Peter Doshi is at it again with the anti-vaccine stuff

Let me start with the conclusion, because Peter Doshi’s article can be a little dry if you let it. I don’t want you to miss the point…

In the end, yes, CDC and vaccine manufacturers are out there paying for pushers of vaccines to push vaccines on the population. But we’re talking about vaccines and not heroin. Independent agencies (like local and state health departments, academic institutions, and competing pharmaceutical companies) all continue to validate the need for vaccination as a life-saving public health intervention. That is the difference between this kind of “pushing” of a “pharmaceutical” and pushing something that truly harms. We don’t need Peter Doshi or Sharyl Attkisson or Age of Autism to be the watchdogs because their anti-vaccine intentions are, in our opinion, very clear. For truly making sure that vaccines do far more good than any harm, we have the dedicated healthcare providers, epidemiologists, biostatisticians, and other public health workers who look at the evidence (observational and experimental) and continue to promote vaccination against all the hate and vitriol of the anti-vaccine cult.

And now, the meat of this blog post…

You remember Peter Doshi, don’t you? He’s the dude who wrote a “shocking” report about the influenza vaccine and how it supposedly didn’t work. As it turns out, the report wasn’t all that shocking. As Dr. Salzberg wrote:

“First, as Snopes.com has already pointed out, Doshi is not a virologist or an epidemiologist, but rather an anthropologist who studies comparative effectiveness research. He never conducted influenza research at Hopkins. (He’s now an Assistant Professor at the University of Maryland’s School of Pharmacy.) Second, Doshi’s 2013 article was an opinion piece (a “feature”), not an original research article, and it did not report any new findings. Third, it is highly misleading to suggest (as the anti-vax article’s title does) that Doshi somehow represents Johns Hopkins University. At Johns Hopkins Hospital, the flu vaccine is required of all personnel who have contact with patients, as a good-practices effort to minimize the risk that a patient will catch the flu from a caregiver.”

People who ask me about Peter Doshi get one simple warning from me: Be careful with his writings because he’s very good at manipulating language. Dr. Salzberg’s article continued:

“Doshi uses this sleight-of-hand to suggest that the vaccine may not be beneficial at all. He never says this outright—instead, he just questions, again and again, whether the precise percentages reported in published studies are accurate. For example, he makes a big deal of a CDC announcement in 2013 that the vaccine’s effectiveness was only 62%. He casts doubt with phrases like

“the 62% reduction statistic almost certainly does not hold true for all subpopulations”

That is almost certainly true, but is meaningless from the point of view of public health. Of course the vaccine doesn’t have the same effectiveness in everyone. The point is that it works most of the time.”

Earlier this year, Peter Doshi was at it again with “just asking questions” (aka JAQ-ing off) about the Vaccine Adverse Events Reporting System (VAERS). There was a technical glitch on the VAERS system that prevented some users from being able to access it. He made a big deal about it, and he never clarified that it was a technical glitch which was correctable and certainly not part of some big conspiracy to keep people from reporting vaccine adverse events. The VAERS site has since been updated, and it is working well, but Peter Doshi will probably not tell you that.

Well, now Peter Doshi is at it again. This time, it’s those horrible pro-vaccine organizations who get all sorts of funding from all sorts of horrible pro-vaccine agencies in the federal government (i.e. the Centers for Disease Control and Prevention [CDC]). He’s written an opinion piece that is chock-full of nuts. And, as I’ve warned you, he uses language to obfuscate the issue.

So let’s dissect it, shall we? He begins:

“Vaccination programs have long been a centerpiece of public health activity. But policies of compulsion have always been controversial. Against a backdrop of recent measles outbreaks, France and Italy moved this year to mandate certain vaccines for school entry. There’s even a renewed push for mandates in the UK, where public health leaders have long resisted compulsory vaccination on the grounds that it undermines the trust between the public and healthcare professionals and is ultimately counterproductive.”

The policies requiring vaccine are controversial not because vaccines are bad but because people keep spreading the idea that vaccines are some sort of poison. People don’t want to be poisoned, and they certainly don’t want their tax money to go toward poisoning others. That is how anti-vaccine groups are born. They’re born out of an idea that is flawed from the beginning. (Like the idea that HIV doesn’t cause AIDS, which we’ll talk about some more later since we’re talking about Peter Doshi.)

