Quack and Burn

There has been interesting and delightful news on the anti-vaxx quack front this past week.  Most recently Dr. Mark Geier of the ghoulish duo, Mark R. Geier and pretend doctor David Geier, has had his license to practise medicine revoked in Missouri and has had his medical license suspended indefinitely in Illinois.  The last remaining state, Hawaii where Mark Geier still holds a valid license has filed a complaint against him.  Todd W. of Harpocrates Speaks has a very nice catalogue of the Geiers' offences.  While the Geiers' creepy clinics are still in operation, one with Mayor Eisenstein of Homefirst, and in spite of their claim, "We are going to open [clinics] everywhere," the loss of all of Mark Geier's licenses to practise medicine and pending action in the one remaining state will ensure that this isn't going to happen.

Another quack, Andrew Wakefield is once again "wanking for coins."  Wakefield and his fawning disciples have hoisted yet another fund-raising scheme for their St. Andy.  This one as the hilariously named, Academic Integrity Fund.  And for $750 one can enjoy dining with the Wakefields AT THEIR TABLE or $250 for being in the same room as the Wakefields to eat tacos and drink frozen margaritas (with cheap house tequila no doubt) at a chain restaurant.

I can't quite seem to figure out what the Academic Integrity Fund funds other than paying for a couple of overwrought, masturbatory blog posts by Wakefield and a couple of others.  Sadly, there are people with more money than brains so he should pull in some payola for his latest venture.

Wakefield has his own Legal Justice Fund which is really just a façade for fawning acolytes to show his fighting spirit against the evil Brian Deer and BMJ.  I doubt his acolytes will even bother to question why there are scores of pages missing from Mr. Deer's testimony and just keep throwing their money at Wakefield.

And whatever happened to his Strategic Autism Initiative (SAI)?  Yet another money suck he created and in his words:

“I have no intention of going away,” he said. “I have set up a new research initiative, the Strategic Autism Initiative, whose aim is to do the science on the environmental causes of autism that the federal agencies want to run away from.”

Not a single study nor publication nor anything to do with autism research has emerged from this so-called non-profit organisation.  It appears as though the SAI has done nothing but fund a few trips for Wakefield to frighten the Minnesota Somali community off of getting the MMR jab for their children and making an empty promise to conduct a study of their autism prevalence.  I guess he can claim partial success by facilitating a measles outbreak in the Minnesota Somali community.

This latest scam is at least the closest thing to just coming right out and saying, "pay me for nothing suckers," than his past "fund-raising" schemes.  And sadly, they will.

Are we bored yet? Measles in WA school, 25 un(der)vaccinated kids at home

Just a quick one - a student in a Washington State Primary school (remember that state with the highest rate of vaccine exemption) has come down with measles. 25 un/dervaccinated children have to stay home until they have 2xMMR or the incubation period is over.

Are we bored of these news yet? Can parents get their children vaccinated already?

Updated 11/4/2012: the child did not have measles after all, which is quite a relief. Meanwhile, Woodland Primary School have cancelled Monday's free immunization clinic for students who have had only one MMR, which is downright silly. I hope the parents who had the fright will get the second MMR after all.

VanDerHorst-Larson: misinformed mother scatters food for the birds

Brian Deer wrote a response to Jennifer VanDerHorst-Larson's letter of complaint to the University of Wisconsin regarding Mr. Deer's invitation to speak there.  Mr. Deer has kindly granted permission to re-print his response.  He is kind when he refers to Ms. VanDerHorst-Larsen as "unwitting" however she is anything but as the "founder of the Canary Party", blaming her child's autism on the MMR jab, opening a clinic which offers "biomedical" treatments and involved with bringing fraud and discredited doctor Andrew Wakefield to Minnesota to convince the local Somali community to stop vaccinating with MMR.

Ms. VanDerHorst's error-riddled and dubious letter along with Mr. Deer's response can be found here.

After the collapse of what was only ever a fringe campaign in the United States, claiming that vaccines were responsible for an epidemic of autism, small groups of ill-informed, misguided and sometimes frankly malicious, people became desperate for attention. This led to a barrage of emails - often abusive or crammed with hate speech - to university staff following my October 2012 lectures in Wisconsin.
The complaint below by one Jennifer VanDerHorst-Larson, who said she was founder of something she called the "Canary Party", was one of the few that didn't ooze with personal bile. But even she hadn't checked her facts.
Ms VanDerHorst-Larson's complaints are numbered, and I respond beneath each.

1. Regarding Mr. Deer's credibility, even those unfamiliar with the details of the controversy would have to question his claim: “Neither I nor BMJ knew Wakefield was in Texas." (Dr. Wakefield has resided in Texas for 11 years and Mr. Deer has "investigated" and reported on him while he has lived in Texas.)

This is a reference by Jennifer VanDerHorst-Larson to a vexatious “gagging” lawsuit filed against the BMJ in Texas, in January 2012, by disgraced former doctor Andrew Wakefield over reports by me in the January 2011 series "Secrets of the MMR scare".  The suit was dismissed by an Austin district court, for lack of jurisdiction, in August 2012.

The BMJ’s jurisdictional case was accompanied by a factual case, supported by a lengthy declaration and supplement by me, verified to be true under penalty of perjury. In June 2012, I was deposed under oath by Wakefield's Texas lawyer for 6½ hours, yielding no evidence whatsoever of any wrongdoing on my part. Were my declaration, supplement and deposition false (and they are so exceptionally detailed that were they not at least substantially true then I would have to be lying), Wakefield's remedy would be obvious. In fact, all of our submissions are true, and are supported by a mass of documentation.

The transparent purpose of the lawsuit was to enable Wakefield to proclaim that he was suing the BMJ, so as to sustain support from persons such as Jennifer VanDerHorst-Larson, to whom he looks for his livelihood.  He chose Texas, where he knows he stands no chance whatsoever of prevailing, rather than England (where defamation laws are notoriously slanted towards plaintiffs, who need to prove nothing, and where defendants carry the burden of proving the truth of what was published) because in England he would have been required under civil procedure rules to pay our costs when he eventually abandoned the case (as he has done three times before, sending me a cheque).

The journalism at issue made no mention of Texas, involved no Texas sources, and was prepared and published at a time when neither the BMJ nor I even knew that Wakefield had remained in the state after being ousted from a job in Austin.  In addition to us participating in three depositions under oath, thousands of pages of discovery was permitted by the BMJ. This discovery produced no reference to any activities connected with Texas, while, in an email exchange, I advised the BMJ editor that I thought Wakefield was in Minnesota (where Jennifer VanDerHorst-Larson was then running an unfounded and irresponsible campaign alleging, among other things, that one in 28 Somalis had autism).  We neither knew nor cared about Wakefield’s whereabouts at the time, and made no inquiries.  This was because my reporting concerned events at the Royal Free hospital and medical school, London, England, during the 1990s.

2. In his letter to the BMJ, National Whistleblower Center board member David Lewis, who examined the "Lancet 12" children's histopathological grading sheets, makes is clear that Wakefield's co-author, pathologist Amar Dhillon, did indeed diagnose colitis "in a number of children" contrary to Mr. Deer's statement at your university that none of the children had bowel disease.

The “National Whistleblowers Center” is a front for the Washington employment law firm Kohn Kohn and Colapinto, which unsuccessfully represented Lewis after he was fired by the Environmental Protection Agency in 2003 following unresolved allegations of research misconduct. Lewis (an authority on sewage sludge) has no qualifications in medicine or pathology, was manifestly incompetent to evaluate bowel histopathology, and took up working with Wakefield at an anti-vaccine conference in Jamaica in January 2011. As I said at my talk at La Crosse, Wisconsin, Lewis’s criticism of my work bizarrely centres on his belief that I know too much about the topics of my writing.  For example, in May 2012 he argued at an anti-vaccine conference in Chicago: “It doesn’t make sense. These are well-written articles by someone who has considerable expertise in medical practice.”

