False Balance in the Media

Just the Vax is recommending a post by Joel Harrison, PhD, MPH has published on Science Based Medicine. Enjoy.

[Note that the full article can be accessed by clicking here and a downloadable PDF version is available by clicking on the note at the top of the article]

The So-Called Vaccine Debate, False Balance in the Mass Media & The Risk to Public Health

Executive Summary

by Joel A. Harrison, PhD, MPH

February 26, 2018

The San Diego Union-Tribune (UT) recently published two opinion pieces on vaccine mandates, responding to California Senate Bill 277 which removed the “personal belief” exemption to vaccine requirements for children entering into day care, elementary or secondary schools. The bill was passed by the California Legislature in 2015:

Mark Sawyer (2017 Oct 5). Immunizations stop infectious outbreaks. San Diego Union-Tribune, page B21-22.

Terry Roark (2017 Oct 5). Exemptions should be option for parents. San Diego Union-Tribune, page B21-22.

Mark Sawyer, MD is a professor of clinical pediatrics in the Division of Infectious Diseases in the UCSD Medical School. Terry Roark is the advocacy director in California for the nonprofit National Vaccine Information Center.

Each piece was given equal length, giving the impression that each side represented a legitimate position, creating a false balance. In all fairness, the UT has posted articles and editorials on other occasions that clearly supported vaccines and the science behind them, e.g., “In a win for science and for student safety, school vaccination rates are the highest they have been in California in at least 15 years” (The San Diego Union-Tribune Editorial Board, 2017). The problem is that people often have short term memories, may not have read the previous pro-vaccine articles in the UT, or, seeing two articles, were influenced more by the one than the other.

As will be shown in this paper, the article by Terry Roark is full of inaccuracies, falsehoods, and misrepresentations, cultivating readers to form an opinion that is invalid. Like Roark, the vast majority of antivaccinationists lack the basic understanding of the science underlying vaccines, view the world as all or none, subscribe to paranoid conspiracy theories, and their certainty of the rightness of their opinion clearly reflects research that shows once people form opinions, they seldom change them and, remarkably, when confronted with evidence that they are wrong, they often embrace their point of view even more tenaciously (Tavris, 2007). Some of this can be attributed to the Dunning-Kruger effect, which posits that people often fail to grasp their level of competence (or more to the point, incompetence), which precludes their ability to form credible opinions.

Summary and Conclusion

In publishing Roark’s opinion piece, in my opinion, The San Diego Union-Tribune is guilty of creating a false balance. My intent is NOT to single out the UT as this is a problem belonging to our mass media in general. However, as the UT is my hometown newspaper, it provided an excellent example.

As I’ve demonstrated in this article, not one point made by Roark is valid. The underlying premise she is coming from is based on a lack of the basics of science, thus, a bogus opinion on vaccines, a lack of understanding of the economics of vaccine production, and a misleading quote, taken out of context, from a Supreme Court decision. Her affiliation with the National Vaccine Information Center and its Co-Founder and President, Barbara Loe Fisher, as shown by Fischer’s statement, leaves little doubt that besides a lack of scientific knowledge, antivaccinationists suffer from paranoid delusions of conspiracy theories, project their own, often vicious, attacks on the integrity and honesty of those promoting vaccines, including threatening statements, and see the world in terms of the Nirvana Fallacy (for more on Barbara Loe Fisher as the main spokesperson for the National Vaccine Information Center, see Orac, 2017). Attacks on the integrity and honesty of scientists says more about the attackers than the scientists. Such attacks indicate that antivaccinationists are incapable of systematically and validly using microbiology, immunology, epidemiology, biostatistics, and the history of infectious diseases to make their case and display, in my opinion, a crass lack of integrity and decency, basically anything and everything goes to influence people’s opinions, regardless of how unscientific, illogical, and including threats and character assassination.

