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


Denialism: ‘Researching’ the case against vaccines

Some of the most error-laden claims coming from those who deny the safety and efficacy of vaccination are accompanied by the confidence of having done their ‘research’.

However there is no way one could properly research, evaluate or study the risks and benefits of vaccination, and ultimately conclude to deny their children the protection it offers. There is no way one could properly educate themselves on the topic and actively entertain the inaccurate mantras used by anti-vaccine lobbyists. Certainly this so-called research shows no sign of being properly guided or assessed for basics such as structure, source material or conclusion.

In fact that last sentence above could apply to many areas other than vaccination. David Dunning and Justin Kruger hypothesised and successfully demonstrated a cognitive bias linked to intellectual skill. Their conclusions are examined in a 2010 episode of The Science Show. The synopsis opens with: The dumb get confident while the intelligent get doubtful. Whilst the “Dunning-Kruger effect” quite rightly takes its place in examining and explaining the phenomena, it has been noted by great thinkers for centuries.

Take this mother interviewed in a masterpiece of false balance cobbled together by Today show reporter Lauren Ellis. It’s true that the ability to gauge risk is not a natural skill in the absence of education and contemplation. We’re hard-wired to choose being safe over sorry. But one cannot objectively or conclusively “look into” the ‘flu (or any) vaccine and decide against it on that basis. The certainty this woman “studied” misinformation and evidence denial is confirmed by the rest of her comment:

When I looked into the ‘flu vaccine it wasn’t proven to be 100% safe. I made a choice that I was going to do the best that I could do to build up their immune systems through whole foods, active exercise and having a loving and caring environment at home. We actually want to invite those kinds of sicknesses into the body because that’s the body’s natural way of boosting its defences.

Along with overestimating their own level of skill the Dunning-Kruger effect lists the failure of the cognitively-challenged to identify genuine skill in others. Our subject is right on cue, later adding; “I think what we do is we cheat a little bit and we listen too much to the doctors”.

Attempting to take more responsibility for one’s health is by itself a positive trend. However the reality is that through a combination of poor regulation, apathetic accreditation, unchecked claims and lucrative scams, an industry has grown from marketing “wellness” alongside denialism. A vital skill today is that required to recognise reputable sources and source material. There is so much specialty, knowledge and experience attached to individual areas of health and medicine that ascertaining expert advice is essential.

Such a skill – let’s call it a research skill – by no means only applies to the choices we make around health, medicine and alternatives to medicine. But the amount of information is so vast and varied that intellectual tools independent of the information presented are more than likely to serve us well. More so, we are all subject to cognitive biases such as pattern recognition or emotional resonance such that we may easily hijack our attempt at objectivity.

Thus a research skill that values evidence and source, based upon merit, helps keep both ‘researcher’ and material in check. Those fortunate enough to be familiar with the scientific method apply a more complex type of such thinking. Individual topics and subject matter can be quite complex but appreciating the scientific method itself and it’s impact on scientific consensus is well within the grasp of interested individuals. Enter Scientific Denialism, which I’ve already quite purposely mentioned alongside marketing (or promoting/defending aspects) of the “wellness” industry.

Diethelm and McKee presented a Viewpoint piece in the European Journal of Public Health in 2009 entitled; Denialsm: what is it and how should scientists respond? They cite the definition of Mark and Chris Hoofnagle:

The employment of rhetorical arguments to give the appearance of legitimate debate where there is none, an approach that has the ultimate goal of rejecting a proposition on which a scientific consensus exists

The Hoofnagle brothers identify five elements of denialism that are employed alone or together. All five can be found with numerous representations emanating from the anti-vaccination sector.

Conspiracy Theories are employed to dismiss scientific consensus arrived at via the peer review process. Granted, the conspiracies advanced by the bulk of anti-vaccination identities go well beyond this goal into rambling nonsense. The Big Pharma Monopoly conspiracy has become a monster of ludicrous proportion. There are examples of unacceptable conduct and flawed research by pharmaceutical companies, that if presented rationally and sparingly might help support criticism of vaccines or their method of use.

Continually serving to delight critics of the anti-vaccination movement in Australia is perpetual “PhD candidate”, Judy Wilyman of Wollongong University. Her thinking, and consequent tone of argument or demand levelled at government, appears crippled by belief in a vast web of conspiracies. Doctors will lie, research conducted by drug companies is by default corrupt, science advocacy groups are motivated to support this corruption – and by extension the member’s arguments are to be dismissed. The government assisted “crime against humanity” of vaccination is helped along by corrupt media and grieving parents relaying “anecdotes” of infant fatality. This is all designed to entrap the community (for whom Judy speaks) using fear and guilt.

Not surprisingly her supervisor is well known for his authorship of scientific denialism. A strident defender of the anti-vaccine and several conspiracy movements, Brian Martin (of Wollongong University) has written frequently on the topic of supposed scientific dissent. He validates the Hoofnagle brothers observation that the peer review process is to the conspiracy theorist a means to suppress scientific dissent. As I’ve noted before, Martin writes in Grassroots Science:

Dissent is central to science: the formulation of new ideas and the discovery of new evidence is the driving force behind scientific advance. At the same time, certain theories, methods, and ways of approaching the world – often called paradigms – are treated as sacrosanct within the professional scientific community. Those who persist in challenging paradigms may be treated not as legitimate scientists but as renegades or outcasts. [...]

For example, there are many individuals who have developed challenges and alternatives to relativity, quantum mechanics, and the theory of evolution, three theories central to modern science. [...]

