I think it would be good for Australia if Tony Abbott was the Prime Minister of Australia
– Alan Jones, influential conservative “shock jock” media identity, climate science denialist and Abbott supporter –
Leigh Sales of ABC’s 7:30 Report hosts an extended interview with radio broadcaster, climate science denialist and beacon for conservative anger, Alan Jones.
Covering issues from mining, to respect for the office of PM, to potential for sustainability, to denial of climate change Jones argues Australia is “entitled” to a better Prime Minister. Side stepping a few points such as flaws in the science challanging climate change vs the wealth of science supporting it, Jones suggests topics choose him. His science illiteracy and propensity for ad hominem attacks against those of differing opinion is at times mixed liberally with logical fallacies as Jones insists on maintaining the upper hand.
Whilst denying using abusive terms Jones immediately defends those he uses as justified. Rob Oakeshott is “brain dead” for supporting climate change agendas and will unlikely get another job. On Greens Senator Sarah Hanson-Young, calling her “a fool is flattering… that’s flattering”. One would have been delighted if the irrelevant anti-Greens sentiment – indeed anti-Left sentiment – buoyed by claims of anti-Right climate conspiracies could be supported with evidence.
Perhaps most regrettably Jones falls back on the commonly debunked climate science denialist tactic of citing ICPP emails as legitimising any and all denial of climate change. Now well established as a careless use of language entirely divorced from the volume of data, the leaked emails are of no moment. One can only imagine if Aussies applied the same logic to Jones’ illegal “cash for comments” scam [Wikipedia entry]. Should his criminal conduct and breach of media codes be seen as cause to mistrust his transparency?
Unusually, despite the platform of the ABC and given the impact of his show on community opinion, Jones produced not one cogent argument to support his irrational position on climate change. His best appeal to authority is to reference interviewing “some of the leading scientists in the world… finest minds” who said anthropogenic climate change affirming science is “a hoax”. Having interviewed a senior IPCC scientist, Jones completely loses track by noting he “agreed with most of the statistics I offered”. Then his famous fallacy gets a run.
Quoting the percentage of CO2 in the atmosphere, the percentage of that arising from from emissions and the percentage of that which is derived from Australia, he triumphantly reinforces the 0.000018% of atmospheric CO2 attributable to Aussie emissions. The child-like reasoning here is shocking. It’s a little number thus cannot be of menace. That climate is certainly effected by tiny, cumulative changes leading to dramatic and devastating consequences seems beyond him. As is the impact of only a couple of degrees increase in average temperature. But is he really serious?
CFCs make up a tiny fraction of 1% of our atmosphere. Yet CFC-11 has 17,500 times carbon dioxide’s capacity to trap heat in the atmosphere. That 0.04% of CO2 Jones loves to quote. Jones has no problem with the science of ozone depletion, nor action taken to preserve the ozone layer. Surely then, a bright chap like him could further appreciate the power of minor changes to atmospheric chemistry. Though there’s no political gain to be found in denying ozone preservation. No cleverly crafted junk science making up cushy rebuttals. What if we applied this dismissal approach to human health?
The size of the HIV or Ebola virus is microscopic. The percentage of body surface area opened by a bullet wound is insignificant. The number of cardiac cells to misfire and lead to a lethal infarction is minuscule compared to the total. A tiny blood vessel amongst hundreds of thousands, effecting 0.000018% or less of brain neurons can change a life, wipe memory, destroy speech, render us blind and so on. No doubt he could comprehend such simple notions. Suffice it to say it pays to remain skeptical of Jones’ motives. Or indeed, respect how effective the climate change denialist movement has been.
There was of course, no defence of the scurrilous and unconscionable abuse of science behind the entire denialist movement. For example, consider this from an article by Donald Prothero published in e-Skeptic, late last September:
As Oreskes and Conway documented from memos leaked to the press and published in their book Merchants of Doubt, in April 1998 the right-wing Marshall Institute, SEPP (Fred Seitz’s lobby that aids tobacco companies and polluters), and ExxonMobil, met in secret at the American Petroleum Institute’s headquarters in Washington, D.C. There they planned a $20 million campaign to get “respected scientists” to cast doubt on climate change, get major PR effort going, and lobby Congress that global warming wasn’t real and was not a threat. Then there was the famously cynical 2002 memo from GOP pollster and spinmeister Frank Luntz to the Bush White House: The scientific debate is closing [against us] but not yet closed. There is still a window of opportunity to challenge the science… Voters believe that there is no consensus about global warming within the scientific community. Should the public come to believe that the scientific issues are settled, their views about global warming will change accordingly. Therefore, you need to continue to make the lack of scientific certainty a primary issue in the debate, and defer to scientists and other experts in the field.
Incredibly Jones says at one point he “finds it hard to believe people in politics behave the way they do, and expect people to take them seriously”. It’s a brilliant example of Poe’s Law colliding with the Dunning-Kruger effect.
Needle Syringe Programs in prisons have proven successful across the globe, including in Iran. Gains are directly transferred to individuals, family members, community members, custodial officers, law enforcement officers and health professionals.
Australia once led the world in Harm Reduction initiatives, a number of which pertain to safe injecting of illicit drugs.
Because of the illegality, potential for tragedy and high risk associated with IV drug use it is very easy to be led astray from the evidence base supporting harm reduction initiatives. Primary amongst these is the funding of over 1,000 Needle, Syringe Programs (NSPs) across Australia. Although introduced against considerable opposition, community acceptance is now very high. More to the point, similar misinformation and conservative opposition was raised against another harm reduction initiative when introduced. Condom use amongst men having sex with men (MSM).
