Vaccines: gambling with our children's health
Why we chose not to vaccinate our children
To my children, without whom this piece wouldn't have come into being.
And to their mother, without whom my children wouldn't have come into being.
As parents we all have to face the issue of vaccination. Many don't question it, simply going along with what the doctors, nurses and health visitors say and letting their children have all the vaccinations the medics recommend. Others are more wary, wanting to know what vaccines are being recommended and why:
- Are the diseases they're supposed to prevent really dangerous, still?
- Are the vaccines really effective?
- Weren't most of the killer childhood diseases only deadly due to poor nutrition and sanitation?
- Weren't death rates coming down before vaccines were introduced?
- Isn't it better for a basically healthy child to go through childhood illnesses naturally, coming out stronger?
Do vaccines really work? Aren't there cases of children who've been vaccinated getting the disease they're supposed to have been immunised against? Aren't there even instances where there's been an outbreak of a disease and where more of the children who catch it have been vaccinated than those who haven't?
And how safe are vaccines anyway? Do we really know? Drug companies — "Big Pharma" — are notorious for covering up ineffectiveness and even devastating side-effects of their products. Is there any monitoring of side-effects that show up more than a couple of weeks after a vaccination? How come the US side-effects reporting system (VAERS - Vaccine Adverse Events Reporting System) shows quite alarming health problems occurring after vaccinations? And why are drug companies protected by governments from being sued for vaccine problems, whilst government funds (read: tax-payers picking up the bill) are used to quietly compensate victims of vaccine damage?
Is it really safe to inject vaccine materials directly into the body, which has skin and mucous membranes to protect it against naturally-occurring infections? Surely it can't be good to repeatedly bombard a baby's immune system with random collections of different bugs? Wouldn't it be better to give vaccines singly (if at all) than as multiple shots like MMR and DTP? And don't vaccines contain Mercury — a notorious poison, and Aluminium — linked to Alzheimer's Disease, and toxic Formaldehyde?
And what about Autism? More children are being diagnosed than ever before and there are many reports of children who've developed symptoms shortly afer vaccinations: surely that can't just be coincidence? What about that doctor who claimed to have found a link between the MMR vaccine and autism and had a paper published in the British medical profession's prestigious journal "The Lancet"? And who was subsequently accused of fraud, his article retracted, and struck off the Medical Register: doesn't that sound like the medical establishment closing ranks in a clumsy attempt to suppress a courageous whistleblower exposing a medical scandal? There are plenty of groups and individuals campaigning on the vaccine-Autism (and specifically MMR-Autism) issue: surely there must be something in it?
There are even people who claim that vaccination is a ploy by Big Pharma to weaken children's immunity, making them more susceptible to diseases and therefore needing more (profitable) medicine — or even to actually make them sick from the vaccines so they need treatment! Certainly the big pharmaceutical companies aren't in the vaccines business out of charity, and doctors and nurses get paid to give vaccines so why should we believe the advice of people who've got a vested interest in them?
Given all these uncertainties why would anyone gamble with their children's health by vaccinating them?
Unfortunately we can't choose not to gamble: we can only choose which way to bet.
Not vaccinating our children is also a gamble: that vaccines are unsafe and/or ineffective, that the diseases they claim to prevent are no longer (or never were) a real danger to our children, and that the entire medical profession and medical scientific community are either incompetent or part of a massive conspiracy to deceive us.
What if infectious diseases really are dangerous; and what if vaccines are reasonably safe and effective, and pose less risk than the diseases they protect against?
Every parent has to decide for themself, but we are betting on our children's lives and health and we owe it to them — as much as we owe them food and shelter and our love — to put the time and effort into really understanding the issues, to put aside our prejudices and preconceptions, to make well-informed decisions for their health and safety. I hope what follows may help.
Big Pharma Conspiracy, much?
Proponents of alternative medicine such as Dr Joe Mercola regard the pharmaceutical industry — "Big Pharma" — as conspiring to promote entirely worthless products purely for profit. Yet Dr Mercola himself runs a business (reckoned to be worth $7 million a year) selling alternative-health products at staggering prices: clearly not a non-profit operation! (Mercola also alleges that paediatrician Dr Paul Offit who spent 25 years developing a vaccine against rotavirus, on which he now holds a patent, and who has written several books for parents and others about vaccines cannot be trusted for advice because of his financial interests whilst Dr Mercola's own financial interests presumably don't compromise the advice he offers to his own readers and customers.)
Natural News' Mike Adams goes further than Mercola and claims that "the controllers" are embarked on a plan to cull 90% of the world population using "flu vaccines containing stealth cancer viruses", "GMOs, chemical food additives, medications and other synthetic chemicals"! (He also claims that the Boston marathon bombing was carried out by the US government itself; puzzlingly, however, he doesn't explain how a genocidal conspiracy willing and able to bomb its own citizens is unable to prevent Mr Adams and his website from telling us the "truth" about their operations!)
Whale.to goes further still, offering conspiracy theories from mind control through covert genocide to our reptilian overlords, and even includes the notorious anti-semitic Protocols of the Elders of Zion forgery which was used by Hitler to justify the Holocaust.
Conspiracies are real. During my lifetime the US and British governments have fabricated evidence to justify wars, governments have engineered coups d'etat, governments, corporations and powerful individuals have murdered political activists, the sexual abuse of children has been systematically covered up and the president of the USA was caught bugging political opponents' offices. And these are incidents we know about: like the tip of an iceberg there may be vastly more hidden.