Western medical authorities at first rejected acupuncture as unscientific but, following demonstrations of its effectiveness, eventually accepted or tolerated it as a practice under the canons of western biomedicine, rejecting its associations with non-Western concepts of the body. [...]

At the same time, some mainstream medical practitioners and researchers are hostile to alternative health. This is apparent in pronouncements that taking vitamin supplements is a waste of money or in police raids on alternative cancer therapists, the raids being encouraged by mainstream opponents.

Many proponents of alternative health say that mainstream medical science is distorted by corporate, government, and professional pressures. In this context, grassroots medical science presents itself as being truer to the ethos of science as a search for truth unsullied by vested interests.

Brian Martin also happens to excel at that exceptional variant of conspiracy theory known as inversionism. Here one’s own tactics and motivation are attributed to critics or those who can justify the antithesis of one’s argument. In Suppressing Research Data: Methods, Context, Accountability, and Responses Martin writes:

Censorship, fraud, and publication biases are ways in which the availability of research data can be distorted. A different process is distortion of the perception of research data rather than distortion of the data itself. In other words, data is openly available, but efforts are made to shape people’s perception of it.

Although this perfectly describes tactics of the anti-vaccination lobby, Martin is writing about what he argues is a regular process in legitimate science and the peer review process.

Diethelm and McKee note that whilst the proper avenue to validate supposed suppression of dissent is ignored by conspiracy theorists, denialism can and does exploit genuine concerns. For our purposes we may note that unethical and dishonest conduct by pharmaceutical companies has indeed occurred. Also the 2006 CSL trial of Fluvax resulted in just one adverse reaction. “Not usually regarded as an adequate signal of a major safety problem”, according to a TGA spokesperson. That single febrile seizure was equal to 0.37% of the study sample. In hindsight a valid predictor of the 0.33% rate of febrile seizures W.A. experienced in April 2010.

Health authorities and practitioners take evident problems with the pharmaceutical industry very seriously. In the case of vaccination it’s perhaps testament to the addition of truly absurd conspiracies and the overlap with New World Order themes that has seen the anti-vaccination lobby squander a potentially effective means to sew their false doubt.

A second feature of denialism is the use of Fake Experts. An excellent example of this is the appalling HIV/AIDS Rethinkers list. If subject to the criteria of listing individuals actually working in the field of HIV from which the theory being “rethought” is sourced, the list would disappear. So it is with the academic integrity of vaccine denialists.

Some such as Meryl Dorey of the Australian (anti) Vaccination Network simply append the title of expert to themselves. All that’s needed is the familiar claim of having “researched” the subject for “twenty years”, whereas doctors (Meryl assures us) study vaccines for only six hours. Few can validate the Dunning-Kruger effect better by insisting smallpox and polio were merely renamed (part of a conspiracy), vaccines certainly cause autism (thousands of documented cases), SIDS, death, shaken baby syndrome and more.

The use of so-called experts who argue in opposition to established knowledge is spread across a diverse field in the case of vaccine denial. Micropalaentologist Viera Scheibner makes much of her title of “doctor”, deceitfully selling herself as a natural scientist who worked for a state authority. A host of chiropractors already in denial of science based medicine see fit to both parrot the standard anti-vaccine rhetoric whilst arguing the immune system can be specifically modulated by chiropractic.

Anti-vaccine groups pay great attention to scam artists such as Dr. Joe Mercola, Mike Adams and Barbara Loe Fisher of the official sounding National Vaccine Information Center. Father and son team Mark and David Geier promote both the belief vaccines cause autism and an abusive hormonal ‘treatment’. They have authored and co-authored a number of papers attempting to link vaccines to autism. Mark Geier has lost his licence to practice in at least 10 USA states.

Sites such as SaneVax or Age of Autism with Dan Olmsted and Mark Blaxill seek to continue the attack on reputable scientists and research. In Australia the new AVN president Greg Beattie describes himself as an author having produced bogus claims, misleading data and irrelevant mortality graphs whilst the universally condemned Melanie’s Marvellous Measles was written by anti-health zealot, Stephanie Messenger. Any of these, or similar identities along with the nonsense they write may be produced by anti-vaccine lobbyists to ‘refute’ genuine evidence-based knowledge on vaccination.

Cherry Picking or Selectivity is a practice the anti-vaccination lobby relies heavily on. Sadly, their harvest is so woeful that we are continually treated to Andrew Wakefield’s discredited and withdrawn Lancet paper, from which the fallacious association with autism is fuelled. Additionally an unproven handful of purported dishonesty levelled at his most effective critics or their careers hovers about regularly “vindicating” Wakefield. This by extension proves vaccines do cause autism, a conspiracy rages against Wakefield and the fake experts have been right all along.

Of course selective use of material and events can have enormous impact. Imagine the magazine Mothers For Moonbeams publishes a piece on the W.A. Fluvax episode and the impact on Saba Button presented selectively with concerns about the increase in the number of childhood vaccinations. Add the type of nonsense written by Natasha Bita in August 2012 falsely “linking” ten deaths to Australia’s influenza vaccine, to “PhD candidate” Judy Wilyman’s claim that vaccines are full of lethal “toxins”, and readers’ confidence in influenza vaccination can fall.

We constantly hear of vaccine-injury compensation cases involving autism-like symptoms, misrepresentation of the Bailey Banks case or a finding from an obscure Italian court as evidence vaccines really do cause autism. Similar selections can be made for a range of conditions unrelated to vaccination.

