Smear! Smear at all costs!

You know you’ve made it big in the anti-vaccine circles when they start attacking you personally, calling into question your integrity, and calling you names like “Pharma Whore.” Before that, you’re just another cog in the Big Pharma machine. After that, you’re a rock star. Take the recent example of “the daily web newspaper of the [non-existent] autism epidemic” and their recent blog post smearing a law professor. Instead of posting all of it, I’ll just post for you the objective portions of the 1,097-word screed (of which 627, or 57%, are quoted words). See if you can make out what the writer is going on about:

“Dorit Reiss, associate law professor Hastings campus University of California, first came to my notice the other week commenting on Rabbi Handler’s article about vaccination in the Jewish Press.”

And:

An email from an anti-vaccine activist to their overlords (Or how the internecine war continues)

The kid claims that someone else sent the following email to Age of Autism, the online newspaper of the non-existent autism epidemic. I think it was he himself who did it, and I’ll tell you why once you read this. It’s a little long, and it repeats a lot of the anti-vaccine nuttery, but it’s worth a read for a good laugh. I’ve highlighted in bold the best parts. (By the way, the published this email on his site. I’ll link to it upon request, but I’m not giving him any more clicks than he needs. Props to my friend for telling me about this.):

The messy measles in Wales and Nigeria

Anti-vaccine activists will tell you that “vaccines didn’t save us” or that it was advances in hygiene and sanitation that caused the decline of what we in the real world call vaccine-preventable diseases. Yes, it is very possible that hygiene and sanitation have prevented some VPDs, but not all VPDs, and not the majority of VPDs. Proof? Look at what is happening in Wales right now.

“Public health officials say confirmed measles cases have risen to 588 in the south Wales outbreak, which is centered on Swansea. The latest figure shows 47 new cases of the disease since Wednesday, although this is less than half the increase of the previous week.”

In case you’re geologically geographically challenged, Wales is part of the United Kingdom on the island known as Great Britain. It is part of the European Union. In short, it’s not the Third World. According to the CIA World Factbook:

“The UK, a leading trading power and financial center, is the third largest economy in Europe after Germany and France.”

Yeah, they’re well off, and their hygiene and sanitation services must be pretty good as well. (Although, to be fair, I’ve never been to Wales.) Nevertheless, we have that huge outbreak of measles in Wales. Why?

Do you like being lied to?

I don’t know about you, but I don’t like being lied to. Yes, the word “lie” is very accusatory, and I better have some damn good evidence to back up any accusations of lying. So, like Jack the Ripper once said, “Let’s take this one piece at a time.”

This is what an anti-vaccine activist wrote in a letter to try and discredit Dr. Paul Offit, the co-developer of a vaccine against rotavirus (my emphases in bold):

“Paul Offit is a doctor at Children’s Hospital of Philadelphia, and is very often seen in vaccine autism stories making claims that vaccines are safe and have no relationship to autism.  But what those stories do not tell the audience is that Paul Offit is a vaccine patent holder and consultant for Merck Pharmaceuticals.  He is a co-creator of the Merck RotaTeq vaccine that is on the CDC’s current vaccine schedule.  It is a vaccine that prevents Rota Virus, a benign virus under which subjects experience a miserable day or so of diarrhea and vomiting, and from which you usually gain immunity after having it twice.  The CDC recommends treating it at home with Pedialyte to prevent dehydration.  In third world countries, Rota virus can be a more serious threat to children’s health, because death can occur from severe dehydration due to lack of infrastructure, clean water and basic sanitation.  But in the US, it is not a serious health threat to any one with indoor plumbing or within driving distance to a 7-11.”

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.

The reasonable and concerned parent of a child with autism

One of the most ardent anti-vaccine people I know is this man.

This man portrays himself as a concerned parent who is just doing what any parent would do. By his account, his son regressed into autism shortly after being vaccinated. In his mind, this is definitive proof that it was the vaccines that caused it. Because of that idea, he has said things like this:

“With less than a half-dozen full-time activists, annual budgets of six figures or less, and umpteen thousand courageous, undaunted, and selfless volunteer parents, our community, held together with duct tape and bailing wire, is in the early to middle stages of bringing the U.S. vaccine program to its knees.”

