Measles makes a slow start to 2018 in Australia

According to the Australian Government’s Department of Health;

Measles is a highly infectious disease caused by the Morbillivirus. The virus is spread from person to person through droplets in the air. Symptoms take between 10 and 14 days to show after infection and include rash, fever, cough, runny nose and inflammation of the eye. Complications of measles include ear, brain and lung infections, which can lead to brain damage and death. Approximately one child in every 1,000 who contracts measles will develop inflammation of the brain (encephalitis). Immunisation rates of up to 95% are required for the sustained control of vaccine preventable diseases, such as measles.

The description above was last updated on March 20th, 2014. As evidenced in the National Notifiable Diseases Surveillance System table below, 2014 was a frightening year for measles infection. The year’s total of 339 was the highest for 16 years and each of the first three months had higher notifications than any other month of the year. Although June and July notifications were only two and four less, respectively.

Numbers of measles notification per State and Territory are tabulated here.

In fact 2014 saw measles outbreaks across the globe. Australia experienced an influx of cases from Asia, Indonesia and the Philippines which resulted in unvaccinated children in Australia being infected according to the Department of Health. There were over 58,000 cases in the Philippines and 110 deaths, reported in February 2015. The USA experienced an outbreak with a similar cause.

The Disease Daily reported in Outbreaks of 2014;

Over the course of the last year, there have been 610 reported cases of measles across twenty states.  The reemergence of measles can be attributed, in part, to increased international travel where infected travelers have imported the disease into the United States. Particularly for 2014, many measles case clusters were traced back to the large ongoing measles outbreak happening in the Philippines. However, those in the United States who have become infected are generally unvaccinated, often by their own volition.

Further highlighting the role the unvaccinated play in sparking measles epidemics, one notes that the CDC also highlighted the role of unvaccinated Amish communities;

2014: The U.S. experienced 23 measles outbreaks in 2014, including one large outbreak of 383 cases, occurring primarily among unvaccinated Amish communities in Ohio. Many of the cases in the U.S. in 2014 were associated with cases brought in from the Philippines, which experienced a large measles outbreak.

The Public Health Agency of Canada also raised concerns of measles infection and unvaccinated children;

Widespread use of the measles vaccine has dramatically reduced the numbers of cases in Canada over the past 45 years. But the recent outbreak in British Columbia is underscoring how the highly contagious virus can very effectively seek out groups of unprotected children.

With respect to The Netherlands a paper by Woudenberg, et al, entitled Large measles epidemic in the Netherlands, May 2013 to March 2014: changing epidemiology examined two measles epidemics (1999-2000 and 2013-14) that primarily effected orthodox Protestants. In the second epidemic, 27 May 2013 – 12 March 2014, 2,700 cases were reported. Molecular typing of the outbreak strain indicated a sequence indistinguishable from a strain first identified in Wales UK in the second half of 2012: the Taunton sequence.

The first Dutch case was identified with the Taunton sequence in May 2013. By this time 900 identical sequences had been reported from the UK, France, Ireland and the Russian Federation, making a source country difficult to identify. The Netherlands outbreak was indicated as the source of outbreaks in Belgium and Canada and from Canada to the USA. Social ties between orthodox Protestants in the Netherlands and Canada leading to the spread of vaccine-preventable disease such as polio, measles, mumps and rubella to Canada has been previously reported.

Reinforcing the importance of national herd immunity to international control of measles the authors of this study conclude in part;

The number of individuals refraining from vaccination is insufficient to sustain endemic measles transmission in the Netherlands. Nevertheless, this situation does pose a risk to public health in the Netherlands and contributes to the worldwide spread of measles, thus forming an impediment to the elimination of measles in Europe and elsewhere.

Amish communities and orthodox Protestants had a documented impact on reducing measles herd immunity in the USA, and Europe and Canada respectively and this was reflected in the 2014 outbreaks. In Australia whilst small numbers struggle to meet immunisation requirements due to social hardship, the anti-vaccination lobby have for years worked hard to spread disinformation, driving down immunisation rates nationally.

