How the Oxford trial pause challenges anti-vaccine conspiracies

Recently the Oxford COVID-19 vaccine trial was paused due to a possible case of transverse myelitis in one of the subjects. Today (Saturday UK time) it was announced that the trial would resume following advice from from safety experts.

Confirmation Update: Transverse myelitis has not been diagnosed in the subject [1], [2], [3], [4].

The news of the pause had the anti-vaccine lobby reacting with as much composure as dozing picnickers who have awoken to find they are laying atop a large nest of very active fire ants.

There is the urge to proclaim we told you so. Yet this includes the realisation that forfeiture of key pegs in anti-vaccine conspiracy is required. What has followed as we see below appears to be confusion, the inability to comprehend events, fabrication of fallacy and bogus reinforcement of elements of the Big Pharma conspiracy.

It’s important not to underestimate how disturbing genuine challenges to an individuals world view can be. In the case of the Oxford trial announcement, the anti-vaccine conspiratorial view of the world is threatened by a distressing reality. For the dedicated anti-vaxxer this leads to uncomfortable cognitive dissonance. In fact anti-vaccine conspiracies must exist in the first place to resolve the cognitive dissonance that arises when scientific evidence and epidemiology overwhelmingly refute the myth of dangerous vaccines and manufactured claims of vaccine injury and death.

In this case there are three main challenges to current anti-vaccine beliefs.

  1. The MSM (mainstream media) presented a transparent account of the Oxford trial pause.
  2. The pause in the trial itself shows that the safety aspect of Phase III clinical trials is working well.
  3. Cursory reading of the situation confirms the efficacy component of Phase III clinical trials and the use of a placebo.

The anti-vaccine lobby contend that mainstream media are biased against the “truth” of vaccine horror because what is reported is not anti-vaccine. If the mistake of giving anti-vaccine identities air-time to push unsubstantiated disinformation is made, criticism swiftly follows. Yet primarily it is the industry requirement to fact check that keeps anti-vaccination views from being presented unchallenged.

It’s more likely that their antics make tabloid or news segments because they are dishonest and at times vindictive. This attracts regular criticism of the Australian Vaccination-risks Network. A scheme by anti-vaxxer Kyia Clayton to interview AVN president Aneeta Hafemeister on ABC Hobart was met with outrage. It was justly criticised on Media Watch which yet again led to Meryl Dorey urging members to bombard the ABC and ACMA with complaints.

Rather than rise to the occasion and present evidence that meets the standard of scientific consensus the AVN has instead accused the media of being part of the larger conspiracy. Attacking mainstream media and articles that are based on vaccine fact is a substantial activity for Australian anti-vaxxers.

A constant claim of anti-vaxxers is that vaccines are never tested adequately for safety. This is partly due to the erroneous belief that vaccines are so full of dangerous chemicals and biological matter that they cannot possibly be safe. Ergo, any genuine monitoring for adverse reactions in large samples would reveal that a high percentage present with such reactions. As this is not the case their only conclusion is the biased testing conspiracy.

Another claim is that vaccines are never tested for efficacy. They don’t work and we have all been deceived. Herd immunity is a fake concept. Vaccines were introduced after improved sanitation and hygiene eliminated most disease and thus deserve no credit. This claim is made with the help of deceitfully crafted graphs plotting mortality, not morbidity, in such small numbers it appears that vaccines had no impact. The two claims specific to Phase III clinical trials are often made together.

This was clear when the AVN responded to an August 2019 SMH article by Liam Mannix, Anti-vaxxers live in an online bubble this scientist wants to burst. Their response is a strange collection of “propositions” the author angrily contends must exist, whilst citing pseudoscience and articles relating to medication, not vaccines.

The AVN piece included this under “Proposition 4”;

…there have never been double-blind, placebo-controlled prospective studies done on either the safety or efficacy of vaccines, not even when a new vaccine is introduced.

Oh my. This persists despite accessible evidence to the contrary and available WHO recommendations. More so, in line with all anti-vaxxers the AVN argue their definition of a placebo (such as saline) is what should be used in vaccine trials. In fact it is used in many trials but the AVN choose to ignore this. This may include shifting the goal posts. Virology Down Under discuss this no true Scotsman anti-vax fallacy related to placebos.