Let’s see some language manipulation:

“The debate is also alive in the US. Although all states require vaccination as a condition for entry to school, most also allow exemptions for families with non-medical philosophical or religious objections. Overall, childhood vaccination levels remain at or near historically high levels, with under 1% of toddlers receiving no vaccines. But beneath the broad national trends there is geographic variation in coverage, and survey data have documented that parental concerns over vaccination safety and timing are common, even among those whose children receive all recommended vaccines.”

Note that Peter Doshi doesn’t mention what a slight drop in vaccine coverage can do. For example, when it comes to the MMR vaccine against Measles, Mumps and Rubella, even a tiny drop in vaccine coverage can lead to an outbreak. So, yeah, it might be good that we’re at under 1% of toddlers, but if that number doubles, or if it reaches 5% in the pockets where anti-vaccine sentiment is high, we can be in for some expensive public health responses.

Peter Doshi continues:

“In 2015, a US federal advisory committee warned that public confidence in vaccines cannot be taken for granted, and some prominent vaccine advocacy organizations are pushing for greater compulsion. But are these groups—which present themselves as reliable sources of information—providing the public with independent information?”

He is now beginning with the JAQ-ing off, and it’s a question that seems to imply that non-independent information is bad. He continues with the example of Senate Bill 277 in California, a bill that became law and removed personal and religious exemptions from vaccine requirement. Instead of saying that their personal belief or their religion prevented them from vaccinating, anti-vaccine people had to find “vaccine friendly” physicians (like noted Douchebag Dr. Bob Sears) who would acquiesce to their fears and allow them to be exempt from vaccination “for medical reasons.” Organizations that were involved in the promotion of that bill’s passage was Every Child By Two (ECBT), the American Academy of Pediatrics (AAP) and the Immunization Action Coalition (IAC). And they were correct to do so because vaccines save lives. But, Peter Doshi writes:

“IAC, ECBT, and AAP have a few things in common. They are all non-profit organizations with large online presences that promote themselves as sources of reliable information on vaccines. They also receive funding from both vaccine manufacturers and the Centers for Disease Control and Prevention.”

Oh, noes! CDC promoting a public health intervention with a great track record of working? What shall we do? Vaccine manufacturers promoting their safe and effective products against deadly diseases? Say it ain’t so.

He finishes that section with a mention of his old nemesis, the influenza vaccine:

“And, in their advocacy for compulsory vaccination, they all have in common a goal that pushes beyond official governmental policy and, in the case of influenza vaccines, the evidence.”

Classic Doshi.

The rest of the article has several more questions for us to consider. “Education or lobbying?” is one of the questions because these organizations dared lobby for a public health bill that has probably saved several lives by now (and all without causing autism, to boot!). “Did ECBT and AAP’s support of the California bill cross a line for the CDC?” Peter Doshi asks. He asks this because there is regulation against CDC using money for lobbying pro or against pending legislation. This is a grey area when it comes to vaccines because CDC’s mandate is to protect health and save lives. For that, vaccines are needed. So support of a bill that has increased vaccine uptake in California fulfills the mission of the agency. Then Peter Doshi goes after the influenza vaccine again:

“One of the non-profit’s use of evidence is also questionable. Multiple reviews have found insufficient evidence that mandatory influenza vaccination for healthcare workers has benefits for patients. As one team of systematic reviewers put it, “evidence from observational studies suggests that a vaccine mandate increases vaccination rates, but evidence on clinical outcomes is lacking.””

I told you the vaccine was his nemesis. Peter Doshi can’t seem to get off of it. Or, rather, he seems to get off on not getting off of it? (I’m just asking.)

The questions keep on coming from Peter Doshi:

“In broad terms, the CDC and vaccine advocacy non-profits share a common goal of increasing vaccination rates. But when it comes to the details—which vaccines, when, for whom, and how to achieve those goals—is there a need for independent sources of information on vaccination policy?”

