Measles in Samoa: Thank the anti-vaccination lobby

The manner in which members of the anti-vaccination lobby have leapt upon the measles tragedy in Samoa identifies their awful, predatory cult quite well.

To completely understand why anti-vaccine activists promote such intellectually vicious lies and indeed hatred regarding an epidemic that Samoa has labelled a state of emergency I’d argue we need to first look back. Back to July last year when headlines reported the deaths of two infants following the MMR vaccination. Or rather, what we now know was thought to be MMR vaccine. We need to look back dear reader because antivaccinationists reacted in an “I told ya so” manner that was almost glee.

Despite there never being a recorded death due to vaccination or a vaccine in Australia, anti-vax profiteers who have peddled lies for years contend that death and disability after vaccination not only happens but are widespread. A vaccinologist was quoted in evidence to the No Jab No Pay Bill hearing that in Australian injuries serious enough to require compensation range between zero and five per year. I do apologise for referring to that occasion yet again. I also recommend the government publication Questions About Vaccination.

We must look back because regrettably it was the bogus causation peddled by anti-vax identities that gave them the confidence to begin commenting on this measles outbreak that hit Samoa in October this year (2019). As for facts, genuine health professionals and epidemiologists would be familiar with adulterated, out of date and counterfeit medications and vaccines causing harm in nations with health systems and infrastructure less developed than in New Zealand or Australia. Yet these events occur far less today due to safety procedures instigated across the globe.

Following investigations into the infant deaths in Samoa evidence was collated concluding “a tragic outcome from error preparing MMR vaccine”. The Immunisation Advisory Centre of New Zealand reports;

On 4 June 2019, both nurses pleaded guilty to negligence causing manslaughter. On 2 August, both nurses were sentenced to five years in prison. During the sentencing hearing, it was confirmed that one of the nurses mixed the MMR vaccine powder with expired muscle relaxant anaesthetic instead of water for injection supplied in a vial with the vaccine. Eight Samoan speaking New Zealand nurses visited Samoa in June to provide training for vaccinating nurses at district hospitals.

The same reference informs us there has never been a death associated with this vaccine in N.Z. It also has a helpful timeline and includes under August 3rd;

Report on RNZ website: The two nurses, who pleaded guilty to negligence causing the manslaughter of two infants, have been sentenced to five years in prison.

The Samoa Observer published a detailed account of the sentencing hearing, where it was confirmed that one of the nurses mixed the MMR vaccine powder with expired muscle relaxant anaesthetic instead of water for injection supplied in a vial with the vaccine.

The entire event effected parent confidence in immunisation. These doubts were magnified by antivaccinationists resulting in a further realisation of their aim: a reduction in vaccination. The Guardian recently reported that the WHO blames the “anti-vaccine scare” for the rise in cases and of course deaths. Kate O’Brien, director of the WHO immunisation department stressed that the rapid spread of measles in Samoa was due to the “very low coverage” of immunisation.

This resulted in the temporary suspension of the country’s immunisation programme and dented parents’ trust in the vaccine, even though it later turned out the deaths were caused by other medicines that were incorrectly administered.

O’Brien said that an anti-vaccine group had been stoking these fears further with a social media campaign, lamenting that “this is now being measured in the lives of children who have died in the course of this outbreak”.

Misinformation about the safety of vaccines, she said, “has had a very remarkable impact on the immunisation programme” in Samoa.

At least 42 fatalities can be attributed to this measles epidemic at time of writing. In the video below anti-vaxxer identity Taylor Winterstein is mentioned as having visited Samoa in June with diehard anti-vaxxer Robert Kennedy Jnr. Winterstein described herself as “pro-science” the narrator tells us. Oh, my.

Please spend some time reading up on this woman who is presently making a living scamming Wellness devotees and the ill out of their money.

Given the harrowing situation in Samoa and the speed at which measles morbidity and mortality is increasing the government has made the measles vaccine compulsory and warned those preventing community members from being vaccinated to stop.

