Monday, September 22, 2014

Off the Deep End of the Stupid Pool

Let's start with the basics:

1)  Vaccines do not cause autism.  They also do not cause asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn's disease, demyelinating diseases, bacterial or viral infections, or bad hair.  At last count, the evidence supporting this claim included 5 randomized control studies, one controlled trial, 27 cohort studies, 17 case-control studies, 5 time-series trials, one crossover trial, 2 ecological studies, and 6 self-controlled case-series studies. Combined, these studies include data from just shy of 14.8 million children, from at least four different countries, and span a period of almost two decades, a time span that meets any reasonable definition of "long term," and quite a few unreasonable ones.  These studies have consistently shown that the risk of serious side effects from the vaccine is vastly smaller than the risk of serious effects from the disease they prevent.

2)  There is no profit motive for Big Bad Pharma, or really, anyone else, to convince anyone that vaccines are safe.  Quite the contrary, the strongest profit motive is, consistently, to convince people that they are as dangerous as possible.  Here are just a few examples:

2a) Mr. Andrew Wakefield had patented a measles vaccine a few months before he proposed that they should switch to the exact vaccine he had patented. His patent would be worthless unless confidence in the extant MMR vaccine could be shaken. All that was a coincidence I'm sure. Since then, he's made a killing selling books to people stupid enough to believe his persecution complex, books that would be worthless if his customers believed that vaccines were both safe and effective. Therefore, Mr. Wakefield has had at least two clear profit motives to convince people that vaccines are dangerous.

2b) Mr. David Mercola has made himself an obscenely rich man partly by peddling a "natural alternative" to vaccination that has never actually been shown to work (on the contrary, its effects are consistently indistinguishable from a similarly-administered placebo). Obviously, his products are worthless if vaccines are seen as safe and effective, giving him a clear profit motive to convince as many people as possible that vaccines are dangerous.

2c) Mr. Mark and David Geier have made themselves quite rich by convincing desperate parents that vaccines cause autism, then chemically castrating austistic children in an (invariably, failed) attempt to cure it. No, by the way, that isn't an exaggeration at all; until they lost their licenses to practice medicine, they literally did exactly that. They called it the Lupron protocol.  Not only are Mr. Mark and David Geier reprehensible excuses for human beings, the treatment they propose has absolutely no chance of working unless vaccines cause autism, so they clearly have a strong profit motive to convince as much of the public as possible that vaccines actually cause autism.  Or at least, they did, until the medical ethics boards of every state where they had been licensed to practice medicine decided that castrating children was crossing a bit of an ethical line.

2d) Pediatricians?  They have a very clear profit motive not to vaccinate.  A recent study analyzed how much money pediatricians actually make off of vaccines (Margaret S. Coleman, PhD, Megan C. Lindley, MPH, John Ekong, MPH, Lance Rodewald, MD Net Financial Gain or Loss From Vaccination in Pediatric Medical Practices PEDIATRICS Vol. 124 pp. S472 -S491).  The conclusion of this study?  At best, pediatricians break even, or, in specific cases, turn a minuscule profit.  On average, they generally lose money every time they administer a vaccine.

2e) As for Big Bad Pharma? The profits they make off of vaccines, per year, essentially amounts to round-off error. They're expensive to produce, difficult to get approved, and high-risk. They also kill profits in other areas of business. Every single dollar spent on, just to name one, the MMR vaccine, saves about $30 more (Zhou, et al., J Infect Dis, 189(2004): S131-145). On average, for every dollar spent administering the vaccines on the standard schedule, around $10 more are saved. Whether vaccines are administered or not, a fair amount of money goes into a pharmaceutical company's pocket, but if we stopped vaccinating, there would be a lot more of it. There is very little to gain on Big Pharma's part for manufacturing vaccines.

Faced with this, a lot of anti-vaccination advocates (the honest ones -- the ones who realize that they can't deny, for instance, that Big Pharma would make a lot more money if they halted all vaccinations, or that a lot of prominent anti-vaccination advocates either have, or have tried to make obscene amounts of money off of that position) go way off the deep end of the stupid pool.  Sure, they'll say, vaccines are a profit killer, and the last thing that Big Pharma would ever want to do is convince you that vaccines are safe, but what they're really doing is causing everyone to get autism (setting aside, for the moment, that vaccines don't actually cause autism), so that they can make money off of treating that.  In other words, Big Pharma cannot possibly have a non-evil motivation for providing vaccines to the marketplace.

To understand just how unbelievably, mind-bogglingly stupid this is, we again need to cover a few basics:

1)  Big Pharma doesn't make any money off of off-patent drugs.  It's called a "patent cliff" for a reason. Here's what happened to the profits Johnson & Johnson made off of Plavix when its patent expired.


This is the norm, by the way, not the exception.  Once a pharmaceutical company loses its patent, it no longer makes any money off of the drug it once had patented.  Then it's the generics manufacturer's turn to make money.  While a lot of pharmaceutical companies have wholly-owned generics companies under their respective umbrellas, the amount made of the drug in generic form is not remotely sufficient to recoup their daily cost of operation.

2)  There are no drugs that cure autism, or even treat its primary symptoms.  The only people who claim otherwise have never shown their treatments to actually work; and often require procedures that are ineffective, and in some cases even dangerous (see above, re: Mark and David Geier).

3)  There are, however, some drugs that can treat some of the related symptoms.

4)  However, none of those drugs are patented.  The primary treatments for symptoms associated with autism are Prozac and Zoloft (whose patents expired in 2001 and 2006 respectively).  In addition, some antipsychotic medications are sometimes used to control energy levels (Resperidol is the most common; its patent expired at the end of 2003, closely followed by Haloperidol, which has been out of patent since the '80s).  Ritalin has been shown to have beneficial effects on people with ASD (its patent expired in 1967).

