Dear parents, you are being lied to...

[Rosewind]

Hi all,
I very much enjoyed this piece by Jennifer Raff over at Violent Metaphors:
violentmetaphors.com/2014/03/25/parents-you-are-being-lied-to/

It's very clearly written with lots and lots of links to back up the points she makes. It has sparked quite a bit of discussion in the comments section, and her follow up piece is mainly comments based.

Anyone here got any thoughts?
Cheers,
Rosewind

Sorry - I shouldn't say 'no one' implies. I should say I haven't seen anyone imply..

Bumbleymummy, correlation does not imply causation.

In Japan they banned the use of MMR ten (ish) years ago, only single vaccines are available and yet they have the same rates of rise in autism as countries still using MMR.

www.newscientist.com/article/dn7076-autism-rises-despite-mmr-ban-in-japan.html#.U1UAvD29LCQ

Should read 20ish years ago!

Bumbleymummy,
Your paper doesn't actually demonstrate that doctors are acting the way you are implying they are. It discusses the reasons for under-reporting of drug side effects, and is in no way specific to vaccines. Vaccines, by their very nature being prophylactic and administered to children, are very much a special case. They are highly monitored, and if you can demonstrate this claimed indifference of the medical community to adverse effects then I am all agog.
This paper discusses vaccine safety monitoring:
www.ncbi.nlm.nih.gov/pmc/articles/PMC1381831/
"Vaccination is an essential component of modern public health programs and is among our most cost-effective medical interventions. Yet despite vaccines' clear effectiveness in reducing risks of diseases that previously attacked large proportions of the population, caused many deaths, and left many people with permanent disabilities, current vaccination policies are not without controversy. Vaccines, like all other pharmaceutical products, are not entirely risk-free; while most known side effects are minor and self-limited, some vaccines have been associated with very rare but serious adverse effects. Because such rare effects are often not evident until vaccines come into widespread use, the Federal government maintains ongoing surveillance programs to monitor vaccine safety. The interpretation of data from such programs is complex and is associated with substantial uncertainty. A continual effort to monitor these data effectively and to develop more precise ways of assessing risks of vaccines is necessary to ensure public confidence in immunization programs."

Yes, I think it is rude to doctors to suggest they’ll dismiss valid concerns from parents about vaccines out of hand. I also think it’s an unsupported claim.
Cheers,
Rosewind

Bumbleymummy,
Right, so: “No one implies that only doctors can use the yellow card scheme - you tried to accuse me of that on the other thread and I clarified that.”

You said on the other thread:

"Well in order to report using the yellow card scheme, the doctor would have to acknowledge that the vaccine caused the reaction.”

I am trying to read this in a way in which it doesn’t imply (or indeed simply say) the doctor would have to acknowledge the vaccine caused the reaction...
Cheers,
Rosewind

ReadyToBreak, I am well aware that correlation does not imply (or prove) causation. IIRC the MMR was only withdrawn in Japan for a few years and during that time the Mumps and Rubella components were given quite close to the measles component anyway. In any case, no one is saying that the MMR is the only cause of the increase in autism cases.

RW, what way do you think I am implying that doctors are acting? I have said that they can under report reactions and that they can be dismissive of associations between the drug/vaccine and the event. The links above support both of those. This is true for all ADRs - not exclusive to vaccines. Are you trying to say that they under report ADRs except in the case of vaccines? You seem to be back tracking a bit from your

"Well, yes there is under-reporting of adverse effects of all drugs. I thought you were trying to make out that vaccines were in some way a special case." my emphasis

and making out vaccines to be 'special case' of your own.

I clarified it for you further down that thread "Well in order for the doctor to report using the yellow card scheme, the doctor would have to acknowledge that the vaccine caused the reaction." I was specifically talking about doctors because, as I said before, they are most people's first point of call if they have a reaction. (particularly a serious one) This does not mean that only doctors can use the scheme and it wouldn't make sense for me to think that considering that I frequently encourage people to use the scheme on this site.

Bumbleymummy,
I am responding to the bits where you claim that doctors are ignoring valid claims about vaccine adverse effects from parents. You then posted a study showing that doctors under-report all drug adverse effects, something I am certainly not contesting. I am trying to clarify where you get the idea that doctors will dismiss reports of vaccine side effects made to them, something you clearly feel strongly about and seem to believe is indeed a special case. Yes, vaccines are rather different to other drugs as they are prophylactic and many are administered to children.
Cheers,
Rosewind

RW, reactions to vaccines are considered under ADRs. Do you think they are not?

Also, how do you define 'valid claim'. Is it only 'valid' if the doctor reports it?

