Dr. Bob Sears, our Douchebag Emerit-ass, is in hot water

News came late to me that Dr. Bob Sears, 2014’s Douchebag of The Year, is now in hot water with the California Medical Board for what the legal filing states that he “was grossly negligent and departed from the standard of care in that he did not obtain the basic information necessary for decision making prior to determining to exclude the possibility of future vaccines, leaving both patient J.G, the patient’s mother, and his future contacts at risk for preventable and communicable diseases”

Orac does a great job of covering all this, so I won’t bore you with the details. You can go read his blog and enjoy some much deserved insolence against “Dr. Bob.”

It goes without saying that this should perk the ears of other anti-vaccine so-called physicians (or physicians in title only, as no physician worth their salt would ever be anti-vaccine). They should be very, very careful about how they carry on their business of promoting anti-vaccine science.

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Dr. Bob Sears in not anti-vaccine, except when he is, which is pretty much all the time

The last time I wrote about Dr. Bob Sears, pediatrician to the uninitiated, I told you about his anti-vaccine views and his anti-vaccine activism on Facebook. Let me make it clear to you that he is an administrator of an anti-vaccine Facebook page:

PAOAVThe page is titles “Parents and Others Against Vaccines.” If that is not anti-vaccine, I don’t know what is. We rational people have a mole in that group, and that’s how we learned of Dr. Bob Sears’ involvement. Yet it doesn’t take covert action to see his anti-vaccine ways. Dr. Bob Sears does the anti-vaccine thing quite well out in the open:

“IF YOU DIDN’T HATE PAUL OFFIT BEFORE . . .
I typically just ignore my critics. None of them are worth my time or emotional energy, and very few of them have anything scientifically worthwhile to say.
But I’m going to give a shout out to my colleague, Dr. Paul Offit, for his brilliant discussion on How to Handle Questions About Vaccine Safety. Every answer he gives is spot on and completely accurate in every way. I don’t know what I’ve been thinking, questioning vaccine safety. His answers are so complete, so truthful, and so without holes that any doctor who is blessed enough to read it will be thoroughly armed with irrefutable answers, and any parent who questions vaccine safety will be instantly converted to the truth.
I wonder just how many doctors believe the arguments he puts forth in his answers. Part of me hopes that most doctors out there aren’t that stupid. That it’s just a select few who are hard-core party-liners that have lied to themselves for so long that they actually believe this stuff. A few of his laughable highlights include:
“You don’t have to trust pharmaceutical companies.” Trust the side-effect reporting system.
Every year, 18,000 young children somehow, magically, caught hepatitis B every year before the vaccine came into use.
And don’t worry about all the side effects on the package insert – they didn’t really happen (ok, that was MY paraphrase)
And the real doozy: $2.8 billion in compensation to vaccine-injured people isn’t actually for those unfortunate enough to have been injured. It’s all just for lawyers to make money. No one has to prove their case in court, so these awards mean nothing.
Now we can all rest easy and completely vaccinate all of our children, on schedule, without a care in the world. Thanks Dr. Offit for helping us see the light!
Dr. Bob”

The word “hate” is quite strong to throw around lightly against Dr. Paul Offit, pediatrician and vaccine creator, especially when Dr. Offit has received threats against his life for promoting the use of vaccines to prevent horrible death and disease in children. But it’s not like Dr. Bob Sears thinks things through very well, is it?

If you’re initiated, then you recognize the common anti-vaccine techniques that Dr. Bob Sears is using:

  1. Doctors are part of a conspiracy: “That it’s just a select few who are hard-core party-liners that have lied to themselves for so long that they actually believe this stuff.”
  2. Vaccines didn’t save us and maybe vaccines cause the disease they’re intended to prevent: “Every year, 18,000 young children somehow, magically, caught hepatitis B every year before the vaccine came into use.”
  3. If it’s on the package insert, it must be true: “And don’t worry about all the side effects on the package insert – they didn’t really happen (ok, that was MY paraphrase)”
  4. Because money has been paid out with no contest through the vaccine court, then the government must be admitting to something: “$2.8 billion in compensation to vaccine-injured people isn’t actually for those unfortunate enough to have been injured.”