Harm Reduction measures were introduced by then federal health minister, Neal Blewett in 1985, ushering in unprecedented acceptance, understanding and management of high risk behaviour leading to the spread of HIV in Australia.
Led by the Minister for Health under the Hawke government, Neal Blewett, Australia undertook several unprecedented and pragmatic steps: it introduced a needle exchange program for intravenous drug users, encouraged open discussion of safe sex, and created the famous Grim Reaper advertising campaign.
There was fierce opposition from the religious right, but 25 years after the initial AIDS outbreak, Australia’s decision to accept human nature in policy making has saved thousands of lives – especially when compared to the USA where ‘morality’ has outweighed practicality in dealing with the illness.
Harm Reduction (HR) is one of the three major prongs of Australia’s illicit drug policy. The policy is called Harm Minimisation. Not “tough on drugs”, not “zero tolerance”. Harm Minimisation includes Supply Reduction, Demand Reduction and Harm Reduction. Over the years the gay lobby and LGBTQ community has forged itself a formidable legal and social identity. I pity the conservative zealot who would insult their ontology. Not so for IV drug users. This is due to many reasons, the more obvious being the transient nature of drug use (experimentation), the social, professional and personal cost of outing oneself as a chronic addict, the complete lack of intention to politically mobilise and the volume of comorbid mental health problems.
To be rather crude whilst it is demonstrably bigoted to discriminate against Australia’s disabled population they are not a force of reckoning. Our communities remain poorly suited to accommodate disabilities. Stigma persists leading to discrimination and inequality.
Similarly whilst we clinically accept the disease model of addiction, many community members still remain blinded to this very real health problem in favour of pop culture “bad guy” stereotypes. This is sheer manna for those with political interests to be seen to be “tough on drugs” or who seek to exploit individuals with a range of disabilities, including drug dependence.
Most Aussie addicts are alcoholics and cigarette smokers. The bulk of public health money dealing with drug induced harm is spent here. Illicit drug addiction consumes under 5% of the total expense. Writing in, Redefining Addiction in MJA Insight Paul Haber noted:
The American Society of Addiction Medicine (ASAM) grappled with this problem for 5 years before releasing its new definition of addiction, which has stimulated interest from around the world with commentaries in The Lancet, Time and elsewhere. ASAM proposes that addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. It is a chronic relapsing and remitting disorder that manifests in continuing use of substances or alcohol despite accumulating harm to the individual and to others. [….]
This addiction disease concept facilitates a medical approach to management, including the need for quality evidence to support clinical interventions and it encourages engagement of medical professionals in this field. Acceptance of the disease model can also reduce the stigma of the disorders. Specific neurobiological abnormalities have been identified such as certain dopamine receptors in the reward system and these are targets for therapeutic intervention.
The funding pittance that is dealt to illicit drug harm reduction in part reflects the dwarfing of this demographic alongside drinkers, smokers and gamblers. The rest is explained in that the lions share is consumed by futile supply reduction efforts in the endless cycle of importation, distribution, dealing and administration. Demand reduction – fighting the demand for drugs through education, rehabilitation and disincentives also receives more money than harm reduction. It remains far, far too easy to raise a voice of ignorance and accuse HR initiatives of “allowing” or “encouraging” drug use.
The ABC news items below discuss the need for needle exchange programs in Australian prisons and the potential for a trial beginning in Canberra’s Alaxander Maconochie prison. It’s probable an HIV epidemic beginning in injecting drug users, and placing the wider Australian community at risk, would begin in Australian prisons. Questions are also raised as to the “shameful” state of Australia’s Harm Reduction initiatives that have fallen behind what is considered effective evidence based practice for prison population health. This is further evidenced by successful programs in other countries around the world. Needle Syringe Programs are strongly supported by a large global evidence base. Significantly, one public health success story is Australia.
Indeed return on investment research in 2009 [PDF] show that “investments in needle and syringe programs were yielding a twenty seven fold return in health, productivity and other gains.” Gino Vumbaca, Executive Director of the Australian National Council on Drugs wrote at the time:
What is striking is the level of public support for the program. The largest regular survey on drug use issues we have, the National Household Survey on Drugs, now records public opposition to the program at less than 20%. The Hawke, Keating, Howard and now Rudd Governments, as well as a myriad of state and territory governments of varying hues over the past 20 years have all lent their support to the program. For some this was in the face of strident opposition. A truly admirable achievement based on evidence, common sense and humanitarian grounds
The World Health Organization commissioned a review of evidence of the effectiveness of Needle and Syringe Programs to reduce HIV which concluded:
There is compelling evidence that increasing the availability and utilisation of sterile injecting equipment for both out-of-treatment and in-treatment injecting drug users contributes substantially to reductions in the rate of HIV transmission. Research from around the world clearly indicates that NSPs make a significant contribution to preventing the spread of HIV/AIDS and hepatitis C.
Between 2000 and 2009, the Australian Government invested $243 million in Needle and Syringe Programs. This resulted in the prevention of an estimated 32,050 new HIV infections and 96,667 cases of hepatitis C. $1.28 billion dollars were saved in direct healthcare costs. [….] The report states: “If NSPs were to decrease in size and number, then relatively large increases in both HIV and hepatitis C could be expected with associated losses of health and life and reduced returns on investment. Significant public health benefits can be attained with further expansion of sterile injecting equipment distribution.”