Thanks.

In a statement to the BMJ, the Royal Free pathologist named by Jennifer VanDerHorst-Larson explicitly denied diagnosing colitis, which requires patient histories and clinical input, which he did not have.  The original data upon which Wakefield says he made his 1998 claims in the Lancet of having discovered a new inflammatory bowel disease was obtained by the BMJ in 2011, put out to expert review and published in its entirety by the journal almost a year ago.  We were that sure about what it revealed.  Some five experts in the appropriate gastroenterological specialties, consulted by us, confirmed a lack of enterocolitis in the data.  To my knowledge, the BMJ has since received not one suggestion from any qualified person that the data we published shows what was claimed by Wakefield.

3. Brian Deer stated at your university that Dr. Peter Fletcher was never Chief Scientific Officer of the UK Department of Health. This statement is easily proven false. [Jennifer VanDerHorst-Larson cites an article in the Daily Mail newspaper]. Deer misrepresented the UK's former Chief Scientific Officer, no doubt due to Dr. Fletcher's criticisms of the MMR: "There are very powerful people in positions of great authority in Britain and elsewhere who have staked their reputations and careers on the safety of MMR and they are willing to do almost anything to protect themselves."

It was put to me after one of my lectures that Fletcher was the UK government’s chief scientific officer, which he was not.  He was appointed in the 1970s to be chief scientific officer to the department of health, one of numerous departmental chief scientific officers throughout the civil service. The UK government’s chief scientific officer (the chief scientist) is a senior public figure, generally granted a knighthood, which Fletcher was not. I revealed in 2005 that Fletcher was paid £40,000 to support Wakefield’s claims, but his views of recent years are unknown and are irrelevant to my investigation of Wakefield's misconduct.

4. Wakefield's co-author in the Lancet Paper, Dr. John Walker Smith, was recently exonerated and had his license to practice medicine restored, showing that Deer's allegations against Wakefield and Walker Smith, which were rubber stamped by the General Medical Council, had no foundation.

Walker-Smith – who first claimed (including in his autobiography, first published in 2003) to have performed invasive research with Wakefield on autistic children under an IRB-approved protocol, but then changed his story after the GMC prosecution concluded its case in 2007 – was not exonerated.  The GMC panel’s findings were quashed in the UK administrative court.  This was because the panel had failed adequately to set out the reasoning behind its decision to revoke his license. The judge stated that the panel (of three doctors and two lay members) was entitled to reach its central conclusion – that he had conducted unauthorised research on vulnerable children for no good clinical reason – but that it had failed to explain its reasoning on numerous matters. For example, it had not set down why it preferred the evidence of one witness as opposed to another, and why it did not apply to Walker-Smith's conduct the famous English law “Bolam” test of medical opinion. In short, the prosecution was defeated by defence tactics (exploiting a loophole in the 1983 Medical Act which uniquely permits accused doctors to stand mute in the face of charges), the complexity of the indictment and inadequate input from the panel's legal advisor.

In conclusion, the judge summed up his ruling: "The panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The GMC's approach to the fundamental issues in the case led it to believe that that was not necessary – an error from which many of the subsequent weaknesses in the panel's determination flowed. It had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician. Its failure to address and decide that question is an error which goes to the root of its determination."

As the judge also made clear, the GMC was entitled to send the case back to the panel (or a new panel) to set out the reasoning for its findings, but as, as I understand it, the GMC took the view that, as Walker-Smith was retired, there would be no public interest in doing so. Among other things, the judge affirmed that claims of IRB approval in Wakefield’s Lancet paper were false and said that there was “no respectable body of opinion” which now endorses Wakefield’s claims linking autism and bowel disease with MMR.
Walker-Smith’s case has no bearing on that of Wakefield, who, on advice from his own legal team, was not funded to appeal the panel's decision. Wakefield’s case involved numerous different charges to those facing his accomplice – including four proven counts of dishonesty – many associated with the fact that, unlike Walker-Smith, he was not a clinician. Wakefield was erased from the medical register in 2010, and that decision is final.

Far from being “rubber stamped”, as Ms VanDerHorst Larson alleges, my findings as of 2004 were endorsed and adopted by the GMC after more than three years of investigation and case preparation by their lawyers. Unlike claims of anti-vaccine campaigners – generally supported by little more than recycled internet fabrications and distortions such as those repeated (probably unwittingly) by Ms VanDerHorst-Larson – my findings have been scrutinised and supported by innumerable editors of three media organisations of international repute, fact-checkers and subeditors, three teams of in-house lawyers, six firms of retained lawyers (including the GMC's), and numerous highly qualified peer reviewers and expert witnesses of preeminent professional stature.

I am presently unaware of any consequential body of professional, media or public opinion to the effect that Wakefield’s Lancet research of 1998 was not fraudulent. Indeed, in October 2012, it was tabulated in a paper published in PNAS, the Proceedings of the National Academy of Sciences, under the category "fraud", as the retracted research with the most citations. In January 2012, Time magazine dubbed Wakefield's work one of the great science frauds of all time. In April 2011, the New York Times described him as "one of the most reviled doctors of his generation".

5. Brian Deer's attacks against Wakefield began when his Sunday Times Editor, Paul Nuki, told him "Find something big" on the "MMR" as Deer himself revealed here [Jennifer VanDerHorst-Larson cites an article I wrote in the BMJ]. Nuki had a DIRECT FAMILY TIE to a government employee responsible for MMR safety. Paul Nuki is the son of Professor George Nuki who sat on the Committee on Safety in Medicines when it passed Pluserix MMR vaccine as safe for use in 1987.

Characteristic of embittered anti-vaccine campaigners, Jennifer VanDerHorst-Larson has altered my words.  I was not invited to “‘Find something big’ on the ‘MMR’”, and I did not reveal this.  At the time in the UK, MMR was by far the biggest running medical media story, and virtually any new information would be regarded by editors as worthy of prominent coverage.  My editor wanted big stories on important topical subjects (as he edited the main Sunday Times news-feature pages) and, at the time, MMR was a big story. I’m not aware of any newspaper that aims to publish small or uninteresting stories.

With regard to Professor Nuki, I'm not sure that even Ms VanDerHorst-Larson is clear about what she's alleging. The suggestion that Paul Nuki’s father, a rheumatologist, sitting on a large supervisory committee in 1987, could have any relevance to my findings in 2004 about Wakefield’s misconduct would be laughable if it wasn’t misrepresented by malignant cranks (among whom I have not included Ms VanDerHorst-Larson) so as to mislead vulnerable people. Professor Nuki was not a “government employee” and the named vaccine product (under a variety of brand names) was licensed throughout the world, including in numerous European countries, such as France, far beyond the writ of any Nuki.  I believe that in some countries it remains in use.

6. In February 2009, Sunday Times proprietor James Murdoch was appointed to the board of MMR manufacturer GlaxoSmithKline with a brief to “help to review external issues that might have the potential for serious impact upon the group's business and reputation"” This was swiftly followed by new attacks on Andrew Wakefield’s reputation by Deer and other Times Newspaper journalists.

My investigation of Wakefield began six years before Mr Murdoch took a nonexecutive directorship of GSK (which he has since resigned).  Mr Murdoch was not the “proprietor” of The Sunday Times, or its parent companies. He has never had editorial responsibility for The Sunday Times, which has an independent editor and directors, but which, like other News Corporation businesses, such as Fox News, has given extensive coverage to anti-vaccine opinions. I've never heard of any Murdoch family member expressing any view about vaccines, and I have never seen anything to suggest that the investigation of Wakefield was of the least interest to drug company shareholders.