And…

“But do advocacy organizations with financial ties to the CDC and vaccine manufacturers have sufficient distance to offer such a service?”

What? No questioning of Dr. Paul Offit’s intentions? Shame on you, Peter. Shame on you.

As far as originality, I have to say that this anti-vaccine article is not very original. (It is anti-vaccine, Peter, because you seem to be questioning the need for vaccine mandates, vaccine information to the public, use of the influenza vaccine, and promotion of the use of vaccines, over and over and over again without a single mention of the good that vaccines have done.)

It’s a lot like this blog post by Age of Autism whose thesis was that ECBT got a lot of pharma money and thus vaccines cause autism, or something. And this other blog post by the same cesspool of so-called reporters which contends that the Immunization Action Coalition got a lot of sweet, sweet cash from CDC.

Noted anti-vaccine activist and conspiracy theory loon, Sharyl Attkisson asked the same questions (or did the same JAQ-ing off) as Peter Doshi did, except that she did it in 2008. (Little late to the party, Peter.) Sharyl wrote:

“There’s nothing illegal about the financial relationships, but to critics, they pose a serious risk for conflicts of interest. As one member of Congress put it, money from the pharmaceutical industry can shape the practices of those who hold themselves out to be “independent.”

The American Academy of Pediatrics, Every Child By Two and Dr. Offit would not agree to interviews, but all told us they’re up front about the money they receive, and it doesn’t sway their opinions.”

So I wonder where Peter Doshi got his inspiration for his latest anti-vaccine post?

Let’s quickly go back to what Dr. Steven Salzberg wrote about Peter Doshi, because it reveals something troubling about Peter’s view of the world:

“Perhaps even more disturbing is that Doshi signed a petition arguing that the HIV virus is not the cause of AIDS, joining the ranks of HIV denialists. He signed this statement while still a graduate student, so I contacted him to ask if he still doubted the link between HIV and AIDS. I also asked him if he supports flu vaccination, if he agrees with the anti-vaccine movement’s use of his statements, and if he believes the flu is a serious public health threat.

On the question of signing the HIV/AIDS petition, Doshi responded that “Seeing how my name was published and people have misconstrued this as some kind of endorsement, I have written the list owner and asked for my name to be removed.” He declined to state directly that he agrees that the HIV virus causes AIDS—though I gave him ample opportunity.”

It seems to me that Peter Doshi has a conspiratorial view of how the world of science works. If 99% of scientists say that HIV causes AIDS, it seems that Peter Doshi (a young Peter Doshi, a graduate student Peter Doshi) rebelled against that. If 99% of scientists and physicians and epidemiologists say that the flu vaccine is a good idea at a population level to mitigate the effects of the seasonal epidemics, it seems that Peter Doshi rebelled against that. Now, if 99% of pediatricians, epidemiologists, and public health authorities are finding ways to counter anti-vaccine nut jobs who are convinced that vaccines are poison and that they can endanger us all, it seems that Peter Doshi rebells agains that.

It would all be fine and well if he wasn’t an associate editor at the BMJ, a highly-respected journal. It makes me fear that articles submitted for review that shed a positive light toward vaccines, or toward the HIV-AIDS causal pathway, are not being accepted, or that hey may be stonewalled. Of course, I have no evidence of this, and pushing that idea without evidence would make me no different than Peter Doshi and Sharyl Attkisson and the bunch of weirdos at Age of Autism. But, still, I can’t help but wonder… And shudder.

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Fifteen Children in South Sudan Die During Vaccine Campaign

The Associated Press is reporting that 15 children have died as a result of a vaccination campaign in South Sudan. According to the report:

“Fifteen young children have died in a botched measles vaccination campaign that saw people as young as 12 years old administering the vaccines, South Sudan’s government announced Friday.

The United Nations said the children died of “severe sepsis/toxicity” from the contaminated vaccine, and the health ministry blamed the deaths on human error. One syringe was used for all the children during the four-day campaign, and the vaccine was stored without refrigeration the entire time.”

So let’s reemphasize the meaningful facts before the anti-vaccine liars get a hold of these news and start to use them to attack the vaccination campaigns here in the United States.