In some vaccine trials a saline placebo is not ethically suitable and the placebo used is not inert. With respect to the urgency COVID-19 presents this article argues that placebos aren’t needed for vaccine challenge trials. In the Oxford trial a non-saline placebo functions as a more effective control as Dr. Norman Swan explains below. The AVN have always objected to Gardasil studies which used AAHS (the amorphous aluminium hydroxyphosphate sulphate adjuvant) as a placebo.

Without citing any reference the AVN offer their definition of a vaccine trial placebo;

By definition, a placebo must be a totally inert substance which will never provoke a response.

In a recent Coronacast episodeThe Oxford vaccine’s troubles. Why it’s not doomed (yet) Norman Swan talked about efficacy and safety in this vaccine trial. Whilst the USA are using a saline placebo, the other participant countries are not. Swan explains;

A few weeks ago, phase 2, phase 3 studies, that’s dose finding and whether or not the vaccine works in large numbers of people and whether it safe, started in Brazil, South Africa and the UK, and they were aiming to recruit 17,000 people. There was also a phase 3 study just beginning in the United States in about 80 sites, trying to recruit about 30,000-odd people. The aim is to have a trial of about 50,000 people.

And interestingly it’s a placebo-controlled trial but the placebo is not saline. It is in the United States, but in Brazil, South Africa and the UK it’s actually not a dummy drug, it’s not saline, it’s a meningococcal vaccine, and they are doing that so that people don’t recognise whether or not they’ve had a placebo. It’s very important in a placebo-controlled trial that you don’t know that you are in the placebo arm. And if you get a shot in your arm and nothing happens and it’s pretty mild you think, well, maybe I’m in the placebo group.

The presenters talk about the seriousness of transverse myelitis and Norman Swan offers this context;

However, there was a study not so long ago which looked at 64 million vaccine doses and really found very little evidence, if any, that transverse myelitis is caused by immunisation. Out of 64 million doses they found seven cases or eight cases that may be associated with it. And they look really widely. They didn’t just look at the week after you’ve had the immunisation or the month after, they looked at almost any time after you’ve had the immunisation, and they conclude that transverse myelitis, unless in very rare circumstances, is not caused by a vaccine. […]

So what they’ve got to find out with this person is are they in the placebo arm, are they in the active arm, is it really transverse myelitis, what are the antibodies that have actually been shown? Are there any other symptoms? And did the person actually get infected with real COVID-19 after the trial had started…

I recommend reading the transcript or listening to this episode of Coronacast. Tegan Taylor and Swan talk more on Phase III trials and discuss the specifics of the Oxford vaccine. It’s an adenovirus carrying genetic material into cells to instruct the cells to produce fragments of COVID-19 virus. It is these fragments that induce an immune response. With respect to the use of placebos in vaccine trials a July 27th episode examines the ethics associated with the fact that subjects in the placebo arm of Phase III trials are not receiving a vaccine.

By the time the Oxford podcast was published on Thursday the AVN was already suggesting on Facebook that there may be more adverse reactions hidden from the public.

AVN Facebook post

Dubious message on AVN Facebook

“It does raise questions”? The problem with the above post is the apparent interpretation by an AVN Facebook administrator that one of the “close friend daughters” who took part in the Oxford trial “is in the Royal” [London Hospital], “diagnosed with Transverse Mylytis” (sic). There is an unverified claim that, “they have asked to keep this quite (sic) as they don’t want the public to know”. The AVN admit the information may not be true.

Yet is this really evidence of a covert case of transverse myelitis? Perhaps Karen McNab is referring to a) her friend’s daughter and also b) the “volunteer” mentioned in the WhatsApp message. The trial subject who had the presumed adverse reaction is a woman who is in hospital.

Of course my interpretation could be wrong. There is however no clear statement that one of the friend’s daughters has transverse myelitis.

Some AVN members were justifiably suspicious.

AVN FB members question source

Rixta Francis, a long term AVN member prone to simply inventing disinformation published her predictably outrageous fallacy of the Oxford trial. This is an excellent example of an immediate, and  feverish attempt to slap at the fire ants of cognitive dissonance. Fellow members are supportive.