One factor is that there are [practical limits] on how big and long-lasting a conspiracy can be: it might be possible that a handful of well-trained, highly motivated and regulated people (such as military personnel at an isolated establishment) might keep a secret about an incident that happened at some point or period in the past but the more people who need to be 'in' on the secret, the more diverse they are, and the longer the conspiracy they are hiding persists the more probable it is that sooner or later someone will give the game away, either accidentally or deliberately. For huge conspiracies such as the moon landings or climate change being a hoax, or vaccine dangers or cures for cancer being suppressed, there would have to be so many people involved that in the real world the cat would have escaped from the bag long ago. Such conspiracies depend on being engineered by masterminds with Bond-villain levels of evil genius and power who also — like Bond villains — make ridiculously stupid mistakes that let the Alex Joneses and Mike Adamses of this world easily see through their conspiracies.
There's also a common-sense principle that extraordinary claims demand extraordinary evidence. If I tell you I saw a cat in my garden you'd probably take my word for it. If I told you I saw a unicorn you'd want some pretty convincing evidence! So if we are to claim that the US and UK governments bombed their own people, or that governments colluded with industry for decades to conceal that vaccines were ineffective and harmful (as claimed in the ["Vaccine Hoax" infographic at the top of this page]) we need to produce very solid evidence.
We know that the big pharmaceutical companies that develop and manufacture drugs and vaccines are dishonest. We know they distort trials, cover up trials showing products that are ineffective and/or unsafe, and influence doctors and others to use their products regardless of their merits. And we know that the medical establishment — regulators, professional journals, patients' associations and doctors — collude with them and consistently fail to rein them in. There are examples from Thalidomide to Vioxx of drugs causing harm instead of good and manufacturers covering up their failings for as long as possible whilst raking in profits. One way we know all this is because Ben Goldacre, in his book [Bad Pharma], tells us what they do and how they do it.
Now I think Ben Goldacre is an OK guy: I think he's honest, knowledgeable and — most importantly — knows the limits of his competence. Dr Mercola seems like a nice guy too although I disgree with a lot of what he says. But I'm a lousy judge of character (actually it seems that [in cases like this we all are]): maybe Mercola is right and Goldacre is wrong. How can we decide?
Fortunately it doesn't depend on a beauty contest, or who has the best rhetoric, to decide whether to trust Ben Goldacre or Joe Mercola or Mike Adams or whale.to's John Scudamore. We can judge by the evidence they present for their claims. Of the 400+ pages of Goldacre's "Bad Pharma", over 34 are of references, almost all of them to peer-reviewed publications. He cites studies showing how trials conducted by drug companies are more likely to show the companies' products favourably than trials conducted independently. He references studies showing how doctors are more likely to prescribe expensive patented drugs made by a company whose reps they have seen or whose corporate hospitality they have accepted. And so on: his book presents real evidence for his allegations; and I, and anybody else, can follow these references to the sources and check them for ourselves. We don't have to take Goldacre's word for it.
Mercola, Natural News and whale.to, however, offer practically no independent evidence, only links to articles on their own websites. Following these keeps us within their own closed world where we have to take everything they say on trust. And no matter how nice and sincere these gentlemen are they can't be experts on everything they talk about. Not even Dr Mercola: I don't know what his medical training and experience is but medicine is a huge field and no one medic can be the world's expert in all of it. Natural News' Mike Adams appears to have no medical training at all, and whale.to's John Scudamore is apparently a Herefordshire pig farmer: I'm sure he'd be scathing if, say, Ben Goldacre claimed expertise in animal husbandry so it doesn't seem unfair to question his own competence in medicine!
So Goldacre's "Bad Pharma" seems to be the most accurate picture of the problems with the pharmaceutical industry.
Besides the failings Goldacre exposes we know that "Big Pharma" also produces drugs which save lives: there are millions of people alive today (most of us know some of them) who would be dead from cancer, heart disease, HIV/AIDS, diabetes, infectious diseases, accidents, burns and countless other causes were it not, in large part, for the products of Big Bad Pharma. The problem seems to be that the system is so compromised that there are mediocre and even downright bad medicines alongside genuinely good ones, and doctors and patients have no way of knowing for sure which is which.
How do we know if vaccines are good medicines rather than mediocre or bad ones?
Whilst vaccines, especially newer ones still in patent, are profitable for the companies that make them, they form a tiny proportion — less than 1% — of their total profits, and most of the big drug companies that produce both vaccines and drugs and other products for treating disease would actually make far more money from treating children hospitalised with vaccine-preventable diseases than they do from the vaccines themselves.
Most drugs are given to relatively small numbers of people who are already sick, and many of those may also be taking other medicines, making side-effects harder to pin down to one drug. Vaccines, however, are given to vast numbers of healthy children so side-effects show up like a sore thumb.
And the way drug approval and regulation works at present means regular drugs only have to be shown to be better than nothing so they don't have particularly high standards of efficacy to acheive. Whereas when vaccines don't work we get outbreaks of the diseases they are supposed to prevent, which are very obvious.
There are huge studies of the safety and effectiveness of vaccines carried out all over the world, and there are systems for picking up and actively monitoring for unexpected side-effects. We know that vaccine formulations are changed from time to time to avoid side-effects or improve efficacy (or sometimes to increase safety at the expense of efficacy) and that this usually occurs even without being driven by "scares" and conspicuous public concern. This suggests that these safety checking and monitoring systems do, generally, work.
So are vaccines safe?
No. Not perfectly, absolutely safe.
Nothing is. Children die or are injured falling down stairs, falling off bikes and out of trees and from food and drinks they turn out to be allergic to or choke on or get food poisoning from, from electrocution and drowning and accidental poisoning and fires and all sorts of other causes.
And some — very, very few, but some — are [injured or even killed] by vaccines.