Such as Fritz Alaiasa Neufelt, the oh-so-savvy businessman selling filtered tap water as the measles fighting “Kangen Water”. Lying as he plays with the lives of ill Samoans he claims that after a spray of his magic water;

“They’re feeling good,” he said. “The measles are already … not cured, but it’s already back to normal”.

The ABC recently reported that the “pro-science” Winterstein was a tad concerned about the governments position. No, not the position of vile Fritz spraying measles sufferers like office plants but the government.

In fact her rational, objective, pro-science mind has applied Godwin’s Law. The ABC cite her calm demeanor;

… Australian-Samoan influencer Taylor Winterstein made recent posts on Facebook and Instagram comparing Samoa’s compulsory vaccination program as akin to “Nazi Germany”.

“Forcing a medical procedure on an entire country, especially one that is proving to be ineffective, dangerous and making the virus more deadly, is straight up barbaric,” she wrote on Facebook.

So um, check it out, right. A “pro-science”, so-called “influencer” who peddles herself as a health guru has a tantrum claiming that the only known safe and effective preventative for measles is “proving to be ineffective, dangerous and making the virus more deadly”. And yeah, Nazi Germany. Pfft. Oh I’m influenced Tay. Trust me.

I’d say you can’t make this stuff up but that’s exactly what they do. Consider the increase in cases below and the time frame it covers.

© Source: virologydownunder.com

Data: Samoan Government Facebook and Ministry of Health websites and media comments. Last update 27/11/19

Preparation: Ian M. Mackay, PhD

Immunisation rates were previously far higher in Samoa. Four years ago MMR coverage was 84%. By 2017 it had already dropped to 60%. Last year (2018) it had fallen to 31%.

There is no doubt. A drop in MMR vaccination has brought Samoa to a tragedy of shocking proportions. Two doses of MMR is the recommended, clearly life saving, dose.

But still, Meryl Dorey of The Australian Vaccination Risks Network tweeted this dishonest evidence free nonsense (left) just recently. Just as Winterstein pushes the piffle that the vaccine makes the virus more deadly, Dorey tries to convince her cult that malpractice is the cause.

I would urge Meryl Dorey to have another look above at the facts and follow some of the links. Revisit what is known about these deaths. Understand that it was not the expected MMR vaccine they received before dying.

Accept two nurses are now serving five years in prison for negligence. Know it was a negligent error in preparing the adulterated mixture that led to the deaths, then an eight month suspension of MMR. Admit the facts, admit the reality. Stop your lies.

Stop your negligence.

Black Salve – The Pro-Necrotic Agent

Last April Questions for Pseudoscience published an informative video on the very nasty, dangerous, bogus skin cancer “treatment” known generally as Black Salve.

Main points might be summed up as;

  • It isn’t anti-tumour cream.
  • It is anti-skin cream.
  • It kills tissue via the caustic salt zinc chloride (listed by the FDA as a fake skin cancer treatment) and sanguinarine (a toxic alkaloid).
  • The combination of zinc chloride and sanguinarine is “incredibly lethal to living tissue”.
  • Apart from burning skin due to its caustic nature zinc chloride adversely effects other body organs and systems (eyes, G.I. tract, lungs).
  • Sanguinarine blocks sodium potassium pumps located in the cell membrane, killing cells.
  • The ridiculous myth peddled by proponents of Black Salve is that cell death can be controlled by removing the salve at just the right time so that only cancer cells are effected.
  • However once begun the process continues leading to widespread necrosis. As cells die, enzymes are released leading to the breakdown of neighbouring cell membranes.
  • A domino effect follows leading to widespread cell death.
  • Thus Black Salve is really a Pro-Necrotic Agent and will kill any tissue it comes into contact with.

In March 2012 we visited the issue of AVN selling the One Answer To Cancer DVD – a blatantly bogus promotion of Black Salve. The post included the banning of this dangerous product by Australia’s TGA, (Therapeutic Goods Administration).

The TGA at that time issued a warning on Black Salve, which was covered by the ABC’s The World Today.