In June 2015 the ABC reported that the “surge” of measles the year before resulted in health authorities calling on Australians to ensure they were up to date with immunisations. If we compare this month’s present number of 4 notifications to the 78 for January 2014 it is clear measles notifications for the first month of this year are just over 5% of January 2014. The figure may rise slightly as further notifications for January reach the NNDSS but at this stage such a low figure is comforting.

Still, there have been warnings specific to measles this year and late last year. Victoria issued a measles health alert (Confirmed measles case in Melbourne) on December 5th 2017. This was a single case acquired overseas and fortunately the national total for December 2017 remains at 2. The alert is now resolved. An identical measles health alert for Melbourne, differing only in where the individual travelled when infectious was issued on January 17th 2018 and remains active.

This was reported in The Age on the same day.

Passengers who flew from Dubai to Melbourne last Thursday have been warned that a fellow passenger has an “extremely infectious” case of the measles.

[…]

Measles has an incubation period of seven to 18 days, so fellow passengers may develop symptoms from Thursday until the end of the month.

As today is the last day of the month this status may change to resolved as of midnight. W.A. Health issued a very similar warning via Twitter on January 11th.

This was reported the same day in Perth Now by Cathy O’Leary.

We have no way of telling what measles notifications will be over the remainder of 2018. September and October last year saw a worrying spike in notifications in Melbourne. However we in Australia can be grateful for No Jab No Pay legislation.

Globally at present measles is proving a problem in developed and developing nations. In the UK the NHS has confirmed well over 100 cases in five regions. The high risk of being unvaccinated and travelling is being stressed to the public. Dr Mary Ramsay, head of immunisation at Public Health England said;

People who have recently travelled, or are planning to travel to Romania, Italy and Germany and have not had two doses of the MMR vaccine are particularly at risk

Countries at risk are evident in this January 12th, 2018 report, Measles in the EU/EEA: current outbreaks, latest data and trends – January 2018. Most cases were unvaccinated or incompletely vaccinated. The report included.

The spread of measles across Europe is due to suboptimal vaccination coverage in many EU/EEA countries: of all measles cases reported during the one-year period 1 December 2016 to 30 November 2017 with known vaccination status, 87% were not vaccinated.

In the first two weeks of January the measles outbreak in the Ukraine has resulted in 1285 cases. Ukraine measles vaccination uptake is regarded as the worst in Europe, being under 50% in recent years according to the Ukraine Health Ministry. It was reported on January 21st that The Acting Health Minister Ulyana Suprun said;

Yesterday it became known about yet another death from measles. This is a child who has not been vaccinated. This is the eighth death case since the start of the outbreak, and this is the tragedy of our society, in which people die from diseases that are prevented by vaccinations […]

In order to achieve the measles elimination goal, the vaccination coverage rates for children targeted by routine vaccination programmes should increase in a number of countries, as the vaccination coverage of the second dose must be at least 95% to interrupt measles circulation and achieve herd immunity.

Presently a tragedy due to neglect, poverty, malnutrition and measles is unfolding in Papua, Indonesia.

AFP reported on January 28th;

Some 800 children have fallen ill and as many as 100 others, mostly toddlers, are feared to have died in what Jakarta called an “extraordinary” outbreak that was first made public this month. […]

When Widodo took office in 2014, he vowed to speed up infrastructure development and services, bolstering hopes for the region, observers said.

“What the government is saying is what we think is important to do (for Papua) is in fact not being done,” said Richard Chauvel, a Papua expert at the University of Melbourne’s Asia Institute. […]

“As measles is easily prevented with a safe and inexpensive vaccine, these deaths should never have happened,” said Freddy Numberi, a former governor of Papua. [He added] that Papua has Indonesia’s lowest life expectancy and highest infant, child and maternal mortality rates.

Without a doubt it is the same pattern across the globe. Measles epidemics will sprout wherever herd immunity is unsuitable. More so it is the unvaccinated who will suffer the consequences of widespread infection, whether in developing or developed nations.