7. Mr. Deer failed to disclose that he was privately the author of at least three complaints to the General Medical Council that later took away Wakefield's license. Violating journalistic ethics, Deer had created the very news that he later covered. (GMC created a letter a year later stating Deer was not listed as the complainant.

I have repeatedly disclosed (including in numerous formal “competing interest” statements) that I supplied information from my investigation to the GMC, as was my public and professional duty. This is routine conduct for journalists faced with regulatory bodies inquiring into areas of mutual interest. This involved no violation of journalistic ethics, and I was honoured by my peers with a British Press Award, the highest distinction for a UK newspaper journalist.

Reports that Wakefield was to face a GMC inquiry were published in the UK media on the same day that my first stories on the Wakefield scandal appeared, and before the GMC approached me asking for my full findings.  It would have been irresponsible and perverse for me to decline to produce evidence when requested by a statutory body inquiring into matters impacting on the safety of children.

The GMC stated that I was not the complainant because the GMC itself was the complainant. This is often the case when doctors face serious misconduct charges.

 8. Mr. Deer also failed to disclose that there were no complaints against Wakefield by the children's families, most of whom very strongly support him, and many of whom credit his team with a diagnosis that led to effective treatment of their children's bowel disease.
The father of the only child in Wakefield’s series who was not entered in (failed) UK compensation litigation described Wakefield’s reporting in the Lancet as "a clear misrepresentation of my son’s history” and "an outright fabrication”.

The BMJ has referred to experts all of the raw data on the children’s bowels obtained from the Royal Free hospital and medical school.  No inflammatory bowel disease was identified.  To my knowledge, nobody has ever claimed that autistic children do not suffer from bowel disease: they suffer from all the same diseases as any other children. A panel of America’s leading experts on gastroenterology in autistic children, including the influential Dr Timothy Buie in Boston, publishing in Pediatrics, has rejected Wakefield’s claims of having discovered a bowel disease distinctive to autism (see statement 4).

9. The Lancet withdrew the Wakefield paper seven months after the Lancet's owner, Sir Crispin Davis, became a non-executive director of MMR manufacturer Glaxo SmithKline. His brother, Nigel Davis, was the high court judge who presided over the secret hearing to remove funding from MMR litigation. Nigel Davis then issued a statement (referring to himself in the third person): "the possibility of any conflict of interest arising from his brother's position did not occur to him."

The Lancet withdrew the Wakefield paper in February 2010, after the conclusion of the GMC case, which among other things found that Wakefield did not have the IRB approval he claimed in the text, and after countless irregularities in the paper were exposed during evidence before the panel.  The Lancet editor said of Wakefield’s conduct: “It's the most appalling catalogue and litany of some the most terrible behaviour in any research.”

The judge named by Jennifer VanDerHorst-Larson did not preside over any “secret hearing to remove funding”.  The decision to remove funding had already been taken by the UK Legal Services Commission, and upheld by an independent review panel, after the plaintiffs’ own lawyers submitted that, as the evidence stood, they could not make a case that MMR caused autism.  The named judge (and two others, including in the London appeal court) merely affirmed (in routine judicial reviews) that the procedures had been correctly executed and the decisions properly founded.

It should be a cause of regret that those anti-vaccine campaigners who know the truth of this matter continue to cause distress to vulnerable people by making the false allegations repeated here by Ms VanDerHorst-Larson.  The case against MMR failed in England because critical evidence had been fabricated, while an overwhelming body of scientific research failed to find any link with autism or bowel disease.  A materially identical case to the one that failed in England in 2003 was presented in the US court of federal claims in 2007, and also failed. Special masters in federal court handed down scathing judgments of Wakefield’s theories and personal integrity.

10. The chairman of the GMC panel that struck Wakefield off the medical register, Surendra Kumar, failed to disclose that he owned shares in MMR manufacturer GlaxoSmithKline.

On 3 November 2008, Wakefield, and his two co-defendants in the GMC case, formally submitted to the panel that its chairman had no conflicts of interest.

11.  Mr. Deer's opening slide at the La Crosse talk, clearly intended to refer to Wakefield, speaks volumes about Deer’s lack of neutrality: “If he wasn’t so fucking greedy, he’d a been tougher to spot.” (The only money Wakefield earned as an expert witness was donated, by him, to the Royal Free Hospital. This is well documented.)

There is no record at the Royal Free of Wakefield ever donating any money, nor has any document ever been produced to this effect. Ms VanDerHorst-Larson simply copies out Wakefield's claims, and does not check them. Wakefield has been asked on numerous occasions for such documentation, and, despite extensive discovery in UK litigation and substantial Freedom of Information disclosures by the relevant public bodies, none has ever been found.  Meanwhile, I obtained papers revealing Wakefield’s longstanding concerns that he should be “incentivised” with large amounts of money (on top of the hidden £435,643, plus expenses, from lawyers), including through secret business schemes expressly intended to exploit the vaccine scare he created.

12. Among the more egregious of his many false statements at La Crosse was Mr. Deer's claim that Dr. Wakefield "called on parents to boycott the MMR vaccine." He in fact recommended parents request the single measles, mumps and rubella shots that were available at that time in the UK, rather than the combination shot.

Ms VanDerHorst-Larson's posited distinction is devoid of difference.

Published 18 October 2012

VanDerHorst-Larson: food for the birds

Toxin Gambit Part 3: Sucrose

Just the Vax is doing a series on vaccine excipients with the hope that we can get through all of them to provide clear and reasoned information about how they are not toxic along with defining what a toxin is.  We have Toxin Gambit Part 1: Formaldehyde, Toxin Gambit Part 2: Polysorbate 80 ( with bonus material that includes how anti-vaxxers are innumerate) and now our latest instalment is about sucrose.  Some of you may stop laughing now. 

This post is actually a re-post of Sucrose: Dangerous Poison or Plain Table Sugar? which has been written by Reuben of The Poxes Blog.  We hope you find this informative and puts a little perspective on what is really a toxin.

Sucrose: Dangerous Poison or Plain Table Sugar?

The answer is clearly "plain table sugar". I'll explain why in a little bit. But let me first show you an anti-vaccine rant about sucrose (emphases mine):

"Here is the promised Sucrose information. It can also be found in the notes section.
Sucrose:Material Safety Data Sheet:http://www.sciencelab.com/msds.php?msdsId=9927285 

The first thing I want to point out is that the MSDS is for the safe handling of large quantities of the chemical. It would be seen in a binder on the floor of a manufacturing plant, storage facility and anywhere it may come in contact with humans working with it. As we can see, this MSDS was updated on 6/09/2012 at 12:00pm. This is important information to note. One must always be sure the MSDS you find is up to date. 

I am NOT going to break down each section of the MSDS. However, I am going to point out Section 3 and 4. As we can see it has a listing of acute and chronic health effects and the first aid required for acute exposure.

The acute affects make it dangerous for skin and eyes to come in contact with it, as well as an indication that ingestion would be unwise. Treating acute exposure is covered in Section 4 of the MSDS. The chronic affects would be difficult to pin down to exclusive exposure to this chemical. We do see it has carcinogenic effects label of A4.

Here are 2 websites that break down the classes of carcinogenicity:

http://sis.nlm.nih.gov/enviro/iupacglossary/annex3.html

http://www.hc-sc.gc.ca/ewh-semt/occup-travail/whmis-simdut/carcinogenesis-carcinogenese-eng.php

It is important to note that “Not classifiable as a human carcinogen” often means the government has not conducted definitive studies to rule one way or the other. Although we are seeing many independent university studies regarding this specific chemical.