Countries, like Australia, that have implemented NSPs have averted HIV epidemics among injecting drug users and, therefore, the community at large. Those countries that have not implemented these measures have often experienced uncontrolled HIV epidemics. There is strong evidence to suggest that when HIV becomes endemic among the injecting drug user community it can then spread to their sexual partners and children, resulting in high mortality rates and large social and economic costs to the entire community.
Conservative ideologues and those with vested interests in punitive measures, have attempted to discredit NSP efficacy. Nations without proper NSPs, such as Sweden are deemed in breach of the UN International Right to Health. See page 3, item D. Religious fundamentalists & other totalitarian belief systems frequently reference Sweden’s “war on people” mentality, obfuscating the human rights abuse. As revealed by WIKILEAKS, the USA work actively to sabotage Harm Reduction initiatives as part of their War On Drugs policy, citing Stockholm as a reliable ally. An excellent discussion of this matter is to be found at Neurobonkers. The Global Commission on Drug Policy has demonstrated the failure of the Drug War. [CNN News]
With respect to needle exchange, rather than advance challenges to NSP efficacy with new research the tactic of a small minority is to attack existing methodology in an out of context, subjective fashion creating the illusion of an argument. An analogue today might be “pertussis diagnoses have increased, therefore the vaccine is ineffective” – a claim advanced by comparison of unrelated data sets.
In May 2010 Norah Palmateer et al. produced a meta-analysis using what they called “Critical appraisal criteria” to challenge the methodology of NSP research. However, even whilst selecting particular modes of distribution and leaving out others, a conclusion that “New studies are required to identify the intervention coverage necessary to achieve sustained changes in blood-borne virus transmission”, was delivered. This is scarcely revolutionary, yet is falsely cited as discrediting NSP efficacy by fundamentalist conservative groups. In truth Palmateer et al actually argue for a shift in analytical focus to biological rather than behavioural data. More so, they write:
The findings of this review should not be used as a justification to close NSPs or hinder their introduction, given that the evidence remains strong regarding self-reported IRB and given that there is no evidence of negative consequences from the reviews examined here. [….] We recommend a step change in evaluations of harm reduction interventions so that future evaluations: (i) focus on biological outcomes rather than behavioural outcomes and are powered to detect changes in HCV incidence; (ii) consider complete packages of harm reduction interventions rather than single interventions; (iii) are randomized where possible (preferably at the community level); and (iv) compare additional interventions or increased coverage/intensity of interventions with current availability.
“The findings of this review should not be used as a justification to close NSPs or hinder their introduction”. Yet this is exactly what the enemies of reason have done, misquoting Palmateer at every turn. The “AVN” of Blood Borne Virus control is a group of far right evangelical lobbyists known as Drug Free Australia. Their “Meryl Dorey”, as it were is their “secretary”, young earth creationist and climate change denialist, Gary Christian. The similarities between Dorey and Christian are striking. No medical or health qualifications, citing of global conspiracies, “social experiments” – not evidence based public health, saving Australians, provision of “truth”, attacking certain research identities, cherry picking of data and outright lies.
When a 27 fold return on investment for NSPs was claculated after years of research, Mr. Christian promptly dismissed this claiming NSPs actually serve to promote drug use and spread viruses. WHO data would prove this if properly adjusted he cried, mimicking Dorey’s claims to “properly read research”. Thus he was able to immediately dismiss what is absolute proof opposition to NSPs is baseless. Indeed, Christian went further.
Harm Reduction is the “normalisation of illicit drug use” not just correlating to, but causing a rise in drug use. Hands up if knowing about NSPs motivates you to experiment with IV drugs. This new take on “condoms cause AIDS” is demonstrably flawed. Just as abstinence, not condoms will prevent STD’s, Christian claims “free HIV testing” not NSPs or harm reduction will control HIV, citing discredited non peer reviewed sources.
Thus arguments raised against the value of exchange program efficacy in cutting blood borne virus spread are emotive, supposedly backed by misrepresented, spurious and/or biased “research” and driven by discredited, conservative fringe lobby groups.
Unsurprisingly the opposition to NSPs in Aussie prisons is based on misinformation and a lack of evidence.
One myth often pulled out by antivaccination lobbyists to malign vaccine safety is the senseless term “Vaccine Shedding”.
Whilst in context we all know what is meant, it’s worth pausing to consider that the term is a byproduct, if you will, of the antivaccination movement’s skill at sowing misinformation. The unrivaled ability to scan a headline and regurgitate some ghastly tale about vaccines. To squeeze another fallacious vaccine “danger” onto the shelf, content in the knowledge it will soon have a life of it’s own.
The colloquial use of this nonsensical term seeks to convey that an individual who has been vaccinated can readily shed part of the vaccine and cause infection in the unvaccinated. Which by definition demands them to have shed not a vaccine but an infectious agent. Indeed a virus or bacterium. Which by extension demands the vaccine to contain a live virus or bacteria. This then opens the door to viral shedding the vast complexities of vaccine induced immunity and viable modes of excretion – aka shedding. That won’t stop your garden variety anti-vaxxer claiming any vaccine can lead to infection of the unvaccinated via this ghastly “vaccine shedding”.
