The importance of relative risk in understanding vaccine effectiveness

A while back I noticed that Greg Beattie was deceiving his readers about pertussis vaccine efficacy by misrepresenting NNDSS data.

Yes, the same Beattie with the bogus claim that vaccines did not reduce infectious diseases. He dresses this up with misleading graphs comparing mortality from vaccine preventable disease to the introduction of X vaccine. These graphs are also bogus in that he omits the impact of vaccine introduction. The stunning success of the vaccine itself and the elimination of infection is always absent from his peculiar artwork.

Beattie’s claim back in 2012 was that the pertussis vaccine failed because high numbers of notifications had been vaccinated against pertussis. This is thunderously misleading in that it’s at the same level as dismissing seat belt safety because most fatalities on our roads involve seat belt wearing occupants. He also avoided explaining all reasons as to why notifications were high. Increased awareness, testing and follow up, pockets of low vaccination driving an epidemic, low booster uptake.

You can check the post here to follow my review of the same data table Beattie used. But it’s pretty simple. By 2011 close to 95% of 0-4 year olds were fully vaccinated by age 2 [NCIRS]. Using the table provided it turns out those not fully vaccinated made up 27.2% of notified infections. Fully vaccinated notifications equal 56.7%.

Relatively speaking a child fully vaccinated against pertussis has a notably reduced chance of being infected. Conversely, the small number who are not fully vaccinated have a frightfully high chance of being infected. To be sure, if 56.7% of notifications collected over 2008 – 2011 are from fully vaccinated children one can argue the vaccine could (and needs to be) more effective. But when the 5% who are not fully vaccinated make up 27.2% of infections, then the claim the vaccine is not effective is patently absurd. A dangerous and irresponsible lie.

Basically this is a story of relative risk being falsely presented as absolute risk. Choose some data and omit other data and the claim looks sound. But the post itself is limited in examining Vaccine Effectiveness vs Relative Risk (Risk Ratio – see screenshot). Understanding related and relative data sets is crucial in grasping how vaccine efficacy can be misrepresented. Regrettably many falsehoods peddled by the anti-vaccine lobby stem from such misrepresentation.

Fortunately an excellent piece addressing this was recently published on The LymphoSite by kill3rtcell. Headed But most of the people who got the disease were vaccinated for it! the post comprehensively addresses vaccine effectiveness, risk ratios and even provides interactive calculators. These crunch values of vaccine effectiveness, vaccination rates and resultant cases in the unvaccinated or vaccinated.

Do head over and read what is an excellent contribution to the deconstruction of misinformation peddled by antivaccinationists.

The screenshot below helps explain what this post accomplishes.

relative risk

© kill3rtcell – The LymphoSite

——————

Parrot Pareidolia?

You may swear this parrot was a female model.

And indeed be right.

Or if you would swear this female model was a parrot…

Pareidolia parrot

Then enjoy the brilliant work of Italian body painting artist, Johannes Stoetter.

Video at YouTube here.

CIA to stop exploiting vaccination programmes

In the first quarter of 2011 Pakistani doctor Shakil Afridi began a hepatitis B vaccination programme in and around one of the poorer cities in Hazara in Northeastern Pakistan.

Abbottabad is similar to less fortunate Pakistani cities struggling with poverty and insufficient access to health services. Employed by the government and considered the top medic in the Khyber tribal area, Dr. Afridi’s vaccination programme was typical of such immunisation initiatives.

shakil afridi

Dr. Shakil Afridi

However what is now well known is that Dr. Afridi had been recruited by the CIA. Provided with only minimal information from CIA operative “Peter”, he was to use the vaccination programme as cover for gathering blood samples from an Abbottabad compound.

The CIA believed Osama bin Laden may be hiding in the compound and were after a DNA sample from children to compare with his late sister. Dr. Afridi had two female staff working with him on the programme. One was able to access the compound and gather blood samples. Afridi and his staff had no idea who the CIA were targetting.

Ultimately the scheme failed and did not lead to the success of the USA confirming this was bin Laden’s hideout.

What is known is that the CIA’s use of this and other vaccination programmes has had a lasting negative effect on their implementation and success. As a result the control of dangerous diseases including polio, has likely been set back years.