That’s the spirit. Let’s bring back the epidemics of vaccine-preventable diseases to levels not seen in decades because of the scientifically unproven fear that vaccines cause autism. And it seems there is nothing that he won’t do, say, and no one he won’t follow (as long as they share the same ideology, of course).

About three years ago, just as the 2009-2010 influenza season was starting, a young woman from the Washington, DC area made the news because she claimed to have had a neurological condition thrust on her from an influenza vaccine. Here is the whole story, but pay attention to this part:

“Once the Internet was buzzing with this story, a guy named [redacted] got on the case. He’s an epidemiologist with the Maryland Department of Health, but he gets antsy when introduced that way, so we’re quoting him here strictly ex officio! Anyway, [he] found Jennings’ case report in the “Vaccine Adverse Event Reporting System,” which tracks this kind of thing. Her VAERS report reads in part, “The admitting neurologist felt that there was a strong psychogenic component to the symptomology, and made a final diagnosis of weakness.””

(This is what [redacted] wrote about that case.)

Things were not all that they seemed about that young lady, who was supported by the man in question and his organization. When asked about that whole thing by “Frontline”, this is how he answered:

“[Interviewer] Talk about the viral spread of an image over the Internet, like [Redskins cheerleader] Desiree Jennings’ flu shot story, for example.[Man] It’s remarkably powerful what an image or an idea can do in today’s day and age, and for a group of parents who feel completely outmatched — because think for a moment about who our enemy is; our enemies are the largest pharmaceutical companies on the planet, making billions of dollars in net profit a year — you’d think that we could never compete with that. But an idea can transmit itself powerfully and very cheaply for millions to see. So in the case of Desiree, here you have an image of this beautiful woman who’s been severely disabled that literally tens of millions of people view overnight, and imagine the chilling effect that has on a flu vaccine that she attributes as the cause of her condition. It’s remarkably powerful.
[Interviewer] Does it matter whether it’s true or not?[Man] Truth always bears out in the end, so I’m a firm believer in that. Are there moments in time where truth is exaggerated or expanded? Absolutely. But truth bears out in the end. …”

“Are there moments when the truth is exaggerated or expanded? Absolutely” Wow. That’s an understatement. Myself and other bloggers, journalists, writers, and, let alone, scientists have documented time and again the misinformation and outright lies from anti-vaccine groups and their members. Everything from conspiracy theories about multinational parties and even extraterrestrial invasions has been discussed and revealed for what it all is: lies and misinformation.

“But truth bears out in the end.” I guess, if the waves of anti-vaccine-induced panic don’t bring about “the end” to people who didn’t know better but to listen to anti-vaccine propaganda.

But the man in question is just being a reasonable, concerned parent. From that same interview on “Frontline”:

“[Interviewer] Once you connected with these groups, you started to play a role in the organization?
[Man] If you saw The Matrix, it’s like all of a sudden you’re looking behind the matrix as to everything that’s going on. We’ve got 1 in 6 kids with learning disability, 1 in 12 with ADHD [attention deficit hyperactivity disorder], 1 in 110 with autism. What’s happening to our children is insane, and once my wife and I were pulled behind the matrix to see what was going on, we felt compelled to act, not only on behalf and in honor of our own son, but on behalf of all these other kids, too.”

It’s all about the children. But I have the sneaky suspicion that it is about something else, too. No, I’m not talking about money. The man has more than enough money to cover the media blitzes against vaccines, supporting his efforts to bring the U.S. vaccine program “to its knees”. I’m talking about an ideology.

An ideology is a way of looking at the world. Ideologies shape our actions and dictate our goals. It is neither good nor bad to have an ideology. It’s just one of those things about being a thinking human being. (Thinking does not equal rational, by the way. Not in this context.) From what I gather in the man’s blog posts and interviews, his ideology is one that vaccines cause autism, period. And, like any good ideologue, he seems to have his champion.

Who is this champion worthy of the man saying the following about him?

“To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one… He’s a symbol of how all of us feel.”

A discredited physician-researcher who was struck off the medical register in the UK and found to have committed fraud in his MMR-autism “study” is, to the man, the equivalent of a freedom and equality fighter AND The Son of God.

Do I really need to write more?

