Fake news and the spreading of measles

“Fake news” isn’t my favourite term for the disinformation spread by antivaccinationists. However it conveys a meaning that is usefully accurate when it comes to labelling deception spread with the aim of misrepresenting the facts about vaccines.

The narrator in the US video below asks the question, “Is fake news making people sick?”. He notes that the country has broken a 25 year old record for measles cases this year. At the time of making the video there were over 700 cases across 22 states since the beginning of 2019. In states where population density is high we can expect to see the impact of vaccine induced immunity and herd immunity (or the lack thereof) in their unmistakably predictable manner.

New York city has had over 400 cases since October 2018. Some – not all – members of the orthodox Hasidic Jewish community have been avoiding vaccines. The narrator tells us this is due to “rampant misinformation around vaccines”, even though the orthodox community “overwhelmingly” believes in vaccines. One woman seems to doubt vaccine safety and efficacy. She argues that “some people question why would I subject my three year old to toxins when it’s not going to protect him or her”.

There is an increase in insular socialising habits in close orthodox communities. This ensures the successful spread of misinformation by The Vaccine Safety Handbook. Packed with the most well constructed vaccine myths, it targets these communities with well debunked anti-vaccine conspiracies, codswallop and even commentary from rabbis, specific to Jewish religious law.

WhatsApp groups have been set up to push anti-vaccine disinformation further, with some orthodox members reporting that their only source of news is via WhatsApp.

If this reminds you of the Somali community in Minnesota in 2017 and 2011, you’re not alone. 80% of reported measles cases in 2017 were of Somali children whose parents had been convinced of the risk between autism and MMR. It was the largest measles outbreak for 30 years.

What’s this got to do with orthodox Jews in New York? Well I mentioned the insular nature of close communities. In an article headed Minnesota’s measles outbreak is what happens when anti-vaxxers target immigrants, it is noted some of these Somali Americans had concerns about higher than average rates of autism amongst their children. This entire episode is indicative of the impact that calculated disinformation can have. Particularly when provided in an area of uncertainty and despite the effort and funding from health experts and government authorities.

In 2008 Somali parents stressed that there appeared to be more 3-4 year old Minnesota Somali children enrolled in the public preschool special education program for Autism Spectrum Disorder, compared to the overall percentage of Somali children enrolled in public schools [page 4].

Also a couple of years before this time MMR vaccine coverage had started to decrease in Minnesota-born Somali children from 2006 at which time rates had been above 90% [Figure 2].

Cultural differences meant that the most genuine efforts to assist the Somali-American community with this issue proved difficult. There is no word in Somali for “autism”. Indeed there is no grey area as one Somali parent put it. Mental health is seen as either “crazy” or “sane”, and this leads to the fear that a child may be called an unhelpful name within the community. A name used behind the parents’ back [page 4].

The Minnesota Department of Health (MDH) worked to re-examine enrollment data for pre-school aged children in the special education program. The results were published in a report which tended to focus on participation rates only. The report [pp 4-5];

…did not attempt to measure the true occurrence of ASD in all children, and it did not attempt to identify possible causes or risk factors for ASD. Instead, the focus was on developing a better understanding of reported differences in program participation rates among preschool-aged children enrolled in this MPS program.

The three main findings in the report confirmed parent’s observations and also raised questions as to better outreach services to Somali children vs genuinely higher levels of ASD, compared to non-Somali children accessing ASD services outside of the MPS. The proportion of Asian and Native American children participating in ASD programs was significantly lower. The cause for this remained elusive. Participation rate differences between Somali pre-school children and pre-school children from other ethnic backgrounds decreased “substantially” over the three years studied. The basis for this final point remained unclear.

Following the 2009 MDH report advocates for the Somali community called for further research. The CDC, NIH and Autism Speaks provided technical assistance and funding to the University of Minnesota. The aim was to focus on ASD in Minnesota and within Somali vs non-Somali communities. The MDH and the University of Minnesota’s Institute on Community Integration added in-kind staff and funding.

Still, we need to remember that it was 2008 when Somali parents first raised their concerns about ASD with the Minnesota Department of Health.

