Yes, You Agreed To This

I waded into an argument last week after seeing what Ren wrote about fluoridation. A Doctor of Dental Surgery (DDS), who shall go unnamed because he’s a bit of a douche about stuff, decided to go on and on about how fluoridation of drinking water is an experiment on unwilling participants. Those participants, he claims, are the public, and the public never agreed to this according to him.

Number one, fluoride in drinking water is nowhere near a toxic level. It’s not even close. And there is little evidence that fluoride bioaccumualtes in humans. The human body is set up to deal with these things quite well. Unless your kidneys are completely in shambles, you’re going to be okay.

Number two, the people/public did agree to fluoridation of the water supply, even if they didn’t have a vote on it. In the United States, we elect people to make these decisions for us. Frankly, we would get nothing done if we had to hold an election every time some public health intervention needed to be made.

Essentially, we assented to have our elected leaders use the best available evidence and intervene on our behalf when a public health problem is identified. If we don’t like it, or if they do the wrong thing, then we vote them out… Or have a revolution or something.

Sorry, George.

This batshit insane rambling that vaccines or fluoride or vitamin K for newborns are all experimental is, well, insane. We took a vote, people. You lost. Live with it and go vote at the next election. Until then, drink up!

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I’d Like to Play a Game

…But I can’t. I can’t play a game with anti-vaccine people because Game Theory assumes that you’re dealing with rational players. When it comes to the people who peddle in anti-vaccine conspiracy theories, you’re not dealing with rational people. You’re dealing, for the most part, with some incredibly irrational individuals who believe any and all conspiracy theories put forth to them by the people they worship.

They’re kind of like a cult, or a loose federation of cults. They have one or two (or three) high priests in the forms of Andrew Jeremy Wakefield, Robert F. Kennedy, Jr. or Del Bigtree. Those three men could sacrifice a virgin at an altar streaming live on social media, and it’s a safe bet that their anti-vaccine followers would find a way to justify the ritual. “It had to be done to stop the vaccine holocaust,” they would probably say. And the people would swallow it up hook, line and sinker.

Look at how they see vaccine package inserts. Package inserts are legal documents required by regulatory agencies to accompany medications. When it comes to vaccines, the package inserts name the ingredients in the vaccines, how the vaccine works, when it should be administered, to whom it should be administered and what kinds of side-effects (if any) were seen during the clinical trials of the vaccination.

Mind you, anti-vaccine people claim that there have been no clinical trials of any of these vaccines. Then, when you point out that it’s in the package inserts — the very same goddamned inserts they want you to read because they contain the truth — they flip it around and say that the package inserts are full of lies. If your head is spinning, wait for it. There’s more.

A few weeks ago, some dude who is a hardcore anti-vaccine advocate/activist/loon physically assaulted a California State Senator. The dude has a following on social media, and he ran unsuccessfully for the senator’s seat. Anti-vaccine luminaries followed the dude and praised him. Ah, but the minute the dude gets violent, they all turned on him and started the conspiracy theory that the dude was in cahoots with the senator in order to make anti-vaccine people look violent and nutty.

Then, just last week, some woman woke up in the morning, went to the state capitol in Sacramento, sat in the gallery of the senate, reached down into her vagina, pulled out a menstrual cup that had blood in it and threw the damned thing on to the senate floor, striking several of the legislators. As she was detained by police, she stood there and screamed to whomever could listen that she did it for the dead babies that vaccines caused.

Well, that is what happened in reality. In nutty-land, she was not an anti-vaccine activist and no one had ever heard of her. She wasn’t there to protest vaccines, either. She was there to protest abortion. And what she threw at the senators was not blood, it was paint, a cup of fruit or nothing at all, depending on which anti-vaccine lunatic you’re listening to.

