Canuck Gal

The Argument Against Vaccination Just Doesn’t Measure Up

The reasons I recently heard to support the non-vaccination of a 3-month-old baby – from two educated and intelligent parents – were disturbing and implausible. Some of their reasons for the decision not to immunize included:

- Vaccine-preventable diseases are “no longer a problem in North America”

- Natural immune systems are able to combat these debilitating and even deadly diseases “with appropriate nutrition”

- Vaccines “are not effective anyway”

- Vaccines did not prevent the decline of diseases such as polio and measles, they were declining naturally as a result of improved hygiene, water systems, etc.

- If their son did catch a vaccine-preventable disease, it could be effectively treated with antibiotics with no risk of permanent disability or death

- Even deadly vaccine-preventable diseases (polio, whooping cough) would not have the same harmful potential today

- Anti-vaccine literature is rarely published in peer-reviewed medical journals because of a “conspiracy theory” among big drug companies and the medical establishment (family doctors) that won’t publish work that opposes their pro-vaccine, money-making agenda

Their arguments were based in rumour, confirmed by popularity among their peers, and their research included reference to a book by an author with an obvious bias against immunization, who used out-dated statistical information, misinterpreted scientific data to prove his pre-set opinion, and omitted relevant, related information that failed to support his conclusions.

In looking up the author of that book, I found his writing referenced in many other anti-vaccine books, literature, and web sites, but found it difficult to locate the author’s credentials with respect to the topic which he was writing about. How disturbing to learn that he didn’t have any. And this author is widely referenced as a “factual” writer.

Imagine my surprise – and alarm – when I learned that the arguments I heard from them – and many more – are repeated within the anti-vaccination community with a blind conviction that ignores opposing information, regardless of how factual and objectively verifiable the opposing information may be. The anti-vaccination literature is widely available – without any set standards for accuracy, credibility, or reliability.

The decision to vaccinate – or not – MUST be based on information that can be objectively verifiable as accurate, current, and reliable.

Indicators of credibility include:

- Current and updated information that includes recent, relevant literature and information

- Posted credentials with respect to education and experience of authors; credentials are related to the field of discussion

- Guarantee of reliable and relevant information on the site, or from the publisher

- Date posted when the site was last updated

- Evidence-based research/science to support facts

- Peer-reviewed literature from credible publishers whose journals are proven reliable based on the scientific research and supporting evidence in the articles they publish; access to either the synopsis or the entire article

- Appropriate references/citations – let me be clear – a basic statistics course will teach anyone how critical accurate citation is – not only does a citation give appropriate credit to the original author, it must be able to be referenced by the reader for objective verification of the material. As well, especially when making claims for or against scientific research and fact, the citation must be accurately documented. Proper citation cannot be taken lightly, and while there are variations of where commas, periods, and the like are placed, a citation – in order for it to be credible – MUST include:

o The name of the author(s)

o the date – when was it published

o the full title of the article or book

o the publisher

o the volume, edition, etc. (if applicable)

o the page numbers from where the cited information was obtained

Among the anti-vaccine web sites and literature, there was a noticeable lack of the above-noted indicators of credibility, and several obvious indicators of misinformation and pseudoscience, some of which included:

- References/citations to non-existent articles

- Total lack of appropriate, accurate referencing

- Lack of recent information

- Deliberate ignorance of recent scientific research

- Continued promotion of old, inaccurate data and literature that has since been proven to be untrue (ie: “MMR causes Autism!”)

- Misrepresentation of the findings of credible scientific articles, including omission of relevant information/suppression of evidence

- Common logical fallacies in their arguments (ie: ad hominem, “straw man”, Misunderstanding the nature of statistics, Observational selection, etc.)

- Common use of “pseudoscience” to support claims, in part:

o the use of testimonial evidence from unverifiable eyewitnesses that are designed to appeal to the emotion of the reader

o “Conspiracy Theories” – stating that their writing and conclusions are suppressed by organized medicine because it is controversial, their work cannot get published in a credible medical journal because organized medicine/government/big drug companies make money off of vaccine promotion

o warning readers not to trust or tell their doctor

o lack of credentials or lack of appropriate accreditation

o lack of appropriate and accurate citation; improper citation; misrepresentation of genuine scientific literature

o references only to other anti-vaccination authors and sites, continuing to reference authors and sites that have been discredited

o reliance on rhetoric, convincing arguments, testimonials, popularity, rumours, and fear-mongering to support and promote their non-factual claims

Questioning the “status quo” in medical research as it relates to the health of your child can only be beneficial if it is based on factual information that stands up to objective scrutiny.