  • Listen to the audio in the player below;

-———

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Australians deserve no-nonsense regulation of chiropractors

Andrew Arnold, the Melbourne based chiropractor whose manipulation of the spine of a two week old infant was described as “deeply disturbing” by the Victorian health minister is presently refraining from treating anyone under 12 years of age.

The ABC reported just over a week ago that health minister Jenny Mikakos also said in part;

It’s appalling that young children and infants are being exposed to potential harm. That’s why I’ve written to the Chiropractic Board of Australia and AHPRA (the Australian Health Practitioner Regulation Agency) to urge them to take the necessary action. There is nothing at the moment that prevents chiropractors from undertaking these risky practices… The advice that I’ve received is that the risk of undertaking spinal manipulation on small infants far outweighs any perceived benefit.

It’s worth noting that chiropractic treatment in general and the manipulation of infants specifically has a history of drawing harsh criticism from health and medical professionals and penalties from regulators. Fairfax reported in December 2011, Doctors take aim at chiropractors. One wonders at the lack of a cogent response to such serious statements from reputable professionals.

The inclusion of a chiropractic course at Central Queensland University prompted 34 scientists, professors and doctors to note federal government funding “gave their ‘pseudoscience’ credibility”. Fairfax reported that their statement included;

…it was also disturbing that some chiropractors spruiked the adjustment of children’s spines for many potentially serious conditions including fever, colic, allergies, asthma, hearing loss and learning disorders.

…the doctors said they were also concerned about chiropractors being the largest ”professional” group in the anti-vaccination network. [Now named The Australian Vaccination Risks Network]

At the time Australian Chiropractors Association president Lawrence Tassell responded by saying the criticism was ridiculous and misinformed. He further contended chiropractic was “evidence-based, including its use on children for the treatment of conditions such as colic.”

Note: The Australian Chiropractors Association was originally The Chiropractic Association of Australia (CAA). [Wikipedia]

Just colic? Was this an admission that fever, asthma, hearing loss, all allergies and all learning disorders did not benefit from chiropractic despite promotional claims that they did? Even so the question of evidence supporting chiropractic for the treatment of colic (crying) was not as Tassell suggested. Months later a Cochrane review consulted research into that very issue.

Conclusions note;

The studies included in this meta-analysis were generally small and methodologically prone to bias, which makes it impossible to arrive at a definitive conclusion about the effectiveness of manipulative therapies for infantile colic.

…most studies had a high risk of performance bias due to the fact that the assessors (parents) were not blind to who had received the intervention. When combining only those trials with a low risk of such performance bias, the results did not reach statistical significance.

This brings to mind criticism of anti-scientific training and ideological dogma favoured by what John Reggars calls fundamentalists. Reggars is past president of the Chiropractors Registration Board of Victoria and past vice president of the Chiropractic and Osteopathic College of Australasia.

In May 2011 Chiropractic and Manual Therapies published Reggars’ wonderfully honest and revealing article, Chiropractic at the crossroads or are we just going around in circles? Reggars is a firm proponent of evidence based therapy. As such he criticises the vertebral subluxation complex and B.J. Palmer’s notion of “dis-ease”. Consider this gem of a paragraph;

The irony of this fervent belief in the VSC and chiropractic philosophy is that its development was not founded on vitalistic theory but rather as a legal strategy, conjured up by an attorney, in the defence of a chiropractor charged with practicing medicine [7, 32, 33]: “Many in chiropractic never learned the origin of the pseudo-religion or chiropractic philosophy. It was nothing more than a legal tactic used in the Morriubo’s case.”[34], and “B.J. Palmer probably developed his disease theory as a result of the winning strategy used by his attorney Thomas Morris to defend Japanese chiropractor Shegatoro Morijubo in Wisconsin in 1907″[35].

– Author’s citations in place.

Reggars also concluded that the Chiropractic Association of Australia (CAA) abandoned science for fundamentalist ideologies. He observed that their “all-encompassing alternative system of healthcare is both misguided and irrational”.

