the CDC, to separate the first MMRV  into the individual vaccines, MMR and Varicella, for the first dose in children under 5. There are also additional vaccines recommended for children under 5 who are catching up, in order to protect them from serious diseases like meningitis.

The reason I wanted to write this is because I often see parents who have decided to get a child caught up, fretting over the idea that the child will have to receive “all n doses at once!” That just doesn’t happen. There is a required time period to space each dose in a series of vaccinations.

Many of the fear mongering websites that hype up the number of doses that children receive are obsessively separating individual vaccine components, like the D, T and P in DTaP and considering those “3 doses”, or “3 vaccines”, instead of one. That makes catching up look like a fearsome and insurmountable chore full of risk and horror (especially if you see these described in a meme implying a serious problem, or worse, one with a skull and crossbones accompanying the outrageous number of doses.)

With all that said, younger children do receive more vaccines than older children because they are much more vulnerable to illnesses like Hib meningitis, and epiglottitis, and Pneumococcal meningitis, sepsis and pneumonia. These serious diseases warrant vaccination for youngsters. So if you have a child under 5, don’t shy away from catching them up just because the vaccine schedule appears more manageable for a 5 year old. Your younger child should be vaccinated according to the recommendations for his or her age.

No further word from Mexico

Without further word from the Mexican government, we’re all left to speculate on the numerous places where the vaccination campaign in La Pimienta might have gone wrong.

At this point, it seems mostly agreed that “external contamination” means external contamination in the vial. It’s anyone’s guess how it happened but if it didn’t come from the manufacture, then something went wrong with the preservatives (e.g. there weren’t any) or the vial being damaged or improperly handled and stored– as in, a multi-dose vial being used and then stored for a longer period than is acceptable, allowing time for significant bacterial growth.

Vaccines are medical products that have to be manufactured, stored and administered safely. When any part of that goes wrong, they can be more risky. Even so, in many cases, storage and administration errors do not cause serious problems. This case is an exception, and there are a handful of other cases like this over the past few years. It is heartbreaking and it should not happen. Transparency, which the Mexican government claims they are committed to in this process, means presenting a full conclusion about where this process went wrong and committing to the prevention of similar errors in the future. I think that is the only answer here. I’m curious about whether we will hear from them again, but it is early yet.

A vaccine-related tragedy in Mexico

Recently there was a news report from the region of Chiapas, Mexico, where two infants died and (according to the official report) 29 are still hospitalized with 6 in critical condition. The deaths and illness followed vaccination with BCG, Hep B, and rotavirus vaccines by Mexican health workers. According to Latin Post, the parents received the vaccinations voluntarily.

The vaccinations were offered on Friday when officials came to La Pimienta, where access to medical care is difficult to come by; they announced over loudspeakers that the shots would be given to newborns, local residents told CNN México.

There are no hospitals or clinics in the area, and residents flock to a small cinder-block health center with a tin roof whenever a doctor passes through the community.

“A small selection of paracetamol and other pills sits on dusty shelves inside,” CNN said of the health centers.

Vaccination campaigns have been suspended only in the region where this occurred, as the Mexican government does not see any risk to children outside of the region. The government is paying for the care of the children and their parents while they recover.

—update–

The latest update indicates bacterial infections were the cause of injury, and the government has stated that the contamination was not in the vaccines but apparently from the environment. There have not been reports of anyone else in the community being ill, only the vaccinated infants, but 21 infants who were vaccinated the same day did not fall ill or have any adverse effect.

The contamination risks that are posed in isolated, rural villages or densely populated refugee camps in unstable regions are not the same risks that people in wealthier nations face when getting vaccinated. The risk does not translate to children in urban and suburban California. The problems are in the circumstances, not the vaccines.

