Tag Archives: vaccines

Vaccine Advocate Chronicles the Opposition

Dr. Paul A. Offit‘s new book documents the history of his detractors.  The pediatric infectious disease specialist and vaccine researcher is a vocal vaccine advocate who has become a target for people who believe that vaccines cause autism and other ills in children. His new book, “Deadly Choices: How the Anti-Vaccine Movement Threatens us All,” follows his 2008 book, “Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure” which focused specifically on the autism accusation.

The new book takes a broader historical view of the anti-vaccine movement, going back to the mid-1800’s in England, when some people actually expressed the fear that the bovine-derived smallpox vaccine would turn their children into cows. “If you look at the messaging and the style of those campaigns, it’s almost identical to today,” Dr. Offit told me in an interview, noting that he hopes the book will put the current anti-vaccine movement into perspective for physicians as well as lay readers.

Dr. Paul A. Offit / Photo by Miriam E. Tucker

According to the book, America’s modern-day anti-vaccine movement began on April 19, 1982, with the airing of “DPT: Vaccine Roulette,” a one-hour documentary on Washington, D.C.’s local NBC affiliate WRC-TV. It described children with a variety of mental and physical disabilities that their parents blamed on the diphtheria-tetanus-pertussis vaccine. The book also discusses today’s anti-vaccine crusaders, including celebrities such as Jenny McCarthy, Jim Carrey, and Bill Maher.

The book is intended to sound an alarm.“The problem with choosing not to vaccinate is not theoretical any more. I think we’re past the tipping point. We’ve had outbreaks of whooping cough, measles, and mumps and even bacterial meningitis that are preventable, because people are choosing not to vaccinate. They’re so scared that they’re more frightened of the vaccine than of the disease…I just think someone has to stand up for these children who are suffering and being hospitalized and dying,” he told me.

Dr. Offit is often attacked on the Internet by people who oppose vaccines, and once received a death threat by email. In June 2006, I was among the attendees at a meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices who had to navigate through a crowd of anti-vaccine protestors lining the sidewalk leading to the CDC’s main Atlanta campus. One protestor held a sign labeling Dr. Offit a terrorist. Another yelled at him through a megaphone, calling him the devil.

I asked if he’s worried about a similar reaction to the new book. “I don’t think it will evoke any more anger than I’ve already evoked,” he replied.

Miriam E. Tucker (@MiriamETucker on Twitter)

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Filed under Allergy and Immunology, Alternative and Complementary Medicine, Dermatology, Drug And Device Safety, Family Medicine, Health Policy, IMNG, Infectious Diseases, Internal Medicine, Neurology and Neurological Surgery, Otolaryngology, Pediatrics, Primary care, Psychiatry, Uncategorized

Narrowing the gap in childhood vaccinations

Image courtesy of truthout.org under Creative Commons license.

Here’s an encouraging look-back at the first decade of this century. In 2000 the United States set a goal of vaccinating 80% of children in the first 18 months of life with the standard 4:3:1:3:3:1 vaccine series to prevent diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B, Haemophilus influenzae type B, and polio. At that time, only 47%-59% of kids were getting all the recommended vaccines (depending on which part of the population you looked at). Each of 12 different subgroups of the population showed disparities in vaccine coverage. Rural kids were less likely than suburban kids to be vaccinated, and black kids were less likely than whites to get protection, for example.

A new study by researchers at the Centers for Disease Control and Prevention shows that most of those disparities disappeared by 2008. Overall, 72%-81% of children got the complete vaccine series. Disparities remained in only 4 of the 12 subgroups. Babies now are getting vaccinated at similar rates no matter what their race or where they live, after accounting for the effects of other factors like poverty. Most groups are getting close to the 80% vaccination goal set by Healthy People 2010.

Some experts who were not associated with the study share some thoughts on how we’ve managed to improve vaccination rates in my story for Elsevier Global Medical News.

The findings also point to the hardest-to-reach babies who still lag behind in vaccination rates — those who have more than one sibling, who live below the poverty level or get care from a public (not private) healthcare provider, and whose mother didn’t finish high school, is unmarried or is less than 30 years old. We’ve still got some work to do.

–Sherry Boschert

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Filed under Allergy and Immunology, Family Medicine, Health Policy, IMNG, Infectious Diseases, Internal Medicine, Obstetrics and Gynecology, Uncategorized

You Don’t Get Paid Enough for This

This is what poliomyelitis looks like.  Image courtesy of the WHO.

