Connecting the dots when you can’t connect two brain cells

Let me connect some dots for you. Merck makes one of the anti-HPV vaccines. Merck gave money to the Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine to endow a chair. In the minds of the anti-vaccine crowd, anyone in that chair (figuratively and literally) might as well be Satan’s spawn. After all, who but Satan’s child would take a position paid for by Big Pharma? No one in their right mind would work for Big Pharma.

Furthermore, no one would ever want to study and become an expert on vaccines through education and hard work because that means you’re a shill. No, you must gain all your knowledge of vaccines and their side-effects from anti-vaccine websites, celebrities, and chiropractors. Sure, there are some honest-to-goodness physicians sprinkled among the nutjobs, but you know what they say about the company you keep. (Anti-vaxxers are not science-based if they have a few scientists and physicians in their ranks. It makes the very few scientists and physicians anti-vaxxers.)

If you, say, study law and become good at defending the legal framework that supports compulsory, mandatory, or required immunization, then you’re a shill. You can’t be anything else. That’s the way things are if you can’t connect two brain cells together then go about trying to connect the dots of the conspiracy theory in your head. Allow me to elaborate.

US girls decide to become less slutty, wash their hands, or get vaccinated? You tell me.

The NY Times is reporting a study published in the Journal of Infectious Diseases where it is reported that the prevalence of HPV infection in girls ages 14 to 19 is half of what it was in 2006. So what happened? Did these girls decide to be “less slutty“? Did hygiene and sanitation finally make their way to these girls’ vaginas? No.

What happened was that anti-HPV vaccines came online in 2006, and lots of girls are getting them. Lots, but not as many as we need to sustain this decrease. We’re far behind other countries in that respect. According to CDC:

“This report shows that HPV vaccine works well, and the report should be a wake-up call to our nation to protect the next generation by increasing HPV vaccination rates,” said CDC Director Tom Frieden, M.D., M.P.H.  “Unfortunately only one third of girls aged 13-17 have been fully vaccinated with HPV vaccine.  Countries such as Rwanda have vaccinated more than 80 percent of their teen girls. Our low vaccination rates represent 50,000 preventable tragedies – 50,000 girls alive today will develop cervical cancer over their lifetime that would have been prevented if we reach 80 percent vaccination rates.  For every year we delay in doing so, another 4,400 girls will develop cervical cancer in their lifetimes.”

Most of you will know that HPV vaccine continues to be demonized, against all the evidence, and anti-vaccine people keep blaming deaths and disabilities on it. A presidential candidate fueled the fire based on similar misconceptions about the vaccine. But, guess what? The evidence keeps coming in. The vaccine is safe, effective, and it is cutting infections in half. Now, we need to replicate these findings in those highly-vaccinated countries to put yet another nail in the coffin of the HPV vaccine conspiracy.

Is it evil?

I’m not a psychiatrist or a psychologist, but, as I’ve been dreaming up the plot of “The Poxes,” I’ve been thinking a lot about the criminal mind. This all came to the forefront yesterday as I watched what was happening in Boston. All at once, I was worried about the people there and the people I know who live in Boston, and then I began to think about the kind of person who does something like bombing a group of people at a sporting event.

Like Ren wrote yesterday:

“Those people were not there in a political protest. They were not there as part of a religious sect. And they were certainly a mix of people from all walks of life and backgrounds. They were as innocent as innocent people get.”

Whoever places bombs in such a group of people is no less than evil.

How much more should we waste on this?

Another day, another study dispelling the myth that vaccines cause autism. I’ve often wondered why scientists at world-renowned institutions spend valuable time and money trying to appease people who see monsters under their beds. Do they do that at home, too? Do they look under the bed each and every night for decades, just to appease the kid? I wouldn’t. There would come a time when I look the kid in the eye and say something like, “Look, kid, there is nothing there. There are no monsters. There never were. There never will be. I don’t care how much you want to believe in those monsters to explain away your life or your situation. We are not discussing this anymore. Period.”

Of course, real life is not at all like that. In real life, we need to appease people, especially people in power or people who are very, very outspoken about their perceived wrongs. So, yet again, we have another study that concludes that, hey, vaccines don’t cause autism.

Big, fat surprise.

But, really, how much more do we need to focus on vaccines as the causative agents of autism? Ten more studies? Five? Fifteen? And how much more money do we throw at the dragon? A million dollars? Ten million?

The people who are anti-vaccine don’t care for those questions. They want us, the scientists, to repeat the studies, repeat the lab tests, and re-analyze the data until they get the answer that they “feel” is the right one. They feel that their child regressed immediately after the vaccines, so the vaccines are to blame. They feel that their child wouldn’t be “lost” had they not vaccinated their child, so the vaccines are to blame.

And so on, and so forth. So where does it end? When do we, the adults in this conversation, tell them, the anti-vaccine groups, that enough is enough? When do we tell them to stop looking for monsters and look for programs and services to help their kids be all that they can be?

Today? Tomorrow? When?

At what point will someone call Shenanigans? (UPDATED)

I call Shenanigans! Well, not the restaurant, of course. I call shenanigans on this: (It’s a little long, so you can skip it and avoid the headache, or read and get a migraine.)

“My reasons for not vaccinating – what are yours?