This type of situation gets used repeatedly by people in other parts of the world (like here in the US) eager to point out the dangers of vaccines. There is this similar report several years ago where 5 infants died from an unknown bacterial infection in a remote village of Chiapas, not associated with a vaccination program. It may be that healthcare worker’s visit and the children’s illnesses coincided– they happened at the same time. An hopeful speculation could be that the health care workers visited the remote region, and perhaps that is why the illnesses were observed in the first place, and the majority of the children were able to receive prompt care. That is called coincidence, and coincidence is both random and very common. As I said, though, it’s only speculation at this point.

In a case where the process truly was at fault, in Syria, vaccines were reconstituted with a muscle relaxant that killed over a dozen children (reports varied widely on the actual number). An overdose of atracurium was the cause of death, and it was a mixup that could have been made with any injectable drug. The error was compounded by the fact that by necessity the small clinic stored preventive vaccines alongside dangerous, but lifesaving emergency drugs.

So what is the point of distinguishing the vaccines- a medical product- from the process of vaccination delivery and administration? Is it just to absolve vaccines, and say they never do any harm? I’ll answer my own rhetorical question– that no, vaccine injuries are not denied for the pure joy of saying “it wasn’t the vaccine.” These injuries are most often denied because it actually wasn’t the vaccine.

First, you make the distinction simply to know how to respond. If the vaccination is inherently dangerous, then it is unethical to use it or to advocate its use. We’ve seen over and over again that vaccination is not inherently dangerous, although there are specific risks that are inherent in the vaccine. These inherent risks need to be considered independently when advocating for, or recommending the use of vaccines. This is where the term “unavoidably unsafe” is used, because of the specific risks that the vaccine itself poses, which can not be ameliorated without negating the entire purpose of vaccination. In other words, vaccines stimulate the immune system to develop immunity, and there is always small risk to that– a risk much reduced compared to immunity provoked by the disease itself.

So again, a safe product that is delivered with negligence, sabotage or with accidental carelessness is still a safe product. Yet, it might be inappropriate to administer the safe product under circumstances where associated dangers can not be remedied.

Can contamination, drug mixups and other errors be avoided? Yes, they can. Vaccines and vaccine programs both remain safe and lifesaving, even when rare (but often highly publicized) tragedies do occur.

If the error occurs during vaccine administration, such as a mixup or post-manufacturing contamination due to improper storage, then that needs to be addressed. Often, situations like that can be controlled and prevented with standardized storage and administration protocol. Reuse of needles is a dangerous practice that can occur with injections, and has occurred with vaccines, injected vitamins and other injected drugs. The problem– needle reuse– can be addressed without pointing the finger at the vaccine campaign, because vaccines can be safely administered without reusing needles. Hygeine during administration is also important, and may have been an issue in the situation in Mexico, as the government has stated that contamination was found outside of the vaccine– presumably meaning the vaccine vial. In that case, it sounds like someone didn’t wash his hands and subsequently handled the child and/or the vaccine. Again, speculation.

The crux of the issue is whether or not the problem is inherent in vaccines– do 60-80% of children who are vaccinated have to worry about severe reactions such as these? No, absolutely not. Rare, isolated clusters of error, improper administration and contamination are not applicable to the entire pediatric population.

Each regions its own risks, and in the US and other developed nations, storage procedures are such that the risks are mostly 1) the wrong vaccine is given, which uncommonly causes any problems at all and 2) the vaccine is ineffective due to improper storage, which is a serious problem because people will not be immune and may not realize it, but it is not a vaccine safety problem in the sense that the vaccine itself does not cause harm in that instance.

By discussing the real problems here, it doesn’t mean that those tragedies don’t matter, but that they have to be resolved honestly and not by indefinitely halting vaccination or placing the blame on unrelated issues, such as vaccine science or manufacture, or advocacy for aid in the form of preventive vaccines, when those are not the problems.

Vaccine conspiracies, a common ground for cults

I am not a social scientist, and the following post is my opinion only.