IIRC the MMR was only withdrawn in Japan for a few years and during that time the Mumps and Rubella components were given quite close to the measles component anyway.

that is incorrect - in Japan, only about 30% of all kids are vaccinated against mumps at all, only about 50% (all girls) would be vaccinated against rubella. The above notion was the straw that Wakefield and friends grasped when the Honda study came out, but, it is wrong.

Catherina, I've just checked and currently, children are offered an MR vaccine in Japan as part of the childhood 'schedule' so they would be vaccinated against rubella. The mumps vaccine is voluntary though. Interesting to see other country's schedules.

Anyway, it was just something I had heard about them being given close together, I don't mind being corrected if that wasn't the case.

another country's schedule*

that is a relatively recent addition, after the Honda paper in 2005 (www.ncbi.nlm.nih.gov/pubmed/15877763) - see for time lines here:

theconversation.com/vaccination-gaps-led-to-rubella-outbreaks-in-japan-and-poland-15970

also, single vaccines may be used idsc.nih.go.jp/vaccine/dschedule/Imm11EN.pdf

Actually, the Japanese policy only to vaccinate girls backfired badly www.cdc.gov/mmwr/preview/mmwrhtml/mm6223a1.htm hence the changes now.

Bumbleymummy,
"10) So clearly they had concerns about it as well which was why it was removed. (not necessarily due to autism)..."
Regarding thiomersal in vaccines, this summary seems pretty apt:
www.who.int/vaccine_safety/committee/topics/thiomersal/questions/en/
It covers the fact that not all vaccines contain thiomersal, that those that do show no evidence of being unsafe, that the mercury in thiomersal is different from methyl mercury and that the elimination of thiomersal from vaccines is purely precautionary.
I think being cautious is a good thing, and obviously where possible everyone should strive to be as "safe" as possible. Actually I do wonder if this precautionary measure (whilst understandable) can be misinterpreted by some. But luckily information like the above makes it very clear that there is no evidence of toxicity from mercury contained in vaccines.
Cheers,
Rosewind

Rosewind, my comment was simply that they obviously had enough concerns about it at the time to remove it from vaccines.

Can you answer my previous questions?

1)Do you not think vaccine reactions are considered ADRs?

2)How do you define 'valid claim' in your above post?

Bumbleymummy,
"11) You can not compare ingested Aluminium to injected Aluminium. The GI tract is an effective filter
"In healthy subjects, only 0.3% of orally administered aluminum is absorbed via the GI tract and the kidneys effectively eliminate aluminum from the human body.""
If you follow the references you'll find this interesting report, all about aluminium containing adjuvants in vaccines:
archive.hhs.gov/nvpo/nvac/documents/Aluminumws.pdf
It's not a particularly long report, and it talks about aluminium in vaccines, not in breast-milk or formula and not ingested. The point being made by quoting figures for breast-milk is that we are exposed to aluminium in our daily lives. It's the third most abundant element in the Earth's crust, it's everywhere. As the report linked to above makes clear one reason they didn't do much investigation of the way aluminium in adjuvants are treated by the body is that there were no detectable negative effects from them, and these adjuvants had (and still have) an excellent safety record. Also there were technical difficulties in investigating this. As it happens there is now the technology to investigate how the body deals with aluminium from vaccines and they've found that (from the initial work) the body seems to eliminate it quickly. Which is probably one of the reasons that these adjuvants have such an excellent safety record.
The thing with aluminium containing adjuvants is that there is no evidence (from their 70 year history of safe and effective use) that they cause any toxicity.
Cheers,
Rosewind

RW,

Two of the points under the 'what we don't know' section from that paper (which I have seen before) :

1)Toxicology and pharmacokinetics of aluminum ad- juvants. Specifically, the processing of aluminum by infants and children.

2)Mechanisms by which aluminum adjuvants interact with the immune system.

It was actually quite shocking how little research had been done into the safety of Al. More than one scientist has identified the need for further research. I think we will ultimately move away from injectable vaccines anyway because there are more effective methods of delivery.

In any case, my point was that you can't compare ingested to injected Aluminium levels - another weak point in the article.