Facebook: Rixta Francis misleads over Oxford COVID vaccine trial
Self published author of The Fiction of Science Rixta is prone to reinterpret reality in the manner above. To appreciate this we need to explore her approach more fully. In an interesting example of how things come round in circles Francis is infamous for her abuse of the memory and parents of baby Riley Hughes, who featured in the SMH article I mentioned above.

Riley died from pertussis in March 2015 before he was old enough to be vaccinated. Feeling a need to educate parents about immunisation Catherine Hughes began the Light For Riley campaign. She now runs the Immunisation Foundation of Australia. Ten months after the death of Riley, Francis falsely claimed Catherine was a member of Stop the AVN, suggested Riley and his pertussis had never existed or that the parents killed infant Riley themselves.

The post below suggests the Oxford adverse reaction has been staged. It includes dismissal of genuine media intention, dismissal of safety and dismissal of efficacy helped by quoting Australia’s CSIRO. Again this is textbook management and minimisation of cognitive dissonance.

AVN Facebook post

Other comments in the thread follow a similar theme and manage to reveal quite ridiculous thought processes. The reason people placed themselves at such risk is because they were offered “a small fortune… it all comes down to money”. Vaccines always cause “horrific injuries”. We “can’t cure cancer but we can make a vaccine in six months for a disease we don’t understand?”.

It will be interesting, but not surprising, to see how this group reacts to the news that the trial has resumed.


Further reading:

Oxford Vaccine Group

Oxford vaccine trial – University of Oxford

How Vaccine hesitancy could undermine Australia’s COVID response – The Guardian, September 12th 2020

Fact Check: Mastercard partnership on vaccination records is unrelated to finances – USA Today, September 9th 2020

Halting the Oxford vaccine trial doesn’t mean it’s not safe – The Conversation, September 9th 2020

Vaccine testing and approval process – CDC

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True colours: Australian Vaccination-risks Network ponder the rights of others

A Current Affair recently reported on the Australian Vaccination-risks Network after they used the cover of late night to sneak their Vaxxed bus into the BIG4 Caloundra Holiday Park.

This bus is used to film anti-vaccine testimonials, sow fear about any possible COVID-19 vaccine and promote COVID-19 disinformation and COVID conspiracies. The CEO of the park Angus Booker quite rightly asked the group to leave. His reason was that he has a policy of not allowing anyone to “conduct their business in our park, especially without our consent”. He explained that this would apply to a political party, to activists or a radio station.

However Meryl Dorey states;

They really don’t care whether your children are killed or injured by vaccines.

This is an unverified claim in an attempt to imply callousness. As there have been no fatalities attributed to vaccines in Australia this is dangerously misleading and highly offensive. The facts help explain why the group, despite advertising for fans to give on-camera accounts of “vaccine deaths” for weeks, still haven’t produced an evidenced backed testimonial. The harm done by this group is seen in the video as a young man contends that his father recently passed away “as a result of a flu vaccination”.

Yet there are no recorded cases of anyone dying as a result of a flu vaccination. It is a bizarre alternative reality they inhabit. One in which according to Meryl Dorey, Italian COVID-19 fatalities were apparently all people who “were going to die anyway” and vaccines, not illness or disease, kill.

In actual reality modern medicine employs a vast arsenal of medication and procedures when managing disease and keeping very ill patients alive. The influenza vaccine is one such tool. It may be given to a patient who is very ill and who later dies from an existing condition or a condition of comorbidity. The vaccine may be given to someone who at a later time passes away from a chronic or acute condition. In both cases however, the flu vaccine has not caused a death. That the AVN revel in this tragic deception, promote it and profit from it is very telling indeed.

Asked to leave the park, Meryl, who raves day and night about the erosion of her rights, reacted in her standard fashion to someone else exercising their rights. She urged Facebook followers to leave “reviews” on the park’s Facebook page. The flying monkeys complied and dutifully threw dirt on both Angus Booker and the BIG4 Holiday park in question. This included the defacing of Angus’ profile picture and reposting it back onto the Big4 business Facebook page. AVN Facebook comments show that others called the caravan park to complain. One loyal devotee to Dorey’s cult urged members to repost the attacks that were removed.

