Archive for the ‘vaccines’ Category

LBC – laughable, blustering, canting (updated twice)

February 12, 2009

In which Dr Aust finally finds something unoriginal to say about the Jeni Barnett business

Ben Goldacre has been asking over at BadScience that people not post vitriolic or abusive comments to Jeni Barnett’s blog.

I have been having a think back to see if I have said anything vitriolic and abusive. So far the nastiest thing I have said was:

“Jeni Barnett’s astonishingly ill-informed comments, petulant on-air behaviour, and dismissive attitude…demonstrate, yet again, just how idiotic – not to mention dangerously deluded -”personalities” can be when they comment on stuff they know F***-All about.”

All of which might be at the watery end of vitriolic, but seems to me to be well short of abusive.

And I also described the programme as “spectacularly awful” Which sounds about right, although I also liked Holfordwatch’s “lamentable”.

Anyway, while Jeni Barnett’s views about MMR were laughable, the sad truth is that she is (as we are all too well aware) not the only person that thinks that way. Nor are her reasons for holding such views atypical

So why do people hold such extraordinary views on the MMR vaccine?

Well, there is research on this. Of course, there is research on everything. The key question is – why do people believe what they do? The media’s dreadful science can hardly be helping, but is it the whole story?

A few years ago, a social science research group in Sussex did an extended “anthropological fieldwork” type study in Brighton on attitudes to, and beliefs about, vaccination, and on what shaped these attitudes and beliefs. Basically, they talked to and interviewed mothers concerning their beliefs about vaccination. The research appeared in an interim report in 2004, and then latterly in two published papers in 2005 and 2006, which can be found here and here respectively (the first paper resembles the interim report). Let me quote the summary of the report, which is essentially identical to the abstract of the first (2005) paper:

Summary

In the context of the high-profile controversy that has unfolded in the UK around the combined measles, mumps and rubella (MMR) vaccine and its possible adverse effects, this paper addresses how parents in Brighton are thinking about MMR for their own children. Research focusing on parents’ engagement with MMR has been dominated by analysis of the proximate influences on their choices, and in particular scientific and media information, guiding policy to focus on information and education. The ethnographic work in Brighton reported in this paper, to be complemented by survey work, begins to question the validity of such reasoning by showing how wider personal and social issues shape parents’ immunization actions. Extended parental narratives show how parents’ practices around MMR are shaped by their personal histories, by birth experiences and related feelings of control, by family health histories, by their readings of their child’s health and particular strengths and vulnerabilities, by particular engagements with health services, by processes of confidence-building and undermining, and by friendships and conversations with others, which are themselves shaped by wider social differences and transformations. “MMR talk” has become a social phenomenon. Many see vaccination as a personal decision which must respond to the particularities of a child’s immune system. These perspectives both challenge key tenets of public health policy, and suggest ways in which people’s engagements with MMR reflect wider changes in their relations with science and the state.

Now, it is not hard to see in their list pretty much every one of the “arguments” that Jeni Barnett produced on her show, and since.

The question for me is not really why Jeni Barnett said what she said. She was out of her depth. She told us what she sincerely believes, all of which was pretty much rank nonsense in a scientific and medical sense. The only real questions relating to Jeni are first, why she thought that she was able to handle a show on this subject, and second, why she was so dismissive of the people who rang in to put her right, usually politely, and often based on real knowledge. These are both legitimate questions for a professional broadcaster.

More important, though – why did LBC make the segment? Why another – yet another, for Heavens sake – desperately silly MMR phone-in? I remember hearing one of these on Radio 5 Live (as it was then) back in 1999 or so. I heard it while driving down the M42 in the old (though then almost-new-ish) Aust-mobile, and it nearly made me drive the car off the road, so relentlessly stupid was it. But I really hoped we might have moved on a bit in the last ten years.

Apparently not.

So what were LBC seeking to achieve? Education? Hardly, given that it was a Vox Pop presented by someone who didn’t really understand the subject, with no expert talking heads. Entertainment? Is vaccination a suitable subject for entertainment programming?

Controversy?

Well, as to that last one, I think the question is the answer.

In which case, I think serious questions should be asked about Jeni Barnett’s editorial team, and also about the senior Programme staff at LBC.

If what Jeni was really being asked to be here was a kind of Shock Jock talk show host, like some of the whackjobs on US TV and radio, then I would personally like to ask the LBC head of Programming why this was thought to be a suitable subject for shock-jock-ery.

The reaction of the Programme Director at LBC, which Ben Goldacre has discussed on his blog, is pathetic. It seems to reduce to:

“Those bastards! They’re out to get Jeni – and us! And all because we did a challenging and entertaining Vox Pop!”

I find I am oddly reminded of the puffs of smoke and faux umbrage that emerged from the Observer when they ran a famously idiotic MMR story and fawning Andrew Wakefield interview back in the Summer of 2007. They similarly didn’t seem to be able to see that this stuff actually does matter. Also similarly, when any number of people pointed out the mistakes, they singularly failed to apologise properly, or to address the question of what responsibilities journalists have WRT some semblance of truth and objectivity.

Really, one has to ask: if these high-up editorial people just don’t get the importance of stuff like this in terms of the media and the wider public conversation, then why are they in the jobs that they are in? Are they really the best the owners could find?

