Meryl Dorey and Australia’s pertussis epidemic

Interviewer: Are you proud that this area has one of the lowest vaccination rates in the country?

Meryl Dorey: I don’t think there’s anything to be proud or ashamed of. I think I am proud that our organisation is assisting parents to get information that they would not otherwise be able to access.

Sunday Night – April 2009

Unfortunately when you’re out to derail vaccination regimes the consequences of singular pursuits can be ignored this way.

I’ve little doubt Meryl would be proud, having labelled vaccines, “instruments of death”. Apart from the standard antivaccination fare, Dorey has a unique approach to reality:

Now, we have a medical community that’s saying if you get measles, if you get whooping cough you’re going to die from it. Well where is the information from that? You didn’t die from it thirty years ago and you’re not going to die from it today. [Audio]

Well that’s certainly misinformation one would not “otherwise be able to access”. Over that same year three tiny babies died from pertussis. From 1993 – 2008, 16 babies under 12 months lost their lives to pertussis. Fatalities continue right up to the present day. In addition survivors are left with hypoxic brain damage, scarred lungs, burst blood vessels in conjunctiva and broken ribs. Adults can seriously injure themselves. Dr. Penny Adams recounts how she prolapsed a cervical disc onto her spinal cord requiring surgery to correct.

As this information is easily accessible we can appreciate why those who monitor Ms. Dorey raise serious concerns about the ethics of allowing her to speak unhindered in public. Seeking to impede someone who claims pride in intentionally spreading falsehoods that can injure and kill Australians is not an attack on free speech.

One of the earliest observations that Meryl Dorey’s antivaccination lobbying could have an effect on local herd immunity was published in early 2003. MAPPING IMMUNISATION COVERAGE AND CONSCIENTIOUS OBJECTORS TO IMMUNISATION IN NSW was written in the NSW Public Health Bulletin, Volume 14, Numbers 1–2 January–February 2003. Authors Brynley Hull and Peter McIntyre note in the discussion (page 12) [Bold mine]:

Although immunisation coverage has greatly improved over the past five years in NSW, and many areas have reached coverage targets, there are areas in NSW where the level of registered conscientious objection to immunisation is great enough to affect immunisation coverage, as measured by the ACIR. One such area is northern NSW, and the Byron Bay SLA in particular, where the rate of conscientious objection is one of the highest in the country.

Presently Australia is in the fifth year of strikingly elevated pertussis notifications. Whilst it seemingly began in Meryl Dorey’s backyard on the north coast, we can easily trace its spread across the nation from media reports. Although not the first report, an article by Amy Corderoy on October 30th, 2010 brings the concerns of Hull and McIntyre to life, over 6 1/2 years later. From Vaccination rates spark epidemic fear. [Bold mine]:

And health authorities warn that NSW could be facing another outbreak as more cases than usual have been seen recently in the areas where the epidemic started. The highest rates of so-called “conscientious objectors” to immunisation are in parts of the north coast – such as Byron Bay – where 12 per cent of children born between 2001 and 2007 were never immunised for any condition. […]

An epidemic of whooping cough in 2008 and 2009 began on the north coast. It quickly swept across the state driven by low vaccination rates in some wealthy parts of Sydney. […]

Dr McAnulty said areas with lower vaccination rates were more at risk. “If you are a parent it is so important for your child to be protected, but also for the other children in your community,” he said.

In 2007 Australia recorded 4,863 cases. In 2008, 14,290. In 2009, 29,786. In 2010, 34,793. Last year, 38,514 and already this year 3,645. For the entire time Ms. Dorey has urged against vaccination, attacking those who choose to vaccinate, mocking health authorities and distorting statistics. A request to answer a thorough deconstruction of her widespread trick to malign vaccine efficacy remains unanswered – which is answer enough for me.

However as unwelcome as antivaccine lobbyists may be, there is more to this epidemic than just irresponsible, if not unconscionable, conduct. Nation wide access to PCR testing has led to a higher number of confirmed diagnoses and this in turn is being “fed” by doctors and health staff with better diagnostic skills – especially during the early stages. It seems that added to an epidemic we’re testing more often and more accurately.

Despite the louder volume of antivaccination arguments, if they were really taking hold and driving the full epidemic we’d expect to see consonant rises in fatalities and hospitalisations. In fact despite the huge numbers of notifications since 2008 below, we’re seeing less fatalities than the epidemic in 1997. Hospitalisations have not increased in pace with notifications.

Frustratingly, increased notifications are exploited by antivaxxers as so-called proof the vaccine is ineffective. Yet if this is the case then a representative increase in fatalities and admission to hospitals should be apparent. It isn’t. This also makes claims by Dorey of “a more virulent virus” hard to sustain. She’d do better to argue a less virulent virus explains the disparity between notifications and serious cases.