Readers are handed the reality of what chiropractors genuinely offer;

Chiropractic trade publications and so-called educational seminar promotion material often abound with advertisements of how practitioners can effectively sell the VSC to an ignorant public. Phrases such as “double your income”, “attract new patients” and “keep your patients longer in care”, are common enticements for chiropractors to attend technique and practice management seminars.

Selling such concepts as lifetime chiropractic care, the use contracts of care, the misuse of diagnostic equipment such as thermography and surface electromyography and the x-raying of every new patient, all contribute to our poor reputation, public distrust and official complaints. […]

And;
For the true believer, the naive practitioner or undergraduate chiropractic student who accepts in good faith the propaganda and pseudoscience peddled by the VSC teachers, mentors and professional organisations, the result is the same, a sense of belonging and an unshakable and unwavering faith in their ideology.

Back in June 2016 Ian Rossborough published a similar video which also drew strong condemnation. The Australian Health Practitioner Regulation Agency (AHPRA) responded by banning him from manipulating the spines of children under six.

It is difficult to watch Andrew Arnold “manipulate” an infant. Yes a baby is distressed and crying. But it’s the manipulation of the parents I also find appalling.

Grabbing the infant’s feet he announces “I’m locking in here”. Really? He lifts the baby offering verbal distractions. “I’m just gunna go upside down for a second… yep and as we go back down just hold his head… Perfect!” Then comes the stick-that-goes-click. Or as chiropractors call it, the Activator. A spring loaded device which delivers an “impulse”. He demonstrates the lowest setting and releases it into what seems to be the right side of the infants cervical spine. Another still image (below) shows Arnold apparently applying the activator to the infants upper cervical spine at the base of the skull.

The application of the activator as seen in the video hurts or distresses the infant immediately and he begins to cry. “…and he’s going to squawk a bit”, Arnold offers as if he planned and expected this all along. Then, he does it again! And guess what? More crying. “Sorry mate” he offers for the parent’s sake. He checks the collar bones “…cause they get a bit crunched up inside”. He checks potential for collar bone crunching by moving the infants hand. “So with this, start to get in the habit of getting a grip here”, and the video finishes with what appears to be reference to the Palmer grasp aka Darwinian reflex.

This reflex in which babies grip fingers develops around three months of age. I do hope Andrew Arnold informed the parents of this. Then again, I hope someone informed Andrew Arnold of this.

There’s little doubt we’re slow to not merely evaluate most chiropractic therapy and indeed most chiropractors as offering nothing more than pseudoscience. That so people many in developed nations believe their demonstrably preposterous claims about treatment is quite surprising. With the amount of pseudoscience and junk medicine accessible online it is little wonder parents will fall for chiropractic claims about treating infants.

Chiropractic clients should be informed that mild to moderate adverse effects are frequently associated with manipulation of the upper spine in adults. Dissection of the vertebral artery and stroke may also occur. [Source]. It’s difficult to imagine more than a very few parents would be comfortable having infants, babies and young children treated if aware of this situation.

A 2008 study found there was very little supporting evidence for the claims chiropractors made regarding pediatric treatment. A 2007 systematic review found that serious adverse effects may be associated with pediatric spinal manipulation. However observation data could not support conclusions on incidence or causation.

It remains firmly demonstrable that evidence to sustain even a fraction of claims made by chiropractors as to how effective pediatric treatment is remains absent. The fact chiropractors themselves have not pursued large scale randomised controlled trials with a vigor akin to that with which they claim an ability to heal is concerning.

I have no doubt there are chiropractors who do strive to follow an evidence based approach to treatment. Yet with some influential chiropractors labelling this approach as out of date in favour of the approach of D.D. Palmer’s 19th century vitalism, they face a struggle to be heard.

As John Reggars noted since the adoption of the fundamentalist approach and application of the vertebral subluxation complex (VSC), chiropractic in Australia has taken a backward step. Chiropractors have abandoned a “scientific and evidence based approach to practice for one founded on ideological dogma”.

Australians are entitled to be protected from expensive, dangerous pseudoscience in the health industry. At present we are faced with regulators who need to develop some rather sharp teeth and make a meal of chiropractic pseudoscience.