Of course, there is the grand delusion that anything bad that happens to a person after getting a vaccine is the direct result of the vaccine. Car accident? The vaccine did it. Blood clot when you’re morbidly obese, a smoker and on birth control, months after a vaccine? The vaccine did it. Stroke when you’re in your 90s, have had high blood pressure all your life and are on anticoagulants? The vaccine did it. Suffocated to death under the weight of your high-as-fuck mother? The vaccine did it. Trump? The vaccine did it. Hillary Clinton? The vaccine did it.

Don’t even get me started on health care people who decided that they are going to be anti-vaccine. When you spend years of your life studying the sciences, and then you decide to deny the evidence and make some money off of lies… That’s psychopathic. That’s someone who cannot be trusted to be licensed to take care of a dog, let alone a human being. (With all due respect to veterinarians who do take care of dogs.) These so-called physicians and nurses who decide to peddle anti-vaccine nonsense should not be licensed to practice anything even remotely related to caring for the health of people.

And that’s why, as much as I want to play games with anti-vaccine people and get them all riled up in order to have them see the error of their ways, I cannot. They’re not rational. They don’t play by the rules of society, let alone reality. They live in either Crosby’s Labyrinth or something eerily similar to it. Up is down. Left is right. What you are seeing is not what your eyes are witnessing but some gummed up version of reality put in front of you by people who control the world and do not allow a shred of truth to get out except through their websites, blogs and social media channels… Channels to which you can subscribe and donate your money since they are not being paid millions. (Not by pharma, anyway.)

So I’ll have to look to another theory that is not Game Theory in order to better understand these nuts and continue to fight them. Because you should not have a shred of doubt that I will fight them until I cannot fight them anymore. And, even then, even when I cannot fight them anymore, someone else will. We’ve been doing it since Jenner, and we’ll do it beyond the age of Offit.

Your move, mother Hubbards. Your move.

It’s never the anti-vaccine people’s fault. It’s always the vaccines, right?

In case you’ve been living under a rock, a woman decided that she was going to go to the Capitol in Sacramento, California, get in through security, go up to the viewing gallery of the state senate, and then throw a menstrual cup full of what she said was her blood onto the senate floor, striking several senators with the fluids.

(Yeah, that was a big run-on sentence. Get over it.)

This is the most recent attack on California legislators who were working on closing the loopholes that allowed quacks and douchebags emerit-ass to sell or give away bogus medical exemptions to vaccine requirements. The bill signed back in 2015 eliminated personal belief exemptions and pretty much said that the only way to be exempt from vaccine requirements was to get a physician to sign-off on it. As you can imagine, some unscrupulous physicians got into the game of giving/selling/providing medical exemptions, so the exemption rate rose.

Now, physicians who give out too many exemptions will be looked at more carefully, and health departments and public health authorities will have the ability to look at those exemptions and verify them. Hooray! Right?

Well, the anti-vaccine crowd isn’t having it. Robert F. Kennedy, Jr. (the bloated kingpin of antivaxxers) and Del Bigtree (the clown prince of antivaxxers) were quick to descend on California and stoke the fears of the anti-vaccine crowd. Words like “tragedy” and “holocaust” were bandied about when it came to vaccines and the now-debunked myth that vaccines cause autism. They held some weird “vigil” for “dead” children, allegedly victims of vaccination, that included stock photographs from the internet and pictures of living people.

Thoughts and prayers, Ethan.

And now, fantastically, anti-vaccine organizations are disavowing the acts of the blood-throwing woman. They say she’s not part of “the movement” and that she doesn’t represent their membership. This is weird and hilarious because they do these marches and protests en masse, with vicious and racist attacks on anyone even remotely associated with vaccines, and then they disavow when one of them goes bananas?

Words have meaning and they have power, folks. These anti-vaccine preachers keep going on and on about the horrors of vaccination, and then they expect no one to do anything about those horrors? They must think we’re idiots.

The Other Epidemics

We would be lying to you if we didn’t tell you that things other than infectious disease and vaccine-preventable diseases are not the only thing that take up our time. Humanity is kind of a funny set of organisms. We do things to ourselves that harm us and harm others.