All one has to do is Google “dangers of sucrose” and you will be bombarded with many health sites, such as livestrong.com, telling of the danger this artificial sweetener poses. I want to present studies though. There have been none in recent years to determine whether long term exposure to sucrose would cause permanent damage to the human body. At least none that I could find.

(Please, if you have links to the study summary in PubMed, post them!)

Here is what I did find:http://www.ncbi.nlm.nih.gov/pubmed/9519848 - This relates to a study done with rats and dogs, but it was a short study. Because I am not a chemist nor a biologist, I’m not sure how this translates to humans consumption. This is an older study and I could find nothing newer.

One more, and it is from 1998. It shows no long term affects:http://www.ncbi.nlm.nih.gov/pubmed/9519849I am not going to report things that don’t exist. However, the MSDS shows definite hazards to being exposed to the chemical in the event of a spill. Again, if you have links to the specific studies I keep seeing mentioned, post them or message them so I can update the notes section and my own records.

Carrie 

**Later today I will address the next 3 ingredients and post it to notes and the wall. Thank you."

Of course she's not a chemist or biologist. If she was, she would know what sucrose is.

There are these chemicals called sugars. They consist of carbons attached to hydrogen and oxygen. If they have six carbons, they are "hexoses". "Hex" is the prefix for "six". If they have five carbons, they are "pentoses", with "pent" being the prefix for five. Human beings take in these hexoses and pentoses and break them down via chemical reactions. These chemical reactions produce energy. Our cells then use that energy to grow and multiply, repair themselves, and just, you know, live.

You are warm right now because you are actively breaking down these sugars and the reactions produce heat.

You've probably heard of "glucose". It's the sugar in your blood right now. It's a hexose, and it packs quite a punch when it comes to energy. The energy is stored in the bonds between the carbons. Break those bonds, and you release a ton of energy.

You've probably also heard of "fructose". It is the sugar in plants. We have glucose, and plants have fructose. We consume fructose when we eat fruits and vegetables. Some have more fructose than others. "High fructose corn syrup" is a corn product (corn has fructose) that has been refined to contain the most fructose possible. It's super sweet because it has a lot of sugar in it. Fructose, a pentose hexose, is a sugar.

Still with me?

Here is a picture of glucose:

Note the six carbons are labeled 1-6.

Now, here is a picture of fructose:

They're not labeled, but there are five six carbons there.

Now, let's talk sucrose.

The reason why that anti-vaccine person is demonizing sucrose is because it is contained in some vaccines. If it is in a vaccine, then either the devil defecated it or aliens produced it. That is to say that anti-vaccine people think that everything inside a vaccine vial is absolute evil and/or not of this world.

But here is why the government has never tested sucrose for toxicity. Check out the picture of sucrose:

Look familiar?

That's right, dear reader! Sucrose is glucose put together with fructose. It's also known as table sugar. It's the white powder that you use to sweeten your coffee or your muffins. Pineapples and apricots produce sucrose as the main sugar. When you eat sucrose, an enzyme in your gut breaks it apart into glucose and fructose. Then these are absorbed into the bloodstream and metabolized.

When you are injected with sucrose, or you are given it by IV as part of a medical therapy, a similar enzyme breaks it apart in your circulation. Then your metabolism takes over.

"But wait, she said it could be a carcinogen?" Tumors (large groups of cancer cells) also need energy. They're cells! So a well-fed person who eats plenty of refined sugar and has cancer is only feeding those cells. It's not a cancer-cause as much as it is a cancer-collaborator.

So don't fear sucrose. It's not evil. It's delicious.

Then again, fear it a little bit if you're overweight or a diabetic... Or both.

PS: Would you like the government to spend millions of dollars and thousands of man-hours to study table sugar?

Mark Geier's license now also *revoked* in Washington

Just a quick happy not that Washington has now also revoked Mark Geier's license to practise medicine, after Indiana and Maryland (see Harpocrates Speaks). Children in Missouri, Ilinois and Hawaii are still not safe - but I am sure it is just a matter of time until their boards catch up.

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.

La Crosse Purposes

Anyone who has an interest in the Andrew Wakefield debacle also knows who Brian Deer is.  Mr. Deer is giving a talk at the University of Wisconsin-La Crosse 4 and 5 October 2012 and that has the Wakefield worshippers in a collective apoplexy.  What is particularly striking about the current Deer versus Wakefield affair is where the latter has been relegated to.

Wakefield was once the darling of media outlets.  But after his demise following the GMC Fitness to Practise Proceeding and the determination of over forty counts of serious professional misconduct, his ouster from the former Thoughtful House (now Johnson Center for Child Health and Development) and subsequent British Medical Journal series by Brian Deer chronicling Wakefield's fraudulent activities, Wakefield is deservedly reduced to wallowing in the dregs.

Brian Deer gets invites to speak at notable universities and societies and wins press awards whilst Wakefield has been reduced to giving interviews to paranoid conspiracy-theorists Alex Jones and Mike Adams, nipping at Brian Deer's heels in the form of failed lawsuits and now appearing in little park sheds with a capacity of 40, a mile away from where Mr. Deer will be presenting to crowds numbering in the hundreds.

That has to sting.  And for your visual entertainment, this is where Wakefield will be:

Myrick Gun Club, La Crosse, Wisconsin.  Capacity: 40.  Cost: $140/day.

(Photo courtesy of: http://jamielynnbuehner.blogspot.com/2012/04/4-my-steers-family.html)

And it looks like it might be a rainy day for the Wakefield fans.  Too bad.

This is where Brian Deer will be presenting:

 

Centennial Hall and Clock Tower, University of Wisconsin-La Crosse.  Capacity: 250.

Just go away Wakefield; you aren't relevant any longer and you certainly haven't done a damn thing to help benefit the autism community.  It's a shame that people with more money than brains don't recognise Wakefield for being the unscrupulous money-suck he is and can't seem to find themselves legitimate figures to identify with.

Pregnant women in the UK to be offered whooping cough vaccination

The British Department of Health announced last week, that starting from today, pregnant women will be offered the whooping cough vaccine to protect their new borns. The idea is that when vaccinated during pregnancy, the maternal antibodies will be passed through the placenta to the baby before birth and will protect the infant in the first couple of months of their lives, when they cannot yet be vaccinated. This move comes after nine infants, all under three months old, died of pertussis in the UK of 302 under 3 month olds who contracted the disease (yes, that is a mortality of 3 percent, 3 of 100). The HPA welcomes this move, after having received notification of 1230 whooping cough cases in August 2012 alone.

Whooping cough is not a mild disease by any stretch of the imagination - the BBC has several testimonials from mothers of babies, but also older kids:

Nine year old Zara Mummery was seven when she caught whooping cough. One night she was coughing so much she stopped breathing.

"It was very frightening, but I remember that my mum brought me into the bathroom and she called the paramedics.

"She was just screaming on the phone 'my child's going to be dead, please come'."

Her mother Katrina said she couldn't get her daughter to breathe.

"It was like she froze. It was one of the most terrifying things any parent can go through, to think they have lost a child."

Zara spent a week in hospital on very strong antibiotics and is now fit and well.

 While the number of cases in the UK are increasing at an alarming rate,

it is worth remembering what the situation was like before the introduction of the vaccine. 

Before routine vaccination in 1957, whooping cough outbreaks in the UK were on a huge scale. It could affect up to 150,000 people and kill 300 in a single year.

What is already being remarked in vaccine-critical circles is that the dTaP/IPV booster vaccine, Repevax, is not recommended for use in pregnant women in the UK. The package information states:

Pregnancy

The effect of REPEVAX on embryo-foetal development has not been assessed. No teratogenic effect of vaccines containing diphtheria or tetanus toxoids, or inactivated poliovirus has been observed following use in pregnant women. Limited post-marketing information is available on the safety of administering REPEVAX to pregnant women.