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Minor Update – 12th Feb:

An interesting post has appeared over at the blogs bit of journalism.co.uk, where Jeni Barnett’s agent, Robert Common, is quoted as saying that he has:

“…personally been very shocked at the hurtful level of criticism [of Jeni Barnett] and its very personal and threatening nature.”

The post has been expanded a couple of times after bloggers (including the Quackometer’s Andy Lewis) pointed out that the published, and now disappeared, comments on Barnett’s blog had been neither personal nor threatening. Common responded to this by saying that:

“The comments/emails [to which he had previously referred] are the ones that have been unpublished.”

It is a shame if some idiots have been posting personal abuse to Barnett’s blog.  Like (probably) everyone who runs a blog, and certainly like everyone who runs a blog of the Bad Science variety, I have received my share of personally abusive comments and emails, and it is unpleasant and unnecessary.

While I understand why Common is defending his client, it must be said that his statements do not offer an explanation as to why all the reasonable comments disappeared from Jeni Barnett’s blog. I could have understood closing the thread after a certain point, if she and he were determined to try and “draw a line” under the business. But deleting the reasoned comments which had set out, for the record, many of the reasons why Barnett’s programme had been wrong on the facts and had angered people, strikes me as  ill-judged.  The journalism.co.uk blogger, Judith Townend, put this point to Robert Common, but he decided he was not making any more statements.

Going back to the original theme, Townend also writes:

Given that Barnett had removed the comment facility on her blog I thought it was important to put the many questions being raised around the web to LBC and Barnett’s agent – for example in the posts and comments at Holford Watch and Quackometer. LBC did not want to make an on-the-record comment.

And in their case, I would say, it is the silence which speaks volumes.

Second Minor Update –  11th March

Via my friend Dr John Crippen I see that Bad Science King Of The Nerds Ben Goldacre has been on London Tonight talking about Jenny B, LBC, and media coverage of MMR.


Now, all you hear from LBC themselves in this film segment is a brief and anodyne statement.

However, it seems that behind the five on-screen minutes lies a positively byzantine web of negotiation and to-ing and fro-ing, probably including “clearing it with the lawyers”. Some of it involving LBC. You can read about it from the producer of the segment, Nick Wallis, here.

Wallis comments:

“Jonathan [Richards, of LBC] was courteous, but was not prepared to put anyone up for interview. I can see why he didn’t (I think they just want this story to go away now).”

Now, I rather suspect the Blogosphere may not be letting LBC forget in such a hurry. I will be waiting with interest to see what happens the next time LBC run a dire science story.

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Measles – spot the worrying trend (Updated)

January 14, 2009


Widely reported in the media, the latest figures show that cases of measles are up again in the UK. The BBC has the story here, including a graph:

bbcs-hpa-graph

…while blogging GP Euan the Northern Doctor offers some analysis here. The story has also been well covered in the Bad Science Blogosphere by both jdc and by Martin the Lay Scientist.

As if by some sort of serendipity, yesterday also marked the re-start of the General Medical Council’s protracted “Fitness to Practise” (misconduct) hearings into Dr Andrew Wakefield, one of the key originators of the UK anti-MMR panic. If there is anyone reading not familiar with the media ”manufactroversy” over MMR, Ben Goldacre offers an introduction here, while journalist Brian Deer gives a magisterial, if lengthy, summary of his investigations into Wakefield and his work on his blog.

One interesting aspect of the new measles figures, highlighted by the Northern Doctor, is that the rates of measles infections seem to vary for different parts of the country. Which got me to wondering why. Of course there are many, many possible reasons, but one variable might be the extent, and kind, of pro-vaccination information that people see.

So what material does the NHS put out?

Pretty anodyne stuff, is the answer.

If you go to the NHS immunisation information site, you can find the current NHS MMR vaccination poster:

nhs-measles-poster

– the big red blob with smaller blobs around it presumably represent a virus particle, or perhaps new virus particles budding from an infected cell, although you would possibly have to be a scientist (or at least have done GCSE science) to work this out.

To me, the whole poster seems… well, boring. It is a pretty enough piece of graphic design, and has the key verbal message, but it has no “What?” value. Just a bunch of words.

The only NHS vaccination poster which appears to have any kind of “Warning” element is the one for the winter ‘flu jab:

uk-flu_jab-pic

This one has a few scary saber-toothed gremlin-type thingies, presumably again representing nasty ‘flu viruses, and a finger-wag. But, again, nothing to really stop you short.

Im Vaterland schaffen wir das anders…

In contrast, a couple of months back my German friend “Sceptic Eric” sent me some pictures of two German posters promoting vaccination that had appeared where he lives:

german-pro-vax-ad-no1-crop

The caption says:

Lisa, aged 9, is blind because of Rubella

(The smaller writing on the red backgrounds says “Vaccinate Now!”)

And the second poster:

german-pro-vax-ad-no1-crop-2

Daniel, aged 12 – left mentally handicapped by Measles.

These appeared, note, on big advertising bill-boards – not hidden away on the wall of the GP’s waiting room. They seem to me to be much more shocking – and thus memorable – posters than the UK ones. Instead of vague exhortations, they focus on the tragic consequences that can follow infectious diseases which people commonly view as harmless.