First, South Sudan has been embroiled in a civil war for quite a while now. They used to be part of Sudan, but broke off and became independent in 2011. The continuing state of war, along with periodic famines, have presented quite a challenge to deliver food, medicine, clean water, and other supplies. To top it off, measles has been on the increase, further putting a burden on the lives of the people there. (And, by extension, the lives of Sudanese refugees the world over as refugees go back to see family and take measles back to their host countries.)

Second, 12 year-old children should not be administering vaccines. Yes, there is a shortage of trained professionals to administer vaccines because of the situation on the ground. But it goes without saying that this was a huge mistake. There are many things that can go wrong — and apparently did — during the administration of a vaccine, and I’m sure 12 year-old children are not trained to handle it.

Third, even with the preservative thimerosal in it (which the MMR vaccine does not have, as it is a live-virus vaccine), vaccines can still become contaminated over the course of several days being open and not in proper storage conditions. Furthermore, needles can collect pathogens from all over the place, including people. They probably passed on those pathogens from person to person, causing all of this.

“The civil war has killed tens of thousands and sent more than 1.8 million people fleeing the country, creating the world’s fastest-growing refugee crisis.

In 2016, South Sudan had at least 2,294 measles cases and 28 people died, according to U.N. data. So far this year, at least one person has died and 665 people have been infected.”

So, when the anti-vaccine jerks tell you that it was the vaccine that killed these children, make sure to fire back with facts.

Peter Doshi is at it again with (anti?) vaccine article (updated)

Remember Peter Doshi? The researcher whose shocking (it isn’t) opinion pieces are used by anti-vaccine zealots almost on a yearly basis? The researcher who presented at an anti-vaccine conference hosted by the notoriously misnamed National Vaccine Information Center? Yeah, you remember. Well, he’s back.

This time, he is apparently outraged that there is a glitch in how certain browsers handle the web address for the Vaccine Adverse Events Reporting System:

“For over three weeks, the website of the US government Vaccination Adverse Reporting System (VAERS) has been inaccessible to most users. The website address, http://www.vaers.hhs.gov, is printed on the vaccine information statements (VISs), short documents listing the benefits and risks of vaccines that are required by law to be distributed with every vaccine dose administered in the US.1

But the website link leads anybody using the web browsers Chrome, Firefox, and some versions of Internet Explorer to a warning page. “Your connection is not private,” it says in large font on my screen (fig 1⇓). “Attackers might be trying to steal your information from http://www.vaers.hhs.gov (for example, passwords, messages, or credit cards).” The only browser that seems to consistently connect properly is Safari, used by only around a quarter of people accessing government sites.2”

See, you should be using Apple products. He continues:

“I can’t speak for others, but I suspect most people will respond to such a warning by closing their browser and moving along. The adverse event will go unreported. Few will realize that connecting to vaers.hhs.gov (that is, dropping the “www.”) takes you to the intended website.”

You don’t say? People who have had an adverse event, or their healthcare providers, will just shrug their shoulders and say, “screw it”? But then he buries the lede:

“Technically, the website is not down. It is just misconfigured such that the website address advertised to millions is not working, and hasn’t been working for at least three weeks.”

So what did Peter Doshi, PhD, do? Did he call CDC to tell them? Did he research the glitch to see why it’s happening? Did he know that there are other ways to report to VAERS beyond online? He apparently just shot off an email and then waited (probably on a gold-lined throne, as I hear they pay well at the BMJ) for a response:

“It’s not known how long this problem has been going on, but I informed the US Department of Health and Human Services, which runs the VAERS program, on 25 April. After not hearing back, I sent another email on 2 May. I then received a call from Elisa (she wouldn’t provide her last name out of a concern for confidentiality), who said the information technology staff were working on it. Presumably they’re still working on it as the problem isn’t fixed.”

Does Peter Doshi, PhD, expect CDC to get on the phone with Mozilla, Google and Microsoft to fix this? Because it’s really their problem. (As he himself wrote, the Safari browser, created and maintained by Apple, deals with the web address just fine.)