Indeed even with low levels of infection the unvaccinated, with an infection rate of approximately 90%, bear the brunt of infection. Australia’s anti-vaccination lobby has for years pushed fear and disinformation, spreading ignorance and apathy leading directly to low herd immunity and epidemics of vaccine preventable disease.

This has resulted in effective legislative change manifesting as No Jab, No Pay and No Jab, No Play. The policy has been successful in raising vaccination uptake.

According to Immunise Australia;

The disease which requires the highest level of vaccine coverage to achieve herd immunity is measles as it is highly infectious. It is estimated that coverage of 92-94% is required for herd immunity from this virus. For this reason the national aspirational immunisation coverage target has been set at 95%. This target provides sufficient herd immunity to prevent transmission of other vaccine preventable diseases and supports Australia’s contribution to achieving measles elimination in the Western Pacific Region.

Fortunately January 2018 has indicated measles notification the lowest in four years. Whilst measles continues to present challenges around the world, Australia should remain vigilant and ensure we keep ahead of any potential outbreak.

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Features of the anti-vaccination movement on Facebook

Recently Australia’s most vocal, persistent and offensive anti-vaccine pressure group, The Australian Vaccination-skeptics Network argued vaccination is a breach of religious freedom. They misinformed the federal parliamentary inquiry into religious freedom that vaccines were prepared with “the products of abortion”.

Vaccination was therefore “a moral evil”, violating teachings of Christianity, Islam, Judaism and Buddhism, they contended citing absolutely no evidence to support their stance. The Australian Medical Association noted that their position was “irrational” and “unscientific”.

It was clear that the AVN was trying to find its way around the No Jab No Pay family assistance requirements and the No Jab No Play policy requirements. In April 2015 it was initially announced that religious exemptions for vaccination would cease. This was reinforced by health minister Greg Hunt in March this year. The only grounds for exemption of childhood vaccination are medical. The AVN’s claim that vaccines contain “the products of abortion” is not only baseless, but well refuted.

The AVN’s ignorance of the moral considerations involved are not difficult to discern. A Vatican City 2005 Statement, Moral reflections on vaccines prepared from cells derived from aborted human foetuses, includes in reference 15;

…the parents who did not accept the vaccination of their own children become responsible for the malformations [due to rubella infection] in question, and for the subsequent abortion of fetuses, when they have been discovered to be malformed.

Still it is quite predictable that this morally bereft pressure group will continue to press the fallacious contention that vaccines contain aborted foetal cells. Social media, particularly Facebook and Twitter are means by which the anti-vaccination lobby interact. Indeed the conduct of antivaccinationists on Facebook has revealed much of their conspiratorial, cruel, cult-like nature.

First we witnessed the anti-vaccine lobby grow with simple access to misinformation via the Internet combined with the ability to invent and spread more. With the growth of social media we have witnessed this social malignancy improve it’s networking skills and spread their dangerous misinformation and conspiracy theories in real time.

In this light I was grateful that the sharp eyes of others interested in the impact of the anti-vaccination lobby had come across the following research paper.

Mapping the anti-vaccination movement on Facebook. Naomi Smith and Tim Graham.

Information, Communication & Society

Published December 27th, 2017. https://doi.org/10.1080/1369118X.2017.1418406

It looked at 6 anti-vaccine Facebook pages.

  1. Fans of the AVN
  2. Dr. Tenpenny on vaccines
  3. Great mothers (and others) questioning vaccines
  4. No vaccines Australia
  5. Age of autism
  6. RAGE against the vaccines

Post, like and comment data were further used to generate 6 social networks which were then further analysed.

Abstract;

Over the past decade, anti-vaccination rhetoric has become part of the mainstream discourse regarding the public health practice of childhood vaccination. These utilise social media to foster online spaces that strengthen and popularise anti-vaccination discourses. In this paper, we examine the characteristics of and the discourses present within six popular anti-vaccination Facebook pages. We examine these large-scale datasets using a range of methods, including social network analysis, gender prediction using historical census data, and generative statistical models for topic analysis (Latent Dirichlet allocation).

