A trawl around the blogosphere finds Lance Knobel in agreement with a piece by Will Hutton in the Observer on the MMR vaccine and media reporting of science. Hutton’s main point is that although most (British) doctors believe the vaccine is safe and that there is no link to autism, the media report the debate to give a completely different impression.
bq. The dissident, so-called whistleblower, however dodgy the research on which his or her ‘evidence’ is based, is afforded massive attention; it is taken as axiomatic that the mainstream, evidence-based government-endorsed view will be self-serving and wrong. More than half of us believe the medical profession is divided over the health risks of MMR; in fact, it is more or less united that there is no risk.
As Hutton remarks, the rate of vaccination for measles in the UK is now so low in some areas that the risks of an epidemic are real. Those parents who listened to the alarmists and end up with a dead or permanently brain damaged child as a result of scaremongering will have cause both to regret their actions and to resent those who represented fringe dissidence as on a par with mainstream opinion.
Hutton continues:
bq. The Royal Society has become increasingly concerned; the scientific community feels beleaguered. It proposes a register of journalists known to treat scientific research fairly, along with ready access to media advice. Scientists have come to dread rather than celebrate interest from the media because they know the mission is to sensationalise or, in some way, draw blood and so score a wider political point. The media respond that the Royal Society wants censorship; to write sympathetically about its concerns is to court being dubbed an establishment lackey.
There’s certainly no danger of such “censorship” in the sister paper of Hutton’s Observer, the Guardian, which today publishes an attack on the Royal Society by one Andy Rowell (provenance unknown), with the subtitle “The Royal Society must not be allowed to stifle the GM debate”. Among the real gems of Rowell’s piece is the following thought: “The scientific establishment’s obsession with the ‘peer review’ means important science that raises risks of GM technology is side-lined.” The rest of the article consists of dubious and unsupported claims that critics of GM have been harrassed and persecuted, including the hapless Arpad Pusztai, who has been thoroughly discredited.
Perhaps Hutton should have a word with his colleagues.
{ 39 comments }
Jack 08.19.03 at 11:21 am
Most British doctors are not in a position to reach an informed decision about the relative safety of MMR vaccines, they are too busy and do not have direct access to research, they must rely on received wisdom.
Mr Hutton’s assertions are in any case as unsupported as his colleagues.
Much debate on the MMR vaccine falls into a false dichotomy. There are in fact at least three options:
Abandon MMR
Use MMR
Use separate vaccinations using different technology.
While it is clear that almost everyone would think that of the first two the latter is preferable, it is the refusal to countenance the third that is strange. There is no significant safety concern but the government has decided that separate vaccinations will not be provided.
The arrogance of this decision and the clearly heavy handed and occasionally “dodgy dossier” like use of statistics is surely at lest as much to blame as actually not to sensationalist reporting of the matter. The closed process of the decsion making process involved is bad and will be a major cause of any measles epidemic that follows.
Jack 08.19.03 at 11:25 am
“at lest as much to blame as actually not to sensationalist reporting of the matter.”
should be
“at least as much to blame as is the actually not too sensationalist reporting”
Chris 08.19.03 at 12:15 pm
FWIW, the official NHS reasons why MMR should be preferred to separate vaccinations are in this PDF.
Jack 08.19.03 at 1:12 pm
The note is patronising and disingenuous. To deal with its main point the policy of not allowing choice has not improved take-up or there would not be a fuss.
The six injections argument is the best one and any parent who has had their child jabbed will find it quite compelling.
The argument about gaps in protection is spurious because it applies equally to MMR.
Beyond nothing in the article discriminates between the two vaccination processes.
The leaflet does not mention cost or exclusivity deals with the supplier.
In particular I doubt that the parents who go to the trouble of asking for an alternative will be the ones who miss out on further injections.
Anyway my point is that Will Hutton is just shooting his mouth off. Of course what he s talking about can and does happen but he is dramatically an importantly oversimplifying to make a dinner party debating point.
E Young 08.19.03 at 2:11 pm
Talking to many parents who are genuinely concerned for their children’s welfare, and to doubt the efficacy of the MMR injection, is a justifiable expression of concern!, is the growing feeling that the medical profession is not to be trusted.
Their vehemence in the defense of MMR, is not reassuring, but suspicious. Couple this to a total distrust of almost everything the Government is involved in, and the low regard for drug company sales tactics, and you have the MMR problem.
Tales of GP’s being financially penalised for not meeting vaccination quotas, fuel the doubt and distrust. As a previous commenter said, heavy-handed, bullying tactics are not good PR, and the patronising attitude does not help either.