Given that The San Diego Union-Tribune has, on the whole, been supportive of vaccines, it would behoove them, as well as our mass media in general, to re-evaluate their choice of opinion pieces and even letters that clearly do not reflect, have NO validity, on other issues as well. The UT’s policy regarding Letters to the Editor, “It is also our policy to attempt to publish letters supporting or opposing a particular issue in a ratio reflecting the number received on each side,” when one side is clearly taking an unscientific, invalid position, promotes false balance and is a disservice to readers (The San Diego Union Tribune. Letters and Commentaries).

Joel A. Harrison (2018 Feb). The So-Called Vaccine Debate, False Balance in the Mass Media, and the Risk to Public Health: Terry Roark’s Opinion Piece in the San Diego Union-Tribune (Oct 5, 2017) , “Exemptions should be option for parents”. Science-Based Medicine.

Joel A. Harrison, PhD, MPH is a retired epidemiologist who has been writing articles over the past years supporting vaccinations for Every Child By Two, an excellent non-profit founded in 1991. Every Child By Two has changed to Vaccinate Your Family, expanding its mission to include vaccines for people of all ages. You can find Executive Summaries of his previous ECBT articles that hyperlink to the complete articles as well as his brief biography on the archived ECBT Expert Commentaries page. Dr. Harrison has studied and worked in several countries, including Sweden (where he earned his doctorate) and Canada (where he earned a Masters degree). Having experienced both the Swedish socialized health care system and the Canadian non-profit single-payer system, over the past 30 years he has devoted considerable time to studying health economics and health care systems, concluding that, though the Swedish system is excellent, given American culture, he believes that a non-profit single-payer system would be best option for the United States. Dr. Harrison is a long time member of Physicians for a National Health Program.

Christopher Exley has Become the New Face of the Anti-Vaxx Aluminium Grift

A new study by Mold et al. Aluminium in brain tissue in autism is not Exley's (corresponding author) first foray into aluminium as the cause of name-that-disorder by any stretch.  His publications vilify aluminium for a sundry of unrelated observations such as impaired sperm counts and quality, Alzheimer's Disease, "vaccine-induced" macrophagic myofaciitis and chronic fatigue syndrome along with fellow aluminium grifter Gherardi, breast cancer and of course vaccines.

The study Aluminium in brain tissue in autism is problematic from the start.  As Orac and The Blood-Brain Barrier Scientist note, Christopher Exley sits on the editorial board of the “Journal of Trace Elements in Medicine and Biology“ where the study was published.  The study also had an extremely rapid submission to acceptance time frame which was 26 October for submission, 21 November for a submitted revision, 23 November for acceptance and 26 November for online publication.  The sole funding source for this study was the Child Medical Safety Research Institute (CMSRI) which is a Dwoskin family foundation.  CMSRI is the funding source for the duo of Shaw and Tomljenovic to the tune of $900,000.00.  Clare Dwoskin is very very anti-vaccine which is evidenced by her statement to journalist John Stossel:

What his daughter went through is NOTHING compared to what the families of autistic children go through every day of their lives. No disease can match this record of human devastation. Vaccines are a holocaust of poison on our children’s brains and immune systems. Shame on you all.

More on what kind of "research" the Dwoskins finance can be found here and here.  The Dwoskins' latest study (prior to this one) with Christopher Shaw as the corresponding author was retracted due to image manipulation and dodgy methods.

While these issues individually don't disqualify the merits of a study, taken together they do cast serious doubt on the scientific rigour, review and impartiality of the study.  More importantly, the methods and results are the issues which ultimately render this study completely meaningless.

The thrust of this study is laid out in the abstract and introduction that state:

Human exposure to the environmental toxin aluminium has been linked, if tentatively, to autism spectrum disorder.

And

Paediatric vaccines that include an aluminium adjuvant are an indirect measure of infant exposure to aluminium and their burgeoning use has been directly correlated with increasing prevalence of ASD [11].