We find that present-day discourses centre around moral outrage and structural oppression by institutional government and the media, suggesting a strong logic of ‘conspiracy-style’ beliefs and thinking. Furthermore, anti-vaccination pages on Facebook reflect a highly ‘feminised’ movement ‒ the vast majority of participants are women. Although anti-vaccination networks on Facebook are large and global in scope, the comment activity sub-networks appear to be ‘small world’. This suggests that social media may have a role in spreading anti-vaccination ideas and making the movement durable on a global scale.

Some key points from the paper’s Discussion and Conclusion might be listed as follows.

  • There is a large amount of online information that is important to the anti-vaccination (AV) community.
  • Social media acts as an “effective hub” in the communication of AV information. The information is “designed to encourage grass roots resistance”.
  • AV communities are relatively sparse, not functioning as close knit communities of support.
  • Yet participation alone in AV groups can reinforce AV beliefs.
  • AV participants are reasonably active across a number of groups.
  • This suggests AV users participation in various AV groups is more autonomous than would be explained by Facebook’s recommender system.
  • Liking and commenting across a number of AV pages may create a “filter bubble” effect.♠
  • This effect is a pattern of involvement and activity that reinforces AV beliefs and conduct.
  • More research is needed to discern how much of this effect is due to the users own conduct as opposed to Facebook’s algorithmic structure.
  • AV Facebook pages exhibit “small world” network structure characteristics. Information diffuses quickly through the network via user comments.
  • “Small world” characteristics may be due to inherent aspects of the AV movement or may manifest due to the Facebook “platform”.
  • Either the former or latter aspect driving development of “small world” specifics will have unique and interesting implications.♣
  • The former suggests that as a social movement the AV lobby might develop as a “small world” network that may be amplified and made more visible online.
  • If the latter, the Facebook platform may be instrumental in the growth of the AV movement, protecting from disruption of outside influences.
  • Wide sharing of posts suggests the AV community has scope beyond the public Facebook pages.
  • Sharing may be important in spreading AV information and growing the AV movement.
  • Gender composition of AV movement reflects cultural understanding of parenting – primarily maternal.
  • Vaccination is historically “a mother’s question”. AV is described by the authors as “a mother’s question”.
  • “AV movement is primarily led by women”. Note; Sherri Tenpenny runs “Vaccine Info” on Facebook.
  • Whilst anti-vaccination is not gender specific, the “gendered nature” of Facebook page participation suggests the AV movement is “feminised”.
  • Several key pre-occupations of AV communities are evident on Facebook pages; institutional arrangements are seen to be perpetuating the harmful practice of vaccination.
  • AV community is “morally outraged about vaccination and structurally oppressed by seemingly tyrannical and conspiratorial government and media”.
  • There is a strong belief in conspiracies driven by government and media; Cover up of vaccine injury and death, spreading of Zika virus by Bill Gates and belief in chemtrails.
  • Comparison of vaccination to the Holocaust indicates strong sense of persecution within AV Facebook pages studied.
  • Strong anti-science and anti-medicine beliefs in tandem with use of natural remedies.
  • Findings limited by sample size.
  • Further, more comprehensive research is needed.

♠ Commonly referred to as an “echo chamber’.

Final paragraph;

The results of this investigation suggest a robust and highly gendered network structure that has a strong sense of moral outrage associated with the practice of vaccination. This ‘righteous indignation’, in combination with the network characteristics identified in this study, indicates that anti-vaccination communities are likely to be persistent across time and global in scope as they utilise the affordances of social media platforms to disseminate anti-vaccination information.

Concerns about vaccination reveal a community that feels persecuted and is suspicious of mainstream medical practice and government-sanctioned methods to prevent disease. In a generation that has rarely seen these diseases first hand, the risk of adverse reaction seems more immediate and pressing than disease prevention.