Again, this is tragic. A number of these angry members wrongly believe they have a vaccine-injured child after digesting disinformation peddled for profit by this group. Or believe vaccines can only harm and actively reject life saving interventions for their children and themselves.

So how would the AVN profit from this? Knowing full well that the CEO is within his rights Dorey and AVN president Aneeta Hafemeister still teased that they had “spoken with a lawyer… and are considering taking action… about the discrimination”. Below are just a couple of eager responses.


Fortunately I haven’t seen an active attempt to raise funds for legal costs but the tone of these comments is concerning. In the past there have been donation campaigns for similar costs in which no action eventuates.

In any case asking Facebook flying monkeys to now focus on the press council with complaints about A Current Affair was a predictable response from the AVN.

Presently the Vaxxed bus is in hiatus with the AVN assuring they will be back on the road in due course.

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Meryl Dorey suddenly believes viruses can only be transmitted by injection

The driving force behind the Australian Vaccination-risks Network is Meryl Dorey who is tagged on this blog, and was highly active at the time of the HCCC Public Health Warning about this group.

Thanks to a tweet by a highly effective critic of the AVN my attention was drawn to a post Meryl made on her Facebook page during a live video broadcast on April 11th this year. What I found compelling was that suddenly – and I do mean suddenly as Dorey had never made this claim before – she announced that her “personal opinion is that viruses can only be transmitted by injection”. As we’ll see this causes problems for one particular anti-vaccine position Meryl has promoted.

The comment below was posted in the context of discussing viral testing and the strange notion of buying “a private test”, presumably to avoid the COVID conspiracy pitfalls. The last sentence contains Meryl’s view about viral transmission by injection. This pattern of adopting stand out themes of conspiracy theories is one Meryl Dorey has followed for years.

Meryl Dorey: viruses only transmitted by injection

Source: Comment 32

The compelling aspect to Dorey’s sudden revelation is that this claim had already been made 12 days earlier by anti-vaxxer and erstwhile Involuntary Medication Objectors Party candidate, Tom Barnett. The video in which he made his claims was removed from Facebook and YouTube.

Barnett claimed in the video;

You can’t catch a virus; it’s impossible. The only way you can catch a virus is by having it injected into your bloodstream.

I say. Meryl apparently decided this sounded pretty good to however she is planning to profit from the COVID-19 crisis. Feel free to search her online material prior to Tom Barnett’s comments for a statement suggesting Meryl Dorey believes viruses can only be transmitted by injection. I for one am having trouble finding such a reference.

Claiming to hold such a position enables one to reject the need for immunisation and to argue that vaccination against viral disease may in fact be the cause of the disease.

Meryl is clearly spinning more plates than is wise with this latest addition of evidence denial. To be specific, her claim that viruses can only be transmitted by injection is a form of germ theory denial |Wikipedia|. Denial of germ theory |Wikipedia| is as old as germ theory itself. Thanks to germ theory significant advances in personal hygiene and public sanitation have brought about improvements in health and reduction in the spread of disease.

Which brings us to a real problem for Meryl Dorey. She claims that vaccinations have done almost nothing, if not absolutely nothing, to prevent disease. She has fallaciously argued before that the documented fall in vaccine-preventable disease is in fact due to better hygiene, diet and sanitation and occurred before the introduction of vaccines. This is very common misinformation pushed by anti-vaxxers usually with heavily doctored graphs that chart disease mortality as opposed to morbidity and are falsely attributed to official sources.

It fails utterly to explain the success of vaccines introduced in the later half of the 20th century such as measles (1963) and haemophilus influenzae type b (1993). The WHO do a good job of dispelling this misinformation here. At the beginning of 2012 I looked at the AVN’s use of this myth and included an explanatory video with audio from both Meryl Dorey and Judy Wilyman.

In it we hear Dorey during a radio interview with Helen Lobato on Melbourne’s 3CR in December 2011 make the familiar claim;

Meryl Dorey: A lot of the credit that’s been given to vaccines for the decline in deaths and infectious diseases has nothing to do with vaccines. Because it all happened before the shots were even introduced.

Helen Lobato: Mmmm… and it was more the diet and the sanitation?

Meryl Dorey: That’s right. Engineers did more to improve the health of Australians than doctors ever have.