Bumbleymummy,
I have hopefully made it clear that I thought you were talking about vaccines in particular. I do suspect that vaccines, being as they are prophylactic and administered to children, are probably subject to rather more scrutiny than other drugs. The very existence of, for example, the VAERS system in the United States would seem to support this idea. When I ask if you have evidence that doctors are dismissing parental concerns about vaccines I mean just that. I used valid claims, I could have said genuine concerns or other words which have the same meaning. I expect that doctors may reject some claims if they are transparently ridiculous? By which I mean that they are claims that a medical professional would very reasonably dismiss as invalid. Perhaps they shouldn't do this, but I would think that most people would think it reasonable if they responded to claims that appeared to have absolutely no basis in fact differently? Wouldn't you?
I hope this little bit of semantics has been cleared up. Clearly any claim can submitted via the Yellow Card Scheme, so there attitude of the doctor involved is unimportant.
Do you have any evidence specific to vaccines to show medical professionals are ignoring any reported side effects, since that's the subject we are talking about? Because I would like to see evidence on this subject (reports of adverse effects to medical professionals being ignored) before tarring them. The link you gave was about doctors faliing themselves to report adverse effects, wasn't it? Not of them rejecting reports from patients.
I am sure that some medical professionals don't act perfectly all the time, they're only human after all. But the idea that a parent going to a doctor about an adverse vaccine reaction will struggle to be taken seriously? That's an allegation I would like to see backed up by some evidence. Because if true it is something that needs to be dealt with, and perhaps you have ideas how this might happen? Do you think there are ways the Yellow Card system might be improved, the way the genuine risks associated with vaccines might be better communicated?
Cheers,
Rosewind

Bumbleymummy,
As the report makes clear the reason for the lack of research was the overriding evidence of the safety of the adjuvants. If you're using something effective and there is no evidence of any toxicity then the drive to investigate its toxicology isn't really going to be there, is it?
Its hard to justify investigating the toxicology of something where all the studies are showing that its use isn't toxic in this mode of administration.
Luckily they're now doing work on it, and finding out why it is so not toxic in this mode of use.
Cheers,
Rosewind

Bumbleymummy,
Actually I do often think that articles (on both sides of the vaccine debate) which go on about how much mercury/aluminium/unobtainium or whatever is in vaccines versus a sandwich somewhat miss the point. What we really want to know is whether the vaccines themselves are safe at that level of element and by that mode of administration. But I can see why people do use the "there's more X in breastmilk" argument, I'd personally rather say that the vaccine safety data we have show that it's safe.
Cheers,
Rosewind

"I do suspect that vaccines, being as they are prophylactic and administered to children, are probably subject to rather more scrutiny than other drugs."

So you think they are a special case? That under reporting of ADR happens but not in relation to vaccination? Or do you accept that vaccine reactions are also under reported, just like other ADRs?

You still haven't said what you consider to be 'valid'. Would you like to share some examples? There are plenty of people on this board who can tell you about their experiences of doctors dismissing their concerns about vaccination. You don't have to look too far to find them unfortunately.

Seeing as vaccines are grouped under ADRs - how would you like me to separate them out? You seem to be assuming that they are a special case that is not susceptible to the same issues with under reporting. I'm wondering why? Does it worry you that vaccine reactions could also be under reported to such an extent?

If you're not looking for evidence of toxicity it may be hard to find. That paper identified two areas that they admitted they don't know enough about. Do you think you know something that they don't?

I can understand why someone would use that argument as well - it's the only thing that they have information on and it gives the impression that they have looked into it and found it safe. Some people find it reassuring because they don't realise how different the levels of absorption are.

Bumbleymummy,
"12) The fact that vaccine reactions are recognised and that (not enough) compensation is paid proves that they can and do happen. So yes, vaccines can be harmful."
Well no one is saying that there aren't sometimes serious reactions to vaccines? Are they? Is anyone here saying that? No. What the overwhelming scientific consensus shows is that the benefits of vaccination far outweigh the risks. The Violent Metaphors blog is US-centric so goes off on a bit of one about the NVICP, which apparently the anti-vaccine lobby really don't like.
But I guess the difference is in how the message is put across? Is it "look there is a system for claiming for vaccine damage! That proves it happens! Vaccines are harmful!"
(I actually went and looked for some actual quotes, but ended up at whale.to and felt a bit sick)
Or is it, "Most immunisations are given without any trouble at all but very rarely there may be problems. The Vaccine Damage Payment Scheme is designed to help with the present and future financial burdens of the person affected by the vaccination and their family..."
From this leaflet, which also mentions the Yellow Card Scheme.
www.nhs.uk/Planners/vaccinations/Documents/A%20guide%20to%20immunisations%20up%20to%2013%20months%20of%20age.pdf
Cheers,
Rosewind

My point was that vaccines can be harmful and the presence of a compensation fund proves that it can and does happen. You appear to agree with me on that.

I'm surprised you thought this article was so great when you've actually agreed with some of my criticisms of it. (whether you've intended to or not!)

Bumbleymummy,
No one is saying that vaccines are not in some rare cases harmful. Not me, not Jennifer Raff, not anyone on this thread. That's such a pointless straw-man. No one denies that vaccines come with inherent risks. What we do say though, and what is overwhelmingly backed up by the science, is that the benefits of vaccination greatly outweigh the risks.
Cheers,
Rosewind