One of my latest reading interests is polygamy. The only reason for this is because Amazon happened to be advertising Sam Brower’s Prophet’s Prey on a day when I happened to be browsing for reading materials about strict religious sects. I was probably looking for information about Quiverful, but found the FLDS instead. It seemed like a good match and so I bit. After reading Prophet’s Prey, I had to know more. It turns out there is a whole world of criticism of polygamy on the web, and one of my very favorite shows is Polygamy: What love is this? hosted by Doris Hanson who escaped from a coercive polygamist sect and later founded the Christian (not Mormon) Shield and Refuge Ministries. I love her grace, beauty, honesty and fearlessness in addressing the rampant abuse that is described by her frequent guests who often have personal experience with polygamist cults in the western US.

Perhaps the most notorious of these polygamist cults is the FLDS, run by the incarcerated, pedophile prophet Warren Jeffs. In her book Escape, Carolyn Jessop describes the cult’s fairly rapid descent from one-man rule in the 80’s to absolute tyranny under the prophet by the early 2000’s. As with many cults who must advise their followers to avoid medical care in order to escape scrutiny, this is common practice in polygamist groups  like the FLDS. Its followers are essentially living outside of the law by practicing bigamy in states where it is a criminal offense. Not surprisingly, Carolyn Jessop recounts a time when orders came from the prophet Rulon Jeffs to avoid vaccinations and all medical care for their children, with very few exceptions for obvious life-threatening emergencies.

Avoiding hospitals was obvious. You don’t want the healthcare personnel to start asking questions about parentage, birth certificates (many birth certificates are forged in polygamst families), social security numbers and the like. Avoiding vaccination wasn’t quite as obvious, so the prophet fabricated a story of conspiracy by the gentile government and pharmaceutical companies to harm children through vaccination. Nothing new.

That might prompt you to ask, well, if their vaccination rates are low, then how about their rates of infectious disease? I don’t think anyone knows.

When the YFZ ranch was raided in Texas in 2008, over 400 children were removed from the cult. They were subsequently returned simply because the confusion and chaos was too great. Social workers couldn’t  figure out who belonged to who for the courts, and logistically, finding foster families for all those children was near impossible. There were pregnant girl children who were taken into custody, yet cult members, some who were even mothers of these very same girls, publicly denied on Larry King that they had ever seen such a thing happen in their community. No underage marriage. No child rape. It never happened. It’s a perfect example of the kind of gaslighting that cults frequently engage in. I will briefly talk about gaslighting again, below.

Given such secrecy and general confusion, there is really no one who has access to these groups to track the health statistics of children raised in the cult. Guests on Polygamy: What love is this? (full video below, skip to 4:55) have described a common tradition of burying infants who don’t survive birth or the newborn stage and unaccounted-for disappearances of infants and small children. Brent Jeffs, in his book Lost Boy, estimates that about 1 family in 5 loses at least one child. Ultimately, we just don’t have the data.

Dr. Paul Offit’s latest book Bad Faith discusses disturbing cases of child medical neglect in cults and religious sects. While adults are at liberty to reject medical care for themselves, even life-saving treatment, making the choice to reject lifesaving treatment for their children is much more controversial. Indeed, parents have been jailed for such neglect, even when it is done on the grounds of “religion.” Yet, some families have successfully petitioned to use “alternative treatments” for their children even in cases where life threatening cancers are highly treatable with conventional medicine, and almost certainly deadly without evidence-based treatment.

Vaccine refusal is not against the law. Vaccine refusal by itself is not medical neglect by any current standards that I am aware of. However, vaccine refusal is a red flag and many pediatricians now are unwilling to be complicit in a parent’s choices to refuse vaccines. I have mixed feelings about this, because it means many of these children will slip through the cracks of our healthcare system which, being far from perfect, has successfully prevented the premature deaths of many children through vaccination and other preventive care.

The thing that worries me most, though, is this abusive cult mentality that arises with conspiratorial thinking. The FLDS and these other cults rely on a narrative that outsiders (“gentiles” to the FLDS) are malign forces that will soon act against them. The same goes with the anti-vaccine movement when it acts either with standalone cultish behaviors, or when the vaccine-conspiracy narrative serves as a proxy for an actual cult (like the FLDS and others) to describe the evil intent of outsiders.