Either way, it’s important to respond to abuse of certain nuances related to increased pertussis notification. For example we can dispense with nonsense such as this stunner from July 2011, which was Dorey’s partial conclusion from revelations of better testing revealing more notifications:

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

Pertussis Notifications To Date

A range of factors accompany low immunisation as a factor in pertussis outbreaks and increased notifications. Nonetheless since an “epidemic of whooping cough in 2008 and 2009 began on the north coast” it’s been reported in every state in epidemic proportions. The advice is unanimous. Vaccination Saves Lives.

In January 2009 ABC’s The Pulse reported with A bad year for whooping cough. We may have found Dorey’s reason as to why “you didn’t die from it 30 years ago”. Mass vaccination:

Whooping cough used to be a disease that everyone got as kids, says Dr Frank Beard, acting senior director of Queensland Health’s Communicable Diseases Branch.

However, numbers plummeted following the introduction of mass vaccination in the 1950s. Cases fell to an all time low in the 1970s and 1980s…

By March 13th, 2009 Tasmania issued its first pertussis alert urging parents to seek vaccination for newborns at 6 weeks rather than 8 weeks of age. Vaccination Alert Following Steep Rise in Whooping Cough Cases. This followed an increase to 99 infections compared to just 4.

Low immunisation behind South Australian whooping cough outbreak, wrote Tory Shepherd on November 5th, 2009:

SOUTH Australia is experiencing its worst whooping cough outbreak on record – and babies are the main victims of the potentially fatal and highly infectious disease. […]

A four-week-old NSW baby who died in March was the first fatality from the disease in a decade. Since then it is understood two other children have died.

By August 31st, 2010 the epidemic was hurting QLD. Whooping cough epidemic gains pace, wrote Amelia Bentley:

Health authorities have warned a whooping cough epidemic is spreading throughout Queensland.

The Sunshine State has the most people in Australia falling ill with the infectious disease, prompting a state-wide call for children and adults to be immunised.

Seventeen days later the Danny Rose reported in Victoria’s Herald Sun. Fourth baby dies of whooping cough:

THE death of another baby in Australia’s slow-moving whooping cough epidemic underscores the importance of broad immunisation coverage, an expert says.

The five-week-old boy died in the intensive care ward of an Adelaide hospital earlier this week, and Professor Peter McIntyre said this was the fourth child death in a pertussis outbreak which started in 2008.

The infant contracted the bacterial lung infection when he was too young to receive the whooping cough vaccine, which can be administered after a child is six weeks old.

Adults represent most notifications and are a common source of infection for children and infants. Presently adult booster rates are around 11.3%, which is too little to be effective. Whilst adults aren’t as vulnerable to harm as babies are, the longer the epidemic has gone on the more the percentage of adults contributing to notifications has become. Comparison of age groups shows a significant increase in adults particularly from 2010 – 2011.

By December 10th, 2010 the Northern Territory Department of Health published, Central Australians urged to protect against whooping cough:

More than 220 people were diagnosed with whooping cough in Central Australia during the past twelve months, according to Coordinator of the Centre for Disease Control for Alice Springs and Barkly regions, Dr Teem-Wing Yip.

“The majority of cases occurred in older children and adults,” Dr Yip said.

“Adults with whooping cough may feel unwell from an annoying cough, but the highly infectious disease can be much more serious in young children,” she said.

“Symptoms of whooping cough in adults may be as minor as an annoying cough, but can cause significant illness. In very young children, the disease can be very serious,” she said.

Fear over whooping cough epidemic, wrote Julia Medew in Victoria on October 21st, 2010:

Jenny Royle, a paediatrician with the hospital’s immunisation service, said Victoria had experienced an unusually sustained epidemic since 2008, with the disease affecting thousands of people, young and old.

This prevalence was now putting newborn babies’ lives at risk.

She said the hospital had seen 19 babies with the disease since August, including three aged six to 12 weeks who ended up in intensive care.

”This is really unprecedented … A baby died in Adelaide a couple of weeks ago with whooping cough, so we’re very concerned about the number of cases we’re seeing here,” Dr Royle said. ”We are worried that we’ll see deaths here too.”

