I’m a bit surprised at the vitriol and ad hominems coming from the Kos community for people who have questions and concerns about the swine flu vaccine and vaccination in general. Calling them cranks or attributing their views to pseudo-science only points out one’s own limited and overly rigid view of a very complicated topic.
In general, I think several different arguments are being improperly merged together:
Is the H1N1 vaccine safe?
Is the H1N1 vaccination strategy necessary and effective?
Is the seasonal flu vaccine necessary and safe?
Is childhood vaccination necessary and safe, especially at a very young age?
Is vaccination at all necessary?
I have to question how many people really want to eliminate vaccination entirely. People understand the benefit and effectiveness of vaccines for diseases like polio. So framing one’s argument against this view is intellectually dishonest.
But I think many people have valid questions about the safety and effectiveness of many aspects of the vaccination. These people are not driven by pseudo-science or medical mythology. They are driven by facts, figures, science and the questionable quality of clinical trials. They are raising valid questions and asking for increased evaluation and testing for legitimate reasons.
Questioning and verifying what we assume to be true is intrinsic to the scientific method. So why the anger and disdain aimed at people who are asking for a closer inspection of medical assumptions?
So what are these issues?
Possible Link Between Autism and Early Vaccination
The immediate knee jerk reaction when one raises the issue of autism is to point out how there have been studies that have completely ruled out any link between autism and vaccinations.
But concerned parents can’t be faulted for questioning the results of certain studies that disprove a link, especially when such a link could have a multi-billion dollar effect to many corporations’ bottom line. The tobacco industry and oil industry have rolled out study after study over the years disproving the link between smoking and cancer/oil combustion and global. So now we’re supposed to fully acquiesce to the studies regarding vaccines and autism but to ignore the studies between smoking/cancer and oil/global warming?
Is there a holy book attached to vaccines that requires our faith, something that smoking and oil do not have?
Just pointing to a study is not enough to disprove a link because not all studies are created equally. Not all studies are funded sincerely. And in general, a single study is never enough to hang your hat on. Studies can be flawed or poorly designed. More studies are needed, many more. Better studies are needed. Not only does the severity of the autism epidemic demand it, but scientific rigor itself demands it.
When we’re talking about a disease that is affecting 1 in 100 newly born children (!!!!!!) where environmental factors are strongly implicated and for which the medical community has ZERO explanation, I don’t see why one would claim that the concerns of parents are anything but intelligent, informed and justified.
Arguing against the parent who will not allow her child to EVER be vaccinated for anything is a straw man. That is not the argument. The questions being raised are:
Do we vaccinate too early? (At birth for Hep B)
Do we vaccinate too much? (> 20 shots before age 2)
Are the ingredients in the vaccine safe? (Aluminum, mercury)
They want answers to these questions. I, as a soon-to-be-father, want answers to these questions. We’re questioning what’s safe and best for our families. That’s all. Science exists because of questions. Why are people afraid of questions?
Questionable Effectiveness of the Seasonal Flu Vaccine
First off, the seasonal flu vaccine is a best guess for the current year based on last year’s viruses. Given how rapidly the flu virus mutates, you don’t need to be a crank to question how effective this guess might actually be. It’s better than nothing, but how much better is it?
The Atlantic Monthly had a phenomenal article recently that exploreshow we’ve come to our understanding of the seasonal flu vaccine’s effectiveness. Take the time to read the article. There’s so much good information in there and it’s not really pro or anti vaccination. It just poses the question of, “Why can’t we fully test away the questions that exist on the effectiveness of the seasonal flu vaccine?”
The one point that stood out for me was how the flu vaccine’s effectiveness is determined:
[S]tudy after study has found that people who get a flu shot in the fall are about half as likely to die that winter—from any cause—as people who do not.
