Thinking about Vaccines? Thinking of Googling? Found AVN? VISA? Think Twice? Well think again.

I’m supposed to be reading up on levels of consciousness but I just had to get this out of my system. That is what this blog is for after all. I apologise for the sometimes acrimonious tone of this blog post. There were times when I got very angry, and when I get angry I get scathing.

I blame Twitter.

And facebook.

This all started when I connected my Twitter feed to my facebook account so that all my fb friends could see my every tweet. As a result a few of my friends saw me have a grumble at people who did not vaccinate their children when there was a confirmed case of whooping cough at my son’s school.

This provoked an unexpected, but interesting response from two facebook friends for whom I have a fair quota of respect, “Why don’t you have any patience for them? It’s their choice, they do the reasearch and choose what is best for their children…” I paraphrase, but you get the gist.

This provoked a long discussion, and some soul searching, not to mention internet searching on the issue.

I was told by my dissenting friends that far from being ignorant, non-vaccinators have read a great deal on the individual vaccines and their side effects. They constantly have to justify their choices on forms to medicos, schools and childcare. Their position has to be well thought out in order to navigate the hurdles a conscientious objector must leap in order for their child to participate in many areas of society the vaccinated take for granted. I would not, under any cirumstances, call them stupid. However, having taken a look at the kind of information out there for people trying to find information on vaccines, I would hazard a guess that they, and others, may have been misinformed at best, criminally misled at worst.

If you google the fairly inncouous “vaccine information australia”. There are a two organisations that crop up immediately. Vaccination Information Servicing Australia (VISA) and Australian Vaccination Network (AVN) were the two top hits. With catchy slogans like “Investigate before you vaccinate.” and “Love them. Protect them. Never inject them.” These websites proport to give you the truth on vaccines that the government won’t.

Sadly, I don’t have the time to nit-pick the websites in their entirety though I would dearly love to! However, I can, I hope, give enough reason to cast a serious shadow of doubt over their reliablility and legitimacy.

Both websites give “10 Reasons Why Parents Question Vaccination” or “10 Reasons to Investigate Before You Vaccinate.” The AVN’s is more detailed so I’ll look at theirs. They contain, if I’m kind, many errors of reasoning bolstered by sound ignorance and an appalling unawareness of the theory and history of vaccination. If I were unkind I would say that most of their “facts” are unsubstantiated in the extreme and that a lot of the more dramatic “facts” are made up.

If there are parents reading this post who are currently investigating the pros and cons of vaccination for their children I would implore them not to rely on the information these websites provide. It is often conveniently out of date, contains glaring misinformation and inaccuracies and in the case of at least one of them occurs within a broader agenda of a “natural life style philosophy” that generally shuns western medicine and endorses living harmoniously with mother nature.

If this is your view point I would still implore you not to take their “facts” at face value. They claim to be critical of scientists and doctors yet they are ill equipped to do any criticising. Judging by their commentary they are neither scientists nor stastisticians, and so in many cases they have their facts and interpretations of facts completely wrong.

A good place to get up to date information is Medline. But even then, if you only read the abstracts you can fall prey to tricks the pharmacutical companies use to make their products look better than rival company products. So in order to really know what’s going on with the latest research you have to be aware of who’s funding it, have a sound knowledge of what makes a good clinical trial or study (how cohort selection can bias results, for example, and the political leanings of the researcher running the trial) and a good grasp of the theory. To give an indication of how tricky I think this is, I have a science degree that included immunology and statistics and I wouldn’t feel capable of getting thoroughly on top of the research without at least a year of doing that and nothing else.

