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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Scrub-a-dub-dub, because you’ve been called out

First and foremost, Happy New Year. Here’s to another year of giving you bits of stuff to mentally nibble on as you go about your day. Now, on with 2015…

Remember Peter Doshi, PhD? He’s the “Hopkins Researcher” non-epidemiologist who claims to know more about influenza than epidemiologists, virologists, and other people who have made influenza research their life’s work. He’s presented on influenza at a conference sponsored by an anti-vaccine organization. And, as I told you before, he signed a letter from the “AIDS Rethinkers” stating that the HIV-AIDS association should be, well, “rethought”. It’s nothing more than AIDS denialism dressed as “skepticism.”

Anyway, Dr. Steven Salzberg, who is a Hopkins researcher, took Peter Doshi, PhD, to task:

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

That’s not all, however. Dr. Salzberg asked Peter Doshi, PhD, about signing that AIDS denialist letter:

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

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

I, too, emailed Peter Doshi, PhD, a while back (October 2013) and asked this:

“I was recently informed that you have taken the position of associate editor with the British Medical Journal. While doing some research on your work, and seeing what influence you have and will have on evidence-based medical practice, I came upon a website (http://aras.ab.ca/rethinkers.php) which lists you as a signatory to a statement denying the existence of a causal relationship between HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome).

I hope you can see how “AIDS denialism” may put into question your judgment of medical and scientific findings submitted for review at BMJ. My questions to you, if I may have a few minutes of your time, are:

– Did you sign that HIV/AIDS statement denying the existence of a causal relationship between the virus and the disease?
– Are you in fact now an associate editor at BMJ?

I extend you much gratitude for taking a moment to answer these questions.”

He never replied, though I never received a notice that the email was not delivered, and I copied him on all known emails he’s used on publications.

On that website, his name was listed thus, a few names under Australian anti-vaccine loon, Meryl Dorey:

Screen Shot 2013-10-04 at 8.41.45 PM

The list looks like this today:

Screen Shot 2014-12-27 at 7.19.17 PM

No more Peter Doshi on the list. It appears that he did as he said he would to Dr. Salzberg and asked that his name be removed. The thing about that page is that it is querying the list from an external database, so we can’t use the “Way Back Machine” or Google to his name when it used to be there. All we have are these screenshots, but, as you can see on Dr. Salzberg’s blog post, Peter Doshi, PhD, never denied signing that letter. (To be a “signatory” you have to contact the list’s administrator, apparently.)

So there you have it. An associate editor at the British Medical Journal has scrubbed his name from a list of AIDS denialists. Do with that what you want. He also doesn’t think the flu is a big deal, so do with that what you want. From Dr. Salzberg’s blog post:

“As for the flu itself, Doshi says “I don’t agree with CDC’s portrayal of influenza as a major public health threat.” So he and I have a serious disagreement there. I asked if he agrees with the anti-vaccinationists who are using his writings to claim that the flu vaccine is ineffective, and he replied that while “ineffective” is “too sweeping,” he has found ”no compelling evidence of hospitalization and mortality reduction in [the] elderly.””

As an epidemiologist doing research into infectious diseases, I will not submit anything to the BMJ for publication for the foreseeable future. I just don’t trust their judgment anymore when they have as an associate editor someone who seems to deny that AIDS is the result of an HIV infection (something 99.999999999% of scientists have agreed on and on whose authority antiretroviral therapy has saved lives) and definitely doesn’t see influenza as a major public health threat. I can only imagine what would happen to any manuscripts I submit on infectious disease.

One more thing…

The HIV “Rethinkers” write thus on their page:

“The next time the media announce that tens of millions of people are dying from Hiv in Africa, ask them how they know that. Remind them that journalists are supposed to question dubious assertions from powerful, drug-industry funded agencies like the WHO, not parrot them as if they were indisputable. Ask them why they report these numbers as if they were actual Aids cases, when in fact they are projections made by WHO’s computer programs, based on very questionable statistical methodologies and contradicted by many facts including the continual large population increases experienced in the countries supposedly worst affected.”

Note the part about the media.

This is what is written on Peter Doshi’s page at his current job with the University of Maryland:

“Doshi also has strong interests in journalism as a vehicle for encouraging better practice and improving the research enterprise.”

Yeah, it should be the reporters that guide the science, not the other way around. Not.

Just in time for Halloween, an anti-vaccine “expert” rises like a zombie

I was looking through the blog’s stats the other day, and I found out that a ton of people were checking out the post about Peter Doshi, PhD. You know the one? The one where I explain to you that Peter Doshi, PhD is not an epidemiologist and how his attempt at epidemiology, at explaining to his audience that the flu is not that bad and that flu deaths were not really flu deaths, how all of that was pretty goddamn awful. Well, his screeds are back, and the anti-vaccine and conspiracy theory websites are plastering it all over the place. Lucky for humanity that people are skeptical about his claims, go and Google his name, and come to this blog.