Vaccine antigens cause a short term response as measured by antibody count (titer tests). The first problem we encounter is that, when tested after a few weeks those antibodies are, in most people, not present anymore. The next problem is that there is no study proving that a high antibody count actually protects from or prevents disease outside of the lab (real world). The third problem and major issue I have with vaccines is their effect on the immune system. In recent years science has learned that the human immune system is much more complicated than we thought. It is composed of two functional branches or compartments which may work together in a mutually cooperative way or in a mutually antagonistic way depending on the health of the individual.

One branch is the humoral immune system (or Th2 function) which primarily produces antibodies in the blood circulation as a sensing or recognizing function of the immune system to the presence of foreign antigens in the body. The other branch is the cellular or cell-mediated immune system (or Th1 function) which primarily destroys, digests and expels foreign antigens out of the body through the activity of its cells found in the thymus, tonsils, adenoids, spleen, lymph nodes and lymph system throughout the body. This process of destroying, digesting and discharging foreign antigens from the body is known as “the acute inflammatory response” and is often accompanied by the classic signs of inflammation: fever, pain, malaise and discharge of mucus, pus, skin rash or diarrhea.

These two functional branches of the immune system may be compared to the two functions in eating: tasting and recognizing the food on the one hand, and digesting the food and eliminating the food waste on the other hand. In the same way, the humoral or Th2 branch of the immune system “tastes” and recognizes and even remembers foreign antigens and the cellular or Th1 branch of the immune system digests and eliminates the foreign antigens from the body. But just as too much repeated tasting of food will ruin the appetite, so also too much repeated stimulation of the “tasting” humoral immune system by an antigen will inhibit and suppress the digesting and eliminating function of the cellular immune system. In other words, overstimulating antibody production can suppress the acute inflammatory response of the cellular immune system!

This explains the polar opposite relationship between acute discharging inflammations on the one hand and allergies and auto-immune inflammations on the other hand. The more a person has of one, the less he or she will have of the other!

A growing number of scientists believe that the increase in America, Europe, Australia and Japan in allergic and auto-immune diseases (which stimulate the humoral or Th2 branch of the immune system) is caused by the lack of stimulation of the cellular or the Th1 branch of the immune system from the lack of acute inflammatory responses and discharges in childhood. We need to identify the factors which cause this shift in the function of the immune system or which cause allergies and auto-immune diseases in childhood to increase!

If we now return to the original question of the mechanism of action of vaccinations, we find what I believe is the key to the puzzle. A vaccination consists of introducing a disease agent or disease antigen into an individual’s body without causing the disease. If the disease agent provoked the whole immune system into action it wouldcause all the symptoms of the disease! The symptoms of a disease are primarily the symptoms (fever, pain, malaise, loss of function) of the acute inflammatory response to the disease. 

So the trick of a vaccination is to stimulate the immune system just enough so that it makes antibodies and “remembers” the disease antigen but not so much that it provokes an acute inflammatory response by the cellular immune system and makes us sick with the disease we’re trying to prevent! Thus a vaccination works by stimulating very much the antibody production (Th2) and by stimulating very little or not at all the digesting and discharging function of the cellular immune system (Th1).

Vaccine antigens are designed to be “unprovocative” or “indigestible” for the cellular immune system (Th1) and highly stimulating for the antibody-mediated humoral immune system (Th2).

Perhaps it is not difficult to see then why the repeated use of vaccinations would tend to shift the functional balance of the immune system toward the antibody-producing side (Th2) and away from the acute inflammatory discharging side (the cell-mediated side or Th1). This has been confirmed by observation especially in the case of Gulf War Illness: most vaccinations cause a shift in immune function from the Th1 side (acute inflammatory discharging response) to the Th2 side (chronic auto-immune or allergic response).

The outcome of this line of thought is that, contrary to previous belief, vaccinations do not strengthen or “boost” the whole immune system. Instead vaccinations overstimulate the “tasting and remembering” function of the antibody-mediated branch of the immune system (Th2) which simultaneously suppresses the cellular immune system (Th1) thus “preventing” the disease in question. What in reality is prevented is not the disease but the ability of our cellular immune system to manifest, to respond to and overcome the disease. 

Those are my reasons for not vaccinating my children. What are yours?”

This is the guy I told you about before, the one who thinks that his daughter’s type I diabetes was caused by the hepatitis B vaccine she received months earlier, the one who thinks he did “academic research” in writing his book. He claims that he’s not anti-vaccine and that he just wants to inform the public so that the public can make their own decisions. “Inform,” I don’t believe that word means what he thinks it means because that whole bunch of drivel up there, all that stuff, it’s chock-full of misinformation.

“Vaccine antigens cause a short term response as measured by antibody count (titer tests). The first problem we encounter is that, when tested after a few weeks those antibodies are, in most people, not present anymore.”

Not so! Pregnant women are checked for immunity by testing their blood for antibodies (titer tests), measuring the immunoglobulin G levels. Immunoglobulin G (IgG) lasts for a very long time. If I take some blood from you now and do a protein electrophoresis on it (separation of proteins by weight), it will look just like this:

From left to right: Albumin, Alpha 1, Alpha 2, Beta, and Gamma globulins (proteins)

See the gamma globulins all the way on the right? They’re your antibodies. They’ll always be there unless you get sick, in which case you get an infusion of antibodies from a donor to keep you safe from infections. This guy is outright lying when he says that antibodies disappear. They don’t, and that’s why so many vaccines will give you long-lasting immunity.