In late January 2011 Victoria’s Chief Medical Officer published an Advisory for health professionals. But the fear felt and prediction of death only weeks earlier was all too real. On February 17th, 2011 Fairfax reported on an infant death in Melbourne. Death Sparks Vaccine Appeal wrote Julia Medew:

THE death of a newborn baby from whooping cough in Melbourne this week has triggered a call for Victorians to vaccinate against the highly contagious disease. […]

Dr Jenny Royle, a paediatrician with the immunisation service at the Royal Children’s Hospital, urged Victorians, young and old, to check they were up to date with their whooping cough vaccinations because the epidemic was putting babies’ lives at serious risk. […]

Whooping cough, also known as pertussis, can cause minor cold-like symptoms for adults but is fatal for about one in 200 babies infected. In infants, it can cause coughing fits that deprive the brain of oxygen, leading to brain damage and death.

On the same day, ACT Health published a Health Alert on pertussis. In order to protect your baby you could:

  • Ensure your baby is vaccinated on time, this can be done from 6 weeks of age.
  • Keep your baby away from anyone with a coughing illness.
  • Ensure everyone in your household is up to date with their vaccinations.
  • Be on the lookout for symptoms of pertussis and consult your GP if concerned

Back near ground zero, four years on, pertussis was still effecting the community. Meryl herself was not happy that grassroots volunteers had slowed her pace, revealing perhaps more legal irregularities than intellectual ones. Vaccination was now likened to “rape with full penetration”. Those with questions were members of “hate groups” seeking to suppress her democratic freedom as an expression of “health fascism”.

Despite her “martyr for the cause” act, the true intent and impact of the likes of Dorey was not lost on Australians. Both online and regular media had taken interest in this person now the subject of a public health warning. On May 15th 2011 Jane Hansen reported in The Sunday TelegraphDoctors warn parents to keep newborns at home as whooping cough epidemic escalates:

DOCTORS have warned parents to keep newborn babies at home to protect them from a whooping cough epidemic triggered by the “chardonnay set and alternatives”. […]

“With vaccination rates so low in this area we say to the mothers of newborns, do not take them out in the community,” local paediatrician Dr Chris Ingall said.

“We’re appalled at how many kids are getting whooping cough because the chardonnay set and the alternatives don’t vaccinate their children.”

Areas with low vaccination rates had 300 per cent more cases of whooping cough between 2008 and 2010, according to figures from NSW Health.

On September 16th, 2011 the importance of vaccination in preventing pertussis was reinforced by Dr. Julie Leask in Clear and present danger: how best to fight the latest whooping cough outbreak.

Tasmania’s Public Health Alert was last updated on November 9th, 2011. Again it reinforced the importance of vaccination and proper conventional care.

By January 4th, 2012 ABC Online reported, WA facing whooping cough epidemic:

Health authorities in Western Australia are warning that the state is on the brink of a whooping cough epidemic.

A record number of more than 3,500 cases were reported last year, more than double the 2010 total. Four babies have died from the infection in as many years and the Health Department is urging parents to be prepared for more cases. […]

“Measles kills, whooping cough kills. All of those diseases that you can now get a vaccination to stop, can kill children.

“So please make sure your children get vaccinated.” [said Paul Armstrong of W.A. Health]

So it isn’t hard to find this epidemic mentioned over and again in every state of Australia, with a repeat of the necessary advice for the community.

The pertussis epidemic that probably began due to low immunisation rates in Byron Bay in 2008/2009 and again in October 2010, likely wreaked havoc and heartbreak across NSW and parts of QLD. Exactly how much can be attributed directly to Meryl Dorey, is impossible to tell but low herd immunity in Lismore and surrounds has been devastating for some. I’m sure people have never heard of Meryl Dorey nor care to, yet still refuse to vaccinate. Sadly, she glows with delight when asked the question that assumes she is responsible for local immunisation denial.

Ranging out across Australia there are far too many factors to consider and many pockets of low immunisation for a number of reasons. Outbreaks chronologically followed the initial Byron Bay outbreak and that’s all that can be said using a rough media guide. A virus of thought can spread faster and further than a viral or bacterial infection.

It is this that makes the likes of Meryl and other enemies of reason the danger that they are, and that requires concerted efforts to address.

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Pertussis notification and vaccination status in context

Across the globe it is known how important the pertussis (whooping cough) vaccine is in preventing both infection and severity of infection with Bordetella pertussis.

Along with vaccines for diphtheria and tetanus, then polio (1950’s), measles, mumps, rubella (1960’s) the Australian pertussis vaccine has contributed to an astonishing 99% reduction in deaths from vaccine preventable disease. Just after the turn of the century pertussis, diphtheria and tetanus vaccines alone had saved over 70,000 lives whilst the population had almost tripled since their inception. Since then pertussis vaccination alone has saved around another 10,000 Australian lives.

From the World Health Organisation, to national or state health authorities across developed nations to your local doctor, the evidence is compelling. Although anyone can catch pertussis it is babies under 12 months who are most vulnerable to infection. The disease can cause disability and death in the unvaccinated. Whilst immunisation provides antibodies to fight pertussis, it does not provide “magical protection”. For that you need chiropractors or other practitioners of alternatives to medicine.