The evidence from studies of millions of children shows that it's a minute risk — around the one-in-several-million range, comparable to the risk of being killed or injured on the road any day of the week, or by falling off a bike or out of a tree or choking on food etc — but there's still a risk. It's a gamble. So the question is: how do the risks of vaccines compare with the risks of not being immunised?Measles is so infectious that in the days before vaccines practically everybody without immunity caught it, so it spread through the population until everyone who had recovered from it had gained immunity and then there would be a few years until enough new children had been born without immunity to sustain another epidemic. For most people Measles is simply an unpleasant illness but some people need hospital treatment, a few end up with brain damage or other permanent disability, and some die. During recent outbreaks in Europe fewer than 1 person in 1000 died, although the figures include very poor Easter European countries and expected death rates of only 1 in 3000 are quoted for countries such as the UK. In an un-vaccinated population with large numbers catching Measles we would also expect to see cases of the horrific SSPA (Sub-Sclerosing Pan Encephalitis) complication which attacks children's brains causing disability and slow death years after infection as a baby. Mass non-vaccination against Polio, which cannot be cured once it has been caught, would result in numbers of children being paralysed, some permanently, and some dying. Diphtheria ("The Strangling Angel") would also exact its toll of death despite the best efforts of present-day medical care. Nowadays thanks to community (or "herd") immunity the risks of not vaccinating are different. For a disease like polio they're practically non-existent: to catch it in the UK one would have to be in contact with someone from some parts of Afghanistan, Pakistan and Nigeria where polio still exists. For most British people this is a very low risk. Polio is part of the regular childhood vaccination programme because if no British children were immunised then it would be easy and quite likely for one traveller bringing an infection from abroad to start a devastating nationwide polio epidemic.
Likewise with diphtheria: thanks to community immunity an unvaccinated child is at little risk but when enough people are unvaccinated it can return and kill
With diseases like measles there's more risk to unvaccinated people, especially in areas of low vaccination such as South Wales (as seen in the recent epidemic), "trendy" places like Totnes and parts of North London, Steiner-Waldorf and Private schools. Although the numbers involved nationwide are small — there was only one death in the South Welsh outbreak — measles is so highly infectious that an unvaccinated individual in a largely-unvaccinated community has a very high chance of catching the disease and is then exposed to the full risk of death, brain damage, SSPE or other complications (and measles also wipes out immunity to other diseases leaving the victim vulnerable to other infections).
With Pertussis (Whooping Cough) an unvaccinated child is fairly likely to catch the disease but, especially for older children, at relatively little risk of dying of it: the greatest risk is to babies too young to be vaccinated who routinely die of it when outbreaks occur. Rubella (German Measles) presents practically no risk to an unvaccinated child but for an unvaccinated pregnant woman can damage her baby. The reason boys are vaccinated against it is to maintain community immunity to protect the unborn babies of expectant mothers who, for whatever reason, are not vaccine-protected.
So in our present society with generally high levels of vaccination and thus community immunity it is possible to "cheat" and avoid whatever risks may be inherent in vaccination by relying on the protection of others who have been vaccinated. For the measles (or the MMR) vaccine one would have to then avoid various parts of the country and sections of society — in practice largely withdrawing from society — to avoid being exposed to the wild disease. With Pertussis it would be a matter for one's conscience whether it would be morally acceptable to have one's child put tiny babies at greater danger of whooping cough. Not immunising girls against Rubella or boys against Mumps might seem less of a good idea as they grow older and the potential harms of the diseases become more severe.
Autism, allergies, diabetes, resistance to infections etc.
What about [Autism]? There had been practically no suggestion of a link with vaccines before [Andrew Wakefield]'s 1998 paper suggested it could be caused by the measles component of MMR. Even if Wakefield's work had not turned out to be based on brazen, profit-motivated fraud, his study of only 12 children was far too small to show any definite connection. It seems to have been through a combination of Wakefield's promotion of his agendas to provide "evidence" for the lawyer sponsoring him to sue vaccine manufacturers, and his own business interest in discrediting MMR in order to sell the alternative vaccine he was patenting, coupled with the media's uncritical adoption of him as a sort of Maverick Science Hero (entirely ignoring the enormous flaws in his case), that we have even heard of him and his idea of a link between MMR and Autism.
Although Wakefield's research was (apart from its fraudulent aspects) scientifically flimsy it elicited evident public concern. In the US there was also a public scare (which was also considered scientifically implausible) about the Mercury-based preservative Thimerosal used in some vaccines. And apart from Autism and ASDs, there were popular claims that vaccines could cause allergies, Type 1 Diabetes and weaken childrens' immune systems and make them more susceptible to all sorts of illnesses. In response to these concerns research has been carried out, many involving large populations in Scandanavia, Japan and the US, comparing vaccinated with unvaccinated children, children who'd had MMR with those who had single vaccines, looking at children who'd had different numbers of vaccinations, children who'd had different total amounts of vaccines; and looking for differences in rates of (and therefore possible connections with) Autism/ASDs, allergies, diabetes, whether children were more or less susceptible to other illnesses and so on. Thanks to the large numbers of children monitored in these studies it now seems clear that if there is any connection between, say, MMR and autism it would be at a level of risk of one in several millions.
Autism immediately after Vaccination
But despite the mass of evidence that there's no link we still hear cases of children who have suddenly become Autistic immediately after a vaccination. This intuitively seems pretty clear-cut evidence of a vaccine causing autism: how could it not be so?
It seems to be a case where our intuition — evolved on the savannahs of East Africa millions of years ago in a world of a few hundred fellow-humans — fails us in the modern world of 7 billion people, many of whom thanks to the internet are practically next-door neighbours. The sheer numbers of people getting vaccines mean that even with absolutely no connection between, say, MMR and Autism, it's simply inevitable by random chance that some Autistic children's symptoms will first show up just after a vaccination. It's a tiny percentage, but when there are millions of children involved that adds up to [hundreds or thousands of cases that we may hear of]. Vaccines would have to actively prevent Autism for there not to be such cases!