Ah yes. “Harmless childhood illnesses”.

An argument one often hears, typically from parents who do not have their children vaccinated is

“Illnesses like measles and mumps were a normal part of childhood. Loads of older people we know had them, and they were fine.”

Well, the German campaign gives some context for this statement. Some children who catch diseases like measles are emphatically NOT fine. Some get very ill, but get better, like the child whose story is described here. Some get even sicker, with things like pneumonia and encephalitis. And unvaccinated adults can get measles, and the nasty consequences, too. As I said in an earlier post, Mrs Dr Aust treated a few seriously ill adult cases like this in her days in hospital acute medicine and Intensive care.

And for Rubella, children with the disease give it to other people. Possibly including pregnant women. After all, pregnant women often have children, including nursery- and school-age children. Schools and nurseries are the best places you can think of for children to catch bugs from one another. This is, I suspect, even truer in the UK than in some other countries. If Governments and schools bang on relentlessly about high levels of attendance; if both parents work, and employers frown on time off for family reasons; if kids are almost universally in nursery from the age of six months up – then it stands to reason that there will be plenty of children at school and nursery who are clearly sickening for something, if not frankly ill. The UK, you might notice, fulfils all the above conditions.

If a woman in early pregnancy catches Rubella, she has about a 20% chance of miscarrying spontaneously. And if her pregnancy goes to term her child has a significant chance – 20-50% depending on precisely when in pregnancy the mother caught Rubella – of being born with Congenital rubella syndrome, which can mean serious physical and developmental problems, like blindness, deafness and mental retardation – as the first German poster indicates.

So why, I wonder, do we not have similar ram-the-vaccination-message-home poster campaigns here in the UK?

Do we think it is too graphic?

Or do we think that, because of all the media’s credulous reporting of the anti-MMR and anti-vaccine scare, people will look at posters like this and see “scare tactics and thought control”?

Or do they say “well, you can get them things just from getting vaccinated, innit?”

[ Err… not. The reported rate of “serious reactions” to MMR is about 3 in 100,000. In contrast, acute measles hospitalizes roughly one child in ten and kills one in every two to five thousand]

The tricks of memory

The flawed argument about “harmless childhood illnesses” is easy to understand. Most people have never seen a case of serious illness following measles. Ergo, measles must be harmless. They are blinded by their own personal experiences, and cannot seem to grasp the statistics.

I can understand this to an extent. I am a child of the 60s, pre the measles vaccination, and I had measles. I was OK. Others, of course, were not. But not anyone I knew.

The problem (from the POV of anti-vaccine scares) is that my experience is more common than the other – getting really ill, or knowing someone closely who did. So people in my age group commonly tend to know people that had measles (them and all their friends) but who got better with no serious, or at least lasting, consequences. They in turn tell their children and friends this.

Of course, the memory may not even be accurate. Even if a cousin or friend was in hospital as a child for a week, would you remember this after thirty years? If it was a classmate? If you too were a child at the time?

Personally, I have only one lasting memory before the age of about seven, and that is that the cake for my fifth birthday was shaped like Thunderbird One and had a Walnut Whip covered in red icing for a nose-cone. And I probably only remember that because there is an old family photo of it somewhere.

So – memory is unreliable. With the benefit of years that wipe away the memory of how lousy you would have felt when you had measles, your bout of measles gets recalled as “I must have had measles, so did everyone I know, we were all fine” (which may, or may not, be accurate) and then translated on into “measles is a totally harmless childhood illness” (which of course is rubbish, as we have already seen).

Heroes in the struggle for reality-over-scares

There is a great article on this, and the underlying statistics, here, written by a retired CDC epidemiologist who survived a life-threatening bout of serious measles complications as a kid in the late 50s. The author blogs as “EpiWonk”. Over the last year or so he has done a great job on his blog of the same name deconstructing the inaccurate and spurious arguments of the MMR-equals-horrors nitwits, specifically when they misuse and abuse epidemiology

And talking of measles, vaccination, and Dr Aust’s patch in the North-west of England, an honourable “local hero” mention should go to Dr Peter Flegg, an Infectious Disease consultant from Blackpool who spends a fair amount of his time online patiently explaining risk-benefit (and related topics) to do with vaccination.

Of course, a lot of the people he is trying to explain it to are figuratively sat with their fingers stuck permanently in their ears while shouting “nyeeah nyeeah nee nyeeah nyeeah, I can’t hear you”. But he keeps trying.

For a fairly recent example of both of these, try the British Medical Journal thread here, where you will find him discussing the relative risks and benefits of vaccination (versus actually catching measles). As you would expect, the real numbers are overwhelmingly in favour of vaccination. Even more remarkable is that Dr Flegg, with heroic restraint, manages not to lose his rag with Jackie Fletcher of JABS and her equally crackers friends.

Yet another person who deserves a lot of kudos for his tireless exposition of the nonsense of the anti-MMR lobby (and anti-vaccine nuts generally) is Dr Anthony Cox, proprietor of the BlackTriangle blog.  Cox has often been found over the years taking on the thankless task of debunking the anti-science ravings of media Wakefield Über-fan Melanie Phillips, and of various inhabitants of that stew of ignorance and prejudice known as “the JABS forums”. For this Cox regularly gets abused in personal terms by the JABS crew, who of course insist endlessly that they “don’t do ad hominem attacks”

So what to do?