The cult’s faithful are portrayed as victims, while outsiders, critics, and those within the cult who begin to express doubt are seen as the offenders. This justifies withdrawal from society, abuse of nonconforming members, and further secretive behaviors.

Take this response by a member of the Vermont Coalition for Vaccine Choice to recent calls for restricting religious exemptions for school admission:

…What’s next? Should all non-vaxxers be forced to wear some sort of visible insignia to identify us to the general public? Should we be segregated from others? Detained somewhere away from the general populace? Hmm, is this starting to sound familiar?…

Self-identifying with a persecuted group (in this case, the most notorious genocide in the western world from the past century) is common among outspoken anti-vaxxers. These parents are perhaps best described as “cognitive minorities” insofar as they can be categorically separated from the larger society. Being a cognitive minority does make life harder. However, it doesn’t necessarily validate your choices. It doesn’t mean that when other people disagree with you, that such disagreement, even contempt, amounts to persecution. In this case, mere belief that vaccines are somehow harmful does not make them harmful, and society’s efforts to contain the known risks posed by unvaccinated clusters of people  is not akin to mass genocide. It’s not even similar. But as Reuben of The Poxes Blog asks, do I really have to say that?

I mentioned gaslighting above, and there is a similar behavior of denial within the anti-vaccine movement. It comes frequently as the statement “I am NOT anti-vaccine” and the recently popular “there is no anti-vaccination movement.” It’s absurd that they say this because clearly there is a social movement, and a well-organized effort to promote vaccine misinformation. They want to deny that they are participants in the harms that result from vaccine refusal, and so they have to deny that they want anything other than freedom of choice for themselves. That argument doesn’t hold up, though, because the constant references to vaccines as “poison” and stoking fears about vaccines does have an effect on other people and it does influence broader social attitudes about vaccines.

People who frequently engage with anti-vaxxers often see more egregious examples of these kinds of mind games, some of which, like gaslighting and victim blaming, are outright abusive. Some anti-vaccine groups ban and excommunicate anyone who joins the group but later decides to vaccinate their children. Although most of these groups are more clique-ish than cultish, there is a fine line between the two, and when anti-vaccine views merge with religious beliefs the situation becomes ripe for the patterns of a true cult to emerge.

Moving on, in my weird little circle of the internet where I talk about vaccines with people whose cognitive reality is different from mine, there’s definitely a preoccupation with feeling oppressed and persecuted. I frequently see references to the holocaust, Jim Crow, and other types of ethnic segregation and genocide. Making fringe lifestyle choices, and being shamed for it doesn’t make you a protected class. Moreover, showing a blatant and disgusting disregard for the impact of your choices on other people, an inescapable reality in the vaccine debate, isn’t a great way to motivate others to sympathize with your cause.

The FLDS suffered a raid by the feds in 1953 and the prophet has since trained his followers to always be prepared for the next raid. Ultimately, the group is preparing for the apocalypse in which the gentiles will be burned from the earth and the chosen ones (righteous FLDS members) will be delivered. People who have escaped the cult almost unanimously describe a childhood where they often practiced hiding from authorities. In the interview I posted above, one of the girls who left the Kingston Group describes having been carefully trained to deal with social workers and police who might show up, and says she became very good at hiding evidence of any kind of wrongdoing, including hiding young children.

The recurring themes on websites like medicalkidnap.com and vaxtruth.org, which describe children being removed from families because of what are represented as benign lifestyle choices, have much in common with the polygamists prepping for the inevitable coming raid and apocalypse. In medical kidnap scare stories, there’s definitely an undercurrent of the same kind of paranoia that enables cult leaders to gain power over their followers. Bizarrely, this kind of prepping and paranoia does, apparently, sometimes lead to the exact situation that the cult fears as happened with the 2008 raid of the YFZ ranch.