Science in Court
In November 1999 Sally Clark was convicted of the murder of her first two children on the basis of what was later acknowledged to be a gross and grotesque miscarriage of justice, due largely to basic misunderstandings of statistical probabilities by prosecution, defence, judges and juries alike. (It was as if the winner of a lottery jackpot were prosecuted for fraud because the odds of them winning the jackpot legitimately were so remote that they must have cheated.)
In March 2003, in a case similar to Sally Clark's, Dutch paediatric nurse Lucia de Berk was sentenced to life imprisonment for murder largely on the basis of the Dutch courts' mind-bogglingly incompetent grasp of statistics.
In October 2012 an Italian court jailed six scientists for failing to correctly predict the magnitude of the 2009 earthquake that devastated the city of L'Aquila, despite the obvious and well-known limitations to seismology's predictive abilities.
It seems fairly clear that courts are capable of grossly misunderstanding science and especially probability. In the case of the Italian MMR - Autism ruling there was no evidence, apart from the coincidence of the child's parents first noticing symptoms of his autism a few days after his vaccination, for linking the two, and the court decision was subsequently overturned.
A related issue is so called "vaccine courts" — the US' National Vaccine Injury Compensation program, the UK's Vaccine Damage Payment scheme etc. If they are paying out billions doesn't it mean that vaccines are pretty dangerous? Actually no: even though these schemes are weighted to give the benefit of the doubt to claimants the overall rate of claims and compensation awards is a tiny proportion of the numbers of vaccines given every year.
Mercury, Aluminium, Formaldehyde and other poisons.
How can it be safe to inject vaccines containing toxic chemicals into tiny babies?
The pioneering Renaissance physician Paracelsus observed "All things are poison, and nothing is without poison; only the dose permits something not to be poisonous". There is a chemical present in all vaccines which can cause confusion, disorientation, nausea, and vomiting, and lead to seizures, coma, and death. It is water. Vitamin D is essential for life but it is as poisonous as cyanide. The amounts of [Mercury, Aluminium and Formaldehyde] used in vaccines are just too small to be harmful, even to tiny babies.
Too much, too soon?
Although there was considered to be no risk that the number of vaccines, or the ages they were given at, could "overwhelm" infants' systems, nevertheless research has recently been carried out specifically to address concerns about children receiving "too many vaccines during the first 2 years of life, ...too many vaccines in a single doctor visit, and a possible link between vaccines and learning disabilities, such as autism". The research looked at hundreds of children with and without autism and compared the number of vaccinations and total quantities of vaccines received by each group. They found no connection.
How Dangerous are the Diseases?
Are the diseases vaccines are supposed to protect against really still dangerous?
Opponents of vaccination point out that death rates for various diseases were falling before vaccines were introduced for them, due to better sanitation, better nutrition, smaller families with less crowded living conditions and better treatment of diseases when they did occur.
A good example of how better treatment saved lives is polio. Many victims used to die of suffocation if the polio virus paralysed their chest muscles so they could no longer breathe. Then in the early 20th century the Iron Lung was developed which could keep alive those whose chest muscles were paralysed by the virus, by mechanically breathing for them.
Despite improvements in living conditions which helped reduce the number of people catching some diseases, and advances in medicine reducing the numbers dying or suffering permanent damage when they did get ill, some children and adults still died from polio, measles, mumps, Hib, diphtheria, Congenital Rubella Syndrome etc, whilst others suffered deafness, brain damage, autism, paralysis and other permanent physical and mental disabilities from these diseases. Vaccines reduced the numbers of these casualties, and the numbers catching these diseases in the first place, to the low levels we take for granted today. Smallpox vaccines totally eradicated the disease which is now officially extinct in the wild (with only some samples kept securely in a laboratory). Polio and measles could also be eradicated if there weren't still [reservoirs of un-vaccinated people] keeping them going in various parts of the world.
How dangerous are the so-called "vaccine preventable" diseases to healthily-fed children (and adults) in societies with good sanitation and healthcare? According to the Peckham Report for every 100 cases of measles notified one results in neurological complications (which can result in deafness or brain damage) and in 1 in 5,000 cases result in death. There is also the horrific — but fortunately rare — disease of SSPE where a child exposed to measles — typically as a baby — suffers progressive, irreversible brain damage causing mental degeneration and slow death years later — possibly as a young teenager. In the UK during the 1970s and 80s this used to happen to 18 children for every 100,000 who caught measles.
Mumps can cause excruciating pain and possible sterility for adolescent boys and young men. Tetanus can cause agonising spasms and take up to a year to recover from.
Pertussis (whooping cough) and Rubella (German Measles) vaccines are not intended to protect the children given them so much as babies too young to be vaccinated (in the case of pertussis) and unborn babies in the womb who can be damaged if their pregnant mother catches the disease (in the case of rubella). This damage — known as Congenital Rubella Syndrome — can include Autism Spectrum Disorders, so ironically (considering the MMR-Autism scare) the Rubella vaccine (part of MMR) actually reduces incidence of ASDs.
Varicella (Chicken Pox) can kill. In Belgium where children aren't routinely immunised against the disease a young girl died in April 2012 from severe complication of chickenpox. Her mother has started an association to inform parents of the dangers and to encourage them to seek vaccination for their children.
Whooping cough still kills small children and especially babies.
If the measles vaccine had not existed then we would expect to see periodic epidemics of measles as we did in the 1940s, 50s and 60s with peaks of a few hundred deaths per year during epidemics (and correspondingly higher numbers of encephalitis, pneumonia etc and hospital admissions). To put these numbers in perspective they would be significantly lower than the numbers of people killed on our roads. It's not that it would be a public-health problem so much as being tragedies for the victims and their loved-ones: literally tragic in the Greek drama sense if their deaths and injuries were preventable but brought about by human folly.