He then dives into the whole “Th1 vs. Th2” thing, but he gets it completely wrong. Here’s what that system is all about: Th1 is about intracellular pathogens, like viruses. Th2 is about extracellular pathogens, like bacteria and fungi. But anti-vaccine people read that “Mercury depletes glutathione and polarizes toward Th2 dominance” and they went nuts over that. Mercury will do that to people. But there are reasons why this isn’t the case with vaccines.

First, the amount of mercury in vaccines was negligible before manufacturers removed all thimerosal (a mercury-containing compound much like salt is a chlorine-containing compound). Even when we do get thimerosal from a vaccine (usually the flu vaccine nowadays), the amount is negligible, and our bodies are really good at dealing with it. Again, it’s all in the chemistry. But, true to anti-vax ideology, this guy swallows the lie hook, line, and sinker, and it seems to me that he wants you to do the same.

But, hey, if you want to believe him, go ahead and spend hundreds of dollars on a lab test you probably don’t need.

“A growing number of scientists believe that the increase in America, Europe, Australia and Japan in allergic and auto-immune diseases (which stimulate the humoral or Th2 branch of the immune system) is caused by the lack of stimulation of the cellular or the Th1 branch of the immune system from the lack of acute inflammatory responses and discharges in childhood.”

I’d really like to meet these scientists and explain to them that the Th1 component really is being stimulated all the time because we’re under constant bombardment by viruses and other intracellular pathogens. Then again, I don’t think these scientists are a “growing number” of them. Rather, I suspect they are the few anti-vaccine “scientists” who like to claim things that aren’t.

“Thus a vaccination works by stimulating very much the antibody production (Th2) and by stimulating very little or not at all the digesting and discharging function of the cellular immune system (Th1).”

This is how I know this guy knows absolutely nothing about immunology. See, when an antigen is introduced into your body — an antigen that shouldn’t be there — macrophages eat that antigen and then present it to your T helper (the “Th”) cells. So, as you can see, the immune system is involved in everything from antigen response through absorption, digestion, and presentation to T helper cells; to B cells, cells that are not even part of the Th system. It is complex, and that’s why he’s getting it all wrong… All of it! It’s as if he can’t read Wikipedia or something.

“Vaccine antigens are designed to be “unprovocative” or “indigestible” for the cellular immune system (Th1) and highly stimulating for the antibody-mediated humoral immune system (Th2).”

What?! Read this and pay attention to this part on the first page:

“Most antigens and vaccines trigger both B and T cell responses, such that there is no rationale in opposing antibody production (‘humoral immunity’) and T cell responses (‘cellular immunity’). In addition, CD4+ T cells are required for most antibody responses, while antibodies exert significant influences on T cell responses to intracellular pathogens.”

The more he posts on his Facebook page, the more I’m convinced he’s one chicken McNugget short of a Happy Meal®.

UPDATE: A reader of the blog asked me to correct/clarify some things. So I did. I’ve bolded them. Also, he posted this on Facebook to counter the anti-vaccine activist’s rant:

Click to enlarge.

I bet it gets deleted because it’s full of truth.

Don’t be an anti-vaccine activist

The South Dakota State Medical Association put out this collection of essays and reports (PDF) on the history of vaccines. It makes for good reading. If you don’t have enough time to read it all, read the afterword, especially this part:

“Public health has faced resistance to vaccination for as long as it has been used to protect the public’s health, but today the scope of the challenge facing public health to address these challenges has grown, including the increasing dependence of consumers on obtaining health information online. For decades, public health has accomplished its mission using its most valuable currency – trust and credibility. The public’s trust in public health and our credibility in using the best scientific and outcome-based evidence to drive our policies have enabled the dramatic successes in vaccination. Maintaining that trust and credibility is key to the success of future public health activities. If, to counter resistance to vaccines, public health overstates vaccine efficacy and effectiveness, the risk of being infected, and experiencing serious illness as the result of a vaccinepreventable disease, or the safety of vaccines, we will ultimately lose public trust and credibility. Our ability to promote vaccines will then be seriously challenged.”

I’ll be the first one to confess that I have, at times, used some of the tactics that anti-vaccine activists have used. I’ve been a troll on their comments section. (This one being my latest, greatest coup.) At times, I have called people names, and I have been very short-tempered when others were exhibiting their stupidity. In short, I’ve been antagonistic, and I blame the anti-vaccine and anti-science forces for making me come off that way.

No more.
How will I go about doing this? Through some simple rules:

1. Don’t exaggerate. Anti-vaccine people will use exaggeration to try and prove their points, sometimes claiming that events that happen once in a thousand years occur often enough to be feared. They do this a lot with Guillain-Barre Syndrome (GBS). This syndrome happens between 3,000 and 6,000 times each year to people regardless of whether or not they received any vaccine. Yes, GBS is known to be one of the things that could happen with vaccines, but it is very rare, and you have equal odds of getting it whether or not you’re vaccinated. But that’s not true to the anti-vaccine activist. To them, there is a clear and present danger of developing GBS with any and all vaccines, and this danger is so high (to them) that you should not get vaccinated.

