Last time we left The Australian Vaccination Network, or rather President Meryl Dorey, we’d had a close look at her use of unrelated data sets and the tendency to use two figures twenty years apart, to argue pertussis vaccination is not efficacious.

Four days later, an AVN member repeated the very same claim on the very same forum. Also, back on the day I posted Meryl had written an extraordinary attack on official health figures based upon the newspaper article, More testing finds more coughing. Dorey’s completely unreferenced and innuendo filled post is entitled 100 times increase in Whooping Cough – is it REALLY just more testing? 

The article quoted is quite sensible and accurate. Dorey’s feverish and misleading extrapolation can only be examined if one reads her entire diatribe then copies and pastes the news article link at the bottom into a browser. What sets her off is focusing on the first paragraph, whilst ignoring the second. The article opens with the observation that better testing has more to do with the outbreak in NSW than with drops in immunisation. Then continues in the second paragraph with [bold mine] “there was no doubt whooping cough increased in areas with low vaccination rates”, according to Professor Booy who is a professor of child health at Westmead Children’s Hospital.

Dorey uses the same leap in notifications from 1991 to today, ignoring the peaks and troughs of infection, smirking that the outbreak, “isn’t real – it’s just more testing”. Then a simple falsehood. “So the fact that we have gone from 300 cases in 1991 to more than 35,000 cases today is just a figment of our imagination…”. From 332 cases in 1991 we had 34,794 last year and as of “today” have 18,299. Source here. Then it’s classic Reductio Ad Persecutorum, the classic logical fallacy named after Meryl Dorey herself.

And the vilification of families who have chosen not to vaccinate by the media, the medical community and the government that has occurred over the last 2 years because of this non-existent epidemic…

There’s been no vilification. Facts are facts. The Reductio Ad Persecutorum we see is entirely down to denial of vaccine efficacy and germ theory. Dorey ignores here the effect on herd immunity in areas with low vaccination rates, and has now redefined the epidemic as “non-existent”. Astonishing. The Hon Nicola Roxon, Federal Minister for Health and Ageing released Protecting Bubs: Whooping Cough Epidemic on February 21st this year, including;

As the current whooping cough epidemic continues, Health and Ageing Minister Nicola Roxon has reminded parents to protect their children with vaccinations, which can begin six weeks after birth.

“All parents should take advantage of the free vaccines provided by the Australian Government to protect young children from whooping cough,” Ms Roxon said. “Babies can be protected with vaccinations at six to eight weeks after birth, then at four months, and then when they reach six months old.

“Vaccines worth about $86 million will be provided in 2010-2011––free of charge for infants, children and adolescents.

[…..]

“Babies are not fully protected until their third dose of the vaccine, so it is important for those around new babies to be free of infection.

Remember, Dorey’s continued demonstrably false argument is that high vaccination rates and increasing pertussis cases prove the pertussis vaccine is not efficacious. This, she argues, is supported by a corresponding rise in diagnoses and notifications. In her article she is clearly selecting the reality of more widespread testing and using it out of context. Her context is that reported effective wider testing is a ploy by the government to dodge the higher notifications of pertussis (and thus vaccine inefficacy). In reality, more widespread testing explains the rise in notifications over the past four years.

Nonetheless she states without any supporting references;

But be that as it may, the fact is that the government has declared an epidemic by their own figures and now, faced with the inconvenient fact (which we have been stating for years) that vaccination rates are at an all-time high, they are now trying to say that there was no epidemic in the first place -it’s only smoke and mirrors. Don’t count on our statistics -they’re only rubbery figures, after all.

Oh, and we haven’t actually seen an increase in pertussis deaths either because Professor Booy says that they were much higher ten years ago. In fact, there were NO deaths at all from pertussis for well over a decade prior to the deaths that occurred in 2009 – one of which was in a child too young to be vaccinated and the other 2 in older, partially-vaccinated infants. So again, don’t trust the government’s statistics because they seem to be either inaccurate or simply made up on the spot!

“Inconvenient fact… smoke and mirrors… rubbery figures… no deaths ‘for well over a decade prior to … 2009’… statistics made up on the spot”. Statistics Dorey uses to make her entire “failed vaccine” argument, I might add. That’s quite a tantrum to throw over one small news article that refers only to vaccination rates in NSW, whilst Dorey is using national figures. Professor Peter McIntyre in a Rapid Roundup article for the Australian science media centre written in September 2010, addresses both death rates and the most important factor in recent diagnostic increases: Local GP access to PCR testing;

“The problem with whooping cough is that it is hard to get a laboratory diagnosis that is definite and doctors may not order the relevant tests so it does tend to be under-recognised. Having said that, the availability of the PCR test (since about 2000 in hospitals but especially over the past two years at the GP level) has greatly increased the number of cases and hospitalisations being recognised.