But that’s only part of the story. “Vaccine shedding” is a double barrelled myth in that transmission is assumed to occur ipso facto. Shedding is not transmission. Period. Yet denial of vaccine efficacy requires internalisation of some whacky stuff. Including the erroneous belief that viral shedding follows MMR vaccination. Yet worse is the myth that inactivated vaccines pose the risk of infection due to “vaccine shedding”. Pertussis often brings out the malicious side of anti-vaxxers. DTaP is inactivated. Indeed the pertussis component is acellular. Update: The acellular pertussis vaccine is an example of a subunit vaccine.
So, you may wonder at the nature of Cynthia Janak who writes in Will the vaccinated infect the unvaccinated? That is the question with Whooping cough:
Before I continue I want to tell you about a fact that is known by the CDC, etc. That is called vaccine shedding. This is the transmission of the virus from a vaccinated person to an unvaccinated person. [….] I want you to understand that this is true for vaccines including the Whooping Cough. What you could have happen is that all these parents and child care workers are going to get the vaccine and then take care of children. [….] The vaccinated have the potential to infect the unvaccinated child. This could cause the next epidemic of disease like what happened with the small pox epidemic.
So, in Cynthia’s mind “vaccine shedding” is, “…transmission of the virus from a vaccinated person to an unvaccinated person”. Wrong. And it’s true for whooping cough. Impossible. Yet Cynthia Janak asserts there’s potential for an epidemic like smallpox? Pure fiction. Contracting pertussis because an unvaccinated and infected child or adult who ignores boosters has breathed on someone is, however, a simple fact. Aiming to inflate the danger of her misguided concern about “vaccine shedding” as “known by the CDC”, Cynthia uses references to FluMist.
FluMist a live attenuated influenza vaccine (LAIV) sprayed into the nostrils and well understood regarding shedding. Concerns about administering a live virus this way should be respected. So should the facts about any risks. It sheds in low concentration for short periods via nasal discharge. It is not associated with person to person transmission. Given that wild type influenza sheds at far higher concentration, is found on fixtures, objects, skin and is strongly associated with transmission, severe illness and complications it seems Cynthia has been selective about what’s “known by the CDC”.
“Vaccine shedding” is better suited to mid 19th century notions like the infectious miasma, wafting about in terrifying unseen clouds held aloft by our lack of knowledge. Nor does the rare instance of shedding suddenly turn any agent into a virus with the infectious capability of Ebola. But anti-vax voices are often raised in triumph that the crime of “vaccine shedding” places the community at greater risk than the rising numbers of unvaccinated.
The scale of error associated with this belief is akin to the myth of potential vaccine injuries outweighing the benefits of vaccination. Serious injuries that do occur are primarily in populations genetically predisposed to latent complications and manifestation is extremely rare. Injuries, disability and death from vaccine preventable disease would occur at magnitudes many hundreds or thousands of times greater and can manifest in anyone. Vaccine injuries are artificially inflated by confusing correlation (sometimes years apart) with causation, and by including red marks, crying, sleep disturbance or omitting that event X was a serious allergic reaction to latex syringe components. Similarly, arguing ones unvaccinated child is at risk from, or has been infected by, a recently vaccinated child is quite a claim.
Viral shedding itself is by no means ignored by the medical community. It’s of primary concern in the management of immune compromised patients, pregnant women and newborns. Varicella is an excellent example in that a.) viral shedding is well understood and b.) the risk from shedding can be discerned from precautions taken. Following varicella vaccination, viral shedding can be detected in the stools for six weeks.
In the case of immunodeficiency disorders or immune suppression from drugs, transfusions, stem cell transplant, chemotherapy etc, the recommendations are to avoid contact with fecal matter of vaccinated subjects and to observe good hygiene. To put this in context, unvaccinated children who spend one hour in a room with an infected child (shedding varicella) stand a 95% chance of contracting varicella (chicken pox). This is why vaccination against varicella is vital and choosing to not vaccinate your child places him or her and by extension countless others at risk of serious complication.
For nursing mothers post natal varicella vaccination need not be delayed if they are varicella-susceptible as varicella hasn’t been found in breast milk post maternal vaccination. There is no problematic risk of viral shedding to newborns provided hand washing and other hygiene measures are followed.
Whilst rare, a post-varicella immunisation vesicular rash can form. Again whilst quite rare, viral shedding can occur at this site. Plainly stated it’s incredibly rare for an unvaccinated child to be infected with varicella from a vaccinated subject and a series of events, including transmission, must occur within a small window of opportunity. Greatest precautions must be taken in the case of immune suppression. Writing in Vaccines in immunocompromised patients, Janet R. Serwint, MD Consulting Editor notes:
Because the varicella virus rarely can be shed through a postimmunization vesicular rash that may develop, recommendations include avoiding contact until the rash resolves.
In March this year there was an interesting case of viral shedding. The antivaccination lobby bellowed that Varicella zoster virus DNA had been found in the saliva of people over 60 vaccinated with the live Zostavax vaccine manufactured by Merck. In this age group Herpes zoster (shingles) is the target. Shingles is the result of infection with VZV earlier in life which may reactivate as immunity declines or from novel infection. Despite blog headings like Vaccinated people SHED LIVE HERPES for up to a month AFTER vaccination, be aware it was 2 of 36 “vaccinated people” who made the grade.
There was no indication of infection risk at the time. Today transmission is considered rare. Packet inserts carried the standard warnings found in varicella immunisations to avoid contact with infants, nursing mothers and immunocompromised individuals. “Doctors never tell you this”, lied the anti-vax lobby. The end result is that, fortuitously, it appears a saliva test could be developed allowing for detection and antiviral therapy before the painful rash appears. All up with rare potential for transmission from about 5% of recipients of a vaccine that’s not widely used it was a non event.