Likewise, there have been a handful of cases of polio vaccine-derived poliomyelitis. A handful! But the anti-vaccine activists make it sound like any polio vaccine will undoubtedly lead to full-blown polio. They will tell you that the polio vaccine in places like India has caused a huge number of cases of “acute flaccid paralysis”, and they will recommend to you — with a straight face — that you are better off just washing your hands and drinking bottled water if you go to India and are not vaccinated.

On the other hand, I’ve seen some vaccine advocates use exaggeration as well. For example, subacute sclerosing panencephalitis (SSPE) is a known complication from having measles. It happens to people, particularly children, who get measles and don’t quite clear the virus. (No, it doesn’t happen from the measles vaccine, despite the vaccine virus being live, attenuated.) This type of encephalitis is incredibly rare, but it debilitating and awful for a child to go through. In an attempt to get people to vaccinate, I have used it as an example of something that could happen if you did not vaccinate. Others have done the same thing. And I’ve noticed that we don’t quite do the due diligence of clarifying the risk. Henceforth, I promise to say something like this, “Listen, the chances of SSPE are incredibly small, but they are larger than the chances of adverse effects from the MMR vaccine. The MMR vaccine reduces your chance of measles to almost nothing, and the chance of encephalitis and other nasty things from measles to even less than that.”

I’ll try not to exaggerate.

2. Don’t smear. One of the favorite things that anti-vaccine people do is to try and smear their opponents or people they disagree with. To some, a certain vaccine researcher and quite awesome pediatrician working in Philadelphia is a “vaccine industrialist” because he spent decades of his life trying to develop a life-saving vaccine and got compensated for it. A journalist who wrote an excellent book on the anti-vaccine forces is a “Pharma mouthpiece”, and so on and so forth. Anyone who comments online in an attempt to set the fact straight is labeled a “Pharma shill” or a “paid commenter.” Very seldom will the anti-vaccine activist address the facts being laid before them.

I have as well failed to address the lies laid before me by anti-vaccine activists and just attacked their intelligence. I have done this for several reasons. First, you can only explain things to people so much before it gets old and exhausting. Second, the very act of using lies to prove a point makes people worthy of one’s questioning of their mental abilities. It’s easier to write, “Listen, you moron. You painfully, obviously did not study biology because of this idiotic statement you’re making.” On the contrary, I plan to have some “canned comments” to just paste to people that make a claim. Usually, “Wakefield committed fraud and none of his claims have been duplicated nor validated” should suffice.

I’ll try to keep my composure and not smear, and not call names.

3. Easy with the anecdotes. I’ll be the first to tell you that there is some use to anecdotes because they can give us a worst case scenario for things. If one of my friends goes to a restaurant and gets gnarly food poisoning 12 to 24 hours later, I’ll probably avoid that restaurant. If another friend goes down a dark alley at night in downtown Managua, Nicaragua, getting stabbed and killed in the process, I’ll probably not go down a dark alley at night in downtown Managua, Nicaragua. Know what I mean?

The problem is when we use anecdotes to say that they represent the majority of cases, or the average experience of every person around you. For example, I told you about the man who is convinced that his daughter has type one diabetes because she got the hepatitis B shot as a newborn. There is no other evidence out there that the hepatitis B vaccine causes type one diabetes, but he continues to claim that his anecdote represents the whole of human experience. That makes him sound even more nutty unreasonable.

So I’ll keep anecdotes to a minimum and try to put them in perspective.

4. Be honest. There will be times when the evidence doesn’t back up what you deeply believe in, and you’ll be very tempted to lie or twist the truth a little bit. Don’t do it. That’s what the anti-science crowd does. They’ll look at the number of cases of a vaccine-preventable disease and how they plummeted after the introduction a vaccine and lie to you, telling you that it was hygiene, soap, or homeopathy that did it, not the vaccines.

You are going to see things that will shake your foundations on something that you believe to be true. I went through it just recently with the flu vaccine. As it turns out, the vaccine is not all that it can be. The injectable vaccine in the US doesn’t have adjuvants, so older people or people with malfunctioning immune systems will not react to the vaccine. Likewise, the intranasal vaccine doesn’t be very good at protecting adults. It does a good job with kids, though.

I had to present these findings to you and to my colleagues, and I didn’t back down because it is important to gain something from the truth, even if it’s a truth we don’t want to hear. It is necessary for science to grow that we correct our way and go on the path of knowledge, not the path of emotion.

I’ll continue to be honest, no matter where that takes me.

Original Antigenic Sin (Sounds ominous, doesn’t it?)

One part of immunology goes a little bit like this:

1. You get exposed to a bacteria or virus.

2. Specialized cells called macrophages (or neutrophils) gobble up the bacteria or virus (or fungus or whatever), and digests it with some enzymes and other chemicals.

3. The macrophage then presents the bits and pieces of the virus or bacteria it just ate. To whom? They present it to B lymphocytes and T lymphocytes.

4. B lymphocytes take the bits and pieces, also called antigens, and create specific antibodies against it.

5. The antibodies attach to circulating viruses and bacteria, inactivating them and marking them for destruction by the T lymphocytes and additional macrophages.

6. If you survive this first encounter, the B lymphocytes go dormant, waiting for the next time you’re infected.

7. If you get infected again, the B lymphocytes are pressed into action again, but they produce the antibodies to which they are already coded, and they do so furiously. New B lymphocytes go back to step 4.

