Vaccination Op-Ed (Lexington Herald Leader 05 Feb 2015)

I’m grateful to the Lexington Herald Leader for publication of an op-ed piece I wrote on Kentucky Senator Rand Paul’s uninformed comments on vaccinations.  Both Paul and New Jersey Governor Chris Christie have made potentially damaging comments on the topic this week.

In the face of a burgeoning measles outbreak, there are countless Americans who would love to take advantage of vaccines but cannot because of their age or existing medical conditions. They are relying on the rest of us to make unselfish decisions in the interest of public health.  We in turn need to be able to rely on representatives like Senator Paul and Governor Christie, who are in unique positions to shape health policies.  Given the statements they’ve made recently, I’m not so sure that we can.

You can read the op-ed here.

herald

A Great Vaccine Debate On CNN

In case you missed it, CNN hosted a fun debate last night (Thursday, January 29).1

Dr. Armand Dorian gets my vote for Man of the Year for calling out “Dr.” Jack Wolfson over his unscientific positions on vaccines and the current measles outbreak in California and 13 other states.  I’ve linked the video below.  Even though CNN sneaks in a 30 second commercial at the beginning, it’s well worth sitting through just to hear Dorian deliver the truth: it’s hard to believe that Wolfson has a medical license.  The man is literally doing harm to his patients.

cnn debate capture

Dorian and Wolfson debate. Click to launch video.

Dorian is a doctor and debunks Wolfson far better than I ever could, so please watch the video, linked here.  But I can’t resist commenting.  Some of Wolfson’s more ridiculous statements are that:

(1) We’re injecting chemicals in our children’s bodies (when we vaccinate).
Well, duh.  Our bodies are made up of chemicals.  Everything we eat and drink is a chemical.  Everything we see, touch, taste, and feel is a chemical.  Dr. Wolfson, here’s a beautiful online version of the periodic table of the elements.2  You should have studied this in grade school.  Chemicals!  Oh my God, they’re everywhere!

According to the CDC, measles is the leading cause of vaccine-preventable death in children.3  Doctors agree that’s a really good reason to inject those chemicals.  They’re saving lives.

(2) Measles results in “typically benign childhood conditions”
Death is not a benign condition.  The CDC says for every 1000 children who get measles, 1 or 2 will die.4  One out of every four who contract the disease will be hospitalized. There is no cure for measles. Getting the vaccine is safer than coming down with the disease. Measles can lead to swelling of the brain and severe respiratory problems.5  And, oh yeah… did I mention death?

(3) “Our children have the right to get infections”
The “right” to get infections?

Sometimes you encounter a statement that’s so utterly stupid there’s just no response.  I suppose our children have the right to die in car crashes, but I’d like to prevent that.

Speaking of car crashes…

(4) “Bad things can happen to anybody.  We can be in a car accident.”
When host Erin Burnett points out to Wolfson that unvaccinated people are in fact dying from measles, he responds with “Bad things can happen to anybody.  We can be in a car accident.”

Yes doctor.  And that’s why we wear seat belts.  There’s some good science behind the seat belt concept, just as there is behind the measles vaccine.  Before the vaccine was invented in the 1960s, there were up to four million cases of the disease in the USA each year, with an average of 48,000 hospitalizations.5  Thanks to the vaccine, measles was eliminated in this country by the year 2000.6  Now, thanks to anti-vaccination campaigns and quack doctors, measles is making a comeback.

(5) “They [our children] need to get appropriate chiropractic care.  Actual healthy doctors […]”
Chiropractors are not doctors.  They have no medical training.  There’s nothing about chiropractic training or care that remotely begins to address handling a virus, which is what causes the measles.

For this statement alone, I agree with Dorian: Wolfson should not be practicing medicine.  He’s violating the Hippocratic oath.

 

Image Credits
CNN screen snapshot is used in accordance with Title 17 U.S.C. Section 107, commonly known as “fair use law”. This material is distributed without profit with the intent to provide commentary, review, education, parody, and increase public health knowledge.

References
(1) Watch Doctors Have Heated Debate Over Vaccination
http://www.cnn.com/videos/tv/2015/01/30/erin-panel-anti-vaccination-debate.cnn

(2) Periodic Table of the Elements
http://www.ptable.com/

(3) CDC Global Health – Measles, Rubella, and CRS
http://www.cdc.gov/globalhealth/measles/

(4) CDC: Measles: Make Sure Your Child Is Fully Immunized
http://www.cdc.gov/Features/Measles/

(5) CDC/American Academy of Pediatrics Bulletin
http://www.cdc.gov/vaccines/vpd-vac/measles/downloads/dis-measles-color-office.pdf

(6) CDC: Frequently Asked Questions about Measles in the U.S.
http://www.cdc.gov/measles/about/faqs.html

If it Quacks Like a Duck — Oscillococcinum

It’s perhaps the most amazing drug on CVS’ shelves today:  It features:

  • No side effects
  • No drug interactions
  • No active ingredients

That’s right.  No active ingredients.  Read on to see if Oscillococcinum might be right for you!

Oscillococcinum thumbnail

Oscillococcinum, a drug with no active ingredients. (See footnotes for image credit.)

Oscillococcinum was a drug originally made from the non-existent oscillococcinum bacterium (wink wink nudge nudge) and marketed as a cure for the flu.  This is curious, as the flu is viral, not bacterial, in nature.

Now made from duck parts that don’t exist — perfect for a quack cure — Oscillococcinum is homeopathic.  One of the features of many homeopathic medicines is that they are repeatedly diluted during production.  Oscillococcinum is typical:  the dilution is so extreme that there’s no original product left in the box when it goes out the door.

CVS-branded oscillococcinum

CVS-branded oscillococcinum. Get your sugar cheaper! (click to enlarge image.)

The dilution factor for CVS’ duck-based medicine is “200C”.  In homeopathy, “200C” means that:

  1. The original product is diluted with water to 1/100th the original concentration
  2. A small sample of the dilution is set aside
  3. That 1/100th sample is taken, diluted with water, and the process is repeated for a total of 200 iterations

As is the case with any homeopathic medicine diluted to such extremes, the odds of receiving any end product (in this case, duck) are so astronomical they border on impossible.