I do and I don’t. The hardcore anti-vaccine types have probably already skipped to the comments section and started writing something full of vitriol that I won’t publish (because it’s full of vitriol). Or they clicked away to the anti-vaccine echo chamber, their hearts festering with hate for me. For those people, I don’t need to continue writing.

For the pro-science, truly reasonable person who accepts the evidence, compares it to what we already know, and follows the science wherever it leads us, this whole thing is nothing they have not heard already. They probably already moved on.

This is for those of you who are on the fence about vaccines, autism, and science in general. I want to reach out to you if you have just discovered that your child is autistic and you’re wondering if it was the vaccines that caused it. Despite what this man and his ideology, his blogs, his celebrity friends, and his fellow ideologues tell you about vaccines, here is the wheat separated from the chaff:

• We have looked at the biological process by which vaccines protect us from infectious diseases by activating our immune system. This process does not lead to autism. Not in humans. Not in lower primates. Not in mice. Not in a computer simulation.
• We have taken groups of children with autism and groups of children without autism and compared their vaccination records. Their vaccination records are the same. Being vaccinated or not has no bearing on the risk of autism.
• We have looked at countries that provide lesser numbers of vaccine doses or overall vaccines. Their rates of autism are comparable to the United States. The reason they may be different in some cases is that they have a different definition of autism or no way to track it, or both.
• We have looked at the risks of reactions from vaccines and determined that those reactions occur at a frequency in orders of magnitude less than if the person gets the infection itself. That is, you’re more likely to be injured by a vaccine-preventable disease than by a vaccine. Heck, you’re more likely to die driving to the doctor to get your vaccine than to get any reaction from a vaccine.
• Reactions to vaccines can and will occur, but, as stated above, they are less frequent and less severe than the diseases themselves. Not vaccinating opens an avenue for those disease to come back and really do a number of the lives and wellbeing of children everywhere, not just yours.

By “we”, I mean scientists, epidemiologists, physicians, researchers… People who have done a lot of studying at accredited institutions of higher learning, who have written peer-reviewed papers, and whose evidence has stood the test of everything. “We” are those of us whose ideology can best be summed up as “that’s interesting, let’s see what the science says” when it comes to issues such as these.

By “we”, I do not mean celebrities who saw a coincidence and ran with it to sell you their story.

I certainly do not mean a man who has taken it upon himself to destroy the one thing that keeps the story being told in “The Poxes” from being a reality.

When statistically significant is insignificant

I love Twitter. I got a hold of this little bit of anti-vax nonsense and just had to bring it to everyone’s attention. Check this out:

Source.

You can click on the image to see it a little larger. The original caption is what caught my eye. It reads: “Snapshot of the Verstraeten study dated 02/29/00 showing a statistically significant relationship between mercury exposure and autism.” My emphasis added in bold because this image shows no such thing. It shows a statistically insignificant relationship between mercury exposure and autism.

However, I realize that some of these terms might as well be in Chinese to some of you, unless you speak Chinese. So let’s break it down piece by piece.

Relative Risk (RR) is the ratio in the risk of developing autism given an exposure to thimerosal between a control and an intervention group. That’s the left-hand axis. The control group doesn’t get thimerosal. The intervention group does.

For example, if the RR is 10, then those exposed to thimerosal have a ten times higher risk of developing autism than those who were not exposed. An RR of 1 means that there is no difference in the risks; both exposed and unexposed have equal risks of developing autism. So, an RR of 1 means that the relationship observed is not statistically significant.

Statistical significance means that the results you observe are not due to random chance. That’s the 95% confidence interval (CI) part. That CI tells you the range of RR values you’d see 95 out of 100 times if you repeated the same experiment 100 times. The CI in this chart is represented by the error bars in each value.

At <37.5 micrograms, there was no difference between the two groups. The RR was 1. Note the lack of error bars for that value because of the low number of study subjects (n=5).

At 37.5 micrograms, the RR is still 1. Again, no difference.

At 50 micrograms, the RR is 0.93. This means that the control group is about 7% more likely to develop autism than the thimerosal group. BUT the CI includes 1, so there is a very good chance that your RR will be 1 if you repeat the experiment 100 times. As a result, this finding is not statistically significance. Certainly, I would not go out to the streets and proclaim that thimerosal protects from autism.