Already regarded with suspicion in developing Islamic nations, Western backed and funded vaccine programmes are subject to anti-vaccination propaganda. Conspiracies linking polio vaccination to deliberate Western plots to spread HIV/AIDS or cause sterility have circulated for years. The incorrect claim that the vaccine is “unclean” under Islamic law has been thankfully countered by the global Islamic Advisory Group on polio.

Pakistan’s polio vaccination programmes have suffered significantly from the plot involving Dr. Afridi. The Pakistani Taliban have placed a “ban” on polio vaccine programmes. 350,000 children have missed out on polio vaccination and access to other health care. A spike in polio infection has seen 66 children diagnosed to date this year compared to a total of 14 for the whole of 2013.

60 health workers have been killed over the past three years due to enforcement of this ban by violent militant groups. Infection has spread across the border to Afghanistan.

On May 5th this year the World Health Organisation announced polio had “re-emerged as a public health emergency”. Some critics have argued 30 years of work to control the virus “could unravel”. The WHO is calling for all children in affected countries to be vaccinated or revaccinated, whilst anyone travelling from these countries should also be revaccinated, and carry proof of this with them.

A few days ago the CIA announced an end to the exploitation of vaccination programmes.

Lisa Monaco, a senior counterterrorism and homeland security adviser to President Obama, wrote in a letter addressed to the leaders of several prominent public health schools that the CIA would not use immunisation programs – or workers – as a means to collect intelligence. Such programs have prompted attacks on medical workers in Pakistan.

“The Director of the Central Intelligence Agency directed in August 2013 that the agency make no operational use of vaccination programs, which includes vaccination workers,” Monaco wrote in the letter, which was first obtained by Yahoo News.

“Similarly, the agency will not seek to obtain or exploit DNA or other genetic material acquired through such programs. This CIA policy applies worldwide and to US and non-US persons alike.”

Former CIA spy Micheal Scheuer, who was a senior adviser to the CIA’s bin Laden unit has criticised the decision. Speaking to the BBC he argued any tool that got the job done is justified.

MICHAEL SCHEUER: If it saves Americans it justifies the end. That’s what the agencies and business want.

BBC INTERVIEWER: Even though potentially thousands of people could die as a result of the spread now of polio?

MICHAEL SCHEUER: Well, you know, stuff happens, Sir.

WILL OCKENDEN: He says the use of vaccination programs by the CIA paid off in the hunt for and execution of Osama bin Laden.

MICHAEL SCHEUER: Without a doubt. It led directly to the killing of Osama bin Laden. It was too late in the war to make much of a difference but as long as he was alive he was involved in planning attacks against the United States and Britain and some of our other allies. It was very much worth the cost.

You can catch the full ABC News audio below, or download the mp3 file here.

Leaving the CIA behind it’s worth noting that logistical problems associated with conflict in Syria and the inexplicable apathy of the Syrian government have seen the resurgence of polio, measles and meningitis. In April it was reported polio had spread from Syria to Iraq.

In Somalia Al Shabaab had banned 16 humanitarian agencies by late 2011. Consequently 300,000 children went unvaccinated for three years. This led to a 2013 outbreak in polio, including 194 cases of paralysis and a spread to Ethiopia and Kenya. Existing Aid programmes managed to control this spread within six months. Large scale measles infection has also proven a problem across the Horn of Africa.

Boku Harem has attacked health facilities responsible for vaccination programmes in Nigeria. Ten polio workers were killed in February of 2013.

According to an editorial just published in Nigeria’s Leadership newspaper, ten countries currently report that polio is in circulation.

The action of the CIA in Pakistan (and apparently elsewhere) has been monumentally reckless. The consequent scattering of polio vaccination reduction, alongside global conflict has led to a global emergency.

The lesson then for the developed world is clear. Now, more than ever, there is no excuse for parents to question the validity of any vaccination.

Particularly polio.

 

  • Below Professor Michael Toole, Deputy Director of Melbourne’s Burnet Institute discusses the problems facing some Islamic nations on ABC 24 (May 24th 2014).

Radical Islam Opposition To Polio Vaccination

The awful autism obsession of the antivaccinationist

On page 11 of the most recent Health Care Complaints Commission investigation into the Australian Vaccination-Skeptics Network, we see the absurdity of vaccines causing autism rearing its head.