I’m not going to waste MY time in debunking Dr. Bob Sears’ laughable assertions. A physician who should know better, and one who lets one of his patients kick off a measles epidemic then lies (or forgets) about it is not worth anyone’s time. Even worse when they pose for a happy time picture with one of the most disgraced medical frauds in recent memory known as Andrew Jeremy Wakefield:

BFFs? (Dr. Bob Sears on the left, Andrew Jeremy Wakefield in the center)

What I see here is a clear example of professional jealousy. I’ll explain.

  • Dr. Paul Offit was part of a team who created a vaccine against Rotavirus, a virus that causes diarrhea and kills thousands of children a year around the world. Because of that vaccine, thousands of children have been saved. Thousands! Dr. Bob Sears, on the other hand, has not done such a thing and resorts to ad hominem attacks on social media to try and counter Dr. Offit’s credibility.
  • Dr. Paul Offit works at the Children’s Hospital of Philadelphia, a premier pediatric medicine institution. Dr. Bob Sears does not, and I’m willing to bet a month’s salary that Dr. Bob Sears could never get a job there, or anywhere where they take infectious disease of children seriously. What’s worse than an anti-vaccine pediatrician? Polio. Polio is worse.
  • Dr. Paul Offit could be living it up right now from the profits of the vaccine he helped create. Instead, he has given up all financial interests in that patent. He doesn’t make money from it. On the other hand, you know who makes money from vaccines? Dr. Bob Sears. Why? Because of his modified schedule, Dr. Bob Sears’ patients who want to “space out” their vaccines (a variation of the “too many too soon” anti-vaccine gambit) more than likely have to pay for each visit to his medical practice, or to the practice of their choice. Or, what, Dr. Bob Sears vaccinates for free? Besides, less (or no) vaccines mean sicker children, and those sick children go see pediatricians like Dr. Bob Sears.
  • Dr. Paul Offit has had dozens of peer-reviewed journal articles published. That’s a big deal if you want to call yourself an expert on something. You have to prove it in your research and your peers have to review and agree with you. Dr. Bob Sears? Not so much. I mean, he has sold hundred of thousands of copies of his anti-vaccine book, so…

One of the things I used to do in high school to impress “Pedro” (not her real name) was to act like I knew more than I did and did more than I did. Whenever some other suitor came around, I’d tell Pedro all about how the suitor was this or that. In essence, I talked smack. Then I turned 17 and realized that the true way to win a competition is to actually compete. With all the jealousy and “hate” that Dr. Bob Sears has against Dr. Paul Offit, one has to wonder about Dr. Bob Sears’ mental age. Is he trying to impress a girl or just the legion of anti-vaccine followers he has?

But, hey, I could be wrong. This could all be a misunderstanding and Dr. Bob Sears is not really anti-vaccine and doesn’t really administrate the Facebook group whose admin page links directly to his Facebook profile (something he would have had to approve of). If it is, I’d like to hear his side of the story.

What do you say, “Bob”?

When a doctor stops behaving like one

You’ve probably heard of the Hippocratic Oath, an oath taken in one form or another by the majority of graduating medical students in the United States. One of the major tenets of the oath is the principle of beneficence: do no harm, prevent any harm, relieve any harm. A physician, and basically anyone who has decided to devote their life to medicine, is morally, ethically, and even legally bound by this principle. They must not cause any harm through their medicine, or take reasonable steps to not cause it. They must prevent their patients from being harmed, or take the reasonable steps to prevent said harm. And they must relieve any harm being caused to their patients, or do the reasonable thing to bring about this relief. I threw in the reasonable clauses there because physicians and other healthcare providers can only do so much. Patients are in many ways responsible for their actions, but it is up to the provider to give proper guidance and counseling based on all the available evidence.

All the available evidence on the MMR vaccine (the vaccine against measles, mumps, and rubella) is that it works very, very well and is very, very safe. Any person getting both doses of the vaccine is over 99% likely to be immune against measles. As an epidemiologist, when I’ve investigated outbreaks of measles in the literature, I’ve found that very rarely are there vaccinated people in the group of those who are sick. In my personal experience, I am yet to find a vaccinated person with measles. (Mumps is another thing. The vaccine seems to wane when it comes to mumps.) So the vaccine is 99% effective. But is it safe?