Enter disgraced fraud, data falsifier and ex-gastroenterologist, Andrew Wakefield, who was struck off the U.K.’s General Medical Council 21 years ago and the many-faced Organic Consumers Association. Wakefield targetted and set about convincing Minnesota’s Somali Community that MMR could not be trusted as health authorities claimed. It caused autism he lied. The rumour spread through the community. During the 2017 measles outbreak Wakefield insisted he didn’t feel responsible at all.

In short Wakefield and fellow antivaccinationists spread his anti-vaccine lies with the result that MMR vaccination fell in the Somali community for a number of years. Immigration status can be a risk factor with respect to immunisation status and this fact played very well into the hands of antivaccinationists.

Nonetheless, no vaccines cause autism.

It’s important to remember, and realise, how much damage antivaccinationists can do to public health. Yes, “fake news” is making people sick. Cities with high density and insular communities that are convinced to skip vaccination will constantly face the possibility of outbreaks. The anti-vaccine lobby and their minions will continue to spread misinformation and where possible it must be refuted.

I read a comment recently dismissing the need for any vaccine and contending that only three people had died since 2000. Forgetting that this US citizen is ignoring the rest of the world, it is just such complacency that helps drive the luxurious nonsense that vaccines are more harmful than the diseases they prevent.

Because after all, in the developed world vaccines are a victim of their own success.

 

 

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Anti-vaccination campaigners: Misleading and Unsafe

When it comes to public advocacy this year, one of the most effective announcements came in December.

The NSW Health Care Complaints Commission issued a public warning under s94A of the Health Care Complaints Act 1993 with regard to the “misleading and unsafe practices by anti-vaccination campaigners”.

The HCCC had received numerous complaints about individuals and associations and is concerned about the risk they pose to public health and safety.

The anti-vaccination lobby pushes messages which;

have the potential to engender fear and alarm in the community, often targeting vulnerable members of the community through misinformation which may have a detrimental effect on the health care decisions of individuals.

 

PUBLIC WARNING UNDER S94A OF THE HEALTH CARE COMPLAINTS ACT 1993:  MISLEADING AND UNSAFE PRACTICES BY ANTI-VACCINATION CAMPAIGNERS

The NSW Health Care Complaints Commission (“the Commission”) has received multiple complaints regarding misleading and unsafe practices by anti-vaccination (“anti-vax”) campaigners and the potential risks that such persons and associations pose to the public health and safety.

Immunisation is a simple, safe and effective way of protecting people against harmful diseases before they come into contact with them. Immunisation protects individuals and the community by reducing the spread of preventable diseases.

Complaints have been received in relation to individuals (including registered and unregistered health practitioners as well as academics) and organisations engaged in the widespread promotion of dangerous anti-vax messages.

Why is this warning being issued?
Misleading and inaccurate information communicated by anti-vax campaigners has the potential to engender fear and alarm in the community and result in fewer people being vaccinated. This information commonly quotes scientific research and studies in support of anti-vax claims, but is often selective, including exaggerating the risks and minimising or discrediting the benefits of vaccines. The research presented does not align with the true evidence-base on which independent and government bodies worldwide make vaccination recommendations.

This is likely to have a detrimental effect on the health care decisions of individuals and may lead them to make decisions not to vaccinate which pose an avoidable risk to their own health and to the safety of the wider community.

It is unfortunate that anti-vax campaigners are also known to target particularly vulnerable members of the community, including impressionable young parents who are concerned about making the right health decisions for their infants.

The spread of misleading and false information by anti-vax campaigners presents an ongoing challenge for government agencies, particularly due to the rise in use of social media and the proliferation of information concerning vaccinations available via the internet.

Given the continuing efforts of anti-vax campaigners to mislead and misinform members of the public, the Commission considers it necessary to warn all health consumers of the danger of relying on information that is not from a reliable and trusted source. This can include websites that appear to be “professional” and groups that are well-organised in their approach. Some persons and associations will go as far as to distance themselves from “anti-vax” campaigners, while essentially promoting the same message.

What should consumers do to protect themselves?
The Commission strongly urges consumers to exercise caution in relying on information concerning the safety and efficacy of vaccinations which is promoted via social media and websites that are not government affiliated or endorsed. Further, consumers should be cautious of persons or groups spreading anti-vax messages via other means, including face-to-face information sessions and other public events.