No it hasn't and is based upon some cherry-picked, weak studies.  The authors obtained five samples of brain tissue from people with confirmed autism spectrum disorder (ASD) for aluminium measurement.  They also obtained ten paraffin-embedded brain tissue samples from ASD individuals for fluorescent microscopy.

There were no controls.  Yes you read that correctly.  Not a single control for any aspect of this study; I'll elaborate.  The authors state:

Total aluminium was measured in each sample by transversely heated graphite furnace atomic absorption spectrometry (TH GFAAS) using matrix-matched standards and an established analytical programme alongside previously validated quality assurance data [13].

The "established analytical programme alongside previously validated quality assurance data" is their own protocol which is from these two studies, Brain burdens of aluminum, iron, and copper and their relationships with amyloid-β pathology in 60 human brains and The Identification of Aluminum in Human Brain Tissue Using Lumogallion and Fluorescence Microscopy.  I don't think validation means what they think it means.  This was internally-validated and not a recognised method for TH GFAAS by having been actually validated independently.

In the recent study two technical things (among many) stand out for the recently published "Aluminium in brain tissue in autism", first there was no mention of blanks used.  Granted it was an abbreviated description given the protracted version was explained in "Brain burdens of aluminum, iron and copper and their relationships with amyloid-β pathology in 60 human brains" (House, Exley et al. 2012), however there is no mention of an aluminium blank used to correct for contamination in either the body of the text nor in the description of Table 1 (Mold, Exley et al. 2017) where the values for aluminium content appear.  But this does appear in the cited study in both the body of the text and the description for it's Table 3 (House, Exley et al. 2012) aluminium content of brain samples.  It's worth mentioning that in the cited study (House, Exley et al. 2012), several samples have negative values and a high degree of intra-sample variation.  This is a problem with with their validation and they weakened this further by not including blanks in the autism study (Mold, Exley et al. 2017) as evidenced by the higher degree of intra-sample variation.

The second technical issue was the use of mean in the aluminium autism study.  Exley stated in his own cited brain aluminium study that due to non-normal distribution of intra-sample values, median with standard deviation was calculated.  This is correct but this was not done for the autism aluminium study, instead they used mean with standard deviation which skewed the means much higher because the outlier values were captured.  These values are further meaningless since the standard deviations are higher than the mean values for 3 of the four lobes sampled.

The mean (SD) aluminium content across all 5 individuals for each lobe were 3.82(5.42), 2.30(2.00), 2.79(4.05) and 3.82(5.17) μg/g dry wt. for the occipital, frontal, temporal and parietal lobes respectively.

Another huge problem for this study is both lack of controls and their own scale of pathology:

Previous measurements of brain aluminium, including our 60 brain study [15], have allowed us to define loose categories of brain aluminium content beginning with ≤1.00 μg/g dry wt. as pathologically benign (as opposed to ‘normal’). Approximately 40% of tissues (24/59) had an aluminium content considered as pathologically-concerning (≥2.00 μg/g dry wt.) while approximately 67% of these tissues had an aluminium content considered as pathologically- significant (≥3.00 μg/g dry wt.). The brains of all 5 individuals had at least one tissue with a pathologically-significant content of aluminium.

They cited The Identification of Aluminum in Human Brain Tissue Using Lumogallion and Fluorescence Microscopy (Mirza, Exley 2016) but it was not developed from samples of 60 brains; it was developed from multiple samples of one brain.  They rated the wildly variable observed aluminium levels in the Mold, Exley et al. 2017 study using a scale they developed in Mirza, Exley 2016 based on one single brain donation.  The authors must have a lot of contempt for their target audience and benefactors or are woefully inept to try and pass this stratification off as valid.  But more importantly, the results are meaningless because they did not include any controls, nor did they include any information on medical and dietary history nor causes of deaths of the individuals whose samples were donated.