It would seem that with the US and UK Governments, both trying to maintain a united front where MMR is concerned, that, rightly or wrongly, there must be some ulterior motive behind the whole scheme.
Another contributing factor is the idea that the cure is worse, and far more risky , than the disease. With Mumps. Measles and Rubella, being seen as far less dangerous than condemming a child to a lifetime of autism, for which there is no cure.
Childhood memories of having had any of the three diseases are of being unwell for two or three weeks, and then back to normal. The idea of contracting autism is horrifying in comparison.
All the PR and rhetoric have left more doubt than reassurance.
E Young 08.19.03 at 2:17 pm
Sorry – read Will Huttons piece, but did not read Lance Knobel’s.
Did not want to repeat their words, but maybe my comment confirmed some of findings.
Chris 08.19.03 at 2:25 pm
bq. “Childhood memories of having had any of the three diseases are of being unwell for two or three weeks, and then back to normal. The idea of contracting autism is horrifying in comparison.”
The very serious (indeed sometimes “horrifying”)complications and dangers of measles, mumps and rubella are well documented as is the incidence of such after-effects. Claims about those risks are based on decades of research and experience. The link between autism and MMR is purely speculative and afaik, large scale studies have failed to support such a link.
Timothy Burke 08.19.03 at 3:35 pm
On one hand, yes, when people come to a crypto-theological conclusion about something like vaccines, they now commonly reach for a quasi-psychotic confection of dissenting studies and evidence to create a rhetorical case for what is effectively a mystical or religious decision. In one virtual community I have participated in, a concerned parent posted in a forum about how she was going to avoid vaccines for her newborn, and not merely because of the supposed autism-MMR link, but also because of the fractional risk that the child might contract the disease for which he was being vaccinated. I found this pretty outrageous, because the mother in question was ultimately pretty frank that she was exploiting the willingness of everyone else in her community to vaccinate their children and accept this risk. (E.g., in a community where 99 children are vaccinated against pertussis, 1 child can forgo the vaccine without fear of pertussis and have no risk from the vaccine itself to boot).
When challenged, she directed some of us to a website that compiled information about the harmful effects of vaccines. It was one of the most dishonest, filthy things I’ve ever seen, misinterpreting many studies with a dedicated malevolence and offering data that was simply frankly bunkum of the worst order–casually conflating late 19th Century vaccination technology with early 21st Century vaccination technology in terms of measuring effectiveness, for example.
And yet. And yet.
There are two things that most scientists and doctors who express frustrations about these beliefs simply don’t understand. The first is, that while it may not be rational (or civic) to avoid vaccination (or many other things) based on the evidence available, it is rational to suspect that the evidentiary materials scientists and doctors are assembling may be suspect in their particulars or even in their broad outlines. Everyone laughs at the scene in “Sleeper” where we find that doctors have discovered that smoking and fatty foods are very good for your health, largely because we recognize the truth behind the laugh, that science really does have paradigms and that paradigms sometimes impede understanding–and that public policy and fear of public reaction also keeps scientists and doctors from frankly admitting the truth of some of what their data shows. Look at how frightened many doctors still are of the overwhelming evidence about the beneficial effects of moderate consumption of alcohol, especially red wine. It’s not as if doctors instantly bow to the truth of their data, and sometimes their data also contains genuinely messy information about what is true and not true. The non-scientific public grasps this particularly well, and it makes a lot of their skepticism and willingness to ignore bodies of scientific evidence at least partially rational–especially in cases like autism, where the condition is poorly understood and where its rising incidence is largely mysterious.
The other thing that many scientists do not grasp when they decry public irrationality about gauging risks is that we don’t evaluate risks through probability. We evaluate risks through narrative. Meaning, we tell stories about the consequences of risking and losing and decide based on the qualitative evaluation of the tragedy or pain involved and the relative preventability of the events that would incur that pain.
So if someone tells me that there is a certain risk involved on an everyday basis that a very small meteor would fall on my child’s head and kill her, and an almost equal risk that a woodchuck living in our backyard might develop rabies, bite her suddenly one afternoon when we weren’t watching and that she would die from rabies because we failed to see the very small bite and didn’t believer her that a monster bit her, there’s a clear difference even if the probabilities are exactly the same.
The difference is in the narratives. The meteor is a freak event. I can do nothing to prevent it, and would feel no guilt, just loss. The woodchuck is different, because I could have prevented it several ways (trapping the woodchuck, watching her more closely, listening when she says a monster bit her). Probability is not the razor that separates these things.