In all cases the following factors should be considered by consumers when presented with any information or advice concerning the safety and efficacy of vaccines and immunisation programs in Australia.To ensure that you are receiving reliable information concerning the safety and efficacy of vaccinations and to assist you in making an informed decision concerning the benefits and risks of particular vaccines, it is recommended that you consult a registered medical practitioner (e.g. your family GP or paediatrician).

Health consumers should be particularly wary of persons claiming to be “experts” or to have conducted “research” into the safety and efficacy of vaccines or immunisation programs in circumstances where they do not hold relevant medical qualifications and are not a registered health practitioner.
Consumers should be wary of persons holding themselves out to hold qualifications that cannot be verified. If you wish to ensure that the person providing advice is a registered health practitioner you should check on the National Register of health practitioners – https://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx

Health professionals play a role in health education and administration of vaccines, however it is not appropriate for health professionals to promote anti-vax messages via their personal social media pages or other online forums.  Consumers should avoid placing any reliance on “comments” made via social media that are not from a reliable and trusted source.

When researching online, it is recommended that you visit trusted government websites including the NSW Health and Commonwealth Department of Health websites and also the National Centre for Immunisation Surveillance and Research (NCIRS) website, which provide reliable information concerning immunisation and Immunisation Programs:

https://www.health.nsw.gov.au/immunisation/Pages/default.aspx

https://beta.health.gov.au/health-topics/immunisation

http://www.ncirs.edu.au/

 

The Health Care Complaints Commission (“the Commission”) has issued a public warning under s94A of the Health Care Complaints Act 1993 regarding Misleading and Unsafe Practices by Anti-Vaccination Campaigners.

The Commission is concerned about a number of complaints it continues to receive regarding misleading and unsafe practices by anti-vaccination (“anti-vax”) campaigners and the potential risks that such persons and associations pose to the public health and safety.

Anti-vax messages have the potential to engender fear and alarm in the community, often targeting vulnerable members of the community through misinformation which may have a detrimental effect on the health care decisions of individuals. Anti-vax campaigners will often selectively quote scientific research and studies in support of anti-vax claims, including exaggerating the risks and minimising or discrediting the benefits of vaccines. The research presented does not align with the evidence-base on which independent and government bodies worldwide make recommendations.

Given the continuing efforts of anti-vax campaigners to mislead and misinform members of the public, the Commission considers it necessary to warn all health consumers of the danger of relying
on information that is not from a reliable and trusted source. This can include websites that appear to be “professional” and groups that are well-organised in their approach that often use popular mechanisms like social media to promote their messages.

What should consumers do to protect themselves?

The Commission strongly urges consumers to:

  • Exercise caution when relying on vaccination efficacy information which is promoted via social media and websites that are not government affiliated or endorsed;
  • Be cautious of persons or groups spreading anti-vax messages via other means, including face-to-face information sessions and other public events;
  • Be wary of persons claiming to be “experts” or to have conducted “research” into the safety and efficacy of vaccination programs;
  • Be wary of persons holding themselves out to hold qualifications that cannot be verified. If you wish to ensure that the person providing advice is a registered health practitioner you should check on the National Register of health practitioners – https://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx;
  • Consult a registered medical practitioner concerning the benefits and risks of vaccines;
  • Visit trusted government websites when researching online, including the NSW Health and Commonwealth Department of Health websites and the National Centre for Immunisation Surveillance and Research (NCIRS) website.

 

Further Information

For further information, contact the Executive Officer of the Health Care Complaints Commission, on 9219 7444 or send an email to media@hccc.nsw.gov.au.

 

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.

The problem of clustered drops in herd immunity

There are many reasons anti-vaccine lobbyists push the falsehood that herd immunity “is a myth”, is not important or simply doesn’t exist.

To listen to recent untruths from Meryl Dorey, one should eagerly accept that it is “documented” in peer reviewed literature as being more or less non-existent. Indeed, “it is a lie” lies Dorey. By essentially mocking the importance of herd immunity, garden variety anti-vaccine tricksters can shirk the responsibility that not vaccinating may harm the wider community, innocent infants or children, and deny larger scale resistance to infection that the immune-compromised rely on.

