Anti-Vaxxer Robert F. Kennedy, Jr. to Chair a Vaccine Commission

U.S. President-Elect Donald Trump has met with anti-vaxxer RFK, Jr. to solicit him for a committee on vaccine safety and research integrity.  Sadly but not surprisingly such an appointment is on par with Trump's other picks for cabinet positions (although this isn't a cabinet position).  RFK, Jr.'s monomania regarding thiomersal has been debunked by the scientific community repeatedly.  Which leads me to believe that failure on that front will lead RFK, Jr. to turn his sights on "too many too soon" which Trump fervently believes.

It is unclear whether Trump is unaware of the CDC's Immunization Safety Office and the Vaccine Safety Datalink or simply doing an end run around them because he can't exert any direct control over them.  In any event, Trump is feeding his own anti-vaxx proclivities at the U.S. taxpayers' expense. Ultimately it is doubtful that anything meaningful will emerge from such a committee but that doesn't mean that RFK, Jr. can't cause a lot of trouble, not to mention the new life which will be breathed into the anti-vaxx movement.  How long before Andrew Wakefield is announced as a co-chair or committee member?

RFK, Jr. admits in an interview with ScienceMag that he has no expertise in science and will place "science people and prominent Americans".

How many people will be on the commission?
A dozen people -- a mix between science people and prominent Americans.
Who will you ask to serve?
I couldn’t tell you. I just finished meeting with the President-elect an hour ago.
When you say “science people,” do you mean experts from the scientific establishment?
Prominent scientists.
Do you mean prominent vaccinologists who believe in the safety and efficacy of today’s vaccines?
We are going to look for people who have expertise in toxicology, epidemiology and in public health.
Do you have scientific training?
No.  My background is I’m an environmental lawyer.  I’m not a scientist. But I have an expertise, I would say in reading science and spotting junk science because that’s what I do with most of my time.

Translation: He is going to look for people who might know a little bit more on the subject of vaccinology who are just as anti-vaccine as he is to launch a performance art showing.  Somehow I suspect that RFK, Jr. and his future committee members aren't exactly qualified to evaluate the science coming out of the CDC.  If it wasn't for the momentary pain in the arse RFK, Jr. and his little band of anti-vaxx warriors will cause for hard-working ethical people, it would be rather entertaining.

I am going to choose to look at the bright side of this which is another Trump rock will be turned over and we will get to see who crawls out.  Just as foisting Breitbart into the spotlight emboldened racists and let us see who they really are, this committee will undoubtedly have the same effect by emboldening anti-vaxx politicians and others who have cravenly kept to the shadows on the subject.  We will get to see who they are and may they have the same backlash inflicted upon them as the racist, bigoted Breitbart fake news site has.

Had organisations such as the Centers for Disease Control, the American Medical Association and the American Academy of Pediatrics been more proactive and damning of anti-vaxx quack physicians and activities, perhaps the creation of a committee such as this would have been more politically unsavoury.  It's time for these organisations, physicians and scientists to step up and push back against pseudo-scientific claims and those who make them and stop relying upon lightning-rods like Dr. Offit to be the only one doing their dirty work for them.

Robert F. Kennedy, Jr., Andrew Wakefield, Dr. Bob Sears and all their other associates are inexpert has-beens and wannbes but that doesn't mean their activities haven't done substantial damage to public health and public trust in our healthcare agencies.  It's time for all of us who are interested in public health and the well-being of our children to send a clear, organised message to these anti-science predators that their meddling in affairs that are way over their heads will not be tolerated.

News in brief: Bob Sears to face medical board over recommendation not to vaccinate and poor record keeping

The OC Register reports yesterday (8 September 2016) that Dr Bob Sears has to face charges over "medical negligence" when he failed to take a detailed medical history of a toddler before writing him an exemption from further vaccination (and other oversights). He is also facing charges of poor record keeping, because apparently, this letter was not on the child's file.

The consequence for Dr Bob can range from a reprimand to the loss of his medical license.

I am sure this decision will find a lot of attention, given the recent introduction of SB277 in California, which mandates vaccines for school attendance unless the child has a medical exemption and fears that some "vaccine friendly" doctors would distribute such exemptions liberally without clear cause, undermining the public health benefits intended by the law. Dr Bob, whose "The Vaccine Book" had been criticised as fuelling irrational, scientifically unfounded, and potentially dangerous fear of vaccines, has been among the vocal critics of this law.

Orac gives a more detailed description of the charges (with a side of Insolence), as does the Poxes blog.

I would hope that any verdict of the medical board would be 100% based on the charges at hand (and any extenuating circumstances, i.e. other instances of writing medical exemptions without rigorous examination of the child, or lapses in record keeping) rather than the notion of making an example of Bob Sears to discourage other doctors.

Addendum (9.13.16): Richard Jaffe is representing Bob Sears.

“I represent Dr. Bob Sears in the California Medical Board’s case against him for writing a medical exemption from vaccination.
We take the board’s accusation seriously. But this case is very clear: this child had two unusual and severe vaccine reactions and his situation warranted a medical exemption. To continue vaccination could have put the child at risk of further harm.
All physicians have an ethical duty to do no harm to a patient. This is no less true when a child suffers serious side effects from any medical intervention.
We anticipate this case will do much to further public education on the importance of recognizing severe vaccine reactions and providing informed consent for medical care. ”

Rick Jaffe

let the education process begin! community support appreciated.

rj

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."

