Anti-Vaccination Advocates on the Front Line of Public Health

Originally posted on Evidence, Please.:

I have a confession to make, people. Sometimes I read the comments. And sometimes I even join in.

Earlier today, ABC News posted a news article on their Facebook page regarding Federal Health Minister Peter Dutton’s meeting with his state counterparts to discuss a possible decision to withhold Family Tax Benefit payments from parents who refuse to vaccinate their children, for non-medical reasons. It’s a complicated issue and one that Dr Julie Leask has addressed in the news article itself.

ABC News’ Facebook moderator invited comments from Facebook users on the topic, prompting much discussion, both advocating and opposing vaccination itself, and agreeing with or criticising the proposal to withhold benefits from families who choose not to vaccinate their children. Having a little free time on my hands, I had a look over the comments and made a few myself; predominantly providing rebuttals to anti-vaccination rhetoric and suggesting that…

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“Healthy Lifestyle” Expo and the “Great” “Debate”.

An open letter to Mrs Dorey regarding her blog surrounding the “Great Debate” on vaccination.

I would like to clear up a few misconceptions that Mrs Dorey is spreading regarding me and Dr Dunlop.

First, Mrs Dorey seems, like Ms Robinson (a.k.a. Annie Infinite), to insinuate that I subscribed Ms Robinson’s email address to a number of pornographic sites.

I certainly did not do this, and at the time I repudiated it and strongly encouraged Ms Robinson to take the matter to the police. I believe in having a civilised debate.

What was on offer from The Healthy Lifestyle, or “You Can Heal Yourself” Expo was not a scientific debate, as I make clear in the correspondence below, where I declined to participate. The leading questions put as topics by the Expo leave a lot to be desired too. Another factor not discussed previously in my refusal to attend is that, unlike Mrs Dorey who puts a roof over her head through donations to the AVSN and selling misinformation, I have a regular job with commitments here in Wollongong. I am using up my leave to take my children back to China to visit their grandparents later this year.

Wayne,

There is no genuine debate when one side ignores scientific evidence. Relatedly, there is no dichotomy between science and natural therapies. Either there is scientific evidence of efficacy and safety or is there is not. The evidence on vaccination is clearly in favour of vaccination except for genuine medical exceptions, and not false concerns about autism [1, 2], etc. of the sort that the Australian Vaccination-Skeptics Network (AVSN) raise.
Regardless of any statements on government sites (and Google returns no hits for the quote you provided without citing a source for), there is no constitutional or other legislative blanket protection of speech, and speech on medical topics is regulated across Australia. The HCCC is currently investing the AVSN and has been preparing a warning for which I have attached the draft (not the first one they have released) – and the full draft report can be found here.
It’s disingenuous to state that the t-shirts are acceptable whilst ignoring the rest of the HCCC enquiry. Further, I wouldn’t call ignoring scientific evidence that can save lives to be loving children. It’s also disingenuous for you to claim you have no opinion on Black Salve when you have previously and illegally run advertisements and a YCHY Expo organiser has expressed her opinions.
I decline to enter into a debate for the following reasons:
*) Whilst I am qualified to speak on the statistics of risk around vaccination and vaccine-preventable diseases I am no more qualified than Mrs Dorey to speak on the detailed medical matters, and
*) False balance debates can send unhelpful messages by presenting a false view of the balance of risks. [3]
If you choose to go ahead with hosting Mrs Dorey, given her lack of scientific qualifications and evidence, in any form, then responsibility rests with you, as it does for any other medical misinformation provided in any form at the Expo.
Regards,
Dr Matthew Berryman
[1] Gerber JS, Offit PA (2009). “Vaccines and autism: a tale of shifting hypotheses”. Clin Infect Dis 48 (4): 456–61.
[2] Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C (2012). “Vaccines for measles, mumps and rubella in children”. Cochrane Database Syst Rev 2: CD004407.
[3] Dixon, Graham, and Christopher Clarke. “The effect of falsely balanced reporting of the autism–vaccine controversy on vaccine safety perceptions and behavioral intentions.” Health education research 28.2 (2013): 352-359.