The opiate epidemic started because people couldn’t deal with pain properly, and their healthcare providers didn’t provide them with adequate care and pain management. Instead of getting to the bottom of what hurts, they were given a pill and sent on their way. The pain was still there, but it was numbed by the medicine. (By “pain,” we mean all the things that make one’s life unbearable, and not just physical pain.) When the medicine ran out, they caught on to the fact that heroin is an opiate, albeit a much stronger one. When the heroin couldn’t do the job anymore, they moved on to stronger opioids like fentanyl. And so, here we are, faced with a man-made epidemic of something that could have been nipped in the bud a decade ago if someone would have just encouraged more mental health treatment for those pains in life that are not physical or are physical but exacerbated by mental anguish.

More recently, public health authorities have declared “second-hand alcoholism” as a public health problem. What is that? When you’re hurt in a car accident that is caused by a drunk driver, you’re the victim of second-hand alcoholism. When you’re born with fetal alcohol syndrome, you’re a victim of second-hand alcoholism. Basically, when someone hurts you because of their drinking, you’re a victim, and there are ways to prevent it from happening.

Obesity? I bet you’ve heard about this one. There is a good chance that you’re fighting with obesity yourself if you’re an American. High-calorie foods and more sedentary lifestyles have brought on increased waist sizes, heart disease, diabetes and increased risk of other diseases and conditions. This one is a tough one because we all need to eat, and the better-paying jobs are usually not the ones that require us to burn a ton of calories. It’s not like you can cut-off people from food or send them to work into the fields. It’s also a matter of where you live because, if all you have is a bodega that sells cheap junk food, you’re not going to have a salad anytime soon.

Then there is the other epidemic, the one that has hit some of us very hard. We’re talking about suicide. When the housing market crashed in 2008, a lot of people lost their jobs and their pensions in a matter of days to weeks. It wasn’t a slow process, or a process that is easier to adjust to. When that happened, desperate people didn’t see any other way out from their predicament than to take their own lives. It wasn’t hard due to the incredible number of guns that are readily available in this country.

As you can see, there are many other things that those of us in public health are focusing on. There’s just too much to do because there is so much we do to ourselves and to others. So don’t miss us too much… But do miss us.

Won’t Someone Think of the Antivaxxers?

Is it bad that I turn on the news on the radio on the way to work hoping and praying that the President of the United States hasn’t done something to collectively embarrass us as a nation? Now, is it bad that I keep doing it knowing full well that it’s not going to happen? You know what they say about what the definition of insanity is…

Speaking of the insane, it seems that antivaxxers have taken their charade about being persecuted one step too far. Well, too far if you’re a reasonable person. They seem to think that nothing is “too far” when it comes to defending their skewed view of the world and attacking those they despise for trying to save lives of children. This time, they decided to compare themselves to Jews and other minorities who were systematically hunted down and killed during the Holocaust.

As Helene Sinnreich, PhD, put it in the Washington Post:

“It is not the first time the anti-vaccination movement has appropriated the Holocaust. Anti-vaccination advocates have called the side effects of vaccinations a modern-day Holocaust. They compare the criticism directed toward parents who choose not to vaccinate their children to the persecution of Jews during the Holocaust and label those who advocate for stringent laws around vaccines as Nazis. But this misuse of history distorts and undermines the actual horrors of the Holocaust. It also ignores that so many Holocaust victims died of infectious diseases — the same ones that vaccines could prevent today.”

Indeed. They keep playing the “I’m being persecuted” card all the time. They call themselves victims when they are not. They claim they are “toxic” or “diseased” from having “too many” vaccinations. And, of course, anything and everything is to be blamed on vaccines.

Dr. Sinnreich continued:

“The death toll from infectious disease was so high because Jews were stripped of basic resources including medical equipment, medicine and food. They were even denied quality soap. Doctors and other care providers helped fight disease in terrible conditions with scant supplies, many succumbing to disease themselves. Starving people traded food for medicine to help family members survive.