CPS kidnapping stories tend to find their way into the mainstream by filtering through more deceptively named organizations like the National Vaccine Information Center– a group that some people fail to view as anti-vaccine because of its careful attempts to represent itself as a neutral organization devoted to choice and transparency. NVIC’s links to these other fringe groups (especially on social media) belie that appearance of neutrality. In the process, they build an illusion of credibility for what are unsubstantiated, fringe ideas that use the same tactics as real, dangerous cults.

Anyway, I’ve rambled on this topic long enough. I’m just disturbed how it isn’t particularly hard to find the intersection of anti-vaccine conspiracies, cult-like religious mentalities and the broader paranoia about government intrusion into the lives of everyday citizens.

In summary, the one thing I fear more than government tyranny is cult tyranny. In the US, it seems that the latter is much easier to accomplish. The people are primed by increasing suspicion of large, powerful entities like governments and corporations, and so they become perfect captives for the little tyrants, like cult leaders, charismatic hucksters, and passionate but exploitative vigilantes.

When vaccines cause all of the problems and none of the solutions

My involvement in the effects of vaccination on the microbiome discussion seems to be wrapping up as most of the anti-vaxers involved have admitted that they either don’t understand science, don’t care about it or are disillusioned by it. Amusingly, these are the same people who offered plenty of criticism about the lack of science cited when I wrote about my personal experience as an anti-vax mom. Yet, when we’re actually discussing a specifically scientific issue, they want to lean back into their personal experiences. Whatever.

Ultimately what has happened in that discussion is that the anti-vaxers want to give all the credit for reduction in disease to anything other than vaccination, while at the same time blaming individual vaccines for nearly everything that has emerged in public health since the introduction of the vaccine. I’m exaggerating the case here, but that’s pretty much what’s going on. There was much resistance to the well-studied observation that disease from S. pneumoniae dramatically declined following the first Prevnar vaccine. But absolute insistence that Prevnar is directly responsible for the increase in MRSA based on scant evidence that the vaccine has any effect on MRSA. It was all followed up with a dire prediction that “the current system is going to end up killing a whole lot of people and someone will be able to overcome the noise and connect it to the vaccine. ”

The vaccine either reduces carriage of the microorganism S. pneumoniae or it doesn’t. If it does, then we can start to hypothesize about the consequences of that. Giving the vaccine all of the credit for the bad stuff (even future calamities) but no credit for the marked reduction in Strep related diseases is wildly illogical. The vaccines appear to have only a modest impact on carriage of microbe species overall, or may have no significant impact on carriage, as suggested by this study that will be published in January 2015.

If they don’t affect carriage of Sp then all of the hypotheses that hinge on that– like the idea that increased rates of MRSA is due to Prevnar– go sailing out the window. You can no longer blame Prevnar for the prophesied future microbial takeover.

The picture is incomplete because the microbiome is an emerging field of study. That is often the case with science, and we don’t just abandon efforts to improve our situation until we’ve answered every question. Sometimes we may not know which questions to ask until we’ve actually made some attempts to affect a change. This isn’t only science, but life.

In conclusion (on my part) the results of hundreds of studies have given no cause for alarm despite some concerns about serotype replacement popularized by the media over the past 7 years or so. The disagreements between myself and my anti-vax counterparts seem to be based primarily on who is willing to make predictions of calamity based on incomplete knowledge. In the medical world there’s an approach called “watchful waiting” or “expectant management.” While “watchful waiting” has been shown to have outcomes just as good or better when it comes to some health conditions, it’s use is only medically justified in certain circumstances. Preventing infectious disease isn’t one of those circumstances.

It seems like the very cautious anti-vaxers also want this approach to apply to vaccines. The flawed assumption is that in the absence of a crystal clear understanding, it will always be safer to do nothing. When it comes to prevention of infectious diseases, watchful waiting doesn’t get us anywhere. The recommended vaccine schedule has been determined to be superior to any type of watchful waiting for everyone except those with known, diagnosed medical contraindications.

In the absence of preventive vaccination programs, contagious diseases will be much more common. The “watchful waiting” alternative in this situation means waiting for an outbreak or an epidemic to spur some people to either rush to vaccine clinics or seek medical care for the disease they catch. That’s simply not the best approach.