 

♣ (4/3/19) NB: Colic may refer to severe abdominal pain caused by an intestinal blockage or gas. Infants are prone to the condition, responding with constant crying. In fact crying is the means by which “colicky” babies are diagnosed. Paediatricians may use the “rule of threes” in diagnosis, particularly items 2-4.

  1. Crying begins at around 3 weeks of age.
  2. Crying for more than 3 hours.
  3. Crying on more than 3 days per week.
  4. Crying this way for more than 3 weeks.

Because crying is what determines infantile colic there is ample disagreement as to the role of intestinal pain or even if colic itself is a myth. Other criticisms involve the convenient use of colic as a diagnosis for excessive crying.

Reading;

Seven Ways to Identify Pseudoscience

Original seven ways – © Relatively Interesting

  • The use of psychobabble – words that sound scientific and professional but are used incorrectly, or in a misleading manner;

Self-help books, folk and pop psychology, and motivational seminars often use psychobabble.  Deepak Chopra is a name that comes to mind at present. Nothing more than a fraud according to Professor Jerry Coyne, one may delight in the Wisdom of Chopra which is a Twitter stream made up of seeming quotes that are randomly generated by words that can be found in his genuine Twitter stream. If anybody breathes prescient life into the words of the late Carl Sagan it is the scoundrel and intellectual mobster Deepak Chopra.

Sagan proffered;

I worry that, especially as the Millennium edges nearer, pseudo-science and superstition will seem year by year more tempting, the siren song of unreason more sonorous and attractive.

  • A substantial reliance on anecdotal evidence;

Without a doubt the alternatives to medicine behemoth would be lost without dramatic tales of self-limiting illnesses merely running their course, or completely false or hugely exaggerated stories of serious, disabling or terminal disease executing an about face due to the power of some wonderful concoction. The frustrating hurdle here for those who promote reason is that almost all work undertaken to convince the patient occurs in their own mind. Scam artists from peddlers of herbs to chiropractors, Baptist religions and indeed even the Catholic Church are swift to take credit if they have been involved.

  • Extraordinary claims in the absence of extraordinary evidence;

From 9/11 being an inside job to images of the apparent exhumation of giant skeletons to alien autopsy videos and shaky vision of UFOs drifting across a grainy background it seems all these and other extraordinary claims have one thing in common. A powerful need to believe in their truth by those that ensure certain – in fact sometimes many – conspiracy theories indeed exist. Now thanks to Netflix we can wander through a range of delightful titles that offer everything from reasonable special effects to WW2 era reports and “experts” convinced our governments expect us to believe the laws of physics have been broken.

  • Claims which cannot be proven false;

Insisting oneself or perhaps a number of people in the world have communicated telepathically at infrequent and random intervals with aliens from a distant star is impossible to disprove on face value. The claimant can continue to insist he/she is unaware of who the other telepathic human recipients are, or when he/she will receive or has received a communication. The communication may be quite benign such as, “Happy Birthday Deepak”.

Ideally the burden of proof should be placed on the party making the claim.

  • Claims that counter established scientific fact;

Often going hand in hand with claims that rely on anecdotal evidence are those that defy scientific fact. Homeopathy stands atop the podium in this regard. Not only is it absolutely certain to not work but its adherents may insist on relaying impossible tales – often knowing they are outright lies – to besmear evidence based medicine and promote junk, bogus cures. For example pertussis (or Whooping Cough) is sometimes referred to as “the 100 day cough”. Prominent Australian antivaccinationist Meryl Dorey claimed on national TV both her vaccinated and unvaccinated children “got it”. She treated it homeopathically and “none of us were sick for more than two weeks and it was nothing worse than a bad cough”.

Countering established fact may be said of an enormous number of claims made about pseudoscientific “cures” for many ailments. Some treat energy meridians or “chakras” that don’t actually exist. These involve peddling herbs, acupuncture, acupressure, chiropractic, osteopathy, chanting, cupping, aligning activities with moon cycles, astrology and more.