The microscopy isn't any better.  There is no validation of the stain specificity nor control for contamination.  The Blood-Brain Barrier Scientist discusses the problems with the microscopy in detail.  Futhermore, they use Photoshop for visualising and enhancing images:

The subsequent merging of fluorescence and bright-field channels was achieved using Photoshop (Adobe Systems Inc. US).

This is not standard practice, in fact it's rather amateurish.  There are dedicated software packages available for fluorescent microscopes that track image capture and enhancements.  There is also no randomisation of microscopy sections nor blinding of the reader.  Presumably (or should be) there are several images taken and randomly selected for results discussion.  This was not done so for all we know, images are cherry-picked for maximum effect.  The fact that the microscopy suddenly had ten different samples (instead of the five previously noted) begs the question of IRB approval not to mention their Table S1 does not appear in the published study.

They make very far-reaching conclusions about their findings but fail to qualify any clinical relevance.  No histology was done so actual pathology of tissues samples is lacking.  The discussion is loaded with supposition with no evidence to support their claims.

A limitation of our study is the small number of cases that were available to study and the limited availability of tissue. Regarding the latter, having access to only 1g of frozen tissue and just 3 serial sections of fixed tissue per lobe would normally be perceived as a significant limitation. Certainly if we had not identified any significant deposits of aluminium in such a small (the average brain weighs between 1500 and 2000g) sample of brain tissue then such a finding would be equivocal. However, the fact that we found aluminium in every sample of brain tissue, frozen or fixed, does suggest very strongly that individuals with a diagnosis of ASD have extraordinarily high levels of aluminium in their brain tissue and that this aluminium is pre-eminently associated with non-neuronal cells including microglia and other inflammatory monocytes.

No the actual limitations of this study are the utter lack of controls, validation and rigour at every step of the way.  Non ASD people and with no pathology are going to also have aluminium deposits in their brain tissue.  Brain tissue banks are precious resources for neuroscience investigators.  It's a gross violation of the scientific method to be wasted on rubbish studies such as this to satisfy a rich matron with a hatred for vaccines.

ETA 12.18.17: Buzzfeed just reported that scientists they spoke with, who have relevant experience have rejected this study due to the problems with the methodology listed here and on other blogs.   Additionally, Christopher Exley has a substantial conflict of interest which he failed to report.  It turns out he is a benefactor and shill for SilicaWaters.com who sell ACILIS by Spritzer, a product that is touted by Exley to remove aluminium from our bodies.  SilicaWaters reports that 10% of their sales is donated to Exley's research into the benefits of drinking silica-rich water.

Kidnapping...Now a Vaccine Adverse Event.

A bizarre story of kidnapping has emerged in California which has been (tastelessly) dubbed, the "Gone Girl" kidnapping.  It was initially believed by the Vallejo Police that kidnap victim, Denise Huskins and her boyfriend Aaron Quinn perpetrated a hoax.  That was not the case as Matthew Muller, a former Marine and disbarred attorney was arrested for the kidnapping of Ms. Huskins.

The man charged in a California kidnapping that police initially dismissed as a hoax said he acted alone, and that mental illness and a side effect from a vaccine contributed to his behavior, the FBI said in a court filing.

Matthew Muller made the comments to a television news reporter during a jailhouse interview in July, FBI Special Agent Wesley Drone said in an affidavit in support of a search warrant. The reporter was not allowed to record the interview and had been asked by Muller not to reveal his comments about acting alone and the vaccine. She did report that Muller said he felt bad for the kidnapping victim and thought the victim deserved an apology.

This sounds like just the type of story that Robert F. Kennedy, Jr. can throw his weight behind and use on his "U.S. tour" as an example of how dangerous vaccines are.