♣ Regarding “small world” characteristics being due to either AV specifics or to the Facebook platform, the authors write;

Both outcomes are equally interesting. The former suggests that social movements (like anti-vaccination) may inevitably develop as ‘small world’ networks structure that is further amplified and made visible online. If it is the latter, this demonstrates that Facebook as a platform has important implications for the dynamics, spread, and durability of social movements outside of the specific case examined here. Indeed, if the materiality or architecture of Facebook shapes networks towards ‘small-worldness’, this suggests that such platforms may be instrumental for the anti-vaccination movement and social movements more broadly to blossom, flourish, and resist being dismantled or disrupted by outside influences.

The above paragraph rings true and undoubtedly applies to a number of anti-science movements and conspiracy theories across the developed world.

Catherine Hughes interviewed on radio about a troll site “fact checking” the Light For Riley charity page

If [the death of infant son Riley] wasn’t enough for the Hughes family they were then subject, and continue to be subject, to a targeted
campaign of online abuse and harassment from the antivaccination movement. But they have kept up their public campaign
because they know better than anyone else the devastating consequences of these diseases.

August 8th 2017 – Shadow Health Minister Catherine King (video)
Australian Immunisation Register and Other Legislation Amendment Bill 2017

The above was read out almost three months ago during House Debates in Parliament, by Shadow Health Minister Ms. Catherine King. She had just previously said;

I would like to finish today by sharing a story of a Western Australian family who I met a number of years ago and who continue to be huge champions for vaccination. They have had very personal and deep experience of just how dangerous vaccine-preventable diseases are. I refer particularly to Catherine and Greg Hughes, who’ve experienced what no parent should have to go through, losing their baby boy to whooping cough

It is clear that the regular consistency of what reasonable hank has called “the abhorrent attacks on the Hughes family”, has also caught Minister King’s attention.

Some minutes later Nola Marino MP, Liberal Representative for Forrest rose to speak and made reference to the Hughes family’s use of social media.

The family took to social media at the time not only to share their grief but also in a desire to help eradicate the disease. They were encouraging people to make sure that their children were vaccinated. In the days before Riley’s death, Mrs Hughes made an impassioned plea to other families to consider vaccinating their children against the disease. She said, ‘If you have not been immunised against whooping cough, please consider getting it done. It was heartbreaking to watch four-week old Riley struggle with it at Prince Margaret Hospital. Please keep him in your thoughts.’

For over two years Australians have benefited from the nonprofit organisation Light For Riley. As is clear in the audio below this charity relies on donations and strives to educate woman about the importance of pertussis boosters during the third trimester of pregnancy. The Hughes have campaigned not only for awareness but also for availability. Every State and Territory offers free pertussis booster shots to pregnant women.

An example of the work done by Catherine and Greg via light For Riley

Catherine Hughes was awarded the 2016 W.A. Young Australian of the Year. There are five words describing Catherine’s work in this summary that take on more significance, given the lies and accusations spread by antivaccinationists; With no thought of reward. Catherine and Greg also won The Australian Skeptics’ Thornett Award, which is given for the Promotion Of Reason, in October 2015.

Still there have been attacks of a reprehensible nature arising from the anti-vaccine lobby. Hank has examined these slurs since their inception and revealed those who invent accusations of barbaric cruelty. Catherine Hughes has responded more than once in writing to address attacks against Riley. By manufacturing conspiracy fantasy those responsible are convincing any observers with an eye for evidence that there is none to discredit Catherine Hughes, Greg Hughes or the Light For Riley charity.

Little has changed in two years and it appears little fresh air is on the antivaccine horizon. From Inside the anti-vaxxination cult, August 6th 2017;

WITHIN 24 hours of their baby boy’s death, Catherine and Greg Hughes were confronted with the ugliness that drives the misinformed anti-vax warriors.

The grieving parents were bombarded with vicious attacks claiming they were “baby-killers” and that their infant son Riley had died because they did not treat him with vitamins and essential oils.

But the inconvenient truth which the Australian Vaccination-sceptics Network and other anti-establishment radicals do not want to acknowledge is that Riley died of whooping cough, for which he was not vaccinated.