Here is a small example of the kind of misinterpretation that can be made by laymen when reading medical or scientific articles:

This article in Nature (Vaccine safety–vaccine benefits:science and the public's perception by Edgar K. Marcuse, Christopher B. Wilson in Nature Reviews Immunology 1, 160-165 (31 October 2001), that I highly recommend for a balanced and honest view on vaccines (though it is dated 2001 - always check the publication date!) contains the snippett: “relatively few infections are prevented by immunisation”. This can be interpretted in two ways. To those that know there are over 400 viruses and bugs out there that the newborn has to come to terms with, this means that immunisation is used to prevent a few of the more horrible kinds of infection. Therefore, relatively few infections are prevented by immunisation and the rest the children deal with on their own. To the lay-person, however, the same snippet may read as “relatively few infections are prevented by immunisation so immunisation obviously doesn’t work. Look, it’s in Nature!” That this interpretation is at odds with the rest of the paper does not matter to the zealous. They can cite that portion to their hearts content and look credible to all but the most astute observers.

There's this kind of misrepresentation and the fact that most of the population isn't capable of accurately assessing risk. Take the person who doesn't like swimming in the ocean for fear of sharks, but crosses roads every day. The risk that they will end up road kill is much higher than the risk that they will be shark food but the human brain is crap at making that assessment even when presented with the numbers. If most of the population can't make that kind of assessment, how can they be expected to make an assessment about immunisation where the theory is more complex and the numbers harder? Most people don't have access to the latest articles (or would rather google than go to a library), and end up being swayed by the scare-mongers who had a bit of bad luck in life and decided to blame their child's autism, cerebral palsy or whatever on an injection they had once.

I worry that 99% of those who say they evaluate the pros and cons are doing less evaluating and more looking for evidence to support their paranoia. And they will find this "evidence" in abundance on the internet.

I've been checking out some of the pro and anti vaccine debate on the internets. Sorry to say that mostly, and I mean to emphasise MOSTLY, the anti proponents don't do themselves any favours at all. They tend to display a glaring ignorance of immunology, epidemiology and medical history - I'd have thought they would be essential reading for anyone claiming to have researched the issue. They also, again MOSTLY, provide no evidence for fairly outlandish claims ("There was a pertussis outbreak in Idaho and 100% of the victims were immunised!!!"). When the pro-vaccine people join the conversation they are flamed down as being in the pocket of big pharma. This was a little unfortunate as the pro-people were more likely to ask for evidence and provide evidence in return.

There was a lot of scary anecdotes from both sides, none of which amounted to a shred of proof about anything but which made for interesting reading. Anyone researching off the beaten track, and I imagine that includes most parents must remember that: THE PLURAL OF ANECDOTE IS NOT PROOF.

Speaking of anecdotes though, the most interesting were the number of parents of autistic children who chimed in to say that they had done an awful lot of reading on the link between MMR and autism themselves, they were not satisfied there was a link, and could everyone please just shut up about it and use their energy for improving conditions and treatment for autistic children? Anecdotal I know, but still, surprising given the forum.

Sorry to say that the few reasonable anti-vaccinators armed with evidence and argument were still very conspiracy theory oriented, but even if they weren't they were drowned out by the complete idiots anyway.

I have no qualifications other than being a fan of medical history, managing to stay awake in immunology and epidemiology and I worked in an industry that creates antibodies for research. Compared to the average Joe I know my stuff. To me, vaccination isn't just about protecting my kids (well, ok, tetanus is) it's about helping to protect the vulnerable in our community, namely tiny babies and people who cannot vaccinate for whatever reason. I don't want to go back to the days where hospitals had to have dedicated measles and pertussis wards. I don't want to live in a world where everyone knows someone affected by polio or congenital rubella.

And this is why I get grumbly when people don't vaccinate. I feel that they're taking their healthy society for granted, even taking advantage of it. I might feel the same way about people who refused to fight if our country was being invaded. I might feel that they weren't earning their safety or protection, that they were letting other people take the risks for them. I'm community minded about vaccination so that's just how I feel. I also think I've done the hours of homework and have earned the right to feel that way.

My next post calls out some of the misinformation on the Australian Vaccination Network website. It's lengthy, but if you're serious about researching vaccines and you don't have a scientific background I recommend you read it all.