You might like to listen to Meryl on the audio player below;

Looking back at Dorey’s frequent promotion of this misinformation on the AVN website, social media and other media it is impossible to find any clarification specific to viral infection being only possible by injection. Nor is there any delineation between bacterial infection and viral infection being controlled by sanitation.

Thus in one foul swoop Dorey has removed the logic behind her claim that sanitation, not vaccination, brought about the control of specific viral infections. If viruses can only be transmitted by injection then improved sanitation must only be responsible for reducing infectious diseases caused by bacteria.

This also removes her concerns over “vaccine shedding” [1], [2] with respect to vaccines designed to prevent viral infection. This is highly significant concerning Dorey’s new claim as material presented to defend the notion of unbridled “vaccine shedding” refers exclusively to viral shedding in stools or in the case of LAIV nasal spray, in nostrils.

As Meryl Dorey and the AVN have challenged health ministers and authorities to accept being injected with a body weight adjusted equivalent of the entire childhood vaccine schedule, I do hope there is no intent to demonstrate strength of conviction by ingesting or inhaling any viral material associated with disease.

Therefore as it now stands I would be fascinated to know how Meryl Dorey intends to justify believing that sanitation, not vaccination, reduced the spread of viral disease given her claim that viruses can only be transmitted by injection.

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In 2015 Bill Gates advised on the need to prepare for a global pandemic

In 2015 Bill Gates gave a TED Talk on the importance of preparedness for a global pandemic caused by “a highly infectious virus”.

An Ebola epidemic that began in December 2013, and continued until 2016, had by that time killed around 10,000 people in West Africa. Gates cites three reasons as to why there weren’t more deaths. 1.) The selfless work by front line health workers including locating infected persons and preventing further spread (see Contact Tracing below). 2.) Ebola is not an airborne virus and by the time those who are infected become contagious, most are so ill as to be bedridden. 3.) The virus did not reach many urban areas and this directly kept the number of cases lower than had Ebola spread throughout urban communities.

Yet he also refers to what he calls “a global failure”. Noting the slowness of response. The failure to study treatment approaches, diagnostics and the application of epidemiological and medical tools.

In what has been shown to be an uncomfortably prescient statement Gates notes;

So next time, we might not be so lucky. You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market.

Gates uses the Spanish Flu of 1918 to demonstrate how quickly an airborne virus can spread. He observes that the World Bank have estimated that a global flu epidemic will cause a drop in global wealth of “over three trillion dollars” and there would be “millions and millions of deaths”.

It’s important to note that the present reality with COVID-19 is not absolutely reflected in Gates’ TED Talk. Trends of global financial impact have not yet played out. Total fatalities will be disturbing and many may lose friends and loved ones, yet the prediction of “millions and millions” of deaths is not a current reality.

Nonetheless the reason that the capacity to reduce morbidity and mortality – to flatten the curve – is in our hands is indeed touched on by Gates. Just after the five minute mark he speaks of our ability to use certain tools to create an effective response system. Science and technology. The use of cell phones to inform the public. Satellite maps to inform on the movement of people. Advances in biology and research that will support rapid turnaround of drugs and vaccines to fit the pathogen responsible for the pandemic.

As I touched on above another factor discussed but not labelled as such by Gates, that is presently more robustly employed to reduce the spread of COVID-19 is Contact Tracing. Gates talks about locating infected persons and preventing further spread. In May 2017 African Health Sciences published a review of contact tracing in containing the 2014 Ebola outbreak. However with an airborne coronavirus this has proven, as expected, to be enormously more complicated.

At the time of writing there exists a spectrum of tactics in various countries, with some considered invasive to privacy. Israel has passed emergency laws to allow its security agency, Shin Bet to tap peoples phones without a warrant.

According to the Computational Privacy Group in the case of Singapore (using TraceTogether), Taiwan and South Korea this involves using cell phones and dedicated software in the;

…recording [of] close proximity between people using Bluetooth, WiFi, or GPS data, [which] could help efficiently notify people that they have earlier been in contact with someone now diagnosed with coronavirus and should self-isolate

The CPG have published Can we fight COVID-19 without resorting to mass surveillance? which looks at both location data and contact tracing in different regions, and the technology used.