Similarly, alternatives to medicine used to “boost immunity” rely on sparse and often irrelevant research into (for example) St. John’s Wort or vitamin deficiency. It will come as no surprise to those familiar with vaccine denialists that Diethelm and McKee note that the towering isolation of the denialists position does not perturb them. Rather they see this as reason to liken themselves to Galileo.

Impossible Expectations from research are used often to create the illusion of doubt or bias. The infamous cry for a study of unvaccinated vs vaccinated children both suggests the efficacy of vaccines has never been properly established, whilst hinting that the unvaccinated are healthier due to the absence of artificial immunity and vaccine toxins. Not only is this absurd from an ethical viewpoint, methodologically it is nonsensical.

In order to correct for the variable of herd immunity, the unvaccinated sample would need to be isolated. In doing so the sample is rendered entirely unrepresentative of the qualities that supposedly need to be tested. More so this research need not be done. The impact of mass vaccination is clear – particularly with the return of diseases following a drop in vaccine uptake.

Gradually the ‘demand’ that vaccines show a 100% rate of safety and efficacy has emerged in more unreasonable quarters. Combined with the inability to acknowledge that as herd immunity drops, both vaccinated and unvaccinated are at increased risk, this impossible expectation ensures the anti-vaccine lobby can ignore basic community responsibility.

Again with alternatives to medicine or seemingly magical ways to fight disease and boost immunity, it is expected that science – or better yet, quantum science – will explain the mechanism behind promises and testimonials.

Finally Misrepresentation and Logical Fallacies are essential tools of the denialist. A very simple, yet highly effective means of misrepresenting the irresponsibility of vaccine denial has been use of the term “pro-vaccinators”. This conveys the impression that not only does a legitimate debate exist but that those unburdened by the delusion vaccination is harmful, may be motivated by ideology or some other non-evidence based reason.

Meryl Dorey of Australia’s AVN frequently insists to have a database listing death and disability from vaccine injury. This same theme of having a vaccine-injured child is presented by individuals both as a reason to attack vaccination and unleash abuse on those who accept vaccine safety. Indeed the correlation as causation fallacy is a primary of the anti-vaccination movement.

Slippery slope, appeal to authority, straw man arguments, inconsistency and more. Logical fallacies abound. Reductio ad absurdum is favoured commonly in explaining that conventional scientists or medical practitioners will defend vaccination because of their position and not the efficacy and safety of vaccines. On the other hand as Judy Wilyman argues, because areas of some affluence may have low vaccination rates this is proof that doctors do not vaccinate their children. Therefore, they are withholding information.

An example of misrepresentation through inconsistency and non-sequiter is the claim that vaccine preventable diseases were under control before mass vaccination. Heavily doctored graphs using the variable of mortality – not incidence or morbidity – peddle the falsehood that vaccines had no effect on disease whilst improved living standards led to their demise.

Bereft of evidence, vaccine denialists place significant energy in convincing their unfortunate devotees that the very fabric of democracy and the right to “health freedom” is under threat. Donate enough money to the AVN and you can save free speech and ensure looming mandatory vaccination is kept at bay. Evoking anger, disgust and suspicion toward those who challenge vaccine denial is a staple of anti-vaccine groups.

♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦

It takes little work to find anti-vaccine articles or identities that present all five aspects of denial in the one argument. Conspiracy theories and fake experts have carved out their own canyon sized themes over the years. Meryl Dorey’s obsession with “real scepticism” and her website aiming to mock scientific skepticism reinforces how effective evidence based deconstruction of her denialism has been.

Ultimately, understanding these tactics and how denialists use them reinforces the argument that accepting to debate a certain topic can be counterproductive. The debater who holds to evidence and argues within the constraints of the scientific method or present consensus, must face an opponent with no regard for truth, logic or bipartisan discourse.

Rather than focus on the topic at hand an effective technique would be to expose the tactics used in vaccine denial. Those engaged in denialism do not deal in evidence or seek to bring about a greater good through the application of truth.

Therefore it’s important that scientific skeptics and health professionals continue to expose vaccine denial for what it is.

As for budding ‘researchers’. They can be rightly satisfied with skills that lead one to reputable source material.

Dorey and Dingle’s Vaccine-Autism Doppelgänger

Back on January 15th Meryl Dorey offered a rather messy tweet designed to sustain her fictitious claim that all vaccines are causally linked to autism.


I say “messy” because the January 14th Huffington Post article linked to, refers to the Vaccine Compensation Injury Program Court, compensating children that the ‘Post author wrongly insists have autism. Yet suppose this author – anti-vaccine terror-tattler David Kirby – was correct. We are still left with compensation awarded to children with autism. Not because of their autism.

Thus Dorey’s misleading query, “… how many more do we need b4 govt admits vaccines cause autism?”, is rather scurrilous. And that’s only if Kirby’s attempt to mislead the reader is based in fact. As it turns out the heading Vaccine Court Awards Millions to Two Children With Autism does not describe the events as they occurred.

In the case of Ryan Mojabi, on page 2 of the Court of Federal Claims Decision Awarding Damages document one reads:

On June 9, 2011, respondent filed a supplemental report pursuant to Vaccine Rule 4(c) stating it was respondent’s view that Ryan suffered a Table injury under the Vaccine Act – namely, an encephalitis within five to fifteen days following receipt of the December 19, 2003 MMR vaccine… and that this case is appropriate for compensation under the terms of the Vaccine Program.

That’s clear. Encephalitis, which is a Table injury under the Vaccine act.