At 62.5 micrograms, the RR is 1.26, meaning that the group receiving thimerosal is 26% more likely to get autism than the control group. BUT look at the CI again! It still includes 1. As before, this result is statistically insignificant.

At over 62.5 micrograms, the RR rises to 2.48. The CI still includes 1. This result is statistically insignificant.

Wait! Doesn’t this show a trend whereby if the exposure is high enough, then the association will be stronger? Nope. It doesn’t. If you look at the error bars, you could hit 1.0 the whole time. Heck, with the logic shown in this article, I could make a case that thimerosal is protective against autism at certain levels.

It’s nonsense (to not use a harsher word).

But anti-vaccine advocates are not known for letting facts get in the way. The author of that piece of nonsense continues with quotes taken out of context from some meeting long used by anti-vaxers as evidence of a plot… Blah! Blah! Blah!

If you don’t know what is statistically significant and what is not, then that pretty much destroys your entire argument from the get-go. If you try to come off as a researcher, when you’re obviously not, then you lose the argument even worse.

But what about that study? Well, read all about it here, here, here, and here, and see how it has been misused to further the anti-vaccine agenda. Too bad they don’t know the difference between significant and insignificant, or they would have not used this study (or this graph).

NVIC: Information that’s not. Exhibit D

I’ve written to you before on how the NVIC (the “National Vaccine Information Center”) should probably take the word “information” off its name. I wrote it here, here, and here. Today, I bring you exhibit D in this lengthy tale of what I consider to be misinformation. (And I’m not the only one that thinks thus.)

I wrote before about how NVIC takes information from the Vaccine Adverse Events Reporting Systems (VAERS) and presents it out of context and without the disclaimers present in the real VAERS reporting site. In the VAERS data site, you will be told this:

“When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.”

If this disclaimer is anywhere on the NVIC site that gives you VAERS data, I can’t find it.

So let’s look at Exhibit D. This exhibit is an entry into VAERS that is being touted as evidence of the dangers of the shingles vaccine. When an anti-vaxer is asked to provide evidence that the shingles vaccine is bad, they point to this entry provided by NVIC:

“Between 4:30 PM and 5:15PM, I consumed several alcohol drinks for New Years Eve and became immediately intoxicated. The amount of alcohol consumed has never intoxicated me. My husband drove me home and after arriving home, became dizzy and collapsed on bathroom floor. Bruised hip and top of hand is only injuries. I have never had this happen to me before and feel it was possibly due to the recent vaccination for Shingles that caused this immediate intoxication. The paperwork provided at the time of vaccination did not say you could not consume alcohol within the few hours after receiving it but obviously it had an adverser effect on me.”

Of course! How did modern medicine miss this? Consuming “several alcohol drinks for New Years Eve” and then becoming “immediately intoxicated” must be due to the shingles vaccine. So did the husband become ill too?

“My husband drove me home and after arriving home, became dizzy and collapsed on bathroom floor.”

Maybe it’s just bad grammar. We’re all guilty of that. Or maybe the husband also drank a lot. In any case, the person uses the same excuse I’ve heard over and over from people that have bad things happen to them when they drink: I’ve always been able to control my liquor.

What about that “paperwork”? Did it really not mention alcohol? It didn’t.

Here is the information page from CDC about the vaccine. There’s nothing in it mentioning alcohol.

Here is the package insert from Merck (PDF), the manufacturer. There is nothing in it mentioning alcohol.

I did a search of the literature and found nothing stating that alcohol should not be consumed after having the vaccine.

And then I did a Google search. Nothing. But NVIC will not tell you this. They’ll present this to you, and many other VAERS entries, without any context. It would be funny if it wasn’t so serious.

The world is less safe tonight

Some people aren’t looking for anything logical, or reasonable. They can be bought, be bullies, but they can’t be reasoned or negotiated with. Some people just want to watch the world burn.

Imagine for a second that you are a parent who has lost a child to a horrible disease. Pretty painful, right? Now, imagine that you are being harassed time and time again because you are doing your best to keep other children from dying a similar death. Imagine that people who don’t know you personally nor had any involvement in the medical treatment of your child publish article after article claiming to know all the details of your child’s illness and blaming you for the death of your child. And then imagine that they do this over and over and over and over and over, even after you have asked them to please stop.