Some of the most recent visitors are coming over from a blog called IO9. They are coming over specifically from a post by Tara Haelle about the myths and facts about the flu vaccine. It’s a good post. My only objection to it is the number of myths she’s trying to debunk all at once. There’s a lot of them, and blog readers are usually TL;DR kind of people. Keep it snappy and keep it short, says the guy who once wrote a 6,000-plus blog post on diabetes. Someone in the comments mentioned an article by Peter Doshi, PhD. It’s the same article from years back, but it has been resurrected, like a zombie, to try and scare people away from the flu vaccine.

I’m glad that so many are skeptical of Peter Doshi, PhD, and I truly hope that someone asks him about the AIDS denialist bit in his history. After all, we wouldn’t want a current professor at the University of Maryland and associate editor at the BMJ being an AIDS denialist, do we? It would be a little bit bad for science. So thanks for the natural news whackaloons for resurrecting Peter Doshi’s article from last year. It’s always fun to deal with zombies.

Happy Halloween! And don't forget to get your flu shot!

“Scary” Peter Doshi, PhD (taken off the conspiracy website and altered a bit)

Another one for Dr. Peter Doshi

It’s been a while since I’ve written to you about Peter Doshi, PhD, the guy who thinks that the flu is not a big deal and who may very well be an HIV-AIDS denialist. He is probably not as prominent now in the anti-science media because he’s busy being the associate editor of the British Medical Journal and calling on drug companies to be more transparent with their data. (Big Pharma is the big fish everyone wants to take down nowadays.) Nevertheless, his work against the stockpile and use of neuraminidase inhibitors (NI) like oseltamivir (aka “Tamiflu”) is still out there. It still gets quoted.

The Lancet put out an article recently about the effectiveness of NIs and their effect on mortality in hospitalized patients. It is a meta analysis. This means that they took together a whole bunch of studies and looked at them in the aggregate. I don’t generally like these studies because it is easy to be biased in the analysis by discounting or ignoring some studies while favoring others. Still, when done well, these studies have more power because they’re looking at more subjects and more outcomes. This particular study took 78 studies done between 2009 and 2011 and looked at the outcomes for treatment while hospitalized. This is what they found:

“We included data for 29 234 patients from 78 studies of patients admitted to hospital between Jan 2, 2009, and March 14, 2011. Compared with no treatment, neuraminidase inhibitor treatment (irrespective of timing) was associated with a reduction in mortality risk (adjusted odds ratio [OR] 0·81; 95% CI 0·70—0·93; p=0·0024). Compared with later treatment, early treatment (within 2 days of symptom onset) was associated with a reduction in mortality risk (adjusted OR 0·48; 95% CI 0·41—0·56; p<0·0001). Early treatment versus no treatment was also associated with a reduction in mortality (adjusted OR 0·50; 95% CI 0·37—0·67; p<0·0001). These associations with reduced mortality risk were less pronounced and not significant in children. There was an increase in the mortality hazard rate with each day’s delay in initiation of treatment up to day 5 as compared with treatment initiated within 2 days of symptom onset (adjusted hazard ratio [HR 1·23] [95% CI 1·18—1·28]; p<0·0001 for the increasing HR with each day’s delay).”

In other words, giving an NI early in the course of the disease is associated with lower mortality, and giving it versus not giving it was also associated with a reduction in mortality risk. Note this: “These associations with reduced mortality risk were less pronounced and not significant in children.” That’s “clutch” right there and something that infectious disease doctors and pediatricians should keep in mind.

NIs are not a magic bullet against influenza. Nothing is, not even the influenza vaccine. But something is better than nothing, and something backed up by evidence is best. Contrary to Dr. Peter Doshi’s assertions about NIs, evidence keeps coming in that it is better to give them than to not give them, and that they actually reduce the risk of death from influenza in some groups. There is both observational and experimental evidence of this.

But you don’t have to just take my word for it.

Influenza is here, it’s bad, and it’s killing people

Contrary to the opinions of people like Peter Doshi, PhD, and others that influenza is not that bad, influenza is pretty bad. Just ask the family of this woman in Texas how bad it is. Or ask the family of this girl. Influenza is being reported from all over the lower 48, Canada, and Mexico. Many public health agencies are now recommending the influenza vaccine as a countermeasure to the increase in cases. As an epidemiologist, I join other epidemiologists in saying that the vaccine is not a good countermeasure, and it shouldn’t be used as the lone countermeasure. It takes a while for it to confer immunity, so it may be too late now that the season is fully underway.

Continue reading

Non-epidemiologist tries to do epidemiology, feeds anti-vaccine activists

One of the rules of this blog has been to not name any names, but it’s going to be broken for this post because it’s hard not to break it in this case. The person I’m going to write about is putting himself out there, sometimes vociferously, to say some things that, as an epidemiologist, I find frustrating. First, a little background. A few months ago, a friend of this blog wrote this post about influenza vaccines. In that post’s comments, the name of one Peter Doshi, PhD, came up. Dr. Doshi wrote this article in the British Medical Journal and delivered this presentation (PDF) at the “Selling Sickness 2013” conference in Washington, DC. In his article and his presentation, Dr. Doshi, who is not an epidemiologist, makes some clear mistakes about the nature of the yearly flu epidemics that we see, the deaths from influenza, and the benefits/risks of the influenza vaccine. Continue reading