Still, referring to Ryan the family had blamed all vaccines administered between March 25th 2003 to February 22nd 2005 as collectively causing “a severe and debilitating injury to his brain, described as Autism Spectrum Disorder”. Without picking over every detail there is a lack of agreement on exactly when and how persistently ill Ryan became. The family had travelled overseas and whilst the totality of doctor’s visits falls well short of that expected for a child as ill as Ryan’s parents allege, evidence was provided that he had presented with fever and rash in Tehran on January 6th 2004.

In August 2007 Ryan’s parents testified he had (post vaccination) experienced screaming, lethargy, floppiness, fever and shaking hands in 2003, just prior to travelling overseas. Ryan’s doctor has no evidence nor record of these events being reported as claimed. Nor that he had agreed to an overseas trip for Ryan whilst he was in that condition.

On page 15 of an earlier court document, Revised Ruling Regarding Factual Finding (May 2009) Ryan’s performance under Checklist for Autism in Toddlers [CHAT] on two dates well past his MMR vaccination, is discussed.

On May 10, 2004, at Ryan’s sixteen month well-child visit, Dr. Armstrong completed a Checklist for Autism in Toddlers (CHAT) screen. Ps’ Ex. 4 At 25. That CHAT screen indicated that Ryan was interested in other children, pretend play, peek-a-boo, points with index finger, makes eye contact, and brings object for show. On January 25, 2005, Dr. Armstrong examined Ryan for his twenty-four month well-baby check. Ps’ Ex. 4 at 31. During the visit, Dr. Armstrong conducted another CHAT screen, and again Ryan positively performed each of the listed behaviors.

The second case involves Emily Lowrie. Emily has a diagnosis of Pervasive Developmental Disorder – not otherwise specified and seizure disorder. PDD is not autism, but may be referred to as “atypical autism”. It is a form of ASD. According to Australia’s Raising Children’s Network, symptoms are “usually fewer or less pronounced” than with Autistic disorder or Asperger’s syndrome. There is evidence that Emily did develop a Table injury close to the time of vaccination. Yet there is no evidence that autism resulted and Kirby’s claim is simply false.

The vaccines-cause-autism devotees excel in labeling PDD-NOS as “autism” and often flesh out large samples by including “autistic like symptoms” where clear diagnoses of encephalitis and encephalopathy exist. As it happens Kirby runs off the tried and true Bailey Banks case. Bailey was diagnosed with PDD – a class of conditions to which autism belongs. Meryl Dorey misled her audience at the Woodford Folk Festival by fudging such diagnoses and for good measure plagiarising part of the Banks’ final ruling document. She added “[Autism]” to misrepresent PDD after lifting a quote directly from page 17 of the Banks v. HHS case file.

Other stunners exploiting the “autism-like” symptoms include the Pace Law School student debacle orchestrated by Mary Holland. This motivated Dorey to inform a commercial radio audience “hundreds, possibly thousands of families had been compensated”, as a result of vaccines causing autism. You can chase more on it up here.

Kirby also mentions Hannah Poling as though it is a foregone conclusion she developed autism from vaccination. Hannah’s mitochondrial enzymatic deficit and many environmental factors may trigger the encephalopathy she was compensated for. Many children with her mitochondrial condition develop encephalopathy in the first two years of life. As is often the case when science meets law, evidence is challenged by other dynamics. In this case it was the tireless efforts of her parents.

Jon Poling a neurologist and his wife Terry Poling a nurse and lawyer unfortunately refer to their victory as a “landmark” in vaccine-autism compensation. Little wonder certain key documents now remain under seal in other cases, providing conspiracy fodder for the likes of Kirby.

Some of Kirby’s conspiratorial nonsense includes:

Some observers will say the vaccine-induced encephalopathy (brain disease) documented in both children is unrelated to their autism spectrum disorder (ASD). Others will say there is plenty of evidence to suggest otherwise. [...] Whether HHS agreed with Ryan’s parents that his vaccine-induced brain disease led to ASD is unknown. The concession document is under seal.

It looked like the family had a weak case.

But then something changed.

In October, 2010, Ryan’s attorney filed four new exhibits (under seal) and proposed amending the court’s “findings of fact.” [...]

Readers are supposed to conclude something dark and dastardly has occurred. Never mind Kirby actually repeats the fact that there is no evidence for his supposition.

Orac does a great job of knocking Kirby off and quite rightly refers to one jaw-dropper as “Grade A conspiracy mongering”. We’re asked to accept that Emily’s mother, Jillian Moller, is relaying a factual account when we read:

After the ASD diagnosis, the judge reportedly became convinced that Emily would prevail. “My attorney said she was angry, she felt forced into a corner with no choice but to find for us,” Moller said. “She said, ‘Emily has autism, and I don’t want to give other families who filed autism claims any hope.'”

One doesn’t expect any different from an attempt to amplify the long disproved, non-existent link between vaccines and autism from Meryl Dorey. Yet even amongst our most radical evidence denialists and defenders of alternatives to medicine, should not a PhD give pause to consult the facts? To at least, say, delineate between autism and PDD-NOS. Maintain a bit of fidelissima integritatum with one’s readers perchance?

Not for Dr. Peter Dingle it seems. He’d tweeted recently and placed the same conclusion in the lap of “the independent court”. Could it be? A fortnight later than Ms. Dorey’s effort the event was repeating itself? Surely there was a new story. But no. Doc Dingle had availed himself of Kirby’s caper and leaped to the same conclusion. With exactly the same HuffPost tweet. It was identical. It was… a dopellgänger!


On a serious note, the damage done by individuals such as Dingle perpetrating this myth is far from insignificant. It ignores the truth and does little for those in genuine need of compensation.