And this is also then what is happening with vaccination and autism. Parents tell stories in their own heads about what autism is and what is would mean, and those are very bad stories–a bright, ‘perfect’ child without any problems suddenly turned into a child who is cut off from emotional and intellectual connections with the world. And they tell stories about what it would mean if it turned out one day in the future that something they did (vaccination) was what caused this thing to happen. The badness of that story is reason alone for a few parents to turn aside, and that’s perfectly understandable if incorrect–because it is how we actually (usually correctly) evaluate the real meaning of probability in our lives.
Jack 08.19.03 at 3:39 pm
MMR vs no vaccination == no contest.
Even if the risks were proven it would save many more lives than it damaged.
That isn’t the issue. There is an alternative vaccination process which does not seem to bear the supposed risk of autism. The government may think if it had to choose between the two MMR would be the way to go and might even be right but it doesn’t so why has it?
It is not clear that there is no scientific evidence and all that is at stake is whatever difference there is between the two vaccination programmes. While as an initial guess the fewer injections required for MMR might have improved uptake but clearly that is not the case now.
If the state of medical statistics was better we might not have so much trouble in casses like this but studies are ften very poorly designed and anyway use very little data, very little research happens after products are launched and vaccines have the worst case where they are given to enormous numbers of people to prevent diseases that are usually not very serious and where relatively small sums of money are at stake.
Quite why the government is so dogmatc on MMR over separate injections is a mystery and does not flow from their stated concerns in an obvious way.
Tripp 08.19.03 at 4:12 pm
jack,
Perhaps the medical establishment prefers the ‘devil they know’ to the ‘devil they don’t’.
Specifically, who is to say that the new vaccination process won’t have worse unforeseen effects?
E Young 08.19.03 at 4:48 pm
I was just reminded that our esteemed leader, when asked if his children had been vaccinated, was somewhat reticent. It turned out that his children had NOT been vaccinated.
Good PR, and certainly gives rise to even more suspicion.
Timothy, your condemnation of the site you visited, was probably warranted, but the – and I quote – It was one of the most dishonest, filthy things I’ve ever seen, misinterpreting many studies with a dedicated malevolence and offering data that was simply frankly bunkum of the worst order, — could, to a dedicated non-believer, be applied to much of bullying rhetoric of the pro-vaccination lobby.
You know the old adage re statistics, and it does seem strange that it was only with the advent of the MMR vaccination – either singly or together, that these ‘horrifying’ statistics became common knowledge. The tactic of suddenly producing ‘statistics’ to back an action, has been seen too many times in the past, to be accepted at face value. It is hardly surprising that narrative proof is more acceptable than some bureaucrat’s statistics.
Maybe, just maybe, the superior, and, dare I say, arrogant attitude of the medical profession and their mentors in Government, are as much to blame for the non-acceptance of MMR and their credo of ‘Do as we say, not as we do’
Chris 08.19.03 at 4:59 pm
e.young
bq. “I was just reminded that our esteemed leader, when asked if his children had been vaccinated, was somewhat reticent. It turned out that his children had NOT been vaccinated.”
I don’t think you are right about this. Blair refused to answer questions about the medical treatment of his children in the face of journalists baying for him to do so. Quite right too. It has never emerged afaik that Leo was not vaccinated and a quick google appears to support this. But if you know differently, post the url.
Chris Young 08.19.03 at 5:13 pm
This is an unbearable discussion, because there are two important issues at stake, and even their relative importance isn’t open to comparison.
1. How do you defend genuine science against the various relativist, new-age and generally post-interesting subjectivists whose books are coming to infest the “science” shelves of our bookshops and libraries – see Chronicle of Higher Edu, via Butterflies and Wheels for a post on Ethno-mathematics, for crying in the beer?
2. How do you judge what is an acceptable risk to subject your children to?
The easy one first. My brother-in-law and his wife, who is a senior nurse, incurred crippling expense and a small risk of prosecution to get separate vaccinations for their children in the last five years.
Will anybody swear they wouldn’t have done the same? If they could have found the money? If they had known where to go? Look, it’s their kids – don’t tell them what are acceptable odds.
Now the hard one. The Royal Society doesn’t work on individual cases. They see the whole edifice of scientific integrity called into question by people publishing bullshit from crop circles to creationism, and they want to defend it.
The peer review process is universally accepted as being imperfect, but until somebody devises a more – dare I say – measurable way of establishing quality in publication, it is the only way of establishing a base line for comparability of results.
Thousands of papers are referred all the time to authors who either revise them or roll with it and move on. What is the matter with the handful who don’t accept this?
And then there is the First Platitude of research – you can’t prove a negative. If a hundred labs tried to replicate Wakefield’s results every week for fifty years and failed, what would they have achieved? Very low confidence in Wakefield’s proposition, not absolute refutation.