 

This correspondence followed my correspondence (below, sent on the 25th of March) to a number of the Expo’s sponsors, suggesting that they examine their financial support of the Expo as a whole (to which the phrase “the event” most clearly refers to), given Mrs Dorey’s attendance and other misleading health information routinely provided. This is also irrespective of whether the Expo was in turn funding her (as they mentioned to me later, they claim they are not), or whether she is running a stall or “debating”, or running a seminar. Furthermore, I noted past advertising and promotion by Ms Robinson of a stall illegally selling black salve. Mrs Dorey also repeats the defamatory remarks by the conference organisers that I resort to name calling, without providing any evidence.

Dear Sir/Madam,

I understand that [Name of Sponsor] is a sponsor of the ‘Healthy’ Lifestyle Expo 2014, also known as the ‘You Can Heal Yourself Expo’, to be held on the Sunshine Coast in May.

This event routinely promotes dangerous medical advice:

  • At last year’s expo there was a stall selling Black Salve, promoted as a do-it-yourself cancer cure; this has a strong risk of causing damage in addition to the risk that it fails to remove all the cancer, which can then spread. I have enclosed a public health warning from the Therapeutic Goods Administration about Black Salve with more information about it.
  • This year’s expo features a seminar by Mrs Meryl Dorey from the Australian Vaccination-Skeptics Network, well known for providing anti-vaccination misinformation (with potentially fatal consequences), and currently subject to an investigation by the NSW Health Care Complaints Commission (draft warning enclosed), in addition to investigations by other government agencies for fraud.

I strongly urge you to support public health by withdrawing your sponsorship of this event.

Regards,

Dr Matthew Berryman

Last but not least, surrounding Mrs Dorey’s mention of Dr Dunlop, I note:

  • The Expo did not email Dr Dunlop an invitation prior to her name being mentioned as a possible debater. 10177473_10152381465720229_7787428432987499745_nPerhaps it was a case of poor communication between Expo organisers, although it’s highly suspicious that another proposed debater also did not receive an invitation:Screenshot 2014-04-11 13.00.38
  • Dr Dunlop declined to participate on the 9th of April, which is not surpising given her views on false debates.

 On 9 Apr 2014, at 14:04, Rachael Dunlop wrote:

Dear Wayne,

No thank you. Please either remove my name from the site or indicate I have declined the invitation to participate.

Kind regards

Rachael

  • I am not sure why Mrs Dorey persisted with this incorrect information well after Dr Dunlop’s email, though we cannot rule out a delay between the Expo receiving Dr Dunlop’s refusal and their subsequently informing Mrs Dorey.

Regards,

Doctor Berryman, BSc. (Maths & Comp. Sci.), BEng. (Comp. Sys. Eng.) Hons. I, PhD (Complex Systems).

 

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Facebook, hate speech and child abuse

Warning: I felt nauseous and cried putting together some of this material.

First, let’s review Facebook’s definitions of violence and hate speech:

Facebook definition of violence

Facebook’s definition of violence

Facebook's definition of hate speech

Facebook’s definition of hate speech

I’d like to know how the below comment, on Meryl’s links to Big Oil and Big Pharma (she sells tupperware and cosmetics, the former made from oil, and L’Oréal owns (owned?) a “big pharma” company, Sanofi-Aventis), can be considered hate speech or a threat.

MD comment

Of course, that’s not the first time that Meryl’s made frivolous complaints to get material removed. But, moving on to more serious matters, I recently became aware of one member of the anti vaccination (antivax)/antifluoride/other conspiracy theory community making threats by private message:

Frankie's a nasty guy

Frankie’s a nasty guy

When the person the message was sent to had done little more than post polite responses to antivax people on public Facebook pages. Yet, after Facebook reviewed a complaint about that message, they found it didn’t breach their “community standards”. Some community if that’s acceptable.