It is right and proper that children injured by vaccines are compensated. With brain damage rates of one in one million related to MMR of course we will see these cases. Yet for cases of measles infection the rates are one in one thousand. Of course there is no anti-vaccine compensation program.

Although differences are subtle, denying the evidence and etiology peculiar to vaccine injury and disability helps no-one. If we consider similar patients all presenting with Acquired Brain Injury, virtually identical symptoms yet various etiology it is easier to see the importance of this. Road trauma, stroke, near drowning, boxing or other sporting injury may all present identical motor, speech, memory and other lifestyle challenges. False links driven by ideology would rightly appear bizarre.

What we do know in these VCIP cases is that several million dollars have been awarded to each child.

Yet it was not because vaccines cause autism.

Scientific consensus is a myth and flu vaccine infects with influenza

I was astonished to read this tweet today from well known anti-vaccination identity, Meryl Dorey:

Certainly, I agree that science never “proves” anything. Mathematics and logic have “proofs”, but not science. Which is why scientific consensus provides us with invaluable insight into evidence that applies to matters of science. More so, it is the flexibility of scientific consensus that gives one confidence in science. Dorey’s proposed infinite loop of unending testing is a semantic trick, designed to convey a feel of impotent stasis.

Scientific consensus provides the best explanation from the very best and most reliable of all possible theories. It has after all, extended lifespan and quality in the developed world. Surely there must be more to this reworking of reality. Facebook rewarded my curiosity.

I see. Further application of what we consulted just recently. Meryl’s Equation: < 100% = 0%.

Thalidomide was a watershed in how drug trials are conducted. The tragedy forever changed the way trials proceed before drugs are released onto the market. Vioxx – Merck’s COX-2 inhibitor – is equally concerning. Yet Vioxx represents regulator apathy and a triumphant change in scientific consensus. The FDA approved it in April 1999 and it was recalled completely by Merck in September 2004. There was no “ignoring evidence that their consensus is wrong”.

I’m not seeking to whitewash either event but they do not render scientific consensus as a valuable and crucial notion, suddenly useless.

I imagine mentioning “mercury” is aiming to cast the removal of thimerosal from childhood vaccines, in response to unfounded fears and a drop vaccination rates, as evidence it was causally related to autism or other horrors. In fact, speaking of consensus this remains a topical point. Many insist it was foolish to pander to the anti-vaccine lobby as it may be abused to legitimise their false claims. Such is exactly what we see here.

Depending upon what it is confirming, scientific consensus may come under attack as its relationship to the scientific method is open to exploitation and abuse. Denial of anthropogenic climate change, vaccine efficacy and promotion of intelligent design (biblical creationism), rely heavily on trying to undermine the fact of overwhelming scientific consensus. A key weapon here is in producing “their” scientists to attack the work of others and advance a sham alternative.

The relationship between scientific consensus and the scientific method is perhaps poorly understood. Thus, it befalls us to educate ourselves about the sources of proposed consensus. And by that I really mean finding reputable sources and knowing how to spot disreputable sources. I found myself recently struggling to explain these notions to a friend.

In Australia a documentary aired called I can change your mind on climate change. Presenting both “sides” (denialist rehash vs evolving facts) it was followed by an episode of QandA that offered a terribly worded poll. The question was “Would you change your mind on climate change”? By itself, my answer to that question is an unhesitating Yes. Availed of convincing evidence and a change in consensus I have no problem answering that I “would”.

Yet I suspect the question was worded to be seen in the context of the programme. In which case it should have read “Would you change your mind on climate change given the pathetically, preposterous, piffle to poke at the periphery of your predisposition to weigh dissenting views?” Er… No.

Nonetheless I spent a futile half hour attempting to explain to my friend that whilst I need no convincing of anthropogenic climate change, those very views are important to me because of the relationship between the scientific method and scientific consensus. It is because the scientific method makes scientific consensus so potentially frail, that I back the notion of anthropogenic climate change.

So it is with any consensus arrived at within science. The scientific method is the weapon of choice with which consensus is changed. Little wonder then, an anti-vaccination crusader seeks to demean both.

Prior to this another tweet had caught my eye:

This is pure nonsense. Being infected with influenza is “one of the most common side effects” of vaccination against influenza? I think not.

In fact the NCIRS have a handy Fact Sheet on influenza vaccination. Influenza vaccines used in Australia are inactive. Influenza cells in vaccines cannot cause infection. They have lost their mojo.

As Julie Leask pointed out, in what a betting person might argue was the catalyst for Meryl’s merriment, only 1% – 10% of recipients report symptoms of mild infection for “a day or two”. In fact the article entitled Monday’s Medical Myth: the flu vaccine will give you influenza also noted other reasons for claims of inefficacy-by-infection.

  1. Anyone vaccinated might get another virus that feels like influenza.
  2. Some people’s immune system does not respond to the vaccine.
  3. Anyone vaccinated may get another strain of influenza.
  4. (As mentioned) less than 10% have mild flu-like symptoms for up to 48 hours.

Other strains of influenza exist because at the time production began, the vaccine strains targeted were calculated to be in circulation months later. This isn’t always correct. Combined with the other issues influenza vaccine is suboptimal. And suboptimal is manna for application of Meryl’s Equation.

Leask points out that we under-react to the risk of influenza. Costing Australia $115 million annually, it kills 3,000 and hospitalises over 13,500 people over 50 each season.

Nonetheless a visit to Facebook was a definite must.