Immunisation against pertussis does mean:

  • A significantly reduced chance of being infected
  • A significantly reduced severity of infection if infected
  • Protection of unvaccinated individuals that one may come into contact with
  • Low levels of community infection with high levels of immunisation

Pertussis epidemics follow on from reduction in immunisation across the community, leading to a drop in herd immunity. The present epidemic Australia is experiencing began in Byron Bay, an area with very low immunisation rates, and then spread to other areas of low immunisation. From the backyard of Meryl Dorey’s anti-vaccination lobby group the seeds for this epidemic were sown a decade ago. Brynley Hull and Peter McIntyre wrote in January 2003 [page 12]:

Although immunisation coverage has greatly improved over the past five years in NSW, and many areas have reached coverage targets, there are areas in NSW where the level of registered conscientious objection to immunisation is great enough to affect immunisation coverage, as measured by the ACIR. One such area is northern NSW, and the Byron Bay SLA in particular, where the rate of conscientious objection is one of the highest in the country.

Despite the crystal clear science and undoubted success of immunisation, movements against all vaccines have grown. They have kept pace with internet driven conspiracy theories, imaginary diseases, imaginary cures and new age beliefs. The most successful currency used by those opposed to scientific success is ignorance and misinformation.

An excellent example regarding pertussis vaccination is that many people incorrectly believe all vaccines, with the exception of influenza, provide lifelong immunity. With pertussis, vaccine induced immunity wanes over time and as noted above whilst it reduces the chance of infection, it is not an impervious shield. Antivaccination lobbyists have taken advantage of this to infer that the pertussis vaccination schedule itself has failed. First, we have ignorance – the expectation that immunity is lifelong. Then follows misinformation.

For example as debunked here more than a few times, figures describing vaccination levels and notification of infection are frequently misused by the Australian Vaccination Network to falsely refute the efficacy of immunisation. Yet these clumsy attempts are piecemeal and misleading. Time and again infection notification and vaccination status is highlighted and infused with qualities that serve to misinform. Placing figures in context yields a very different picture which, given that they seek to deny international trends that have existed for decades, is not surprising.

The question, or challenge if you will, is about the veracity of the pertussis vaccination schedule. Thus we must take care to ensure we elucidate notifications related to full immunisation as per the schedule. Take the following table of children between 0 – 4 years old, diagnosed with pertussis:

Pertussis notification by vaccination status 0-4 years, Australia August 2011

We see that a total of 9,333 notifications have been tabulated. 5,296 or 56.7% are fully vaccinated.

986 are partially vaccinated. 800 are not vaccinated. 754 are ineligible for vaccination. This gives us a total of 2,540 or 27.2% who are not fully vaccinated.

1,497 or 16% are unknown.

Do these figures reflect infection in the community? No, they reflect the vaccine status of children diagnosed.

Firstly as the table informs us “fully vaccinated” does not necessarily conform with fully vaccinated under the National Immunisation Program. Ineligible cases between 6-8 weeks of age that had received one dose in 2009 are included in “fully vaccinated”. Both these facts artificially inflate the “fully vaccinated” category.

Next we must accept that this table underestimates the actual number of infections in the community. The National Notifiable Diseases Surveillance System relies on a passive surveillance system which does not capture every case of pertussis in the community.

Which raises the question. Who is not making notification? Can we infer anything about the vaccination status of those not recorded in the above table? If so, does this help us understand the figures in the table better? As a matter of fact, yes.

Do these figures reflect the efficacy of pertussis vaccination? In other words, is this telling us that there are over twice as many infected children in our community who have been vaccinated (56.7%), than those who have not been fully vaccinated (27.2%) and thus reflect low vaccine efficacy? No.

Far more children are vaccinated against pertussis than those who are not. 95% vs 5% in fact. Even with greatly reduced chance of infection the sheer numbers of vaccinated children mean that “fully vaccinated” will dominate notifications. These figures also reflect the greater likelihood of parents who vaccinate to take their child to a GP and follow through with reporting, and also reflect the likelihood of conscientious objectors to avoid a GP and to not follow through with reporting.

For example a USA study published in Vaccine in December last year showed that parents who do not vaccinate their children are four times more likely to take their child to a chiropractor than a conventional doctor. In Australia we already know that chiropractors are vocal antivaccination proponents with strong links to antivaccination lobby groups such as the Australian Vaccination Network. Many chiropractors in Australia actively mislead consumers on the topic of vaccination making impossible claims, actively deriding vaccination.