Invisible Threat Just Became Visible

Invisible Threat is a documentary written, produced and directed by student filmakers from Carlsbad High school and their award-winning broadcast journalism program CHSTV Films.  It is an exquisitely done short film about the vaccine-autism manufactroversy.  CHSTV Films was approached by the Rotary Club International to produce a film about the immune system and how vaccines work to support their "Don't Wait, Vaccinate!" program.  However, the student broadcast journalists of CHSTV Films had their own idea:

But the young people and their advisors thought the Rotary proposal — to make a 20-minute educational film explaining how the immune system and immunization work — seemed boring, they said. And they bristled when the Rotarians told them how the movie should be made, added Bradley Streicher, one of the students who worked on it.

"We said, if we do this, we have to do this on our terms," he said. "We wanted to explore this from both sides."

Little did these students know what they were about to embark upon and the vitriol they would have to endure to see this documentary completed and released.  Over a year prior to completing the film, the North County Times of Escondido, CA reported on it and the hate blog Age of Autism wasted no time sliming the students and their project.  Links to the NC Times are dead, I understand the paper folded and fortunately for the Age of Autism denizens their vicious comments railing against the student journalists involved with Invisible Threat can no longer be seen.  However, the school received numerous threatening and harassing phone calls and their Facebook page continues to get nasty ad hominem comments (which are deleted).

The adult volunteers involved with Invisible Threat were rightfully concerned for the students' safety and wanted to terminate the project.  The students were not deterred however and it was then that they became the teachers and convinced the parent/teacher volunteers to forge ahead.

It was outrageous to me that the adults would cave to the intimidation. My passion for not backing down was as a student broadcast journalist and the lessons I’d learned making our first film, We Must Remember. In response to that film, it was white supremacists who were angry and contacting us, but we didn’t drop the project. The documentary was about American teens who discover the horrors of the Holocaust first hand by interviewing survivors, traveling to several concentration camps in Europe, and interviewing German teens with Nazi grandparents. The Academy Award winning producer for Schindler’s List, Branko Lustig, took our team to Croatia for the international premiere. There the filmmakers had the opportunity to speak to Serbian, Muslim, and Croatian teens about the lesson we learned. We Must Remember was made to promote tolerance and alert people to the dangers of bullying, while teaching history from a peer-to-peer approach. How could we back down from a topic because of bullying after what we learned and experienced with We Must Remember? The adults weren’t budging until I asked them to “Remember what happens when good people do nothing!”

The documentary was completed and select screenings were arranged.  Apparently one that took place on Capitol Hill provoked a new round of vapid criticisms, oddly by those who hadn't even seen the film.

Focus Autism and AutismOne organizations complained about the movie's Rotary Club backing and about the involvement of Dr. Paul Offit, a University of Pennsylvania pediatrician and immunization proponent. They argued that "Invisible Threat" was "scripted with industry talking points" and that the movie seemed to be the work of adults operating under false pretenses, not students.

It is important to note that AutismOne is a notorious anti-vaxx organisation who gives a platform to fraudulent researcher Andrew Jeremy Wakefield, showcases horrible and abusive "autism treatments" such as bleach enemas, DIY faecal transplants, chemical castration and chelation and off-label prescription drug use.  Until this year, anti-vaxxer Jenny McCarthy sponsored Autism One conferences and still owns Generation Rescue an alleged autism charity that promotes unproven and dangerous "autism treatments" along with funding anti-vaxx "studies".  Focus Autism is another faux "autism resource" whose members and founders disseminate the discredited vaccine autism causation idea.  They attack perceived enemies as well as allies who don't toe their party line.

These are the groups and individuals with a clear axe to grind because they are the very types Invisible Threat features in their documentary.  But these are not particularly rational nor ethical people to begin with given what they advocate for.

The film has been completed, distributed to academic and public health institutions and has received glowing reviews and endorsements.  Invisible Threat has been scheduled to be released in conjunction with the 2014 National Immunization Awareness Month.  If you are a public health official, school administrator, healthcare provider or member of an academic institution, please visit Every Child By Two or contact ThreatInfo@gmail.com to arrange for a screening and/or get a copy of Invisible Threat.  Please support these amazing students and their broadcast journalism program while educating the public about the threat to our health and well-being due to falling vaccination rates.  A student involved with the production of Invisible Threat made an amazingly eloquent statement about what she learned during the making of the film:

"My personal conclusion is that vaccinations causing autism is a social controversy, not a scientific one."