So what do we take from the rise in measles rates?  We conclude, I think, that it is worrying, though not as worrying as the prospect of a further rise if vaccination rates don’t increase again. And we conclude that more effort is needed to get the vaccination message out.  And to educate people on the real rates of complications of measles, rather than of vaccines.

Perhaps it is time we spent some of the money the Government likes to spend paying celebs to appear in health campaigns on a pro-vaccination campaign (with or without celeb). Or on some German-style posters. Or both. We certainly need to do something.

Euan the Northern Doctor tells us he has managed more than a decade of practicing medicine in hospital, and latterly as a GP, without seeing a single confirmed case of measles – thanks, of course, to mass childhood vaccination:


“I don’t recall having ever seen a case of measles and I am hopeful it will stay that way.”

I hope so too. Though I am not all that confident.

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Update:  Saturday  Feb 7th. Jeni Barnett is a mother and an ex-actress. So she knows all about vaccination. ..err…?

Since this post was written, the MMR vaccine has rocketed back into the news again in the UK (at least in the blogosphere) with the furore about actress turned rent-a-quote presenter Jeni Barnett and her spectacularly awful phone-in on vaccination. I have never, I think, seen an issue which has united the BadScience bloggers and the medical bloggers (like my e-friends Dr Crippen, Dr Grumble, the Jobbing Doctor and Euan the Northern Doctor) in such unanimous fashion. Indeed, it seems like Dr Aust is probably the only BadScience blogger NOT to have covered the issue (mainly because so far I can’t think of anything new or distinctive to say). Anyway, Holfordwatch has an excellent roll-call of the blogs which, in a predictable but gratifying “Streisand Effect”, have covered the issue.

Jeni Barnett’s astonishingly ill-informed comments, petulant on-air behaviour, and dismissive attitude to anyone – notably actual healthcare folks – that rang in to correct her demonstrate, yet again, just how idiotic – not to mention dangerously deluded -“personalities” can be when they comment on stuff they know F-All about.  Holfordwatch has links to all the transcripts if you haven’t already read them, or heard the programme.

It all reminded me oddly of  a depressing TV debate I saw, just a bit more than five years ago, that followed on from Channel 5’s airing of the notorious 2003 TV Play “Hear the Silence”, about a mother convinced her child had been damaged by the MMR vaccine. The play – Guardian TV review here – featured Juliet Stevenson as the mother, and had a ludicrously saintly version of Andrew Wakefield (glossily impersonated by actor Hugh Bonneville) as its main hero. It was a powerful and compelling piece of drama…

…except that everything in it relating to MMR was farcically inaccurate, and utterly wrong.

What got me, however, was not so much the play as the studio debate afterwards – in which Juliet Stevenson, a fine actor but with no scientific or medical knowledge or training, harangued the medical and scientific types about the (imaginary) risks of MMR vaccination. Embodying the role is one thing, but deciding you now know enough to harangue people about the science on national TV? As so often, the phrase “The Arrogance of Ignorance” springs to mind – see also Jeni Barnett, or Jenny McCarthy in the US.

You can read what the British Medical Journal’s commentators – child health experts David Elliman and Helen Bedford, and GP, author, and Channel 5 debate participant Mike Fitzpatrick – thought of Hear the Silence here and here. Sadly, you won’t be able to get to the full text versions unless you have BMA, University or Athens login privileges, though you will be unsurprised to hear that they were not impressed. However, you can read, for free, the Rapid Responses (e-Letters)  that the BMJ received about the articles. The thread following Fitzpatrick’s article is notable for some sane responses from another doctor-turned-author, Neville Goodman. You will be unsurprised that the thread following the other BMJ piece eventually ends up with anti-vaccine über-obsessive John Stone of JABS talking to himself (as usual) long after everyone else has left (as usual).

Meanwhile, more measles – and a death

Finally, just a couple of days ago, as the shit hit the fan over Jeni Barnett’s dismal programme, I got an e-Mail from my German-language correspondent Sceptic Eric, directing me here. This is a piece about a recent Swiss measles epidemic, including the death of a 12 year old girl from measles encephalitis (1).

Perhaps Jeni Barnett would care to read it before putting up any more ill-informed self-justification on her blog.

(1) Sorry, Google machine translation, so a bit incoherent, though you can get the gist. If you can read a bit of German, the original is here.

The same case (I think) is reported in the French-language Swiss press, e.g. here (a thank-you to Svetlana for pointing this out) – and English machine-translation is here.

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Postscript

While I was writing the original lengthy ramble Californian blogger Liz Ditz drew my attention to a talk given by American scientist and “skeptic” Dr. Steven Salzberg a couple of months back in the States, and now up on youtube. If anyone needs a concise video introduction to the MMR anti-vaccine scare, it is a good place to start. Prof S thinks we should all be doing more to combat the still-bubbling anti-vaccine hysteria:

“Scientists and skeptics need to act to quell the rumors and educate the public, so that vaccines, one of the greatest medical successes in history, remain an effective tool in our fight against disease.”