Vaccines emerged as a powerful, if expensive, tool for resistance. Smugglers found ways to bring medicine and even nascent vaccines into the ghetto. Those few who could obtain a vial of vaccine on the black market paid more than 100 times their weight in gold to obtain them. The going rate for a vaccine in the Warsaw ghetto could buy 30,000 bowls of soup — an astronomical amount in a place where people perished of hunger in the streets.”

So, yeah… Privileged (predominantly) white people in the United States, all very much free to do as they wish, are comparing themselves to the Holocaust victims who were forcibly removed from their homes and put into ghettos without basic supplies needed to be alive. They are comparing themselves to people who would pay with their lives for having the protection that vaccines provided. Antivaxxers are so persecuted.

Won’t someone think of the antivaxxers?

Look at this image:

Dead bodies being pulled from a train carrying Romanian Jews toward prison and death camps. (Source)

Ignorant anti-vaccine activists want you to believe that they are being treated in the same way. They want you to believe that a requirement to vaccinate so that we’re all safe — especially those too young or too sick to be vaccinated — is the same thing as between 12 and 17 million people experienced during the Holocaust. Nothing could be further from the truth, but antivaxxers are not exactly known for their firm grasp of the truth.

Or this image:

Bodies of dead children from the Warsaw ghetto. (Source)

Antivaxxers will have you believe that they are suffering a holocaust of their own from all the “injuries” from vaccines. But where are the bodies? Are children who are immunized being hauled away like waste in carts? Where are the mass graves?

What anti-vaccine people are going through with quarantines and exclusions from schools IS NOTHING AT ALL LIKE WHAT JEWS WENT THROUGH IN THE HOLOCAUST. No, they are not being persecuted. There’s no police force searching for them and dragging them away to jail (or worse). There is no law preventing them from getting married or having children.

How much more clearer can we make it?!

Violinist Schools Us on Vaccines (Hilarity Ensues)

Have I told you that Pedro, my partner, (not her real name) is a car mechanic? Yeah, and that makes me an expert in fixing cars. Why, I’m the best car-fixer there ever was, all because of Pedro.

If you believe that, I have a bridge in Brooklyn to sell you.

So why is it that Alison Peters Fujito is schooling us about vaccines? She’s a violinist with the Pittsburgh Symphony Orchestra, and there is nothing remotely associated with vaccines that she has studied, according to her page on the Orchestra’s site. The only thing I can think of is that her husband is a professor of chemistry at LaRoche College.

So what does Alison Peters Fujito say about vaccines? She wrote an “editorial” at the website of one Sharyl Attkisson, titled “Vaccine-autism link: A rebuttal to the “There is no debate” narrative.” First, now that you know that Alison Peters Fujito is a violinist, you must next know who Sharyl Attkisson is as well.

Sharyl fancies herself a journalist, much like I fancy myself an airplane pilot because I have dozens of hours of flight experience. Sharyl Attkisson once thought that her computer had been hacked by the Obama Administration, posting a video of the alleged hacking. Numerous tech blogs were able reproduce the effect she was showing and explained that it was just a stuck delete key on her keyboard. You shouldn’t be surprised that this and other conspiracy theory shenanigans got Sharyl Attkisson a little estranged from CBS. No worries, though, Sinclair Broadcasting gave her a syndicated show to push more conspiracy theories.

Like all good conspiracy nuts, Sharyl Attkisson seems to love the idea that vaccines cause autism. There is no evidence of this, of course. All the science points away from any kind of link between vaccines and autism. The more we epidemiologists, scientists, medical professionals and the like (but not violinists) look into it, we find even more evidence that such a link doesn’t exist. But that’s not enough for anti-vaccine conspiracy nuts. They need a link to exist, or they are nothing.

Such is the case with Alison Peters Fujito, it seems. She begins her editorial with a few sentences that reminded me more of Sharyl Attkisson than the person she is criticizing:

Some people are unable to see any perspective other than their own. It’s already disturbing when they insist, over and over, that opposing facts don’t exist, as though repetition can make unpleasant truths disappear. But when they resort to misdirection, deliberate pejoratives, and outright lies, there is more going on than just myopia.