Questioning the “status quo” to the point of ignoring any and all information that does not support the non-vaccination stance while remaining blind to obvious indicators of pseudoscience or “quack” literature is unacceptable.. as is ignoring valid, relevant, fact-based, scientific research.. as is avoiding any form of critical thinking and using the same logical fallacies within the anti-vaccine literature to support the continued decision not to immunize.. as is ignoring evidence-based, objectively reliable evidence and favouring blatant misinformation.

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“One of the saddest lessons of history is this: If we’ve been bamboozled long enough, we tend to reject any evidence of the bamboozle. The bamboozle has captured us. Once you give a charlatan power over you, you almost never get it back”

~ Carl Sagan

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Despite anti-vaccination suggestions that vaccine-preventable diseases are no longer a problem in developed countries, recent literature and statistics prove otherwise, with rising numbers of recent outbreaks – including whooping cough, measles, polio, mumps, etc. – in Europe, the United States, and Canada.

The risks that non-vaccinated children pose to those around them, including other children, infants, adults, and health care professionals have yet to be determined, as does the cost of the treatment of such diseases vs. the cost of prevention.

I believe that parents need to make the choice for or against vaccination based on accurate, objectively verifiable information. Unfortunately, there is no anti-vaccination literature that provides factual, scientific, evidence-based reasons to support their position.

That anti-vaccination charlatans continue to deliberately distribute misinformation wrapped up in rhetoric, “confirmed” by anecdotal stories designed to play to the emotion of the parent, and full of logical fallacies – is unethical and absolutely unacceptable.

The vaccine information links below are in no particular order:

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http://csicop.org/si/2007-06/novella.html

Breakdown of MMR vaccine, studies, non-credible researchers, Wakefield’s charges, relevant research.

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http://skeptico.blogs.com/skeptico/2008/01/extraordinary-c.html

“Extraordinary claims require extraordinary evidence”, in part (emphasis mine):

“Extraordinary claims require extraordinary evidence because they usually contradict claims that are backed by extraordinary evidence. The evidence for the extraordinary claim must support the new claim as well as explain why the old claims that are now being abandoned, previously appeared to be correct. The extraordinary evidence must account for the abandoned claim, while also explaining the new one” (Skeptico, retrieved 2008-02-24 from http://skeptico.blogs.com/skeptico/2008/01/extraordinary-c.html)

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http://www.quackwatch.com/01QuackeryRelatedTopics/quackweb.html

How to spot a “quacky” web site

http://www.who.int/immunization_safety/safety_quality/approved_vaccine_safety_websites/en/index.html

WHO list of web sites containing credibility and content good practices criteria, explains why they believe the sites to be credible, who funds them, and type of info they provide

http://immunizationinfo.org/immunization_science_detail.cfv?id=51

NNII synopsis of JAMA study on the content and design characteristics of anti-vaccination web sites (2002), in part:

“All of the sites suggested that vaccines cause illnesses or disorders of unknown cause, such as autism, sudden infant death syndrome, immune dysfunction, diabetes, neurological disorders, allergic rhinitis, eczema, and asthma.

All of the sites linked to other anti-vaccine web sites.

Most of the sites provided personal accounts of children whose parents felt they had been harmed by vaccines. Most also provided information on how to avoid vaccinations. Seven sites (32%) displayed pictures of menacing needles, and 5 sites (23%) displayed pictures of children allegedly harmed or killed by vaccine reactions.

Many of the sites promoted homeopathy, alternative health, and natural methods of enhancing immunity instead of vaccinations.

Most sites suggested that vaccine public health policy is motivated by profit and that universal vaccination recommendations promote a cover-up of vaccine adverse effects.

The relevance/bottom line

Anti-vaccination web sites express a variety of claims that rely on emotion-filled anecdotes. Much of the content is largely unsupported by peer-reviewed scientific literature. Although all concerns about vaccine safety and effectiveness are important, these anti-vaccine web sites confuse timing with cause and effect. In other words, the anti-vaccine web sites suggest that because something bad happens to a child after being immunized, the vaccine must have caused the problem”. (retrieved 2008-02-24 from http://immunizationinfo.org/immunization_science_detail.cfv?id=51)

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http://www.bmj.com/cgi/content/abstract/332/7534/146

Study on whether evidence-based aid changed parental decision not to vaccinate their children (2006).