I’ve emailed Peter Doshi, PhD, to congratulate him on this new little nugget he’s given the anti-vaccine nuts. They love it when someone with a doctoral-level education sees any issue, no matter how small, with the system of immunizations in the United States and abroad. See, when someone sees things your way, and when that person is highly educated and holds a position at a prestigious journal, then your views (no matter how skewed) are valid. The horrible things in your imagination become a little more real.

Update! A reader pointed something out to us that bears repeating:

“The problem is the SSL certificate was generated for vaers.hhs.gov but he is going to http://www.vaers.hhs.gov.

Because of this mismatch, the browser is rejecting it. HHS needs a certificate that covers both vaers.hhs.gov and http://www.vaers.hhs.gov. It is indeed a misconfiguration but it’s relatively minor.

The government is making a sincere effort to make sure their web sites are more secure, but sometimes they mess up. Most users will

SSL certificates facilitate encryption of traffic between the user and web site. They also allow users to verify that they are connected to the real web site, rather than a hacker’s web site. The mismatch is causing the browser to think that the user is not going to the genuine site.”

Want to kill your employment chances?

Imagine that you’re not a wealthy, privileged “kid.” Imagine you’re just a regular Joe, or Jane. Imagine that you are going into a job interview and the people interviewing you have looked you up online to see what you’ve been up to. Are you at all concerned with what they’ll find?

I mean, yeah, they’ll probably see those pictures of you from college or high school, the ones where you’re acting the fool and making an ass out of yourself. They probably will find that angry blog post you wrote about your girlfriend. But will they find anything that will prevent you from getting the job?

If you’re a self-professed epidemiologist, and you want to get a job as an epidemiologist, do you think it’s a good idea to spew anti-vaccine, anti-science nonsense? Never mind the misogyny and racism, or the xenophobic language, but what about the anti-vaccine nonsense?

Would you hire someone as an epidemiologist if they said something like this?

“How is it that so many women march on Washington against something the president said on a hot mic 12 years ago, but not against the mandating of a vaccination that causes ovarian failure, paralysis and death? While the drug company Merck bought off feminists to lobby for the human papilloma virus (HPV) vaccine, thousands of women and girls have been killed, paralyzed or sterilized as result of its side-effects.

All that was done in the name of preventing a sexually transmitted virus that causes cervical cancer, even though early screening remains far-and-away the most effective prevention. Meanwhile, the vaccine offers a limited duration of immunity and virtual uncertainty that any risk of cervical cancer is reduced.

InfoWars and Daily Mail have more on the story.”

InfoWars? Daily Mail? Those are the source of your scientific information on the HPV vaccine? Jesus H. Christ. There is no credible evidence that the HPV vaccine causes “ovarian failure, paralysis and death,” but there is plenty of evidence that it prevents cancer.

Would you employ someone in an office with people from all sorts of backgrounds if they wrote this?

“That autistic women are much more likely to be dykes is not a huge surprise in light of how Asperger Syndrome has an even more disproportionately higher male-female ratio than the autism spectrum as a whole. This fact is likely due to Asperger’s diagnostic criteria restricting its diagnosis to people with average or above-average IQs. Men vastly outnumber women in above-average intelligence.”

Or this?

“Self-styled victims come in many other forms of identity-defined politics: man-hating feminists, cop-killing Black Lives Matter terrorists, illegal immigrants who think they are entitled to amnesty and Muslims who complain about “Islamophobia” and deny that Islam has anything to do with Islamic terrorist attacks.”

Or this?

“There are third-wave feminists who exaggerate sexual assault statistics, who fabricate claims that men have higher wages than women and who advocate the killing of all white men. There is the Black Lives Matter movement which has proven itself to be a form of social justice cancer similar to feminism – advocating racially segregated dormitories and the murder of police officers (two of whom were actually murdered in New York City by a BLM supporter).”

Yeah, I didn’t think so. Lucky us this kid will never see the inside of an office at a health department or work in any capacity to set policy. Unlucky for us that he has the wealth from his family to allow him to continue spewing this anger and hate for a while instead of flipping burgers at a local burger joint.