Is “anti-vaccine” a pejorative?

Anti-vaxers hate being called anti-vaccine. Apparently, even categorizing vicious vaccine-opponents as a group, e.g. the “anti-vaccine movement” is insulting.

Wow.

From “Sara’s” first sentence (“When I was expecting my first child, I was introduced to the anti-vaccine movement,”) the tone is insulting at best. The term “anti-vaccine movement” is a pejorative; it’s meant to polarize and denigrate people who question or criticize vaccine safety. If you criticize Toyota for the fact they they didn’t admit problems with stuck accelerator, and even tried to cover up the issue, that doesn’t make you anti-car. Calling critics “anti-vaccine” is a deliberate attempt to demean and polarize.

Far more troublesome is the number of generalizations that gloss over or even ignore facts that refute her position.

I don’t care.

I don’t care that these people’s feelings get hurt when there are doctors,  scientists, legal scholars and other advocates who do great, lifesaving work and have to dodge insults and death threats for speaking out against this dangerous anti-vaccine trend. For example, Dr. Paul Offit, a very public vaccine advocate and Chair of Pediatrics at the Children’s Hospital of Philadelphia, has had to have his mail screened for explosives, and be accompanied by personal security after receiving threats following his testimony at an autism hearing. Since then he has been on the radar of the anti-vaccine cult and is a frequent target of vague and specific threats.

Other advocates with less public personas, including parent advocates with whom I have had regular contact, also receive similarly disturbing threats and invasions of privacy. The insults I have seen flung towards very respectful, passionate people go far, far beyond mere categorization based on their political stance.

By the way, there’s no doubt about it. This is a political issue. It’s not a scientific controversy.

Let me explain, though, what I mean when I say anti-vaccine. These are the people I don’t include when I use the term:

• Vaccine hesitant parents or parents who have simply chosen not to vaccinate because of fears about vaccine safety, but otherwise do not try to advance vaccine fearmongering. If they want to be called “non-vaxing,” “delayed/selective” or any other label, then fine, whatever. I just hope that they’re making these decisions while their kids are involved with real medical doctors or medical caregivers.
• Vaccine safety advocates, in general, who are engaged in efforts to actually make vaccines safer. This happens to include many academic vaccine researchers, and professionals within the CDC, FDA, NIH and other oft-maligned organizations or agencies.
• Persons or caregivers of persons with health conditions who are seeking answers about the condition, and may be privately or publicly asking questions about the role of vaccines or other drugs.

People that I do consider “anti-vaccine” or part of the “anti-vaccine movement” are those who promote fear, uncertainty and doubt (FUD) about individual vaccines and/or the recommended vaccine schedule or the vaccine program as a whole, including:

• People who lie, distort and manipulate information in order to make parents afraid of vaccines, or to promote various “vaccine choice” causes that are based on lies.
• People who insist, even in the face of overwhelming evidence to the contrary, that vaccines caused permanent unwanted health conditions or death.
• People who promote conspiracies about vaccines without any evidence.
• People who resist information about vaccine safety, deny that vaccine safety is properly understood, or imply malfeasance in vaccine research despite a lack of evidence and have a pattern of doing this even when their errors are pointed out.
• People who say vaccines are loaded with toxins, poisons, etc, and use other frightening, emotive words to describe vaccine ingredients or procedures.
• Doctors and researchers who make fraudulent claims, conduct fraudulent or misleading research, and especially those who profit from promoting fears about vaccines.
• Various other quacks and businessmen who profits from vaccine fear.
• Anyone who considers themselves anti-vaccine.

I think it’s pretty simple. Leave a comment if you think my attempts to categorize people is whack, but if you just want to whine about how it makes you feel marginalized, you’ll get no sympathy from me.

Also, check out You Might Be Anti-Vaccine If…. by MomsWhoVax

Vaccine opponents have facts, too

Vaccine opponents have facts, too, they just don’t seem to base their decisions on them.