“We were told that we were baby-killers simply because we were raising awareness about pregnancy vaccination — a proven method of protecting infants from this disease which we weren’t told about at the time we were pregnant with Riley,” Ms Hughes told the Herald Sun.

“We were accused of being employees of pharmaceutical companies, we were told that our child didn’t ever exist, and we were even accused of killing Riley ourselves.”

[…]

Recently a page attacking Light For Riley appeared on Facebook. Capturing the very nadir of human behaviour in antivaccine circles, it is titled Light For Riley Fact Checker. Predictably the lies begin immediately. The logo proclaims, “Nearly died after my last vaccines. Still can’t get a medical exemption”. An image of a young girl accompanies this nonsense, but that’s as far as it goes. There’s no story, no evidence, no medical statement. Nothing. It is vile and insulting but yet again reveals the fantasy world dependent upon conspiracy that the anti-vaccine lobby can’t live without. Wayne Baird – the AVSN’s shiny new public officer is an administrator.

Any child who genuinely almost died from a diagnosed Adverse Event Following Immunisation would be afforded exceptional care. Yet the bogus claim made over and again by antivaccinationists is that vaccines cause serious injuries and death. The reality is that they do not, yet making this claim appears to assuage any need for diagnosis, documentation or indeed any evidence beyond the claim itself. More so if a claimed vaccine harm occurs in consonance with a supposed conspiracy designed to suppress information the antivaccinationist may confidently argue that deaths from vaccine preventable disease serve to promote vaccination.

This particular Big Pharma claim is a favourite of Judy Wilyman and the AVSN. Also without any evidence the so-called “fact checker” has accused Catherine and Greg Hughes of being paid off by pharmaceutical companies. Tracy Hardy from Mouths of Mums has written about the scam page here. OUTRAGE: Antivax Facebook group mocks the death of baby boy. This is beyond outrageous and has our blood boiling along with this poor family. Yes indeed. Hard to disagree with that observation.

The page not only presents an outright lie concerning a near fatal vaccine injury but attempts to discredit information on Light For Riley. One bizarre post challenges donations for polio vaccines in third world countries. Apparently Light For Riley, “haven’t told your supporters is that polio is transmitted via the oral-faecal route, so hygiene and clean water are very important for preventing polio transmission.” It’s more likely that supporters are aware of this and also of the horror of polio in developed nations before Salk’s vaccine.

What I find most concerning about this “fact check” page is that it relies on the dodgy kudos inherent in vaccine injuries. Across the anti-vaccine lobby the notion that all vaccines potentially cause serious harm all the time is being pushed. Therefore vaccine injuries are rampant. Vaccines don’t really work and the pertussis vaccine is the cause of pertussis.

Disinformation being pushed about vaccines is big on fear yet free of substance.

  • ♣ Below – Catherine Hughes speaking with Oliver Peterson on Perth Live, 6PR October 25th

Greg Hughes responds to the so-called “Fact Checker” page;

Just when you think anti-vaccine lobbyists can’t sink to a new low, last night we were alerted to a page set up, mocking our dead son and lying about us.

Normally I’m not one to provide any oxygen to pages full of misinformation, however a couple of items on the page caught my eye and so I refused to let this one slip.

The about section states as follows:

“This page is making the Light For Riley page accountable to the misinformation they spread about vaccines. Light For Riley are funded by pharmaceutical companies to promote the death of their baby. This page is unfunded and has no conflicts of interest when it comes to promoting accurate information about the vaccine industry.”

Let me give these anonymous liars a fact-check of their own.

We have NEVER accepted funding from pharmaceutical companies. We are run by volunteers, nobody is paid a wage and our activism has only come at expense to us. For the most part we have poured our own money and efforts into the campaign with the two primary motivations being to honour our son and to ensure no family endures the heartache we suffered.

[…]

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

Lies and Deceit from Australia’s “Vaxxed” promoters

Lies and deception are second nature to the Australian Vaccination skeptics Network and particularly the group’s conspiracy-pushing driving force, Meryl Dorey.