Even more worrying, is that Facebook allows a group for the promotion and discussion of child abuse to stand. First, let me make a few things clear:
I do not consider antivax people in general to be child abusers. Misguided, certainly, but there is usually no intent to cause harm to a child—they simply believe that vaccines are ineffective and dangerous, which is not true, but still, that’s what these people believe. And most are otherwise taking on board other measures, often useful. Example:

not child abuse

not child abuse

What I do consider child abuse is when parents, some of whom are happy to be vaccinated themselves, want to deliberately infect their children with diseases that they know full well are at best very unpleasant, and worse carries the risk of serious complications, including death. These parents have intent to harm their children, no matter how much they want to brush aside the risks of complications.

Before we jump in to look at this child abuse group that Facebook considers to meet “community standards”, let’s review a few extra facts on a couple of diseases and the vaccinations for them.

Here’s a primer on Chicken Pox (Varicella), and, particularly in high risk groups (which includes infants), it carries risk of complications. Measles is also nasty, and even in otherwise health people carries the following complications:

About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. About one out of 1,000 gets encephalitis, and one or two out of 1,000 die. Other rash-causing diseases often confused with measles include roseola (roseola infantum) and rubella (German measles).

No, Vitamin C (or E) won’t help you, and vitamin supplements have a long history of health myths. Nor are better nutrition and hygiene alone responsible for the reduction in disease. Compared with the risks of the MMRV vaccine that prevents both measles and varicella (chicken pox) along with mumps and rubella (German measles), the benefits (outlined in articles above) are huge. Vaccines aren’t linked to an increase in allergies, or cœliac disease or in autism.

Stats and science are important, but somewhat pale in comparison with these descriptions of cases in ICU from an Intensive Care Specialist:

I am an Intensive Care Specialist. Although it was a while ago now, I do remember my first job in Intensive Care (ICU). During my first week I admitted a young man onto ICU with chicken pox. He was 18-19, a young, fit, healthy, tradie. He liked football (soccer – it was England), and had never had any major illnesses before. He was fully vaccinated according to the schedule of the day (this was in the late 1990′s). This was in the days before there was a vaccine for chicken pox. He had chicken pox pneumonia, and was in respiratory failure as a result of this. He was struggling to breathe, and working really hard just to get the air in and out of his lungs. We had to give him an anaesthetic, and put him on a ventilator to try and keep him alive. At that time I had no idea that chicken pox could be so dangerous. I knew it was contagious, I mean, although I had escaped with mild disease when I was a kid, I remember that 26 of my class of 28 kids were off school at the same time with it. I hadn’t remembered learning specifically about it at med school, but I certainly did some reading during that first week on ICU.

It is not unusual, or rare, for it to cause pneumonia of such a severity that it requires hospital care. Not all that get it survive. He was ventilated for a couple of weeks. He, and his family, suffered terribly during that time. He was lucky though. He did survive. His lungs will be permanently scarred though, and I’m not sure he’ll ever play football again. He was the first patient I looked after in ICU with a vaccine preventable disease. The first of so many. The last was only this week, when I tried to help a gentleman with shingles. Shingles is excruciatingly painful, and also caused by the varicella virus. Thankfully, both these diseases are now preventable by vaccination.

So, without further ado, here’s the group for people (currently 482 members) who want to deliberately infect their kids with chicken pox (and in some cases as you’ll see, measles):

Chicken Pox Party group overview

Chicken Pox Party

Here’s a selection of the discussion I recently obtained from this closed group:

1 2 3 4 5 6 7 8 9 10 11

This next one is hugely worrying. Not only are they planning on trying to get a 5 month old infant infected with chicken pox (recall: one of the high risk categories for complications), they are also planning on giving said 5 month old chiropractic treatment to help manage the disease. Not only do they quote the disproven (and nonsensical) vitalistic theory behind false chiropractic claims; there is no evidence that any chiropractic treatment is of value in children and carries with it the risk of spinal injuries (which can lead to death).