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http://whitecoatunderground.com/2008/02/19/flu-woo-immuno-woo-and-vaccine-woo-all-in-one11/

Excellent commentary on an excellent example of an “article” that highlights the very problems in logic, credibility, credentials, fact-based evidence, and sourcing that are mentioned above.

http://www.spiked-online.com/Articles/00000002D418.htm

Myths of Immunity

http://www.aafp.org/afp/20021201/2113.html

Separating Myth from Reality in Vaccine Adverse Events, discusses rumours of links between vaccines and MS, Type 1 Diabetes, Autism, discusses “thimerosal” in vaccines, discusses consequences of non-vaccination, in part (emphasis mine):

“A recent study⁴⁴ in Colorado demonstrated that children who were exempted from immunization were 22 times more likely to develop measles and almost six times more likely to acquire pertussis than vaccinated children. School was the site of infection in more than 20 percent of the children who developed measles or pertussis. In this study, each 1 percent increase in children exempted from immunization increased the risk of a pertussis outbreak by 12 percent.⁴⁴ Because immunizations against measles and pertussis are not 100 percent effective, there was a 60 percent and a 90 percent annual increased risk of measles and pertussis among vaccinated children three to 18 years of age for each 1 percent increase in the proportion of unimmunized children (exemptors) by county.^44,45 Consequently, the choice of some parents not to immunize their children increases the risk for children who are immunized. These parents may not realize that the individual choice not to vaccinate a child has public health consequences.” (retrieved 2008-02-24 from http://www.aafp.org/afp/20021201/2113.html)

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“In case of dissension, never dare to judge till you’ve heard the other side”

~ Euripedes

 

http://www.mmrthefacts.nhs.uk/library/research.php

Resource site for MMR information

http://www.mmrthefacts.nhs.uk/library/timeline.php?t=showall

MMR – timeline of relevant research

http://www.signonsandiego.com/news/health/20080212-9999-1m12measles.html

Measles outbreak in San Diego, January and February 2008

http://scienceblogs.com/authority/2008/02/infectious_diseases_vaccinatio.php

Blog response to San Diego outbreak

http://www.quackwatch.org/01QuackeryRelatedTopics/autism.html

Scientific review of the evidence in relation to Autism and treatment)

http://www.vaccinesafety.edu/cc-thim.htm

Removal of mercury (thimerosal) does not stop the rise in Autism

http://csicop.org/si/2004-01/anti-vaccination.html

Whooping Cough (pertussis) – epidemics as a result of non-vaccination

http://www.bmj.com/cgi/content/full/318/7192/1173

(link to actual article in the BMJ that refutes link between pertussis vaccine and wheezing)

 

http://www.geocities.com/issues_in_immunization/safety/dtp_and_autoimmune.htm

(no link between DTP/DTaP and allergic or autoimmune diseases, hyper-linked to the synopses of the articles on PubMed)

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17168158&ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

(No links between MMR and Autism, 2006, link to synopsis of article on PubMed)

http://www.ncbi.nlm.nih.gov/pubmed/17928818?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlusDrugs1

(December 2007 article confirming no links between MMR vaccine and Autism, link to synopsis of article on PubMed)

http://www.geocities.com/issues_in_immunization/safety/essery_dpt_protects_sids.htm (DPT vaccine helps protect against SIDS)

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“I maintain there is much more wonder in science than in pseudoscience. And in addition, to whatever measure this term has any meaning, science has the additional virtue, and it is not an inconsiderable one, of being true”

~ Carl Sagan

http://www.quackwatch.com/01QuackeryRelatedTopics/pseudo.html

Distinguishing between science and pseudoscience.

http://immunizationinfo.org/immunization_issues_detail.cfv?id=52

Common claims found on misinformation web sites, includes description of logical fallacies, dangers of misinformation, problems with “experts” making factual claims outside of their field of expertise, description of pseudoscience, below (emphasis mine):

“Pseudoscience. Pseudoscientific claims cannot be verified by other researchers because they are often ambiguous and not measurable. In most cases, these claims are not submitted to peer review (that is, review by experts) before making them public and the methods are usually difficult to understand, making the observations difficult to replicate. Often, data may be represented to show one outcome when another is the case. Other times the methods that are used are likely to give a predetermined outcome. Only data purporting to support the claims is presented while conflicting data are ignored or discarded” (retrieved 2008-02-24 from http://immunizationinfo.org/immunization_issues_detail.cfv?id=52)

http://users.tpg.com.au/users/tps-seti/baloney.html

“Baloney Detector” – Common Logical Fallacies

http://www.unc.edu/depts/wcweb/handouts/fallacies.html

More examples of Logical Fallacies, definitions, examples.

http://www.accd.edu/sac/history/keller/ACCDitg/SSCT.htm

Definition of critical thinking, importance of

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“Absence of evidence is not evidence of absence”

~ Carl Sagan