The talk may be a bit US-focussed for UK listeners, but it is a good introduction to the whole story. It is in five parts – if you haven’t got the patience for the whole lot, and/or are already familiar with the main bits, you could skip to parts four and five to see the kind of things that American defenders of vaccination like Dr Paul Offit are up against (more on Offit here).

Part One,  8:31 min – Intro to autism & Wakefield’s paper.

Part Two, 7:54 – Brian Deer’s revelation of Wakefield’s misdeeds and Wakefield’s responses.

Part Three 6:34– Mostly on the thimerosal (vaccine preservative) – autism scare so beloved of ex-travel writer David Kirby

Part Four 8:54– Why Is Autism Ripe for Quacks to Exploit? segueing into “What does science say about autism?”

Part Five 8:49 – Continued discussion of increased incidence of vaccine preventable disease with fall in vaccination levels, plus a discussion of “Is there an autism epidemic?” and “What is really known about the causes of autism”. Finishes with US lawyers’ attacks on vaccines and courting of public opinion by anti-vaccine groups.

Who needs facts? These vaccine conspiracy pieces write themselves…

June 4, 2008

As I write this, Chief PR Man and Publicist of the “New Wave” Vaccines-Cause-Autism-No-They-Really-Do movement, David Kirby, should have done his turn in the House of Lords and be winding up his “free public lecture”. I won’t wish him the stocks and some rotten fruit – that would be churlish – though I might hope his audience includes some of the London-based Badscience fraternity, and/or a few sceptical scientists and doctors.

(Sadly, an audience of rabid mercury obsessives, anti-vaccine nuts, ambulance-chasing lawyers, credulous journalists, nutritionistas, Patrick Holford and Dr John Briffa seems more likely. But let’s hope I’m wrong).

What I am really, really hoping is that Kirby’s turns at the HoP and later do not produce more dismal newspaper articles tomorrow like the one the Daily Telegraph ran last week.

Ah, the Telegraph.

Those snippy satirists over at Private Eye have been running stories for some weeks suggesting that all is not well at the Telegraph, that once esteemed bastion of the more pepper-ish end of the British Establishment.

(For any non-UK based readers, I should explain when I was growing up in the 60s and 70s it was understood that all retired British colonels read The Times. Retired colonels who felt we could have kept the Empire by shooting more indigenous people, and who mourned the abolition of hanging and flogging, also read the Telegraph, as did all Conservative Party voters aged over 60).

Several of the Private Eye stories involve the abolition of posts at the Telegraph for specialist correspondents, all while the number of people there tasked with reporting the minor doings of “Celebs” increases. In the latest piece on this, Private Eye comment on the departure of one of the Torygraphs’s science reporters.

When I read this it reminded me I had meant to do a post about the Telegraph’s deeply lame more MMR “controversy” article, before I got buried under a pile of students’ exam essays.

So now that I have some time, what is the connection between the Telegraph’s latest here-we-go-again chunk of MMR idiocy, and the apparent disappearance of their specialist correspondents?

Wanted: MMR journalists – relevant background strictly optional.

Well, Cassandra Jardine, the journalist credited with the Telegraph story, is not a science or medical correspondent. She is a writer who mainly deals with parenting and parent issues.

If the reporting of the MMR saga taught us one thing, it is that media coverage of medical and scientific topics by non-science-literate journalists is a recipe for slavishly credulous bollocks.

A lot of serious analyses of the media coverage of the original Andrew Wakefield-triggered MMR furore have been written. One scholarly one, written by academics at the Cardiff University School of Journalism , can be found here.

One of the points highlighted is how vast quantities of the coverage was written by news or “feature” writers, and not by specialist medical or science correspondents – who might have had a chance of understanding the issues, or at least of thinking it was important to report that all the science, scientists and doctors were lined up solidly against Wakefield.

Instead, the coverage keyed on parental fears, on the feeling that public health officials and the Government were being evasive – vastly exacerbated by the Blairs’ refusal to reveal what jabs they had given baby Leo – and on the narrative device of the ”Brave Maverick Doctor” (Andrew Wakefield).

A number of the feature journalists writing about MMR seemed to find Wakefield’s undoubted charm and charisma, plus the triple narratives of “tragic parents”, “brave maverick doctor” and “Government conceals the truth” utterly irrestible. Quite a number of them seem to have made virtually entire careers out of it.

Michael Fitzpatrick, GP, author, parent of an autistic child and vaccine scare debunker, wrote an angry piece some time back in which he produced a list – though as he says, a non-exhaustive one – of:

Gullible hacks: journalists duped by the anti-MMR campaign

One of the names that appears on his list is that of Beezy Marsh of the Daily Mail. Many of Marsh’s articles on MMR for the Mail were coauthored with Sally Beck.

…who is credited at the end of the Cassandra Jardine piece for “additional reporting”. A quick Google of:

“Sally Beck” autism MMR

– reveals many previous MMR / autism stories, including the ones co-authored with Beezy Marsh.

So Cassandra Jardine’s “researcher” on the Telegraph story is a journalist with a long history of writing credulous MMR stories. What a surprise.

Who needs balance when you’ve got controversy?