KISS 11 June 2014: Vaccination protects from severe pertussis

An ongoing outbreak of pertussis in Oregon, spanning from 2010 to 2012 and 624 cases, offered the exceptional opportunity to analyse disease severity. Vaccination history, treatment, demographic, and outcome information was available for almost all (98.7%) of the patients, of which 45% were up to date with currently recommended vaccinations. The paper finds:

Ever-vaccinated cases were significantly less likely to be hospitalized or develop severe illness (adjusted odds ratio [aOR], 0.2; 95% confidence interval [CI], .1-.8 and aOR, 0.4; 95% CI, .2-.9, respectively). ACIP up-to-date patients stopped coughing significantly more rapidly than unvaccinated patients (adjusted hazard ratio, 1.7; 95% CI, 1.3-2.2). [my bold]

 Read more here.

Routine vaccination leaves man quadriplegic? Open Letter to Channel Nine

Like several other outlets, Channel Nine News reported the story of Ben Hammond, a Western Australian father of five, who came down with a debilitating episode of what is purported to be ADEM after a whooping cough booster. Now the Northern Rivers Vaccination Supporters have written an Open Letter to Channel Nine, which I am reposting here with kind permission, since it is, in contrast to Channel Nine's piece, evidence based and factual and important.

AN OPEN LETTER REGARDING A RECENT CHANNEL NINE NEWS STORY, THEIR INACCURATE PORTRAYAL OF VACCINE RISK, AND THE IMPORTANCE OF THE ADULT WHOOPING COUGH BOOSTER.

A news story that aired nationally on 2nd and 3rd June, 2014 on the Channel Nine News network and the Today Show was inaccurate and grossly irresponsible.

The story featured Perth father Ben Hammond, who received a Diptheria/Tetanus/Pertussis booster, and became seriously ill eleven days afterwards. Ben’s condition was said to be ADEM (Acute Disseminated Encephalomyelitis), a rare auto immune condition. This disease lead to Ben becoming quadriplegic for several months.

First of all, we wish to express our sorrow and sympathy for everything this man and his family have been through. By all accounts they have suffered a great deal physically, emotionally, and financially.
We are not writing to challenge or diminish what has happened to the Hammonds. This family deserves the support and generosity of the public to help them get back on their feet. We support a full investigation into the cause of his illness, so there is transparency on the facts of whether the vaccine caused it and the risks.
However the story breaches the Australian Communications and Media Authority Code of Practice (1):

• Section 4.3.1: The article was not factual or accurate and did not represent
  viewpoints fairly. It did not state:
    o How rarely, if ever, it has been shown that ADEM can be
       caused by vaccination
    o Any evidence to support this allegation
    o Why adults require the Whooping Cough (pertussis)
       booster
    o The relative risk to babies of whooping cough, versus
        the risk of the alleged vaccine reaction
• Section 4.3.2: It could cause public panic about vaccines and place
  newborn babies at risk

Why adults require Whooping cough boosters:
The Hammonds were offered a free booster during the time that Australia was experiencing the world’s largest Whooping Cough epidemic. This peaked at 38,500 cases in 2011. In response to thousands of babies being hospitalised and tragically over ten babies dying nationally, State governments have distributed millions of doses of the vaccine for free to new parents since 2009. Without the program, the number of grieving families would have been significantly higher.
Our group includes families whose babies have died from Whooping Cough, and who have worked hard to raise awareness of the need for adult boosters. This has saved lives, particularly of vulnerable premature babies.

Adults need a booster because of waning immunity, this happens both after the vaccine, and following ‘natural’ infection. Recent research has shown that this can occur as quickly as after four years(2). Unfortunately, nationally, less that 12% of adults have had a Whooping Cough booster (3). This means if there is an outbreak, an adult is susceptible to catching the disease, and passing it on to others. For most adults, this causes an irritating coughing illness that can last for months and lead to rib fractures and pneumonia; in young infants it can be deadly. Babies cannot have their first dose of protective vaccine until they are 6 weeks to 2 months old, so these very young babies must rely on adults being up-to-date with their boosters to be protected (4).

Risk of whooping cough to babies:
The story did not state the relative risk of acquiring ADEM after a vaccination, when compared to the risk of a baby catching whooping cough.

   • Nearly all babies that catch whooping cough require care in hospital.
   • It tragically proves fatal in 1 in 200 who catch it (5).
   • There is no cure for whooping cough. Babies face months of disease, and once it takes hold, the only treatment is supportive, with oxygen, and for critical cases, ventilation and ECMO (life support that, at best, also carries a very high mortality) (6).

Thankfully new research has shown that if a woman gets vaccinated when pregnant, this may halve the risk of the baby catching whooping cough (7). However, we are concerned your program will negatively impact on the uptake of this vital public health measure.

The facts about ADEM:
The news story should have featured a medical expert, to provide some facts about ADEM. Without the context of how rarely ADEM occurs after a vaccination, this omission could greatly damage public confidence in the vaccination program.

The alarmist headlines used such as “Routine vaccination almost fatal” “Vaccine danger” “Man becomes quadriplegic following routine vaccination” “One shot left him crippled” “Destroyed his life” and “Vaccination nightmare” were not counterbalanced with any information portraying the real-life risk of developing ADEM. Instead, we were solely given the Hammonds' own assertion of it’s cause.