Herd immunity is an impressive function of mass vaccination. More so it is remarkably easy to understand. But the anti-vaccine lobby refuse to accept any need for or benefit from, mass vaccination. It is even more bizarre when one considers the parallels to so-called “natural immunity” – such as with marvellous measles, or “right of passage” infection and immunity. With mass vaccination we can control the spread of immunity and thus the spread and ultimate impact of vaccine preventable disease.

We should never forget that claims of raising impeccably healthy and disease-free unvaccinated children can exist only for as long as vaccine-induced herd immunity remains at a crucial level. The level that permits a free ride and protection from most vaccine preventable diseases for these very children.

Once again the formula frequently relied upon is “< 100% = 0%” – such as this 1973 article. One popular mode is that if a child is vaccinated against X, they should be safe from infection with X. Even worse is a distortion of epidemiological factors at play. This involves citing nationwide or statewide vaccination rates – which level out as reasonably high – along with reported outbreaks, such as those seen of pertussis or measles. Or including individuals who have had just one MMR jab (in the case of measles) or those whose vaccine-induced pertussis immunity has certainly waned.

This not-very-clever deception ignores the fact that areas with low vaccination uptake provide the ideal conditions for infection to spread rapidly.

The video below compares the difference in infection spread in the sparsely located unvaccinated compared to a cluster of unvaccinated individuals.

Herd Immunity

Measles Vaccination: make an informed choice

Recently in Melbourne Australia, the wanderings of a baby infected with measles prompted Victoria’s Chief Health Officer Dr Rosemary Lester to name certain venues and alert the public. The 11 month old had, while infectious, visited four major shopping complexes, two restaurants, a cafe, a children’s play centre, a church and a chemist. Dr. Lester stressed those who attended these venues should ensure they pay extra attention to symptoms such as;

…common cold symptoms such as fever, sore throat, red eyes and a cough. The characteristic measles rash usually begins 2-5 days after the first symptoms, she said, generally starting on the face and then spreading to the rest of the body.

A bit of a rash, sore throat and temperature then. I’ve heard groups who insist vaccines don’t work or aren’t needed pass measles off as nothing to worry about. Yet the article also included this from Dr. Lester;

“Anyone developing these symptoms is advised to ring ahead to their GP or hospital and alert them that they have fever and a rash,” Dr Lester said. “If you know you have been in contact with a measles case please alert your GP or hospital emergency department. The GP or hospital will then be able to provide treatment in a way that minimises transmission.”

Hmmm. Maybe hospitals in Victoria are running drills this month. Practising for something serious with this little rashy-coughy thing. After all a Slovakian micro-palaeontologist had described it as a simple “right of passage”. And if anyone would know about infectious disease in Australia it is a Slovakian micro-palaeontologist, not a mere Chief Health Officer of a state holding around six million people. But then the piece by the paper’s Health Editor went on to state measles is highly infectious. It is particularly dangerous for young children and young adults.

Those most at risk of getting the disease are people who have not been vaccinated, particularly adults between 33 and 47 years because many in this age group did not receive measles vaccine, and people whose immune systems have been compromised because of cancer treatment, for example.

Perhaps, as they say, this is not a drill. I remember reading material from those against vaccination. They spend a lot of time and caps lock justifying why vaccines are dangerous, or useless, or part of a conspiracy. The claim that vaccines are useless is backed by graphs which plot disease induced mortality against time and contend X vaccine was introduced well after mortality reached zero. Clean water, nutrition and better living standards stopped these infectious diseases they insist, not vaccines. So I decided to check the measles graphs drawn up by renowned antivaccinationist Greg Beattie.