But would you actually want the duck?

A quick look at the CVS product info sheet tells us that Oscillococcinum:

“is made from tissue that might be infected with flu—ducks, which are known to carry influenza”

Wait.  What’s happening here?  Is CVS selling me an infected bird?  That’s freaky scary.  When I get the flu shot, at least I know the virus in the shot is dead.

Or, is CVS selling me pure water & sugar… a product from which all the duck has been removed?  Back to the product info sheet:

“Oscillococcinum is of 200c potency, meaning that it is diluted to one part in 10 400 (a dilution so high that even if you started with a chunk of duck the size of the sun, not one molecule would remain).”1

Wow.  Balls the size of… (!)

The imaginary active ingredient has been completely removed from this product, and CVS doesn’t even try to hide it:  they brag about it!

If you’re a CVS customer paying for this stuff, you’re paying for filler product.  Water and sugar.  Actually, it’s questionable whether or not you’re even getting any water.  The ingredients list only shows sugar.  What you’re definitely not getting is duck.  (For that reason, we’ll leave the dangers of ingesting a disease-laden bird for another article.)

Oscillococcinum gets a special mention in Jean-Marie Abgrall’s “Healing or Stealing?: Medical Charlatans in the New Age”.2  The drug was invented in 1919 when a Frenchman noticed an “oscillating” condition in flu patients and a corresponding “oscillating” amount of an imaginary germ he decided to call “oscillococcus”.  The only problem was, he thought he noticed the same microbe in herpes, chicken pox, shingles, and cancer patients — and decided all the diseases were caused by the same thing.  Mon dieu!8

The Frenchman tested a vaccine he developed on his cancer patients who, of course, died.  Afraid of being infected by his patients, the doctor went in search of his oscilloccinum bacterium in the wild.  He claims to have found it in a duck.  I’m not making this [expletive deleted] up.  No one else has ever seen oscilloccinum.  It doesn’t really exist.  But this hasn’t stopped snake… erm…  duck oil salesmen from cashing in.

oscillococcinum contains no active ingredients

Oscillococcinum isn’t all it’s quacked up to be.  It contain no active ingredient(s)! (Photo by the author)

Manufactured by the French company Boiron, Oscillococcinum has been singled out for deceptive marketing in the United States.  In June 2010, Homeopathy for Health, a Washington vendor, was cited by the FDA for a slew of violations, including marketing Oscillococcinum as a treatment for H1N1 (“Swine Flu”) and “relief of flu symptoms”.3 Although the CVS literature lists one late 1980s study with marginal results touting Oscillococcinum efficacy,2 no other studies back the CVS claims.  This is not surprising.  If you only have one study to back you up, take that study, trumpet it loudly, and hope nobody notices.

When sugar pills are shown to stop the flu virus, let’s all meet in the bakery aisle of the supermarket when we get sick, and skip the trip to the doctor.

As I write this, CVS is actively removing protests regarding Oscillococcinum sales from its Facebook page.  These posts, to the best of my knowledge, truthfully inform consumers that the product contains no active ingredients, has never been shown to be of any help in combating the flu, and, in fact, could be dangerous: influenza is a serious disease and can be deadly.5, 6

CVS places homeopathic medicines next to real medicines on their shelves (with similar packaging) with no consumer warnings, making it difficult for a trusting public to know what they’re buying.  When a pharmacy dispenses real medicine and real flu vaccines along with sugar pills without any cautionary text, it’s a problem.  Skipping real treatment in favor of Oscillococcinum could do real harm.

A “drug” made from sugar and non-existent duck parts?  A company that takes pride in its public health outreach programs4 should be ashamed of itself for this quackery — no pun intended.  I hope readers will take a moment to go the CVS Facebook page7 and express their unhappiness.  As consumers, we deserve better.

Postscript (18 December 2014)  Alert readers have pointed out that CVS is not the only vendor selling this fake medicine.  Indeed, since writing this article, I’ve found it online at Amazon and Drugstore.com.  It’s reportedly been seen on the shelves of Walmart, Walgreens, and Rite-Aid–though I haven’t witnessed that myself.  I’ll be writing follow-up articles to cover this.  No matter where you find it–if you find it–please encourage sellers of oscillococcinum to remove this useless product from their shelves.

References

(1)  CVS: Influenza: Studied Homeopathic Remedies
http://health.cvs.com/GetContent.aspx?token=f75979d3-9c7c-4b16-af56-3e122a3f19e3..&chunkiid=38325#scientific

(2) Healing Or Stealing?: Medical Charlatans in the New Age
Healing Or Stealing?: Medical Charlatans in the New Age. pp. 40–41. ISBN 1-892941-51-1

(3) FDA Inspections, Compliance, Enforcement, and Criminal Investigations: Warning Letter
http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm215236.htm

(4) CVS stops selling tobacco, offers quit-smoking programs
http://www.usatoday.com/story/news/nation/2014/09/03/cvs-steps-selling-tobacco-changes-name/14967821/

(5) CDC Fast Stats: Influenza
http://www.cdc.gov/nchs/fastats/flu.htm

(6) Key Facts about Influenza (Flu) & Flu Vaccine
http://www.cdc.gov/flu/keyfacts.htm

(7) CVS (Facebook)
https://www.facebook.com/CVS

(8) Mon Dieu! (My God!)
http://www.youtube.com/watch?v=x0oMQu2id6I

 

Legal Stuff

CVS Oscillococcinum product image used in accordance with Title 17 U.S.C. Section 107, commonly known as “fair use law”. This material is distributed without profit with the intent to provide commentary, review, education, parody, and increase public health knowledge.

Duck image by the author.  Copyright (c) 2014 Mark Aaron Alsip.  All rights reserved.