Of course, this is the “quick and dirty” description of what happens inside of us when we are exposed to viruses and bacteria that cause disease. The actual process is much longer and complex, too long and complex to explain here. But you get the point. You’re exposed, you make antibodies, and, if you’re exposed ever again, you respond quickly and vigorously, preventing the new infection from gaining a foothold and making you sick.

This is the reason why some diseases like chickenpox usually only attack us once. The “memory” of the dormant-then-activated B lymphocytes lasts long, and the chickenpox virus is antigenically similar from one wave of infections to the next. That is, the antigens don’t change in shape, and the antibodies can attach to the new infection as easily as they did when they first defended you.

There are some exceptions to this reaction, also called an “anamnestic response”. There are times when the interval from one infection to another is too long, and the dormant B lymphocytes end up dying and are unavailable to defend you when the second infection occurs. There are also times when you have an underlying medical condition that prevents those B lymphocytes from responding. Or, if they do respond, the other cells cannot come along for the ride and help in the defense of your body.

The best way to keep your body always primed and ready would be to be continuously exposed to the disease. And that was the case when chickenpox and measles were around, killing people. You’d be exposed over and over since you were very likely to come into contact with a person who had them when you were a kid, when you had your kids, when your kids had kids, or if you were a person who had a new batch of snot-nosed  kids to deal with every so often – like a teacher.

One thing that vaccines did very well was to make cases of things like chickenpox dwindle and almost disappear. Instead of getting the infection and the high chance of bad outcomes from it (e.g. encephalitis, skin infections, or pneumonia), you just got a shot full of antigens – the bits and pieces of the virus – and your immune system would be primed and ready, sans actual disease. However, instead of being re-exposed from time to time, you no longer are exposed. If your B lymphocytes die off, then you’re not immune to the disease anymore. This is why we need boosters.

We also need boosters because, although we’ve tried and tried hard, there are still plenty of cases of chickenpox, measles, whooping cough, and other vaccine-preventable diseases. Are they around because other animal species can also get them and so “hide” in their natural host until they hit humans again? Not really. Humans are the only natural reservoir for many of these diseases, especially chickenpox and measles. (Yes, there are other diseases out there that hit animals and are related to human diseases, but they’re not exactly the same.)

Boosters work, and they work well.

However, vaccines don’t work as well with viruses whose antigens change quickly, or whose natural reservoir is not humanity. This is the case with influenza viruses. Type A and B viruses can infect humans, pigs, birds, horses, dogs, and even some seals. So we can get rid of the viruses from humans, but they’ll just go hang out with pigs until a non-immune person gets exposed to them. Also, influenza viruses change their antigens almost yearly. To our immune system, this year’s flu is not caused by last year’s flu. Our dormant B cells can throw off antibodies, but those antibodies are not adept to neutralizing this year’s flu if they were created against the flu from years ago.

Or is it?

During the 2009 flu pandemic, there was an interesting phenomenon occurring in the populations that were infected. Children were making plenty of antibodies against the new flu virus. Older adults were making plenty of antibodies against the new flu virus. But young adults and adults were not making these antibodies. What the heck, right? We’ll get back to that observation in a second.

An epidemiologist made an interesting observation about the immune system some years ago. He noticed that people exposed to a flu virus (say it is “flu X”) would make really good antibodies against that flu X. If they were exposed to flu Y, however, they would make a lot of antibodies against flu X, but very little against Y. When he took into account these people’s age, he noticed that they belonged to a subset of people that had not seen an epidemic of flu X ever, but were old enough to have seen flu W, M, or flu N at some time. On the other hand, people who had seen flu X when they were very young or had not seen any flu of any kind, well, those people made plenty of good antibody against flu Y.

This epidemiologist called this observation the “Original Antigenic Sin” theory. He theorized that people who had seen other flus would make antibodies only against the flu they had originally encountered when they were children. Their antibodies were being made by the dormant B lymphocytes that were called to action after the new infection. These people were young adults and adults, and they didn’t do well with new flu viruses because that reaction from old, dormant B lymphocytes was vigorous enough to trick other B lymphocytes into thinking that enough was being done. However, the reaction was not specific enough to deal with the new flu.

On the other hand, children who had not seen the flu before made a vigorous and specific response to the new flu because they had no old B lymphocytes to take over. Older adults also had a good antibody response to a new flu because their old and dormant B lymphocytes had died out. To them, the infection was new, immunologically speaking. Here, I made a table to explain it better:

Immune response is not indicative of disease outcome, by the way.

During the 2009 pandemic, epidemiologists saw that older adults were not getting sick as much – or as severely – as younger adults. One of the things that explained this was this concept of original antigenic sin. Another thing that explains it is that older adults are more likely to be consecutively vaccinated for quite some time because they’ve been placed on the recommendation list. One other thing that could explain this was that these older adults had been exposed to the same H1N1 virus many years prior and had some sort of “lifelong” immunity against it.

Remember, during the pandemic, children were affected just as bad as young adults, throwing the original sin theory out the window. They made a lot of antibodies, but this wasn’t a sign that they fared any better.

It was that last point that didn’t make much sense. Yes, the 2009 H1N1 virus is similar to previous H1N1s seen in history, but, from an antigenic point of view, it was new. It was novel. And that novelty is the only thing that explains why it went around the world so quickly. Unfortunately, many in the media, in public policy, and – why else would I be well into 1,300 words of this post? – anti-vaccine people, believe that grandma and grandpa Smith, at the age of 70+, have an immune system that remembers a virus from decades ago.