In cosmology or evolutionary biology, that would be sufficient, final.
Good enough for your children?
Which is why the discussion is unbearable. Because from the point of view of the Royal Society, Wakefield’s results are just one more piece of crap work that needs to be put in proportion. Because if it isn’t, then the floodgates are open to every pseudo-scientific wingnut who can find a tabloid journalist who’s impressed by big words. And Kansas can teach Genesis as science and Tex Colson can prove that preaching stops re-offending (Mark Kleiman)and so on. But your children?
Ah, I dunno, as Mark Twain would say, when he did. PS. I don’t take a position on whether the government’s decision to refuse separate jabs is underpinned by economic concerns, and I do agree with Jack that if the alternatives are MMR or no shots then there’s no contest.
Walt Pohl 08.19.03 at 5:34 pm
Clearly the government agencies involved should do whatever’s needed from a PR perspective. But it’s hard to fault them for being taken aback by this whole development. The media has been totally unobjective on this issue. I was convinced myself that the MMR vaccine was causing autism until I read some more about it.
Howie Kurtz 08.19.03 at 7:48 pm
it is taken as axiomatic that
Did George Will ghost write this piece?
zizka 08.19.03 at 9:33 pm
Dwight Meredith of PLA as well as the Wampumblog blogger have been following this issue closely (both have autistic kids). As far as I know, they’re both wait-and-see on the facts, but not too happy with the profession’s response. Since the preservative has been discontinued, as I understand, a natural experiment will give us an answer in a few years.
Apparently there has been a real, quite large, increase in the incidence of autism (not explainable by statistical glitches, reporting changes, or reclassification). So if it’s not vaccination, people should be looking for the cause elsewhere.
I’m a bit surprised that any mercury compound is ever used in medicine. A friend of mine was permanently disabled by a mercury compound used in dermatology; something about her skin apparently made her absorb more than other patients did, but it seems knowing things like that is what we have dermatologists for.
Damien Smith 08.19.03 at 9:34 pm
I find it interesting that Hutton kept his comments confiend to MMR. He could easily have broadened his discussion to include the uncertainty inherent in global warming, or, as Chris pointed out, the debate about GM food.
I do think, though, tha the government itself had a role to play in this, though. The inept handling of both BSE and foot-and-mouth disease have eroded confidence in government pronouncements based on scientific evidence. NGO’s have also contributed towards making science a matter of interest, not fact; in the foot-and-mouth case, for example, policy was driven bot by animal welfare but by the need to satisfy the National Farmers Union and preserve an export market for British beef.
Timothy Burke is also right about the role of anecdotes vs probabilities. Probability is often counterintuitive, understanding it takes some effort. Established heuristics, couple with narrative, can often prove to be more compelling.
Jack 08.19.03 at 9:34 pm
tripp, the alternatives are well established but have been replaced by MMR so it isn’t familiarity. In any case doctors are being actively prevented from using the alternatives.
In tin foil hat moments I would dearly love to see the contract between the manufacturer of MMR and the NHS
Invisible Adjunct 08.19.03 at 9:43 pm
“I found this pretty outrageous, because the mother in question was ultimately pretty frank that she was exploiting the willingness of everyone else in her community to vaccinate their children and accept this risk. (E.g., in a community where 99 children are vaccinated against pertussis, 1 child can forgo the vaccine without fear of pertussis and have no risk from the vaccine itself to boot).”
That’s exactly right. The anti-vax parents can afford to forego vaccination only because the vast majority of us don’t. I call these parents “free riders.”
I hung out for a while at a virtual community that included a significant contingent of alterna-mommies. What I began to realize was that much of their “progressive parenting” (which often included an anti-vax stance) was basically anti-political in its focus and intent: a retreat to the private; a refusal to recognize any common good or shared civic responsibility. “Nothing matters more than my own child” is sometimes a laudable expression of parental selflessness, but is sometimes a form of displaced narcissism. The world out there is inescapably corrupt, and to compromise on any issue is to compromise not only my own lifestyle choices but also my own personal integrity. So I’ll tend my own garden, and create my own all-organic, all-cloth diaper, no vaccination utopia, and to hell with what they say about public health.
E Young 08.19.03 at 9:53 pm
Chris,
What a can of worms – did as you suggested and did a little Googling.
Most links were commenting on the Blairs refusal to answer, one way or the other.
http://society.guardian.co.uk/publichealth/story/0,11098,622403,00.htm
and 800 others in similar vein.