With MMR the lack of viral shedding renders any risk of horizontal transmission in this manner null and void. If challenged with the claim of “vaccine shedding” specific to Measles, Mumps, Rubella vaccination you’re being misled.
Immunocompromised contacts should be advised to avoid contact with stool from the immunised child if possible, particularly after the first vaccine dose for at least 14 days. Since the risk of vaccine transmission and subsequent vaccine-derived disease with the current vaccines is much less than the risk of wild type rotavirus disease in immunocompromised contacts, vaccination should be encouraged.
The “vaccine shedding” bogeyman got a free kick with the FluMist LAIV vaccine. You may remember the hype. The spraying of “living influenza virus” straight into children’s brains was going to lead to mutation and death on an unprecedented scale. It would genetically revert to the wild type. Transmission would thus be uncontrolled. It would quickly prove useless against changing seasonal strains. ADR’s would rise…. and so on. Ultimately the cost proved to be a deterrent. Mayo Clinic have produced a welcome article on LAIV Myths.
In a comprehensive 2008 study with a sample aged 2 – 49 years, shedding “of short duration and at low titers” was detected in nasal swabs on days 1 – 11. LAIV recipients “should only avoid contact with severely immunocompromised persons for 7 days after vaccination”.
One concern regarding use of LAIV among HCP has been the potential for transmitting vaccine virus from persons receiving vaccine to nonimmune patients at high risk. Available data indicate that children and adults vaccinated with LAIV can shed vaccine viruses for >2 days after vaccination, although in lower titers than typically occur with shedding of wild-type influenza viruses. Shedding should not be equated with person-to-person transmission of vaccine viruses, although transmission of shed vaccine viruses from vaccinated persons to nonvaccinated persons has been documented in rare instances among children in a day care center.
One study conducted in a child care center assessed transmissibility of vaccine viruses from 98 vaccinated persons to 99 unvaccinated controls aged 8–36 months; 80% of vaccine recipients shed one or more virus strains (mean duration: 7.6 days). [….] The estimated probability of acquiring vaccine virus after close contact with a single LAIV recipient in this child care population was 0.6%–2.4%.
It was also documented that should HIV positive children be exposed to LAIV shedding, “… serious adverse outcomes would not be expected to occur frequently”. So the combination of live virus shedding and immune deficiency in the case of LAIV presents low risk. Certainly the overall risk associated with the rare transmission following shedding after LAIV is insignificant given the risk of regular influenza virus transmission.
We’re running out of dramatic scenarios for the antivaccination lobby to cling to. With polio the wild virus replicates in the intestine and is shed in stools for up to a month. Transmission in developed nations is thus faecal-oral like other stool shed viral components. It is of course so rare as to be unheard of. However, given that the IOM report into evidence and causality of vaccine adverse effects found a causal link between the oral polio vaccine (OPV) and vaccine associated paralytic polio (or Vaccine Derived Polio Virus), we should seriously consider shedding in areas where this is documented.
In fact the question has been asked if prolonged VDPV shedding could be a source of reintroduction following polio eradication. The more compromised the immune system the more likely the individual is to have problems with vaccine induced immunity. A study looking for VDPV shedding in immune deficient subjects in Abidjan, Cote d’Ivoire found no cases in a sample of 419, and therefore a “minimal risk of reintroduction [after eradication]”. In respect of general exposure to shedding in these environments transmission of the wild type polio virus eliminates any concern over post vaccination viral shedding. Crowding, sewerage, water quality etc all contribute to wild polio spread in ways that do not apply to the developed world.
Remembering that viral shedding is of paramount concern in the management of immune deficiency and immunocompromise, let’s revisit the Janet R. Serwint, MD of Vaccines in immunocompromised patients. Rather than warn against exposure to immunised children the recommendation is to ensure schedules are up to date and an annual inactivated influenza vaccine is on board. Pay attention to reference to MMR, varicella and rotavirus:
One strategy worth emphasizing is the immunization of household contacts, particularly other children and adolescents in the family. This procedure is essential to try to minimize exposure of the immunocompromised patient to household contacts who might contract vaccine-preventable illnesses. Pediatric health-care clinicians need to update and review the vaccine status of all siblings and pediatric-age household members. Annual influenza vaccination of all family members with inactivated influenza vaccine is recommended in addition to ensuring routine immunization of all other recommended vaccines.
MMR, varicella, and rotavirus vaccines, although live viral vaccines, are recommended for immunocompetent household contacts because transmission of the virus is rare. The lack of viral shedding with MMR eliminates concern regarding transmission. Because the varicella virus rarely can be shed through a postimmunization vesicular rash that may develop, recommendations include avoiding contact until the rash resolves. For the rotavirus vaccine, avoidance of contact with the stools by the immunocompromised patient and good hand hygiene measures by all family members for at least 1 week after vaccination should be implemented.