To be clear, a lot of pharmaceutical companies are researching ASD, and attempting to develop pharmacological interventions that may alleviate its major symptoms.  The amount spent on this research runs in the range of 2-5 billion dollars per year, depending on the company you're talking about.

So, in summary, there are a few rather major flaws with the narrative they are proposing.

1) For this narrative to be true, Big Pharma would have to have drugs marketed that make money off of treating autism.  They don't.

1a) Therefore, if this narrative were true, they would be causing a disease that they have absolutely no way of making money off of, and will not for the foreseeable future.

2) If this narrative were true, it would mean that Big Pharma already knows what causes autism, and therefore wouldn't need to spend billions researching its causes and progression.

2a) So, for this narrative to be true, Big Pharma would have to be knowingly wasting billions of dollars researching the underlying causes of a disease that they themselves are knowingly causing.

4) Finally, and most importantly, for this narrative to be true, vaccines would have to actually cause autism.

4a) So, for this narrative to be true, they would have to spend enormous amounts of money manufacturing all of the evidence evidence that vaccines do not cause autism (since that's literally what all of the evidence says), and concealing evidence that it does (since nobody has yet produced any), to keep a product on the market that they don't make much money off of, in order to increase the prevalence of a disease that they can't make money off of, and won't be able to for the foreseeable future.

The TL;DR version?  They're literally arguing that Big Phrama is an evil, profit-mongering corporation, that is pursuing a strategy that cannot possibly produce a profit any time in the foreseeable future.

Thank you for your attention.

Sunday, September 21, 2014

THERE HAVE NEVER BEEN ANY STUDIES SHOWING THAT VACCINES ARE SAFE!!!11ONEONEELEVENTYONE!1!!

Except, of course, for these ones:

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Afzal, MA., Ozoemena, LC., O’Hare, A., Kidger, KA., Bentley, ML., Minor, PD.Absence of detectable measles virus genome sequence in blood of autistic children who have had their MMR vaccination during the routine childhood immunization schedule of UK. Journal Medical Virology. 2006 May;78(5):623-30.http://www.ncbi.nlm.nih.gov/pubmed/16555271

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Andrews, N., Miller, E., Grant, A., Stowe, J., Osborn, V., & Taylor, B. (2004). Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United Kingdom does not support a causal association. Pediatrics, 114, 584-591. http://www.ncbi.nlm.nih.gov/pubmed/15342825

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Bower, H. New research demolishes link between MMR vaccine and autism.British Medical Journal. 1999. Jun 19;318(7199):1643. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116011/

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DeStefano, F., Bhasin, T. K., Thompson, W. W., Yeargin-Allsopp, M., & Boyle, C. (2004). Age at first measles-mumps-rubella vaccination in children with autism and school-matched control subjects: a population-based study in metropolitan Atlanta. Pediatrics, 113(2), 259-266. http://www.ncbi.nlm.nih.gov/pubmed/14754936

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DeStefano, F. Chen, RT. Negative association between MMR and autism. Lancet. 1999 Jun 12;353(9169):1987-8. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(99)00160-9/fulltext

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Fombonne, E., Zakarian, R., Bennett, A., Meng, L., & McLean-Heywood, D. (2006). Pervasive developmental disorders in Montreal, Quebec, Canada: Prevalence and links with immunizations. Pediatrics 118(1) e139-e150; doi:10.1542/peds.2005-2993. http://pediatrics.aappublications.org/content/118/1/e139

García-Fernández, L., Hernández, AV., Suárez Moreno, V., Fiestas, F. Addressing the controversy regarding the association between thimerosal-containing vaccines and autism. Revista Peruana de Medicine Experimental Salud Publica. 2013 Apr;30(2):268-74. http://www.ncbi.nlm.nih.gov/pubmed/23949514

Gentile, I., Bravaccio, C., Bonavolta, R., Zappulo, E., Scarica, S., Riccio, MP., Settimi, A., Portella, G., Pascotta, A., Borgia, G. Response to measles-mumps-rubella vaccine in children with autism spectrum disorders. In Vivo 2013 May-Jun;27(3):377-82. http://www.ncbi.nlm.nih.gov/pubmed/23606694

Gerber, J. S., & Offit, P. A. (2009). Vaccines and autism: a tale of shifting hypotheses. Clinical Infectious Diseases, 48(4), 456-461. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908388/

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Muhle, R., Trentacoste, SV., Rapin, I. The genetics of autism. Pediatrics. 2004 May;113(5):e472-86. http://www.ncbi.nlm.nih.gov/pubmed/15121991

Nelson, KB., Bauman, ML. Thimerosal and autism? Pediatrics. 2003. Mar;111(3):674-9. http://pediatrics.aappublications.org/content/111/3/674.long

Offit PA. Thimerosal and vaccines–a cautionary tale. New England Journal of Medicine. 2007. Sep 27;357(13):1278-9. PubMed PMID: 17898096. http://www.ncbi.nlm.nih.gov/pubmed/17898096

Offit, PA., Coffin, SE. Communicating science to the public: MMR vaccine and autism. Vaccine. 2003. Dec 8;22(1):1-6. http://www.ncbi.nlm.nih.gov/pubmed/14604564

Patja, A., Davidkin, I., Kurki, T., Marku, J., Kallio, T., Valle, M., Peltola, H. Serious adverse events after measles-mumps-rubella vaccination during a fourteen-year prospective follow-up. 2000. Pediatric Infectious Diseases Journal. 2000;19:1127-34. http://www.nccn.net/~wwithin/MMR.pdf

Parker, S.K., Schwartz, B., Todd, J., Pickering, L.K. Thimerosal-containing vaccines and autistic spectrum disorder: A critical review of published original data. 2004. Pediatrics, 114, 793-804. http://www.ncbi.nlm.nih.gov/pubmed/15342856