ADEM may or may not be associated with some vaccines. We know that it occurs at such an extremely low rate it is impossible to determine causality with any scientific accuracy.
Indeed it is so rare the risk is something like 8 out of 1 million risk to the general population. Out of those cases, less than 5% follow immunisation, and it is much more likely to follow infection by one of the vaccine preventable diseases (8). There are many common and not-so-common bacteria and viruses that induce ADEM at much higher rates than those associated with vaccination.
The only vaccine proven to induce ADEM is the Semple form of the rabies vaccine. Other vaccines have all been implicated, most commonly the MMR vaccine, but the majority of the studies that correlate vaccination with ADEM onset use small samples or case studies (because there are so few cases to begin with). Large scale epidemiological studies have not shown an increased risk of ADEM following vaccination.

Also misleading was the implication Mr Hammond had “no immune system" and “no kidney or liver function” from the vaccine. ADEM should not cause organ dysfunction or immune suppression (although medication used to treat it can), and the paralysis it causes is usually temporary.
We take vaccine safety and transparency about that safety very seriously, and support the Hammond's use of the media to highlight the rare possibility of adverse vaccine reactions. The family deserves respect, and privacy, and we understand their need for financial assistance. We hope Ben’s case highlights the importance of a no-fault vaccine injury compensation program in Australia, for when adverse reactions to vaccines do occur.

However, unnecessarily scaring people away from vaccination programs such as against whooping cough could deter adults from having a booster, and place vulnerable newborns at high risk. News reports regarding vaccination should be clear and balanced. They need to present the relative risks of an adverse reaction to a vaccine when compared with the risks from vaccine preventable diseases. The media’s role in public perception of healthcare, risk of disease, and vaccine safety should not be underestimated, nor the responsibility taken lightly.


1: http://tinyurl.com/ltbyrl4
2: Wendelboe, A. M., Van Rie, A., Salmaso, S., & Englund, J. A. (2005). Duration of immunity against pertussis after natural infection or vaccination. The Pediatric infectious disease journal, 24(5), S58-S61
3: http://www.aihw.gov.au/publication-detail/?id=10737418409
4: http://www.chainofprotection.org/adultimmunisation
5: http://tinyurl.com/pwfthsw
6: http://tinyurl.com/msyg6pg
7: http://tinyurl.com/k3rp7t3
8: Huynh, W., Cordato, D. J., Kehdi, E., Masters, L. T., & Dedousis, C. (2008). Post-vaccination encephalomyelitis: literature review and illustrative case. Journal of Clinical Neuroscience, 15(12), 1315-1322.

May the Forth... just a friendly reminder

Find a "vaccine friendly" doctor

that is, one who is friendly and vaccinated. In honour of National Infant Immunization Week, which starts today, the CDC has announced their 2014 Childhood Immunization Champion Awards. Check them out - maybe you are lucky enough to live near one - there is one per state :)

Anniversary

the third anniversary of Angelina's diagnosis. Just before, she had been a completely healthy six year old:


then SSPE, the late and invariably fatal measles complication became overt. This video by the German Association of Pediatricians explains the stages - watch it, you'll get the gist - at first, she is "only" clumsy and falls, then the seizures start, and very few months later Angelina was incapable to doing anything. This is the condition she has been in for the past 2.5 years:




Angelina's mother wonders at the end of this video, why parents do not vaccinate their children, while they are all buckling them up in the car. She does support mandatory vaccination (no shots, no school does not exist in Germany).

I agree with the doctor in this video:

Parents - go get your children vaccinated, especially against measles, mumps and rubella. If you are not immune, talk to your doctor and get yourself up to date.
If you are afraid to vaccinate, talk to your doctor and work with him/her on "unscaring" yourself. Then vaccinate your child/yourself. Thank you.

You are an anti-vaccine activist? Have a careful look at that film clip. It shows the results of not vaccinating. Measles could have long been eradicated, where it not for pro-disease activists like you. Please realise that the risk of infecting a baby with measles is something you cannot control.

Measles Madness

no really - absolutely madness. Do parents in the US not realise how good they have it with measles not circulating and their babies protected? We are 10 weeks into the year, not quite 20% and the CDC reports 71 cases of measles. SEVENTYONE! In 10 weeks! That is as many as in the entire year 2009 and more than in 2010 and 2012.

7 cases in Orange County. 19 in New York - 5 of those hospitalised - that is a quarter. Honestly? What is this? The Middle Ages? The potential for further spread and infection of vulnerable, young, old, sick, immuno-suppressed is horrendous - look at this from the Orange County outbreak:

SEVEN possible exposures in 5 different hospitals/doctors' practises, TWO different schools exposed, with 1 (only - luckily) and 13 kids with philosophical exemptions respectively. What will it take for people to sober up? For uneducated C-rated starlets to shut up and get their child appropriate medical care? Will a child have to die?

It is time for vaccinating parents to speak up. Stop being tolerant of your friends' and neighbours' vaccine denial. Tell them that what they are doing is unacceptable and dangerous. Start asking questions at your daycare centers, schools, doctors' offices - how many of their pupils/patients are unvaccinated out of personal choice. Tell them it is not acceptable and dangerous to be complacent. Speak up.