It sounds spot on like this was going to be a takedown of Sharyl Attkisson. Instead, she’s trying to take down a medical doctor, vaccine expert and father of an autistic young woman:

This past week, in response to Sharyl Attkisson’s op-ed two days prior, vaccine developer Dr. Peter Hotez wrote an op-ed piece in The Hill, claiming “there is no debate” in a manner eerily reminiscent of “the Party is always right” from George Orwell’s 1984. The entire basis of Attkisson’s piece was the recent affidavit of Dr. Andrew Zimmerman, one of the country’s top pediatric neurologists, who served as the US government’s expert witness defending vaccines in the so-called “Vaccine Court.” In a stunning about-face, he testified that vaccines can cause autism in children with pre-existing mitochondrial dysfunction, and that he had communicated this to DOJ lawyers in 2007.

Ah, yes, Dr. Peter Hotez is a pharma shill because he’s worked on the development of vaccines. He is not to be trusted because of the decades of experience in vaccine science. To the conspiracy nuts, he probably doesn’t even have a daughter, let alone one who is autistic.

And that affidavit by Dr. Andrew Zimmerman? It was much ado about nothing. As Orac explains, Dr. Zimmerman himself has explained that his affidavit is being misinterpreted by “the media” (i.e. Sharyl Attkisson), and that he supports vaccination. The problem is that Dr. Zimmerman tied himself into a knot trying to push an idea that linked autism-like outcomes with mitochondrial dysfunction and mitochondrial dysfunction with infectious disease. The anti-vaccine loons took that and said, “Hey, if you can have mitochondrial dysfunction with an infection, then you surely must have it with vaccines… And if vaccines can cause mitochondrial dysfunction, they surely cause autism.”

Such are the leaps of the anti-vaccine groups. So Alison Peters Fujito continues:

Other neurologists have observed the same link. Zimmerman himself claims that there was a cover-up. Yet, Hotez never directly addressed Zimmerman’s affidavit, or mentioned mitochondrial dysfunction or its relationship to autism and vaccines.

Instead, he repeated his version of “the Party is always right,” trotted out links to vaccine industry “astroturf” blogs, and presented irrelevant and flawed studies (this one actually gave the same vaccine/thimerosal dosage to both cases and controls, while this one was shown to be in error, and this one is debunked here ), none of which address the possibility of mitochondrial dysfunction.

As a scientist, Hotez should know that there’s no such thing as a “study showing there’s no link” to anything. A study may fail to show a link, but that doesn’t mean there’s no link. Surely we learned this from the tobacco industry’s “studies.”

Dr. Hotez has written books about this. He’s published studies about this. The fact that Alison Peters Fujito is so angry about his links to blogs and “flawed studies” shows how narrow her view is, something that she criticized in her opening paragraph. The studies are flawed because, in the anti-vaccine view, all studies need to compare vaccinated and unvaccinated children. That is, they want children to be unvaccinated and see if they die or not. (Spoiler alert: They die at higher rates than vaccinated children.)

Then, with what I assume was a straight look on her face, Alison Peters Fujito mentions “astroturf” blogs. This, as most anti-vaccine information comes from blogs by non-experts… By, say, violinists at orchestras who are married to chemistry professors. (“Astroturf blogs” are Sharyl Attkisson’s words, so I’m wondering if Alison Peters Fujito is sucking up to Sharyl Attkisson, or if Sharyl Attkisson spruced Alison’s blog post a little.)

This blog, for example, is astroturf to Sharyl Attkisson. She probably thinks I’m getting a ton of cash for writing this. (Fifty cents per word, actually… In Colombian pesos.)