Reports in Australia have suggested that tracking the public through their phones has been considered and that the federal government is “looking to Singapore” and the TraceTogether app. Victoria’s Department of Health and Human Services has expanded contact tracing to include use of the messaging platform Whispir.

IT News reports;

The department will begin using the cloud-based platform from Thursday to regularly interact with those that have come into close contact with someone who has contracted COVID-19.

The platform, which will automate interactions between the department and select individuals, will also be used to enforce self-isolation for Victorians who have confirmed cases of the virus.

Gates was more than reasonably accurate in predicting our response. Presented without exact figures from the epidemiology and pathology of the infectious agent Gates’ description of how we could and would respond deserves high marks.

Presently we are witnessing the application of the tools at our disposal to flatten the curve of morbidity and mortality. We know that only an effective vaccine can break the back of the pandemic as it now exists. Drugs that target specific symptoms and slow or prevent the impact on COVID-19 comorbidity are greatly needed. The use of cell phone apps to both inform and trace the public is well underway.

Most importantly we have accepted that staying at home, social distancing and increasingly reducing the number of people together in public, together with effective hand washing and smothering of coughs or sneezes are vitally effective measures. Some of these measures should be employed every flu season and it’s hoped we will continue to do just that.

One imagines we will be better prepared in future for the emergence of another pandemic. Gates was right in that we needed to prepare. We see that clearly now in the need for hospital beds, ventilators and other medical equipment. He also noted the necessity of strong health systems in poor countries and presently the need for increased funding in developing nations is a reality. [AlJazeera news video]

To finish off perhaps we should focus on what Gates observed at the end of his talk;

So I think this should absolutely be a priority. There’s no need to panic. We don’t have to hoard cans of spaghetti or go down into the basement. But we need to get going, because time is not on our side.

In fact, if there’s one positive thing that can come out of the Ebola epidemic, it’s that it can serve as an early warning, a wake-up call, to get ready. If we start now, we can be ready for the next epidemic.

Of course we were not utterly unprepared for a pandemic. Far from it. There are global and national agencies throughout the world that focus on both the risk of a viral pandemic and how we can best prepare. Developing nations are closely monitored by organisations such as the WHO and the UN. Still the lack of any treatment or vaccine to prevent COVID-19 has proven to be an enormous hurdle.

Developed nations are in a better position to fund and respond to recommendations. Australia has a Health Management Plan for Pandemic Influenza, last updated in August 2019. The UK has its Pandemic Contingency/Major Infectious Diseases Outbreak Plan. Similar plans exist around the world.

An interesting dynamic in the USA at present is whilst President Trump has criticised the CDC for its response to coronavirus, he had from 2018 cut their budget for global disease management and closed government units dedicated to preventing pandemics.

Trump’s administration has also cut similar funding for the National Security Council (NSC), Department of Homeland Security (DHS), and Health and Human Services (HHS). Other cuts to CDC funding used to manage chronic disease are scheduled for 2021 and as yet have not been approved by Congress. Perhaps justifiably Trump has come under scorn for his approach to the coronavirus outbreak.

Funding for the prevention of pandemics is an essential part of a solid public health budget. Without a doubt these budgets should be designed with input from scientists. By shirking reason and evidence in their pursuit of “alternative facts” and a post truth world, the Trump administration had maneuvered itself into an increasingly perilous position.

One hopes that as we move toward the future and find ourselves past the COVID-19 pandemic that we aim to listen to the evidence, learn from the past and prepare for pandemics we cannot yet predict.


 

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TRANSCRIPT

00:17
When I was a kid, the disaster we worried about most was a nuclear war. That’s why we had a barrel like this down in our basement, filled with cans of food and water. When the nuclear attack came, we were supposed to go downstairs, hunker down, and eat out of that barrel.

00:37
Today the greatest risk of global catastrophe doesn’t look like this. Instead, it looks like this. If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes. Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents. But we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.

01:20
Let’s look at Ebola. I’m sure all of you read about it in the newspaper, lots of tough challenges. I followed it carefully through the case analysis tools we use to track polio eradication. And as you look at what went on, the problem wasn’t that there was a system that didn’t work well enough, the problem was that we didn’t have a system at all. In fact, there’s some pretty obvious key missing pieces.