Never one to stray far from the spotlight Dorey has been active in promoting the anti-vaccine conspiracy theory propaganda flick, Vaxxed. Along with Polly Tommy, Brian Hooker, Tasha David and Suzanne Humphries, Dorey has recently caused a stir in misleading the managers of venues booked to screen the bogus “documentary”.

This sort of scam was to be expected given the mid-May warning about the film and involvement of disgraced ex-doctor, Andrew Wakefield. On May 15th The West Australian published Parents warned on Perth screening of anti-vaccination film, Vaxxed.

Parents are being warned to ignore propaganda promoting the first WA screening of the anti-vaccination documentary Vaxxed.

The screening of the controversial film in Perth on Friday is being advertised through social media, with the southern suburbs location due to be given to ticketholders 30 minutes beforehand.

Directed by Andrew Wakefield — a former doctor whose debunked study played a key role in the anti-vaccination movement — the film reignites false claims about a link between the mumps, measles and rubella vaccine and autism. […]

Australian Medical Association national president Michael Gannon said people only had to see who the filmmaker was to know the content was questionable.

“Andrew Wakefield was found to have fraudulently produced evidence around the original MMR scare in Britain, which led to him being deregistered as a doctor,” Dr Gannon said

By the time the planned July 25th screening in QLD was due, the group was seemingly getting creative. QLD Premier Annastacia Palaszczuk heads a state government that is firmly pro-vaccine. Still, the venue chosen by the Vaxxed crew to peddle their nonsense was Miami State High School. As the ABC later reported;

Earlier this month Health Minister Cameron Dick urged residents to boycott the film that has caused controversy by linking a measles-mumps-rubella vaccine to autism.

Oh my.

In order to slip by the looming conflict of interest and the likely surety that anti-vaccine twaddle would be denied a state school venue, the Vaxxed crew decided to, well.., to lie. About the booking. The, um, purpose. About the purpose of the booking. Mmm, yes um, they did. The ABC quote the QLD Premier;

My preliminary advice is that there has been some misrepresentation to the school in question, Ms Palaszczuk said.

“They conveyed to the principal that it was to be conveying information about organic produce.”

A report at Diluted Thinking (which I recommend reading) includes a statement from the Miami State High School Principal, Sue Dalton. It’s quite clear that at no time was the intention to screen or the eventual screening of Vaxxed conveyed by those deceiving Miami State School. Sue Dalton’s statement notes;

The school hall was hired to an independent local business owner to promote their healthy lifestyle business of organic foods and coffee. It is incredibly disappointing that the agreed purpose of the use of hire did not reflect the forum that was presented last night.

Reasonable Hank also covered this abuse of state education facilities and has fortunately included video of Polly Tommy revealing her unstable anti-vaccinationism. This would appear to be a woman crippled by malignant ideology and intent on spreading potentially lethal falsehood.

The next morning, July 27th, The Gold Coast Bulletin published an ideal front page.

Incredibly the dishonest Vaxxed crew again played their hand at deceit on July 28th taking advantage of Lake Macquarie City Council. Diluted Thinking covers this matter in depth presenting an excellent examination of the facts leading to a comprehensive conclusion. Dorey and Tommey are exposed as the amateur charlatans that they are.

The Newcastle Herald have covered the appalling conduct of the Vaxxed crew. Anger as Charleston community centre The Place screens film linking vaccines with autism;

HEALTH authorities and a Lake Macquarie councillor whose son is on the autism spectrum have slammed a decision to screen a film linking vaccines with autism at a Charlestown community centre.

On Friday night The Place, a not-for-profit centre set up between Lake Macquarie council and property group GPT, hosted a screening of Vaxxed, a documentary that is being toured by the Australian Vaccination-skeptics Network (AVN).

The AVN told Hunter ticket-holders of the venue by text and email two hours before the screening.

Lake Macquarie Liberal councillor Kevin Baker, a director of The Place, said he was shocked centre management had agreed to screen the film, whose central premise is that the measles, mumps and rubella vaccine may be leading to an epidemic of autism diagnoses in children.

