The Great Vaccine Follow-up (and Swine Flu too!)

Since my last post, "The Great Vaccine Debate," (which was spurred by a recent article in Slate about the dangers un-vaccinated children pose to children and adults with suppressed immune systems) I have received some interesting feedback and comments, which I thought I would share. I continue to think about the dimensions of the issue myself. I've been watching a lot of The Daily Show lately and Jon Stewart's persistent criticism of mainstream media television outlets, such as Fox, CNN, and MSNBC, is that they boil down news and current issues to two sides squaring off against each other, giving each side equal weight. This seems to be happening in the vaccination issue as well. People think that both sides are equally (scientifically) valid and that whatever people decide should be respected by the other side. First of all, there shouldn't really be sides here as much as claims that have qualities and quantities of evidence. Second of all, many of these same people (on the far left, at least) wouldn't agree that there are two valid sides to global warming or to abstinence-only sex education, for example, and would see deniers and abstinence-only zealots as being anti-science. But being anti-vaccine is being anti-science in a very similar way. Also, not vaccinating against infectious diseases means deciding to put vulnerable people and public health at risk and that's, well, dangerous, and very hard to respect.

Here is what other folks had to say:

The author of the article, Stephanie Tatel, sent me this quote from one of the parents on the pediatric leukemia list-serve she's on, referring to her son who finished his chemo treatment, "My son is permanently immune deficient. He also has autism. I will run for the nearest vaccine, anytime. Hysterical vaccine worriers have never sat by their child's bedside, unsure if he would make it through the night. "

One friend who is very active in the pro-natural childbirth, pro-breast feeding and pro-local food worlds told me, "The broader discussion of vaccinations is fascinating, for the reason you cited: why is it that rational, educated, smart people refuse to believe science? So often I hear the argument that our bodies know how to fight off disease, which is similar to the argument I've told mothers about drug-free childbirth. What is getting missed in that discussion is that people for thousands of years died from those diseases: their bodies cannot fight the bugs all the time. And while most of our bodies can birth children naturally, I've yet to meet a mother who would turn away the skills of modern medicine if and when she has a complication. I've never heard of someone refusing a midwife's decision to transfer, for example. Sadly, the group that tends not to vaccinate also tends to be the pro-breastfeeding, pro-natural birth, pro-organic, local food group. I often feel that I'm in an awkward place within my local circle--seeing otherwise smart people make a poor choice because one issue is closely bound with others that they believe in. How to get them to broaden their view? This article is a good start. Otherwise, talking, talking, talking."

Another friend who is a resident in internal medicine at a major research hospital said, "As you can imagine, I have many discussions with patients regularly on what they do or don't want to take and the value of scientific literature. The question of community good is another level that doesn't usually come into play but adds another level of complexity and importance."

A science and environment journalist said, "There is nothing like wading into the whole vaccination debate to get the blood pumping. Take it from me, the person who gets to write about things like this, climate change, autism, stem cells, plus a whole host of other scientific issues that get people all riled up and emotional. Rationally presenting facts does nothing in many of these circumstances."

But I feel a stubborn need to keep rationally (albeit sometimes emotionally) pushing paying attention to the facts. This past week, I got into some conversations on facebook about the flu and H1N1 vaccines, and since I was fresh from this other debate, I was chomping at the bit. This vaccine is new and and I think people are right to question its safety and effectiveness. There is good reason to suspect the big pharmaceutical companies. In these matters government institutions can be inefficient and incompetent, and also inappropriately influenced by the drug companies. I'm not saying we should all rush out and get the H1N1 or flu vaccines without careful consideration. But that doesn't mean we should give in to pseudoscience and misinformation, either. We should think critically about these matters, but get our information from reliable sources with the goal of making informed decisions.