How Effective are Vaccines?
Statements like "90% of whooping cough outbreak victims are already vaccinated against whooping cough" sound alarming but are really an example of the saying ""lies, damned lies and statistics".
Like other medicines, no vaccine is 100% effective so if there's an outbreak of (say) whooping cough then some people will catch it even though they've been vaccinated. Percentage figures can be misleading — "damned lies and statistics". It's the actual numbers catching the disease that matter: 10 vaccinated people getting ill because a vaccine is only 90% effective is obviously better than 100 unvaccinated victims.
If every single person in the population had been vaccinated then, even though not many people actually caught a disease, we'd be able to say "100% of victims are already vaccinated". The 90% figure quoted above doesn't actually tell us anything about the effectiveness of the vaccine any more than "50% of people have below-average intelligence" tells us anything about the intelligence of a population. If not everybody is vaccinated then in a disease outbreak we may find that 10% of vaccinated people catch the disease and 90% of unvaccinated ones do. But if most people are vaccinated then the number of vaccinated people who still get the disease may still outnumber the unvaccinated ones.
In the case of whooping cough babies too young to be vaccinated are most at risk from the disease, and we know the vaccine isn't 100% effective, so the ideal is where 100% of those catching it are vaccinated because that means only older children — who are at less risk — are getting it, and vulnerable, unvaccinated, babies are being protected by community immunity.
A corollary of the fact that vaccines are less than perfect is that even if someone — say, one of your children — has been vaccinated they may still be vulnerable to the disease, if they are one of the ones for whom the vaccine didn't work, and you wouldn't know until they got exposed to the disease. Since unvaccinated children are much more likely to catch and pass on diseases they still pose a threat to some vaccinated children as well as to other unvaccinated ones.
Even where someone gets a disease they've been vaccinated against it may be less severe.
For example with Chicken Pox (varicella) it is known as "breakthrough varicella" and typically results in far fewer pox lesions which tend to be flatter rather than the riased, fluid-filled lesions of wild chicken pox, and typically do not blister or bleed and are much less contagious.
The Kids and I
When our first child was born I trawled the fledgling internet (using Alta Vista — this was before Google existed) for information on vaccines to set against the rather blandly reassuring trust-us-we're-the-government information we received from official sources. Some of what I found seemed to be the product of paranoid conspiracy thinking but there did seem to be some genuine concerns and arguments: whether it was vaccines or improvements in public sanitation etc that had brought down diseases, whether the diseases being vaccinated against were still a significant risk in this country, whether it was better for well-fed basically healthy children to go through diseases naturally rather than be vaccinated against them, and whether there might be long-term side-effects that weren't being checked for and picked up.
Trust me, I'm a politician
I had grown up in and lived through times when
- victims of the drug Thalidomide were fighting for compensation from the drug manufacturers
- Rachel Carson's "Silent Spring" showed how industrialised agriculture's cumulative pesticides like DDT were killing wildlife and possibly harming human health through residues in food
- we learned how Vietnamese children were being born deformed as a result of their parents' exposure to the Americans' Agent Orange defoliant used during the Vietnam War
- a whistleblower exposed documents revealing that a US President had lied about the Vietnam War
- investigative journalists uncovered the bugging of opposition politicians' offices by a US President and his subsequent attempted cover-up
- accidents at Three Mile Island and Chernobyl nuclear power plants and discharges of radioactive material from Windscale (later renamed Sellafield) exposed shoddy safety standards in the nuclear industry and the complacent, indifferent attitudes of the regulators and governments
- in response to the BSE epidemic and concerns that it could lead to fatal brain disease, Tory government minister John Selwyn Gummer fed a beefburger to his own daughter in a publicity stunt in front of photographers
I'd discovered that Cannabis wasn't the Reefer Madness bogey it was officially portrayed to be but was safer (and a lot more enjoyable!) than alcohol, but that even its medicinal uses were prohibited by stupid laws. I identified with the counter-culture, Anarchist, alternative and underground movement of Oz, International Times, R. Crumb, Freak Bros, Nicholas Saunders' Alternative London self-help directory, wholefoods, squatting, Green Gatherings and Anti-Nuclear protest, and I'd been active in student protests, the Legalise Cannabis Campaign, peace camps, organising a CND bike ride from London to the Trident base at Barrow-in-Furness, been arrested in Trafalgar Square at a confluence of a Stop The City and anti-Cruise Missile demos and had been taken to court for a non-payment protest against the Poll Tax.
The medical profession I had grown up with tended to be aloof, patronising and arrogant: "trust me I'm a doctor" types who would be personally offended if you asked them to justify their medical opinions and decisions. I knew very little about health and medicine: my only significant health issue had been migraines against which conventional medicine was (in those days) powerless but which some "alternative" therapies — Bioenergetics, Alexander Technique, Feverfew and Tiger Balm — seemed to help with. I knew people who'd had ghastly experiences at the hands of the mental health profession (which had not long abandoned Lobotomy and electric shock treatment and whose only tools seemed to be incarcerating people in Cuckoo's Nest-like institutions and medicating them with powerful and often debilitating drugs) whilst it was people outside the profession who were offering humane, person-centred approaches to psychotherapy (and in the case of early NLP practitioners pioneering a systematic approach based on what could be shown objectively to work).
Given this background I didn't find it hard to suspect that commercial, profit-motive factors and political expedience might be involved in official vaccine recommendations, and while we were thinking about the vaccines issue we came across someone who practiced something called Homeopathy, who matter-of-factly informed us that it could treat any of the diseases vaccines were supposed to protect against if our child did catch them. I knew nothing about homeopathy but I'd somewhere picked up the idea that it was one of those things that nobody knew how it worked but that even doctors acknowledged that it just did. Combined with our distrust of the Establishment in general and the Medical Establishment in particular, and being keen to find a reassuring alternative to the frankly scary prospect of injecting our precious, delicate new-born baby with unknown and irreversible agents, this led us to decide to have him vaccinated only against Tetanus — which seemed a real risk for the active outdoors-ey child we hoped ours would be — but not the rest.