Parker, S. Todd, J., Schwartz., B., Pickering, L.K. Thimerosal-containing vaccines and autistic spectrum disorder: A critical review of published original data. 2005. Pediatrics. Jan;115(1):200. http://www.ncbi.nlm.nih.gov/pubmed/15630018

Pichichero, ME., Cernichiari, E., Lopreiato, J., Treanor, J. Mercury concentrations and metabolism in infants receiving vaccines containing thiomersal: a descriptive study. Lancet. 2002 Nov 30;360(9347):1737-41. http://www.ncbi.nlm.nih.gov/pubmed/12480426

Peltola, H., Patja, A., Leinikki, P., Valle, M., Davidkin, I., & Paunio, M. No evidence for measles, mumps, and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study. 1998. Lancet, 351(9112), 1327. http://www.ncbi.nlm.nih.gov/pubmed/9643797

Price, C. S., Thompson, W. W., Goodson, B., Weintraub, E. S., Croen, L. A., Hinrichsen, V. L., DeStefano, F. Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism. 2010. Pediatrics, 126(4), 656-664. http://www.ncbi.nlm.nih.gov/pubmed/20837594

Roehr B. Study finds no association between vaccines and autism. 2013. British Medical Journal. Apr 3;346:f2095. doi: 10.1136/bmj.f2095. http://www.ncbi.nlm.nih.gov/pubmed/23554072

Richler, J., Luyster, R., Risi, S., Hsu, W. L., Dawson, G., Bernier, R., … & Lord, C. (2006). Is there a ‘regressive phenotype’ of Autism Spectrum Disorder associated with the measles-mumps-rubella vaccine? A CPEA Study. Journal of Autism and Developmental Disorders, 36(3), 299-316. http://www.ncbi.nlm.nih.gov/pubmed/16729252

Rumke, HC., Visser, HK. Childhood vaccinations anno 2004. II. The real and presumed side effects of vaccination. Nederlands Tijdschrift voor Geneeskunde.2004 Feb 21;148(8):364-71. http://www.ncbi.nlm.nih.gov/pubmed/15032089

Schechter, R., Grether, JK. Continuing increases in autism reported to California’s developmental services system: mercury in retrograde. Archives of General Psychiatry. 2008 Jan;65(1):19-24. doi: 10.1001/archgenpsychiatry.2007.1. http://www.ncbi.nlm.nih.gov/pubmed/18180424

Schultz, ST. Does thimerosal or other mercury exposure increase the risk for autism? A review of the current literature. Acta Neurobiologiae Experimentalis. 2010;70(2):187-95.http://www.ncbi.nlm.nih.gov/pubmed/20628442

Shevell, M., Fombonne, E. Autism and MMR vaccination or thimerosal exposure: an urban legend? Canadian Journal of Neurological Sciences. 2006 Nov;33(4):339-40. http://cjns.metapress.com/content/xqxx6ha3ufaeuunv/?genre=article&issn=0317-1671&volume=33&issue=4&spage=339

Singh, VK. Rivas, WH. Detection of antinuclear and antilaminin antibodies in autistic children who received thimerosal-containing vaccines – mercury as in thimerosal-containing vaccines is likely not related to autoimmune phenomenon in autism. Journal of Biomedical Science. 2004 Sep-Oct;11(5):607-10. http://www.ncbi.nlm.nih.gov/pubmed/15316135

Smeeth, L., Cook, C., Fombonne, E., Heavey, L., Rodrigues, L. C., Smith, P. G., & Hall, A. J. (2004). MMR vaccination and pervasive developmental disorders: a case-control study. The Lancet, 364(9438), 963-969. http://www.ncbi.nlm.nih.gov/pubmed/15364187

Smith, M. J., & Woods, C. R. On-time vaccine receipt in the first year does not adversely affect neuropsychological outcomes. Pediatrics. 2010. 125(6), 1134-1141. http://www.ncbi.nlm.nih.gov/pubmed/20498176

Solt, I., Bornstein, J. Childhood vaccines and autism – much ado about nothing? Harefuah. 2010 Apr;149(4):251-5, 260. http://www.ncbi.nlm.nih.gov/pubmed/20812501

Steffenburg, S., Steffenburg, U., Gillberg, C. Autism spectrum disorders in children with active epilepsy and learning disability: comorbidity, pre and perinatal backgound, and seizure characteristics. Developmental Medicine and Child Neurology. 2003 Nov;45(11):724-30. http://www.ncbi.nlm.nih.gov/pubmed/14580127

Stehr-Green, P., Tull, P., Stellfeld, M., Mortenson, PB., Simpson, D. Autism and thimerosal-containing vaccines: lack of consistent evidence for an association. American Journal of Preventive Medicine. 2003 Aug;25(2):101-6. http://www.ncbi.nlm.nih.gov/pubmed/12880876

Takahashi, H., Suzumura, S., Shirakizawa, F., Wada, N., Tanaka-Taya, K., Arai, S., Okabe, N., Ichikawa, H., Sato, T. An epidemiological study on Japanese Autism concerning Routine Childhood Immunization History. Japanese Journal of Infectious Diseases. 56, 114-117, 2003. http://www0.nih.go.jp/JJID/56/114.pdf

Taylor, B. Vaccines and the changing epidemiology of autism. Child: Care, Health and Development Journal. 2006 Sep;32(5):511-9. http://www.ncbi.nlm.nih.gov/pubmed/16919130

Taylor, B., Miller, E., Farrington, C., Petropoulos, M., Favot-Mayaud, I., Li, J., & Waight, P. A. (1999). Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet, 353(9169), 2026-20. http://www.ncbi.nlm.nih.gov/pubmed/10376617