Beattie_measles1Greg Beattie’s “Figure 1” from Fooling Ourselves

The above graph is from Beattie’s Fooling Ourselves. The Australian Vaccination-sceptics Network is littered with this and many others from Beattie. Material published by the AV-sN has been independently examined and discredited in the preparation of a public statement and warning by the NSW Health Care Complaints Commission. It appears then, Beattie’s graphs have been examined and discredited in an official capacity. There is no mistake as to why the HCCC warned the public to exercise caution in viewing “misleading” material. It is important to focus on Beattie’s intent here. Namely that vaccines had no impact or an irrelevant impact on the control of infectious disease. In part this post challenges the intent of Beattie’s graphs by presenting independent data that show vaccines most certainly had a powerful effect in controlling the spread of vaccine preventable disease. Thus Beattie’s cunning use of mortality rate above, is met with absolute and predicted numbers. Greg Beattie cites the Australian Bureau of Statistics, Commonwealth Year Books and “data published by the Commonwealth” in Cumpston’s 1927 The History of Diptheria, Scarlet Fever, Measles and Whooping Cough in Australia. One notes the first problem is his reliance on mortality and not morbidity. Death as a consequence of a vaccine preventable disease is a limited indicator of how effective vaccination has been in reducing infection. Overall morbidity (infection) offers a more realistic picture. Indeed the anti-vaccine lobby are today only too quick to point to the number of pertussis notifications in those vaccinated, when launching attacks on the efficacy of the vaccine or the need to be vacccinated. They concomitantly avoid noting pertussis mortality in Australia hits the unvaccinated. The vaccinated cop a less dangerous, and to date, non-lethal infection. [Update] Children not vaccinated against pertussis are 24 times more likely to be infected with the wild strain, than those who are vaccinated. Below is another graph from Communicable Diseases Intelligence. I’ve boxed in measles in red and used coloured horizontal lines to link mortality to years pre and post introduction of the measles vaccine. It’s clear that the greatest gap – or in fact drop – in mortality follows the introduction of measles immunisation. Thereafter reductions are smaller and more evenly spaced. Diptheria tetanus polio measles highlight Could there be more important facts left out by Beattie? Clearly his graph is designed to visually convince the reader that the measles vaccine was introduced when measles was all but eradicated. Thus Beattie contends vaccination had no impact on its control. So what of Beattie? Do we afford him the benefit of the doubt? You be the judge. Immediately after the graph he writes in Fooling Ourselves.

The graph for measles (Figure 1) shows us that the five-yearly death rate, 100 years before the vaccine was introduced, was around 170. One hundred years later, and immediately prior to introducing the vaccine, it was less than one. That’s a reduction of 99.5%—before the vaccine arrived. The remainder of less than 1% is therefore the only portion of the decline to which the vaccine can possibly lay claim, because it simply was not around for the first 99.5%. […]
Let’s check that again: One hundred years later, and immediately prior to introducing the vaccine, it (the five year mortality rate from measles) was less than one. Looking at the CDI graph above, and countless others that can be wheeled out from developed nations around the world he is simply misinforming his readers. Less than one for five years? Whilst the CDI graph plots 150 from 1966 – 1975. An excellent way to further debunk Beattie’s “vaccines-didn’t-save-us” mess is through statistical estimation of the deaths that would have occurred without immunisation. Cost effectiveness and the money saved through improved health is vital. Love it or loathe it the cost of running a vaccine-conspiracy would be monumental. The savings to be made in controlling infectious disease are also wonderfully impressive and much time and energy goes into ensuring we invest in what pays for itself. The figure loving, graph scribing, number crunching chaps at Applied Economics are deft hands at such dark arts. In a semantic flick of the bird to antivaccinationists they write;

The trend in measles deaths since 1940 reveals a secular decline. This reflects a reduction in case fatality associated with a general improvement in health status as well as the introduction of antibiotics in the late 1940s (Russell, 1988). By fitting a trend to measles deaths for the period 1940–69 and extrapolating it from 1970 onwards, we can estimate the deaths that would have occurred without immunisation. A trend can also be fitted to actual deaths that occurred with immunisation. The difference between these two trend curves is our estimate of the lives saved because of immunisation.

I’ll leave you dear reader to pop over and peer at their graphs revealing the “lives saved because of immunisation”. They also sacrifice many pure white A4 sheets doing the same with Hib vaccination. Nonetheless here is (the businesses end of) the table born of such mysterious chanting and ritual. Pre immunisation years from 1940 are available. The point here is to further debunk the antivaccinationist claim that vaccines did nothing. By analysing pre and post immunisation mortality and morbidity trends, a strong estimate of lives saved and disease prevented can be clearly demonstrated.