But we can do much better than this and begin to build a profile of parents who refuse vaccination and later choose conscientious objection. Five days ago Australian Doctor reflected on the study:

A US survey found parents who refused childhood vaccinations were four times more likely to have sent their youngest, school-aged child to a chiropractor than parents of vaccinated children. Parents who conscientiously objected to school immunisation requirements were also more likely to have strong concerns about vaccines, to distrust local doctors and to have had one or more births in a non-hospital, alternative setting. […]

Are naturopathic and complementary healthcare providers reinforcing parental concerns and ‘anti-vaccine’ opinions or promoting exemptions, or are they providing healthcare without emphasizing vaccinations?

The pattern emerging is one of anti-conventional medicine, reinforced by alternatives to medicine masquerading as “complementary healthcare”.  For our purposes we must now accept that unvaccinated children may be up to four times less likely to visit a GP when ill with pertussis. This means they may be up to four times less likely to appear as a notification. Regardless of exactly how many unvaccinated children are missed, we can see with confidence that the total is skewed away from highlighting unvaccinated children.

Thus the 8.6% of unvaccinated children noted in the table above (n=800) is possibly a significant underestimation. As parents who do vaccinate are more likely to visit a GP and report diligently, the total is additionally skewed toward the fully vaccinated. What this actually means regarding community impact is best captured in this post written by a mother whose vaccinated child was infected by an unvaccinated child who had been sent to school.

Now comes the fascinating aspect. “Unknown”. What does this mean? Really? For whatever reason, somewhere along the line the child’s vaccination status is not recorded at all, is recorded and fails to make it to the final notification table or is lost to genuine confusion or poor record keeping.

However if parents are not registered on the ACIR as conscientious objectors or as completing their children’s vaccination schedules they are also listed as “unknown”. Thus the following from Brynley Hull and Peter McIntyre is compelling [bold mine]:

Additionally, the proportion of conscientious objectors on the [Australian Childhood Immunisation Register] ACIR is likely to be an underestimate of the proportion of parents who don’t immunise because they disagree with immunisation, particularly in more economically advantaged areas. There are some non-immunising parents who ‘object to registering’, and they will refuse to complete any government-provided form.

“Refuse to complete any government-provided form”. Such as those that question the immunisation status of one’s child? That also is where a significant number of “unknown” cases have their genesis.

In tandem with our emerging profile of anti-conventional medicine beliefs driving the decision to not vaccinate and combined with the observation that CO’s are likely to contribute to the “unknown” category by not registering on the ACIR, we are able to make a strong inference that unvaccinated out-rate vaccinated in this category.

Whilst it is impossible to make outright factual quantified claims and rewrite that table, we may conclude that placed in the context of community trends it gives a less than reliable indication of infected subjects within the community. What it does give us is a snap shot of the vaccine status of notifications. Placed in context those notifications appear to be skewed away from unvaccinated and toward vaccinated subjects.

The most significant reason is the overwhelming numbers of vaccinated children in the community. Although appearing as a notification they have a far less severe case of pertussis and are unlikely to suffer disability or death. Other reasons for this would appear to be the intentional avoidance or substitution of conventional medicine, diagnosis and reporting of vaccination status by those in denial of vaccine efficacy.

Of course, people will use these figures to attack the overwhelming evidence in support of vaccination. That’s just what eccentric parent Greg Beattie has tried. It’s simply gobsmacking to read his misleading claim that only 11% of pertussis infections aren’t vaccinated. Actually it’s only 8.6%.

But the point to be made is whilst only 5% of 0-4 year olds aren’t “fully vaccinated” they make up a disproportionate 27.2% of infection notifications. Unsurprisingly his novel mathematics have been dealt with unceremoniously by A Drunken Madman.

There is no debate here. Pertussis vaccination saves lives.

No vaccination is no joke

Montage of some of the more memorable moments of Meryl Dorey contradicting herself and offending common sense.

My personal request of Meryl Dorey

We (antivaccination lobbyists) are the real Australian skeptics

Meryl Dorey Jan. 4th, 2012

As many of you may have noticed, the rapidly rising pertussis epidemic in W.A. was reported by the ABC today.

This predictably sent Meryl Dorey of the AVN into histrionics. One of her ridiculous claims is that pertussis has increased “10,000%” with a 25% increase in vaccination. If you choose the figure of 332 from the very first year – 1991 – of compulsory reporting (which actually reflects sloppy reporting, gradual awareness and slow administrative changes) and compare it to today’s epidemic figure as Dorey does, it’s a dodgy trick.