I’ve written about my time as an anti-vax mom on my other blog. I probably wasn’t the typical vaccine opponent because, while I gleaned some entertainment from the conspiracy theories, I wasn’t much of a conspiracy theorist myself. In my view, most of the anti-vaccine rhetoric hinges on either cynicism about the government or outright conspiratorial thinking.

However, I was fascinated by vaccine science– or what I knew about it as a (at the time) sophomore pursuing a biology degree. The thing is, I knew a lot of other intelligent, creative parents (mostly mothers) who were also interested in the science, the “peer-reviewed papers” that vaccine advocates so often demand, and still chose not to vaccinate their children. It isn’t always a lack of facts, or a total disregard for them that leads to vaccine rejection. More often, it seems, it’s just decision-making based on different priorities. For me, the decision was made partially on misinformation, partially on real information, and mostly on culture, emotion and superstition.

I recently wrote:

I was intrigued by the [anti-vaccine] information I was reading, especially the speculations that there wasn’t sufficient science on disease ecology and the assertion that we were somehow cheating nature in a way that would come back to bite us.

Today, this topic– microbial ecology– still captures my attention, which explains my most recent post on this blog. This is where I praise the vaccine opponents for bringing some real, and fascinating evidence into the discussion instead of the absolute woo that’s all too common. That is, the effects of the PCV vaccine on microbe colonization in the nose and throat. Even when they bring solid evidence to the table,. the knee-jerk rejection of vaccines, and mixing good science with pseudoscience and fear, is more than obnoxious. So while I’m giving credit where it’s due, I have to insist that the anti-vaccine position is still dangerously warped.

There is a lot of evidence that vaccines have prevented infections, both mild and very serious. There is evidence that individual vaccines have reduced hospitalizations from the targeted illnesses and secondary infections. An emerging topic in research is the concern that bacterial conjugate vaccines, like PCV, is the possibility that vaccines will lead to the dominance of new species of microbes that colonize the nose and throat, and new types of infections will emerge that may make the overall impact of vaccines like these quite weak. So far, this hasn’t been observed as a significant problem, although some reported cases of ear infections caused by non-vaccine strain pneumococcal bacteria and staph that made the news, implicating vaccines as a possible cause for the shift.

In the PCV references in my last post,  I pointed out that the authors in one study specifically looked for and detected no increase in disease caused by non-vaccine strains. Not only were S. pneumoniae ear infections reduced (77%), but that contributed to an overall decline in ear infections (60%) meaning that there was no apparent, clinical illness caused by niche replacement. This study was in Israel, and from the abstract alone it was unclear which other factors were controlled for, including exposure to secondhand smoke.

There are different ways of monitoring the impact of the pneumococcal conjugate vaccines. One is by monitoring the incidence of invasive disease– like meningitis, sepsis and pneumonia. Another way is to monitor the incidence of minor illness like ear infections, either in total or specifically from strains included in the vaccine. Finally, one can monitor nasal swabs to get an idea for how the vaccine impacts colonization by the bacteria strains, but not necessarily infection.

H. influenzae (Hi) vs. S. pneumoniae (Sp), as well as S. aureus (Sa) and Sp, compete in ways that may lead to one of these other pathogens to emerge and cause illness in the absence of Sp. There has been much study on this subject, and a few plausible mechanisms determined from in-vitro studies– specifically the production of hydrogen peroxide by Sp contributing to a decrease in Hib. Yet, from nasal swabs of inoculated mice, it appeared that Hi outcompeted Sp. Hard to draw a conclusion from that. Since we can vaccinate for Hib (an invasive-disease causing strain of Hi) and 13 strains of Sp, the issues of these two competing seems kind of a moot point since cases of invasive disease from both have declined (Hib disease by 99% according to CDC surveillance).

