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The Slippery Slope Of Anti-Vaccine Complacency

I got a package in the mail today: My very own (complimentary) copy of Paul Offit’s new book, “Deadly Choices; How the Anti-Vaccine Movement Threatens Us All.” Needless to say, I can’t wait to read it. Not coincidentally, Dr. Offit has been making the rounds of interviews in the wake of the book’s release. Although I haven’t heard any of them directly, I did see a reference to this NPR interview on the FaceBook page of an old friend, who quoted from it thusly:

IRA FLATOW:  You write that some pediatricians will not see kids who are not vaccinated. Is that a good solution to the problem?

DR. PAUL OFFIT: I don’t know what’s a good solution to that problem. And I feel tremendous sympathy for the clinician who’s in private practice. On the one hand, and my wife sort of expressed this, she’s a general practitioner, a pediatrician, you know, she’ll say, you know, parents will come into her office and say I don’t want to get vaccines, including, for example, the Haemophilus influenzae vaccine, which is vaccine that prevents what was, at one point, a very common cause of bacterial meningitis.

And, you know, we’ve had three cases or three deaths, actually, from this particular bacterial form of meningitis in the Philadelphia area just in the last couple years.

And, you know, to her, it’s like, you know, let me love your child. Please don’t put me in a position where I have to practice substandard care, which can result in harm, which can hurt your child. Please don’t ask me to do that.

And I certainly understand the sentiment. On the other hand, if you don’t see that child, you know, where does that child go? Do they go to a chiropractor who doesn’t vaccinate?

I think it’s hard because then you lose any chance to really immunize the child.

My friend then offers his take, that of a pediatrician in private practice. Read more »

*This blog post was originally published at Musings of a Dinosaur*

Influenza: It’s Not “Just The Flu”

One of our readers suggested that I review the book The Great Influenza: The Epic Story of the Deadliest Plague in History, by John M. Barry. It’s not a new book (it was published in 2004) but it is very pertinent to several of the issues that we have been discussing on this blog, especially in regards to the current anti-vaccine movement. It’s well worth reading for its historical insights, for its illumination of the scientific method, and for its accurate reporting of what science has learned about influenza.

In the great flu epidemic of 1918, influenza killed as many people in 24 weeks as AIDS has killed in 24 years. It’s hard to even imagine what that must have been like, but this book helps us imagine it. It tells horror stories: Children found alone and starving beside the corpses of their parents in homes where all the adults had died, decomposing bodies piling up because there was no one left who was healthy enough to bury them.

Sometimes the disease developed with stunning rapidity: During one three-mile streetcar trip, the conductor, three passengers, and the driver died. In another incident, apparently healthy soldiers were being transferred to a new post by train: During the trip, men started coughing, bleeding, and collapsing; and by the time it arrived at its destination, 25 percent of the soldiers were so sick they had to be taken directly from train to hospital. Two-thirds of them were eventually hospitalized in all, and 10 percent of them died. The mind boggles. Read more »

*This blog post was originally published at Science-Based Medicine*

What Does “Anti-Vaccine” Really Mean?

We write a lot about vaccines here at Science-Based Medicine. Indeed, as I write this, I note that there are 155 posts under the Vaccines category, with this post to make it 156. This is third only to Science and Medicine (which is such a vague, generic category that I’ve been seriously tempted to get rid of it, anyway) and Science and the Media.

There is no doubt that vaccines represent one of the most common topics that we cover here on SBM, and with good reason. That good reason is that, compared to virtually any other modality used in the world of SBM, vaccines are under the most persistent attack from a vocal group of people, who, either because they mistakenly believe that vaccines caused their children’s autism, because they don’t like being told what to do by The Man, because they think that “natural” is always better to the point of thinking that it’s better to get a vaccine-preventable disease in order to achieve immunity than to vaccinate against it, or because a combination of some or all of the above plus other reasons, are anti-vaccine.

“Anti-vaccine.” We regularly throw that word around here at SBM — and, most of the time, with good reason. Many skeptics and defenders of SBM also throw that word around, again with good reason most of the time. There really is a shocking amount of anti-vaccine sentiment out there. But what does “anti-vaccine” really mean? What is “anti-vaccine?” Who is “anti-vaccine?”

Given that this is my first post for SBM’s self-declared Vaccine Awareness Week, proposed to counter Barbara Loe Fisher’s National Vaccine Information Center’s and Joe Mercola’s proposal that November 1-6 be designated “Vaccine Awareness Week” for the purpose of posting all sorts of pseudoscience and misinformation about “vaccine injury” and how dangerous vaccines supposedly are, we decided to try to co-opt the concept for the purpose of countering the pseudoscience promoted by the anti-vaccine movement. Read more »

*This blog post was originally published at Science-Based Medicine*

More Unvaccinated Children Cause Public Health Fears To Increase

Dr. Robert Sears’ The Vaccine Book, is, as Dr. Rahul Parikh puts it, “a nightmare for pediatricians like me.”

In a piece from Salon, Dr. Parikh brings his issues to the author. The controversy of the book is the so-called “alternative vaccine schedule,” which, as vaccine developer Paul Offit puts it:

…is “misrepresentation of vaccine science” that “misinforms parents trying to make the right decision for their children” in the Journal of Pediatrics. And yet, as a pediatrician myself, I have seen an increasing number of caring, reasonable parents hold it up like a bible in my practice (and that of my colleagues).

This post, however,  isn’t about the vaccine controversy — I’ll leave you to read Dr. Parikh’s excellent piece for yourself.

What I found interesting was a passage discussing the public health fears stemming from an increasing number of unvaccinated children. Read more »

*This blog post was originally published at KevinMD.com*

High-Dose Flu Vaccine For Older Adults

Dr. Novella  has recently written about this year’s seasonal flu vaccine and Dr. Crislip has reviewed the evidence for flu vaccine efficacy. There’s one little wrinkle that they didn’t address — one that I’m more attuned to because I’m older than they are.

I got my Medicare card last summer, so I am now officially one of the “elderly.” A recent review by Goodwin et al. showed that the antibody response to flu vaccines is significantly lower in the elderly. They called for a more immunogenic vaccine formulation for that age group. My age group. One manufacturer has responded. Read more »

*This blog post was originally published at Science-Based Medicine*

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