Measles in the Netherlands: I'll call it

I was tempted last week, when the measles cases in the Dutch Bible Belt topped 600, but then I didn't. It suddenly appeared morbid, petty and like I wanted it to happen. By last Thursday, 780 measles cases had been reported in the current outbreak. So I'll do it.

There'll be a death. Soon.

In Europe, for about every 1000 reported measles cases, there is one death. The latest outbreak was in Wales, it ended last month with 1219 cases and one death, Gareth Colfer-Williams, who died of giant cell pneumonia, a specific complication of measles. But that particular area in the Netherlands has had its own outbreak in 1999/2000, totalling 3292 cases, over 150 hospitalisations and 3 deaths. It is eerie how this pans out to 1 in 1000. As a side note, 94% of patients were totally unvaccinated and only 1 of the 3292 had had 2xMMR. In fact, the vaccine works so well, that unvaccinated individuals were 224 times more likely to acquire measles than were the vaccinated. But I am getting side tracked. I called it. I hope I am wrong.

Meanwhile, measles break out in the Dutch Bible Belt...

The Netherlands do have a "Bible belt" - an area which has a high density of fundamentalist protestants, characterised by their vaccine refusal (and a generally conservative attitude amongst the very liberal Dutch). This has, over the years, given rise to serious outbreaks of vaccine preventable diseases, extending far beyond the belt region. For example, in 1978, a polio outbreak in the Netherlands, totalling over a 100 cases, of which 80 (all unvaccinated) were paralytic and one was fatal, spread to Canada and the United States leading to 14 cases of paralytic polio in unvaccinated Amish, and a further 2 non-paralytic cases in unvaccinated non Mennonite in the area. Apart from the molecular analysis of the virus, showing that the cases were related, the infection chain was also clear:

During the 1978 outbreak, members of the affected religious group traveled from the Netherlands to Canada, where cases subsequently appeared. An Amish family from an Ontario town 15 miles from the affected area moved in late summer 1978 to the Pennsylvania town where the first U.S. Amish case subsequently occurred, in January 1979.

Another polio outbreak struck the area in 1992/3, most of the 71 cases amongst the unvaccinated Bible belt inhabitants. This outbreak also spread to Canada.

In 1999/2000, a measles epidemic struck the Bible belt and neighbouring regions, totalling just under 3300 cases, of which 94% were entirely unvaccinated, and only one patient had had both MMRs. 16% had complications, over 150 were hospitalised, and 3 patients died. Importantly No association was observed between preexisting illness and either reason for admission (P = 0.5) or residual symptoms at discharge (P = 0.5) contradicting the notion that measles are a generally "harmless" disease in "healthy" children.

More recently, in 2004/5, rubella (the "r" in the MMR) swept through in the Bible belt, also spreading to Canada. The consequences were devastating:

In The Netherlands and Canada, 387 and 309 rubella cases were reported, respectively. Of these, 97% were in unvaccinated individuals of orthodox protestant denomination. Reported consequences of rubella in pregnancy were 2 fetal deaths and 14 infants with congenital infection. Of the latter, 11 had clinical defects including deafness in all but eye defects in none. 

The reason should be crystal clear - low vaccination uptake. The Dutch equivalent of the CDC, the RIVM publishes the numbers in handy maps - see the MMR vaccination coverage in the 1998 cohort (as school children, the baby chart was not available) vs measles cases:

The darker, the bad

Now, 13 years after the last big outbreak (enough time for the next generation of unvaccinated Bible belters), the next outbreak has started, with one protestant primary school boasting an impressive 1 in 5 pupils infected:

the "belt" even more visible in infant vaccination gaps

This is an impressive illustration how vaccine refusal (in religious and quasi-religious groupings) leads to large national and international disease outbreaks, causing significant illness, disability and death. These communities effective provide CPR to diseases that should have long been eradicated by providing a "renewable" population of susceptible individuals. Since it may not be possible to change the attitude of certain groups, it is even more important to uphold vaccination coverage around them, to reduce the potential for spread as much as possible.

Insolent demands and reality

There is a measles outbreak in Wales. 1181 cases of measles have been reported since 1 November 2012. Quite impressive for a small country (Wales has about 3 million inhabitants). Public Health Wales have done a stellar job in reporting numbers, breaking them down into the different Welsh regions and they run a Facebook page on which you can ask questions and will get them answered. Countless weekend and in-school clinics were run to get the Welsh youth protected (a lot of teens did not get their MMRs/or MMR booster in the wake of Wakefield's manufactuversy).

Despite PHW's fabulous work, the pro-disease faction have been up in arms. First of all, they abused the fact that not all cases were laboratory confirmed to claim that there is no outbreak, it is fabricated, all to cause panic to increase vaccine uptake (like good vaccination uptake was a bad thing). Never mind that laboratory confirmed cases are catching up with the reported numbers (like they should, those tests take some time to come back); that is part of the conspiracy, too (lowers voice "they noticed that numbers don't match, so they are making new numbers up" - really).

Equally suspicious, according to the anti-vaccine-critical, is that the vaccination status of reported cases is not reported in real time. PHW quite clearly stated on their web site that they'll publish a full report after the outbreak:

and explained on their Facebook page (multiple times) which cases were tested:

many anti-vaccine posters still insist that the delayed publication of numbers was fishy (after all, GPs should know whether their patient has been vaccinated or not) and continually allege that real time reporting was somehow important for their decision.