A Stop the AVN member snapped this tweet on ABC News Breakfast from a cast iron flying pig

Because the “25% increase” comes from a 70% vaccination coverage in 1991 and a 95% coverage now. Strange, because a decade later in 2001, vaccination was only 70.6% and the figure of notified cases is 9,541. Sure we do have an epidemic figure for 2011 of over 36,000. But choosing a different year shows an increase of 3.8 times – not 10,000% – despite almost an identical increase in childhood vaccination.

I’ve laid it out all below. The entire method Meryl uses, and offered it back to her as actually showing a decrease of over 50% in 6 years. It’s her technique using her data sources. It’s rather silly as one cannot compare unrelated data sets. But in an attempt to draw some sense from Meryl on a fairly clear point I’ve (yet again) worked through the figures to seek a reply.

Meryl Dorey’s extraordinary claim about ABC journalistic integrity

I posted it twice today on the ABC News Breakfast Facebook page and also on Stop AVN. No “coward” stuff as Meryl alleged to Tiga Bayles. No “hiding behind anonymity” as Bayles suggested. No “suppression of free speech”. Just open and honest requests for a reply, based on evidence. Meryl’s claimed forte.

Originally I asked for a point by point response. Yet, I’m asking Meryl now, to respond to just one of my points. Just one. So far, there’s just silence. We shall see.

Summoning help, Dorey writes about: “…the rabid pro-vaxxers who would happily see all of our children dead or injured if they thought it would protect them or their families.”

Above Meryl you write:

…it’s all across Australia – why they chose WA I have no idea? (sic)

Well Meryl, whooping cough in WA has increased by almost 500% since 2009.

ABC News Breakfast

Also Meryl, WA has the lowest rate of child vaccination in the country. According to Julie Leask, senior research fellow at the National Centre for Immunisation Research & Surveillance of Vaccine Preventable Diseases, “Delay might be due to [WA’s] adolescent vax policy”.

Julie Leask Tweet

As “Australia’s leading vaccination expert” I thought you’d know these things, Meryl.

Anyway, as on Facebook here’s the same request for a reply. All I’ve updated from Facebook is the NNDSS pertussis notification figures accessed now, at time of writing, and changed it to a first person address.

As I stressed Meryl, failure to address this surely indicates admission that your claim on pertussis is false. You may very well believe it, but if so, it must stack up to scrutiny. No agro, no bullying, just a golden opportunity to speak freely. So, excuses to not answer are thin on the ground.

I hope that’s not too annoying and I’d be delighted to have you. Fire when ready….

Here’s the original from Facebook.

Hi Meryl.

Could you address this point by point please. It’s the same post as above, but I reckon it’s about time you helped clear the air. If not, do I assume you agree that your claims on pertussis are invalid?

Thanks very much:

Contrary to your claims, the epidemic began in your backyard with low vaccination rates and spread out from there. From SMH, October 2010:

“The highest rates of so-called “conscientious objectors” to immunisation are in parts of the north coast – such as Byron Bay – where 12 per cent of children born between 2001 and 2007 were never immunised for any condition. […]

An epidemic of whooping cough in 2008 and 2009 began on the north coast. It quickly swept across the state driven by low vaccination rates in some wealthy parts of Sydney. Low-income areas in western Sydney also had less immunisation and were linked to outbreaks, Dr Menzies said.”

Now, let’s debunk your claim of high vaccination rates causally equating to high pertussis infection, using – not other information and techniques – but your actual tables and own technique.

You source your 95% from under 2 year olds in a 2006 table (as per Woodford slides on your blog). Also, here it is – http://i.imgur.com/w9I9g.jpg. This makes up one half of 1/18th of all age groups from your next source, a NNDSS table of whooping cough notifications: http://i.imgur.com/XOrUY.png

These are the 2 tables you sent to the NSW HCCC in September 2009 (see p. 6 http://www.mediafire.com/?dw32azbk97obakm) to whom you made the very same claim, in response to a complaint.

You only quote absolute figures about pertussis after all – not percentages, or age groups, or if a notification is asymptomatic, or was a tourist, or international flight attendant/maritime worker/business traveller/etc.

Here’s the NNDSS age groups showing the highest infection rate is between 40 – 65 years in 2007. Before the epidemic.
http://i.imgur.com/0eGTw.png

Although now, the three age groups up to 14 years show large increases, if we add up the notifications above this we see that most notifications still come from adults who have no immunity. It has waned and they need a booster. Their vaccination (booster) rate is 11.3% – not 95%. We need to increase this by about 7 times to reach herd immunity.
See p. 18 of Adult Immunisation Survey to confirm 11.3%.

You are using “unrelated data”. Just like the rise in driving licences is not causally related to the rise in road trauma, or that the best safety advice (according to your thinking) would thus be to abandon licence testing. You are wrong to quote these NNDSS figures in this way, because we know nothing about their vaccine status or immunity. All we know is that most are adults who have no immunity.