An interesting link was:
http://www.whale.to/v/mmrtemple.html
Commenting on Cherie’s health guru advising against vaccination, but still -‘no comment’
Then paydirt:
http://news.independent.co.uk/uk/health/story.jsp?story=117824
02 February 2002
Tony Blair’s son Leo was given the MMR vaccine last week, The Independent learnt yesterday, as health officials disclosed that the number of babies being immunised was lower than ever.
However, later that year:
iaindale.blogspot.com/2002_03_01_iaindale_archive.html
gives us a contradictory tale:
Sunday, March 17, 2002 ::
I have it on very good authority that Leo Blair has NOT had the MMR jab after all, and instead, has had three separate jabs. Downing Street at first refused to confirm or deny that Leo had had the MMR jab, saying that it was no one’s business. The Great Leader then said that it was ridiculous to think that his government would be giving advice to other parents which he and Cherie would not be prepared to follow themselves. But I have been told that the Conservative Health Spokesman Liam Fox is about to reveal that he knows that Leo has not had the jab. Or is he? We should know this week… If this is in fact true it is hypocrisy of the first degree. Ok, it’s not the first time that New Labour has displayed this characteristic, but it would surely be the most blatant example.
There was another link – which, as luck would have it, I can no longer find, which positively suggested that Leo had been given three separate injections.
This would all seem to suggest that the Blairs’ also had their doubts and misgivings about the triple jab, that they took their time to form an opinion, is to their credit, considering the pressure they must have been under. The smarmy evasion of a direct answer is typical of a politician stalling for time.
My take is that Mrs.B did not want it, while Mr.B was for it, if only for appearance sake, and he took a while to win her round, with the compromise of three single jabs, which is just the option that so many ordinary folk wanted in the first place.
Amazing how stubborn A Blair can be at times, and strange that that was the only link I could find that had positive confirmation of ‘the jab’, surely something of such universal interest would have attracted more comment.
Jack 08.19.03 at 11:19 pm
And why should we know where his kids go to school and not whether or not his kid had the injection. It seems less personal and of greater public interest.
Dan Simon 08.20.03 at 12:38 am
I find the discussion of the possible ulterior motives of the medical community rather ironic. If you Google “thimerosal” (the vaccine additive implicated by various crackpots as the cause of autism) in the US, four of the top ten hits are Websites offering information on thimerosal litigation. When I publicly expressed skepticism about the thimerosal-autism link a while ago, I got a rather strident email from one of these folks that sounded for all the world like he was a crusading activist, rather than a tort lawyer drumming up business (as his email account revealed him to be).
A few years ago, recognizing the devastating potential of liability lawsuits over side effects to destroy the vaccine industry, the US Congress passed legislation to protect vaccine manufacturers. But they left a loophole: liability for the effects of vaccine additives was not covered. Tort lawyers are attempting to exploit this loophole to the maximum, and thimerosal is their weapon of choice.
There are very good reasons to believe that autism actually develops long before its symptoms appear–that is, long before any vaccinations are administered. But there are plenty of people who have a clear selfish interest in arguing otherwise.
Dave Arthur 08.20.03 at 1:59 am
A few comments on different points.
1) Science reporting in the UK press is abysmal, a shocking contrast to their generally superior coverage of politics, economics and things cultural. In politics/econ stories seem well-documented, the ratio of facts and quotes to opinion and analysis is high – as though they think the audience can think through the issues without being spoon-fed opinions. Science coverage looks a lot like culture – there is no story unless it is a parable for modern times, or a tragic conflict, or a conspiracy. I refer to the Times, Guardian/Observer, Independent, and BBC (online and occasionally tv.) I have not read the others enough to comment.
Some reports are not based even on anecdotes, they are based on rumors of anecdotes. E. Young’s best evidence is of a report that someone was practically sure Leo had the three separate injections. Case closed, The Eagle Has Landed.
2) Is it the public’s business to know the medical records about relatives of elected officials? Minors, to boot? How much more appalling an erosion of medical privacy rights could there be? Leo is not a public official, and for that matter, neither is Cherie Blair, who is allowed to agree or disagree with her husband’s policies without doing it in public. I believe this even though I am inclined to believe they are both sensible people who had the standard injections. I suppose it is inevitable that the talented professional political reporters would ask more interesting questions than their science-as-voodoo colleagues, but you folks really don’t want to go down that road.
3) Why refuse to allow three injections, even for a fee? Well, don’t overlook the way many in the medical profession talk to mothers as though it were the 1950’s. Do this, don’t do that. Simplify instructions beyond all recognition, and don’t adjust them to individual circumstances. If breastfeeding has benefits, tell mothers who bottlefeed that they are risking illness, pain and lower intelligence for their selfishness. Don’t change this advice if the mother has medical reasons not to – mastectomies or medications. Having endured that attitude for eighteen months, one can understand why some mothers refuse perfectly sound reasoning on MMR when it is presented as another false dichotomy.
