Spitting on the graves of children lost to influenza

A friend of mine who has worked in influenza surveillance for years send to me this blog post from the Huffington Post. It’s written by Lawrence Solomon, who, by all accounts, has zero experience in infectious diseases or epidemiology. Still, that doesn’t stop him from attempting to write about influenza deaths in an authoritative way, quoting, what else,  anti-vaccine and anti-science material. In fact, I need not go farther than his first sentence to know what he’s all about in this post:

“Flu results in “about 250,000 to 500,000 yearly deaths” worldwide, Wikipedia tells us. “The typical estimate is 36,000 [deaths] a year in the United States,” reports NBC, citing the Centers for Disease Control. “Somewhere between 4,000 and 8,000 Canadians a year die of influenza and its related complications, according to the Public Health Agency of Canada,” the Globe and Mail says, adding that “Those numbers are controversial because they are estimates.””

Why are these number estimates? It’s simple. We can’t possibly count each and every single case of influenza, or influenza-related deaths, in the world. What we can do is use the tools of science and mathematics to come up with a best estimate. If you read further in Lawrence Solomon’s piece in the Huffington Post, you’d think that we epidemiologists come up with these numbers at random, or, if we do use science and math, that we adjust those numbers to some sort of agenda. To make his point, Lawrence Solomon goes to the latest go-to guy in Peter Doshi, PhD (who is not an epidemiologist of any sort but still wants to be some sort of authority on influenza and influenza vaccine science):

“Peer reviewed publications accept Dr. Doshi’s vaccine research, even if he doesn’t meet your standards. But are you saying that you would accept the views of epidemiologists who turned thumbs down on vaccines? It would be my pleasure to present some to you, if that is your test.”

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Junkie Drug Heads, Chiropractors, and Non-Epidemiologists

An anti-vaccine chiropractor said this:

billydemoss

Alright, alright, he wrote it. What article is he pointing us “junkie drug heads” who vaccinate to? An article by our old friend Peter Doshi, PhD. If you remember, I told you how that non-epidemiologist was trying to do epidemiology and only ended up feeding the anti-vaccine people like the chiropractor above. Further, I’ve told you how Doshi has yet to answer whether or not he still thinks that HIV doesn’t cause AIDS. Aside from all the other problems that the non-epidemiologist manages to include in his article, the article is an opinion piece from a non-epidemiologist.

The non-epidemiologist clearly does not understand the epidemiology of influenza. He doesn’t understand that not all cases of influenza are reportable, and neither are the lab tests’ results. He doesn’t understand that epidemiologists only know about deaths from the surveillance that they do, and that most of those deaths are reported only because deaths in children are reportable while adult deaths are not. He tells us that the flu is not a big deal and that the vaccine doesn’t really work, even though he’s been told that he’s wrong and it’s been pointed out in the very meta-analysis that he collaborated on that the flu vaccine has a moderate benefit to it, one outweighing any of the risks from the vaccine. And the non-epidemiologist prances around anti-vaccine conferences with his credentials, making the cranks use him and his opinions as justification for being anti-vaccine.

So what does the non-epidemiologist’s opinion piece say, anyway? Let’s start with the abstract:

“Officials and professional societies treat influenza as a major public health threat for which the annual vaccine offers a safe and effective solution. In this article, I challenge these basic assumptions. I show that there is no good evidence that vaccines reduce serious complications of influenza, the outcomes the policy is meant to address. Moreover, promotional messages conflate “influenza” (disease caused by influenza viruses) with “flu” (a syndrome with many causes, of which influenza viruses appear to be a minor contributor). This lack of precision causes physicians and potential vaccine recipients to have unrealistic assumptions about the vaccine’s potential benefit, and impedes dissemination of the evidence on nonpharmaceutical interventions against respiratory diseases. In addition, there are potential vaccine-related harms, as unexpected and serious adverse effects of influenza vaccines have occurred. I argue that decisions surrounding influenza vaccines need to include a discussion of these risks and benefits.”

Actually, let’s just stop right there. It’s the same stuff he’s been touting left and right under the guise of being an expert on epidemiology, influenza, and immunizations. He isn’t. He’s just some poor post-doc wannabe who likes the accolades he gets from vaccine deniers (who are a lot like AIDS deniers, interestingly enough). There is no good evidence? How about this, this, this, this, this, and this? Are we all wrong? Because the only “bad” think anti-vaccine activists attribute to the flu vaccine are things that real scientists and real epidemiologists have ruled out using real science and publishing it (not opinion pieces).

Physicians don’t know the difference between “influenza” and the “flu”? Really? Then why do they only test people (on the average and in the long run as one of my biostatistician colleagues says) who exhibit clear signs and symptoms of influenza? Doshi is just playing with words. And, like a true anti-vaccine fanatic, he exaggerates the risks of influenza. Like any other nut, because it’s not 100% safe, it’s 100% the excrement of Satan. He “argue(s) that decisions surrounding influenza vaccines need to include a discussion of these risks and benefits”… Why? Because they don’t? You think we in public health don’t look at the evidence for and against before recommending any vaccination? In his mind, we probably don’t.

Non-epidemiologists who think they’re epidemiologists aside, note how the anti-vaccine chiropractor in the screen shot above just goes on some sort of lunatic rant about illegal drug use and vaccines. It doesn’t really make sense, but, yet, not much of what they say makes sense. If I didn’t know any better, I’d bet that we don’t exist in the same planes of reality.