So, in effect they cannot be compared – but for the record I’ll continue on as if they can be compared.

We do know pertussis fatalities occur in the unvaccinated. Vaccinated can of course catch pertussis yet experience far milder symptoms and faster recovery. The claim that vaccination for pertussis is an impervious shield has never been made by health authorities. But the claim that it should be and if not, it’s useless, is being scurrilously made by yourself.

Okay, let’s use your method on another year.

We can see (using the same NNDSS data) that 2007 was the lowest year of infection on record since 1999 – http://i.imgur.com/XOrUY.png. It is also the 5th lowest year since records began.
Many discount the first recording years of 1991 and 1992 as very, very low anomalies that show a slowish start to new legislation requiring reporting of whooping cough. This would make 2007 the 3rd lowest ever. But I’m happy to take the 5th lowest year ever.

Rather different to your claim, no? But from your data source no less.

Now, looking again at your vaccination rate table (http://i.imgur.com/w9I9g.jpg) we see 2001 had only 70.6% vaccination. Infection was 9,541 Aussies. By 2007 – still using both your data tables we see 95% vaccination of babies and 4,864 cases of pertussis (http://i.imgur.com/XOrUY.png).

So, using your “technique” on merely another part of the same NNDSS table we can also claim vaccination more than halved pertussis notifications in a mere 6 years.

Your data, your method, the very same tables you quote from. Why then is this not your message? Why don’t you tell Aussies that these sources show a greater than 50% drop in whooping cough in just 6 years?

Because it’s selective statistical sleight of hand, is it not? We both can’t be right. It’s a simple trick – and I’m arguing that you know it is.

You are intentionally misleading Australians. This is why the NSW HCCC issued a public health warning that you “quote selectively from research to suggest that vaccination may be dangerous.”

Also, it’s strange that you cite 1990 vaccination coverage of 70% vs 2006 coverage of 95%, omitting to say it dipped to 61% in the mid 90’s and had only increased by 0.6% in the 10 years from 1991. Could this be because you want to create an impression? Perhaps.

It’s all in your table. Should you not address all figures? Why do you not address all figures?

Also, a good look at any NNDSS notification table shows rises and falls in infection. Contrary to your claim of a steady increase in infection as vaccine coverage rose, pertussis always rises and falls.

In fact the first 10 years when coverage went from 70% to 61% to 70.6% corresponds to notification levels similar to and greater than the second 10 years (http://i.imgur.com/XOrUY.png).

1997 is almost as high the 2008 epidemic year and vaccination coverage was under 70%. So, again we must ask – are you seeking to create an impression?

Epidemics are a different ball game. Once immunisation fell below a safe level in Byron Bay it took off like lots of little fires in low immunisation areas joining to create a massive bush fire.

So, low immunisation caused this outbreak not any problem with the vaccine. The answer? Get adults immunised and ensure babies get cocooned and immunised ASAP.

There’s nothing to stop me using the very same data and going around saying Australia had one of the lowest pertussis levels since notifications began, until your, Meryl Dorey’s lobbying against vaccination led to the 2008 epidemic (and cite Dr. Menzies, plus news reports etc to back me up).

But science doesn’t make leaps like that. We’d need better research. You really don’t use science, despite boasting of such – just tricks with scientific data hoping nobody will check. Please prove me wrong.

Let’s recap: I’ve used only your tables and your own argument style to a.) debunk your claims on pertussis vaccination = infection, b.) shown how it can be used to show a vaccine induced 50% plus reduction in only 6 years [2001 – 2007] and c.) pointed out some curious gaps in your coverage of the data that don’t seem to support your claims.

I look forward to your reply,

Thank you,

Paul Gallagher

(emailed to Meryl Dorey on Jan. 7th, 2012)

Second ABC complaint upheld: Meryl Dorey “distorted and selectively presented information” on pertussis vaccination

Unfortunately, she (Meryl Dorey) added little and took the opportunity to promote a case against the use of the pertussis vaccine based on distorted and selectively presented information.

♦ ABC Audience & Consumer Affairs, December 19th, 2011 ♦

Readers of musings and mumblings here may remember a look at one Meryl Wynn Dorey’s “ABC of immunisation lies“, following Nicola Roxon’s Immunisation Incentive announcement.

Ms. Dorey kicked off deceiving Terri Begley’s audience on Mornings, November 15th on ABC 612. As covered by reasonablehank in ABC Complaint upheld – Meryl Dorey “disingenuous” and “added little” with “unsubstantiated claims”, a complaint was lodged and upheld by ABC Corporate Affairs.