When our second child came along we didn't think so long and hard about it but basically followed suit (though for some reason we didn't even get him the Tetanus shot — possibly that was no longer available singly rather than as part of a multiple vaccine). It wasn't until fairly recently that I started to question our earlier decisions. Partly it was prompted by our older son going off to University: I was aware that Meningitis exacts a continuing tragic toll of University students so I wanted him to be protected against that. I also knew that Mumps Orchitis was not a fun thing to get as an adult man (I'd heard the words "exquisite agony" used to describe it somewhere) so that seemed worth him being protected against as well. And I'd been reading: in particular Ben Goldacre's "Bad Science" had shown me that, whilst the pharamaceutical industry was as venal and corrupt as I'd taken it to be and wilfully perverted the practice of evidence-based medicine to suit its commercial ends, so-called "conventional" medicine is at least in principle based on what provably works rather than the wishful thinking of most ["alternative" medicine"].
Shortly after our older son's innoculations my wife had a minor accident, cutting her hand on rusty metal in the garden, and had a Tetanus booster. This prompted me to think again about our younger son's vaccinations (or lack of them). By this time I knew Roald Dahl's tragic story of how his daughter Olivia died of Measles and did some more reading and realised that such diseases weren't necessarily so trivial. Despite some misgivings on my wife's part (she doesn't share my views regarding alt-med) we agreed for our younger child to have his vaccinations too.
The late Margaret Thatcher famous declared of herself "the lady's not for turning" and in politics, and many other walks of life, "U-turns" and "flip-flopping" are regarded as personal moral failures. This is unfortunate. We all make mistakes: our minds, which evolved to deal with the human-scale world of plants, animals, natural objects and small numbers of other people, are poorly adapted to deal with the complexities of our modern societies teeming with other humans and machines and social structures of mousetrap-like complexity. Studies show time and again that we are swayed by what others around us think to the point of overriding our own judgement, that we pay more attention to evidence that fits our existing beliefs than that which contradicts them, that we (in the West) over-estimate our abilities to understand complex matters, that we see patterns in what is actually random and ascribe cause-and-effect relationships to pure coincidence. Adding to our natural fallabilities a stigma to admitting when we are wrong is not helpful!
We tend to think science is about gravity and relativity and evolution and penicillin and the chemistry that turns oil into plastics and so on, but those are just the fruits of science. None of these fruits would be possible without the ways science has developed of finding out what is real despite our minds' tendencies to mislead and deceive us. One way that scientists do this is by describing in detail what they think and do and sharing it with others who
[pick it apart] looking for faults. Real Scientists do this, and accept it being done to their work, not grudgingly but because that's what validates their work. An idea, or some experimental finding, has little value on its own: the more other experts in the field have checked over the workings-out and tested the theories and repeated the experiments the more valid and accepted someone's work becomes. The reason we accept Einstein's theories of relativity are not that he was a lovable eccentric with crazy hair, but because thousands of people have tested his ideas and time after time they fit the evidence. And the reason science rejects Andrew Wakefield's idea that MMR causes Autism is not distaste for his priviledged background, his dangerous and unethical medical experiments on vulnerable children or that he stood to make millions from his own patented but unproven vaccine, but because the evidence doesn't support his claims.
(Links to articles on how science works in the section below.)
We have different ways of making sense of the world, and specifically of health issues. Some people refer to their own experience or that of people they know. Many of us (at least, those of of older generations) know someone who caught measles or chicken pox or mumps and was just fine, so we tend to think of them as mild illnesses: nothing to be worried about. But we can also find examples of children who caught measles and died (like Roald Dahl's daughter Olivia) or had chicken pox and were brain damaged or died. Individual examples like these don't tell us much about these diseases; we can deduce that they're not OK for everyone — some people can die from them — but that they're not fatal for everyone because most people do survive. Smoking is similar: there are countless tales of people who've smoked 60 a day all their lives and lived to a ripe old age as fit as a fiddle, but there are plenty more who die of lung cancer and heart disease which we know — because we've looked at what happens to millions of smokers and non-smokers over the years — were caused by smoking. So this sort of anecdotal, testimonial evidence isn't good to go on for making important decisions about our children's (or our own) health.
Instinct and intuition are not reliable guides to complex health issues either. When one is no-nappy parenting I'm sure one quickly develops an exquisite intuitive instinct for when one's baby is about to poo (we didn't try this ourselves!), just as we learn to sub-consciously register when they're getting hungry or tired or ill or something's generally not right (or, when they're older, up to mischief!). But our instincts and intuitions also tell us that spiders are more dangerous than cars and completely fail to warn us about all sorts of actual hazards like the damage we can suffer from intense sunshine and what contact with electricity can do to us.
In many ways I'm pretty conventional: heterosexual, cis-gendered, with a wife, a mortgage and two kids. But I'll proudly "come out" as Wrong. I've been wrong in the past about more things than I care to remember, I'm sure I'm wrong about stuff now and will be wrong about things in the future. I identify as a "skeptic" (like a scientist without the white coat: someone who tries to adopt a scientific attitude even if they don't do science for a living). I think there's an objective reality which exists independently of what we believe: we can fool ourselves but we can't fool nature; we can have our own opinions but we can't have our own facts. There either is or there isn't a god or gods, angels, fairies, life after death, telepathy, a Higgs Boson, gravity waves and dark matter. The planet either is or is not warming significantly. There are various factors that cause cancers, HIV, Autistic Spectrum Disorders, Diabetes and heart diseases. By careful, clever and honest investigation — often coupled with plain good luck — we can discover the reality of these matters. But often nature — and our human nature — will mislead us, and we have to recognise our prodigious talent for being wrong and humbly change our minds when the evidence suggests so.