Yes, yes it is. Despite any claims to the contrary, there are no links between the MMR vaccine and any of the ailments exaggerated by the anti-vaccine crowd. It doesn’t cause autism. Very, very few people get more than a local reaction to it. Rarely does it cause encephalitis, but that clears up on its own. In short, the vaccine has prevented measles cases in orders of magnitude greater than any injury it has caused. I will bet my life’s savings on the vaccine any day of the week over a bout of measles. With modern medical technology, measles is less of a killer than it was before the vaccine, but you still don’t want to get it. It can be crippling, incapacitating.

To recap so far: Vaccine good. No vaccine bad. Thus, based on the principle of beneficence, healthcare providers must recommend and give the MMR vaccine to their patients to prevent a harm called measles, especially when there is an outbreak of the bug going on in their vicinity.

One physician in the United States who graduated from Georgetown University is Robert “Bob” W. Sears, MD, FAAP. He went through medical school and must have learned about immunology, virology, and maybe even some epidemiology. He is board certified in pediatrics. If I were a betting man, I’d bet that he knows all about the Hippocratic Oath and about beneficence. It’s just that (to me) he acts like he doesn’t, or like he doesn’t understand the things he should have learned in college and medical school, and beyond. Why? Because of his stance on vaccination.

“Dr. Bob” wrote a book called “The Vaccine Book: Making the Right Decision For Your Child“. The title is innocent enough to make you think that maybe he is for vaccines but just wants them spaced out. Maybe he knows something we don’t? After all, he is a board certified pediatrician. The trouble with his book is that he gets a lot of things wrong. Don’t take my word for it. Take the word of Dr. Paul Offit, a pediatrician himself, vaccine researcher and developer:

“Sears wants parents to use the information he has provided to make their own decisions about whether to vaccinate their children. “I have offered you all the information you need to make this decision,” he writes, “but I have held back from actually telling you what to do. I want you to formulate your own decision without letting my opinion sway you one way or the other.” Unfortunately, Sears, who wants parents to make informed decisions, has written a book that will largely misinform them.”

And take the word of the world’s authorities on vaccination science.

Still, you might be inclined to think that Dr. Bob is not anti-vaccine. After all, he’s not saying that you should stop vaccines altogether. He just wants you think that you can delay the administration of them because… Because something. I don’t know why. There’s no real reason to do so; No scientific reason, anyway.

Let’s stop here quick for an update on the return of measles to the United States. According to the California Department of Health, there have been 32 confirmed cases of measles this year, compared to only three last year. Ten of this year’s cases are in Los Angeles alone. If this isn’t an outbreak, I don’t know what is. And I know my outbreaks, I’m an epidemiologist and I’ve taught epidemiology. But Dr. Bob has a different take on this outbreak. To him, it’s not an outbreak at all:

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Here’s the text:

“Measles Epidemic . . . NOT!

Why is it that every time there are a few cases of measles, everyone panics? I just don’t get it. So, here’s the situation in the O.C., where I live and practice. Seven cases. Seven. That’s 7. Not 700, not a million Seven. So, why do people panic? Here’s one reason: the ^$#@*&%&*$# media. News reports go out stating that there are outbreaks of measles, and everyone needs to be concerned. Everyone is quick to blame those who don’t vaccinate, AND those who don’t vaccinate start to panic. We’ve gotten dozens of calls to our office with people wanting to know if they should come in for the vaccine.”

I do wonder if Dr. Robert “Bob” W. Sears is acting like a physician and recommending the vaccine to his patients in a time of a measles outbreak in his state, under the principle of beneficence? What kind of specialized knowledge does Dr. Bob have that the California Department of Health doesn’t to assure his patients that there is no outbreak of measles in the state, though there are ten times more cases right now than this same time frame last year? If anyone has answers to these questions, let me know. I’m not asking them rhetorically. This is a pediatrician, a board certified physician, blowing off information from public health authorities. It is in the public’s best interest to know if one of the physicians charged with taking care of the public’s children is not acting like a physician and more like an anti-vaccine activist.