Flu Vaccine: The Aluminum Lining

flu vaccineAs Modern Alternative Mama (MAMA) launches new articles as part of her shameful “Vaccine Injury Awareness Monthcampaign, I’ll continue laying out the facts that show she’s wrong and dangerous.  Today I’m debunking her recent article “No Flu Shot For Me! Fighting the Flu With Essential Oils.”1

I’m glad she published this article, because it touches on two major topics that come up in nearly every anti-vaccine argument: aluminum in vaccines and flu vaccinations for pregnant women.

So, in this debunking, we’ll be looking at:

  • “Toxic” aluminum in vaccines
  • Safety of flu vaccines in pregnant women
  • Use of “essential oils” (EOs) to combat viruses, and the toxicity of EOs

An important disclaimer here: I’m not a doctor.  Even though I did stay at a Holiday Inn Express last night,9, 10 your ultimate source for medical information should always be a qualified doctor, not something you read on the internet.  I’m here to point out what real doctors and scientists are saying about the nonsense anti-vaccine proponents are spouting.  You’re a smart person.  Please do the research.  The outcomes are important.

Aluminum

Right away, the original article sways from truth and science like Justin Bieber’s car during one of his drunk driving sprees15.  Not only does MAMA lie about which vaccines include aluminum, she doesn’t understand that it’s safe.

In fact, in other articles, MAMA recommends eating foods rich in aluminum (such as spinach, tea, and potatoes).17, 20, 24  But, for the flu vaccine, not only do we get a reversal of opinion, we get an outright lie:

“We do know, however, that aluminum is added to the flu shot to increase the body’s response to the vaccine. Aluminum is a neurotoxin.”

If you disregard the specific Haemophilus influenzae type b vaccine, flu vaccines do not contain aluminum.2, 11, 12 You also won’t find aluminum in other vaccines commonly claimed to be “toxic” by anti-vaxxers, such as those for polio, MMR, or shingles.  Oops.

But, is aluminum a danger in the vaccines (such as hepatitis A & B) that contain it?  No.

Aluminum is added to some vaccines to help boost the response of the body’s immune system.  The most common metal in the Earth’s crust,3 aluminum is an unavoidable part of our diet.  In the USA, the average adult consumes 7-9mg of aluminum per day by eating but eliminates most of it as feces (poop).  People with kidney disease are an exception: the disease effects the body’s ability to eliminate aluminum.33

Our average adult will accumulate between 50 and 100mg of aluminum in their bodies over an entire lifetime.3  Nearly 100% of that total comes from the food they’ll eat, the water they’ll drink2, and the air they’ll breathe.  In addition to water, foods naturally containing aluminum include potatoes, spinach, and tea.4 Babies ingest aluminum regardless of whether they’re breast-fed or given milk from a bottle.2

Aluminum enters the environment via natural processes.  A healthy human body is excellent at removing aluminum, regardless of whether it comes from a vaccine or the all-natural health food you ate for dinner.  Studies in humans show it’s poorly absorbed in the first place, and for animals in general, the absorption rate is less than 1%.4   It’s ironic that Modern Alternative Mama publishes “healthy living” spinach recipes17 when spinach naturally contains five times the amount of aluminum of other foods.16

So, you can’t avoid aluminum unless you give up eating, drinking, and breathing.  But there’s no need to worry: your body can (and does) handle the aluminum safely.  There is no aluminum in the common flu shot.2, 11, 12  For other shots that contain aluminum (for example, hepatitis A & B), the amount of aluminum is insignificant compared to what we obtain from eating, drinking, and breathing.  But your body doesn’t care where the aluminum comes from: it removes it the anti-vaxxer’s favorite way — naturally.

Pregnancy

No good anti-vaccine terror campaign is complete without a cherry-picked legalese quote from a medication insert, and MAMA does not disappoint, chastising a Walgreens’ campaign to get pregnant women vaccinated:

“Walgreen’s conveniently left out the fact that the vaccine inserts themselves recommend women avoid receiving the flu shot.”

This isn’t really true.  Her two inserts say the shots should be given if clearly needed.  And medical experts agree the vaccine is clearly needed.  Pregnant women who get the flu are at a greater risk of complications — including hospitalization and death — than non-pregnant women.  The risk to unborn babies is also higher, including premature birth.7, 18  

Recent research suggests the risk to unvaccinated pregnant women may be higher because their immune systems react in an unusually strong manner when they contract the flu, and urges pregnant women to get the vaccination to prevent the inflammatory effects of the full disease.25, 26 (The flu shot is a “dead” virus and cannot give you the flu.)

The vaccine has benefits beyond helping the mother stay alive and healthy.  Antibodies generated in her body as a result of the vaccination can be passed to the unborn baby, giving it protection until it’s old enough to receive its first vaccination at age 6 months.7, 19  Millions of pregnant women have been vaccinated against the flu with no harm to either the mother or baby.7

There’s one important warning:  According to the CDC, pregnant women should not receive the live version of the vaccine (the nasal spray), but the inactivated version (the shot) is harmless.7, 18, 19 Although we’re specifically talking about pregnant women here, this warning about the live version of the vaccine also applies to certain other groups such as immunosuppressed persons.32 When in doubt, always talk to your doctor.

To contradict all this medical evidence, we get a trio of lies from the anti-vaccination article:

“but manufacturers admit that the impact on a developing human just isn’t known”

“Considering the ‘regular’ flu shots cannot verify safety for pregnant women”

“Besides the lack of safety testing for pregnant women”

Ahem. From the CDC:

“Studies of several thousand pregnant women in scientific literature have assessed the safety of using the flu vaccine during pregnancy. These studies have shown no evidence of harm to pregnant women, to the unborn child (or fetus) or to newborns of vaccinated women.”8

And if you do the research, studies back this up.8, 13, 14

It’s interesting to pause here and consider the hypocrisy of MAMA.  Later in her article, she’ll tout the amazing benefits of essential oils in combating viruses, even though their safety for use during pregnancy has never been studied.

Essential Oils

MAMA begins by misquoting a real scientific study6, which looked at the effects of essential oils (EO) on bacteria.

The problem is that the flu isn’t caused by bacteria.  It’s caused by a virus.  There’s a huge difference.  Bacteria are single-celled living organisms; viruses are small packages of DNA or RNA that cannot “live” without being injected into a living cell.