“It’s something that’s pretty close to me. I’ve got close family with autism including my nephew, and my son sits on the spectrum,” he said.

[…]

Hunter New England Health firmly refuted the film’s portrayal of vaccination as harmful to children.

“High vaccination rates have ensured that serious childhood diseases including measles have become rare in Hunter New England,” a spokesperson said.

“We will continue to encourage parents to vaccinate their children.”

[…]

The health service also took aim at Vaxxed director Andrew Wakefield, the lead author of a controversial study published in 1998 and since retracted that claimed the autism link.

On the topic of Dorey deception, she was behind a microphone the following day, July 29th, at the Club On East in Sutherland NSW. Dorey spends almost ten minutes preaching to the converted. However this doesn’t lend a grain of truth to anything she says. Except of course that they find it harder getting media attention than previously. This is due to the effective and ongoing work of Stop The AVN which has simply held the AVN and AVsN to account with respect to various health, fair trading and business legislation in NSW and Australia.

  • Listen to the audio below;

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Dipping into her fantasy bag Dorey claims that “we have pushed really hard to try and make vaccination reaction reporting mandatory for doctors”. It seems that until doctors report vaccines as striking down huge numbers of children through illness and death, Meryl Dorey will not be satisfied on adverse reaction reporting.

They have also tried to get an ethically impossible study completed to compare the health of the fully vaccinated and the fully unvaccinated. Perhaps this is part of the reason anti-vaccinationists dismiss herd immunity. Sound methodology for such a study is quite a challenge given that the health of “the unvaccinated” benefits from herd immunity.

Dorey then claims that following a visit to Canberra the head of the Liberal Party wrote a letter to the AVN stating, “we know why you’re asking this question and we will not do this study, because it could lead to changes in vaccination policy”.

To laughter Dorey contends that this response she has plainly made up means that, “vaccination policy is what requires protection in Australia, not the children”.

Later Dorey argues that, “we have the Health Minister in Victoria saying there are no side effects for any vaccine”. Jill Hennessey said no such thing. In fact I remember this incident because there was anti-vaccine hysteria splitting hairs. It was the media release in concern that led to the wave of abusive emails, Facebook posts and tweets. The minister never mentioned “side effects”. She mentioned vaccine “risks” and unfortunately she suggested there “are no risks”, when in fact there are minuscule risks.

There are no risks in vaccinating your children, the science is really clear. Talk to a G.P. Don’t get your advice from a quack on the Internet.

This anti-vaccine video channel has the minister’s media appearance. Still whilst she was likely overly focused on the fear being pushed by the anti-vaccine lobby and made a general statement she has since made other statements. A media release in 2017 again never mentioned “side effects”, but included.

Despite scientific evidence proving they are safe and effective, and have saved millions of lives, around 25 per cent of people still have concerns about vaccines.

This more recent and more accurate statement is what Meryl Dorey should focus on, rather than conveniently making up something based on the hysteria of almost 18 months ago. This doesn’t stop Dorey getting audience members “who know someone with a vaccine injury” to stand up. About 25 people stand up. Dorey suggests this is about half. Yet not only is this an inaccurate manner in which to gather data Dorey was present when this statement listing serious vaccine injuries between zero and five per year was made to the Social Services Legislative Amendment in 2015.

After misleading her audience on the topic of vaccine injuries Dorey leads into “the right to have free and informed health choices for our children. Nobody has the right to take that away”.

In fact I agree. So one must ask Meryl Dorey why she would seek to sabotage the Australian vaccine schedule and place countless individuals at risk of vaccine preventable disease? Why take away the very best informed health programmes that evidence based medicine has to offer? What she calls “free and informed health choices”, are in fact misinformed and radically dangerous choices prompted by fear and ignorance.

To the pile of misinformation that Meryl Dorey has been pushing onto the ignorant for her own gain for years we must certainly add Andrew Wakefield’s latest scam; Vaxxed.