I'm not quite sure why I am wading into all of this; I am no scientist. I got my worst high school grades in science courses and in college while taking an introductory chemistry class, I did a little science experiment of my own. Problem: Can I pass this class? Background Research: The class is known for being easy and straight forward. Hypothesis: Yes, I can! Experiment: Take two exams; study for the first and not for the second. Results: Only a few percentage points higher on the one I studied for, but failed both. Conclusion: No, I can't, especially if I'm too lazy to do the (granted, low-weighted) homework assignments or go to the TA-lead help sessions. Other than conducting some amateurish social science research and taking a statistics-for-teachers course during my master's degree program (and those were my least favorite parts of the program) in education, I have no background in science or social science research. I am susceptible to being overly influenced by emotional and irrational fears and conspiracy theories, especially if they are well presented. All that being said, I have been raised to consult with the best evidence, thinkers, scholars, professionals, experts, and researchers to get at the truth and to make the most informed decisions possible (and to research the sources before I consult with them) about how to vote, how to eat, how to treat illness, how to raise my children, how to spend money, how to maintain good health.

This article by Russell Blaylock, M.D. spurred one of the discussions about the H1N1 vaccine. I flipped out when I started to read it, but then I stopped and asked my very rational, scientifically-trained, smarty-pants husband to read it and let me know what he thought. Here are his thoughts, "Some of his points are no doubt true. And the flu vaccines (seasonal or H1N1) are a different issue than the other vaccines, for which there is near absolute medical consensus. But he is cherry picking the evidence, and accepting certain studies which confirm his viewpoint, while not accepting others that don't, and then distorting the evidence. The NIH and NEJM are pretty clear now that the vaccine works, maybe not as well as the other vaccines, and maybe the consequences of not taking them aren't quite as strong (H1N1 does not seem to be lethal like polio). But according to this study, it still works."

Cedar also pointed out that Blaylock has insurmountable credibility issues, "He is a total wacko right-wing nut job who thinks that the Soviets invented crack cocaine, MS is caused by aspartame, and that his special vitamins can prevent your brain from aging. You should read his Wikipedia page, but not for the page itself, but for the fantastic links to some of his more bizarre writings." The last thing he told me was that the web site that the article was published on was an organization founded and chaired by Blaylock, which lacks any peer review or oversight. The article is well written and sounds authoritative, but it's all him; there's no scientific or medical consensus behind what he's saying. There's no consequence to him if he's wrong, whereas major publications have at least some vested interest in being balanced and supported by solid evidence.

Another facebook friend posted this You Tube video featuring Dr. Rauni Kilde's thoughts on the swine flu and its vaccine. This, too, freaked me out until I realized she was not actually speaking cogently and until I read about her background and figured out the woman was in a serious car accident and suffers from mental illness.

I am disturbed by the number of people who are willing to accept the ideas of people like Blaylock and Kilde without question and by how quick they are to distort the arguments of those who do question or attempt to refute them. With access to the internet there is so much information that is so quickly available on any given topic. In turn, it's quick and easy for us to spread that information around. This is a wonderfully liberating development in many ways, but it is also dangerous. We need to make extra certain that the information we're reading and passing along is reliable and that it has been vetted. Consulting with professionals, experts, academics, journalists, and (qualified) bloggers is essential. And we need to vet those folks, too. When it comes to topics like the vaccines, we should be skeptical and ask questions of our scientists and government, but in that case we need to be skeptical of the skeptics, as well. This piece from NPR's Weekend Edition gives an excerpt from New Yorker science and technology journalist Michael Specter's new book, Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives, represents both what I'm trying to get at in this piece and also may be an example of a reliable source. I say "may be" because I'd have to read it or what a New York Times book review has to say about it first.

Speaking of reliable sources, I found that these were worth consulting on the subject of vaccines:

1) The Children's Hospital of Philadelphia has a great Vaccine Education Center.

2) a recently published article in Wired magazine on vaccine hysteria.

3) this conversation about the hysterical public reaction to the death in Britain of a 14-year-old girl, and the media's role in that, who coincidentally had had the vaccine for cervical cancer immediately before she died.

4) an article in Wired on the history of vaccine panic.

4) this article about the flu and H1N1 vaccines in the Atlantic.

5) this recent opinion piece in the New York Times advocating for the consideration of gender differences when producing vaccines (H1N1 and otherwise).

Please let me know if you know of any others. After this, I plan to return to writing about politics, education, and food. This commentary by Mike Rose in truthdig about ill-conceived trends in education reform is a good place to start, or you can read about the infinitely important topic of salad dressing on my food blog.