In their FAQs for GPs, the reason for the recommendation despite this disclaimer is provided:

Why does the Patient Information Leaflet state that Repevax® should not be used in pregnancy?

This says that the vaccine is not recommended for use in pregnancy because of the routine exclusion of pregnant women from clinical trials, and not because of any specific safety concerns or evidence of harm in pregnancy. Use in pregnancy is not contraindicated.

The CDC recently published the reasoning behind their older recommendation to vaccinate pregnant women against pertussis, and, using data from VAERS and two smaller studies, found that vaccination during pregnancy is safe. There is good indication that vaccine-induced antibodies pass through the placenta and hence would protect the newborn.

This new recommendation could save lives - I'll tell my pregnant friends about it - you should, too.

Non-Medical Vaccine Exemptions: Balancing Parental Rights and Public Health

U.S. Religious and Philosophical Vaccine Exemptions 

Philosophical and religious vaccine exemptions have been a hot topic lately with California's AB 2109 Bill which would require parents who wish to opt out of vaccination obtain an approved healthcare providers' signature that the parents have been advised of the risks of not vaccinating.  And Washington State's recent passing of the same type of bill has anti-vaxx groups in a collective apoplexy.  New Jersey is also discussing tightening their religious exemptions and a new bill S1759 has been submitted to the state Senate for a vote.  New Jersey has no philosophical exemption so its religious exemption has been easily used for parents to opt out of vaccines.

I like others have a problem with just religious exemptions for the reason that there are no recognised religious organisations that oppose vaccines and they also exclude secular beliefs.  In fact, there is no constitutional right or protection requiring religious exemptions to be provided.  There are no constitutional protections from compulsory vaccination for philosophical reasons either in spite of vapid assertions to the contrary.

An Equal Protection challenge to vaccination regulations was denied in Zucht v. King as the U.S. Supreme Court ruled that vaccination laws do not discriminate against schoolchildren to the exclusion of others similarly situated (i.e., children not enrolled in school). (221)  In the case of Adams v. Milwaukee, Justice Brandeis reaffirmed Jacobson's holding that states may delegate the power to order vaccinations to local municipalities, and that broad discretion must be granted in the application and enforcement of the resulting public health regulations. (222)  In Prince v. Massachusetts, the Supreme Court held that the First Amendment's Free Exercise Clause does not allow for the right to expose the community or one's children to harm from disease. (223)  An Arkansas court later affirmed that school vaccination requirements do not deprive individuals of liberty and property interests without due process of the law. (224) Moreover, even where a parent objects to compulsory vaccination, a child does not have an absolute right to enter school to receive an education. (225)  Clearly then, the rights of individuals to be free from unwanted government interference in the form of compulsory vaccinations have been severely limited by the courts where public health is at stake.

But what about the constitutionality of compulsory vaccinations where no exemptions at all are provided--i.e., neither for philosophical nor religious reasons?  Again, the judiciary has held that individual rights may be restricted in the name of the public welfare without violating the Constitution.

States that do offer religious exemptions place themselves in a more precarious position legally.

Some state courts have held that parents must be members of a "nationally recognized and established church or religious denomination" in order to claim an exemption, (229) but others have found that similar regulations violate the Equal Protection Clause of the Constitution by giving preference to certain religions over other. (230)  Moreover, some courts have gone as far as to say that providing any religious exemption violates the Equal Protection Clause because it "discriminate[s] against the great majority of children whose parents have no such religious convictions." (231)

As it stands now, 48 U.S. states allow religious exemptions and 20 allow philosophical exemptions.   Some retrospective analyses of Arkansas, which allowed philosophical vaccine exemptions beginning the 2003-2004 school year have revealed a startling trend which has been observed in other states as well.

Total exemptions numbered 529 in Year 1; 651 in Year 2; 764 in Year 3; and 1145 in Year 4. Between Years 1 and 2, the total number of exemptions granted rose by 23%. After philosophical exemptions were allowed in Year 3, total exemptions granted increased by 17% over the previous year, and by 50% more from Year 3 to 4 (Figure 1).

In Year 3, nonmedical exemptions (including religious and philosophical options) were 1.37-fold higher than nonmedical exemptions in Year 2 (139 versus 64) and 1.67-fold higher than nonmedical exemptions in Year 1 (110 versus 64), when religion was the only option for nonmedical exemptions. In Year 4, nonmedical exemptions (62) were 2.12-fold higher than in Year 2 and 2.58-fold higher than in Year 1. In Years 3 and 4, the majority of the nonmedical exemptions (58% [403 of 700] and 67% [721 of 1083], respectively) were based on philosophical rather than religious (297 and 362, respectively) reasons.

Medical exemptions constituted 21% of all exemptions in both Years 1 and 2. However, with the introduction of philosophical exemptions, the absolute number of medical exemptions dropped by more than half (from 139 in Year 2 to 64 in Year 3 and 62 in Year 4). Thus, medical exemptions accounted for only 8% of Year 3 and 5% of Year 4 exemptions.

Emphasis added.  This is a concerning statistic as it would appear "vaccine-friendly" physicians may have been issuing medical exemptions where they weren't medically-indicated.  This seems to be an unintended finding that should be addressed by public health officials in concert with state medical regulators.

A more recent study conducted by Safi et al. (2012) and includes additional years of data sets has confirmed the previous finding by Thompson et al. (2007).  However Safi et al. included some additional statistics which reveal a number of interesting findings:

Analysis of exemptions by vaccine type revealed that in the 2009 –2010 school year, 70.8% (1922) of exemptions were requested for all vaccines, 9.2% (249) were requested for two or more vaccines, and 20% (543) were requested for a single vaccine. A similar pattern also was seen for previous years. More than 92.8% of single-vaccine exemptions requested were for the measles, mumps, and rubella (MMR) vaccine and 4.6% were for both hepatitis B and varicella. Of 504 single MMR vaccine exemptions, 436 (86.5%) were requested for college students. MMR vaccine is the only required immunization for college enrollment in Arkansas.

The prevalence of children in home schools, not involved in any public school activities, who are undervaccinated is not known, nor of foreign children residing in Arkansas. Even though vaccine exemption–associated outbreaks have not yet been identified during this study period (2001–2010), the increasing trend of exemption in specific colleges in Arkansas raises particular concern because of previous links of infected (symptomatic or asymptomatic) exempted students with mumps and measles outbreaks. ^{[4], [9], [10], [11] and [12]}

Private schools are not included in the collection of these statistics and given the date of the incident, Safi et al. were unaware of this recent Arkansas boarding school measles outbreak. It has also become well-known that Waldorf Schools have become hotbeds for high vaccine exemptions and thus pertussis and measles outbreaks.  The MMR triple jab had the highest number of exemptions for school age and university students which appears to be a shameful repercussion of Wakefield et al.'s fraudulent and retracted Lancet paper even over a decade after the fact.

The recent moves by various states to tighten the ability to acquire non-medical vaccine exemptions are laudable but rather futile efforts that are easily overcome by determined anti-vaxx groups whether it be through convincing credulous politicians to ignore experts in Vermont, lobbying California to include naturopaths as an approved healthcare practitioner to provide vaccine exemption counselling for AB2109 (which is as good as a rubber stamp) and challenging states over the constitutionality of tightening existing religious exemptions such as New Jersey.  Parents who hold these beliefs will not be swayed by a brief meeting with a "healthcare practitioner" who will be undoubtedly shopped for in order to provide a signature needed to be on their way as quickly as possible.  These measures will not increase vaccination rates in any appreciable way.  Political-correctness and pseudo-scientific grandstanding have no business in public health policy, only solid scientific evidence does.