Taylor, B., Miller, E., Lingam, R., Andrews, N., Simmons, A., & Stowe, J. Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. 2002. British Medical Journal, 324(7334), 393-396. http://www.ncbi.nlm.nih.gov/pubmed/11850369

Taylor, B., Lingam, R., Simmons, A., Stowe, J., Miller, E., Andrews, N. Autism and MMR vaccination in North London: no causal relationship. 2002. Molecular Psychiatry. 7 Suppl2:S7-8. http://www.ncbi.nlm.nih.gov/pubmed/12142932

Thjodleifsson, B., Davidsdóttir, K., Agnarsson, U., Sigthórsson, G., Kjeld, M., Bjarnason, I. Effect of Pentavac and measles-mumps-rubella (MMR) vaccination on the intestine. Gut.2002 Dec;51(6):816-7. http://www.ncbi.nlm.nih.gov/pubmed/12427783

Thompson, WW., Price, C., Goodson, B., Shay, DK., Benson, P., Hinrichsen, BL., Lewis, E., Eriksen, E., Ray, P., Marcy, SM., Dunn, J., Jackson, LA., Lieu, TA., Black, S., Stewart, G., Weintraub, ES., Davis, RL., DeStefano, F., Vaccine Data Link Safety Team. Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years. New England Journal of Medicine. 2007 Sep 27;357(13):1281-92. http://www.ncbi.nlm.nih.gov/pubmed/17898097

Uchiyama, T., Kurosawa, M., & Inaba, Y. MMR-vaccine and regression in autism spectrum disorders: negative results presented from Japan. 2007. Journal of Autism and Developmental Disorders, 37(2), 210-217. http://www.ncbi.nlm.nih.gov/pubmed/16865547

Uno, Y., Uchiyama, T., Kurosawa, M., Aleksic, B., & Ozaki, N. The combined measles, mumps, and rubella vaccines and the total number of vaccines are not associated with development of autism spectrum disorder: first case–control study in Asia. 2012. Vaccine, 30(28), 4292-4298. http://www.ncbi.nlm.nih.gov/pubmed/22521285

Verstraeten T., Davis, RL., DeStefano, F., Lieu, TA., Rhodes, PH., Black, SB., Shinefield, H., Chen RT. Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases. Pediatrics.2003 Nov;112(5):1039-48. http://www.ncbi.nlm.nih.gov/pubmed/14595043

Whitehouse, AJ., Maybery, M., Wray, JA., Hickey, M. No association between early gastrointestinal problems and autistic-like traits in the general population. Developmental Medicine and Childhood Neurology. 2011. May;53(5):457-62. doi: 10.1111/j.1469-8749.2011.03915.x. Epub 2011 Mar 21. http://www.ncbi.nlm.nih.gov/pubmed/21418197

Weisser, K., Bauer, K., Volkers, P., Keller-Stanislawski, B. Thimerosal and immunizations – evidence does not support the hypothesis of a potential relationship between neurodevelopmental disorders and thiomersal-containing vaccines. 2004. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. Dec;47(12):1165-74. http://www.ncbi.nlm.nih.gov/pubmed/15583887

MMR vaccine is not linked to Crohn’s disease or autism. Commun Dis Rep CDR Weekly. 1998 Mar 27;8(13):113. http://www.ncbi.nlm.nih.gov/pubmed/9592960'

Taylor LE et al. Vaccines are not associated with autism: an Evidence-Based Meta Analysis of case-control and Cohort Studies Vaccine (2014) http://autismoevaccini.files.wordpress.com/2014/05/vaccines-are-not-as sociated-with-autism.pdf

Tuesday, December 07, 2010

Another reason why Anti-vaccination advocates are idiots, part II

I've got some criticism as to how I didn't actually support my premise that there's a lot more money to be made off of not vaccinating than vaccinating.

TDaP$27.00
MMR$26.00
Hib$5.40
Varicella$5.45


Now, first, let's start with the basics: the numbers in the right hand column are not costs of a dose of any of those vaccines. They're very conservative estimates of the amount of money every dollar spent on those vaccines saves. In other words, if you spend one dollar on a TDaP vaccine, you save 27, and so on.

Now, the sources for this data are as follows:

For the TDaP vaccine,

Ekwuemeet al, Arch PediatrAdolescMed, 154(Aug 2000): 797-803

MMR:

Zhou, et al., J Infect Dis, 189(2004): S131-145

Hib:

Zhou, et al., Pediatrics, 110:4(Oct 2002): 653-661

Varicella:

Lieu, et al., JAMA, 271(1994): 375-81

None of these scientists have any connection to any pharmaceutical company.

If you look at just these four vaccines, for every dollar spent on a vaccine, just shy of 16 dollars are saved. That money would go into the pockets of the very pharmaceutical companies that anti-vaccinations advocates so insist are lining their pockets by forcing vaccines upon the unwilling public.  They'd make a lot more by letting everyone just get the measles.

What is the most profitable vaccine on the market? The one that isn't given.

Monday, September 13, 2010

Another reason why Anti-vaccination advocates are idiots

I shouldn't have to say this, but I do.

I receive no funding whatsoever from any pharmaceutical or biotechnology company in existence anywhere in the world.

None.

Zip.

I have never so much as seen a single penny from one in dividends, project support, or salary from any pharmaceutical company. Indeed, all funds I have ever worked for come from competitive grants from the NIH or the AHA. Currently, the entirety of my salary is paid by a postdoctoral fellowship from the American Heart Association. The AHA, in turn, is entirely funded by private donations which the individual donors can apply to their tax returns. I have no knowledge of who the individual donors are, and therefore can have no possible knowledge of their individual motivations or what they wish for my research to show, therefore, it is completely and utterly impossible for any pharmaceutical company to exert any influence upon me, even if I were performing any research which would motivate them to do so. I am not. The AHA has no say on whether, or what, I publish, and holds no power over my academic freedom.