Trau schau wem (a Dr Bob post)

dedicated to Chris Hickie, MD, PhD

It's been a while since we talked about Dr. Bob Sears, the author of The Vaccine Book, in which he advertises his "alternative vaccination schedule" (which almost doubles the number of office visits at $$$). Dr. Bob, as he likes to call himself, has been widely criticised for his anti-vaccine-critical stance, by us and many others. Don't know how people get the idea he could be anti-vaccine, actually - cannot be his staunchly pro-vaccine friends, like Andy Wakefield

It cannot be his absolutely unwavering pro-vaccine activism on Mothering.com:

 

For any parent who decides not to vaccinate, I don't try to talk them into vaccinating. Going unvaccinated is not a dangerous choice. It's a reasonably small risk.

It cannot be his well measured and positive foreword to an unreservedly pro-vaccine book:

.../... blablabla .../...

With so much care not to be mistaken for someone who is actually against vaccination, I must wonder how Dr. Bob Sears ended up one of the administrators of the:

Parents and Others against Vaccinations 

(my emphasis) facebook group. Ever so slightly embarrassing to get caught on that one amongst anti-vaccine's finest:

If I had not done so already, I would seriously seek my vaccine information somewhere else.

*Trau schau wem = watch whom you trust

iPhone Apps for Vaccine Record-Keeping

Catherina posted an article about record-keeping and the importance of tracking our children's vaccinations.  Erroneous entries can be made, we move and records can be lost.  Michelle on NannyPro.com has listed several iPhone Apps that can be used to create, track and set reminders for immunisations.  Some are free and some are just a few dollars.  There are even apps for travel vaccinations and general vaccine information so go check them out.

To Hep B or Not to Hep B...

The Hepatitis B vaccine, particularly the infant birth dose has been somewhat controversial as of late.  The reasons for this are based upon fallacious claims by so-called experts and dodgy studies.  But parents need to base their decisions on facts, not junk science and not proclamations from self-proclaimed experts who have never even conducted research.  Let's examine the facts about hepatitis B disease and vaccine:

Mythical Claim: Hepatitis B is a sexually or IV drug transmitted disease.

Fact: Hepatitis B is not just a sexually or IV drug transmitted disease.  It is the primary mode of transmission in industrialised countries, like the U.S. but in others, vertical transmission i.e. from mother to newborn during birth is the most prevalent mode of transmission and worldwide, accounts for 40-50% of hepatitis b infections.  Hepatitis B virus is spread via infected blood or bodily fluids through breaks in the skin and mucosa.  Additionally, hepatitis b virus can remain infectious on inanimate objects such as razors and surfaces for a week.

Prior to 1991 in the U.S. it has been estimated that 16,000 children under the age of ten years old were infected each year through contact with HBsAg-positive family/household members and outside contacts.  Also during that time, 30-40% of adults infected had no risk factors which implies more casual contact with infected people and/or fomites with hepatitis b virus contamination.

Mythical Claim: Most people who get hepatitis B virus clear it.

Fact: Most adults who become infected with hepatitis b are able to clear the virus, however it is estimated that 17.5% of those who acquire hepatitis b remain infected and become lifelong carriers.  About 25% of carriers who experience acute clinical illness die of cirrhosis or primary liver cancer.  The younger the age at infection, the greater the risk of becoming a chronic, lifelong carrier is.  Seventy to ninety percent of infants born to HBeAg positive mothers and don't receive immunoprophlaxis (hepatitis b vaccination and immunoglobulin) will become chronically-infected by the age of six months old.