Writing in Science-Based Medicine about problems associated with suboptimal flu vaccination Mark Crislip touches on “vaccine goofs” prone to Meryl’s Equation (<100% = 0%).

So it’s a suboptimal vaccine.  And that’s a problem. One, because it will make it more difficult to prove efficacy in clinical studies and two, there is a sub group of anti vaccine goofs who seem to require that vaccines either be perfect, with 100% efficacy and 100% safe, or they are not worth taking.

The CDC have this to say:

At least two factors play an important role in determining the likelihood that influenza vaccine will protect a person from influenza illness: 1) characteristics of the person being vaccinated (such as their age and health), and 2) the similarity or “match” between the influenza viruses in the vaccine and those spreading in the community. During years when the viruses in the vaccine and circulating viruses are not well matched, it’s possible that no benefit from vaccination may be observed. During years when the viruses in the vaccine and circulating viruses are very well matched, it’s possible to measure substantial benefits from vaccination in terms of preventing influenza illness.


[In older people] influenza vaccine is about 30– 40% effective in preventing symptoms of the flu, 50–60% effective against hospitalisation due to influenza, and 70– 80% effective against death from complications of  influenza. Influenza vaccination also appears to reduce the risk of heart attacks and strokes. When there  is a good match between the influenza strains in the vaccine and those causing current disease, the vaccine can prevent illness in about 70–90% of healthy children and adults. The vaccine is less effective in those with an impaired immune system

Certainly then there is no evidence that the influenza vaccine doesn’t work or as claimed, “causes the flu”.

I don’t quite know what sparked this most recent attack on “skeptics” and science in general but I would hope to see better from a so-called “health educator” able to raise funds as a charity.

For now the scientific consensus is sound and overwhelmingly in favour of mass vaccination.

Vaccine Package Inserts: Not all you should be reading

If the AVN do make it to Canberra during this first quarter, “to lobby for changes to Federal legislation protecting the rights of Australians to choose not to vaccinate or to vaccinate selectively”, I’ll be particularly interested in the worth of item 5 on their list:

All parents to be provided with the manufacturer’s package inserts to the vaccines they are supposed to be giving their children with the ingredients, side effects and contraindications highlighted. We want this information to be provided well in advance of them having to make these decisions to allow them time to ask their healthcare providers questions about both safety and efficacy.

Of what possible use is this complex clinically relevant information to parents who need advice on vaccination? How often have we heard antivaccination lobbyists rattle off the worst of the worst as if they are guaranteed in all cases? Just who will these opportunistic “healthcare providers” be who finally chat with the wide eyed terrified parents thinking of an alternative? This particularly immoral intent of Meryl Dorey’s overall scheme to sabotage vaccination in Australia is born of connivance of such intellectual paucity as to demand it be placed in context.

Assuming Meryl will be flying to Canberra, let’s imagine for a moment, it is not vaccination but air travel that’s being targetted as dangerous and thus in need of informing passengers of all “adverse side effects” to flying. This becomes compelling when we note that deaths from MMR and attributed to DTap vaccination remain at zero. Studies examining the that myth DTap – or any vaccination – is related to SIDS found the rate of SIDS in those recently vaccinated was equal to chance.

Around 1990 Hannah Buxton was injected with contaminated MMR. 18 months later she was dead due to the contaminants not MMR, and her parents were awarded £20,000. A BMJ article (also citing Hannah) published in September 1994 notes over 100 families had won the right to seek compensation for the death and disability of their children following MMR. In the 1990’s vaccines were looking like big business for injury compensation lawyers and this BMJ article is cited as desperate “proof” of MMR fatality. Yet that’s a distortion of the truth. No fatalities have been attributed to MMR. Encephalitis from vaccination is so rare and from measles comparatively so common that to refuse MMR on these grounds is to be grossly misinformed.

Let’s imagine if an airline took this “package insert” logic seriously and chose to inform all passengers of all risks prior to flying. We’ll exclude specifics like metal fatigue and focus on injury and death. To cover “discussion” with a healthcare professional they might add descriptive accounts of what happens to passengers involved in accidents. It could be worked in to the pre flight briefing.

Here’s my proposed “report”, using entirely accurate information and statistics, of flying with such an airline. Airlines that believe in informed choice. Let’s say I’m in need of a decently priced flight, scanning the internet for a bargain…


One caught my eye. Package Insert Airlines: Where Informed Choice Matters. “Strange”, I thought. I called the number and spoke to the charming lass on the other end. Yes, they had a seat going my way at exactly the time I needed it. Good price too. Just before I hung up, I asked about the name. She explained to me that the airline had been set up by a small consortium who made their fortune printing vaccine package inserts.

“Before take off we explain everything you need to know about your safety and flying”, she gushed happily, “so you can make an informed choice about staying on board”. Wow. Sounded generous. I packed a quick bag and headed off.

After booking in I had a while to wait but before I found an uncomfortable chair, we were paged to start boarding. It didn’t take long for the airliner to fill up. A few moments later an air hostess with a name badge reading Johanna took her position as the standard safety recording started. She pointed out the exits and toilets then, keeping up with the recording, helped demonstrate the possible effects of crashing on take off.

16% of on board fatalities occur during take off, the recording informed us pleasantly. Passengers are usually burned horrifically beyond recognition in a giant fireball. The unspeakable agony felt by those not immediately toasted is at times expressed in blood curdling screams but this is hampered by inhaled high temperature air igniting throat, larynx and lung tissue, poisonous gases and melting facial tissue, particularly the nose, lips and tongue. Loved ones in the terminal are ensured an excellent view. 