Further, I receive no funding, support, or salary from any manufacturer of vaccines. See above.

Pretty much anybody who speaks out against the idiocy that is the anti-vaccination movement has to include a disclaimer like the above.

Now, here's why they shouldn't have to.

It takes a truly delusional mind to claim, with a straight face, that the reason pharmaceutical companies produce vaccines is to turn a profit. Yes, there are a few vaccines that have made quite a lot of money for the manufacturers. Gardasil, for example, made its manufacturers somewhere in the ballpark of 1.5 billion dollars.

Setting aside the fact that making money off of an exceptionally effective treatment which reduces a woman's chance of developing cervical cancer to nearly zero is not implicitly evil (as much as anti-vaccination advocates would like you to think otherwise), Gardasil is deep, deep in the minority.

In general, vaccine production is so ridiculously unprofitable, convincing manufacturers to make the vaccines is a challenge in itself. The single most-applied vaccine worldwide the BCG vaccine against tuberculosis. Its profit margin is, for all practical purposes, zero, once transportation to the needed areas is taken into consideration.

But for the moment, let us assume that that is not the case. Let's assume that all doses are created equal, profit-wise. A dose of viagra makes the exact same profit as a dose of the Tdap vaccine.

Which of the two will turn a greater profit: one dose of the vaccine, or a month's worth of drugs to keep the symptoms under control?

In short, if vaccine manufacturers were really the profit-grubbing evil entities that the anti-vaccine morons believed they were, they wouldn't make vaccines. They'd want as many of us to catch the disease as possible for one simple reason: it's vastly more profitable to treat a disease than it is to prevent it.

Monday, October 26, 2009

If there is a Hell, Jenny McCarthy and Jim Carrey will spend eternity in an Iron Lung

Okay, let me start with a full disclosure of my own biases:

The anti-vaccination movement is potentially the single greatest threat to public health.

Note that I don't qualify that as "in America," or "in the third world" or "in westernized countries." They are potentially the single greatest threat to public health, period.

Let me go a step further, if you do not get your child vaccinated, or worse, you convince someone else not to get their child vaccinated, you are guilty of child abuse by any reasonable (if not legally-actionable) definition of the term. You're playing roulette with their lives and hoping that they're fortunate enough never to be exposed to any of the diseases which vaccines will protect them from.

Also in the interest of full disclosure, I should mention the following: vaccines are, collectively, the lowest-cost, highest effectiveness, most portable, dispersable, and long-term solution to most of the world's diseases. This, incidentally, is not a matter of my own opinion, it's a matter of track record. Small pox, polio, tetanus, diphtheria, measles, rubella, and other diseases which, in Canada and the US, are little more than a distant memory. It's estimated that one in five people would not now be alive if not for this medical miracle.

Now, let me add a one last statement to the preceding ones. If you do not get your child vaccinated, you are abusing the children that child will go to school with. Morally, I see the refusal to get your child vaccinated as the equivalent of taking a baseball bat to a baby, then walking over to the houses of the children that child will go to school with, and taking a baseball bat to them, too. This, unfortunately, is the leap that the anti-vaccination movement never makes. By not getting vaccinated, you are not only harming your own child, you're harming someone else's.

By that standard of evidence Jenny McCarthy and Jim Carrey have been brutally bludgeoning countless millions of children.

Metaphorically speaking.

Let's start with the basics:

Vaccines do not cause autism. The one study which has ever presented a link between vaccination and autism was shown to be fraudulent.

In the interest of completeness, here is that particular citation.

Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoidnodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 1998;351:637-641

By contrast, however, we have papers showing no link between vaccines and autism:

Dales L, Hammer SJ, Smith NJ. Time trends in autism and in MMR immunization coverage in California. JAMA. 2001;285:1183-1185.

Davis RL, Kramarz P, Bohlke K, et al. Measles-mumps-rubella and other measles-containing vaccines do not increase the risk for infl ammatory bowel disease: a casecontrol study from the Vaccine Safety Datalink project. Arch Pediatr Adolesc Med. 2001;155:354-359.

DeStefano F, Bhasin TK, Thompson WW, Yeargin-Allsopp M, Boyle C. Age at first measles-mumps-rubella vaccination in children with autism and school-matched control subjects: a population-based study in metropolitan Atlanta. Pediatrics. 2004;113:259-266.

DeStefano F, Chen RT. Negative association between MMR and autism. Lancet. 1999;353:1986-1987.

Farrington CP, Miller E, Taylor B. MMR and autism: further evidence against a causal association. Vaccine. 2001;19:3632-3635.

Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics. 2001;108:E58.

Fombonne E, Cook EH Jr. MMR and autistic enterocolitis: consistent epidemiological failure to fi nd an association. Mol Psychiatry. 2003;8:133-134.

Honda H, Shimizu Y, Rutter M. No effect of MMR withdrawal on the incidence of autism: a total population study. J Child Psychol Psychiatry. 2005;46:572-579.

Kaye JA, del Mar Melero-Montes M, Jick H. Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis.
BMJ. 2001;322:460-463.

Madsen KM, Hviid A, Vestergaard M, et al. A populationbased study of measles, mumps and rubella vaccination and autism. N Engl J Med. 2002;347:1477-1482.

No link between Thimerosol (a preservative found in vaccines) and autism (or, for that matter, any ill-effects):

Andrews N, Miller E, Grant A, Stowe J, Osborne V, Taylor B. Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United Kingdom does not support a causal association. Pediatrics. 2004;114:584-591.

Fombonne E, Zakarian R, Bennett A, Meng L, McLean- Heywood D. Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations. Pediatrics. 2006;118:E139-150.

