Unsure about vaccinations? Try reading "Deadly Choices"

[arkestra]

I got Whooping Cough recently at age 43, what fun. Apparently vaccine immunity for WC wears off after a few decades. It was as ill as I have ever been and I was pretty much out of action for 3 months. There has been an increase of WC cases recently in the SW of England, where I live. I could rant at anti -vaccine campaigners, but what would be the point? I am more concerned that the people who are unsure have access to a clear statement of the pro-vaccine position.

So can I suggest that anyone who is unsure about vaccination reads "Deadly Choices" on the pro-vaccine front even if they read nothing else?

I just had my early summer ruined. But babies get killed by this kind of thing. I totally get why people find vaccines icky and unsettling, there are hard wired ways we intuitively think about our bodies that foster that kind of reaction. So just read this book if you're on the fence OK? It would be nice if lots of other 40-somethings don't irritate everyone else with their wheezing and self-pity

(Gets back off soapbox)

Bathtime now so need to break! I really don't think Offit means 10,000 vaccines at once is ok though... See what others think maybe?....

The other thing is, for people like him what's at risk is not just money but reputation and power. For an egotist to be wrong would be personally completely cataclysmic.

He could, and someone offered him money LaVolcan! Seems he's got enough already.

Seriously though. I'm taking a joking tone to this thread because I don't take Offit seriously.

But there are plenty of people who do. And he should be thoroughly ashamed of himself for his 'theoretical' pronouncements about thousands of vaccines - meant to delude parents into not questioning the safety, reactivity and synergy of viruses in combined vaccines.

Shame On Him.

Not a fan then?

Well, you see arkestra, I don't really consider vaccine and general health and drug safety as being a question of whether one is a 'fan' or not.

I reserve 'fandom' for light pursuits such as music and film (or ahem, books).

Drug safety is on a whole different level. IYSWIM.

You're not an antivaxxxxer scardy cat tinhatfoiler, BC you're fundamentally anti-science; either that or you just don't understand science. Take your pick.

crumblenuts - 'Paul Offit says a baby could have 10,000 vaccines in a day. What a goon.'

What a fucking piss-poor non-critique. It's hard to credit someone so wholly devoid of perspicacity or intellectual rigour thinks their crack-pot opinions are worthy of a wider audience.

I was indulging in slang, do forgive me

More seriously though - the orthodox pro-vax side view Wakefield as pretty dishonest. I know about that. But I know less of - and am interested in - what the other side think about Offit and why.

Ah but you see JoTheHot I actually do know a whole lot about vaccine science - not altogether through choice but because my eldest daughter had quite frightening reactions to her baby vaccines. And from said experience, I don't wish to generalise about vaccines - simply I have a view which is personal to me and mine; that vaccine safety is not good enough. And I know a lot about it with regards to my own child and her/our medical history.

Not everybody fits into the mould you see.

arkestra - well, slang, whatever. I think that science and drug safety need to be discussed seriously.

Speaking of which - you seem keen on Offit's book (his second I believe on these issues) - does he clearly state his financial interest in vaccines? if not, why not?

I'm interested in your opinion of what he states, or not, and why or why not...

Your call.

Also, it might interest you to know, as you obviously have a keen and personal interest in pertussis vaccines, that my eldest daughter was wholly vaccinated against pertussis (as following French state vaccine recommendations, so three vaccines, as we live in France). And yet she contracted pertussis (yes, lab tested) despite being comprehensively vaccinated.

Whether that is due to the undeniable mutation of pertussis or not, I don't know.

What do you think, OP?

Hi Beachcomber - I've read around on that and it seems Pertussis immunity, whether naturally or artificially induced, is not for as long as we would all wish. No mutations necessary. And reinfection possible in both cases because, as we would I am sure agree, immunity doesn't always build as we would wish either. Not an exact science.

Since you still seem worried about my usage of slang, let me assure you that I have assumed everyone on this thread is commenting because they take the issue of vaccines seriously, and I would like to extend you the same courtesy.

Re Offit's commercial interests - I honestly don't remember whether he declared anything. Probably not. But I am more interested in hidden interests, eg stuff not easily checkable through a quick google. If interests are not hidden then I tend to focus on the quality of logical arguments and the provenance of quoted facts rather than guessing about motivation - I think, as I am sure you do, that serious stuff like this is best played without dismissing people's arguments based solely on their identity.

Perhaps if you read the book you could check for yourself? I am about to start one by Wakefield.

Well, let's hope that your memory fails you and that Offit does have the integrity to declare his significant financial and professional careerist interests in the subject.