So we’re off to a bad start already, with an article using research performed on bacteria to support a conclusion about viruses.

Interestingly, it turns out that chemicals found in essential oils are being studied for anti-viral properties, and are showing promise — in test tubes.22, 23  MAMA doesn’t cite any of these studies, for obvious reasons.  No doubt, if the research results in a promising medicine that works when ingested, anti-vaxxers will dismiss it as a Big Pharma conspiracy.

Or perhaps essential oil fans are embarrassed by the track record of EOs with the FDA.  For example, in September 2014, Living Young, the manufacturer of “Thieves Blend”, an essential oil often pushed on alternative medicine web sites as a cure for nearly everything, was warned by the FDA for making unsubstantiated medical claims about their oil including, incredibly, as a cure for Ebola.22

Regardless, an article that is supposed to be focused on the flu virus keeps wandering away like a lost puppy to talk about essential oils and bacteria.  After many paragraphs on this red herring, MAMA pulls this magical conclusion out of her [expletive deleted]:

There are many essential oils known for being antiviral. Tea tree (melaleuca), basil, lemon, peppermint, and more. All these oils will enter your body, enter your cells, and fight off viruses that have already taken over your cells. It’s pretty amazing.

What would be even more amazing would be even a single reference to back up this claim!

What we do know from science about essential oils is that some of them can be toxic when ingested:

“However, the ingestion of a few milliliters of essential oils may cause severe symptoms of intoxication like vomiting, respiration failure, and unconsciousness and may lead to death, especially when infants are concerned.”28, 29

A University of Minnesota (UoM) article30 warns that while many essential oils are safe when used on the skin, some can cause serious harm — including liver and other organ damage — when ingested.  The same article warns that some EOs are not safe to apply to the skin, or should not be applied to the skin without dilution, else photo-toxicity can result.  UoM reminds the reader that peppermint oil is heavily laced with methanol-one, which has caused young children to stop breathing.

For children who actually drink an essential oil containing methanol or other toxic ingredients, the results can be tragic.31

Conclusion

The flu is dangerous.  In 2010, influenza and pneumonia (which go hand-in-hand) killed over 53,000 people in the United States.27 Except for the Haemophilus influenzae type b vaccine, flu vaccines do not contain aluminum, but aluminum is unavoidable in our diets, and our bodies process it naturally.  Other vaccines that contain aluminum contain far lower amounts than the water we drink or the food we eat, and are safe.

The live (nasal) form of the flu vaccine is not recommended for pregnant women, but the dead (injected) form has been given to millions of pregnant women and medical studies conclude that it is safe.  Finally, although scientific research is being done on the possible benefits of chemicals extracted from essential oils, the article being debunked presents no evidence of any trials in humans — because, as of this writing, there aren’t any.  In fact, some essential oils are known to be toxic when ingested by animals.

References

Note: to avoid increasing search engine exposure for quack web sites, I use the DoNotLink URL obfuscator on their links.  I promise I’m not redirecting you to porn 🙂

(1) No Flu Shot For Me! Fighting the Flu With Essential Oils (original MAMA article)
http://www.donotlink.com/bxtb

(2)  Aluminum in Vaccines: What you should know
http://www.chop.edu/export/download/pdfs/articles/vaccine-education-center/aluminum.pdf

(3) extract, CRC Handbook of Chemistry and Physics, 77th Edition
http://education.jlab.org/glossary/abund_ele.html

(4) Aluminum in Drinking Water (World Health Organization)
http://www.who.int/water_sanitation_health/dwq/chemicals/en/aluminium.pdf

(5)  The Cell: A Molecular Approach. 2nd edition
http://www.ncbi.nlm.nih.gov/books/NBK9928/

(6)  Effect of Essential Oils on Pathogenic Bacteria
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3873673/

(7)  CDC: Pregnant Women Need a Flu Shot
http://www.cdc.gov/flu/pdf/freeresources/pregnant/flushot_pregnant_factsheet.pdf

(8) Seasonal Flu Vaccine Safety and Pregnant Women
http://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm

(9) Holiday Inn Express (Nuclear Meltdown)
http://www.youtube.com/watch?v=wm-h7YR_410

(10) Holiday Inn Express (Jeopardy)
http://www.youtube.com/watch?v=G0o0Jjtvq0Y

(11) Vaccines and Aluminum
https://www.chop.edu/service/vaccine-education-center/vaccine-safety/vaccine-ingredients/aluminum.html

(12)  Vaccine Excipient & Media Summary
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-2.pdf

(13)  Adverse events in pregnant women following administration of trivalent inactivated influenza vaccine and live attenuated influenza vaccine in the Vaccine Adverse Event Reporting System, 1990-2009
http://www.ncbi.nlm.nih.gov/pubmed/20965490

(14)  Trivalent inactivated influenza vaccine and spontaneous abortion
http://www.ncbi.nlm.nih.gov/pubmed/23262941

(15)  Justin Bieber arrested on drunken driving, resisting arrest charges
http://www.cnn.com/2014/01/23/showbiz/justin-bieber-arrest/

(16)  Aluminum in Your Diet
http://www.livestrong.com/article/403282-aluminum-in-your-diet/

(17)   Spinach and Goat Cheese Quesadillas  (original MAMA article)
http://www.donotlink.com/bxu5

(18)  Seasonal Flu Vaccine Safety and Pregnant Women
http://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm

(19)  MAYO Clinic: Pregnancy week by week
http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/expert-answers/influenza/faq-20058522

(20)  Boost Your Produce Budget: smart shopping tips for buying local (MAMA article)
http://www.donotlink.com/bxwg

(21) Virucidal effect of peppermint oil on the enveloped viruses herpes simplex virus type 1 and type 2 in vitro
http://www.ncbi.nlm.nih.gov/pubmed/13678235

(22)  FDA Inspections, Compliance, Enforcement, and Criminal Investigations Warning Letter to “Thieves Oil” Manufacturer
http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2014/ucm416023.htm