Think about it for a second, then keep reading.
I bring your attention now to this post and this other post and this other one as well (thanks, Hank, 22MAR13) by “Reasonable Hank”. In those posts, Hank clearly documents the continued harassment of a family in Australia who lost a daughter to pertussis (whooping cough). The harassment comes from an anti-vaccine organization that claims that the girl in question either did not die from pertussis or, if she did, it was from being vaccinated, or from not being breastfed, or from medical incompetence, or something.

The truth is that the vaccine against pertussis is safe and effective. Is it 100% safe and 100% effective? No. Nothing is. A brand new jet flying hundreds of passengers right now over any part of the world is not 100% safe nor 100% effective. The water you will drink today will not be 100% safe nor 100% effective. Yet the vaccine is the best shot we have at keeping this disease at bay.

Many people from many scientific backgrounds – and even laymen – have tried to explain in very simple terms to the anti-vaccine advocates in question how the pertussis vaccine works, why it works, and how it can help provide protection to those too young, too old, too weak, too sick, or otherwise unable to be vaccinated. But these anti-vaccine people are not willing to listen to reason. They’re not willing to look at any facts. They live in their own version of reality.

And the world is less safe for it.

What happens in mouse liver cancer cells in a petri dish in a lab stays in mouse liver cancer cells in a petri dish in a lab

An anti-vaccine advocate – and a very angry one in my opinion – posted the following abstract of a research paper on her blog:

Hepatitis B vaccine induces apoptotic death in Hepa1-6 cells.Hamza H, Cao J, Li X, Li C, Zhu M, Zhao S.
Source Key Lab of Agricultural Animal Genetics, Breeding, and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, People’s Republic of China.
Heyam68_hamza@yahoo.com
AbstractVaccines can have adverse side-effects, and these are predominantly associated with the inclusion of chemical additives such as aluminum hydroxide adjuvant. The objective of this study was to establish an in vitro model system amenable to mechanistic investigations of cytotoxicity induced by hepatitis B vaccine, and to investigate the mechanisms of vaccine-induced cell death. The mouse liver hepatoma cell line Hepa1-6 was treated with two doses of adjuvanted (aluminium hydroxide) hepatitis B vaccine (0.5 and 1 μg protein per ml) and cell integrity was measured after 24, 48 and 72 h. Hepatitis B vaccine exposure increased cell apoptosis as detected by flow cytometry and TUNEL assay. Vaccine exposure was accompanied by significant increases in the levels of activated caspase 3, a key effector caspase in the apoptosis cascade. Early transcriptional events were detected by qRT-PCR. We report that hepatitis B vaccine exposure resulted in significant upregulation of the key genes encoding caspase 7, caspase 9, Inhibitor caspase-activated DNase (ICAD), Rho-associated coiled-coil containing protein kinase 1 (ROCK-1), and Apoptotic protease activating factor 1 (Apaf-1). Upregulation of cleaved caspase 3,7 were detected by western blot in addition to Apaf-1 and caspase 9 expressions argues that cell death takes place via the intrinsic apoptotic pathway in which release of cytochrome c from the mitochondria triggers the assembly of a caspase activation complex. We conclude that exposure of Hepa1-6 cells to a low dose of adjuvanted hepatitis B vaccine leads to loss of mitochondrial integrity, apoptosis induction, and cell death, apoptosis effect was observed also in C2C12 mouse myoblast cell line after treated with low dose of vaccine (0.3, 0.1, 0.05 μg/ml). In addition In vivo apoptotic effect of hepatitis B vaccine was observed in mouse liver.

I realize that’s a lot of digest. As I wrote before, yes, you can do your own research, but you need to know what you are looking at and looking for so you don’t end up looking like a fool on your own anti-vaccine blogs. And I write “blogs” because more than a few anti-vaccine blogs looked at this paper, called it a “study”, and drew their conclusion that the hepatitis B vaccine is a horrible, horrible thing. Let’s look at the key things you need to know to understand this research paper and not be so scared so as to ignore the proper science behind its findings.
First, you need to know what apoptosis is. Not only is it the name of the journal in which this paper was published, it is also the scientific term for “programmed cell death” or just “cell death”. See, biological organisms are always reproducing. It’s not an accident that teenagers are so horny. We’re programmed to eat, grow, and reproduce. Eat. Grow. And reproduce. Everything from single-celled bacteria to whales all eat, grow, and reproduce. But we can’t reproduce forever. Some of our cells need to die to make way for the newer cells. As a result, mechanisms in our cells trigger cell death. Without apoptosis, we would have cancer.