Heron J, Golding J. Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the United Kingdom does not support a causal association.
Pediatrics. 2004;114:577-583.

Hviid A, Stellfeld M, Wohlfahrt J, Melbye M. Association between thimerosal-containing vaccine and autism. JAMA. 2003;290:1763-1766.

Madsen KM, Lauritsen MB, Pedersen CB, et al. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003;112:604-606.

Schechter R, Grether J. Continuing increases in autism reported to California’s developmental services system: mercury in retrograde. Arch Gen Psychiatry. 2008;65:19-24.

Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, Simpson D. Autism and thimerosal-containing vaccines: lack of consistent evidence for an association. Am J Prev Med. 2003;25:101-106.

Verstraeten T, Davis RL, DeStefano F, et al. Study of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases. Pediatrics. 2003;112:1039-1048.

And, just for good measure, studies showing no link between vaccines and inflammatory bowel disease:

Peltola H, Patja A, Leinikki P, Valle M, Davidkin I, Paunio M. No evidence for measles, mumps and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study. Lancet. 1998;351:1327-1328.

Just to be clear on this.

So, why do people still claim that vaccines cause autism?

Well, let's start with the issues that they have with the above studies. You never, ever, ever hear them go after the actual studies themselves. On the contrary, they always, always, go after the authors. If they got funding from, or were employed by, a manufacturer of vaccines, they clearly could not be trusted (but, for some reason, when one deliberately falsifies their data, that article is gospel). See for yourself: from Generation Rescue's own website, they never once, ever address the science. They present the scientists as if, because they had jobs which involved making vaccines, created a bias in their data. Even if that is true, they never explain, ever, how that alleged bias produces an error in their results.

By contrast, they offer no argument in favor of their own position.

Again, from their own website:

In 1983, autism rates were 1 in 10,000 and there were 11 vaccines in the pediatric schedule. Today there are 36 pediatric vaccines and autism rates are reported as high as 1 in 80 in local school districts in Oregon and New Jersey.


Clearly, nobody ever told them that correlation does not denote causality. For example, consider the following argument:

Since 1988, there has been a dramatic increase in the importation of oranges from Mexico. Also since 1988, there has been a dramatic reduction in the number of traffic fatalities. Therefore, we should increase our importation of oranges in order to eliminate traffic fatalities.


Ridiculous? Exactly. And it's the exact same argument that Operation Rescue is attempting to make with regards to vaccination. One could just as readily claim that Netscape (which did not exist in 1983) causes autism, or that M. C. Hammer pants suppress it.

Put simply, the fact that two events occur concurrently is not evidence that there is a causal relationship, or for that matter, any relationship at all.

That's not to say that correlative data is not very valuable. Often, you can establish causality using correlative data. However, there are a few things which need to be established first.

1) a mechanism of causality must be established. In the case of vaccines, no causal mechanism by which children could even be potentially harmed has any evidence to support it.

2) We must be able to predict ahead of time what will happen, given a set of criteria. I'll come back to this in a second.

3) confounding factors, where present, must be addressed and accounted for. This last one can be very difficult, which is part of the reason why Project Rescue's data is complete bullshit. They make the claims that a) the US has the largest vaccine schedule, and b) the US has one of the highest rates of autism. There are an enormous number of confounding factors here, not the least of which being the fact that autism is a random affliction with an ill-defined pathology, and a tendency to be over diagnosed.

Let's address that second criteria for a moment.

Let's take Project Rescue's own numbers and consider the hypothesis of vaccines resulting in early infant mortality.

Now, first things first. Note that their numbers are the total mortality rates for children under five.

In other words, every child under five who dies in a car accident, every child who ever dies of diseases not included in the vaccine schedule, every child who dies in a plane accident, of cancer, or of any other of the millions of possible afflictions or accidents that can befall a child, is counted in that number.

In other words, while vaccines are a medical miracle, they won't protect your child from an automobile accident, or from drowning in the bathtub, or from falling off of a playground slide. When counted against those causes of death in the countries listed, the number of children who die from diseases which vaccines prevent pales to insignificance. The reason it pales to insignificance is that as long as assholes like Jenny McCarthy and Jim Carrey are having a relatively minor effect on vaccination rates, most people in the US are still vaccinated against these diseases.

If you actually plot the infant mortality rate against the number of vaccines, you get something which shows no clear correlation at all. None. It's a blob of data points.



Which is pretty much to be expected, since the overwhelming majority of children who die under five don't die of something that a vaccine could have prevented. Largely because a vaccine prevented them from dying of it.

But, let's try the other side of the coin. What happens if, suddenly, we stop vaccinating? Let's consider a single disease: diptheria.

Remember, in order to establish causality, we need to make sure that three important concerns are addressed: a mechanism of causality is established, prediction of the outcome in advance based upon that mechanism of causality, and a minimum of confounding factors. The reason I picked diptheria is because it is a disease which is primarily fatal to children under five years old.

So, if we were to look at a country where diptheria vaccinations suddenly dropped off what would we predict?

Remember, we have a proposed mechanism of action: the reason that diptheria rates are so low is because most people are being vaccinated against it. Most children have immunity to the disease from childhood and are therefore not being infected. Therefore, we can predict what would happen if the rate of vaccination suddenly dropped off. Not immediately, but within ten years, we would see a massive increase in the rate of the disease.

In the Soviet Union, in 1991, 2000 cases of diptheria were reported. As the soviet block disintegrated, vaccination rates went into free-fall.

Now, another reason I chose diptheria is because it significantly reduces the number of confounding factors. Transmission is virtually always directly person to person. Break-down of infrastructure would have very little effect upon its transmission.

So, what would the prediction be for diptheria, if the vaccinations stopped?