Dr Pappas said he was concerned the decision was an endorsement of chiropractic treatment for infants when there was no scientific evidence to support it.

”I think they have put the chiropractor’s interests before the interests of the public,” Dr Pappas said. ”[Treating infants] is inappropriate and it carries a very small but real risk of causing damage, and in some cases, devastating damage.”

A review published in the Pediatrics journal in 2007 also found serious adverse events relating to spinal manipulations in children, including a brain haemorrhage and paraplegia.

12 13 14 15

There are some group members also interested in infecting their kids with measles:
Measles

and, despite warnings in the group description and from members (who seem more concerned by the illegality than the public health hazards), those who still seem keen on sending chicken pox via the frigging postal system and provide strategies on minimising detection (presumably the US post are on the lookout for licked lollipops alone):
Cp in the mail

Also noteworthy is this discussion, bearing in mind the extra risks to pregnant mothers and unborn children from chicken pox. At least the mothers have naturally acquired immunity (unless for some reason they didn’t—these cases do occur).

CP in pregnancy

Even if you disagree with me that the above is child abuse, there is still no clear category to report child abuse discussion on Facebook:

reporting options

and Facebook thus decide that the Chicken Pox Party group meets their “community standards”:

CP group Ok by FB

And just in case you think this is a US phenomena, behold parts of this discussion (in the following images) I found on public pages between Australian Facebook users:
chicken pox6

Come on Facebook, lift your game.

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Book review: How Animals Grieve

I am reading How Animals Grieve by Barbara J. King, and it’s quite a moving, yet scientific, read. King obviously cares very deeply about animals, and presents her research and that of others, as well as a number of moving stories, yet is very clear about studies vs anecdotes (and the proper use of them), making clear what is on solid basis and what is speculation / uncertain. I’m still part-way through the book, but wanted to get a bit of a review out there as it’s such a great book; I will update this post with any more thoughts if I have them while reading the rest. Any corrections / comments to this post are as always, most welcome.

As an academic with a science/engineering background, I couldn’t help but ponder a few of the statements:

  • The author writes “Death-related behavior in these insects is, as far as we can tell, driven purely by chemicals. While it’s possible that entomologists just don’t know how to recognize displays of insect emotion, I’m comfortable in hypothesizing that ants don’t feel grief for their dead comrades.” As that section stands, though, it’s more of a generalisation; for it to be a hypothesis it must make some sort of prediction, which we don’t get to until King then presents definitions of love and grief and how they are intertwined, a key point of this book, in particular the part “the animal who loves will suffer in some visible way. She may refuse to eat, lose weight, become ill, act out, grow listless, or exhibit body language that conveys sadness or depression.” So to link the two sections of text, and make it a hypothesis: we do not expect ants to show any behaviour that carries some detriment to the individual.
  • King writes “The key to success for at least some nonhuman animals seems not to be pure brain power, but instead a lengthy period of mutual attunement with humans. Thanks to their history of domestication, dogs have had extensive “practice” reading the movements of human companions. DNA science, together with archaeological research, tells us that dogs and humans initiated this process over ten thousand years ago, maybe even as early as fifteen thousand years ago.” Whilst perhaps our ancestors selected dog ancestors to be those who were particularly attuned, perhaps it’s more a case of simply an exaptation of existing behaviour, modified by the nurturing process of raising a dog in a household? This is a bit of a nature vs. nuture debate; I’m not denying there is some selective pressure I just think the ball may lie more firmly in the nuture side.
  • On a cat who can tell when patients in a nursing home are about to shuffle off this mortal coil, King writes “The explanation for Oscar’s death predictions lies, I believe, with the smell of molecules called ketones as they are released from a dying body.” Now I’m not an expert on the biology of dying, but as far as I understand there are some conditions, namely organ failure, where release of ketones may occur prior to death, and others that don’t, leading to this hypothesis: in those patients who suffer organ failure, Oscar the cat would be able to predict, whereas if someone dies suddenly from a myocardical infarction, then Oscar wouldn’t be able to predict that.
  • On the landing of the chimpanzee Ham in his space capsule in the ocean, King writes “Or was he terrified, both because of intense heat and because he was bobbing around untended in the ocean for three hours, not knowing what would happen next? The image is hard for the mind to take, Ham alone in the capsule, with no other being to empathize or to comfort him during what can only have been a truly frightening experience.” Yet I suspect part of the terror in that situation comes from our knowledge that the capsule had holes and was gradually sinking, and our knowledge that that may lead to death. I suspect Ham may have been a bit frightened by the whole experience, landing and water coming in, but not very frightened in the way we feel when we put ourselves in that situation through the act of reading.