Mythical Claim: I don't need to get tested for hepatitis b when I'm pregnant.

Fact: The recommendation is for all pregnant woman to get tested for hepatitis b surface antigen (HbsAg). It is crucial that you know what your test results are and what they mean.  The tests used are not 100% accurate but do have excellent specificity and sensitivity.  Anyone in the household or other close contacts should also be tested.  If using a midwife, please be sure that hepatitis b testing is done.

Mythical Claim: Other countries don't give a birth dose of hepatitis b vaccine.  The U.S. shouldn't be giving newborns a vaccination.

Fact: Other countries do administer a birth dose of hepatitis b vaccine:  Bulgaria, Croatia, Estonia, Germany and Latvia (if mother is HbsAg positive or unknown status), Poland, Portugal, Romania, Spain and Turkey.  This is just the EU.  Some factors to consider when trying to compare the U.S. to other countries that don't vaccinate for hepatitis b is healthcare systems, epidemiology of the disease and immigration.  The U.S.doesn't have universal healthcare as do many EU countries which means that many hepatitis b infected pregnant women and their contacts fall through the cracks and don't know their hepatitis b status.  The U.S. has a high rate of immigration and visitors from countries with high endemicity of hepatitis b.  Although the UK is experiencing an increasing rate of hepatitis b-infected pregnant women who have emigrated from other countries.  During the period of 1990 to 2004, the incidence of hepatitis b infection declined in children 19 years and younger by 94% when the hepatitis b series starting from birth was implemented.  This didn't happen by magic.

Hepatitis b infection in newborns carries an extremely high risk of chronic infection and complications of fulminant liver disease.  There is no guarantee that teenagers who become sexually-active and become infected will clear the virus and not also become chronic carriers, not even your beliefs in a "superior" lifestyle.  Please base your decisions on facts and not fictitious claims meant to incite fear, uncertainty and doubt.

H3N2 The New Swine Flu?

Unbeknownst to most there is constant influenza monitoring occurring globally.  This allows us to estimate the strains most likely to circulate through human populations, develop vaccines targeted for the three most likely strains and simply prepare for annual influenza seasons. Prior to the culmination of candidate vaccine strains is monitoring animal populations where most, if not all influenza strains originate, mutate and become infectious to humans where additional mutations occur and so on.  Some strains never make it into humans but many do.

One such influenza strain is being monitored in swine populations, H3N2 and its variant H3N2v has been infecting humans.  Thus far, human infections have been reported in 8 states since July 2011, Hawaii, Illinois, Ohio, Iowa, Maine, Pennsylvania, Utah and West Virginia.  All infected have had probable or definite exposure to infected swine however there have been three cases that were deemed as human to human transmitted.  Although human-human transmission appears to be very limited, H3N2v does contain the M or matrix gene from the 2009 H1N1 influenza strain which may confer increased transmissibility to and between humans.

Since 90% and more pigs tested have been found to be infected with H3N2, the CDC is recommending that those who are vulnerable to influenza complications such as infants, young children, pregnant women, elderly and immune-compromised people avoid contact with pigs such as farms and fairs.

100% certainty

Very few things are 100% certain in life and as a biomedical researcher, I am used to expressing things cautiously using phrases like "is consistent with", "there is no evidence for". However, of late, I have seen a claim that I can say with 100% certainty is not true.

My DS/DD caught pertussis from the vaccine (and iterations thereof, like "from the vaccine that a vaccinated child shed").

Not true. How do I know that?