I think I was wrong about vaccines and disease when our first child was born. I'd read up on vaccines and diseases and thought I understood the issues — to be honest I thought I understood them better than the doctors who were advising us otherwise. I was a classic example of the "Dunning-Kruger effect": not only did I not really understand the subject but I didn't even realise how little I understood!
I think we (and others around us) were lucky that neither of our children got measles or mumps or diphtheria or whooping cough and that my wife didn't catch German measles while she was carrying our children. For that I think we largely have to thank other parents who did vaccinate their children for the community (or "herd") immunity that protected ours. And of course the medical science that made vaccine protection and that community immunity possible.
The issue of vaccines, and whether to vaccinate or not, arouses heated debate and, sometimes, outright vilification of those with differing opinions. I don't wish to contribute to that. Issues like vaccination — and many other health issues, not to mention climate change, genetic engineering, nuclear power and other topics prone to generate more heat than light — are generally outside the competence of the lay person to understand thoroughly. Even if we know how to read a scientific paper (and know what papers to read to find out about a particular subject) many relevant papers can be prohibitively expensive to access for those of us outside the academic or research communities. And the scientific literature is written by scientists, for scientists and is pretty impenetrable to those (even other scientists) without a grounding in the subject area. So how can we make sound judgements? Who can we rely on for advice: government agencies, health authorities, doctors, science journalists, the media, bloggers, self-appointed experts, celebrities, campaign groups, our friends, our own intuition and instincts ... ?
Trust me, I'm a blogger
Agencies such as the World Health Organisation, the US Centers for Disease Control and the UK's Health Protection Agency present the official views. Some people are probably entirely happy with official recommendations, but they are probably not reading this! At the other end of the spectrum there are those who think there's a massive global conspiracy and all the official bodies are lying to us; I will leave those folks to suggest why (whether it's because they're in the pockets of Big Pharma or that vaccines are being used to implant us all with tracking agents). But I don't think you have to be a paranoid conspiracy theorist to be a bit sceptical of official recommendations: government agencies are bureaucracies and subject to political and commercial influences and inertia and sometimes plain old incompetence. So where can one go for a second opinion?
I don't think there is any single 100% reliable trustworthy source. Obviously in the case of a medical issue such as vaccination medical doctors and researchers may at least have relevant knowledge of the issues, but being doctors or researchers doesn't make them all world experts in every field of medicine, and there are plenty with cranky ideas which are probably plain wrong. (And then there are those who are "doctors" because they have a PhD — which can be in anything from Ancient History to Zoology — not to mention those who simply buy academically-unaccredited correspondence course qualifications.)
Apart from medics there is no shortage on the internet of lay people and groups weighing in to advise us about vaccines, whether for or against. They're usually very clear in their pro- or anti-vaccine agenda and one has to wonder: if some new evidence came along that contradicted their position would they embrace it and change their stance, or ignore it or deny it? And this is where I find myself judging the sources I value.
I have mentioned Ben Goldacre: blogger, sometime Guardian columnist and author of "Bad Science" and "Bad Pharma". He's a doctor and medical researcher but doesn't big up the "Dr" title and in his books and blog posts he fairly even-handedly takes apart the defects he sees in conventional medicine (his book "Bad Pharma" is all about that), alternative medicine, the media, education and much else beside. I don't suppose he's right about everything (and on his blogs there are often commentators pointing out errors he's made) but he seems to be more interested in what's factual than what supports a particular agenda.
Another medic and blogger who seems more interested in truth than agenda is Orac. For example in a blog post about Steve Jobs' illness and death he criticises a "skeptical", anti-alternative-medicine blogger for claiming that Jobs died because he initially pursued "alternative" treatment for his cancer; Orac points out that the evidence does not support such a claim. I find people like this much more plausible than those who seem to want to fit everything into their pro- or anti-alternative medicine views.
A feature of many bloggers' writing I dislike is their disparaging references to those they strongly disagree with. An example from Orac's article on Steve Jobs is his reference to an alt-med proponent as a "despicable crank". There's no need for this: one can express strong opinions in "parliamentary" language, and excoriate ideas one despises, but I think ad hominems polarise discussions and make communication between people with differing views harder. This is particularly pertinent to an article by Orac on the psychology of parents' decisions whether or not to vaccinate their children. Entitled (without a hint of irony) "Winning antivaccine hearts and minds" the content of the article is thought-provoking and potentially of interest to parents inclined either way, as it shows how much we may be swayed by what our friends, relatives and neighbours think, but it is couched in such belligerent language that only those fairly firmly rooted in the pro-vaccine camp would be likely to read it.
As Orac's 'winning hearts and minds' piece shows valuable information may be conveyed in off-puttingly partisan language and if we are to consider things open-mindedly we have to see past the rhetoric, whether tirades against "quackery" or allegations of being a "shill" for "Big Pharma", and digest the factual content.
An important aspect of sources that gives me confidence is where they give references for the evidence they present, and where the references are to authoritative sources, especially peer-reviewed scientific literature. However the mere presence of such references isn't a guarantee of accuracy: the references may not back up what the author is claiming! Although there are papers that aren't freely available to the general public a reasonable number of them are and I find many worth reading and at least trying to get the gist (to be honest a lot goes over my head). Even for papers that aren't themselves freely available their abstracts are usually online and these should at least convey what the paper is claiming. The fact that a paper has been published in a peer-reviewed journal doesn't make it the authoritative word on its subject: it should just mean that its methods are reasonably sound and its conclusions have some plausibility. It can still, however, be wrong and sadly, as Goldacre points out, a journal that publishes a paper may not publish a follow-up that confirms its findings, or even one that contradicts them! And of course papers can get published that are the results of scientific fraud, like that of Wakefield and his collaborators in 1998, and which are subsequently retracted. So one paper on its own doesn't prove anything: only in combination with other work does it build up a convincing body of evidence. Even if Wakefield's research had been genuine, and even if it had involved enough children to give us confidence in his findings, it would have required other people's work confirming his findings to give us reasonable confidence in them.