(23)  Susceptibility of Drug-Resistant Clinical Herpes Simplex Virus Type 1 Strains to Essential Oils of Ginger, Thyme, Hyssop, and Sandalwood
http://aac.asm.org/content/51/5/1859.full

(24) Recipe Collection: Cheesy Potatoes (MAMA article)
http://www.donotlink.com/bxxt

(25)  Immune response turned up high by flu during pregnancy
https://med.stanford.edu/news/all-news/2014/09/immune-response-turned-up–not-down–by-flu-during-pregnancy–st.html

(26) Immune Response Turned Up, Not Down, by Flu During Pregnancy
http://www.sciencenewsline.com/articles/2014092221530035.html

(27) Deaths and Mortality
http://www.cdc.gov/nchs/fastats/deaths.htm

(28)  Essential Oil Poisoning, Woolf, Clinical Toxicology, 1999, Vol. 37, No. 6 : pp 721-727
http://informahealthcare.com/doi/pdf/10.1081/CLT-100102450

(29) Antimicrobial Effect of Essential Oil Isolated from Eucalyptus globulus Labill
http://www.agriculturejournals.cz/publicFiles/39925.pdf

(30)  Are Essential Oils Safe?
http://www.takingcharge.csh.umn.edu/explore-healing-practices/aromatherapy/are-essential-oils-safe

(31)  A Case of Methanol Poisoning in a Child
http://www.hindawi.com/journals/crin/2014/652129/

(32)  Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) — United States, 2014–15 Influenza Season
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm#Considerations_Use_Live_Attenuated

(33)  ATSDR Division of Toxicology and Environmental Medicine: Aluminum
http://www.atsdr.cdc.gov/toxprofiles/tp22-c1-b.pdf

Image Credits

Pandermix flu vaccine from WikiMedia Commons, released into public domain with no restrictions.

Pregnant woman by Inferis, from WikiMedia Commons, used under Creative Commons Attribution-Share Alike 2.0 Generic license.  Image owner does not necessarily share or endorse the views put forth by the author of this article.

Aluminum by Romary, from WikiMedia Commons, used under GNU Free Documentation License.  Image owner does not necessarily share or endorse the views put forth by the author of this article.

Essential Oil from WikiMedia Commons, released into public domain with no restrictions.

Which is Safer: Vaccines or Illnesses?

An internet alternative medicine fringe web site, Modern Alternative Mama (MAMA), has begun promoting “Vaccine Injury Awareness Month” in conjunction with (an announced) dangerous campaign to hawk natural cures for cancer, in scientific mockery of Breast Cancer Awareness Month.

I’ll debunk the cancer quackery when it’s published by MAMA, but since the vaccine nonsense came first, I’ll have a go at it in this article.  The MAMA article, “Which is Safer: Vaccines or Illnesses?” 1, solemnly informs us that:

whatweneedxamLet’s get started…

How Dangerous are these Diseases?
This is best answered using pre- and post-vaccination numbers for the United States from a well-referenced article by the National Network for Immunization Information (NNii)2:

  • Before 1985, Haemophilus Influenzae type b (Hib) caused serious infections in 20,000 children each year.   In 2002, there were 34 cases.
  • In the 1964-65 rubella epidemic, 12.5 million people were infected.  Of the 20,000 babies born with rubella, 11,600 were deaf, 3,580 were blind, and 1,800 were mentally retarded.  There were only 4 cases of congenital rubella between 2001 and 2004.
  • In 1952, polio paralyzed more than 21,000 people.  In 2002, the United States was polio-free.
  • In the 1920s up to 200,000 cases of diphtheria were reported each year, killing up to  3,000 annually. In 2002, the number of cases in the USA: one.
  • Prior to 1963, measles killed more than more than 500 people per year out of an infected total of more than 3 million/year.  In 2002, there were 44 cases of measles nationwide.  (Recently, when vaccination rates dropped due to anti-vaxxers, serious outbreaks of the disease occurred in unvaccinated persons in states such as California and Ohio.  Ohio alone exceeded the entire 2002 nationwide total).
  • In the 1940s, whooping cough killed up to 8,000 children per year, infecting an average of 175,000 per year.  In 2002, only 771 cases were reported.

Despite all of this, MAMA somehow concludes:

ooopsNo MAMA.  The people more likely to get any of these preventable diseases are the people who have not been vaccinated.  Look at the statistics.

How Dangerous are These Vaccines?
MAMA’s best answer to this question is given in her quote here:

donotbelieveUnfortunately, in science, what one person believes or doesn’t believe doesn’t matter.  “I don’t believe it” and conspiracy theories figure heavily into MAMA’s work.

Resorting to scare tactics in the guise of science, MAMA then pulls a package insert from an MMR vaccine and lists every possible side effect, including:

sidesIt’s interesting to note MAMA’s hypocrisy here as we quote her article’s thoughts on scare tactics, regarding CDC commentary on ear infections as a vaccine side effect:

scare2MAMA isn’t a bit shy about listing “death” as a possible side effect of the MMR vaccine (which has never been proven6), but that doesn’t stop her from accusing the CDC of fear-mongering.  Not to mention openly lying in saying that the CDC statement concludes that hearing loss is likely.

MAMA’s fear-mongering continues with a cherry-picked statistic from the national Vaccine Adverse Event Reporting System (VAERS):

vaers1What MAMA doesn’t tell you is the most important thing about VAERS: anyone can file a VAERS report.  No cause-effect relationship between a vaccination and the reported problem is ever established.  For example, I can get the MMR (measles, mumps, rubella) vaccination tomorrow, get food poisoning at lunch from a bad burrito, and report the resulting vomiting and diarrhea to VAERS as a reaction to the vaccine, and into the database it goes. 7  This disclaimer is in the first paragraph of the VAERS database description.

The irony thickens.  Had MAMA actually read the VAERS introduction, she would have seen the disclaimer:

“VAERS data contains coincidental events” 7

… and she wouldn’t write mind-numbingly contradictory tripe like this in the introduction to her article, where she demands hard evidence, not stories, in the vaccine debate:

vaers3Yes MAMA, please… no scary tales.  If you’re going to quote from the VAERS database, understand what it is first.  Really.  Please.