A hallmark of many stories written by the journalists on Mike Fitzpatrick’s list is that they purport to cover the MMR saga in a balanced way, but have been castigated by the Bad Science blog-o-verse for factual errors, for quoting multiple anti-vaccination campaigners without making their allegiances clear, and for presenting the story as if the evidence and informed opinion over MMR and autism was evenly balanced. To give an example, you can find Sally Beck’s and Beezy Marsh’s articles being flayed online by one blogger from the genetic and “neurodiversity” autistic causation / treatment camp (e.g. here).

Jardine’s Telegraph article, with Beck’s “additional reporting”, quotes David Kirby extensively. It also quotes ex-NIH Head Bernardine Healy. It quotes actress and “model” turned autism and anti-vaccination activist Jenny McCarthy It quotes a lawyer for UK parents who want to sue the MMR vaccine manufacturers. It quotes Laura Hewitson of the University of Pittsburgh, whose (very) preliminary study on giving monkeys vaccines is being touted as the new “smoking gun” by anti-vaccination activists.

The only voice on the other side is Sir David King, the former Government Chief Scientist, quoted early on (in one line of an article that runs to nearly 1700 words) as saying that epidemiological studies have found no link between the MMR vaccine and autism.

Everyone else quoted in the article, with the possible exception of Bernardine Healy, is an out-front anti-vaccination voice. There is the parent and campaigner (Jenny McCarthy). There is the spokesperson (David Kirby). There is the lawyer for the parents who are convinced that vaccines damaged their children. Remember that the abandoned UK anti-MMR vaccine litigation depended heavily on lawyers acting for the parents, who secured the legal aid that eventually paid out over £ 15 million pounds to fund the lawsuit. Much of this £ 15 million of taxpayers’ cash went to a motley collection of often ill-qualified or discredited “experts”, most of them connected to Wakefield, almost all of them unashamedly anti-vaccine, and some of them quite clearly bonkers.

Laura Hewitson is described in the Telegraph article as a scientific specialist in obstetrics, gynaecology and reproductive sciences at the University of Pittsburgh. All of that is accurate. However, she is also, as revealed on the autism blogs, a litigant in a vaccine-injury suit. Her partner is the IT man for Andrew Wakefield’s Thoughtful House autism clinic. And Andrew Wakefield is a co-author on her work, which is yet to appear in a peer-reviewed publication and has been scientifically dismantled on the blogs.

[2010 update – as those who follow the MMR story will know, Wakefield is now gone from Thoughtful House, his departure closely following the damning GMC judgement. However, the TH website now tells us that Laura Hewitson “joined Thoughtful House in 2008 as a staff scientist”. Hewitson also appears no longer to be employed by the University of Pittsburgh. So Hewitson seems to have replaced Wakefield as TH’s senior researcher.]

Of all those quoted, only Bernadine Healy has the slightest claim to be taken in any way seriously. And even she is hardly reliable when the consensus of expert opinion is completely opposite to what she is saying. Healy has recently used her newspaper columns to make rather odd statements lashing out at the “Evidence Based Medicine” movement. It is also a long time since Healy was involved with the NIH – she was director from 1991-3, appointed by George Bush Senior, and in recent years she has been mostly a high-powered administrator. It has brought a wry grimace to the face to see how her remarks about MMR have been hailed by the anti-vaccine lobby, who are usually vociferous in their loathing of any “medical establishment authority figure”, and complain loudly about “argument from authority”. Personally I do not think Healy is terribly credible on the MMR-autism issue. She is, or was, a cardiologist, not an immunologist, paediatrician, epidemiologist or vaccine specialist.

So – was this a balanced article? Hardly.

So what was it?

It’s The Men in Black (Vaccine Branch)

An interesting comment by Sally Beck appeared last summer on the noted Autism blog Left Brain Right Brain (comments thread here), and seems to me to give an insight into the kind of journalistic thinking so much in evidence over MMR:

Sally Beck on July 18th, 2007 23:03:03

Just to throw this into the mix. As a journalist checking this shambles since 1998. It’s interesting that the first two facts thrown at me by government didn’t stand up. The first was that MMR has eradicated measles. Check the ONS figures back to 1890 and you’ll see that the measles problem was solving itself nicely without intervention. The graph had virtually flatlined before any medical intervention, meaning that the single measles jab and the MMR had very little to do with the reduction in deaths. Plot a graph logarithmically and you’ll see that deaths from measles would have ceased quite naturally this year. To put deaths from measles into perspective, the year the MMR was introduced there were 16 deaths. Deaths from asthma currently stand at around 1500 annually…

When the medical profession disected Wakefield’s peer reviewed 1998 study, in a newsletter titled ‘problems in pharmacology’ (monthly newsletter to GPs, interestingly titled) they concluded that they could neither prove nor refute the findings. They felt this was enough to recommend continued use of the MMR. I wonder why they didn’t recommend further research so that they could conclusively prove or refute?

In the chronology of the affair I’ve been noticing that newspapers have continually forgotten to list that the MMR jab was withdrawn here – as it was in Canada and Japan – because the cheap version they introduced was causing encephalitis and meningitis. All the children in Wakefield’s study had received this jab with the Urabe strain of mumps.