I'm surprised that as a person who appears to be condoning pertussis vaccinations, you don't seem to be concerned with the alarming mutations of this bacteria (whether said mutations are a consequence of mass vaccination or not is a subject that must surely be of interest to you if you take these issues seriously on a public health level).

Vaccination (surely even to the most gung-ho of vaccinators) must always be about risk/benefit ratio and an honest, robust and impartial approximation of thereof to the individual. (At least if one respects the Hippocratic Oath - non? )

Wow the pro-vaccers are really cross tonight.

Do you think it's a good idea to give a baby 10,000 vaccines in one go JotheHot? Paul Offit says they could cope? Do you? I would say that anybody who says a baby can cope with 10,000 vaccines in one go is a goon. Maybe you agree with him [shrug] I can't stop you.

Offit's public declamations on vaccine science appeal to the lowest common denominator and are designed to do exactly that. Like I said - he is the spokesperson for pharma lobbying.

Hence why I am unable to take this thread particularly seriously.

Which sounds harsh - but it isn't meant to really. I was Offit's audience until personal experience forced me to look at a more serious side to vaccine science. I would love to be a non critical vaccine consumer.

Here's one I made earlier JotheHot. "The problem is that he was using that statement to reassure parents and minimise the dangers of vaccines. The use of the word "theoretical" is just a cover. The whole point of it is to reassure parents, so he IS saying a baby can have 10,000 vaccines in one day, but with the technical get out clause, oh I only meant theoretically. But there's no reason for him to say it except to reassure parents about combined vaccines." Which bit of this isn't true?

Hi Beachcomber

Offit's interests - I have quite a good memory so it's unlikely that he did declare anything - I am sorry that you are so disappointed! I can only reiterate that I view the quality of logical argument and statistical validity of the underlying research as incomparably more important than the identity of the person writing. I appreciate this is not everyone's cup of tea but there we are.

Alarming mutations - here I have some good news for you. I am not displaying a lack of concern over peer-reviewed research that indicates vaccination is causing alarming mutations - I am just utterly ignorant of the existence of the research. It sounds very interesting and I would really appreciate a link to the research concerned? I certainly don't think that vaccines are without potential negative consequences. Most interesting things in life involve complex trade-offs and I would far rather be aware of the trade-offs than not. Obviously this needs to be peer-reviewed research with some degree of statistical validity. I'm not talking about a Cochrane review though.

Risk/reward etc - I am very interested that (even in jest) you imply that the Hippocratic Oath won't be adhered to by all the people in the vaccine debate. One thing that amazes me is that everyone is clearly very well-intentioned, and that they also frequently state that the people on the other side are not well-intentioned at all. I totally agree with you that the most fruitful course is to try our best to concentrate on the risk/reward benefit and try to avoid being blown off course by saying people are selfish, or unconcerned, or financially invested, or somehow morally deficient in other respects. I don't think any of these bad things are true of any participant in this thread for instance. Many of them clearly hate each other's guts but none of them strike me as having an issue with the Hippocratic Oath.

Do you know I'm beginning to find it a bit annoying and boring when people play ratatat ginger with a thread, they blow in with some usually insulting comment, which you address as if it was a normal comment, and then they never come back, it's like knock knock ginger and run away just to annoy someone. Grr. Obviously not you arkestra.

Appreciated Crumbled

It's like there's lots of flak flying around. incoming! incoming! everyone wading through swamps of personal insults and barbed put-downs...

Anyway I'm off to bed because I don't want to turn into this person

www.nejm.org/doi/full/10.1056/NEJMc1209369

www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0046407

www.cidd.psu.edu/research/synopses/acellular-vaccine-enhancement-b.-parapertussis

Thanks Beachcomber - I will read those and get back.

Another request for evidence - do you have (statistically valid) evidence around problems arising from combined vaccinations? The thrust of Offit's rhetoric in the "10,000 vaccines" quote is that he is flatly denying that combined vaccinations increase risk. He is not saying that he wants to inject babies with 10,000 vaccines but it is a very strong bit of rhetoric denying vaccine combination risk. It is correspondingly vulnerable to counter-evidence, if such evidence exists. I get that Offit is very far from the vaccine sceptic's position in this respect, and so as a result Offit appears to be misleading to the vaccine sceptics to a culpable degree. If there is (statistically valid) evidence indicating that vaccine combination increases risk then

1. It is a solid strike against Offit. By contrast, slating Offit as an "industry mouthpiece" actually makes him look good because it gives the appearance that people don't actually have any proper counter-arguments to what he is saying.

2. It is strong evidence in general in favour of the vaccine sceptic position against multiple vaccines.

I would recommend "Bad Pharma" as a strong evidence-based takedown of many bad aspects of Pharma and reguatory research. That is actually a book that you may enjoy! Made me wince anyway. If there was something similar that could be assembled (with evidence) around vaccines you would potentially be getting somewhere.