In other words, please don’t assume that they are all New-Agers; put thoughtful, intelligent people on a diet of rumor, accusation and dire warnings from both sides and you should expect some errors.
3a) Not to mention a depleted sense of civic duty to a community that treats one with so little respect.
4) At least the controversy brought out that all MMR brands used thimerosal, for no good reason in countries with reliable refrigeration and transport. the same preservative that used to irritate many eyes twenty years ago in contact lens solution. Once we found out, we (in the US anyway) demanded alternatives, and after a brief period of short supplies, we now have it. Much less hysteria too. (But hideous political reporting, apologies to Howie Kurtz)
5) Speaking of which, this is a blog aimed at people who read philosophy, we’re allowed to say “axiomatic” and expect the audience to understand. Our prose is less punchy and pyramidal than in the Washington Post, but when you earn very little money, you throw around those $50 words instead.
E Young 08.20.03 at 3:34 am
Dave ,
I was not trying to pry into the Blairs personal life, I’m really not that interested. I had previously quoted a hearsay comment, and was quite rightly taken to task for not giving an URL to support the urban legend.
In view of the interest in the matter of MMR, it is surely not unreasonable for interested parties to be inquistive of the PM’s view on the matter.
Unfortunately, politicians, and New Labour in particular, are deemed as untrustworthy, therefore something a little more is expected than just a bland speech of support for a Government sponsored programme, hence the persistence in seeking a positive reply to the question of Leo’s vaccination. The more that they prevaricate, the harder it is for them to be believed.
Looking to please my critic, I searched for longer than I care to admit, there was nothing to say, positively, whether the boy had, or had not been vaccinated.
Mr. Blair has never confirmed or denied the fact, all is supposition. I think the root problem is that the public feels that if we are required to obey, or perform in a certain fashion, then so should our leaders. Any hint of them doing something different immediately raises a red flag, and leads to all the suppositions and rumours.
A politician being allowed to get away with speeding, is one thing, but something as serious as the MMR is altogether another matter, positive proof is required…
I must say that it does seem strange that he suddenly gets a fit of righteousness re his families privacy, when he is quite happy to discuss more intimate matters when it suits his public image.
susan 08.20.03 at 5:39 am
To add to Dan’s comments, the abstract of the study on irregularities in head size during the first year of life in autistic children can be found here: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12865374&dopt=Abstract (sorry for ugly link).
Jack 08.20.03 at 12:11 pm
In the UK the issue has little to do with litigation. In any case while on the one hand the the enormous volumes in which these medicines are distributed practically guarantees that any side effect will show up somewhere and the statistics will be very hard to gather and interpret thus opening the door to litigation, by the same token even marginal safety improvements become important and the requirements of safety even more vital.
While Cherie might not be a public official, recent UK legal precedent allows fathers to insist upon MMR vaccination in direct opposition to mothers so it is clearly Tony’s prerogative. We may not have a right to pry into confidential medical records but this clearly has no reflection upon Leo’s character and is not intrusive. If Leo had been vaccinated it would have been very helpful to the campaign to win acceptance for MMR. If not it is shocking hypocrisy to insist on everyone else doing it. So I don’t think we have the right to access to this information but I find the Prime Minister’s behaviour in this affair puzzling unless he did not have Leo vaccinated.
My position is that if MMR were the only alternative there would be no question that it would be a good thing. I can even see why it would be preferable as a recommendation to separate shots. I however don’t like the way that alternatives that meet the same health policy goals have been all but outlawed. This arrogation of decision making over very personal matters, because unnecessary, unaccountable and counterprductive, is an example of bureaucracy gone badly wrong.
I object to Will Hutton’s article because it is little more than complacent sneering — he could have said the same thing about Thalidomide for all the facts he uses. Bad science is not the preserve of sceptics. The proponents of GM touting marvellous benefits are at least as unscientific. In particular being an expert in gene splicing does not make you good at public or ecological safety. Nor does a debate which treats genetic modifcation as either safe or unsafe. Clearly you can do all sorts of dangerous things with genetic engineering just as you can with drugs. What will happen when agricultural genetic engineering gets its first Thalidomide?
I’m all for challenging bad science where it comes up but it should be challenged with good science, not glib dismissals.