I call bullshit - there is nothing unique about the Wales outbreak. Last year, just north east of Wales, the Merseyside measles outbreak saw 359 confirmed measles cases, of which, not surprisingly, only 12 (3.3%) had received 2 MMRs. Those hugely relevant numbers (the two outbreaks within a year and 150 miles of each other) are convincing truly hesitant parents:

Meanwhile, I received the following letter from my Health Board:

It seems that although we have been registered with the same GP for many years, and said GP should have all of our children's vaccination records, and I have in writing that they are up to date, their Child Health System has our son down as "not [having] completed the full course of 2 doses of MMR". Obviously, ascertaining vaccine coverage is not quite as trivial as some think.

Thank you PHW for checking before publishing data on vaccine coverage without verification.

Now if you or your child really have not had 2 MMRs - go get them now. MMR is highly effective in protecting you and your loved ones from measles.

Fear mongering and responsibilties - UK private vaccine clinic fuels MMR fears

Wales is currently heading the leader board, unfortunately not in a good way (like for rugby), but for measles infections in the Western hemisphere. Since February, Wales has had nearly 900 reported measles cases, 80 of them hospitalised, and, as feared, now the first suspected death, 25 year old Gareth Colfer-Williams. A lot has been written about responsibility. Obviously, Andrew Wakefield came up as the main culprit, who in turn blamed the government for the outbreak, which they rejected. To be honest, to solely blame Wakefield for the MMR mess would be too much credit to the man. The MMR mess is a media manufactuversy as beautifully summarised by Ben Goldacre. And the greed for the headlines has not stopped, and Wakefield is still given front page coverage by irresponsible papers.

Meanwhile, clinics providing single vaccines for measles and rubella are having a field day. Under the guise of "we are just responding to parental fears" one private provider of single measles vaccines, the Children's Immunisation Clinic (CIC), is advertising their services (£ 50/~US$ 75 registration plus £ 110/US$ 165) playing on the MMR-autism lie, while making totally untenable claims. This starts off with:

A high percentage of the children we vaccinate also have allergies and excema which indicate they may not have a perfectly functioning immune system – and even so we have no recorded adverse reactions.

Wow - that is impressive. I wonder how they do that, given that the Rouvax for example, one of the vaccines that CIC is offering, has the following adverse effects (my bold):

The most common side effects (in more than 1 in 10 subjects vaccinated) seen in clinical trials were irritability/agitation and rhinopharyngeal catarrh.
Other side effects that occurred in more than 1 in 100 subjects vaccinated in clinical trials were fever >38°C, injection site reaction, rash/cutaneous eruptions, conjunctivitis, nausea, vomiting, abdominal pain, diarrhea.

They then post a google link to Hannah Poling:

In October 2008 Hannah Poling an autistic child won a huge payout from a triple vaccine manufacturer, who said that she had a DNA genetic predisposition to become autistic given the MMR vaccine More Info…

 and concluding with this beauty:

In 2009 a Dr Walker in the USA has studied 275 autistic children and found in a large percentage of the cases that these children had the live Measles virus living in their gut after vaccination with the triple MMR .You can see more about this on the Daily Mail online. We do not use the same MMR or Measles virus vaccine in the vaccine we have chosen to use.

At this point already, I know I am never going to entrust my child to this clinic. The Daily Mail as a source for medical information? Honestly? The article they mean is the one previously bemoaned by Liz Ditz to have been posted without time stamp. Everything else is false, too.

Steven Walker's work was presented as a poster at the IMFAR conference in 2006, so no "study", not in 2009 either.

The abstract reports on results of 82 kids, 70 of them supposedly had measles vaccine virus in the gut. They tell us they have samples of >275, but have not analysed them all. Also, we know since Dr Bustin's testimony to the Autism Omnibus proceedings and Hornig et al that measles virus has not and cannot been found in the guts of > 80% of autistic children.

I think this claim "We do not use the same MMR or Measles virus vaccine in the vaccine we have chosen to use" is a lie. We already know that the clinic have not looked at Walker's data, since they misrepresent his findings. There is actually no way the people at the clinic can know what vaccines the children Walker looked at had received, because it is not reported in the abstract and a full paper has not been published since 2006. Given that Arthur Krigsman is the senior author of the abstract and children have been flown to him certainly at least from the UK, it is not clear which measles vaccine strain they had been vaccinated with. The French Rouvax, CIC are offering contains the Schwarz strain, which is also the measles strain used in GSK's Priorix, often used in Europe, the Indian Sii M-Vax, also on offer at CIC contains the Edmonston-Zagreb strain, also contained in the Swiss MMR-Triviraten (Berna) (CIC also import vaccines from China and Russia, if someone knows what vaccine strain is in those, email me).

Now, tell me how you can interpret the above facts and let the clinic appear in a good light. At best, their research was irresponsibly shoddy and they conveniently believed the Daily Mail. At worst, they are intentionally fuelling parental fears to sell their singles with false claims. It gets worse though - on the side bar, on the lower right, the clinic claim:




No Autism in over 10 years and amongst 18000 Patient Record Cards?! That is an outstanding record and it sounds dangerously like a "warranty" (I am not a lawyer, but a lawyer friend of mine pointed this out). Absolutely amazing, especially given that autism/ASD prevalence in the UK has been published to be 1 in 67, so they should be looking at about 282 patients on the spectrum, give or take a few. The reason for their "Clinic Highlight" might be their rather unorthodox method of assessment...  "We [the clinic] ask you [the patient] tell us if you have an adverse reaction within a few days of the vaccine."