Second, you need to know what “in vitro” means. In vitro is scientific jargon for “happening in a test tube” or “happening in a petri dish”. Basically, in vitro is something that happens in a lab and outside a living, breathing organism. This research was done just that way, in vitro. It wasn’t done in a living mouse. It wasn’t done in a primate. So it wasn’t done in a human. (But our anti-vaccine “friend” is trying to point out the horrors of the hepatitis B vaccine with this paper.) Yes, they mentioned something in the end: “In addition In vivo apoptotic effect of hepatitis B vaccine was observed in mouse liver.” We’ll address that in a second or two.

Third, you need to know what kind of cells were used. They were not human cells. They were not primate cells. They were mouse cells. In fact, they were mouse liver cells. Were they regular mouse liver cells? Nope. They were mouse liver cells from a hepatoma, a liver tumor. So they were already abnormal cells to begin with. Remember what I wrote about apoptosis up there? Without apoptosis we get cancer? These researchers are trying to draw conclusions about apoptosis as it relates to the hepatitis B vaccine using mouse liver cells from a mouse with liver cancer. (But our anti-vaccine “friend” is trying to point out the horrors of the hepatitis B vaccine with this paper. No, that’s not a typo. I’m emphasizing her aim as I emphasize the non-weight of the study she cites.)

Fourth, you need to know what they did. They poured hepatitis B vaccine over the mouse liver cancer cells in a petri dish in lab conditions and measured how many cells were alive after certain periods of time. They also measured chemicals put out by the cells at those times. They concluded, quite right, that pouring vaccine over mouse cancer cells in a petri dish leads to changes at the molecular level of the cells, so much so that they begin dying. Big surprise. Here’s why…

Living, breathing biological systems are quite complex. When we are immunized, our bodies begin to work on the vaccines from the moment they enter our skin, muscles, airway, or gut. (Contrary to what anti-vaccine people will tell you, vaccines are not given straight into the bloodstream.) The cells around the vaccine site begin to metabolize, break down, the vaccine. White blood cells respond to the site to begin the process of identifying the attenuated pathogen or bit of pathogen and begin production of antibodies for immunity. The whole thing takes many steps in many places beginning at the site of immunization and ending at the site where the byproducts of the vaccine exit our body – like the intestines, the kidneys, or, yes, the liver (which leads to the intestines).

People seem to think that hepatitis vaccines, because they are aimed at protecting the liver, somehow act upon the liver. This is not the case in humans. The vaccine acts upon our immune system, which creates antibodies to be on “standby” to protect the liver. When you get exposed to hepatitis B, the virus doesn’t enter the liver directly. It needs to elude the immune system and find your liver. This is why not everyone who is exposed gets sick, though they still make antibodies to show exposure.

In short, you and I are made up of trillions of cells which make up dozens of types of tissues and organs, and they all work together to protect and repair each other. Mouse liver cancer cells in a petri dish in a lab stood no chance no matter what you threw at them, short of nutritive broth. You could have put deionized water in there and see them swell up and explode due to osmosis. You could have put water with a high salt content in there and see them shrivel. Does that mean that drinking water will make your liver explode? Of course not! Our entire body will work together to keep osmotic pressures at a balance. That’s why you pee, to keep water levels in check.

But that’s not what the anti-vaccine people read into this. They just read the title of the paper, called it a “study”, and ran away with the results. Why? Because it suits their needs. Because they don’t understand the science. Because they want to scare you.

Oh, and about that last sentence in the abstract: Without having the full paper in hand, we cannot conclude a single thing about what happened “in vivo” (the scientific jargon for having occurred within a living organism). For all we know, the human vaccine is bad for mice, or they injected it right into their liver. But all that is speculation unless I have more information. I won’t speculate. I’m not an antivaxer.