Johanna did her best to imitate writhing dying passengers with melting faces, finally letting out a high pitched scream and then finished with a pleasant smile. The recording continued. 14% of onboard fatalities occur during the initial climb, usually due to catastrophic systems failure. Cabin staff will wander by lying to you that everything is just fine. The pilots are trained to try to guide the highly explosive jet-fuel filled plane in for an emergency landing. You will guess something horrible is wrong and the plane will veer dramatically as we return to the tarmac. Johanna gestured pleasantly out the window, smiling all the time.

The angle of descent will be simply horrific, the recording went on. The fuselage and wings will shudder under the force of descent and you will be convinced you are about to die. Passengers must remain seated, but may pray, swear, scream and make hurried calls to loved ones not in the terminal. Due to the extreme strain placed upon the aircraft systems, small fires may well break out burning, choking and gagging you. Any fires near the fuel tanks may result in a catastrophic explosion creating quite a spectacle. Your loved ones in the terminal will have an excellent view of something like this. Johanna turned to point at a large image that had come up on the screen behind her:

Assuming we do not make it in for a safe emergency landing there is information available in small packages on the back of the seat in front of you. Please remove package insert one, instructed the recording. “Ah, Package Insert Airlines“, I mused staring at a bunch of information I couldn’t really understand. Surely this was written for scientists, or experts in this field. It was about G forces and deceleration and how much energy the cabin would absorb.

Please turn to Table One said the pleasant recording as Johanna held up an example of Table One:

Assuming we will be crash landing and not emergency landing you should familarise yourself with the pain and suffering that possibly awaits. As we observe, up to a 40G deceleration may result in nasal fracture, compression of a vertebral body (the bones of your spine), a broken lower jaw or a fracture dislocation of the top most bone of your spine – on which rests your skull – on the vertebral bone beneath. The classic “hinge fracture”. At this point any sudden or unnecessary movement as opposed to say, lying motionless, will sever your spinal cord leaving you paralysed for life. Except for your facial muscles.

Johanna beamed and highlighted her face like she was selling moisturiser. The recording continued with the Johanna doing her best to imitate horribly injured and dying passengers. “Around 50G the maxilla, or front of your face, breaks up and may pierce the skin of the face, but will certainly lacerate the upper mucosa of the lip and cheek. Bleeding will be profound. The major vessel carrying blood to and from the heart spontaneously sprouts big leaks and that can be bad.

Above 80G it just rips open and blood quickly fills your thorax or abdomen, choking you in a grotesque display of gurgling and gasping as blood forces it’s way out from the lungs to the mouth and nose. Johanna was writhing dramatically upside down over the back of a seat gagging and snotting like a trooper. Your bladder and bowel, the recording went on, if not having done so already, will empty spontaneously and dramatically. Please remain seated. I looked at Johanna expectantly but she gave a gentle shake of her head.

 Above this level as we enter 100G plus, the pelvis will fracture of it’s own accord. Please refer to package insert 1A for information on how crucial the pelvis is for ambulation, spinal health, organ protection, core stability, bladder and bowel, sexual health, reproduction, sitting comfortably… on and on it went covering every tiny detail of a fractured pelvis, pain, rehabilitation and permanent disability. People had for some time been leaving in ones and twos. A mother grabbed her baby and screamed that we were all insane before sobbing her way off the plane. I was starting to forget exactly what I was doing here myself.

Vertebral body transection means the bones of your spinal column split transversely and slice front to back or back to front, with part of the vertebra slicing through the spinal cord. This can occur at multiple points. It is important to remember, the recording intoned, that these injuries are not exclusive. So a crash landing deceleration at around 200G may include a fractured nose with the front of your face crumbling off but stuck under the skin, vertebral compression and transection with almost certain quadriplegia or paraplegia, your insides filled with blood that you gurgle and splatter from your nose and mouth and a shattered pelvis, leaving you to wallow in your own waste, until you die are burned or perhaps rescued to begin your life as a permanent patient.

Johanna had been mimicking at extraordinary speed, pulling grotesque faces, shuddering with vertebral injuries, shaking her head violently back and forth working up to a grand finale in which she gasped wide eyed, spluttered and with tongue hanging out collapsed in a heap on the aisle floor, twitching and writhing. Those of us not vomiting into the sick bags broke into a round of applause. She stood up beaming, adjusting her hair. Thinking this must surely be the end of a compelling but pointless exercise a few of us settled down until, horribly, the recording started again.

13% of fatalities occur during the latter stage of the climb once flaps have been raised. Please open package insert 2 and note injuries, suffering and death are much the same as for the initial initial phase of climb. You will note on package insert 2A we have included Total Body Fragmentation which applies to both failed ascent and descent and is pretty much what it sounds like, the soothing voice continued. We shall cover this in due course but it is important to stress that you may be killed during the latter part of ascent.

Once at cruising altitude you may be comforted to know that only 16% of fatalities occur up there in the cold, cold air. Although the same quantity as take off fatalities you may feel assured that on average, 57% of flight time for a 1.5 hour flight is spent cruising. Package insert 3 covers uncontrolled decompression. For our purposes please note Explosive and Rapid cabin decompression effects upon the body which you may experience alone or in tandem with high altitude injuries and hypothermia.

Should a large hole appear in the fuselage, perhaps due to a bomb, maintenance failure, metal fatigue, cargo door failure or just really bad luck passengers may expect explosive decompression. Contrary to the urban myth your body will not “blow up” killing you instantly and painlessly. As air escapes from the cabin in about half a second it will suck all the air from your lungs rupturing pulmonary tissue whilst you find it impossible to inhale as blood flows freely from your mouth and nose.