In conclusion it’s clear that “vaccine shedding” is a nonsense phrase. The lack of accounts of children transmitting viruses to younger siblings and friends after vaccination is a dead giveaway. Whilst viral shedding is a reality we can be confident that:
Viral shedding applies only to live virus vaccines and is significantly low, low risk
Post vaccination viral shedding of rotavirus and varicella is detected in the stools for 4-6 weeks respectively. It’s of such low risk as to be of cautionary interest regarding immunocompromised individuals
Genuine concern about viral shedding in these groups is managed with sound hygiene and avoiding contact with stools
In rare cases of post varicella immunisation vesicular rash shedding may occur. Transmission is still unlikely
The lack of viral shedding following MMR eliminates any concerns about transmission
Claims of DTaP shedding and transmission are bogus
Stories about whooping cough transmission from vaccine shedding are demonstrably false
Stories of polio infection being a risk due to shedding are designed to scare
Antivaccination lobbyists use false and incomplete information about shedding to create fear of vaccines/the vaccinated
Shedding of LAIV is at markedly low concentration, short duration and transmission is dwarfed by seasonal influenza transmission
Accurate information about the topic is drowned out by antivaccination sites and “mothering” forums making inaccurate claims
It’s official! Reports that have been coming in from Middle Earth for the last couple of days are indeed accurate. Dr. Rachie (aka Dr. Rachael Dunlop) has unleashed the power of science on the undead corpses of nine vaccination myths, expunging their essence for all time.
All good fiction-fantasies have their mythical characters and the best mythical characters are those that keep returning time and again despite being killed off. So it is with these nine. Although long dead these myths have been constantly exhumed. Script writers of the antivaccination movement, faced with oblivion, have kept writing them into the story time and again.
Known as ring-wraiths because the argument that sustains the myth is circular nonsense they have been led by the most powerful and most often killed myth, Vaccines Cause Autism. Lured to Mount Mama Mia by rumours of untapped Quantum nearby, the nine never stood a chance. Autism was the first to fall as Rachie recounted the disgrace to befall Andrew Wakefield and his fraudulent caper. It was cut down with a double reminder that, as a result of this fraud, he was now unlicensed and the work withdrawn from publication. Retracted!
Before it could summon any more lies or buy the blood of any more children, Dr. Rachie finished Autism off with the weight of 20 years research and a brand new comprehensive review. She wrote in the ancient, powerful, yet sacred runes of science:
The largest study was done in Denmark and covered all children born from January 1991 through December 1998. A total of 537,303 children of which eighty-two percent were vaccinated for MMR were examined and there was no association between vaccination and the development of autistic disorder.
Further, in August 2011, an exhaustive review of the scientific literature by the Institute of Medicine in the US concluded that overall “few health problems are caused by or clearly associated with vaccines”. …12,000 peer-reviewed articles, covering eight different vaccines were pored over by a committee of 18 experts in the largest review of adverse events associated with vaccines since 1994… there is no causal relationship between vaccines and autism.
It was predictable who would fall next. Vaccines CauseAutism’s trusted side kick Vaccines Contain Mercury shrank back from the power of Science. Witnesses claim the air crackled with electricity as Dr. Rachie intoned confidently from The Book Of Evidence. She reminded the ghastly creature:
Mercury has not been present in routine childhood vaccines in Australia since 2000 and it was never in the MMR vaccine. Prior to 2000, thimerosal, an organomercury compound, was used in the manufacturing process of vaccines as a preservative.
Writhing and shrieking in despair it was finished off with more reminders that methyl mercury and bio-accumulation apply to sea foods. Then it suffered the same fate as ethyl mercury (the erstwhile preservative) does on entering the body, if it is used in adult vaccines. Total elimination.
This immediately got the attention of journalists assembled nearby. Vaccines Contain Mercury and Vaccines Cause Autism had stopped off mere days earlier at the Magical Homeopathy Well as they travelled, they thought, in search of Quantum. It was there they spoke to a small gathering of journalists, admitting they intended to mix the magic water with the Quantum to concoct The Elixir of Everything.
“We’ve never felt more alive, more invigorated than right now”, said the King of vaccine myths – Vaccines Cause Autism
Posing for Fountain Of Beauty photo’s (left) outside the Magical Well, the pair cut a sadder spectacle than Fran Sheffield and Isaac Golden in a medical library.
Asked if they knew they were in fact, long dead and to all intents and purposes had never really existed, Vaccines Cause Autism responded confidently:
“Quite the contrary my dear fellow. We’ve never felt more alive, more invigorated than right now and both look forward to another summer of terrifying innocent parents and driving up vaccine preventable disease. We have promotional tours planned with Meryl Dorey who’s been awfully suppressed of late, poor thing… free speech and what. But with some grossly inflated figures on the number of shots kids receive before school – it’s 12 but we’re saying something like 35 – and appearances with our friend and colleague “Vaccines have never been tested”, we should have a splendid time of it. Besides chaps we don’t have a lot of say in the matter. It’s the Power of the Burning Stupid that keeps us going and with this interweb business today there’s no shortage of that, what?”
Such confidence was clearly best suited to behind the silicon battlements of his home fortress on Mount McCarthy. Against the power of science the wraiths stood not a chance. The next to fall was Vaccines Contain Toxic Ingredients. A particularly irrational creature this one takes advantage of general ignorance. Eg, few know that whilst infants receive about 4 milligrams of aluminium from vaccines in the first 6 months of life, they receive 10 milligrams from breast milk and 40 mg from formula over the same time. Yet aluminium is essential as an adjuvant and actually allows less antigen per dose. Adjuvants work to aid the immune response making the vaccine more effective.
Dr. Rachie looks at some more myths about toxic ingredients from those exploiting ignorance to outright lies. She noted wisely that the dose makes the poison, throwing this at the creature in a blazing ball of pure, lethal fact. You may hear of how carcinogenic formaldehyde is and that it’s in vaccines. What scaremongers omit to tell you is that it’s only carcinogenic at certain concentrations. Whilst these concentrations aren’t found in vaccines they are found in particle board and other building materials. So, throw out your furniture and rebuild your house if you have an issue with formaldehyde.