What can States do About Balancing Parental Rights with Public Health?

It's rather easy, in theory at least but would provide parents and public health with the fairest way to balance their respective interests bearing in mind that public health policies are measures to create benefit and protection for the majority of a population.

• Eliminate all religious exemptions and have just philosophical exemptions

States would eliminate, or more realistically reduce the number of legal challenges that can be made by simply providing philosophical exemptions.  There are secular reasons for seeking vaccine exemptions and no religious belief should be deemed superior to another in the matter of exemption from vaccines.

• Enact philosophical exemptions for particular vaccines and all vaccines

Track specific vaccine exemptions rather than make them "all or nothing".  States such as California and Colorado are already doing this (more or less).  This provides more accurate data regarding vaccine uptake and provides schools requisite information to manage outbreaks more fairly and effectively.  As it stands now, any student with a vaccine exemption is required to stay home from school in the event of an outbreak which can mean several weeks out during the school year.  This may be rightfully deserved according to some but ultimately, the children suffer for the parents' actions and tutors are provided by schools at taxpayer expense if a certain number of consecutive days are missed.

Allowing selective exemptions would prevent unnecessary exclusions from school.  For example, a student with an exemption for hepatitis b would be allowed to remain in school in the event of a measles outbreak.  Parents who have an "all vaccines" exemption on file for their children would of course be required to stay home in the event of an outbreak of any VPD.  Outbreak control measures may include requiring students stay out of school for an outbreak of a VPD anywhere in the school district rather than just at the school of enrolment given disease transmission dynamics and incubation periods.

• Standardise criteria for state vaccine mandates

Rigorous criteria for determining which vaccine antigens should be mandated by a state is currently being used in the State of Washington as reported by Lantos et al. (2010):

Washington became one of the first states to develop explicit criteria when its Board of Health convened an Immunization Advisory Committee in 2005 to provide recommendations for how to determine whether a new antigen should be part of the State's required immunizations for entry into school or child care.⁵¹ The Washington State Board of Health realized, in part, that rigorous criteria were needed as it became clear that several vaccines in development were likely to be recommended for children and adolescents and proponents were likely to propose mandates. Indeed, in 2005, the quadrivalent conjugate meningococcal vaccine was licensed, followed by the first human papillomavirus (HPV) vaccine and the first rotavirus vaccine in 2006.

Washington State's 9 criteria are grouped into 3 categories: vaccine effectiveness, public health disease burden, and implementation.⁵² These criteria are meant to sufficiently address the different layers involved in public policy decisions. There are 4 criteria of vaccine-effectiveness; (1) the vaccine containing the antigen has been recommended by Advisory Committee on Immunization Practices; (2) its effectiveness has been established by immunogenicity; (3) it is cost-effective from a society perspective; and (4) it is safe with an acceptable level of adverse effects. The 2 public health burden criteria are (1) that the vaccine containing the antigen prevents a disease that has significant morbidity and/or mortality; and (2) that vaccinating children and adolescents reduces transmission of the disease. The last 3 criteria reflect implementation of the vaccination program: the vaccine must be acceptable to the medical community and the public, the administrative burdens of delivering the vaccine must be acceptable, and the burden of compliance for vaccination is considered reasonable for the parent.

The process for evaluating an antigen for inclusion in school mandates in Washington State involves 3 steps. The Board of Health first does a preliminary review of the antigen of interest to determine whether there is enough information about the antigen for the 9 criteria to be used. Second, a group of representatives from public health, primary care, epidemiology, ethics, and others (such as parents and school administrators) is appointed by the Board. Finally, these appointees review the antigen in question using the 9 criteria and provide a recommendation to the Board. Although these criteria and the process in which an antigen is evaluated against them require some clarifications, they offer a deliberate and informed approach to determining which vaccines should, and should not, be required for school entry.⁵¹ Washington State's Board of Health used these criteria to include the meningococcal vaccine as part of the require immunizations for school entry in 2005. Washington State does not include the HPV or rotavirus vaccines in its school immunization laws.

Other states have come to different decisions. As of June 2009, school mandates exist in 18 states for the meningococcal vaccine,⁵³ and in 2 states (District of Columbia and Virginia) for the HPV vaccine.⁵⁴ No state has a school mandate for the rotavirus vaccines.

Such a process will ensure that an evidence-based approach will be implemented to decide which vaccines should be part of school vaccine mandates.  Such an evidence-based and transparent method may also serve to address some parental fears about vaccinating by addressing individual state's VPD epidemiology.

• Require private and parochial schools to adopt and record the same mandatory vaccines and/or exemptions as public schools

The State of West Virginia (which only has a medical vaccine exemption) requires this already.  Many or most U.S. private and parochial schools do not require vaccines for school entry and/or attract anti-vaxx parents with easy opt outs for vaccines.  Some of these schools have exemption rates of over 80%, particularly Waldorf Schools.  Since schools are the primary sources of disease transmission, there is simply no justification for allowing private and/or parochial schools different standards for vaccine requirements.

• Limit the number of philosophical vaccine exemptions

Given the alarming numbers of philosophical and religious exemptions that some state school districts and counties are issuing, it has become necessary to cap the number of non-medical exemptions for any given school.  These exemptions are based upon pseudo-scientific information that is easily available to credulous parents concerned with vaccine adverse effects; there is no reason to continue to entertain these fallacious beliefs and extraordinary senses of entitlement in the form of high numbers of vaccine exemptions that erode herd immunity.

Herd immunity assumes the equal distribution of susceptible people; this very crucial aspect of herd immunity is compromised by high numbers of non-vaccinated geographically-clustered, particularly at a school level.  In order to achieve herd immunity threshold, the minimum percentage of people vaccinated for a disease is based upon vaccine effectiveness, disease transmissibility or infectiousness (for example measles is far more transmissible than hepatitis b so a higher percentage of people need to be vaccinated for the former than the latter), population mixing and vaccine failure.  For example, measles vaccination uptake to achieve herd immunity threshold is estimated to be 90-93% due to the extremely high infectiousness of measles and an estimated 5% primary vaccine failure rate.  And again, that is also assuming an equal distribution of susceptible people in a large population.

There are several school districts and/or counties throughout the U.S. that do not reach this threshold, California being a glaring example.  Using measles again as an example of how to cap philosophical exemptions and hypothetical school A with a student population of 1000 students, the upper limit for the number of unvaccinated children must be lower than 7% to account for clustering of susceptible children, let's arbitrarily say 4% which would be 40 students.  Medical exemptions would be provided first, next allow selective vaccinators in order of one and two vaccines refused and if the 4% exemption for measles vaccination hasn't been met then full vaccine exemptions can be provided for the remainder.  A higher number of exemptions could be allowed for say, hepatitis a and b but a lower number for pertussis.  Such a system would "reward" those who have their children vaccinated the most according to state mandates and encourage at least some vaccination.

Implementation of philosophical exemptions could be done by lottery and monitoring of medical exemptions which would have the potential for abuse should be considered.

• Requirement of an informed consent statement for philosophical exemptions

This is in line with what Washington State has already enacted and what California may be next in doing.  With all due respect to these state's public health officials, higher standards of informed consent with greater efficiency need to be implemented.  Instead of requiring a signature from a "healthcare provider" which can mean naturopaths who are notoriously anti-vaccine or one of Dr. Bob Sears "vaccine-friendly" doctors, hold public seminars for potential philosophical exemption-seekers with qualified professional scientists and/or physicians.  Said professional scientists and/or physicians would be very familiar with anti-vaccine arguments, websites and purveyors of vaccine misinformation in order to more adequately address parental concerns and objections to vaccines.  A single speaker could reach hundreds of parents at a time taking the burden off of individual providers, disseminate much more relevant information, while dismantling anti-vaccine myths and provide statements of informed consent at the end of the seminar.