Dave Arthur 08.20.03 at 6:06 pm
E. Young – Of course the public is free to mistrust their leaders for getting away with speeding or for arrogant imposition of policies. No one in this conversation has endorsed arrogance. That doesn’t mean the evidence of the link between autism and MMR is any good, or that there is serious harm involved in giving a child six needles instead of two. Parents should be allowed to choose the latter even though there is no evidence of the former being a problem.
E. and Jack – There may be some public interest in knowing whether the Blairs were hypocritical, but not a public right to the information. Their interest is completely overridden by two important privacy rights: medical privacy and protection of minors. Sure, it’s hard to imagine any harm to the kid based on information about his vaccination, but then again, people might spend the rest of his childhood scrutinizing his behavior for evidence of mild autism. More to the point, however, what other harmless medical information would be considered part of the public domain – AIDS testing? referral for counseling? cancer screening?
Look, if Blair is arrogant and heavyhanded, inexplicably prohibiting separate vaccines at patient’s expense from consenting physicians, then he is equally wrong even if he is not a hypocrite. You can criticize the government – the policy or the ministers – regardless of Leo’s history.
Does anyone really think arrogance and undemocratic leadership are somehow justified by sincerity? Please. Sure, it’s easier to attack him if he’s also hypocritical, but that’s not the right argument. His public position might still be the right one, and the private one wrong. (Jack – Which is why the precedent for fathers overriding mothers is irrelevant; we don’t need to know how they decided or what they decided to judge the regulations.)
The interest in personal medical decisions is merely prurient, a nasty habit in a popular culture used to tabloid coverage of movie stars and politicians. It’s a slippery slope, however, and I really hope your side of the pond resists its lure.
JRoth 08.20.03 at 7:15 pm
I don’t necessarily think that Leo’s medical history should be public record, but I do think that the question is different. It is not prurience that leads to the question. It’s simple human nature.
If someone tells you to do something dubious, the instinctive reaction is, “You first.” Blair & his gov’t are telling the people of England to vaccinate their children one particular way, by one particular drug. And the parents of England are saying, “You first.”
As for the PR aspect of it, images of politicians and leaders publicly engaging in activities they exhort their followers to do are commonplace. Mayors biking to work, Presidents donating blood, they’re all widely-accepted ways of displaying leadership and heading off dissent. I certainly understand the Blairs not wanting to drag poor Leo into this, but I find it churlish to denigrate people for expecting (or at least inquiring after) this sort of symbolic act.
One last thing: people who link thimerisol to autism will only be “crackpots” when you, sir, have another, more credible explanation for a phenomenon that legitimate scientists acknowledge as being real, yet cannot explain. I, and the “crackpots”, await your revelation of The Answer.
Dan Simon 08.20.03 at 7:40 pm
We may not understand what the cause of autism is, but that doesn’t imply that we can’t make very reliable statements about what the cause of autism isn’t. Autism isn’t caused by lycanthropy, and it isn’t caused by animal magnetism, and it isn’t caused by an imbalance of humors. People who believe in any of these causes of autism could quite rightly be called crackpots.
Based on all the strong evidence we’ve seen that autism’s origins precede vaccination in the children it affects, we can say with considerable confidence that autism isn’t caused by anything in vaccines, either.
E Young 08.20.03 at 9:29 pm
Dan Simon,
You state; “Based on all the strong evidence we’ve seen that autism’s origins precede vaccination in the children it affects,”.
This is a very recent view, and appears to be more conjecture than provable reality. (In spite of your choice of words). Assuming that your statement has some validity, if autism was inherent in a child prior to vaccination, then the incidence of autism in any group of children would be constant. It is not, and has not been since the advent of the triple MMR injection.
It is this coincidence, this apparent ’cause and effect’, that has led to so much doubt in the public’s mind.
Jack 08.21.03 at 8:48 am
Dave, the point about the court case is first of all to draw attention to a rather surprising and overbearing decision and secondly to undermine the “it’s up to Cherie and she’s not a public figure” line of reasoning.
I’m not saying the the Blairs must reveal whether or not Leo has been vaccinated, just that I can’t see why they wouldn’t.
I do think it makes a difference however. I refuse to be bound by rules that don’t also bind the Blairs. While I don’t expect to catch measles from Leo I think the process by which such decisions are made is important and if politicians aren’t interested in whether or not they would mind their rules applying to themselves should be an important part of that. I don’t want to be ruled by Lord Farquaad of “many of you may die, but that’s a sacrifice I’m willing to make” fame.