Without a doubt denial of anthropogenic climate change should be mentioned here and we might again reflect upon to Carl Sagan’s worrying prediction.

  • Absence of adequate peer review;

In 2015 antivaccinationist and critic of vaccine science Judy Wilyman, under the auspicies of antivaccinationist and conspiracy sympathiser Dr. Brian Martin, finished her PhD at the University of Wollongong. The controversy surrounding inadequate peer review between 2012 to 2016 and indeed until today is a function of the copious inaccuracies in her thesis. Entitled “A critical analysis of the Australian Government’s rationale for its vaccination policy”, it was an immature an inaccurate antivaccination conspiracy rant. The fact that it was accepted, and indeed accepted with its discredited bibliography, indicates a clear absence of adequate peer review.

Tragically this eventuality has emboldened Wilyman to demand respect from academics and to level outrageous personal claims at her critics, rather than attempt to publish respectable material.

  • Claims that are repeated despite being refuted;

Whilst a great deal of the above intellectual repugnance deserves a slice of this pie, the authors at Relatively Interesting have populated it with the anti-vaccination obsession with the globally damaging claim that vaccines cause autism. Originally at a 1998 media conference designed to reassure parents, head author of the now rejected paper Andrew Wakefield proffered the baseless claim that rather than use the MMR trivalent vaccine, parents should consider choosing single shot vaccines. The “vaccines cause autism” claim has not only been shown to be false and cannot be replicated, but it is now well established that Wakefield acted with the sole aim of making tens and probably hundreds of millions of pounds via his plan to establish immuno-analysis laboratories for the new condition he was calling autistic enterocolitis. He also held patents for single shot measles, mumps and rubella vaccines.

A five member General Medical Council panel found Wakefield guilty of over 30 charges including 12 of causing children to endure “clinically unjustified” invasive testing procedures, buying blood at children’s birthday parties and managing four counts of dishonesty. Then, his “continued lack of insight” into his conduct, and consequences thereof, meant that only “total erasure” from the medical register was warranted. Today on the back of countless refutations of Wakefields claims he now pushes the fraudumentary Vaxxed full of false information and complete with the tampered audio of phone conversations.

Regrettably today more than in recent years we can benefit from keeping an eye out for these seven markers of pseudo-science.

Evidence absent for The Northern Star’s support of Olivia Odey

Update October 9th – ABC Media Watch, Northern Star HPV headline wrong

Just under a week ago The Northern Star published a one sided article alleging that a healthy 16 year old female was stricken with a host of physical ailments following administration of “the Gardasil vaccine”.

This specific claim is unverified in that conclusive evidence or clinical diagnoses pointing to Gardasil are absent. More so, from the viewpoint of international epidemiology, the two complex syndromes identified are not accepted as vaccine injuries caused by Gardasil. Toward the end of the article, Teen left in wheelchair after Gardasil HPV ‘reaction’, readers are informed that Olivia Odey (now 18);

…believes her symptoms were linked to a reaction to the Gardasil vaccine against cervical cancer, which the teenager had a few weeks prior to the onset of her symptoms.

No doubt given the weight of peer reviewed literature on the topic, and evidence offered in the article, Ms. Odey is indeed left with only her “belief”. Initially after presenting to hospital, “all tests came back normal”.

“I definitely think there was a link, but there’s no way to prove it,” Ms Odey said, admitting the proposition was controversial and “brushed aside by medical professionals”.

According to the Australian HPV vaccine website, for every million doses of the vaccine given there are only around three serious allergic reactions.

Adverse Events Following Immunisation are not “brushed aside” by Australian medical professionals. Regrettably, the article does not cast the profession in a favourable light and Ms. Odey reports, “a frustrating battle with the conventional medical system”.

“They wanted to send my mum and I across the road to a mental institution and told me ‘if there was a fire you would run right out of here’.