01:51
We didn’t have a group of epidemiologists ready to go, who would have gone, seen what the disease was, seen how far it had spread. The case reports came in on paper. It was very delayed before they were put online and they were extremely inaccurate. We didn’t have a medical team ready to go. We didn’t have a way of preparing people. Now, Médecins Sans Frontières did a great job orchestrating volunteers. But even so, we were far slower than we should have been getting the thousands of workers into these countries. And a large epidemic would require us to have hundreds of thousands of workers. There was no one there to look at treatment approaches. No one to look at the diagnostics. No one to figure out what tools should be used. As an example, we could have taken the blood of survivors, processed it, and put that plasma back in people to protect them. But that was never tried.

02:53
So there was a lot that was missing. And these things are really a global failure. The WHO is funded to monitor epidemics, but not to do these things I talked about. Now, in the movies it’s quite different. There’s a group of handsome epidemiologists ready to go, they move in, they save the day, but that’s just pure Hollywood.

03:22
The failure to prepare could allow the next epidemic to be dramatically more devastating than Ebola. Let’s look at the progression of Ebola over this year. About 10,000 people died, and nearly all were in the three West African countries. There’s three reasons why it didn’t spread more. The first is that there was a lot of heroic work by the health workers. They found the people and they prevented more infections. The second is the nature of the virus. Ebola does not spread through the air. And by the time you’re contagious, most people are so sick that they’re bedridden. Third, it didn’t get into many urban areas. And that was just luck. If it had gotten into a lot more urban areas, the case numbers would have been much larger.

04:17
So next time, we might not be so lucky. You can have a virus where people feel well enough while they’re infectious that they get on a plane or they go to a market. The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism. So there are things that would literally make things a thousand times worse.

04:39
In fact, let’s look at a model of a virus spread through the air, like the Spanish Flu back in 1918. So here’s what would happen: It would spread throughout the world very, very quickly. And you can see over 30 million people died from that epidemic. So this is a serious problem. We should be concerned.

05:04
But in fact, we can build a really good response system. We have the benefits of all the science and technology that we talk about here. We’ve got cell phones to get information from the public and get information out to them. We have satellite maps where we can see where people are and where they’re moving. We have advances in biology that should dramatically change the turnaround time to look at a pathogen and be able to make drugs and vaccines that fit for that pathogen. So we can have tools, but those tools need to be put into an overall global health system. And we need preparedness.

05:41

The best lessons, I think, on how to get prepared are again, what we do for war. For soldiers, we have full-time, waiting to go. We have reserves that can scale us up to large numbers. NATO has a mobile unit that can deploy very rapidly. NATO does a lot of war games to check, are people well trained? Do they understand about fuel and logistics and the same radio frequencies? So they are absolutely ready to go. So those are the kinds of things we need to deal with an epidemic.

06:13
What are the key pieces? First, we need strong health systems in poor countries. That’s where mothers can give birth safely, kids can get all their vaccines. But, also where we’ll see the outbreak very early on. We need a medical reserve corps: lots of people who’ve got the training and background who are ready to go, with the expertise. And then we need to pair those medical people with the military. Taking advantage of the military’s ability to move fast, do logistics and secure areas. We need to do simulations, germ games, not war games, so that we see where the holes are. The last time a germ game was done in the United States was back in 2001, and it didn’t go so well. So far the score is germs: 1, people: 0. Finally, we need lots of advanced R&D in areas of vaccines and diagnostics. There are some big breakthroughs, like the Adeno-associated virus, that could work very, very quickly.

07:21
Now I don’t have an exact budget for what this would cost, but I’m quite sure it’s very modest compared to the potential harm. The World Bank estimates that if we have a worldwide flu epidemic, global wealth will go down by over three trillion dollars and we’d have millions and millions of deaths. These investments offer significant benefits beyond just being ready for the epidemic. The primary healthcare, the R&D, those things would reduce global health equity and make the world more just as well as more safe.

07:55
So I think this should absolutely be a priority. There’s no need to panic. We don’t have to hoard cans of spaghetti or go down into the basement. But we need to get going, because time is not on our side.

08:09
In fact, if there’s one positive thing that can come out of the Ebola epidemic, it’s that it can serve as an early warning, a wake-up call, to get ready. If we start now, we can be ready for the next epidemic.