The AVSN claim to present on their website 68 “medical journal studies [that] support the link between vaccination and autism”. According to the HCCC the expert they consulted concluded a case of correlation confused as causation was evident. A read of the list shows the expert is being kind in no small part. Given that the AVSN claim these studies show a link between vaccines and autism, the list is quite absurd.

Despite the absence of mercury in childhood vaccines we get much on environmental mercury and autism, ADHD and blood mercury levels, swollen brains and autism, etc. But we have a numeric problem Houston. Of the 68 (cough) articles, I could count just 30 that included the word “vaccine” or “vaccination” in the title, abstract or conclusion. But maybe I’m expecting too much. Articles are numbered but items 5, 12, 48, 49 and 68 don’t exist. At all.

The AVSN use the typical misinformation that succeeds at confusing young worried parents and educated, affluent parents who can afford lots of Internet time. Such as citing the damage huge doses of certain toxins or heavy metals can do, without stressing vaccines contain either another variant or minuscule amounts long shown to be perfectly safe. Since having changed their byline from Love them, Protect them, Never inject them to Because every issue has two sides, they have done a poor job of presenting both sides.

The AVSN for example do not provide access to the Institute Of Medicine publication, Adverse Effects Of Vaccines; Evidence and Causality. This has been pointed out by the HCCC along with a host of biased schemes the AVSN execute in the hope of driving the public away from vaccination. In addition the hubris-riddled response that has been crafted for the HCCC and published online, is indicative of a mindset with no concept of community responsibility.

Myths and concerns about vaccination note on page 29 under “Mercury in vaccines can cause autism”:

There is no evidence that thiomersal (a mercury based preservative) in vaccines has caused any health problems, except perhaps minor reactions such as redness at the injection site. [...] The form of organic mercury contained within thiomersal is “ethyl mercury” which doesn’t accumulate in the body, unlike the closely related methyl mercury which does accumulate and is neurotoxic. [...] MMR vaccine and other live attenuated viral vaccines never contained thiomersal.

Of course there is a dollar to be made insisting vaccines cause autism and other disabilities. As reported recently by Fairfax:

The Office of Liquor Gaming and Racing has confirmed it is investigating ”problems” in the Australian Vaccination-Skeptics Network’s financial statements.
The anti-vaccine group has raised nearly $2 million in the past seven years but has never done any ”charity”, according to Stop the AVN, a coalition of critics formed after the parents of a baby who died of whooping cough were targeted by the network. [...]

The 2008 financial statement said the group had more than $50,500 of assets, yet in its 2009 statement, assets from 2008 are listed as only about half that amount.
And nearly two-thirds of $281,855 in expenses listed on its 2010 financial statements are not explained, given only the title ”other expenses”. The 2012 statement for the group has not been submitted.
A chartered accountant who examined the documents for Fairfax Media, but declined to be named for fear he would be harassed, said the documents were ”the worst set of financial statements I have ever seen”.

$2 million! And where is that money? Well, you see… no-one really knows. A visit to this document reveals a copious tally of financial irregularities and charitable breaches by the (then) AVN. Both the Charitable Fundraising and Charitable Trusts Acts are called into question, “on a number of occasions” according to the NSW state watchdog, the OLGR.

Published just recently at Diluted Thinking the article, AVSN Pays Meryl Dorey is a must read. It is a thorough breakdown of financial irregularities and unanswered questions from 2004 to 2008.

It is of course beyond ironic that a hero of the AVSN is disgraced “vaccine/autism” fraudster, Andrew Wakefield. It’s old news that Brian Deer was able to track Andrew Wakefield’s scam because the latter had left a trail of intriguing financial records and/or references.

Follow the money was what Deer did in true investigative journalistic style. It is indeed somewhat silly that the anti-vaccine lobby today bellow follow the money, but in doing so can draw only one step from a vaccine to its manufacturer. The money trail Deer uncovered was far more impressive.

Wakefield was paid £150 plus expenses per hour by Richard Barr’s law firm. In total this came to £435 643, which was arguably to create a syndrome to drive the class action of anti-vaccine and genuinely misled (by Wakefield) litigants.