The children who’ve allegedly died from measles: So far we have no names, only newspaper reports. What do we really know about these kids? Do we know whether they actually existed – if so, someone put me in touch with a parent so I can interview them. Do we know whether their immune systems were compromised in some way? Do we know whether they were taking immunosuppresant drugs? We know very little about them. What we know after centuries of catching measles is that healthy children do not die of measles. I suspect most of the authors here over 40 have all had measles. I know I certainly have and I don’t seem to be impaired in any way – even at this late hour.

What we can conclude is that we are not being given the full picture. Nothing here is transparent and until the facts from both sides are laid out on the table, we really won’t know. I’m looking forward to following the GMC hearing.

(italics mine)

So basically, it seems Sally Beck is from the “there must be a conspiracy here somewhere” school of journalism that has done so much over the last decade to sustain the MMR-autism link mass delusion.

For a recent example of what can happen to healthy children who catch measles, even if there are no lasting consequences, this is worth a read.

A re-write of some of Sally Beck’s comment above, to re-adjust it closer to reality, might run as follows:

“What we know after centuries of catching measles is that most healthy children do not die of measles, provided we have sophisticated hospital care available for the ones that get really ill. And even then about 1 in every 2000 kids who get measles will be permanently brain damaged, or will die. I suspect most of the authors here over 40 have all had measles. I know I certainly have and I don’t seem to be impaired in any way – even at this late hour. Of course, because the numbers that suffer permanent damage are small with modern advanced care, we are likely not to have personally known anyone who was seriously ill with measles. This tends to make us believe – erroneously – that measles is just uncomfortable, and no more.”

Well, I have some news for Sally Beck:

The doctors who have treated kids with life-threatening acute viral illnesses on the medical wards and ICUs, including Mrs Dr Aust, would disagree.

And I also have a suggested alternative title for the Telegraph article:

“MMR – the “debate” that won’t go away – because journalists don’t understand science, but instinctively see column-inch generating Govt cover-ups everywhere”

PS – one of Andrew Wakefield’s greatest fans among UK columnists has always been that scourge of centre-left orthodoxy Melanie Phillips, who also weighed in again on MMR last week. A special Talking Science “above and beyond” award ought to go to Black Triangle.blog proprietor Anthony (Cox), who can be found on the comments thread below the article trying to explain science and evidence to the anti-vaccine believers. His restraint and calm in the face of flaming, taunting and name-calling, not to mention blinding stupidity and frank obsessional psychoses, is positively superhuman.

The “toxins in vaccines” crowd are still with us

May 29, 2008

Rather depressingly, the anti-vaccinationists, those Never-say-die Energizer Bunny types of the Alt Reality fraternity, are back for another round.

As a lot of Bad Science-aware people will already know, American surgeon-blogger Orac, of Respectful Insolence blog fame – and bete noire of the vaccines-cause-autism lobby – has been writing about the imminent UK arrival (well, next week) or American writer and darling of the anti-MMR vaccine crew, David Kirby. It turns out that Kirby is not just doing some book–signings and the odd lecture; he is also down to give a briefing in the Houses of Parliament, no less. To quote Orac:

“My British readers, say it ain’t so! Hot on the heels of learning that, bankrolled by antivaccinationists, David Kirby is planning a trip to the U.K. in early June, I find out something even more disturbing.”

Orac then reproduces the following press release:

From: “Clifford G. Miller”

May 23, 2008 — CONTACT: David Kirby – dkirby@nyc.rr.com

BESTSELLING AMERICAN AUTHOR
DAVID KIRBY TO SPEAK AT HOUSES OF PARLIAMENT

Briefing by Journalist Who Covers Vaccine-Autism Debate is Sponsored
By Lord Robin Granville Hodgson, Baron Hodgson of Shropshire

U.S. Journalist David Kirby, author of the award winning book “Evidence of Harm, Mercury in Vaccines and the Autism Epidemic – A Medical Controversy,” will give a special briefing on this debate at the Houses of Parliament in London, on Wednesday, 4 June.

Mr. Kirby will speak about recent legal, political and scientific developments in the United States in the ongoing vaccine-autism controversy. The briefing is open to Peers in the House of Lords, Members of Parliament, their Staff, members of the Media, and Invited Guests.

The briefing will take place on Wednesday, 4 June at 3:30PM at the Houses of Parliament, Palace of Westminster, Committee Room 4. It is being sponsored by His Lordship Robin Hodgson, Baron Hodgson of Astley Abbotts, Shropshire.

In addition to his Parliament briefing, Mr. Kirby will also give a free public lecture on Wednesday 4th June, 6:30-10PM at Regent Hall, 275 Oxford Street, London.

Hmm. A number of things spring to mind.

First, Kirby’s book may be “award-winning”, but it has very definitely not been winning science awards. Orac has written scathingly about David Kirby’s (mis) understanding and (mis) use of scientific evidence.

Second, Kirby is frequently billed in articles or press releases as a “former New York Times contributor”. This is strictly factually correct as written, but conceals the fact that Kirby was not a science or health correspondent for the venerable NYT. He was actually a travel writer.