But allegations that people are captured by vested interests, or are not taking things seriously, or somehow view the Hippocratic Oath as irrelevant, or are otherwise acting in bad faith - all that actually works against the strength of your arguments for many observers.

Vaccination is not causing mutations and BC's papers are not supporting the notion that they do.

Dr. Offit declares his involvement in the invention of the rotavirus vaccine in every article he publishes, see for example here: pediatrics.aappublications.org/content/123/1/e164.full and it is mentioned in every newspaper article I have seen about him. It is actually considered an item of esteem to have achieved something that saves thousands of lives every year, so why would he not mention it? And yes, he made about 6 million dollars from the sale of the patent, but that was his intellectual property to sell. Again, there is nothing wrong with earning money with your inventions. His current income is not dependent on vaccine sales.

Dr. Offit is a scientist and doctor of tremendous integrity who has been known to speak up against certain vaccination even: news.sciencemag.org/2011/10/advisory-panel-urges-u.s.-conduct-controversial-anthrax-vaccine-trial-children

"I don't see how you can ethically do a study on a child where there is no chance the child benefits from that study," says Paul Offit, an infectious disease specialist at the Children's Hospital of Philadelphia in Pennsylvania, who often speaks out in favor of childhood vaccination. Offit attended one of the meetings of the working group and spoke out against a study. "I didn't prevail," he says.

He is a good man.

Hi CaterinaJTV

My assumption is also that Offit is a good man. I actually don't have a beef with anyone's ethical standpoint on vaccines until I get evidence to the contrary.

I can simultaneously believe that

• he is well-intentioned
• his vaccine is a great public good
• he has benefitted financially from it
• his book is informative and well-argued
• his statement on 10,000 vaccines is vulnerable to counter-argument if the evidence exists

I need to do some work now but I will read the papers for myself and get back on them and on anything else people raise to me.

Here's my take on the papers. Not sure about which alarm bells should be ringing for me?

1. www.nejm.org/doi/full/10.1056/NEJMc1209369

Pertacin is a component of acellular pertussis vaccines. There is evidence that B. pertussis is adapting to vaccine pressure, with the first detected appearance of a pertacin-negative strain in the US: such variants have already been detected in Japan, France, and Finland. If this trend continues, it will reduce the effectiveness of acellular Pertussis vaccines.

2. www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0046407

We propose that both waning immunity and pathogen adaption have contributed to the persistence and resurgence of pertussis.

3. www.cidd.psu.edu/research/synopses/acellular-vaccine-enhancement-b.-parapertussis

There is evidence from trials in mice that that acellular vaccine-induced protection against B. pertussis can actually increase vulnerability to B. parapertussis. While the mechanism is still unclear, it indicates that future B. pertussis vaccines should also explicitly target B. parapertussis.

Does Offit also declare his consultancy with Merck and how much money he has earned as inventor of their Rotateq vaccine? (Not just that he shares a patent with them for Rotateq but the actual amount of money he made when the Children?s Hospital of Philadelphia sold its royalty interest - I believe it is estimated as at least 29 million dollars.)

Does he declare that he was simultaneously inventor of a Merck vaccine and on the CDC's Advisory Committee on Immunization Practices (ACIP) ? (The committee which voted to add rota virus vaccination to the mandatory US vaccine schedule.)

Does he declare that he participated in ACIP discussions on the decision to withdraw their recommendation for RotaShield (Wyeth's rotavirus vaccine) for causing intussusception - a dangerous adverse event that Rotateq is known to cause too? (A decision which left Merck with a monopoly on the market.)

Does he declare that the decision to include Rotateq in the schedule by the ACIP led to revenue of 655 million dollars in under two years for Merck?

Does he declare that as inventor of Rotateq and named patent holder he earned millions of dollars from the decision (that he participated in) to include the vaccine in the schedule?

Does he declare that he is on the board of Every Child By Two - a vaccine lobby which is largely funded by Wyeth? (which recommends rota virus vaccination.)

Surely a 'good man' of 'tremendous integrity' would struggle with so many (undeclared) conflicts

(1) and (2) are mostly just saying "evolution is true" to me. Eg vaccine selection pressure induces change in the population.

The interesting thing is to me is not that evolution is true (I kind of knew that already) but how quickly adaption takes place.

Flu is very hard to vaccinate against because it has a very high rate of shift. If pertussis is towards that end of things then this has natural negative implications on how effective we can expect vaccines to be. Doesn't mean pertussis vaccines are either useless or dangerous.