It is also not patently crackpot to worry about Timerisol. It is unnecessary, has been reomved from eyecare products, safety screening tests are actually very poorly designed for testing the safety of somthing that is to be given to millions without an immediate and greater danger — the samples are very small, the surveys are carried out by people with a vested interest in one outcome and becuase of litigation practices a vested iterest in not admitting getting it wrong. Even a tiny effect is important when soething is going to be given to millions of people.
As a point of interest, was it Thimerisol that received protection against litigation in the Homeland security legislation?
Dan Simon 08.22.03 at 1:47 am
“e young” : A few important points….
1) In science, a bad explanation is worse than the lack of an explanation. Pointing to the latter is no excuse for supporting one of the former.
2) Many, many things began around the time of the MMR vaccination. Almost all of them are universally acknowledged not to cause autism (or to have been caused by the MMR vaccine, for that matter). Claiming a causal link based on this one fact is frankly just silly.
3) A massive recent scientific study in Denmark provided strong evidence against a link between the MMR vaccine and autism. (For a refutation of the thimerosal-autism link, see the CDC’s FAQ.)
back40 08.22.03 at 1:57 am
It seemed to me that Chris’s main point was about the low quality of media reporting of science and that the MMR issue was an example.
Hutton’s article was focused on media.
Perhaps there will be another opportunity to discuss Hutton’s question: “When our media are more interested in reporting opinion as fact, how will we ever discover the truth?”
E Young 08.22.03 at 5:28 am
1)Agreed, it was the lack of timely information that caused this argument in the first place, followed by poor explanations.
2)Once again your sweeping statements, (“universally acknowledged not to cause autism,”) are not quite on the mark. Many things were considered as the cause, and subsequently dismissed, but MMR was a persistent suspect. Along with poor clinical practice when the jab was administered.
3)Thimerisol contains ethyl mercury, and it was on this where suspicion lay. Very little is known of the toxicity of low level dosage of ethyl mercury. Thimerisol is now being phased out as a preservative, or the single jab is available if preffered.
New cases of autism in California have fallen since preservative free jabs have become available, even though the same numbers of injections as previous have been given.
Could all be coicidence….
My original comment was to point up the fact that the medical profession was remiss in informing the public, on the merits etc. of the MMR jab, if they, and the bureaucrats treated their clients as adults rather than as imbeciles, then this whole sorry mess may not have happened. Not all the fault lies with the public!.
Will Hutton’s article complained merely of the media’s penchant for reporting rumour rather than fact, a valid point of view.
Dave 08.22.03 at 2:45 pm
“I’m not saying the the Blairs must reveal whether or not Leo has been vaccinated, just that I can’t see why they wouldn’t.”
Here’s one: suppose the next big medical-political debate turns out to be about whether baby boys should be circumcized, or whether the NHS should pay for the procedure. On the one side are opponents of unnecessary surgery and cost-cutters, on the other are American expats and various religious groups; on the first side are people who call those groups barbaric, especially the Americans.
On your logic, the prime minister should tell us how his son was treated, whether it matched his public position. That’s kind of reasonable, but imagine being that child, and later adolescent. Imagine being asked over the years if he wishes his parents had made the other choice.
If you think that’s farfetched, remember that at one point in one of the lawsuits against Clinton some woman described his penis in a deposition, and his doctor had to offer a sworn statement that her description was wrong. There the point wasn’t mere prurience, it was an attempt to humiliate and harass as a political or legal strategy. His good friend Tony Blair is rightly cautious, imo.
“I do think it makes a difference however. I refuse to be bound by rules that don’t also bind the Blairs.”
Agreed. But right now those rules protect your privacy as well.
Look, we have gotten very far off track here (thanks back40!), I agree that it would be awful if he was unreasonably dogmatic about such an emotional issue and did what he forbade others to do. Especially because he makes such a point of his sincerity and moral stance. But to make that the focus of one’s protest is to fight on his territory, and make a weaker case.
Now, instead of discussing the medical question (is the MMR harmful) or the subsequent prudential/political question (is it reasonable to offer separate shots if it will reassure parents), we’re discussing TB’s personality.
Oh, and to E Young, I never used the word “crackpot” even though I disagree with the position. No need for insults.
dsquared 08.22.03 at 5:14 pm
Chris: I don’t think it’s true that Pustzai was “discredited”. Nobody seemed to have the slightest interest in his work, beyond a thorough and shameful hatchet-job.
E Young 08.22.03 at 10:10 pm
Re the use of ‘crackpot’
Dave,
Neither did I – it may have been Jack. Would I ever be so rude?.
E Young 08.22.03 at 10:22 pm
Re Crackpots
Dave,
No, it was also mentioned by jroth
Dave Arthur 08.23.03 at 1:49 pm
E – Oops, I should scroll and read slower. -D
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