In the afternoon Dorey popped up again on ABC 666 Drive speaking with Louise Maher. Again she seized the opportunity to launch into rapid fire fiction on pertussis infection and vaccine efficacy. This trick has been picked apart a few times here. So, I shot of a long complaint with references, tables and tactics laid out. To my delight the dedicated folk at ABC Audience and Consumer Affairs waded through it and the complaint was upheld. With their permission I’ve copied the response below.

The only other point (related to media correspondence) I’d like to cover is that I also sent a synopsis of Dorey’s pertussis and autism tricks to Tiga Bayles prior to her appearance on his Let’s Talk show. It had my name, phone number and email address. He didn’t raise any of the points as Dorey recited exactly what I’d warned him she would, choosing to feign surprise and smooth her path. He did however mention “the haters” and “sad small-minded people” who “hide behind anonymity too”.

Dorey agreed that her opponents were “cowards”, members of a “hate group” and guilty of a range of lousy transgressions, primarily around suppressing free speech. Without sounding too small minded, I did feel this was most unhelpful on Tiga’s part. Others also wrote openly to him and still more had articles published on widely read publications, such as The Drum and Mamamia. Meryl Dorey’s critics are not anonymous.

With that out of the way, we can enjoy knowing that both of Dorey’s appearances on ABC on November 15th have resulted in upheld complaints.

Reprinted with permission of ABC Audience and Consumer Affairs.

Dear Mr. Gallagher,

Thank you for your email of November 27 concerning the interview of Meryl Dorey conducted by Louise Maher on radio 666.

As your correspondence raised concerns of misleading and inaccurate content, your email was referred to Audience and Consumer Affairs for consideration and response. The unit is separate and independent from ABC program areas and is responsible for investigating complaints alleging a broadcast or publication was in contravention of the ABC’s editorial standards. In light of your concerns, we have reviewed the broadcast and assessed it against the ABC’s editorial requirements for accuracy, as outlined in section 2 of the ABC’s Editorial Policies: http://www.abc.net.au/corp/pubs/edpols.htm. In the interests of procedural fairness, we have also sought and considered material from ABC radio.

On Thursday November 24 Louise Maher spoke to the ACT Chief Health Officer Dr Paul Kelly about a measles outbreak at a Steiner school in the ACT.  The following day she looked at the government’s announcement that day that from July 2012 up to $2100 of the family tax benefit per child will be conditional on a child being immunised, and spoke to Dr Julie Leask, from the National Centre for Immunisation Research and senior lecturer at the School of Public Health at Sydney University and Meryl Dorey from the Australian Vaccination Network.

The program team believed that Ms Dorey would have something to add to the discussion about the Government’s initiative. Unfortunately, she added little and took the opportunity to promote a case against the use of the pertussis vaccine based on distorted and selectively presented information. As this was not anticipated, the presenter was not in a position to effectively challenge Ms Dorey’s assertions. To her credit, Ms Maher recognised this and acted to get expert advice to air from the Chief Medical Officer of the ACT.

That interview was ultimately aired on the following Monday. The effect of that delay was to potentially mislead listeners about the effectiveness of the pertussis vaccine. This was exacerbated by the fact that the introduction to Ms Dorey did not adequately contextualise Ms Dorey’s comments by informing listeners that she is a campaigner against vaccination who has no medical qualifications and her organisation has been the subject of a warning by the NSW Health Care Complaints Commission for providing misleading information to the public.

Notwithstanding the team’s efforts to address claims made by Ms Dorey, it is our view that she wasn’t introduced with sufficient context to ensure listeners were not misled by her unsubstantiated claims.

Radio management apologises for this lapse. It advises that it will again communicate to radio staff the importance of providing listeners with all relevant context and information when presenting controversial and potentially dangerous viewpoints – particularly if they propose to interview Ms Dorey again.

Accordingly, Audience and Consumer Affairs conclude the broadcast was not in keeping with the ABC’s editorial standards for accuracy as outlined in section 2.1 of the ABC’s Editorial Polices. Please be assured that your comments and this decision have been conveyed to ABC Radio management and the producers of the program.

Thank you for taking the time to write; your feedback is appreciated.

For your reference, the ABC Editorial Policies are available online at http://www.abc.net.au/corp/pubs/documents/codeofpractice2011.pdf

Should you be dissatisfied with this response to your complaint, you may be able to pursue your complaint with the Australian Communications and Media Authority, http://www.acma.gov.au.

Yours sincerely

(redacted)

Audience & Consumer Affairs

  • Louise Maher receiving “distorted and selectively presented information” on the use of the pertussis vaccine:

MP3 file for download here.