But, then again, we don’t need to look far to see if Dr. Bob is anti-vaccine:

PAOAV

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Well, if he is not anti-vaccine, then I’m the Prime Minister of Burundi. I mean, he is the administrator of a goddamned anti-vaccine, private Facebook group. So has he been lying when he says he’s not anti-vaccine? Probably. I’d have more respect for the man if just came out of the anti-vaccine closet and proudly proclaimed to be anti-science, like other medically-trained healthcare providers have. Then we wouldn’t have to play this game of exposing Dr. Robert “Bob” W. Sears to the world for the anti-vaccine activist that we see in him.

In which I break a rule and call out Dr. Bob Sears

Dr. Bob Sears, famed pediatrician who seems to live to write books, wrote the following on his Facebook page:

“New Study in Journal of Pediatrics Shows Number of Vaccine Antigens Not Associated with Autism Risk… Another waste of money in another attempt to pretend to do research on vaccines and autism.”

Because we haven’t wasted enough money and resources chasing that windmill? He continues:

“Now, if I were to do a study (and have several million bucks to fund it), here’s how I would look at the question of whether or not an increased number of vaccines relates to an increased risk of autism: I would take a bunch of kids who had all the vaccines on the regular schedule and look at the rate of autism in that group. We know that it’s about 1 in 50 kids. Then I’d take a whole bunch of kids who were only partially vaccinated and look at the rate of autism. I would subdivide the partially vaccinated group into subgroups based on the total number of vaccines given during infancy. I would perhaps have a group that delayed vaccines. And hey, while we’re at it, let’s really go crazy and find a few totally unvaccinated kids just for fun. On the other hand, no. Let’s not. It would be totally unethical to subject a group of totally unvaccinated children to any type of medical research. Ok, back to my study. These data would then give us a true look at autism rates compared to number of vaccines given and the age at which they were given.
Now THAT would be an interesting study. Unfortunately, it’s just too logical. It’s much better to study things in a confusing and illogical manner so you can get some results that the press can really sink their teeth into.”

Really? IF you had the money? You haven’t made enough from your books, Dr. Bob Sears?

And when the heck did you become an epidemiologist? Oh, you didn’t. I can tell from your study “design.” The study you’re criticizing (PDF) is a case-control study. The researchers started with cases (kids with autism) and controls (kids who were neurotypical). They then assessed if there was a difference in the number of antigens and vaccines they received. That is, was there a difference in the odds of getting a vaccine as it relates to autism? There wasn’t. Kids with autism were just as likely to be exposed to vaccines as kids without autism. We do case-control studies when the cases are too few in number. We do it to get a good idea of causality. We do it because it’s the right study to do, Dr. Bob Sears.

That’s not what the anti-vaccine people, like Dr. Bob Sears seems to be, want to hear.

Dr. Bob Sears wants a retrospective cohort study, where you take kids with different levels of exposure and then go back through medical records to see if they are autistic, or how autistic they are. It sounds reasonable, right? The problem with that study design is that autism is rare, even at a 1 in 50 prevalence rate. To get a significant number of autistic and non-autistic kids for comparison, you’d have to enroll thousands and thousands and thousands of kids. If you don’t do that, you run the risk of having too small a sample, screwing up the statistics. Further, it’s really hard to assess temporal (chicken or egg) associations. And there are all sorts of biases, including selection and recall bias that can affect your results.

And we couldn’t possibly do a prospective cohort study because, well, it would never go through an IRB. Never. Never ever.

But it’s not like Dr. Bob Sears has a mastery of vaccine science. He doesn’t. So why assume he knows anything about epidemiology?

He does know about straw men arguments and pharma shill gambits, though:

“So, is anyone really surprised to see the Journal of Pediatrics study? What were you expecting? CDC researchers to publish as study that actually showed an increased risk of autism related to vaccines? The CDC would NEVER simply publish such a study. I doubt anyone would. Anyone at the CDC who published such a study would be fired faster than they could sell their Pharma stock.”

Dr. Bob Sears has revealed his true anti-vaccine nature. Can’t wait for the next measles outbreak from one his patients and for him to deny it.

Now, for a list of studies that have found no association between vaccines and autism, check out the Autism Science Foundation’s page on the subject. But Dr. Bob Sears is right on one thing, how much more should we waste?