Are There Any Benefits to These Diseases?
I’ll leave that up to the reader.

Are blindness, deafness, paralyzation, mental retardation, and death beneficial?

Anyone?

Third World Countries

Perhaps the most offensive part of the the MAMA article deals with Africa.

The article is written in debate/response format, addressed to a reader named Erich, who she tries to shame (along with the CDC) as a fear-mongerer for pointing out the elephant in the room regarding vaccinations and disease.  Before I give you the answer, let’s see if you can figure it out by reading a passage directed to Erich:

canwejustagreeNo MAMA, we cannot agree, because it’s piss-poor science.  You admit you have the data.  Maybe you should have looked at it.  Since you picked Africa, I’ll pick Africa.  Let’s talk polio, which has been eradicated in the USA (your “first world” country) thanks to vaccinations:

According to UNICEF, more than 70% of the world’s children who have not been vaccinated against polio live either in Africa or Asia. 3

Polio remains an active problem in ten countries worldwide.  Of those countries, eight are in Africa:  Angola, Chad, Democratic Republic of Congo,  Nigeria, Cameroon, Equatorial Guinea, Ethiopia, and Somalia. 4,5

Eight poorly vaccinated countries.  No wonder MAMA wants to dismiss Africa.

Polio in the Wild (CDC image)

Polio in the Wild (CDC image)

MAMA’s dismissal of immunization statistics regarding Africa is not only scientifically dishonest, it’s also, IMHO, heartless.  African children are not being vaccinated because of socioeconomic conditions (poverty, war, etc.).  According to UNICEF, one impoverished child dies every 20 seconds from a disease preventable by a vaccine.

“Children in remote rural regions and impoverished areas of cities in poor and emerging countries are not being vaccinated” — UNICEF Report

… and, of course, children in “first world” countries such as the USA are being vaccinated… unless MAMA gets her way.

Figures lie, and liars figure…

A large part of the MAMA article involves some very hazy math prefaced repeatedly by her favorite term “let’s assume”.  Rather than combat fictional numbers, I’ll simply point out that she quotes from the CDC “Pink Book” (Epidemiology and Prevention of Vaccine-Preventable Diseases) which supports her anti-vaccine numbers like a flea supports an elephant on its back.  But then we get this gem:

notsureWhy oh why would you rely on statistics from a source you don’t believe is accurate?  And why oh why would you write a supposedly science-based article and lace it with statements about your beliefs, and your assumptions, rather than hard numbers?

Why?

assumeBecause when you assume, and base your pseudoscience on personal beliefs, you can make anything seem true.

 

References
(Please note: to avoid increasing search engine positioning for dubious, quack web sites, I use the excellent DoNotLink.com redirect service for hyperlinks to these sites).

(1) Which is Safer: Vaccines or Illnesses?  (original MAMA article)
http://www.donotlink.com/bw1o

(2)  Vaccine Effectiveness:  Do vaccines work?
http://www.immunizationinfo.org/parents/why-immunize

(3) UNICEF Immunization
http://www.unicef.org/immunization/index_bigpicture.html

(4)  UNICEF Polio
http://www.unicef.org/immunization/polio/

(5) Interim CDC Guidance for Polio Vaccination for Travel to and from Countries Affected by Wild Polio Virus
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6327a4.htm

(6)   MMR (Measles, Mumps, & Rubella) Vaccine
http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html#reaction

(7)  VAERS Data
https://vaers.hhs.gov/data/index

Nurses Against Mandatory Patient Safety

I’ve just run across a post in a Facebook group that epitomizes my favorite Isaac Asimov quote:

“There is a cult of ignorance […] nurtured by the false notion that democracy means that ‘my ignorance is just as good as your knowledge’.”

Here’s the post, from a group known as Nurses Against Mandatory Vaccines:
CaptureLet’s concentrate on the highlighted portion:   If you are a nurse or other health care provider in direct contact with patients, not only is it your employer’s right to know which medical diagnoses and/or vaccinations you’ve had, it is the patient’s right to know. 

You see, like bad advice, diseases can be passed along from person to person.  In the case of a medical provider who comes into contact with a lot of infectious disease, the odds of passing along the disease increases– much in the same way the odds of receiving bad advice increase for those coming into more frequent contact with the bad advice found in the Nurses Against Bad Vaccines forum.

Perhaps the nurse who wrote this gem of a post has never heard of contagious diseases such as Ebola.  If I’m a patient and my nurse has Ebola, he is carrying with him a near-certain death sentence (1) —  a highly contagious death-sentence during certain stages of the disease.  Certain death for him; very likely certain death for me.  I don’t have a right to know?  Really?

There’s a word for this idea, and that word describes the material that comes out of the back ends of male cattle after a long day of feeding.  (To prevent offending the delicate sensibilities of my readers, I don’t want to say the word “bullshit” in my blog.)

Oops.

Back to the subject…

If my medical care provider has been diagnosed with an infectious disease, I have a right to know his/her medical condition.  Going back to the Isaac Asimov quote:  the nurse may feel that he/she has a democratic right to keep this information secret.  However, not realizing the danger he/she poses to me is scientific ignorance on the nurse’s part, and it does not trump the patient’s scientific knowledge.  Come to think of it, it doesn’t trump the patient’s rights either.

But What if the Nurse Isn’t Infected Yet?
Maybe an already-infected Ebola patient is an unfair example.  In the spirit of sincerity and fairness, let’s look at pre-infection cases involving more common infectious diseases that are preventable by safe and effective vaccines which are readily available: Influenza,  Measles, Mumps, Rubella, and Chickenpox (2).  (Of these, Measles is particularly deadly in children (3), and Chickenpox can cause extreme complications (and even death) in adults (4).)

What the author of this Nurses Against Mandatory Vaccines post is really campaigning against is getting vaccinated and/or making their vaccination status known.  Do I as a patient have a right to know if my nurse has been vaccinated, and/or demand removal from the doctor’s office of nurses who haven’t?