And it’s that last point that anti-vaccine people have been harking for a while now, and especially in light of the current 2012-13 H3N2 flu season that has been so heavy. They claim that children should be exposed now to this potentially deadly flu in order to get “lifelong” immunity, and they use that observation from the 2009 pandemic as an explanation. When presented with the possibility that older adults fared better because of consecutive immunization, they scamper away or present some bogus explanation. When presented with the evidence that children didn’t do so well in 2009, they also counter with poor science and really no good evidence.

In essence, the anti-vaccine crowd would very much like to have kids exposed to a potentially deadly pathogen instead of being vaccinated because, in their minds, it will lead to lifelong immunity and none of the “dangers” of vaccines. They do this for measles, for chickenpox, for whooping cough, and now for flu. They ignore all the families who have been severely affected by influenza, some whose children have died and others who have been left with severe consequences of their infection. Worse, with regards to the flu, they ignore that the flu mutates very fast and has other animals as reservoirs, making our immune system susceptible to it every year, almost like clockwork.

Of course, almost like clockwork, anti-vaccine people will say that we all survived past pandemics and epidemics, so the flu isn’t deadly. This is almost like saying that we all survived World War II, so that war wasn’t deadly. That is, they have very different definition of deadly. And you can tell that they do because they say a vaccine is deadly while things like polio, measles, and flu are not. All the evidence says they are deadly. Very deadly.

So, now that you have this information, you’ll be able to counter the argument that an exposure to flu now is a guarantee to immunity later. Tell them that it doesn’t work that way with flu because it mutates fast. When they bring up what happened in 2009, tell them about the original antigenic sin and how they’re misinterpreting it. Then, when they bring up someone who didn’t die from the flu, bring up someone who has… And then ask for someone who has died from vaccines.

If you fill up a stadium with the number of people who have died from flu, you’d only need to fill a seat or two to represent the number of people who have directly died from a flu vaccine. Again, anti-vaccine people are not good gamblers.

Denialism pure and simple (UPDATED)

When I was in college, I took a course on military science. This course talked about the scientific discoveries we have made through war. By trying to kill each other off in a simpler manner, we’ve discovered a lot, from a scientific point of view. During that course, we spent about three weeks focuses completely on the Nazi medical experiments. If you haven’t heard the story, I invite you to go to the Holocaust Museum in DC and take a look at their exhibits. In essence, Nazi medical “researchers” conducted unethical experiments on humans (concentration camp prisoners, prisoners of war, etc.). We discussed for three or four classes whether or not we — the then future scientists — should use any of the knowledge gained from those experiments in order to expand science.

I won’t bore you with the philosophical and ethical discussions that erupted then. No, I will entertain you with the story of the one guy in class who decided that he was going debunk the “myth” of the Holocaust. Actually, it’s a short story; he was kicked out of class at the discretion of the professor. The guy actually wanted to argue with our professor, a Holocaust survivor.

I laughed out loud. That fool of a student.

But it does lead to an interesting question: How do you know what is true to be the truth? How do we know that the Holocaust really did happen? What evidence for and against can we believe?

Of course, this is a non-starter for many people who are reasonable and understand the concepts of historical evidence. There were thousands upon thousands of first-hand accounts of what happened in Nazi-occupied Europe. There are movies and records kept by the Nazis themselves. There are movies and documents from Allied Forces that liberated the concentration camps. In short, the Holocaust happened. There is no doubt about it.

Yet there are those who walk on this earth and deny that the Holocaust happened. Whether or not they believe that it happened is between them and their god. They go around telling everyone they can that it didn’t happen, that’s is a Jewish conspiracy, or that the Holocaust is a misrepresentation of what really happened. (I’m sure it was nothing but kittens and puppies in Auschwitz.)

Then there are those Holocaust deniers who also deny that the HIV virus causes AIDS. Even better, some of them deny that HIV even exists. They say that it’s all an attempt from the pharmaceutical industry to bleed the public dry through the sale of laboratory tests and unnecessary drugs. (I guess all of those dead people in Africa and elsewhere died of kitten and puppy overdoses.)

There is a particularly interesting person out there who goes by the moniker of “Putin Reloaded“. PR is interesting because there is no conspiracy theory that he doesn’t like. For example, this is what he has to say about HIV not being the cause for AIDS:

Antibody tests are not valid surrogates of virus detection, for all antibodies are heterophile and promiscuous. 

If you don’t know what those words mean look it up! 

About 30% of people have at least one “hiv” antibody in their blood, that’s how absurd the assumption is: http://www.ncbi.nlm.nih.gov/pubmed/2230270 Frequency of indeterminate western blot tests in healthy adults at low risk for human immunodeficiency virus infection. ” 32% (low risk controls) had indeterminate Western blot tests, most of which demonstrated a single band of lowintensity. The most common bands were p24 (47%), GAG p17 p55 (34%), and POL p31 p66 (36%); envelope bands were unusual (gp41, 2%; gp120, 2%).” Confirmed by: http://elcid.demon.nl/1995_Western_blot_35pc_of_donors_have_1_band_at_least.png Antibodies to Human Immunodeficiency Virus (HIV-1) in Autoimmune Diseases. ” 126 blood donors as a control group…At least one band was shown on immunoblotting in 26% of patients with autoimmune diseases and 35% of controls. ” 

So HIV tests are basically tools to fool perfectly healthy individuals into believing they’re carriers of a deadly virus and put them on deadly drugs. A self-fulfilled prophecy.