Ms. Odey apparently experienced photo-phobia, numbness, shingles, food allergies, tingling, joint pain, lethargy and discolouration of the legs. But it was heart palpitations that led her mother to contact a cardiologist in Auckland. The cardiologist referred her to a “specialised pain doctor”. She was diagnosed within an hour and began treatment the next day. Olivia Odey had been diagnosed with Complex Regional Pain Syndrome (Fact Sheet), also known as Reflex Sympathetic Dystrophy and Central Neural Sensitisation Syndrome [Central Sensitisation] (Physiopedia videos).

We should note with respect to diagnosing CRPS;

There is no diagnostic test for CRPS. Diagnosis is based on a person’s medical history and their symptoms. Sometimes, a doctor may order blood tests, bone scans, x-rays, CT scans or MRI scans to rule out other conditions that have similar symptoms.

Thus being diagnosed within an hour and beginning treatment within a day is seemingly unusual to say the least. Ms. Odey’s entire recovery is unusual. We’re informed neuroplasticity explains;

To come off the pain drugs Ms Odey did a three-day course on how to “retrain your brain pathways and change your physiology just by changing your thoughts and beliefs.”

CRPS is classified as a Rare Disorder and whilst there is a significant range of symptoms and intensity, factors relating to causation include trauma such as a fracture, forceful injury, crush injury, amputation, stroke, and spinal cord injury. Other disorders may predispose to CRPS;

However, it has become increasingly clear that it plays a role in many different chronic pain disorders. It can occur with chronic low back pain, chronic neck pain, whiplash injuries, chronic tension headaches, migraine headaches, rheumatoid arthritis, osteoarthritis of the knee, endometriosis, injuries sustained in a motor vehicle accident, and after surgeries. Fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, all seem to have the common denominator of central sensitization as well. […]

What isn’t clear in Ms. Odey’s case is if these possible causes were ruled out before blaming Gardasil.

Of great significance is that;

A prior history of anxiety, physical and psychological trauma, and depression are significantly predictive of onset of chronic pain later in life. […] The onset of pain is often associated with subsequent development of conditions such as depression, fear-avoidance, anxiety and other stressors.

Again it isn’t clear if all possible contributing stressors were ruled out.

The table below summarises the range of symptoms associated with CRPS.

Source: Australian Pain Management Association

 

Given the complications listed in the above table one can appreciate the slow progression of physical therapy outlined below.

Desensitization – “to hurt is not to harm”. Over a period of time the person with CRPS will be encouraged to desensitize the affected limb so that the hypersensitivity and allodynia is reduced. For example, over a period of three years Annette, a CPRS patient, began with moving a silk scarf over her foot, progressed to being able to wear a foot stocking, to a sock, sandal and finally a closed in shoe for a short period. This process took three years but improvements are still being made.

Graded motor imagery (GMI) combined with medical management is recognized as being effective in reducing pain in CRPS. GMI involves encouraging the person to differentiate between left and right limbs to re-establish right and left concepts in the brain. Progressively, a mirror box is introduced. The person is asked to watch the mirrored image of the unaffected limb moving in the mirror. Then, the person moves the affected limb in the mirror box while watching the mirrored image of the unaffected limb. This tricks the brain into thinking it is seeing the limb with CRPS moving without pain.

Finally we can find comprehensive refutation of the notion that HPV vaccination causes Regional Pain Syndrome and Central Sensitisation from reputable sources in the literature. A Safety Study of Gardasil 9 in PRISM/Sentinel using sequential analysis, is worth consulting. Version 2 was published only three days ago – September 27th 2017. Page 2 contains the paragraph on Complex Regional Pain Syndrome. Following a clinical description of CRPS the paragraph continues (italics and bold mine);

In June 2013, the Japanese Ministry of Health, Labor, and Welfare suspended its recommendation of routine immunization with HPV vaccine in girls and women following post-vaccination reports of serious chronic pain and concern about a possible association with HPV. In early November 2015, the European Medicines Agency’s Pharmacovigilance Risk Assessment Committee completed a detailed scientific review of the evidence related to a possible association between HPV vaccines and CRPS. The Committee concluded that the evidence did not support a causal link between the vaccines and the syndrome. Although U.S. vaccine safety information sources such as the Vaccine Adverse Event Reporting System (VAERS) have not suggested an increased risk of CRPS following HPV vaccination either, some post-HPV-vaccine cases have been reported to VAERS.