They are obviously way out of their depth now, because it is all fine and well to make exaggerated claims when it is "only" about people's money. But now Wales is steering towards breaking the 1000 mark of measles cases (probably by next week), children and young adults are very very sick and one might have died, and the tolerance wears thin. While CIC is still keeping up appearances for the BBC, they seriously lost it in response to a short article in last week's Sunday Times and in the middle of a massive rant (which they really want you to read in its entirety and not quote out of context, so they mention it twice, probably because they know how tedious their rant is) about "offering singles will increase herd immunity" and "not politicising the issue" slip in this paragraph (all typos are [sic]):

9) CIC is not judgmental about parents’ choice of vaccine (any vaccination ,generally ,is better than none) nor does it have any preconceived ideas as to the causes, be they single trigger(s) or perhaps even several different combinations of triggers.
Anecdotally though,  that portion of the parents who tell us their stories , all confirm that there was a dramatic change in behaviour, either with their child ,from their circle of friends , neighbours or work colleagues; and these families make up a significant minority proportion  of our population,
The emotional and financial burden on the family, the limited funding of the UK’s Health sector all point to potential benefit of further timely research into those specific cases which may then be identifiable as being preventable An unencumbered choice for either single or multivalent MMR vaccine options would do less harm  than the current situation of a large portion not willing to engage in any vaccination programme.

Goodness, somebody save them from themselves. CIC are in a hole, they should stop digging. If they wanted to keep up the illusion that they are there "to help" instead of setting up shop in Swansea in the middle of an outbreak and charging full price for their services, maybe they should have offered their singles at cost? Just to maintain the illusion that they weren't hell bent on keeping the MMR autism lie alive for their own business interest? Just an idea.

Sherri Tenpenny is not a scientific researcher and she does not know how to set up a study

 A couple of days ago, this meme started making the rounds through the internet:

Strange - I have a friend who had the same experience with measles and pertussis (I think it was even third grade that he missed), but he is pro-vaccine as a result. Tenpenny on the other hand is convinced that if a study looked at the "tens of thousands" of unvaccinated children and compared, say, days missed from school, it would find that unvaccinated children miss less school, and that would be a sign that "the unvaccinated kis are healthier" (1:49). Then again, she did miss third grade, because she "was sick, and it was good" (1:55). Or maybe she just is "not a scientific researcher" and does "not know how to set all these things up" (2:01). Listen for yourself:

Messenger's muddled message (updated)

or something along the lines of that. Stephanie Messenger wrote a little book about measles and how great they are - for kids aged 6 to 10. Stephanie's first son died of what she thinks was a vaccine reaction (heartbreaking picture warning), but her sister says was Alexander Disease. Losing a child is very very sad. It doesn't give anyone the right to spew dangerous nonsense and advertise vaccine refusal and taking carrot juice against measles instead. You say "what"? Here's blurb (you can also read Skepticat's summary - it is way cool):

Melanie has measles, so Tina and her mum go over to play and bring healthy food, including carrot juice, because of the vitamin A, which makes measles not so bad. Tina doesn't get measles, because she eats so healthily, which means that Melanie's mum must be a bad mum, because she didn't feed her Melanie enough carrot juice or something. Measles also makes you strong and is great to get, but when junk food guzzling vaccinated Jared gets the measles, it'll hopefully teach him to eat well. Not sure how something that is great to get teaches you a lesson.

Ridunculous! A lot of bloggers have been enraged (it is those details - that the teacher in Melanie's class is pregnant for example), see these insights and well-deserved insolence.

However, what made me (and Katie) really angry is the similarity of the rhythm of "Melanie's marvellous Measles" with "George's marvellous Medicine" a book by Roald Dahl. I cannot possibly know whether this intentional. I do know for sure, though, that while Stephanie thinks measles make kids "mature", and that kids "can feel hot for a day or so" with measles, Roald Dahl knows that they kill. They killed his daughter, Olivia (the smiling girl in the foreground).



Roald Dahl knows that measles are a dangerous illness - he writes:

Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything. “Are you feeling all right?” I asked her. “I feel all sleepy, ” she said. In an hour, she was unconscious. In twelve hours she was dead. The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her. That was twenty-four years ago in 1962, but even now, if a child with measles happens to develop the same deadly reaction from measles as Olivia did, there would still be nothing the doctors could do to help her. On the other hand, there is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunised against measles.

 (my bold - again, read the whole thing, this man has a way with words)

So, how does one limit the reach of a dangerous disease door-to-door saleswoman? After some initial resistance, one supplier, Booktopia, took Messenger's marvellous Megalomania off their shelves - here's the press report (worth listening to if just for the lovely accent):



For those who are so inclined, there is a petition asking Pearson Australia Group (Angus and Robertson, and Bookworld) to end sales of ‘Melanie's Marvellous Measles’ in any forum (form?). I am not sure that banning bad books is the way forward, although peddling deadly diseases to kids is pretty far out there. It appears Stephanie Messenger is not going to leave it at that anyway and is planning Messengers Marvellous Movie - making use of another media and providing blog fodder for many posts to come.

Sad really.