 Estimated deaths due to, and notifications of, measles tabulated as with or without immunisation

Consequently estimated lives saved and estimated cases averted based solely on measles immunisation can be calculated as the difference

Deaths Notification
 Year Without Immunisation With immunisation Estimated lives saved Without immunisation With immunisation Estimated cases averted
1970 16 10 6 110,693 77,000 33,693
1971 15 10 5 112,391 67,459 44,932
1972 14 10 4 114,061 59,100 54,961
1973 13 10 3 115,706 51,777 63,929
1974 13 9 4 117,325 45,362 71,964
1975 12 9 3 118,921 39,741 79,180
1976 11 9 2 120,494 34,817 85,677
1977 11 8 3 122,044 30,503 91,542
1978 10 8 2 123,574 26,723 96,851
1979 10 7 3 125,083 23,412 101,671
1980 9 7 2 126,573 20,511 106,062
1981 9 7 2 128,044 17,969 110,075
1982 8 6 2 129,497 15,743 113,754
1983 8 6 2 130,932 13,792 117,140
1984 8 6 2 132,351 12,083 120,268
1985 7 5 2 133,753 10,586 123,167
1986 7 5 2 135,139 9,274 125,865
1987 6 4 2 136,511 8,125 128,385
1988 6 4 2 137,867 7,118 130,749
1989 6 4 2 139,209 6,236 132,973
1990 6 4 2 140,537 5,464 135,074
1991 5 3 2 141,852 4,787 137,065
1992 5 3 2 143,153 4,194 138,960
1993 5 2 3 144,442 3,674 140,768
1994 5 2 3 145,719 3,219 142,500
1995 4 2 2 146,983 2,820 144,163
1996 4 1 3 148,236 2,470 145,765
1997 4 1 3 149,477 2,164 147,313
1998 4 0 4 150,707 1,896 148,811
1999 3 0 3 151,927 1,661 150,266
2000 3 0 3 153,136 1,455 151,680
2001 3 0 3 154,335 1,275 153,059
2002 3 0 3 155,523 1,117 154,406
2003 3 0 3 156,702 979 155,723

 © Applied Economics

These are impressive figures. Lives are saved and disease is averted due to the MMR vaccination. Conversely with no vaccine induced protection from measles lives are lost, disease is spread and disability and suffering ensues. There can be few better examples as to the efficacy of mass immunisation, or indeed, the danger of the anti-vaccine lobby.

Consulting reputable publications we can see that measles is indeed a potentially very serious disease. Health authorities have never denied that vaccination carries a negligible risk. The anti-vaccine lobby is apt to demand vaccines be both 100% effective and 100% safe. As a public we are rather poor at assessing risk-benefit and thus many fall prey to the anti-vaccine slogans and lies.

Encephalitis is a one in a million plus risk as a consequence of measles vaccination. As a consequence of measles it is a one in a thousand risk. In short those who argue “natural immunity” is best subject their children to the risk of brain damage or death at a rate 1,000 times greater than had they chosen MMR. For every ten who contract encephalitis one will die and four will be permanently brain damaged. Around one third of those infected will develop complications that will likely require hospitalisation.

Depending on age, one child dies for every 2,500 – 5,000 cases of measles.

MMR vs infection

© The Encephalitis Society – Access full document here

Recently the vaccine-autism zombie had some life breathed into it. Fortunately it turns out that just as Wakefield perpetrated his original – and ongoing – fraud for money, the author of the latest scam is a member of a group erroneously believing vaccines cause autism and will stop at nothing to mislead the public to this same misconception. The “paper” was withdrawn in one month. A statement has been published by Dr. William Thompson who was deceived into becomming a “whistleblower”.

He was recorded against his will and it appears the anti-vaccine author Brian Hooker had worked for months to get the pro-vaccine Thompson on record as sounding like a whistleblower.

And so it continues. This is indeed not a drill. We do have reasonably healthy rates of vaccination but the return of measles, varicella and other vaccine preventable diseases means there is no room for complacency.

Make an informed decision. Vaccination saves lives.

The history of measles

Australian Immunisation Handbook – 2013

MMR

Measles Fact Sheet – WA Health

NCIRS – events in MMR vaccination practice