Oh, really? When PR is confronted with questions about PCR and viral cultures being used to confirm antibody tests, he gets really defensive and claims that one is personally attacking him.

PR is also into Holocaust denial, as I stated before:

“Recall that the Holocaust is an unfalsifiable theory, ie, it is impossible to refute because it is expressly prohibited by law in many European countries. Therefore, the Jewish Holocaust is not a historical fact but a legend that it takes an act of faith to believe.”

(Thanks to Pedro [not her real name] for the translation.)

So why am I writing about PR?

I’m writing about PR because he is exactly the kind of person that needs to be countered at all possible opportunities. In your private life (e.g. at work, in your family) and in your public life (e.g. out with friends) you must counter the ramblings of people who deny historical facts and scientific evidence. I’d advice you to be gentle and respectful, but you know me better than that by now.

To the AIDS denier, you must explain to anyone within earshot of that AIDS denier that we know that HIV causes AIDS because the grand majority of people who are infected with HIV go on to develop AIDS if they are not treated. They also go on to die. We know that the grand majority of people with AIDS have HIV infection. We know that the virus multiplies inside of immune cells, thus killing the immune system and allowing for opportunistic infections. Plenty of us have held the hand of a dying AIDS patient. Are there infected people who do not develop AIDS? Yes. Are there people who develop AIDS but were not infected with HIV? Yes. AIDS is a collection of diseases and conditions, a syndrome. But we see it in people with HIV infection for the most part (almost 100%).

The AIDS denier will try to use rare occurrences as clear evidence of their point. Don’t let them.

Likewise, the Holocaust denier will say that there were no extermination camps in Germany during the Nazi regime. This is true. The extermination camps were outside the country of Germany and in Nazi-occupied Europe. Here’s a map. They will also tell you that Hitler never signed an order to exterminate 6 million Jews and another 6 million “undesirables”. For that, read this.

In other words, stand up to the bigots, the denialists. Tell them and anyone around them why, how, when, and where they are wrong. Be ready to present the evidence, like radioactive decay to young Earth creationists, the physics of water vapor to those who believe that airplanes are dropping chemicals in contrails, or simple epidemiology to those who believe vaccines cause autism. It is important that we do this because they can do a lot of damage with their ideas.

A lot of damage.

**** UPDATE ****

The troll decided to show up in the comments section. Let me make this clear to you, Mr. PR, this is not your blog. This is not your platform to spread more antisemitism, misogyny  and AIDS denialism. Your comments are not accepted, and they will be deleted. (What’s that about misogyny  Mr. PR has told a group of female scientists that women naturally lack initiative and need father figures to guide them and tell them what to do next.)

Oh, ye who have ears and yet won’t listen

There is a hilarious thread going on on Facebook right now between an anti-vaxer and a pro-vaxer. (Yes, I checked in with a few comments and explanations, but mine are just a small fraction of the comments.) Go over and check it out before it gets deleted by the anti-vaxer.

If you don’t want to go over and read, I’ll give you the long and short of it:

The anti-vaxer calls herself “Vaccine Skeptic Society” and a “non-profit organization”. Mind you, she is just one person, an at-home medical coder (per some conversations of hers on Facebook), and someone who is totally ignorant of science. Okay, maybe not totally ignorant, but she does come off as knowing nothing, absolutely nothing about science.

(She should also be careful because calling yourself a non-profit without being one is a crime, and I have been so far unable to find her registered as a non-profit anywhere.)

The anti-vaxer began claiming that the influenza season is a result of influenza vaccination. That is, she postulated that the flu vaccine — and shedding from the vaccine, which is incredibly improbable with the nasal vaccine and impossible with the injected vaccine — causes the yearly epidemics that we see in the northern and southern hemispheres. I’m not kidding. Check this out:

And Easter eggs cause Easter

Those 150 comments are her and a couple of science-oriented people, myself included, trying to set her straight. But then she just goes off on a tangent. This is a later post of hers, in which she alleges that H. influenzae (a bacteria) is what really caused the pandemic:

Because something believed in 1918 is so true today

Now, I would try to explain to her why she’s wrong and why that was just what scientists believed at the time, but it would be pointless. (Viruses as such were theorized before 1918, but it wasn’t until the invention of the scanning electron micrograph that they were visualized and later isolated. Shortly after that, we had a vaccine. In between the SEM and the vaccine, we were able to isolate antibodies. Later, we’d isolate the virus from corpses of people who died in the pandemic, but no H. influenzae.)

It would be pointless to argue because she is a germ theory denialist.

Anyway, if you want to have a good laugh at someone who is rabidly anti-vaccine and wants to come off as a scientist, go over to her page. Chuckle as you read her write over and over that she’s “just asking questions” and wants to have a “balanced” debate.

There are bigger, more important reasons why I’m pointing out her stupidity. I’m pointing out her stupidity because it is classic of most anti-science and anti-vaccine people. They know very little to nothing about the sciences of microbiology and immunology, yet they pretend that they do. They then go and google for any science article that sort of kind of confirms their beliefs and post it on their own echo chambers to show to their followers how smart they are. (Their followers are just as clueless about science as they are, by the way.)