Pseudoscience groups have yet to come up with a shred of evidence that any vaccine I’ve mentioned here is dangerous, while study after study has shown that vaccinations are key to preventing the spread of these diseases.  I’ve blogged on this twice with exhaustive lists of references (5) (6).

If my nurse has not been vaccinated against infectious diseases, I have a right to know.  Because of herd immunity (7) and the fact that no vaccine provides a 100% guarantee, it’s especially important that an unvaccinated health care provider doesn’t come anywhere near myself or a loved one. To be blunt, I have a right to know if my nurse is a potential Typhoid Mary (8).

Health care workers are exposed to more potential virus carriers than you or I.  That’s a fact of life in the hospital or doctor’s office.  There’s a reason that experts recommended that the first people to receive the first Ebola vaccines be healthcare providers (9) — not only were they most at risk — they were the most likely to become breeding grounds for the virus and pass it on to other people.

Because a health care worker’s first priority is the care of the patient, and vaccines do not place the health care worker at risk, patients have a right to know if their health care provider is an unvaccinated breeding ground for a highly infectious disease.

Legal Precedent/Expectations
But is there a legal precedent for this?  Are there any other professions where both the employer and the consumer have a legal expectation to know the health status of the employee?

Well, yes.  As a matter of fact, there is.

Have you ever flown on a commercial airliner?  The health requirements for airline pilots are quite strict (10).  When an anti-vaccine nurse steps onto her flight from Dallas to Miami, she knows for a fact that the pilot in the cockpit is certifiably free of nearly two dozen serious medical conditions (11).   Why?  Because the health and safety of others are directly affected by the pilot.

If the pilot has a problem in flight, it very quickly becomes a problem for every passenger on the plane.

Sounds a lot like vaccinations, doesn’t it?  Any anti-vaccine nurses out there willing to fly on a Delta Airlines flight piloted by a woman suffering from angina pectoris, epilepsy, or substance abuse?   I didn’t think so.

So, no, a person whose work directly involves the safety of others does not have a right to expectation of privacy concerning health matters that would adversely and directly affect others, and/or engage in health behavior that would adversely and directly affect others.  Nurses, get your vaccinations.

Epilogue
In an upcoming article, I’ll be taking down some specific, dangerously false information being put out by anti-vaccine groups, including the hilarious claim that your best defense against the Shingles infection is repeated exposure to/infection by Chickenpox.  Until then, I’ll leave you with a photo of myself getting the 45th flu shot of my life, and encourage you to talk to your doctor and get one for yourself and your children as well.

I’m not dead yet!

shot

(1) Medline Plus, Ebola Hemorrhagic Fever
http://www.nlm.nih.gov/medlineplus/ency/article/001339.htm

(2) Vaccines.gov
http://www.vaccines.gov/diseases/index.html

(3) Vaccines to Prevent Measles
http://www.vaccines.gov/diseases/measles/index.html

(4) CDC – Chickenpox Complications
http://www.cdc.gov/chickenpox/about/complications.html

(5)  The state With the Highest Vaccination Rate Has the Highest Infant Mortality Rate
https://badscidebunked.wordpress.com/2014/09/24/copy2/

(6)  Uneducated Chiropractor and Nurse Endanger Life of Three Month Old Child
https://badscidebunked.wordpress.com/2014/09/21/uneducated-chiropractor-and-nurse-endanger-life-of-three-month-old-child/

(7)  Herd Immunity
http://www.vaccines.gov/basics/protection/

(8)  Typhoid Mary
http://en.wikipedia.org/wiki/Typhoid_Mary

(9)  A looming problem: How to ration Ebola vaccines and medicines
http://www.latimes.com/science/la-sci-ebola-drug-rationing-20140918-story.html#page=1

(10)  FAA:  Pilot Medical Certification Questions and Answers
https://www.faa.gov/licenses_certificates/medical_certification/faq/

(11)  FAA:  Disqualifying Conditions for Pilot Certification
https://www.faa.gov/licenses_certificates/medical_certification/faq/response6/

“The state With the Highest Vaccination Rate Has the Highest Infant Mortality Rate”

It’s rare to run across facts from an anti-vaccine proponent, so it shocked me when I found out this one was true:

maryjo-blurAccording to a 2010 CDC report on infant mortality, Mississippi led the USA with 9.62 infant deaths per 1,000 live births (1). Gleefully, anti-vaxxers point out multiple references showing Mississippi also leads the nation in vaccinating children, with rates at or better than 99.9% overall. For example see references (2) and (3).

As a scientist, I’m forced to concede facts, and here we have one:  the state with the best vaccination record is also losing children at the highest rate.

So what’s the problem here? Are vaccinations failing to protect the children of Mississippi as the anti-vaccination forum post claimed? Or, worse yet, are vaccinations somehow harming the children?

Well, as is often the case, just because someone is throwing a fact out at you, it doesn’t mean they’re being honest. I’ve always found this to be true of the anti-vaccination crowd, so I did a bit of research. My suspicions were confirmed, and what’s really happening in Mississippi is obvious.

Comparing Apples to Oranges
The problem is that Mississippi children are dying at birth, before they ever have a shot at vaccination (no pun intended). Or, they’re dying from causes that couldn’t be helped by a vaccine. For example, how do you vaccinate a child in the womb against a parent who smokes (smoking causes pre-mature birth, which leads to higher infant mortality)?

According to a 2013 Mississippi Infant Mortality Report (4), pre-term birth complications are the leading causes of infant death. Birth defects account for 19.1% of deaths, low birth weight/prematurity 15.2%, Sudden Infant Death Syndrome (SIDS) 10.6%… accidents, maternal complications, respiratory distress, and infections present at birth are all in the top 10 – none possibly preventable (or caused by) vaccines.

Let’s say this again because it’s the point anti-vaxxers intentionally choose to ignore: Mississippi infants are dying before they ever live long enough to get vaccinated.