Rest in peace, Dan Olmsted

Dan Olmsted, one of the editors of Age of Autism (the blog full of lies and misrepresentations, and a near-psychotic obsession with trying to link vaccines and conspiracies to anything that happens in the world) has passed away. There must always be honor in the battlefield of ideas, especially from those of us who fight with facts and evidence in our arsenal. So, please, do not celebrate his death. Be respectful of the people who love him and will be heartbroken at his passing.

Rest in peace, Dan Olmsted.

Did you miss me?

It would be a world-class understatement to tell you that I’ve been busy lately. I’ve traveled from one side of the planet to the other and back. I’ve been chasing viruses and bacteria wherever that three-lettered health organization has needed me, and I’m exhausted. So I’m back home to recoup before heading out into the cruel, cruel world again as the freelance epidemiologist I’ve become.

Before I go sip on some tea and watch a movie or two on HBO, I wanted to tell you that the Zika outbreak in the Caribbean seems to be waning. Don’t be fooled, however. The mosquitoes are there, and so are the people. Sexual transmission is likely ongoing, so this lull in activity is only temporary. Zika will come back soon enough, and it’s going to make a mess of things. Just wait until it gets hot in the South.

When that happens, we’re going to have ourselves a good, old-fashioned, all-American outbreak. You know the type? Where politicians don’t know what to do and only do the wrong thing? Especially with Trump in the White House. I’m getting the popcorn ready.

Next time, I’ll tell you all about how the new territorial epidemiologist of a US Territory doesn’t believe Zika is a thing. (I wish I was joking.)

Laugh it up, jerks. Laugh it up.

I used to have a boss who was well into his 70s when he decided to retire. He had worked at the health department where I was just a young number-cruncher longer than I had been alive. He joked about starting to work as a public health inspector in the Johnson Administration. Slowly and steadily, he moved up the ranks to becoming the director of a very busy infectious diseases unit at a very busy health department.

He was there in 1976 when Legionnaires’ Disease appeared. He told me about being on a call with people in the White House and how they wanted something, anything done, and done immediately. That same year, the swine flu fiasco happened, throwing the flu vaccine program into disarray. And he was at his highest position when all the crazy was unleashed over “Vaccine Roulette” and the resulting anti-vaccine nonsense.

He survived all that, and more. From one administration at the federal and state levels to another. His bosses came and went. The things they stood for changed and changed, and tragedies happened. And he was still there in his old age, fighting the good fight.

As you might have guessed, anti-vaccine zealots from The Kid to the anti-Semitic jerks at Age of Autism are celebrating the Trump victory since Trump has questioned vaccines and has embraced certain anti-science people. Apparently, Andrew Jeremy Wakefield once posed for a picture a few feet away from Trump, so Trump is now likely to ban all vaccines everywhere for all time. Makes sense, right?

Much like their knowledge of vaccines, anti-vaccine activists show an ignorance of how public health works in America. The vaccine advisory committee is not made up of political appointees or partisans. It’s made up of experts on the subject matter. They recommend what vaccines to give to what age groups, and the recommendations are followed (or not) at the state and local level. In order to shut down all vaccines everywhere forever, anti-vaccine-obsessed people would need to convince all states and territories that the Earth is flat, or something just as ludicrous.

Could a Trump Administration pull the plug on funding? Yeah, maybe, but we’ve done a lot more with a lot less. (That’s what my old boss used to tell us stories about. One year, they had their budget cut by 70%, and they still managed to expand their services year after year, even if just a little bit.) See, unlike anti-vaccine activists, we in public health are not in it for the money. We don’t travel to far-away and very dangerous places for money. We are okay with being held at gunpoint when something gets lost in translation at a checkpoint in a banana republic because we know we’re there to serve, and, frankly, dying for what we do is a badge of honor. We’d become immortal if we ever die in the service of public health.

So, yeah, laugh it up, jerks. Write all your little blog posts about how beautiful it will be to live in a Trump-led world. (Spoiler Alert: He’s not leading anyone. He’s not a leader. It’s not some title you are given.) We will continue to vaccinate tomorrow, next year, and next century. We might stumble and fall here and there, yes. But, just when you celebrate at the thought of burying us, you will weep when you realize we’re seeds… When you realize what we’ve survived and, thus, what has made us stronger.