Well, a number of people carry diptheria asymptomatically, which is what makes it such a dangerous disease. They're contagious, but they don't look like they are. In a population of individuals which is largely immune due to vaccination, these carriers are of no real concern. This is due to something called herd immunity. I'll get to that in a second.

However, if, for some reason, the level of immunity in a population drops, not only can more people catch it, but it can spread more easily through a population.

Sure enough, in the Soviet Union in 1991, 2000 cases of diptheria were reported. That was when the vaccination against it dropped precipitously. Within eight years, over 200,000 cases, with 5000 deaths reported from it. That's a hundred-fold increase.

Now, consider the criteria I laid out before.

1) a mechanism of causality has to be established. Vaccines provide an immunity from disease.

2) we can predict, in advance, the outcome of a specific perturbation, based upon the mechanism of causality. If the above is correct, we should observe a resurgence of the disease after immunization is cut off.

3) confounding factors are reduced. In this case, we're dealing with the exact same population over eight years, and the transmission vector of the disease is well-understood.

And it's not just that. The opposite was observed in the case of Pertussis in the United states. Immediately after the introduction of the pertussis vaccine, cases plummeted into freefall.

We are now seeing the same thing happening in the United States, as a direct consequence of the anti-vaccination movement. People are dying, and people like Jenny McCarthy and Jim Carrey are killing them.

Now, here's the side of things that anti-vaccination advocates don't realize. They're not just harming themselves. They're harming everyone else. That's the side of the equation you never, ever hear from Generation Rescue, or any of the other anti-vaccination movements. A critical component of the vaccination schedule is herd immunity. If enough people in a population are immune to a disease, they are individually better protected against it. You get better protection if you are completely unvaccinated, and are surrounded by a herd, friends and neighbors, who are protected than you are if you are completely protected, and surrounded by a herd which is not. This is a non-trivial point, and something you never hear Jenny McCarthy mention in any of her interviews or press conferences. Every single person who gets convinced not to vaccinate harms not only themselves, but those around them.

In the case of childhood vaccinations, we're talking about children. Children at the Kindergarten level and younger. Even if those children are vaccinated, if enough individuals in their herd are not, they're less well protected.

Seriously. Get vaccinated. If you don't care about your own kid, the least you could do is care about someone else's.

Monday, June 23, 2008

In Honor of George Carlin

Shit
Piss
Fuck
Cunt
Cocksucker
Motherfucker
Tits.

Monday, May 19, 2008

One small step for civil rights

So California courts decided to give gay marriage an okay. Which isn't terribly surprising. I mean, we've been here before in California. Repeatedly.

Interestingly enough, the legislature in the state of California recently voted in favor of same-sex marriage. The governator decided to veto it; in spite of his campaign promise never to exercise such a veto.

So, as I understand it, the general rule of thumb in the states is as follows:

-the actions of the judicial branch are invalid, since they are not the "will of the people", however, in California, the actions of the courts are preferrable to the legislature, so the opposite rule applies.

-the actions of the representative legislative branch is invalid, as it doesn't represent the "will of the people", except in Massachusetts, where the judicial branch is the invalid actionary member and the legislature acting to overturn their constitutionally-based decision is the proper course of action.

-the actions of the executive branch, acting against the will of the courts and the legislature is a heinous abuse of power, if it is in San Francisco or New York and the action being taken is to bestow rights upon citizens. If it is the governator of California, acting against his own campaign promises and against the elected representatives of the people, then that's an okay thing.

-In other words, it would seem that the good ol' GOP intends to implement a full chaosocracy where the majority has absolute power over the minority and can abuse them and deny them any and all rights via the voting booth, thus overturning the constitutional, representative government which has served us up until today, using the "might makes right and makes your rights invalid" theory of government. The mob mentality right now makes this the most efficient path to achieve their desired results, much as has been done in many past governments, with limited, yet hideously disasterous results.

Summary: Tearing apart the very basis of government in this country and hurtling towards ruin is okay, as long as, in the process, they make sure them faggots don't get adequate health care, family, and estate options, since that'd be disastrous.

I can't wait to see how this plays out.

Friday, May 02, 2008

"Acceptance of evolution is a sign of low self-esteem"

A creationist whackjob recently made the following, sweeping, ridiculous statement:

Most of you who believe the evolved story IMHO seem to have such a low opinion of mankind, it translates to low self esteem.


I responded as follows:

If evolution is correct, the number of individual beings which could be standing here in your place vastly outnumber all of the grains of sand, on all of the beaches, in all of the world. You're the inheritor of a genetic legacy which stretches back 3.8 billion years through the eons, and which has circled the center of our galaxy about 20 times. You're the endpoint of billions of generations of births, competitions, wars, and deaths; the only possible sequence of hereditary combinations that can possibly result in you. Your forbears have survived arguably the single greatest ecological catastrophe ever to hit the planet; when the earliest plants started poisoning the atmosphere with oxygen. Yet, your ancestors learned to use this poisonous gas to produce energy in a way that had never been attempted before; an evolutionary triumph which paved the way for the first multicellular life. Your genetic line has survived floods, freezes, and meteor impacts from the skies themselves, preserving this single genetic line through the eons to lead ultimately to you. This is a legacy you share with every living thing on earth, from the largest creature ever to have lived; the blue whale; to the lowliest prion. You share this legacy with the blades of grass between your toes and the trees that give you shade. You are a thread in a huge, amazing, incredibly diverse tapestry of living things; some of whom have clawed their way out of the seas to survive on land, some of whom remained in the ocean, and a few of whom stood on land for a few million years, ultimately said "well, screw this" and marched back into the sea. Once we add cosmology into the mix, not only does this legacy stretch to everything living, but to the non-living as well. You share your origins with the stars and planets. The asteroids which hang in space, all the way down to the loneliest hydrogen atom in deep space. All the parts that make you stretch back through the eons and have borne witness to the very birth of the universe. They have seen the birth and death of stars, supernovae, black holes and pulsars. They've seen planets torn to pieces and solar systems form. They've seen galaxies coalesce and skies darken.