But Wakefield needed to ensure he profited from all the sufferers of his syndrome. Once the world had been fooled into believing “autistic enterocolitis” was a genuine syndrome, then it would have to be diagnosed. First he filed for his March 1995 Diagnostic patent that claimed in part:

Crohn’s disease or ulcerative colitis may be diagnosed by detecting measles virus in bowel tissue, bowel products or body fluids

Based on this, on September 9th 1996 a client of Richard Barr known as Child 2 was the first child subject to what the GMC later described as a “clinically unwarranted” ileocolonoscopy.

The day after Child 2 had undergone his ileocolonoscopy Wakefield produced a document headed, Inventor/school/investor meeting 1. 4 which calculated that by working on MMR litigant samples, profits of £72.5m per year were to be had. This document left no doubt as to from where the money should be sourced. The profits would go to a yet to be formed company specialising in molecular viral diagnostic tests:

In view of the unique services offered by the Company and its technology, particularly for the molecular diagnostic, the assays can command premium prices. The ability of the Company to commercialise its candidate products depends upon the extent to which reimbursement for the cost of such products will be available from government health administration authorities, private health providers and, in the context of the molecular diagnostic, the Legal Aid Board.

More could be gleaned from a confidential submission (1999) to the Legal Aid board in his quest to secure the future of an immunodiagnostic business he would be director of. Unigenetics Ltd was incorporated in February of that year with Dublin pathologist, John O’Leary and would be registered in the Republic of Ireland. Here Wakefield argued the link b/w MMR and autism had been shown. Unigenetics scored £800 000 of tax payer funds to conduct PCR tests of dubious pursuit.

In addition to these petty “legal costs and salary” monies Wakefield would get another £90 000 per year – more than half of which was for travel. Deer reported that trading was to be fronted by another planned immunodiagnostic company Carmel Healthcare Ltd (also registered in the Irish Republic) and named after Wakefield’s wife. Within this venture Wakefield would take 37% of the earnings, the parent of child “Number 10″ would take 22.2%. A venture capitalist would get 18%. Royal Free’s professor of gastroenterology, Roy Pounder would get 11.7% and Professor John O’Leary another champion of “MMR causes autism” would get 11.1%.

Deer was given a copy of a prospectus 35 pages long.

This included confirmation of planned “litigation driven testing” from the USA and UK, along with delightful profit. Of course all business relied upon Wakefield’s new syndrome which at this point remained to be proven. As he had not found Crohn’s disease in the 12 children, Wakefield coined the term “autistic enterocolitis”. The prospectus sought to raise an investment of £700 000.

It is estimated that the initial market for the diagnostic will be litigation driven testing of patients with autistic enterocolitis from both the UK and the USA… It is estimated that by year 3, income from this testing could be about £3 300 000 rising to about £28 000 000 as diagnostic testing in support of therapeutic regimes come on stream.

[...]

Once the work of Professor O’Leary and Dr Wakefield is published, either late in 1999 or early in 2000, which will provide unequivocal evidence for the presence of the vaccine derived measles virus in biopsy samples the public and political pressure for a thorough, wide ranging investigation into the aetiology of the bowel conditions will be overwhelming.

As a consequence of the public, political and legal pressures brought to bear, the demand for a diagnostic able to discriminate between wild type and vaccine derived measles strains will be enormous.

Deer reported on yet another new company which was for the running of a joint business with the UCL medical school. Immunospecifics Biotechnologies Ltd would produce immunotherapeutics, vaccines and a diagnostic test. Beneficiaries were as with Carmel. Wakefield, the parent of “number 10″, the venture capatilist, Pounder and Prof. John O’Leary.

There are issues around Wakefield’s immunodiagnostics which antivaccinationists should simply admit, and by not admitting such merely lend their cause less credence (if that were possible).

  • Transfer factor for use in vaccines and treatments had basically been written out of the literature. A lack of evidence, risk of infection and unjustified cost had relegated this 1940’s blood product to the realm of an Internet peddled cure-all scam.
  • The Neuro Immuno Therapeutics drama run by Hugh Fudenberg. To cure autism – which he reckons is caused by MMR – Hugh would use, you guessed it, Transfer factor. In August 2004 Brian Deer caught up with him. At the time he was under sanction for use and prescription of controlled drugs. Help yourself to a search-and-read on Hugh. If you remember Bill Maher’s claim that a flu shot five years consecutively equals a ten-fold increase in the chances of developing Alzheimers, you might be relieved to know that the source is Hugh Fudenberg.
  • The Dublin measles tests which could not deliver consistency of results, emerged as a problem years later, during vaccine related lawsuits in the USA and Britain.