An extraordinarily rapid heart beat will only make this worse. Try try remain calm. Oxygen masks will drop down in front of you. Of such little pressure, they are useless and serve only to distract you in your final moments of life which are excruciatingly painful and unimaginably terrifying. Please keep an eye out for flying passengers, body parts or projectiles which will hit you with the force of bomb fragments, or slice, rip and tear your body into pieces.

As the freezing air fills the cabin the relative humidity changes rapidly, causing a dense fog to form. Depending on your distance from the cause of decompression, Johanna gestured to the front and back of the plane, you may experience the effects of rapid, not explosive cabin decompression. Blood and lung tissue is less likely to splatter in your vicinity although lung tissue damage to yourself and others is still likely. The further from the cause of decompression and the better restrained the more adverse reactions that can be expected over time and the more painful your slower demise.

Should you be unfortunate enough to be seated or standing near the decompression zone you will exit the aircraft at high speed experiencing physical decompression, pulmonary damage and bleeding, retinal bleeding, hypothermia, edema, numbness, wind sheer and insomnia. As you plunge toward the earth you may reach speeds that tear clothes, hair and skin from the body.

For those still on board, hypothermia sets in within a few minutes but not before hypoxia begins to kill off brain cells and precipitate organ failure. As you lapse in and out of consciousness you may notice the frozen vomit blocking the blood and pulmonary edema discharge from escaping the oral cavity. Limbs, hands and feet begin to swell as fluid escapes the blood stream and lymph vessels to build up in the tissues. Your retinas may hemorrhage as your body temperature rises to fever levels. Cerebral edema will creep up on you the longer you find the captain is able to control the plane through an interminably long descent. This brain swelling will lead to blinding headaches and more lapses into unconsciousness as life threatening hypothermia sets in. 

The recording continued on like this for a while with Johanna diving and falling and rolling about the cabin. She pleasantly gestured to where body parts are most likely to become wedged, and gave a realistic impression of someone trying unsuccessfully to breathe through the drop down oxygen masks. She sat in the seats most likely to accompany decapitation given the chosen place of decompression and managed a sterling performance as a hysterical young mother trying hopelessly to stop her toddler from being sucked out of an imaginary gaping hole in the fuselage.

I couldn’t see the point to all this convoluted intricate information. I suspected it had some legal purpose but I was 19 times less likely to die like this than in the car I drove to the airport. I couldn’t imagine the stupidity involved in thinking such highly specific and biased information had any bearing on flying whatsoever, beyond creating the illusion there was something to fear.

I tuned back in at times as this marathon of irrelevance continued to inform me that another 16% of fatalities occurred during descent and initial approach. 25% occurred during final approach and landing. Then they got onto multiple injury specifics. 45% of intact (Intact?!) fatalities had a spinal fracture. 47.6% of accident victims had a ruptured heart and 35% also had a ruptured aorta. Only 20% of fatalities don’t have limb fractures the recording pleasantly informed us adding that a sound knowledge of Total Body Fragmentation would help us make an informed choice.

Thorax injuries were the most common. Liver, spleen, diaphragm. GI tract injuries were the least common. Skull, brain and facial destruction was very common. Great I thought. Your turds survive but your brain is mash. Neck, spine, wrist, femur, humorous, tibia… then combinations… and fatalities… until I couldn’t think much beyond Total Body Fragmentation sucks man. “Flying Causes Total Body Fragmentation”, I wanted to yell. Which free speech suppressing scientists had been holding back such vital information? I needed to know this, didn’t I? I couldn’t just trust one of the most successful, safest industries in the world, could I?

Then I realised something. Total Body Fragmentation was an incredible rarity. So were aviation accidents. It was Informed Choice that really sucked, and looking around it had emptied a good deal of the plane, having filled people’s heads with nonsense.

I hoped they weren’t driving home.


So, dear reader. If you’ll pardon the foray you can appreciate just how nonsensical this obsession with package inserts is. There is however, a sinister side to this apparent “information”. As I hinted at above, using it to educate people is fatally flawed. Parents need to know about the probability of adverse events of all types, including disease affecting their children. The fact that extreme events are possible is completely irrelevant to making an informed choice.

It’s simple mum. MMR does not kill and measles is 1,000 times more likely to leave your child with irreparable brain damage. If they must, parents need to speak to a doctor about this information, not be lured into panicked confusion. Dorey’s request is just as much a statement: You are not being given safe advice. And that, is an outright lie.

Yet there’s more to consider. As I note above studies have been done on the myth of vaccine induced SIDS. This is not on package inserts, nor is Shaken Baby Syndrome. Yet Dorey insists both these causes (and others) of death are side effects of vaccination. Toxic poisoning without “prior testing on infants” is happening right now via vaccination, she claims.

In her mind extremely rare possibilities must be advertised as likely probabilities. As must a growing number of invented fictions: immune disorders, failure to thrive, leaking intestines, heavy metal build up, slow learning and almost any ailment is blamed on vaccines, water or medication. So if she is granted her wish by chance, it will only be the beginning.

Yet importantly I set out above to highlight what we take for granted. The fear of flying is considered irrational. A phobia. In short Dorey seeks to propagate a phobic fear of vaccines that will cripple critical and safe decision making.

Meryl Dorey is well aware that “informed choice” is really “Meryl’s choice”. It is not free speech, but plain deception.

Parents deserve facts, not irrational fear.

Risk From Disease vs Risk From Vaccine


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