Another major contributor to infant mortality in Mississippi is socioeconomic conditions. According to the same report (4), poor and un-insured women, teens, and African-American women are more likely to lose babies due to pre-term births.  For example, there are 14.1 pre-term births for white Mississippian women vs. 20.6 for blacks per 1,000 live births.  As pointed out two paragraphs earlier, pre-term birth complications are the leading cause of infant death in this state.

Why am I harping on about social and economic conditions in a discussion of infant mortality rates in Mississippi?  Well, we know they’re a contributor to higher infant mortality. Guess which is the poorest state in the USA? Yes, it’s Mississippi (5).   How do you vaccinate a child against a mother’s lack of access to proper pre-natal care?

The socioeconomic study is reinforced by a CDC study (6) that shows infant mortality rates nationwide for black women are more than twice those for white women. Why would this matter for infant mortality in Mississippi? According to the 2010 U.S. Census, Mississippi has the highest percentage of African-Americans in the United States (7).

Last but not least, exposure to cigarette smoke is known to have an effect on low birthweight, which in turn increases the risk of infant mortality (4). A 2013 Gallup poll places Mississippi third in the nation when it comes to addiction to cigarette smoking, behind only Kentucky and West Virginia (8). No wonder so many children are dying. How do you vaccinate a child against a parent who smokes?

So now we know why so many children are dying in Mississippi, and anti-vaccine nutters are comparing apples to oranges when quoting infant mortality and vaccination rates for the state.

But let’s not stop there – let’s compare vaccinated Mississippi children against unvaccinated children in other states.

Comparing Apples to Apples
Before poorly informed anti-vaccination campaigners started making their rounds, measles was a disease that was considered beaten. Now, thanks to unvaccinated children, it’s on the comeback, and people are dying (12).

In the news recently, the three states with the highest number of measles outbreaks were Ohio [138], California [60], and New York City [26] (9). How do OH, CA, and NY compare to well-vaccinated Mississippi when it comes to MMR (Measles-Mumps-Rubella) vaccinations?   If you’re anti-vaccine lady whose quote opened this article, you’re not going to like the answer:  Ohio, California, and New York lag Mississippi by 3 to 7 percent in vaccination levels (9).  And that lady needs to sit down now and hold on to her seat:

How many measles cases have been reported in highly vaccinated Mississippi?  In the last decade, there has been one confirmed case of measles in the Magnolia State.

To drive the point home, most of the 288 measles cases reported in the USA this year have been in unvaccinated persons or those with unknown vaccination status (9).  So Mississippi is clearly doing a great job, once the child lives long enough to get vaccinated.

If the anti-vaccine lady is still seated, she should stay there, because it gets worse.

Measles isn’t the only example for which we have hard evidence.  In 2012, the largest Chickenpox outbreak in the USA hit Vigo County in Indiana (11). 84 cases were reported in a county that usually sees less than 10 per year. Chickenpox can cause serious problems for older children and adults and is extremely contagious.

In 2012, the state of Indiana reported 469 cases of Chickenpox. Mississippi reported only 11 (13). Not surprisingly, Indiana ranks very poorly compared to Mississippi – approximately 7% less of the Indiana population is vaccinated against Chickenpox (3).  Again, when you look at the facts, Mississippi’s vaccination programs are working, while states with poor vaccination records are suffering the consequences.

Conclusion
When reading anti-vaccination posts in online forums and on Facebook, it’s best to keep an old saying in mind:

 “Figures don’t lie, but liars figure”

The quote has been attributed to various sources including Mark Twain, but regardless of who said it, the truth behind the Mississippi vaccination/infant mortality myth is nothing more than a phenomenon with a fancy name of false or illusory correlation: you simply take two numbers that have nothing to do with each other, and convince your audience that there’s a relationship between them.

I’ll close by a fun example of false correlation that everyone can understand, courtesy of the Spurious Correlation Generator at http://www.tylervigen.com: Did you know that taking anti-diabetic drugs is directly linked to your chances of drowning in a fishing boat accident?

Hey, anti-vaccine believers, the numbers don’t lie!

correlation

References
(1)  CDC Infant Deaths Per 1,000 Live Births, By State: 2010
http://www.cdc.gov/nchs/pressroom/states/INFANT_MORTALITY_RATES_STATE_2010.pdf

(2)  Advisory Board Company Daily Briefing – States With the Best – and Worst – Vaccine Coverage (August 2013)
http://www.advisory.com/daily-briefing/2013/08/08/the-states-with-the-best-and-worst-vaccine-coverage

(3)  CDC MMWR Vaccination Coverage Among Children in Kindergarten –USA, 2012-13 School Year
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a3.htm?s_cid=mm6230a3_e#Tab1

 (4)  Mississippi Department of Health and Vital Statistics
http://msdh.ms.gov/msdhsite/_static/resources/5629.pdf

(5) State & County Quick Facts, United States Census Bureau
http://quickfacts.census.gov/qfd/download_data.html

(6)  Recent Declines in Infant Mortality in the United States, NCHS Data Brief, April 2013 http://www.cdc.gov/nchs/data/databriefs/db120.pdf

(7)  Historical Census Statistics on Population Totals By Race, U.S. Census Bureau http://www.census.gov/population/www/documentation/twps0056/twps0056.html

(8)  Gallup Well-Being: In U.S., Smoking Rate Loest in Utah, Highest in Kentucky http://www.gallup.com/poll/167771/smoking-rate-lowest-utah-highest-kentucky.aspx

(9)  CDC Morbidity and Mortality Weekly Report
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm

(10)  Mississippi Morbidity Report, Vol 24, No. 12. Dec 2008
http://msdh.ms.gov/msdhsite/_static/resources/3095.pdf

(11)  Largest Chickenpox Outbreak in the U.S. Hits Vigo County in Indiana  (Huffington Post 11/27/2012)
http://www.huffingtonpost.com/2012/11/27/chickenpox-outbreak-largest-vigo-county-indiana_n_2199231.html

(12)  World Health Organization “Measles”
http://www.who.int/mediacentre/factsheets/fs286/en/

(13)  CDC Morbidity and Mortality Weekly Report, Summary of Notifiable Diseases – United States 2012
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6153a1.htm?s_cid=mm6153a1_w