There have been big national epidemics in 1996/7, in 2000/1 and most recently in 2008/9. In South Australia, where this death occurred, the epidemic was later than in many other parts of Australia and is still current.

Bearing this in mind, it is important to note that despite a very large increase in reported cases in the 2008/9 epidemic compared with 1996/7, there were a total of nine infant deaths in 1996/7 but there have been, with the most recent death in SA, a total of four deaths recognised in 2008-2010.

Meryl Dorey also makes some alarming and demonstrably false claims about the documented mutation in two strains of pertussis. Firstly she claims it’s the “elephant in the room” that the medical community almost never refers to. This nonsense is followed by arguing that the cause is overuse of pertussis vaccination, “much like overuse of antibiotics” led to decreased antibiotic effectiveness. Vaccination levels required for herd immunity and “overuse” of antibiotics are quite different issues however.

Dorey argues incorrectly that nobody seems to know if the vaccine is ineffective or less effective. So, she then makes up her own mind claiming without evidence that the mutated strain is more virulent and dangerous, thus leading to more deaths here and around the world. Then we get this stunner;

So not only is the pertussis shot not preventing vaccinated people from getting pertussis – it could also be responsible for the increased death rate.

So what is happening? There are several strains of circulating bordetella pertussis bacteria. In early 2010 researchers from the University of NSW school of biotechnology and biomolecular sciences discovered mutations in the two most common strains – MT27 and MT70. The whole cell pertussis vaccine contained hundreds of antigens providing widespread protection. It also correlated to more cases of irritability and fever. The acellular vaccine introduced in 2000 is highly tolerable with several variations. Each variation contains between three to five purified pertussis antigens.

This certainly makes it easier for any potential mutation to defeat vaccine induced immunity. Yet in the absence of conclusive data we can only be sure that some strains will have greater effect. Co-author of the study Associate Professor Ruiting Lan says the acellular vaccine might have contributed to the mutation. What we can say is that the pertussis vaccine may not be fully effective.

Professor Lyn Gilbert is a clinical microbiologist at the University of Sydney. She was involved in the study and notes that whilst bordetella pertussis may mutate to bypass herd immunity, bacteria can and do evolve spontaneously. Dr Nick Wood, from the National Centre for Immunisation Research and Surveillance has also noted that antibiotic use may have played a role in this bordetella pertussis mutation. Do note this is not the overuse of antibiotics leading to antibiotic resistance and super strains Meryl Dorey was alluding to. The World Today covered this back on February 11th, 2010 including both Professor Lyn Gilbert and Associate Professor Lan;

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A comprehensive US article in The Journal of The American Medical Association, Research Aims to Boost Pertussis Control quotes Fritz Mooi, PhD, senior scientist at the National Institute for Public Health and the Environment, Bilthoven, the Netherlands. He suggests lowered efficacy and faster waning of immunity associated with the acellular vaccine isn’t a sufficient explanation, for the present outbreaks. He and his colleagues, “posit that this is occurring in response to selection pressure from the vaccine”. What’s quite bizarre is that Meryl Dorey posted this article on her Facebook page. It includes;

James Cherry, MD, a pediatrician at Ronald Reagan UCLA Medical Center, in Los Angeles, and one of the world’s leading experts on whooping cough, maintains that the increase in cases reflects greater awareness and improved recognition of the disease among clinicians as well as availability of better laboratory tests and greater access to them.

The one thing I don’t want to do here is to use Ms. Dorey’s misplaced confidence in blaming a pertussis mutation on “overuse” of vaccination, to convey a conclusive argument that B. pertussis strains MT27 and MT70 have not adapted to the acellular vaccine via mutation. This may well turn out to be the case, but it does not justify attacks on vaccination regimes or the vaccine. There have been mutations before through adaption of B. pertussis to the vaccine.

This was the case for The Netherlands outbreak in 1996. Ironically, Dorey has been referring to this outbreak for years as proof of general pertussis vaccine inefficacy. She has been most cautious to not admit or refer to the mutation in The Netherlands as this ran contrary to her claim that pertussis vaccination – both whole cell and acellular – was ineffective. Frankly it now beggars belief she has jumped on the band wagon only to use the situation in Australia to spread fear, rail at health departments, misinform and mislead further.

As I pointed out above, whilst Professor Booy is referring to sufficient levels of vaccination in NSW, Dorey has inexplicably launched an attack on Australia’s national figures. Less than a month before, a Herald Sun article reported AMA Victorian president Dr Harry Hemley as saying “immunisation in the community is tending to wane”.

Ultimately this is another hysterical and difficult to follow anti-vaccination rant from Meryl Dorey. She definitely wants to eat her cake and keep it also. In attempting this she meanders throughout the entire bakery emerging into the spotlight covered in flour and jam, with no more evidence than the odd crumb picked up accidentally along the way.

This Today Show clip on the pertussis epidemic offers good advice and disturbing figures.