This brings to the forefront the need for better science education at the elementary and secondary school levels. We really can’t get more people like the idiot above get out into the public, create Facebook pages alleging to be non-profit organizations (a crime) and “just ask questions” that lie and deceive unknowing people out of a safe and effective way to prevent deadly communicable diseases. Because, soon enough, some poor new parent is going to stumble onto her rants and get the wrong idea about vaccines, refuse to vaccinate their child, and lose or have that child injured by a vaccine-preventable disease.

Oh, yes, it’s that important to learn science early and often.

It’s all in the chemistry

When I was a kid, one of my father’s friends bought a bottle of alcohol from a man on the street. He brought it over to my dad’s work to share. Dad took one whiff of it and threw it away. His friend was mad, but my dad knew exactly what he was doing. Dad had grown with solvents and chemicals, so he knew methanol when he smelled it.

A trained chemist could have also made the distinction. They can also recognize methanol when they see it. You see, although ethanol and methanol are made up of the same atoms of Carbon, Oxygen, and Hydrogen, the arrangement of the atoms is what’s key. How atoms are arranged in a chemical maters a whole lot, and it is something you need to keep in mind when you are being bombarded by misinformation about vaccine preservatives.

In our “cocktail o’ death” example, ethanol, the actual alcohol that makes you all sorts of easy to get along with, looks like this:

In this image, C is for Carbon, H is for Hydrogen, and O is for Oxygen. On the other hand, methanol looks like this:

Oh, look! It’s made up of the same stuff. Of course, if you look closely, you’ll see that methanol has one carbon while ethanol has two carbons. (Those links between the atoms represent electrons linking the atoms through energy bonds. The ones that look like cones are drawn that way to represent the 3D position of the atoms, with the solid cone telling us that the hydrogen atom is toward us while the hydrogen atom with the segmented cone is behind, or away, from us.) These chemicals are collectively called “alcohols”, and you can recognize them because they all have a carbon that is attached to an OH. The length of the carbon chain tells you the name of the alcohol. One carbon and it’s “methanol”. Two carbons and it’s “ethanol”. Three carbons, and it’s “propanol”. A form of propanol, where the OH is attached to the middle of three carbons, is isopropyl alcohol, rubbing alcohol.

Here’s a fun at-home science project. Mix equal parts rubbing alcohol and distilled water. Note that the alcohol kind of mixes in with the water. Now add salt to the solution and notice what happens. The alcohol layer separates out pretty well from the now salty water. Go on and try it, or watch this video:

This gets me to my next point. Table salt is sodium chloride, and it looks like this:

See how it’s made up of one atom of sodium (Na) and one atom of chloride (Cl)? Together, they make up table salt. You’ve added table salt to water, haven’t you? When you make a nice soup or something salty? Does it blow up? It does not. However, this is what happens when you add sodium alone to water:

That’s right, it explodes! How about chloride? Chlorine gas has been used to kill people as a chemical weapon. So how can these two very serious and deadly things come together to be just plain table salt? Well, it’s all in the chemistry.

This is how table salt is made in the laboratory:

On our planet, the salt deposits and salt in the oceans was made millions of years ago, when this planet was a ball of melted stuff.

Okay, so what about the preservatives in vaccines? What does this little chemistry lesson have to do with those?

Well, I gave you this short lesson in chemistry to stress the fact that chemicals are all about the chemistry. First, you have to understand how the chemical reacts with us. Do we absorb and retain it, or do we excrete it? In the case of thimerosal, we do absorb it, but we don’t retain it. We get rid of it quite easily. Think of it as an analogous reaction as ethanol and methanol; both are alcohols, one is deadly at a low concentration (methanol), while the other is also deadly, but you have a ton of fun getting there. (So to speak.)

Thimerosal is an organic mercury, meaning that it’s mercury that’s attached to a carbon compound. This is what allows it to be processed and discarded by the body. Inorganic mercury, the mercury you see in thermometers, is not attached to those carbon compounds, so it’s hard for the body to get rid of it. Inorganic mercury is usually attached to a “salt”, and it can really do a number on your kidneys.

What about formaldehyde? That’s also a vaccine preservative. Remember what I wrote about “one is deadly at a low concentration”? Well, this is not true of formaldehyde. You need a hefty dose of it to mess you up. Vaccines don’t have that much in them, and you process it and get rid of it pretty quickly. Does it look familiar?

Wow! One hydrogen away from being methanol. In fact, your body turns methanol into formaldehyde on the way to making water-soluble formic acid formate that can be excreted from your body and is a building block for other things. But the body doesn’t get formaldehyde from drinking it only. We get it from our own cellular processes. We make more formaldehyde in our own cellular processes than we get from a vaccine.

The long and short of this all is that you really need to be well-versed in chemistry before you go believing the lies and misinformation of those who say that vaccines are “witches’ brews” and whatnots. Notice that they won’t tell you how much of the “toxin” is in the vaccine, and they’ll quote studies done on mice whereby the mice were given those “toxins” in what would be the “truckload” for us. You really do need to get yourself educated, or these anti-vaxers will trick you into a dangerous decision.

EDITS: Edited to correct the reaction of formaldehyde to formate, not formic acid.