For Sp vs. Sa,  this 2004 paper showing an inverse relationship between these organisms has been cited at least 90 times, meaning there has been a good deal of follow-up research on this topic. This 2014 paper did a follow up study, and found:

Among subjects colonized with pneumococci, the number also carrying either H. influenzae or S. aureus fell during the study and at 14 days post-inoculation, the proportion carrying S. aureus was significantly lower among those who were colonized with S. pneumoniae (p=0.008) compared to non-colonized subjects.These data on bacterial associations are the first to be reported surrounding experimental human pneumococcal colonization and show that co-colonizing effects are likely subtle rather than absolute.

In 2005, children with HIV were more likely to be carriers of S. aureus than HIV-negative children. Among children with HIV, those colonized with S. pneumoniae were not more or less likely to carry S. aureus than those who were not colonized– so S. aureus infection was independent of S. pneumoniae infection.

And in 2009, parental colonization with S. aureus was found to be an important factor in whether or not children carry the bacteria.

PCV appears to have had a significant and dramatic effect on the incidence of pneumococcal meningitis, but because of its recent introduction, it’s less clear at the moment whether or not this will have an overall impact of reducing cases of invasive meningitis, given the possibility of serotype replacement or niche replacement by another bacterial pathogen. Hib conjugate vaccine, on the other hand, has been around long enough to show a reduced incidence of Hib meningitis without a corresponding increase in bacteria meningitis from other pathogens. Of greater concern, complicated pneumonia increased over time, as a subset of pneumonia cases despite the introduction of PCV7 (prior to PCV13). This increase occurred even with a drop in cases with a bacterial cause, and a dramatic drop in pneumococcal cases. The increase in cases caused by staph appeared to be linked to a surge in MRSA prevalence. Immunization status was unavailable in the study linked above. However, the WHO assessed the growing rates of empyema in Australia and found:

…the absolute increase in the incidence of hospitalizations for empyema and for viral pneumonia (3 and 70 hospitalizations more per 10⁶ person–years, respectively) was much smaller than the absolute decrease in the incidence of hospitalization for bacterial pneumonia (623 hospitalizations fewer per 10⁶ person–years).

The hardcore anti-vaxers apparently trumpeted the incorrect story of “pneumonia caused by pneumococcal vaccine!” I hadn’t heard of any of this until now, probably because at the time this news came out I was a terrified young mother and just seeing words like “empyema” on my computer screen would make me an anxious mess. So, I missed it. However, as a consequence of my own tendency toward panic, I do understand why vaccine-hesitant parents who read package inserts and see scary words like “thrombocytopenia” and “encephalopathy,” would be further frightened by reports that muddy the waters and make it seem like maybe newer vaccines aren’t worth it.

As interesting as this is to geeky laypersons and some fierce vaccine critics, it is of little concern to the average parent. Every study I have seen covering this topic has indicated a need for further study and more careful methods to sort it out, but none have suggested that it’s an issue worthy of frantic urgency. It certainly doesn’t warrant ditching the vaccine program in part or in whole in the name of microbiome integrity. Anyway, the Active Bacterial Core Surveillance program reaches over 42 million people in the US and monitors bacterial infections, including treatment resistant organisms. This is one of several tools in place to pick up possible shifts in infection rates. So we have time to wait for further studies while still taking advantage of the apparent benefits of PCV 13, even though the full picture is incomplete.

I mentioned that anti-vaxers have facts, too, because these niggling topics rarely come up in those pro-vax forums made up of lay advocates rather than professionals in the field. The most dismissive pro-vax individuals miss the opportunity to learn from their opponents. Vaccine critics like to think that a lack of discussion of issues like this among pro-vax warriors online is indicative of willful ignorance or blind defense of vaccines. Thus the oft-mocked “do your research!” What they’re referring to is consumer research. The anti-vaccine crowd does not produce quality, peer-reviewed research that supports their position, though they may occasionally find some and cling to it. The reality is that none of us can study and discuss every topic in depth in the way we all might like. Then, the controversy is so heated in social media that there’s little chance for a thorough, informative discussion most days of the week.

That, my friends, is why I have this blog. Here I pretend to be part of a discussion, even though there may be no one listening.