ETA (11/1/13) Bookworld have now announced that they will no longer sell Melanie's Marvellous Measles. Messenger says this "doesn't matter". I am afraid she is right...

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.

"QUACK" says the Quack, the Board says "NEIGH" - it's quiet now, what do you say?

with apologies to Sandra Boynton

On 22 August 2012, the Maryland State Board of Physicians revoked Mark R. Geier's license to practise Medicine (dare I say "finally"?). This follows almost a year of legal proceedings (covered very well by Todd W. at Harpocrates Speaks, here, and here and by Kathleen Seidel at Neurodiversity.com, here and here) - visually:

On September 15, 2011, the Board charged Mark R. Geier, M.D., with numerous violations of the Medical Practice Act, including: (1) unprofessional conduct in the practice of medicine; (2) willfully making or filing a false report or record in the practice of medicine; (3) willfully failing to file or record any medical report as required under law; (4) practicing medicine with an unauthorized person or aiding an unauthorized person in the practice of medicine; (5) grossly overutilizing health care services; (6) failing to meet appropriate standards for the provision of quality medical care; and (7) failing to keep adequate medical records, under Md. Health Occ. Code Ann. § 14-404(a) (3) (ii), (11), (12), (18), (19), (22), (40), respectively. 

A five-day evidentiary hearing was held before an Administrative Law Judge ("ALJ") ofthe Office of Administrative Hearings in December of 2011. On March 13, 2012, the ALJ issued a Proposed Decision finding that Dr. Geier had violated numerous provisions of the Medical Practice Act and recommending that his license be revoked. Exceptions and responses were filed by both parties. An oral exceptions hearing was held before the full Board on May 23, 2012. This Final Decision and Order is the Board's final administrative decision in this case.

Carole J. Catalfo, the Executive Director of the Maryland State Board of Physicians has had it. Her ruling leaves nothing open to interpretations - she finds (footnotes removed):

(1) Dr. Geier failed to meet basic medical standards for evaluating patients and conducting medical examinations and keeping adequate records of treatments and diagnoses. He failed to conduct an adequate initial evaluation of any of these patients and failed to make an adequate record of an examination for any of these patients. He began treatment often without sufficient information about the patients' physical condition. In many cases, [Dr. Geier] had no information at all about the Patients' physical condition.,

This is consistent with the details that came out in the case of Dr Geier's son David Geier practising Medicine without a license (Justthevax passim). She further finds:

(2) Dr. Geier treated patients with Lupron, a medication that is not approved by the FDA in the absence of precocious puberty. He did not, however, perform an adequate examination to determine whether these patients had precocious puberty, or the cause of these patients' symptoms. ../.
(3) Based on his theory that Lupron therapy is appropriate in certain situations in which its administration is not approved by the FDA or the American Academy of Pediatrics, Dr. Geier purported to treat patients who met his profile with Lupron. With the exception of Patient E, however, none of these patients met even Dr. Geier's profile for Lupron therapy.

This abhorrent practise to "diagnose" any child with "precocious puberty" irrespective of age and physical evidence to be able to prescribe Lupron, a strong hormone modulator, which essentially equals chemical castration is part of Team Geier's proprietary theory. They postulate (I paraphrase - see père et fils Geier here) that excessive testosterone binds mercury from vaccines in the body/brain, and that the administration of Lupron will release the mercury which can than be chelated. That is complete gobbledygook of course, but unfortunately, far too many parents believed them (read Kathleen Seidel's outstanding series on "The Lupron Protocol") - the Geiers claimed to have treated more than fifty children already in 2006. Consequently, following Lupron prescription:

(4) Dr. Geier prescribed chelation therapy to patients who failed to display the need for chelation. He began this therapy without documenting a reason for the treatment and without adequate documented informed consent. He violated the standard of quality care by so doing. He also violated the standard of quality care by prescribing for patients the drug DMPS, a drug not approved for any use in the United States.

(5) Dr. Geier provided a consent form to the parent of Patient I that named an FDAapproved drug and which falsely stated that it was to be used in the chelation treatment when another drug, DMPS, which was not FDA-approved, was to be used (and in fact was used) in the chelation treatment. 

It gets worse:

(6) After prescribing these treatments without an adequate previous medical examination and without adequate informed consent, Dr. Geier then failed to adequately monitor whether these treatments were working.

"Experimental" treatments on human patients will have to undergo review by an institutional review board, which is supposed to advise and control the physicians. The Geiers' review board was made up of family and friends:

(7) Dr. Geier provided drug therapy to Patient I according to a protocol not approved by the FDA after telling the parent that his protocol was approved by an Institutional Review Board, when in fact the Institutional Review Board consisted entirely of persons affiliated with his practice and did not meet the requirements of federal or state law.

The court further finds that Dr Geier had parents sign an "informed consent" form that named the wrong drug (FDA licensed) to be applied, while an unlicensed drug ended up being used on their children (8). He inflated his credentials, claiming an American Board of Medical Specialties certification he did not have (9). The Board also finds that the record keeping of Dr. Geier was too poor to even be suitable for assessing patient progress. Nevertheless, he made decisions to continue or alter medication (10). Dr. Geier falsely made a diagnosis of precocious puberty in patients who did not have this condition and he did not perform the necessary medical examinations to be able to make this diagnosis (11). 