Pertussis is a bacterial infection. Whole, living bacteria called Bordetella pertussis enter our nose/mouth because someone coughed them at us and they stick to the tiny little hairs (cilia) in our respiratory tract - here is a picture (source):

The bacteria have some proteins on the surface that help them hold on to those hairs and manipulate the immune response. In order to have a noticeable effect, the bacteria have to multiply, using loads of genes and proteins within their cell membrane (see below) and the nutrients provided by our body. Here is a picture of the bacteria (coloured from an electron micrograph in which they are 40.000x enlarged - source):

So why can't the vaccine cause pertussis? Because there are no bacteria in it. The vaccine only contains the surface bits that help the bacteria attach to those ciliated cells in your respiratory tract. For example, Daptacel contains:

10 µg detoxified pertussis toxin (PTx), 5 µg filamentous hemagglutinin (FHA), 3 µg pertactin (PRN), and 5 µg fimbriae types 2 and 3 (FIM) - I have circled them in red in the following picture (source):

The idea is that in response to vaccination, the body generates antibodies only against those proteins - those will bind to the surface of the bacteria when someone coughs at you and prevent the bacteria from sticking to your respiratory tract. Everything that is not circled in red is NOT in the vaccine. There is no chance that some surface bits injected into your arm or leg cause an illness that requires loads of bacteria sticking to those tiny cilia in your respiratory tract. Furthermore, the vaccine also does not contain the tracheal cytotoxin, which the bacteria release and which paralyses those cilia and prevent them from clearing your airways, which is what causes the characteristic cough (<- click on that link - this is what pertussis sounds like).

100%

Blogust 2012: be opinionated - save a life!

HT to Chris for reminding me:  Shot at Life had this cool idea - they are running Blogust:

Blogust is a first-of-its-kind blog relay for good that is bringing together 31 of the most influential online voices in the country to change the world through blogging. Each day throughout the month of August, one influencer will post about someone that inspires them and then “pass the baton” to another blogger for the following day. The twist is this: every comment on a Blogust post will initiate a $20 donation to help immunize a child in a developing country.



Your pro-vaccine comment will save a life, but, what is even better, "their" anti-vaccine comment will save a life (by vaccination) as well. So check out their calendar and stir up the discussion.

Vaccine Trials: Methods and Best Practices

Time and time again, the strange notion that "vaccines have never been tested in combination" and iterations of that is propagated online and in the media. We had previously addressed this myth, when Dr Bob Sears appeared on Fox Friends. We even presented a handy list of papers, proving how comprehensively vaccines are tested before they can be licensed.

Hexavac with Hepatitis A
Hexavalent vaccine with Rotateq
DTaP with Hib
PCV-13 with all infant vaccines
MMR and Varicella
PCV-7 with MMR, Hib and Varicella
Pediarix with Hib and Infanrix-hexa
New Hib with all infant vaccines
MMR with Varicella
MMR-V with Hib-HepB
MMR-V with all infant vaccines
Meningococcal-C with Hep B and Pentacel
Pentacel with PCV-7

But somehow, it doesn't seem to matter how easily digestible factual information is presented. It is always easier to complain [concerned/enraged/engaged tone on] vaccines have never been tested in combination [tone off; start triumphant gaze].

In my experience, knowledge sticks best when you have honestly worked for it. Here is the chance for anyone who really wants to know how vaccines are tested before licensed - Coursera.org is offering a free online course for anyone interested in the topic, run by experts in Health and Health Education from the Johns Hopkins Bloomberg School School of Public Health.



Go enroll, learn, and the next time you make a claim about vaccine testing you will be equipped to back it up with actual evidence (which is a great feeling).

August is National Immunization Awareness Month

The title says it all, tomorrow, National Immunization Awareness Month starts and Just the Vax will support vaccination awareness by blogging daily on vaccine related issues. Since a daily blog is about 30x the frequency of our usual activity, some posts might just be a "read this today" reference to other people's blogs. So let's warm up with this post by Orac over at Respectful Insolence, who today exposes Joe Mercola's typical anti-vaccine cherry picking and distortion of data:

Joe Mercola attacks vaccinations again. Film at 11.

and as a reminder why immunization awareness is really important - pertussis soars in the UK with 5 dead babies this year to date:

Whooping cough outbreak spreads to very young babies