This is what poliomyelitis looks like. Image courtesy of the WHO.

from the American Academy of Pediatrics National Conference and Exhibition in Washington, D.C.

There’s no doubt that pediatricians have a lot of tasks to fit into a 10-minute healthy child visit.  Not only do they have to give vaccinations — for which they often lose money — but these days they also have to invest time in educating parents about the safety and importance of those vaccines.  You pediatricians out there certainly don’t get paid enough for this.  Actually, you don’t get paid for this at all.

This afternoon, I sat through Dr. Gary Marshall’s talk on how to address parents’ concerns about vaccines.  Dr. Marshall is the chief of the division of pediatric infectious diseases at the University of Louisville (Ky.).  He discussed a number of reasons why vaccination safety is on parental radar these days, ranging from misinformed celebrities providing medical information to a general lack of understanding of vaccinology and the safety measures that are built into the vaccine development/licensure/marketing process.

Fundamentally though, we suffer from our tremendous success in virtually eradicating some truly terrible diseases.  Without the specter of polio, tuberculosis, or measles in the news, the public has shifted from a fear of the diseases that these vaccines are intended to prevent to fear of the extremely rare side effects of the vaccines.  As a result, pediatricians have to expend time they do not have on discussing the benefits of vaccinations and addressing parents’ fears.  This is time that they could be devoting to more pressing and challenging health concerns for children, such as obesity, injury/violence prevention, and drug abuse.

This what measles look like. Image courtesy of NLM.

This is what measles looks like. Image courtesy of NLM.

 

In the question and answer session, Dr. Marshall noted that it is ethical and permissible to discharge patients from a practice if their parents refuse vaccination. While this might ease the burden on the practice, is doing so really the best thing for the child?  The implication is that, as long as a pediatrician is caring for the child, there is still the faint possibility that repeated discussion of vaccines with the parents might ultimately lead to the child being vaccinated.

You pediatricians sure don’t get paid enough for this.

—Kerri Wachter, @knwachter on Twitter

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Filed under Infectious Diseases, Pediatrics

Fair and Balanced News: Too Much of a Good Thing

Image courtesy of Wikimedia user Mareklug (creative commons)

Image courtesy of Wikimedia user Mareklug (creative commons)

National Foundation for Infectious Diseases’ 12th Annual Conference on Vaccine Research, Baltimore, Maryland

I often hide my name badge at meetings if it proclaims my status as media. This is almost always to ward off PR flacks. Today, I slunk out of an afternoon session of the NFID’s vaccine research meeting hiding my badge because I was just plain embarrassed.

As part of a talk on autism NOT being linked to vaccinations, Dr. Paul A. Offit took the media to task for giving equal time and weight to the other side, i.e. Jenny McCarthy and the vaccines-gave-my-kid-autism lobby. Dr. Offit, who is the head of the Infectious Diseases section at the Children’s Hospital of Philadelphia, cited the late Tim Russert’s “Meet the Press'”segment, which gave equal time to Dr. Harvey Fineberg, head of the Institute of Medicine, and former Dean of the Harvard School of Public Health and David Kirby, a journalist who wrote a book about the link betweent autism and the MMR vaccine.  [Full disclosure: Dr. Offit is the author of the book Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure]  His point was not whether it was a fair fight but that it shouldn’t have been a fight at all, given the preponderance of evidence against a link.

I admit that I slunk lower in my seat to hide the day-glow green ribbon shouting “PRESS”.  I’d like to say by way of disclaimer that there is a huge difference between those of us who write for physicians and those who write for the lay public.  I have a chemistry degree for crying out loud.  Still, I felt guilty by association.

I knew immediately where the disconnect is.  As a journalism student, it was drummed into my head that there are TWO sides to every story and you are doing your readers a disservice by not including both in your story.  No one ever said anything about evaluating the relative weight to give to those two sides. 

Admittedly, distraught parents of autistic children make for very compelling reading and viewing.  They do not, however, offset the eons of medical and scientific training and the mountains of data that tell us that vaccines do not cause autism.  The scientists—because they are scientists and can’t say with statistical absolute certainty that vaccines do not cause autism—do not phrase it this way but it’s what the evidence amounts to. 

And don’t even get me (or Dr. Offit) started on the Oprah episode with Ms. McCarthy…

For an excellent discussion of the bad science involved in the autism vs. vaccines pseudocontroversy, see surgical oncologist Dr. David Gorski’s blog post on Science-Based Medicine.

—Kerri Wachter (@knwachter)

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Filed under Infectious Diseases, Pediatrics, Psychiatry