Monday, December 9, 2013

Looking Closer at an Anti-Vax Website

A few months ago, I saw couple different friends on Facebook share the following link from an anti-vax website called GreenMedInfo. (With the tagline "Education Equals Empowerment"...ah irony.)

I've had this rebuttal rolling around my head ever since. (Yes...I am slow at doing things.) As the title makes clear, the jist of the article is that the measles vaccine is scarier than the actual measles. The friends who shared this are well-meaning people who are all loving mothers, and I would of course never want to see their children contract measles. I hate that any children suffer from preventable diseases, so I am writing to hopefully expose what a shoddy, reprehensible, misleading piece of garbage this article is, and I am concerned that people I know and love may have been convinced by it.

If you already lean towards distrusting the medical establishment, you might easily be swayed by this author if you just gave the article a quick skim without checking his data. Not everyone has time for the tedious work of examining footnotes, I know, so I've tried to perform a service here by digging a little deeper, and....well. The discrepancy I found between what the author, Sayer Ji, claims his sources say, and what they *actually* say, is pretty jaw-dropping.

(Disclaimer: I'm not a scientist - I went to college back in the halcyon pre-recession years and majored blithely in American history, one of those fluffy liberal arts degrees that arms you with nothing but critical thinking skills with which to feed yourself (I loved it and have never gone hungry, regrets!). I have your average college-educated-person's understanding of vaccine science and the concept of herd immunity. So I have no special expertise, but honestly, you don't need scientific expertise to spot the red flags here - they will smack you in the face as soon as you do a little digging. Let's look closer, shall we?)


First, let's take a look at author's credentials. His bio at the bottom of the website sounds very authoritative, doesn't it? "Founder" of - ooh, he's a "founder" of something, that sure sounds impressive. Let's follow the link to his Google Plus page: oh....the highest degree he earned is a BA from Philosophy. Hmm...he has about as much scientific expertise as I do. Why should I trust his judgment?? On his website bio he claims to have been published by the New York Times (the only reputable one of the list he mentions), but on his Google Plus page that outlet is missing. Hmmmmm. Then in the very last sentence, what is his job? He's a "consultant for the natural products industry". Hmmmmmmmmm. So he is making money when people choose "natural" remedies instead of traditional medicine like vaccines, but he is writing all these articles as a supposedly neutral observer. HELLO conflict of interest! There are red flags all over this bio. But let's ignore his credentials for now and just look at his arguments.


Sayer Ji writes:

"First, we should acknowledge one underreported fact of immunology: vaccine-induced antibody elevations do not guarantee real world protection against the pathogen the vaccine is intended to immunize us against, which is the only true measure of their value.

This is not a new observation. It goes back decades, with a 1990 study published in the Journal of Infectious Diseases finding that even though 95% of a population of urban African children had measles antibodies after vaccination, vaccine efficacy was not more than 68%.[1]"

Is that really the finding of that study? Let's look at the footnote a little closer. From the abstract:

"Measles incidence, vaccine efficacy, and mortality were examined prospectively in two districts in Bissau where vaccine coverage for children aged 12-23 months was 81% (Bandim 1) and 61% (Bandim 2). There was little difference in cumulative measles incidence before 9 months of age (6.1% and 7.6%, respectively). Between 9 months and 2 years of age, however, 6.1% contracted measles in Bandim 1 and 13.7% in Bandim 2. Even adjusting for vaccination status, incidence was significantly higher in Bandim 2 (relative risk 1.6, P = .04). Even though 95% of the children had measles antibodies after vaccination, vaccine efficacy was not more than 68% (95% confidence interval [CI] 39%-84%) and was unrelated to age at vaccination. Unvaccinated children had a mortality hazard ratio of 3.0 compared with vaccinated children (P = .002), indicating a protective efficacy against death of 66% (CI 32%-83%) of measles vaccination. These data suggest that it will be necessary to vaccinate before age 9 months to control measles in hyperendemic urban African areas." (bolding = mine)

Did you follow that? Ji either completely misunderstood or flat out lied about the results of this study. He completely mischaracterized the study's findings! COMPLETELY!!! When he gave the statistic that "95% of a population of urban African children had measles antibodies after vaccination", he implied that 95% of the entire population was vaccinated - when that is ABSOLUTELY NOT what the abstract says. It states that vaccine coverage in the two districts studied was 81% at best (61% in the second district) - and both of those coverage rates are significantly lower than the level needed to achieve herd immunity. The 95% is a measure of the group of children who received the vaccine - 95% of them were found to have measles antibodies after vaccination.

Look at the first chart in the Wikipedia entry on herd immunity (from the CDC and World Health Organization, so reputable sources, don't be a Wikipedia snob): the vaccination rate necessary to achieve herd immunity for measles is 92-94%. OF COURSE the vaccine in this study had only a 68% efficacy rate - because so many people remained unvaccinated! The findings of this study say the exact opposite of what Sayer Ji is (ab)using it in order to argue - it says that more people need to be vaccinated, not less! Here is a great graphic to get a visual sense of the importance of herd immunity:

File:Community Immunity.jpg

If you couldn't tell by the amount of bolding and all-caps so far in the previous paragraphs, the level of incompetency shown by Sayer Ji in using this study as evidence in his favor is making my head spin. When 19-39% of a population is unvaccinated, then sure, it's true that "vaccine-induced antibody elevations do not guarantee real world protection against the pathogen the vaccine is intended to immunize us against". But if you understand the concept of herd immunity, you know that vaccine efficacy is greatly reduced when substantial portions of a population do not vaccinate.