Vaccines Have Never Been Tested suffers a gruesome fate. With her lab coat glowing incandescently Dr. Rachie held The Book of Evidence aloft enveloping this long dead beast in the pure light of reason:
When people claim that vaccines have “never been tested” they usually mean that they have not undergone randomized placebo controlled trials (RCTs). To do an RCT of a vaccine you would need to take two groups of kids, give one group the vaccine, and the other a placebo, then expose both groups to the disease to see which ones survive. Raise your hand if you can see the problem here…
In fact other vaccines have been tested. Remember the 2 million children who parents shoved them forward to receive the polio vaccine in a trial? Or the extensive HPV vaccination trials just finished to great success in Australia?
Vaccines Don’t Work Because Vaccinated Kids Get The Disease crumpled under the weight of evidence that crushed boulders to dust and left craters in the ground. Including the harsh reality that fatalities occur in the unvaccinated. Put simply, vaccines may not be magical or transcend the laws of reality as do vaccine myths but they prepare the immune system to fight viral infections. And in the main, some diseases making a comeback, like measles, only effect the unvaccinated. Using this argument on immunity that wanes or is specific to strains (such as whooping cough and influenza) is a darstardly trick of this myth. Keep an eye out for this ghoul. Don’t be fooled and get yourself a booster for pertussis.
Improved Living Standards Not Vaccination Reduced Disease A truly heinous beast indeed. We dealt with this one here copiously when Viera Scheibner tried it on recently, if you wish to check the video. But Dr. Rachie uses the sure fire Powerful Evidence Kill Shot to dispense with this Being from beyond. Gazes were quickly averted as sounds of cracking bones and squishing innards mixed with Mia’s cheering.
Since 1993 when the Hib (Haemophilus influenzae type b) vaccine was introduced into the Aussie schedule there’s been a >90% drop. In fact it’s now so rare epiglottitis once a sign of Hib can’t be assumed to be so. When isolated today, lab’ tests may reveal Haemophilus influenzae not to be Type b. This is a powerful impact from a single vaccine over a time when public sanitation, access to clean water and living conditions have not changed.
Infectious Diseases Are Harmless – Children are meant to get them never saw it coming. Wearing earplugs to block out ridicule and mocking laughter, this foul demonic entity was slayed with a barrage of Truth. Amongst other great points Dr. Rachie destroyed this “right of passage” wraith – dead before it hit the ground – with a devastating:
If you still think infectious diseases are harmless, wander through your local cemetery one day and note how many children died from diseases that we no longer see in society today – stamped out largely due to mass vaccination.
Vaccines Cause or Spread The Disease They Are Meant To Prevent has always been completely mad, so this was a mercy killing in truth. Leaping and frothing about uncontrollably it’s hard to comprehend it’s intent. You may have read some annoying anti-vax blurb or Facebook post about “my sister’s, neighbour’s, butcher’s, dog’s, vet’s, accountant was off for weeks with the flu after having the vaccine”. Bollocks. Only a large scale production failure could lead to “disease by vaccine”.
Before it vanished in a puff of smoke Dr. Rachie marched up to the wretched odourous thing, and inscribed on it’s forehead magical runes using the Quill Of Logical Legend:
Experiencing a slight temperature and/or a sore arm after getting a vaccine is actually a good thing. While some people misinterpret this as “getting the flu after the flu vaccine” it simply indicates that your immune system is responding…. This means next time you come across the disease in the environment your body is ready with an arsenal of antibodies to attack it before it can make you really sick.
My Child’s Immune System Will Be Overwhelmed is a rather pathetic little myth with low self esteem and a profound lack of confidence. And you can see why. With a mighty heave it was tossed into the Glare Of Truth under the rays of which it crackled and sizzled and finally shrivelled to a blackened crisp:
The amount of immune challenges that children fight every day (2,000 — 6,000) is significantly greater than the number of antigens in any combination of vaccines (about 150 for the entire vaccination schedule).
Well, that’s nine dead ringwraiths. All thanks to Dr. Rachael Dunlop, using nothing but Science. But like any good story they can be revived with another telling. So do be on the lookout. There are more goodies over in the article which is one I highly recommend following up on. There’s some great links and if you reckon there’s more myths (and there are) you can dig up some evidence based answers there to strike down these ghoulish zombies when they stagger into view.
For those aware of anti-vax tactics, there’s a jolly good comment from Mia who has no time for them or their deceptive ways. Striding across the drawbridge from her castle she cast a withering eye upon the Anti-vax Orcs, cowering below mumbling the same spells over and over. Undeterred by their putrid breath or horrid ugliness Mia spoke:
NOTE: looking through the hundreds of comments in the backend of the site, I can see the Anti-Vaccination people are up to their usual dirty tricks of linking to bogus crap research and commenting many many times under different names to try and make their cause seem better supported than it is.
People? VACCINATE your babies. Give your children boosters. And get a booster yourself.
And no, I don’t respect other people’s choices to not immunise their kids when they have the potential to kill other people’s babies.
It’s like respecting other people’s ‘right’ to drink and drive.
Bollocks to that.
Now if only we could work that into a public service announcement….
For a mob that officially professes “no position” on vaccination the Chiroprctors’ Association of Australia disseminate ample false, misleading and quite dangerous antivaccination hanky panky.