It appears that Mark Geier had objections to Dr. Grossman as an expert witness, saying that she was not a "true peer". Given her impressive list of qualifications, I would almost tend to agree with that notion - the court states:

Dr. Grossman is board certified in pediatrics and developmental-behavioral pediatrics and has been an Associate Professor of Pediatrics, the Director of the Behavioral and Developmental Pediatrics Fellowship Program at the University of Maryland School of Medicine and the head of the Division of Behavioral and Developmental Pediatrics at that institution. She has also held many other positions of great responsibility in her 35-year career in pediatrics. She testified knowledgeably about the standard of care applicable to pediatric patients in general and to these patients in particular. The Board is satisfied that she was appropriately admitted as an expert in this case.

I felt like hugging Carole Catalfo for the following statement:

The fact that she may not have been familiar with the details of some of Dr. Geier's idiosyncratic theories, theories that appear to be supported in large part by literature that he or his son created and which have been rejected to some extent by the Institutes of Medicine of the National Academy of Science, does not detract from the weight of her testimony about the quality of the actual medical treatment provided to these patients, in the Board's opinion.

True that! The deconstruction of Mark Geier continues, as Dr Catalfo observes:

Dr. Geier, however, is not a "trained clinician." He completed only a one-year residency in obstetrics and gynecology, has no formal specialized training in the treatment of autism, and is not Board certified in any medical specialty.

The board also had few good words about the statements of Dr. Jerry Kartzinel (if the name rings a bell that is because you have seen him on this with Andy Wakefield):

The Board also notes that Dr. Kartzinel's testimony on the adequacy of Dr. Geier's physical examinations of these patients was particularly unpersuasive. ../..

He testified that a physical examination of the patients is highly overrated (Tr. 200) and that the physician "generally ... can bide by his eye" (Tr. 148-49) and just try to "get a gestalt," and that it is not even necessary for the physician to document that "gestalt" in the medical record. (Tr. 182) It is sufficient for the physician then to "step back and say, did I get a clinical response that everybody is thrilled with, or was it a swing and a miss," according to Dr. Kartzinel. (Tr. 155) In the Board's opinion, what Dr. Kartzinel describes as an acceptable medical examination and mode of treatment is not acceptable at all, and it is questionable as to whether this conduct can even be described as "medical."

Traurige Gestalt* is more like it. The hubris that those phrases reveal is not untypical amongst the "brave maverick doctors".

In their ruling, the State Medical Board do not speak to the allegation that Dr. Mark Geier let his unqualified son, David, practise Medicine. The Board state that this is being dealt with elsewhere (it has been) and that:

The Board will not make a decision in this case on this same factual issue based upon the less complete record made in this case. In light of the egregious violations of the standard of quality care and the deliberate unprofessional conduct set out in the numbered facts recited above, a decision as to whether Dr. Mark Geier also allowed Mr. David Geier to practice medicine without a license would have no effect on the sanction that the Board would impose on Dr. Mark Geier.

Read the Sanction in full, very slowly, word by word to understand that these proceedings dealt with a high number of unambiguous violations and there is really no room for a "misunderstanding" of what happened:

The ALJ commented that Dr. Geier abused the trust that these patients' families placed in him. "By dissembling, misrepresenting, failing to see his patients for months and years before treating them, applying a protocol-based treatment to children who do not fit the protocol, using non-FDA-approved drugs without fully informed consent, and for all of the other violations found and discussed in this Proposed Decision, he abused that trust. I agree with the State that these actions betray the relationship of a physician to a vulnerable child and his desperate parents."
The Board agrees.
The ALJ proposed that the Board revoke Dr. Geier's license. Dr. Geier has displayed in this case an almost total disregard of basic medical and ethical standards by treating patients without properly examining or diagnosing them, continuing treatment without properly evaluating its effectiveness, and providing "informed consent" forms that were misleading and in at least one case blatantly false. He provided treatments supposedly according to an investigational protocol, but the investigation was approved only by a sham Institutional Review Board, and he applied protocols to patients who did not fit his own profile. He provided treatment by a drug not approved for use in this country while informing parents that a different drug would be used. His actions toward his patients were not those of an honest and competent physician, nor do they appear to be those of an objective and ethical researcher. Dr. Geier made little use of those methodologies that distinguish the practice of medicine as a profession. At the same time, he profited greatly from the minimal efforts he made for these patients. In plain words, Dr. Geier exploited these patients under the guise of providing competent medical treatment. Such a use of a medical license is anathema to the Board. The Board has no hesitation in revoking his medical license.

Which they do:

What do I say? For the moment, I remain very quiet and listen to the weeeeeee sound that the Geiers' descent makes - they have been falling for a while and they have not hit rock bottom yet. It is likely that the repeated practising Medicine without a license and the number of other behaviours that led to this license revocation will have further consequences (like fines or even jail time). I also think that some insurance companies might want to have another look at the diagnosis and prescription practise of Dr Geier. Some parents (especially if they had to pay out of pocket) might want their money back.

Most of all though, as a parent, I am relieved that vulnerable children are safe from unlicensed drugs in uncontrolled treatment of undiagnosed conditions based on untrue hypotheses. My hope is that those who were treated with Lupron will not have sustained permanent damage and will find trained specialists to take care of their (hormonal and other) needs.

*sad figure

Hat tip to Stephen Barrett, MD

ETA: now also very nicely covered by Todd W. on Harpocrates Speaks