Some may ask why even bother to have philosophical exemptions but I feel as though our society can withstand a certain amount of individual freedoms without infringing on the safety of others.  However, there are some areas of the U.S. that appear to have a disproportionate number of parents who feel as though their own entitlements supersede those of the community to the point that once-eliminated or lowly endemic vaccine-preventable diseases are creating outbreaks with their direct actions.

Although philosophical and religious vaccine exemptions are a politically-charged issue, medical science must be the basis for public health decisions and not emotive, politically-motivated ones.  Contrary to popular belief, we do not have a constitutional right to philosophical nor religious vaccine exemptions; the courts have been clear on that.  Such exemptions are a privilege and unfortunately, a privilege which is being abused to the point of endangering society and must be adapted to protect the larger society while maintaining some ability for individual freedoms.

Buy this Book Before Big Bad Pharma has it Pulled off the market

Here's Ben Goldacre holding the first copy of his new book "Bad Pharma" (I will hold mine tonight, squee):

Those of you who have followed the story of "Bad Science" will know that the first edition was missing a chapter, because the dangerous quack discussed in that story was suing Dr. Goldacre. The chapter appeared online after the law suit and was added to the second edition of the book.

Now Ben might be facetious when he asks his readers to buy the book before it gets pulled, but it is not an unrealistic worry given his previous experience and industry practise. What can you expect? Luckily, Ben Goldacre generously shares the whole Introduction here:

So to be clear, this whole book is about meticulously defending every assertion in the paragraph that follows.

Drugs are tested by the people who manufacture them, in poorly designed trials, on hopelessly small numbers of weird, unrepresentative patients, and analysed using techniques which are flawed by design, in such a way that they exaggerate the benefits of treatments. Unsurprisingly, these trials tend to produce results that favour the manufacturer. When trials throw up results that companies doesn’t like, they are perfectly entitled to hide them from doctors and patients, so we only ever see a distorted picture of any drug’s true effects. Regulators see most of the trial data, but only from early on in its life, and even then they don’t give this data to doctors or patients, or even to other parts of government. This distorted evidence is then communicated and applied in a distorted fashion. In their forty years of practice after leaving medical school, doctors hear about what works through ad hoc oral traditions, from sales reps, colleagues or journals. But those colleagues can be in the pay of drug companies – often undisclosed – and the journals are too. And so are the patient groups. And finally, academic papers, which everyone thinks of as objective, are often covertly planned and written by people who work directly for the companies, without disclosure. Sometimes whole academic journals are even owned outright by one drug company. Aside from all this, for several of the most important and enduring problems in medicine, we have no idea what the best treatment is, because it’s not in anyone’s financial interest to conduct any trials at all. These are ongoing problems, and although people have claimed to fix many of them, for the most part, they have failed; so all these problems persist, but worse than ever, because now people can pretend that everything is fine after all.

In short - the book that everyone should read and that could be the beginning of something amazingly beautiful: evidence-based medicine.

For those of you in the US - ask a European friend to send you the book or bridge the time until January 2013 with reading Ben's excellent blog.

NOTE: I linked to Amazon.co.uk and Amazon.com up there, but if you have a chance, support your local book store and buy it there.

Edited to add: David Colquhoun, the excellent pharmacologist and skeptic has weighed in. I have changed the book link to a store which pays taxes in the UK following his example.

Speaking of Potential Outbreaks - New SARS-Like Virus Detected in UK

The British Health Protection Agency warns today:

The Health Protection Agency (HPA) can confirm the diagnosis of one laboratory confirmed case of severe respiratory illness associated with a new type of coronavirus. The patient, who is from the Middle East and recently arrived in the UK, is receiving intensive care treatment in a London hospital.


In recent months, this new human coronavirus was also identified in a patient with acute respiratory illness in Saudi Arabia, who subsequently died.

This comes after the death of a man from the same virus in Saudi Arabia. With the Hajj starting in a month from now, the risk of an outbreak is very real and health personnel is being advised how to deal with patients with respiratory illnesses accordingly.

Update: what the WHO says.

Holy Bear Turd - Get in Line, Epis...

Mountain Laurel Waldorf School stands good chances of doubling the US' measles cases:

The school has just over 130 students enrolled. .../... According to NYS Health Commissioner Shah, nearly half of the students have not been immunized for measles.

Wow.

Students and staff who have not been immunized have been excluded from the school until the danger of infection passes. While measles immunization is a requirement in New York State, private schools have the authority to make exceptions. The concern in New Paltz is for anyone who may have attended or visited the school after September 10.

Indeed.

Update: This morning the actual numbers appeared:

Eighty of the private grade school's 145 students were sent home, said Ulster County Health Commissioner Carol Smith. Since the weekend, 27 children have been vaccinated and allowed to return to school, Smith said Monday.

I found this statement of one of the parents of the vaccinated children interesting:

One Mountain Laurel parent, John Ascione, has two children attending the school; both have been vaccinated. He characterized opposition to vaccination as a result of skepticism by some parents of children attending an alternative-minded school to what he called the "corporate influence" in such institutions as the Food and Drug Administration and the CDC.

I wonder whether he and the other parents are fully aware of the Steiner philosophy and that it is not just a squishy, nacheral, crunchy alternative to teh ebil FDA/CDC run world.

In Yet Other News, Bears Still Crap in the Woods

and measles prefer the crunchy (unvaccinated) Waldorf/Steiner pupils, especially those who travel. The Dutchess County Department of Health wrote Friday:

The Dutchess County Department of Health announced today a confirmed case of measles in a student at the Mountain Laurel Waldorf School in New Paltz, NY.  Anyone who has visited this school since September 10th or has had any contact with anyone from this school should immediately make sure that they are up to date with their measles vaccinations.  All medical practices and laboratories in the area should be on high alert that there may be a number of other children and families who have been exposed and could be communicable.

We have learned that a number of students at this school were not vaccinated and may become ill and put other children and families at risk for contracting measles.

Mountain Laurel Waldorf School has no alert on their website, but if the student attended the school for several days before being diagnosed, it may be too late anyway. A potential feast for epidemiologists (and bloggers), coming at high risk for the children involved.

On the other hand, Waldorf-minded parents might be delighted. In the Steiner philosophy, measles (and other rashy diseases) help the kids mature:

At the higher emotional and mental levels, negative forces such as greed and selfishness have also been expelled. So a child who has measles is afterwards less self-centered and more openhearted, and often more able to express his or her individuality. The personality becomes rounder and fuller, and more joyful and contented, as a step towards maturity and adulthood.

And don't worry about complications or death, since

Serious complications in childhood illness which produce permanent damage or even death are probably deeply founded in the destiny of the person concerned.

Yes, totally out there, but so is the entire cult (see Melanie Byng's excellent three part series on DC's Improbable Science blog). Steiner Kindies and schools and anthroposophically minded doctors have therefore been doing a great job in keeping measles circulating and racking up impressive case numbers, like the 174 within 3 weeks at a 300 pupil Steiner school in Salzburg in 2008 or the 400+ cases in the practice of one doctor in the 1999/2000 measles outbreak in Coburg Bavaria.

Hopefully, this new outbreak will end with as few cases as the recent outbreak at Ozark Adventist Academy.