One caper of Wakefields that many know of is his “safer vaccine” patent for a monovalent measles vaccine. As the Royal Free Hospital approached the release of his paper Wakefield made copies on tape as to how he should announce his bogus findings. One – which is in circulation today – includes:

There is sufficient anxiety in my own mind for the long term safety of the polyvalent vaccine—that is, the MMR vaccination in combination—that I think it should be suspended in favour of the single vaccines

But of course! Just as well that like the patent for immunodiagnostics he had the “safer vaccine” patent for the single measles vaccine. And he filed for this nine months before his now retracted paper was published.

Wakefield patent

The opening paragraph is breathtaking:

The present invention relates to a new vaccine for the elimination of MMR and measles virus and to a pharmaceutical or therapeutic composition for the treatment of IBD (Inflammatory Bowel Disease); particularly Crohn’s disease and Ulcerative Colitis and Regressive Behavioural Disease (RBD).

After falsely claiming MMR vaccination leads to Crohn’s disease and other forms of IBD we read on page two (far right) above (bold mine):

What is needed therefore is a safer vaccine which does not give rise to these problems and a treatment for those with existing IBD. I have now discovered a combined vaccine/therapeutic agent which is not only most probably safer to administer to neonates and others by way of vaccination, but which also can be used to treat IBD whether as a complete cure or to alleviate symptoms.

This was first revealed in the UK Sunday Times. Wakefield denied this “conspiracy”:

The claim appears to be that, whilst at the Royal Free Hospital, I was developing a new vaccine to compete with MMR and that I conspired to undermine confidence in MMR vaccine in order to promote this new vaccine, and that this represented a conflict of interest. This is untrue. The facts are that: [...]

it has never been my aim or intention to design, produce or promote a vaccine to compete with MMR; [...]

A provisional patent filing was made for the use of measles virus-specific TF in regressive autism and inflammatory bowel disease (Regressive Bowel Disease; RBD).

The reference to the possible use of TF to protect children against measles infection – the thrust of the Sunday Times’ conspiracy theory – was put in as an afterthought in the patent. It was entirely speculative and never pursued in any shape, manner or form.

The provisional patent filing was entirely speculative and was for a possible therapy; as such, it had no bearing on the 1998 Lancet paper.

That the patent application with its firm conclusion of an MMR derived pathology appeared nine months before publication of his paper is not the only Crystal Ball caper by Wakefield. A fortnight before selecting any children that eventually made up his insignificant 12 child sample, Wakefield and Richard Barr co-authored a letter that included (bold mine):

Children with enteritis and disintegrative disorder, form part of a new syndrome. The evidence is undeniably in favour of a specific vaccine induced pathology

That claim would have taken the word of Hugh Fudenberg at that particular time in history.

The end for Wakefield came just after plans for Carmel Healthcare were finalised, potentially making way for his incredibly profitable business. A new head of medicine, Mark Pepys was appointed to the UCL Medical School (once known as the Royal Free and University College Medical School). He is a fellow of the Royal Society and ensured impressive grant money. He wasn’t impressed by Wakefield, threatening to not transfer his own unit to UCL if Wakefield was even there.

With the help of theoretical physicist Chris Llewellyn-Smith he made his move in December 1999. A mere two months after Pepys moved to the Royal Free Wakefield was called to UCL’s London head offices. There, at last, he was made to face the audacity of his scam and handed a two page letter of his very own to have and to hold and of course, to read. It included:

We remain concerned about a possible serious conflict of interest between your academic employment by UCL, and your involvement with Carmel. This concern arose originally because the company’s business plan appears to depend on premature, scientifically unjustified publication of results, which do not conform to the rigorous academic and scientific standards that are generally expected. [...]

Good scientific practice now demands that you and others seek to confirm or refute robustly, reliably, and above all reproducibly, the possible causal relationships between MMR vaccination and autism/“autistic enterocolitis”/inflammatory bowel disease that you have postulated.

Yay verily.

UCL were keen to help, offering him an ongoing position on staff or a full twelve months paid absence to allow for further research. 150 subjects would be provided to Wakefield. 12.5 times larger than his initial sample. Wakefield agreed.

Time passed.