The estimate of 50 percent mortality reduction is based on “cohort studies,” which compare death rates in large groups, or cohorts, of people who choose to be vaccinated, against death rates in groups who don’t. But people who choose to be vaccinated may differ in many important respects from people who go unvaccinated—and those differences can influence the chance of death during flu season. Education, lifestyle, income, and many other “confounding” factors can come into play, and as a result, cohort studies are notoriously prone to bias. When researchers crunch the numbers, they typically try to factor out variables that could bias the results, but, as Jefferson remarks, “you can adjust for the confounders you know about, not for the ones you don’t,” and researchers can’t always anticipate what factors are likely to be important to whether a patient dies from flu. There is always the chance that they might miss some critical confounder that renders their results entirely wrong.
I’m a believer in science and this is obviously a bad study. So why don’t we run a better study? The ideal would be a blind, placebo based study where some people get the flu shot and others don’t. Then see whether it makes a difference in influenza rates and adverse effect/death rates. Easy peasy, no?
When Lisa Jackson, a physician and senior investigator with the Group Health Research Center, in Seattle, began wondering aloud to colleagues if maybe something was amiss with the estimate of 50 percent mortality reduction for people who get flu vaccine, the response she got sounded more like doctrine than science. “People told me, ‘No good can come of [asking] this,’” she says. “‘Potentially a lot of bad could happen’ for me professionally by raising any criticism that might dissuade people from getting vaccinated, because of course, ‘We know that vaccine works.’ This was the prevailing wisdom.”
In the end, such a study would be considered unethical.
This is the curious state of debate about the government’s two main weapons in the fight against pandemic flu. At first, government officials declare that both vaccines and drugs are effective. When faced with contrary evidence, the adherents acknowledge that the science is not as crisp as they might wish. Then, in response to calls for placebo-controlled trials, which would provide clear results one way or the other, the proponents say such studies would deprive patients of vaccines and drugs that have already been deemed effective. “We can’t just let people die,” says Cox.
Who’s afraid of science now?
Open Question On How A Given Vaccine Or Drug Affects Our Bodies Long Term
I’m sure that this is where Bill Maher is coming from with his recent rant against vaccines. There’s a long list of drugs that had unexpected side effects that were not realized for years and often times, the manufacturer would hide any evidence of these side effects because it would affect their bottom line.
So there is nothing wrong with being skeptical of putting stuff into our bodies to make us well. There is nothing wrong with wanting to forego pharmaceutical treatments in favor of natural remedies when possible. (Or just letting one get sick and heal naturally, my preferred view on the flu.)
This isn’t crankery or mystical living. It’s a healthy dose of skepticism.
I read an interesting article on a Canadian study that shows that people who got the seasonal flu in the past two years were MORE likely to succumb to the H1N1 virus. Now, it’s just one study and it hasn’t even passed through peer review yet. But it raises an really interesting question about a possible unexpected effect caused by the seasonal flu.
Just a question. It’s what moves science and medicine forward.
Valid questions. Valid concerns. Not cranks. Not pseudo scientists or quacks. Rational people pushing forward our understanding of medicine. It’s not like it hasn’t happened before. From the same Atlantic Monthly Article:
The annals of medicine are littered with treatments and tests that became medical doctrine on the slimmest of evidence, and were then declared sacrosanct and beyond scientific investigation. In the 1980s and ’90s, for example, cancer specialists were convinced that high-dose chemotherapy followed by a bone-marrow transplant was the best hope for women with advanced breast cancer, and many refused to enroll their patients in randomized clinical trials that were designed to test transplants against the standard—and far less toxic—therapy. The trials, they said, were unethical, because they knew transplants worked. When the studies were concluded, in 1999 and 2000, it turned out that bone-marrow transplants were killing patients.
Another recent example involves drugs related to the analgesic lidocaine. In the 1970s, doctors noticed that the drugs seemed to make the heart beat rhythmically, and they began prescribing them to patients suffering from irregular heartbeats, assuming that restoring a proper rhythm would reduce the patient’s risk of dying. Prominent cardiologists for years opposed clinical trials of the drugs, saying it would be medical malpractice to withhold them from patients in a control group. The drugs were widely used for two decades, until a government-sponsored study showed in 1989 that patients who were prescribed the medicine were three and a half times as likely to die as those given a placebo.