08:26
Thank you.

No reason to not vaccinate but anti-vaxxers continue to resist sound health policy

On April 17th last year Paul Offit was interviewed by Christiane Amanpour of CNN on the fact that there is “no legitimate reason” for not vaccinating.

This video very recently accompanied a February 21st article by U.S. pediatrician Dr. Edith Brancho-Sanchez, entitled Several vaccines at once might be too much for parents, but kids are just fine. The article reinforced the fact that the misinformation regarding the safety and efficacy of vaccines causes variations of anxiety in parents who take their children to be vaccinated.

It was reported that a 2014 USA National Immunization Surveillance Survey indicated that;

… over a third of parents of children ages 19 to 35 months followed delayed immunization schedules. Of the parents surveyed, 23% followed an alternate schedule that either limited the number of shots per visit or skipped at least one vaccine series altogether. Another 14% followed an unknown or unclassifiable schedule that did not follow a pattern and was not in line with national recommendations. Children who followed an alternate pattern were four times as likely not to be up to date on their vaccines and those who followed an unclassifiable pattern were over twice as likely not to be up to date.

Regrettably pediatricians are in a Catch 22 situation. They need to build parental trust. A 2015 study published in Pediatrics indicated that 93% of 534 pediatricians had been asked by parents of children under 2 to spread out vaccines. 82% believed complying with the parent’s request would build trust, whilst 80% thought if they declined, this may lead to parents leaving their practice.

In Connecticut, USA state lawmakers “narrowly advanced a bill” this week that seeks to ban religious vaccine exemptions for children. Despite reports of a 25% increase in religious exemptions from last year anti-vaccine opposition to the bill was fierce including protests in Connecticut’s Legislative Office Building. One Democrat representative, who seemed to have abandoned any pretense of basing his decision on evidence, referred to vaccination as “injecting a witches brew of chemicals”.

Here in Australia the leading anti-vaccine disinformation group The Australian Vaccination-risks Network has called on members and fellow anti-vaxxers to heed another infamous Action Alert. They are targetting Victoria and South Australia. In Victoria the Health Services Amendment Bill 2020 seeks to provide for mandatory vaccination of healthcare and ambulance workers with specific immunisations. Ten days ago the Victorian Minister for Health published this media release outlining the logic behind the decision.

The vaccines included are the flu vaccine, whooping cough, measles, chicken pox and hepatitis B. It is astonishing, as we witness the evolving impact of COVID-19 in the absence of a vaccine, that groups such as the AVN seek to multiply these negative effects. They have teamed up with the anti-science, anti-medicine group, Health Freedom Victoria helping to disseminate their “generic letter” for anti-vaxxers to mail to “all Victorian politicians including your local member”. Of course one may pen ones own. Be sure to stress you “vehemently oppose this draconian overreach of the Andrews’ government”.

They also advise to follow up with phone calls. Following that, they basically suggest harassing Martin Foley who is Minister for Mental Health, Minister for Equality and Minister for Creative Industries. Martin Foley’s mental health portfolio sees him quite active in reducing discrimination for Victorians living with mental health challenges. Health Freedom Victoria want anti-vaxxers working in the health sector to email and call Mr. Foley to;

Tell him you are appalled that he would change the Discrimination Act to get away with forcing you to take an untested and unwanted medical procedure in order to keep your job

In the material they have disseminated to encourage targetting Martin Foley, Health Freedom Victoria refer to him as, “the Minister for amongst other things, Mental Health and Discrimination”.

South Australia introduced No Jab No Play legislation on September 30th 2019. Again there is a “generic letter” ready to go. In both cases the AVN seek to motivate loyal anti-vaccine followers to engage in pestering letter and/or email writing campaigns, asking those involved to follow up with a phone call, in this case “within half an hour but at least by the end of the day”. This is to confirm they have received your email and will be sending a Decision Regulatory Impact Statement (RIS). Of course one should inform the person you’ll call back in two weeks to chase up that RIS. And why?

In the words of the AVN themselves;

Phone calls increase their workload, so they’re more likely to do their job to avoid getting repeat calls.

Yep, you read that right. Wasting the time of your local members already busy and hard working staff is ensuring they “do their job”.

Now, it’s over to Paul Offit…