The universe is much more grand, more amazing, more beautiful, more elegant and more subtle than has ever been written in any holy book, and you are here, against nigh-incalculable odds, to see it all. Just consider that for a moment.

If that's a sign of low self esteem, what the hell are your standards for a high one?

Tuesday, April 29, 2008

Since when is being "elite" a bad thing?

Barack Hussein Obama, the current front-runner for the democratic nomination has been labeled left and right as an "elite."

What bothers me about this is they throw around that label as if it were a bad thing.

Seriously: when did it happen that being "elite" was something to draw condescension? There was once a time when being "elite" drew respect and admiration. I'm working my ass off for 60-80 hours a week in the hopes of someday becoming an "elite scientist." It's my goal to be the absolute best at what I do. I'll realistically never reach that goal, but shouldn't I shoot for it?

Why shouldn't we demand the same of our elected officials? Why should we not demand the best from the people who will lead our country for the next four to eight years? Shouldn't the person we elect as president represent the absolute best from among us. In other words, what the hell do you want from a president, if not the "elite?"

Scratch that, I don't want an "elite" president. I want one who's embarrassingly superior to me in every conceivable way. I want a repeatedly self-made trillionaire who, in his spare time after bringing about world peace, can solve the climate crisis, the oil crisis, develop stem cell therapy, teach grades K-12 in all subjects, and still find time to walk the dog every day.

We've already tried the president that you'd want to hang out and have a beer with. That didn't work too well for us. In fact, I think it's probably fair to say that it worked absurdly badly for us. Insanely badly, in fact. Our economy is circling the drain; we're stuck in an endless, pointless and quite likely illegal war; the rest of the world hates us; we're falling behind China in every conceivable manner; and scientific literacy among high school students is right now barely above Turkey.

Seriously. We could use an elite president right now.

Wednesday, April 23, 2008

Dear Moron,

I guess when you get to a major turning point, it's pretty natural to think about where you came from. Or maybe it's just that I'm in the process of packing up, and I found a few mementos from my high school days. Either way, it's related to the fact that I'm about to get married, move away, and start working for a living as opposed to doing mostly fun stuff for a living.

I was fifteen once, interestingly enough. Frankly, I was ill-prepared for being a fifteen-year-old male, which is probably why I did a pretty crappy job of it. The bottom line is that at fifteen, life, generally, sucks. There really isn't a claim you can make to the contrary. I know for a fact that every time my parents told me that "these are the best years of your life" (we've all heard it) my general reaction was "oh, shit."

So I've been realizing lately that the face looking back at me from the mirror is no longer fifteen years old. He's seen a not insubstantial amount of the world, and he's lived a rather interesting life.

Didn't seem like it was going to turn out that way at fifteen, but then it never does, does it?

At any rate, I was wondering recently what I would write if the laws of physics could be bent, slightly, for just a moment. What if I could write to the fifteen year old I used to be? What would I say?

Dear moron,

I figured this greeting would be the best way to convince you that I'm you. I mean, who else would greet you that way? Of course, if you want more proof, look up on the very top shelf of your closet. You'll find a shoebox labeled "playboys" (brilliant hiding place, by the way). In that shoebox, you'll find a bottle of hydrogen peroxide, a bottle of isopropyl alcohol, a package of double-edged razor blades, anywhere between two and six sterile gauze pads, and a roll of surgical tape. Nobody but you knows about that, right?

While we're on the subject, cut back a little (no pun intended). I'm not going to tell you to quit just what say that instead of three or four times a week cut it down to, say, two or three? You're not going to quit any time soon. And you're going to try (and fail) to do so a number of times between now and the time that you're looking at my face in the mirror, and the truth is, those blades helped you through a lot of rough patches in your life. As coping mechanisms go, you could do worse, I guess.

Okay, depending on when you're getting this, you've either just flunked a math exam, or you're about to. That'll be a first for you, won't it? You'll deal, and you'll be stronger for it. Take my word for it, it's not the end of the world. About five years from now, nobody's going to give a rat's ass what grades you got in High School. Believe me, you have a lot more school to go through before you're done. High school is gonna get lost in the flurry long before you're done.

I know that right now you're thinking that you're going to be a doctor, and that's all there is to it. Well, you're not. And interestingly enough, that's a decision you'll make after being accepted to med school. I know, weird, huh? The point I'm trying to make is that life has a nasty habit of never working out quite the way you plan for it to work out. If I were to tell you now that your first three publications in a scientific journal would be in astrophysics, what would you say? What if I told you that the next three would be in the American Journal of Physiology and the Biophysical Journal (times two)? Exactly.

If you're fifteen, you also just got dumped for the first time, or you're just about to. Sorry for the spoiler. It hurts. A lot. But you'll survive that too. Maybe you need things like that to happen. Maybe it's things like that that make you stronger. All I'm going to say is just wait 'till you meet your future wife. You've read Romeo & Juliet as well as all of the classic romances who talk about that one instant when they find that one person and they just know that their life is never going to be the same again. You don't buy all that bullshit, do you? Trust me: you will.

Don't worry. Let things fall the way that they should. Let them fall the way that they will, and don't freak out when they don't quite fall where you want them to. The only constant in life is that it's never what you expect. It's always moving, always changing, always persevering.

Oh, and when dad tells you that these are the best years of your life, you can call bullshit on that one. You're nowhere near the best years of your life. Not yet.

Keep an eye out for me. I'll be the one looking back at you from the mirror in about fourteen years.

Sincerely,
Drew