The Toxin Gambit Part 2: Polysorbate 80 and a Maths Fail

Previously we posted The Toxin Gambit 1: Formaldehyde which was an in-depth examination of what formaldehyde is, actual toxic doses and the amount in vaccines.  We feel these examinations are important for parents who have been frightened into believing that vaccine excipients are harmful when they are, in fact not, particularly in the amounts contained within vaccines.  A blogger who goes by the name of Amanda is one such person attempting to either justify her own fears of polysorbate-80 and/or trying to frighten others.  In either case she is demonstrably wrong with her interpretation of information and is a case study in why you should pay attention in maths classes.

I recently saw a woman on facebook complaining about teh ebil sodium chloride in vaccines, claiming "Sodium chloride: Raises blood pressure and inhibits muscle contraction and growth", channelling Natural News (the Nazi reference was missing from her post though). Did you know that vaccines contain up to 9mg/ml sodium chloride? Yes, that would be .9%, also known as "physiological salt solution" or "normal saline" - the stuff you can get intravenously in half litre amounts (BTDT) and that doesn't even sting when you clean wounds with it. Scientific illiteracy is rife among the anti-vaccine minded and I was just pointed to another example - this time, polysorbate 80 is the evil vaccine ingredient - the Blog "Blinded by the Light" comes up with a malware warning, so be careful when you click the link, I will copy and paste the best bits here, so you don't have to go (here is a pdf as downloaded Saturday morning). Amanda, the blog author, has a "holistic and spiritual paradigm" - maths and sciences are lacking from her approach though, so I am not sure she can claim the "holistic". She has several concerns about the use of Polysorbate 80 in vaccines:

According to the Material Safety Data Sheet (MSDS) for PolySorbate 80 there is no information available regarding carcinogenic, mutagenic, teratogenic, or developmental toxicity effects. [1]

There is information on toxicity though - the LD50 (dose at which half of the experimental animals die) is 34500 µl (microliter) per kilogram body weight - this is the equivalent of 24 teaspoons (or 36.6 grams, see below) full of pure Polysorbate 80 for a 3.5 kilogram newborn baby. A huge amount. Vaccines contain a maximum of 100µg per dose (that is threehundredandsixtyfivethousandsevenhundred [365'700] times less than the LD50 for a newborn, we ingest 1000x that (100mg) per day, since Polysorbate 80 is used as an emulsifier in many foods (for example ice cream, yumm). 

Amanda continues (her bolds and italics and underlines):

Reproductive Issues

I’m as apprehensive as the next guy when it comes to animal studies and results given. If you give a rat (or any animal for that matter) large doses of any chemical I’m sure cancer and health issues will ensue. However, this study is interesting.

A research group in 1993 studied the effects on the reproductive organs of rats with very small doses of polysorbate 80 which resulted in infertility. Specifically, they found that Polysorbate 80 accelerated the maturation of the female rats, damaged the vagina and womb lining, caused significant hormonal changes, severe ovary deformities and ultimately rendered the young female rats infertile. [3] 

To give you an idea by what I mean by very small. The dose given to the rats was 0.1 mcg. Compare this to the three-stage injection of the HPV vaccine Gardasil that would contain 50 mcg each injection. [3] [4]

If we assume the baby rats weighed 6 ounces (which  baby rats do normally weigh between 5-6 ounces), to be equivalent, the prepubescent teenage girl would have to weigh approximately 300 lbs.

Wow! That is horrible! Horribly wrong that is. Let me take you through this. We'll start with some basic measurements.

1 ml (milliliter = 1/1000th of a liter) of water weighs 1 g (gram)

1 ml = 1000 µl/mcl (microliter = 1/1'000'000th of a liter)

1 ml of Polysorbate 80 weighs 1.06-1.09 g, so it is a bit denser/heavier than water - I will calculate with 1.06 from here on.

An ounce is 28.35 g - 6 ounces are 170 g, about the weight of a full baby bottle.

300 lbs are about 137 kilograms (that is one big preteen).

Now let's see what the paper actually states:

So, neonatal female rats were injected with 0.1 ml of 1% or 5% or 10% Tween 80 (that is the same thing as Polysorbate 80, just a trade name) on 4 consecutive days. They were injected IP into the peritoneal cavity, which is in direct contact with the uterus. Now Amanda claims the amount given to the rat pups was 0.1mcg (=microgram) and calculates from there. That is wrong.

Remember, 1 ml weighs 1g (1 ml of Polysorbate 80 weighs 1.06 g, so I am going to go with that in the per rat calculations). Pups were applied 0.1ml = 0.1 gram. 0.1 gram is 100 milligram or 100'000 microgram. 1% of that is 1000 microgram (but since it was 1% of Polysorbate 80, 1060 microgram in 100 microliter). Pups were injected 4x with 1%, 5% or 10%, so they received:

1%: 4x1060 microgramm = 4240 microgramm (roughly forty two thousand times more than Amanda claims) 

5%: 4x5300 microgram = 21200 microgram

10%: 4x10600 microgramm = 42400 microgramm (or 42 mg)

What does a newborn rat weigh? Amanda sounds very authoritative when she states "5 to 6 ounces", but that is about as wrong as the rest – newborn rats pups up to the age of about 5 days are called "pinkies". This is why: they are the size and shape of a pinky and weigh about 8 g (less than a third of an ounce). When they are 7 days old, they are "fuzzies" – and weigh about 15 g (half an ounce). 

6 ounce baby bottle    -   3 day old rat pups    -     7 day old rat pups:

Notice how delicate their skin is and remember that the injection these pups have received did not go into the muscle (IM) or under the skin (ID) as vaccine, but IP, into the tummy essentially right next to the uterus.

We go on with an average weight of 12 gram per pup. Your 1% group will have gotten 353'333 microgram (or 353 mg) per kilogram bodyweight (1000/12 x 4240 µg). In order to apply the equivalent amount to a 50 kilo preteen (to stay with the Gardasil example), you would have to apply 17'667'000 microgram, or nearly 18 grams of pure Polysorbate 80 (that is 3.5 heaped tea spoons full - good luck getting that into three 0.5ml syringes).

Your three shots of Gardasil contain 150 microgram of polysorbate 80. In order to expose your preteen to the same amount of Polysorbate 80 that those pups (in the 1% group) got, she should weigh about 0.42 g or about the 12th of a teaspoon full (or 326'000 times less than Amanda claimed).

The wild speculation continues under the heading "Immunocontraceptive". Amanda cites a patent application for a vaccine intended to sterilise animals by vaccinating them with zona pellucida glycoprotein. The inventors explicitly propose to use Polysorbate 80 as an emulsifier, not an active ingredient and at the concentrations in the patent (0.2% in 0.5ml injected intramuscular) it is not going to do anything with the fertility of the recipient without the active ingredient.

Amanda's next worry is disruption of the blood brain barrier - according to her reference 10, not found in the citation list, already observed "at intrevenous systemic doses as low as 3 mg". That may or may not be true (since she doesn't reference the paper she refers to, it could be that those 3 mg were applied to 20 g mice), however, 3 mg are 3000 µg, vaccines contain between 25 and 100 µg of Polysorbate and are not given systemically (despite the "directly into the blood stream" canard that the anti-vaccine minded like to use).

Edited on 24 Sept 2012 to add: Amanda has very kindly come up with reference 10, which in turn cites this 1985 paper for the actual experiment. 25-35g mice (young adult females) were intravenously injected with 3 milligram per kilogram of polysorbate 80 together with methotrexate. If you upscale this to your 50 kilo preteen (3mg/kg), she'll need 150 mg (150'000 microgram) IV to be able to expect an effect on the blood brain barrier. However, vaccines contain 1500 to 6000 times less polysorbate 80 than that and are given into the muscle and not into the blood stream. -end edit-

It is sad that Amanda went out, equipped with very little understanding of maths, immunology, chemistry, or animal experiments, seemingly with the intention to be scared (and to scare)?