I think Wikipedia is often quite reliable. Even where articles about contentious issues have been subject to editing by people eager to convey one side or another of an argument the process often involves them challenging the references cited by their opponents so that the article becomes based on pretty reliable sources.
With newspapers (either online or in print) I look for the name of the article's author: are they a science journalist? As Goldacre points out newspapers seem to think non-science-specialists are capable of covering important complex science issues although they wouldn't dream of letting the same general journalists tackle major complex finance, politics or sport stories. And even science journalists can find themselves out of their depth in branches of science they have no particular expertise in. BBC News seems generally more trustworthy. However news reports rarely give references, although sometimes Googling the names of researchers or institutions or keywords mentioned can get to the source of a story.
I'm a bit suspicious of most health-related websites and blogs. Many of the 'skeptical' blogs seem to adopt a didactic approach: the authors seem certain that they are right and are telling their readers about it. I think the authors probably do know what they're talking about but they often seem to be selling their particular point of view in black and white terms rather than exploring an issue that may be more complicated and less clear cut. It's possible to draw on perfectly accurate material but still convey a biased view of the world by selecting what to include or exclude. My litmus test would be how they would react to evidence that severely challenged their views; say, that MMR did cause Autism, or that homeopathy or acupuncture worked. I don't think any reputable skeptic or scientist would outright reject sound evidence, but I imagine someone like Orac might evaluate such evidence more open-mindedly and with a genuine curiousity and interest, than many others.
On the other side of the fence, however, commentators like Dr Joe Mercola, the whale.to website and Natural News seem to live in a world of Big Pharma / Medical Establishment [conspiracy theories]. Whilst we know that Big Pharma does do many bad — and some downright evil — things, and they corruptly and deleteriously influence much that goes on in medicine, they don't run the whole world or even everything that goes on in medicine: there are safe and effective treatments and honest, independent-thinking doctors and medical researchers within "conventional" medicine, and unscrupulous charalatans within the "alternative medicine" industry. So I don't find these sites to be sources of unbiased information! (I am sure some of what they say is true but — as with the more polarised skeptic sites — I suspect the facts don't support the story they're trying to tell with them.)
Place your bets
We somehow have to sift through our uncertainties regarding the available evidence and take a decision which can irrevocably affect our child's health — or even make the difference between life and death. It's not an enviable position to be in. We have to decide whether:
- vaccination is a conspiracy engineered by evil corporations, governments and/or the shadowy organisations that really control everything to profit Big Pharma and maybe worsen the health of the people in order to control and profit from us all,
- medical researchers, epidemiologists, public health analysts and all others concerned don't really understand the immune system, disease and its transmission
- medical science, the pharmaceutical industry and government agencies work together seamlessley to bring us the best healthcare available at all times regardless of cost or political expediency,
- or something in-between.
How plausible are these possibilities and what are the implications?
If vaccination really is a huge conspiracy of the sort alleged by Mercola, Natural News & Co, and vaccines are designed to harm our kids rather than protect them, then presumably all the history of deaths and disability from infectious diseases, and children in Iron Lungs, is a fabrication to bolster the conspiracy, and "polio survivors" are stooges. If so is it enough to simply refuse vaccination for our kids? Could a conspiracy so Big-Brother-like that it can manipulate history be so easily thwarted? Surely they could find ways to surreptitiously inject our kids, perhaps like the pellet gun used to assasinate Georgi Markov? To keep our children safe we would need to take them away from the world and live self-sufficient and survivalist-style, repelling all strangers in a mountain eyrie or a securely guarded compound like Osama bin Laden's family. And if there is such a powerful and pervasive conspiracy how come it hasn't silenced Natural News' Mike Adams and others who daily "expose" it?
What if there's a lesser, medical conspiracy of the sort darkly implied by Joe Mercola and Andrew Wakefield, and Big Pharma is covering up harms such as MMR causing Autism (and probably a host of other diseases)? Even this conspiracy would have to be pretty pervasive, subverting different groups of researchers around the world and falsifying huge numbers of the medical records in the UK, Scandanavia, Japan, the US and elsewhere that provide the mass of evidence disproving large-scale vaccine harms. And then one has to ask why they didn't also cover up, say, problems with the Urabe strain Mumps vaccine in MMR, or whole-cell Pertussis or oral Polio vaccines — and many others that have been publicly acknowledged to have had safety issues?
My personal punt is that
- biology and immunology really is complicated: it's not just medical researchers and practitioners pretending so to protect their lucrative jobs,
- medical science generally does understand diseases and immunology pretty well, and a lot better than us lay people doing our "research" on Google,
- governments don't spend money on vaccinating citizens unless they're pretty sure that it will result in saving money overall by reducing death and illness (especially expensive hospital care) by preventing disease,
- there's pretty good monitoring of both disease levels and vaccine side effects (including credible possible long-term effects),
- nothing's perfect: some vaccines turn out to be less effective or to have worse side-effects than expected (and, scanadalously, sometimes a government will use a cheaper, worse vaccine when a better but more expensive one is available),
- the whole business of vaccinating practically the entire population is very high profile so there's a huge incentive for the Powers That Be not to get it too badly wrong, so:
- vaccines, disease risks and vaccination programmes are monitored and revised reasonably well.
What do you think? (You can email me via the link in the comments section.)