Much has been made of the Japanese suspension of HPV vaccination due to post-vaccination reports of serious chronic pain and concern about a possible association with HPV. Interestingly if we follow the link above to version 2, we find that the citation to these post vaccination reports is; Kinoshita T, Abe RT, Hineno A, Tsunekawa K, Nakane S, Ikeda S. Peripheral sympathetic nerve dysfunction in adolescent Japanese girls following immunization with the human papillomavirus vaccine. Intern Med. 2014;53:2185-200.

To better understand the reliability of the report of Kinoshita et al, we should consult the 2017 critique, Tackling Antivaxers in the Literature by David Hawkes, Joanne Benhamu and Julia Brotherton. Whilst a number of examples are addressed in this publication it is the widespread criticism of Kinoshita et al and the subject of peripheral sympathetic nerve dysfunction following the HPV vaccine that is significant.

The Introduction reads;

To understand strategies used by Human Papillomavirus (HPV) vaccine critical authors, exemplified by a recent publication in the Nature published journal, Scientific Reports, to produce a false evidence base in the peer reviewed scientific literature.

Methods;

Critical analysis of anti (HPVE) vaccine papers, including retracted articles, links between authors of these papers and conflicts of interests, journals used to publish these papers, self citations and dissemination of these articles and associated commentary on social media.

HPV Vaccination: Japan;

Several publications have been produced by Japanese authors critical of HPV vaccination. In 2014, Kinoshita et al published a paper entitled “Peripheral Sympathetic Nerve Dysfunction in Adolescent Girls following Immunization with the Human Papillomavirus Vaccine” in Internal Medicine (a small journal with an impact factor of less than 1). To date it has been cited over 40 times. Despite several (published) letters of concern highlighting errors in the paper from highly respected researchers in the field the manuscript remains available. A recent publication by Aratani et al in the Nature published journal Scientific Reports has caused similar concern and is currently under review by the journal. This case garnered a much wider audience and an article highlighting concerns was featured in Science. This suggests that scientists are being more proactive in combatting bad HPV vaccination science.

In July last year Outcomes for girls without HPV vaccination in Japan was published in the Lancet. The author’s final paragraph read;

Sadly, Japan’s failure to provide HPV vaccination for young women has now become a global concern. Similar trends are occurring in countries outside of Japan, which will lead to increased incidences of HPV-related cancers. Although further efforts are required to overcome the many barriers leading to decreasing cervical cancer mortality, many challenges remain.

A comprehensive summary of the paper is available here, Lack of vaccinations increased risk of HPV infections in Japan;

Japanese women who became adolescents between 1993 and 2008, a period in which vaccination against cervical cancer was temporarily suspended, are at higher risk of having HPV16/18 infection, which is known to trigger the onset of cervical cancer. However, the infection risk can be decreased if vaccination is re-established. […]

The authors strongly recommend that HPV vaccination encouragement is resumed before the end of 2016, to reduce the risk of future infection in different age groups and to ensure all women will receive protection against cervical cancer.

As time progresses there continues to be a lack of evidence that may be considered as verification that HPV vaccines are causally linked to the conditions mentioned by Olivia Odey and described by Alina Rylko in The Northern Star article. Ms. Odey is heading to Byron Bay to begin a health blog. Yet in the present climate in which Australian vaccine safety and efficacy has been attacked by organised anti-vaccine lobbyists the tone of the article seems patently irresponsible.

The present consensus holds that CRPS and Central Sensitisation occur at levels expected of the populations effected. Evidence doesn’t support a causal link between the vaccines and the syndrome. Reports following HPV vaccination are consistent with what is expected for the age group. No fact sheets specific to these conditions list any vaccination as a cause or a predisposing condition. Data will continue to be gathered.

As yet there is no conclusive evidence to support Ms. Odey’s “belief” that Gardasil caused her condition.

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European Medicines Agency (EMA) virtual press briefing – Human papillomavirus (HPV) vaccines