Ultimately, the book builds a solid case for both love and grief in a number of different species of animals, according to King’s reasonable and grounded definitions of both. The solid use of narrative makes this a compelling read even for the lay audience it is targeted at, and it’s a deeply moving book with images that I will keep with me for a long time, and make me ponder the beautiful and diverse range of animals that I share this pale blue dot with. If this bit doesn’t tug at your heart strings, and make you realise that animals can show grief, I am not sure what will:

On the following day, before moving on to another part of the Elephant Sanctuary, Sissy made a choice that surprised the people who witnessed it. She placed her beloved tire, her security blanket, on her friend’s grave. There she left it, an elephant memorial offering, for several days.

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Stop the AVN

Tomorrow (and possibly Friday) there is an appeal hearing before the New South Wales Administrative Decisions Tribunal to decide on whether the Australian Vaccination Network’s name is misleading. To illustrate their stance, I note their book on vaccination, recently released for free, contains 27 references to the word “poison” (they are not poisonous), close to 100 mentions of vaccination being ineffective, over 50 on the word danger / dangerous, etc. If that doesn’t illustrate the anti-vaccination stance of the AVN I don’t know what would.

The research shows that up to 53% of Australians have concerns about vaccination. It is important that these parents get their information from a credible source. People need to know that Australian Vaccination Network is a fringe group of hard core vaccine refusers. Their name deliberately seems amibigous in order to present themselves as presenting serious research on both sides. They merely present non-scientific information on the anti-vaccination side. Your doctor is often your best choice when you have questions concerning your health.

I note the comments by New South Wales Fair Trading’s Principal Solicitor in his decision that is being appealed:

All in all, the available information shows, in my opinion, that the AVN is mostly concerned with opposing vaccination and mandatory immunisation. When issues have two sides, it takes just one of them.

One would expect that an organisation with the name ‘Australian Vaccination Network’ would provide comprehensive and credible information on vaccinations in Australia, and a balanced view on what is involved in the processes and benefits and risks involved, as well perhaps on where and how such treatment can be obtained. The AVN does not do this. Its views are anti-vaccination, and it advises against being vaccinated or taking part in immunisation programs. Complaints received by NSW Fair Trading support this view of the AVN. Parents of young children may be particularly interested in learning about issues concerning vaccination and may easily come across the name Australian Vaccination Network in an Internet search, only to find its issue is opposing vaccination. The name does not suggest that it is anti-vaccination.

The issue here is not with the nature, objects or functions of the AVN or what it espouses, but rather with its name. It can adopt another that is not unacceptable. Free speech is not the issue.

I find:

  • The Australian Vaccination Network Inc’s message is anti-vaccination.
  • Its name does not reflect that message or its true nature, objects or functions.
  • Its name is likely to mislead the public

As such, the name is unacceptable for registration as a name under the Associations Incorporation Act 2009.

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Angry

Warning: some pretty grotesque pictures ahead, as well as some really disturbing and sad stories.

You have been warned.

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