Take CAA NSW branch vice president, Nimrod Weiner. The Weiner from Newtown Community Chiropractic whose Nimroddery was pegged as a “rant on vaccines” by The Australian. Although he feverishly ran for cover after outraging real doctors, not-a-real-doctor Weiner’s “rant” bibliography can be found here. A hodge podge of dusty conspiracy twaddle and outright lies, much from the Australian Vaccination Network it alone refutes Weiner’s claim:
I’m good at knowing how to read a research aritcle, and knowing whether it’s viable or not. I’m also good at collecting a lot of research. This vaccine topic I update every single week. So what we’re looking at is new as of yesterday morning.
He didn’t write that, but announced this to attendees of his seminar Vaccinations: An informed choice, in what can quite justifiably be called a lie. There’s more on the entire debacle along with a Radio National segment here. At times we’ve met other crackpots from the CAA. Jason Parkes and Rob Hutchings, both of whom approach their profession like a religious fundamentalist approaches taking up arms. Warren Sipser who believes vaccines cause harm yet chiropractic “repairs DNA”. Genevieve Keating is another pleasant sounding predator who specialises in convincing parents chiropractic builds super human kids. They lean toward the weird beliefs of founder Daniel David Palmer and his views on “God given energy flows”.
Sipser was the subject of an article in The Australian headed The Chiro Kids which brought home just how ludicrous (and scurrilous) the new brand of Mystical Chiropractors really are. Thanks to Dr. Rachael Dunlop we can read the CAA’s Media Release warning CAA members of that article. It’s disturbing stuff given these quacks are subsidised by our government (Medicare foots the bill for five sessions per year) and health insurers. Written by CAA national president Simon Floreani, it is a straight out attempt at damage control, obfuscation and dodging questions.
Floreani himself has run antivaccination clinics and is a member of the Australian Vaccination Network. He describes Dorey’s little fraudulent scheme as a valuable resource for patients. Simon is married to Jennifer Floreani, famous for writing an article supposedly describing (Update – as noted below the bogus article has been removed but can be found here pp. 348-349) her newborn’s battle with pertussis, picked up from an older sibling. Given the outcome and treatment the article is almost certainly fraudulent, but if perchance the diagnosis is correct then at best it is reckless neglect and at worst simple child abuse.
She writes (bold hers):
This experience did indeed test our resolve and we were forced to draw on our support network of healthcare providers. We performed chiropractic checks on our baby daily and utilised a whooping cough homeopathic. I dosed myself with an array of vitamins to boost his immunity via breast milk and kept him hydrated with constant breastfeeding.
Whooping cough is often slow to develop and may respond well to conservative management, including chiropractic, osteopathy, homeopathy, herbs, acupuncture or acupressure. Within two days, the severity of our baby’s symptoms cleared and within a two week period, each of our boys had a complete resolution of their symptoms.
Fortunately for the Floreani’s this little tale is just that – a tale and a comical one too. Every type of “conservative management” is absolutely non efficacious. Babies with pertussis gag, choke and may have profound difficulty breathing making this nonsense of super fortified breast milk as a realistic option seem laughable. More so, there’s no evidence an increase of maternal vitamin intake when breastfeeding will do anything but produce expensive maternal urine. Even more farcical is the notion of “boosting immunity” with vitamins. Either way, if their baby did have pertussis there’d be no magic recovery after two days but admission to intensive care many days later as the insanity of their hokery pokery gradually sank in. Yet, that’s not really the point.
The dangerous, deluded and unconscionable message pushed on parents here is that using your breasts, vitamins and witch doctor spells, you can clear up a potentially fatal disease within two days. It’s outrageous and a bald faced lie that I cannot even begin to comprehend the motivation for. What’s infuriating is that chiropractors exploit the confirmation bias in parents and the Floreani’s are prime examples.
Parents who believe these nonsense manipulations cure everything report that yes treatment keeps children healthy. They also report inaccurately that lapses in treatment lead to poor health. Knowing this, chiropractors are famous for setting treatment frequencies, with some even insisting on treatment contracts. That the locus lies with parental bias has been shown splendidly in trials on colic.
As we know, chiropractors claim they can “successfully treat” colic or – in their lingo – Irritable Baby Syndrome. Trials show that if parents believed their baby received chiropractic care, whether they did or did not, they reported improvement. If they believed that no chiropractic care was applied – even when it was – they reported a worsening of colic. You can catch up with Simon Floreani admitting no proper trials exist here on Lateline back in July 2009.
He’s caught out claiming injuries from neck manipulation are one in 5.85 million cases when in fact they are gauged at 1.3-5 per 100,000 manipulations, by insurer Kaiser Permanente, who refuse to cover the practice. In short Floreani is claiming instance of vertebral injury is 60 – 300 times less than it is.
On August 21st this year, a video entitled “Homeopathy evidence and research” filmed by Simon Floreani and featuring homeopath and fraud Isaac Golden, appeared on YouTube. The video below looks initially at the rise of the Mystical Chiropractors and then picks through Golden’s claims of Cuban “homeopathic immunisation” and his own so-called PhD on “homeopathic immunisation”.
When used to defend against a complaint to the TGA about homeoprophylaxis, Golden’s PhD actually helped uphold the CRP decision of misleading claims by fellow crook, Fran Sheffield. This is because even Golden admits in his thesis text that his sample was flawed in size and there was no chance of contracting infection. In short he showed nothing.