A more specific question for us UK geeks would seem to be how Lord (Robin) Hodgson, the peer sponsoring the event and a real Tory grandee, is connected to David Kirby. Hodgson has no track record on health issues, as his key Shadow “portfolios” for the Conservative Party in the Lords have been Trade and Home Affairs.

Where is the noble Lord coming from?

I had written a long discussion on this, but as I was about to post it I saw that noted autism blogger Mike Stanton had beaten me to it over on his excellent Action for Autism blog. So rather than repeat what he has said, please pop over there and read his discussion of Lord Hodgson’s views on vaccines, as expressed in a House of Lords debate back in Feb 2003.

To cut to the chase, Hodgson has a son diagnosed with mild Attention Deficit Hyperactivity Disorder (ADHD). Like many parents with kids with ADHD or autistic spectrum disorders (ASD), he has felt dissatisfied with the mainstream treatments on offer and become interested in alternative therapies. However, he has also seemingly bought some of the anti-vaccine lobby line:

“It is unlikely that there is any one single cause [of ADHD]. Genetics and heredity will probably be found to play a significant part. But what other factors are in play? One matter looks increasingly likely to be a significant contributory cause: the requirement in this country that every baby receives three injections in the first 16 weeks of life as immunisation against diphtheria, tetanus and whole cell pertussis—whooping cough, to laymen—(DTwP). As I understand it, each standard dose of the vaccine used in the UK contains 50 micrograms of a substance called thimerosal. Each dose of thimerosal contains 25 micrograms of ethylmercury. Mercury is a highly toxic substance. That means that, by the 16th week of life, every baby in this country, with an inevitably fragile immune and nervous system, has been injected with 75 micrograms of ethylmercury…”

This would explain the Hodgson – Clifford G Miller – David Kirby connection: as even a cursory squint at Clifford G Miller’s website will show, he is a long-time anti-vaccine campaigner, and serial haunter of the BMJ electronic comments threads on the topic.

But… the vaccines don’t have mercury in any more

The problem for Kirby and other thimerosal aficionados – including British psychologist and author Lisa Blakemore Brown, who Hodgson also mentioned in his speech, and who seems to have played a part in Kirby’s upcoming UK tour – is that the thimerosal theory is on its last legs. This is mainly because even once thimerosal was removed from the vaccines – which happened in September 2004 in the UK – ASD diagnosis rates have not dropped. Hence, as Orac has again noted, the move to blaming ill-defined ”Toxins”.

[PS – the MMR vaccine, contrary to the urban legends, never contained thimerosal. If you want to read more about thimerosal there is an old (2003) NHS factsheet here (NB – pdf). And the lack of effect of removing thimerosal from infant vaccines on autism rates has been shown by large studies in Denmark, Canada and the USA, all of which stopped using thimerosal earlier than the UK did.]

Given these facts, it is hard to disagree with Orac’s view that it isn’t mercury, or toxins that really matter – for these people ”It’s All About the Vaccines”

And why now?

A further interesting question is: what has re-activated Lord Hodgson’s interest now?

Since UK politicians are infinitely more sensitive to what is going on in politics – including US politics – than to what is going on in science, one wonders if this isn’t in some way a knock-on effect of the rather ambiguous remarks some of the US Presidential candidates have been making about an autism “epidemic” (see Orac posts passim, for instance here). Indeed, the press release that accompanies David Kirby’s visit specifically makes this connection in a later section.

Orac has detailed how all the US presidential candidates, plus ex-President Bill Clinton, have been making depressingly ambiguous – not to mention scientifically inaccurate, and even disturbingly stupid – statements about autism and its possible causes. Many bloggers think the candidates should sack their science advisers, although perhaps we should sit tight and just put it down to electioneering politicians’ desire not to put off a single potential voter, no matter what way-out things the voter might believe.

However, let’s hope whichever of the US candidates does gets elected in November can find proper science advisers once in office, rather than being swayed by celebrity nitwits like Jenny “I read it on Google” McCarthy. There should be a few folk round the National Institutes of Health (NIH) and the Centres for Disease Control (CDC) that can direct them to suitable people.

And closer to home, let’s hope Lords and MPs give David Kirby’s blusterings the wide berth they deserve. Or perhaps even better, let’s hope some of the science and medicine-literate Lords and MPs can be persuaded to go along and nail Kirby with some hard questions about the facts, as opposed to his conspiracy theories and scaremongering. If you would like to give your MP a prod, you can contact them via writetothem.com, or look up the email address of any Lords you can think of with medical or scientific know-how here.

I have little doubt that anti-vaccine types are writing to their MPs as you read this, urging them to give an ear to Kirby’s anti-vaccine PR. So feel free to give your elected and non-elected representatives a more scientific steer.

Stop press: Mike Stanton has just added a second post about Lord Hodgson’s comments on thimerosal and vaccination. Mike’s take is that Hodgson should be careful who he takes scientific advice from, as someone has been pointing him to some dire “anti-vaccine fringe science”, including a couple of notoriously awful papers – read the post for more. The dangers of self-styled experts and cargo-cult science are, of course, topics familiar to readers here.

Follow-up: To hear an eye-witness account of what a damp squib it turned out to be (i.e. no-one at the lecture but the usual mercury /vaccines conspiracy crazies, and barely anyone at all at the House of Lords), click here and follow the links.