After three months he was asked for a progress report. Six months later in September 2000 Wakefield replied:

It is clear that academic freedom is essential, and cannot be traded. It is the unanimous decision of my collaborators and co-workers that it is only appropriate that we define our research objectives, we enact the studies as appropriately reviewed and approved, and we decide as and when we deem the work suitable for submission for peer review.

Fail. By October of 2001 he was asked not to let the door hit his lying backside on the way out. In January of 2010 the General Medical Council found Wakefield had been “dishonest, irresponsibile and showed callous disregard for the distress and pain of children.”  [Science Based Medicine]

After close to a decade of multiple studies had failed to replicate his “findings” or any link between MMR, its components and autism the Lancet retracted the Wakefield paper [Science Based Medicine] [BMJ] on February 2nd 2010. The journal’s editor, Richard Horton described the statements in the “fatally flawed” paper as “utterly false”.

On May 25th of that year he was struck off the medical registrar by the General Medical Council.

Still today, as is clear above, there are scam artists profitting from peddling the lie that vaccines cause autism. Their paper-thin efforts may well be pathetic but still have a measurably negative effect on public health. With no regard for evidence or responsibility for the consequences of their actions, one can hope that these arrogant fraudsters will one day too face the weight of the law.

Yay verily.

Access Ministries’ Biblezine Blunder

Think the allure of Cosmo, minus the sleaze, plus the easy-to-read New Century Version of the New Testament

- Christianity Today describing the Biblezine Revolve -

Last weekend it was reported that Access Ministries had handed out “Biblezine” material to Victorian primary students.

The psychologically invasive material is typical conservative fundamental evangelism, with no place in Access’ so-called religious “education” classes. Long the subject of controversy for proselytising to students – what Access CEO Evonne Paddison described as “the greatest mission field in Australia” –  the latest revelation of volunteer conduct has led to an Education Department investigation.

The Department labelled the material as “inappropriate and offensive”. Biblezine material handed out advises primary school aged kids that masturbation and sex before marriage are sinful and girls who wear revealing clothes are inviting sexual assault. The Age reported that girls must not go bra-less because then:

your nipples are much more noticeable and a distraction and temptation for men

Don’t wear jeans cut low around the waist or tube tops because guys are:

sexually stimulated by what they see

The Bible says not to cause anyone else to sin. Are you putting sexual thoughts about your body into guys’ heads? If you are showing a lot of skin you probably are.

In a masterpiece of philosophical reasoning the question of how far can one go before one is no longer “pure”, comes up. A definite quandary given that condoms promote promiscuity. Thus, better to ponder, “How much dog poop stirred into your cookie batter does it take to ruin the whole batter.”

Indeed.

Homosexual feelings? No prizes for guessing where this would go. Time to get some counselling. If you are gay, Biblezine advise that it’s best “to never act on it”, The Age reports.

Access Ministries argue that they do not approve of the Biblezine material, which was handed out at Torquay College by volunteers from the Torquay Christian Fellowship Centre. A key provider of the Magnify Biblezine in Victoria is Scripture Union Victoria.

There are a range of Biblezines published and emanating from the USA. Apart from Scripture Union’s Magnify, there is Revolve 2 and Refuel 2 which popped up at Torquay College. Real is a Biblezine for the “hip-hop crowd”.

Yet Revolve, which offered the totally awesome advice on the power of girls nipples, has been spreading it’s wisdom for over a decade. From Christianity Today – way back in 2003 – we can consult Ten Things You Should Know About The New Girls Biblezine Revolve.

Still there is good news afoot. Since 2011 the number of ACCESS enrolements has fallen by one third. From 940 schools in 2011 to a delightfully devilish 666 last year. The change has followed a move to an “opt-in” choice for students in an environment where schools “may” provide religious instruction.

Previously classes were run on an “opt-out” basis whilst schools themselves were bullied into believing classes “must” be run if offered.

Of course Paddison disputes the Education Department figures claiming to have Access volunteers running classes in 780 schools last year. She has taken to disseminating a ”clarification” email to all schools offering the program.

It finishes:

we request all schools to adhere to the legislation.

Perhaps it would be more in keeping with Access tradition if Evonne Paddison had warned, “I’ll be back”.

Follow

Get every new post delivered to your Inbox.

Join 263 other followers