And who has ever claimed that vaccines "guarantee" immunity against the real world pathogens? "Guarantee" is a word used by salesmen, not scientists. Scientists know that the protection provided by vaccines is imperfect (it's highly effective, but not perfectly effective), and is absolutely dependent on herd immunity. That is the very reason why doctors and scientists talk about herd immunity so much! If there is no herd immunity, then everyone is at greater risk, even people who have been vaccinated.

(I skipped footnotes 2 and 3 because they were heavier on the medical jargon - I didn't understand all the technical details. I am willing to bet, however, that if they were too technical for ME, than Mr. Ji and his Philosophy BA didn't fare much better. Footnote 4 was just a cite of another GreenMedInfo article.)

FOOTNOTES 5, 6 and 7:

Ji writes:

" has been known for several decades that the administration of measles vaccine in underdeveloped countries may actually be resulting in higher infant mortality rates.[5] [6] "

Let's check the abstracts of footnote 5 and footnote 6. They tell the story of a high-titre measles vaccine (I had to google titres) approved in 1989 for use in infants younger than 9 months, but then rescinded in 1992 because of safety concerns after higher levels of female mortality were detected in some trials. Footnote 5 merely describes the situation, speculating that "It is suspected that high-titre vaccines cause long-term disruption of immune function, including an imbalance in the type of helper T cell response" with the caveat that "Aaby et al. also suggest that standard-titre vaccines reduce overall mortality by general immunostimulation." Science is trial and error. They found that high-titre vaccines seemed to not be working but they didn't know why so they stopped administering them in order to find out.

Following up in footnote 6, "Investigators have hypothesized that HT vaccine had caused immune suppression similar to that of measles infection. The present review suggests first that the HT vaccine itself is unlikely to be the cause because the effect was not found in all studies. Second, the increased mortality started only after 9 to 10 months of age when controls received ST measles vaccine, and HT groups received the "control vaccine." It was not found in the studies that provided another measles vaccine instead of control vaccine. Third, because the HT studies with excess mortality rates showed increased female mortality rates, we need to find environmental or contextual conditions associated with increased female mortality rates in some studies to explain the problem associated with HT measles vaccination." Correlation is not causation, people.

Let's look back at Sayer Ji's original sentence: " has been known for several decades that the administration of measles vaccine in underdeveloped countries may actually be resulting in higher infant mortality rates.[5] [6] " Or, you know, they MAY not, since that's not what the results of those studies found at all. There was no clear link shown between the HT vaccines and higher female mortality (Ji neglects to mention it was only female, not both female and male, infant mortality, that rose in the documented cases.) On the other hand, I did find in my Googling this article published in the journal Pediatrics in 1999 ostensibly defending the safety of the original HT vaccine in the first place. (I say ostensibly b/c I'm not going to pay to read the whole thing, but there's the cite if you want to).

Ji's next sentence reads: "This has, in fact, been a persistent criticism levied against UNICEF's vaccine-heavy strategy in certain regions of Africa, which appear to have increased mortality rates.[7]" Footnote 7 leads not to a scientific study but to this BBC News article vaguely describing a study with no direct cite. It describes a UN program that promoted a combination of vaccines (no indication they were measles vaccines, notably), Vitamin A pills, and mosquito nets in an effort to decrease child mortality, but fell short of its goal of reducing mortality by 25%. The article is barely two paragraphs (that actually describe mixed results - failure in some areas, but success in others), not a scientific study and certainly not enough evidence to draw a bright line to the conclusion that vaccines increased mortality rates.

  • 1985, Texas, USA: According to an article published in the New England Journal of Medicine in 1987, "An outbreak of measles occurred among adolescents in Corpus Christi, Texas, in the spring of 1985, even though vaccination requirements for school attendance had been thoroughly enforced." They concluded: "We conclude that outbreaks of measles can occur in secondary schools, even when more than 99 percent of the students have been vaccinated and more than 95 percent are immune."[8]
Yes, that is the final sentence of the abstract. Let's look at the few preceding sentences though:

"Stratified analysis showed that the number of doses of vaccine received was the most important predictor of antibody response. Ninety-five percent confidence intervals of seronegative rates were 0 to 3.3 percent for students who had received two prior doses of vaccine, as compared with 3.6 to 6.8 percent for students who had received only a single dose. After the survey, none of the 1732 seropositive students contracted measles. Fourteen of 74 seronegative students, all of whom had been vaccinated, contracted measles. In addition, three seronegative students seroconverted without experiencing any symptoms. 

So, the students who received *two* doses of the vaccine were much less likely to test negative for the antibodies that fight measles (which they should hopefully test positive for after receiving the vaccine, but remember? There are very high success rates with vaccines, but no "100% guarantees") What does this tell us? That your kid should get both doses, not no doses.


Okay people, I am going to wrap things up here, because this post is crazy long already - I've been working on it for days and I just want to hit publish. If there is interest I will follow up with a Part 2 examining the rest of his footnotes. But I think there is enough evidence here to show you this man and his website, GreenMedInfo, are not to be trusted, right?

Do you see the pattern here? Sayer Ji has consistently misinterpreted and misconstrued the results of the studies he is citing. NONE OF THEM SAY WHAT HE SAYS THEY DO. Please, please, don't buy what this snake-oil salesman with a degree in PHILOSOPHY, of all things, is selling as medical advice. Your kids' health is at risk if you choose not to vaccinate. And not just yours, but MINE.

Thanks for reading if you made it to the end! (What's wrong with you?) :)


Tyler and Kristen said...

This was great! Thanks for doing all the leg work on that. It got me all riled up about vacinations. I have a few friends that I think need to hear it as well, mind if I share it on facebook?

Jaime said...

Thanks!! I would love for you to share it!

Post-it Note said...

Phew this was a lot of work! Kudos.