Alison Peters Fujito continues:

Yet that’s exactly what Hotez did, claiming “clinical studies with over one million children enrolled, showing there’s no link between vaccines and autism,” [bolding mine] linking only a single, severely-flawed meta-analysis (with no children enrolled) of older studies that looked at either one ingredient (thimerosal) or one vaccine (MMR)

The conclusion of that meta-analysis is based in part on studies rejected by the Institute of Medicine as too flawed to be considered for their 2012 report on the vaccines/autism link. Regardless, none of those studies considered the possibility of mitochondrial dysfunction.

Despite Hotez’s reference to “at least 99 autism genes,” no specific genes are known to cause autism. In fact, the study he linked does not identify genes that cause autism, but merely notes some frequency of some de novo variants among some individuals with autism.

Dr. Hotez seems to forget that correlation does not equal causation.

I like how Alison Peters Fujito, violinist, has determined that studies cannot show no association but only fail to show an association. I giggle at the thought of her holding her violin and sitting in an epidemiology class, arguing that all the evidence in the world can only “fail to show an association.” That’s not how it works, Carol… I mean, Alison.

Epidemiological studies can be done in a way that you can say with confidence that one thing is not associated with the other, including causal association, not just correlation. These studies can be observational or experimental, and both types have been done to look at autism and vaccines.

We, scientists (not violinists), have looked at newborns and followed them through their childhood. We then look at the ones eventually diagnosed with autism and those who are deemed neurotypical. We then compare their vaccination status, which vaccines they’ve received, and whether or not there are confounding factors involved. Again, spoiler alert, there is no association between vaccines and autism.

We, scientists (not violinists), have looked at autistic children and neurotypical children and gone backwards through their medical histories. There are no differences in vaccination rates, controlling for other factors like having anti-vaccine parents. There’s just nothing different as far as vaccination is concerned between autistic children and neurotypical children, no matter what Sharyl Attkisson and Alison Peters Fujito want you to believe.

Alison Peters Fujito finishes her blog post (in case you thought it was a published piece of research, like the ones Dr. Hotez has actually written in peer-reviewed journals) with a misrepresentation of the Universal Declaration on Bioethics and Human Rights:

The right to decline an unwanted medical intervention, free from coercion, is, in fact, codified in Article 6 (Consent) of UNESCO’s 2005 Universal Declaration on Bioethics and Human Rights:

Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information. The consent should, where appropriate, be express and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice. (bolding mine)

Please note section 3 of the same Article, which protects us all from the Orwellian principles Hotez seems to be espousing:

In no case should a collective community agreement or the consent of a community leader or other authority substitute for an individual’s informed consent.

We should all be troubled by scientists, doctors, or any industry insider so enraged by our reluctance to buy what they’re selling, they try to censor all conversation that disagrees with their sales pitch.

That’s not science, it’s not good medicine, and it’s deceptive.

What is deceptive is that Alison Peters Fujito is not giving you the full idea of what those passages mean. There is consent and there is assent. Consent comes into play if you’re an adult in full use of all your mental capabilities. Then you as an individual can make the choice of whether or not you want a medical procedure to be performed on you. You can weigh the risks and benefits to yourself.

But what if you’re a child? Can a newborn baby weight the risks of not vaccinating and understand that those risks far outweigh the risks of vaccinating? Of course not. It’s up to the parents to make that decision. Children need to assent to the better judgment of the adults caring for them. We, as a society, are also responsible for those children, and that is why the courts — and reasonable people — are in agreement that children can and should be removed from the care of irresponsible parents.

So, yes, you can say that you don’t want a vaccine for yourself, but you are mistaken if you decide that a child is “yours” (as in your property) and that you have the right to place that child in danger. You don’t, and no human rights declaration in the world would ever agree with you. In fact, children have a universal human right to be healthy, and that health comes with vaccination.

It’s not up for debate. Vaccines work. Vaccines save lives. The only people who don’t think so rely on their “instincts” and “feelings,” or on the misinformation shared by people like Sharyl Attkisson and Alison Peters Fujito. Absent vaccines, I think these two would find a way to argue that the Earth is flat, and that you have a right to ignore things disappearing over the horizon.