March 2015


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Mitchel Cohen <[log in to unmask]>
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Science for the People Discussion List <[log in to unmask]>
Sat, 14 Mar 2015 07:41:18 -0400
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The arguments denouncing those who oppose giving 
their kids Measles vaccine continues with a 
powerful article in The Nation by Annie Sparrow, 
who propounds administering mandatory measles 
vaccinations in the U.S. and the rest of the world.

Unlike most Vaxxers, Sparrow comes right out and 
says the vaccine is safe. "Not only is measles 
proliferating; so are the nasty allegations about 
the danger of the vaccine by anti-vaxxer 
ideologues and unscrupulous politicians, even 
though the vaccine is not only safe, but mass 
measles vaccination is also the single best 
public-health intervention we have" -- no "ifs, 
ands, or buts" about it. Not even a qualifying 
adverb like "reasonably" safe, "pretty" safe, and 
the like. Just "safe". No one ever has 
experienced any negative reaction to the MMR 
vaccine, apparently. It's "safe". But of course, 
it isn't. Recipients of the vaccine have 
experienced all sorts of negative reactions. 
Which discredits her entire string of absolutist 
generalizations in her war-cry.

How can she fail to mention the patented MMR 
vaccine's ingredients and their potential 
dangers. In other words, no fair presentation of 
the significant questions that pro-choicers are 
raising, not even to strike them down in a rational manner, one by one.

According to the CDC list of excipient 
ingredients in vaccines 
the patented MMR vaccines contain the following:

MMR (MMR-II): Medium 199, Minimum Essential 
Medium, phosphate, recombinant human albumin, 
neomycin, sorbitol, hydrolyzed gelatin, chick 
embryo cell culture, WI-38 human diploid lung fibroblasts

MMRV (ProQuad): sucrose, hydrolyzed gelatin, 
sorbitol, monosodium L-glutamate, sodium 
phosphate dibasic, human albumin, sodium 
bicarbonate, potassium phosphate monobasic, 
potassium chloride, potassium phosphate dibasic, 
neomycin, bovine calf serum, chick embryo cell 
culture, WI-38 human diploid lung fibroblasts, MRC-5 cells

Additionally, we can ask whether injecting human 
DNA into children may also cause autism (even 
without mercury, which is not the only cause)?

And how about the MSG in one of the measles 
vaccines, or the antibiotic neomycin and the GMO sorbitol in both?

They all contain animal parts, and are tested on animals.

Dr. Brian Hooker re-assessed data provided by the 
Centers for Disease Control and found -- after 
retractions and corrections -- links between the 
timing of the first MMR vaccine and autism 
incidence in African American males, and that 
"consideration should be made in the current 
United States vaccination schedule for genetic 
subpopulations that may be associated with vaccine adverse events."

All unconscionably ignored by Dr. Sparrow.

Marshalling all the Vaxxer arguments against 
parental choice -- which makes Sparrow's piece in 
The Nation the important one to refute if you 
advocate parental choice for the measles vaccine 
-- Sparrow goes on to viciously attack, in 
several blistering paragraphs, "the 
unconscionable malpractice of Andrew Wakefield" 
and The Lancet, which published Wakefield et 
al.'s research results. Not a single mention that 
British courts have exonerated Wakefield's co-researcher, and more.

Sparrow conflates incidence of measles with other 
more deadly diseases, manufacturing and twisting 
the hysteria (good debating technique, but not so 
good if you want to get to the truth) and then 
returns to talk about measles as though that's 
what she was discussing all along, as though all 
arguments around the patented MMR vaccine are the 
same as those discussing other diseases and how to prevent them.

Along the way, she provides the basis for U.S. 
imperial "intervention" in Africa, in the name of 
"public health", while ignoring the rather 
delicate "question" that of the SV40 virus, for 
one, and pretending that it doesn't exist. The 
CIA could not have done a better job.

Virologist Jonathan Latham explains this matter succinctly:

"My take on this issue (as a virologist) is that there are genuine and
scientific reasons to have concern about vaccines in general, and specific
reasons to have concern about certain individual ones. There have been
vaccine disasters and near-misses. For example, several million Americans
have the virus SV40 which they got from a contaminated vaccine. (SV stands
for Simian Virus). The biological consequences of SV40 virus are unknown.
But the point is the risks of vaccines are real and incontrovertible and can
hardly be denied.
At the same time there are companies hoping to make a lot of money from
vaccines who would like these risks to be buried."

Almost all "anti-Vaccine choicers", including 
Sparrow, conflate and confuse what should be seen 
as separate issues in a fair debate. The 
questions around this particular vaccine are not 
necessarily the same as those concerning other 
vaccines. For some people they are, but for many 
those questioning the particular MMR vaccine are 
calling for professionals to go through the 
studies one vaccine at a time, and examine each patented vaccine unto itself.

Nor is Sparrow above even obvious twistory of 
political facts, that The Nation's fact-checkers 
should have caught. She writes that "In Syria, 
the government's efforts to withhold routine 
childhood vaccinations in areas considered 
politically unsympathetic to the dictatorship was 
one of the reasons for the popular uprising." How 
she omits that it was the UN that has halted a 
measles vaccination campaign in northern Syria 
after at least 15 children died after receiving 
shots, as confirmed by the UN Children's Fund 
(UNICEF) and World Health Organization, is simply 
amazing. Following the vaccine, some of the 
children's bodies swelled and they suffocated to 
death. Readers should question every other "truth" that Dr. Sparrow proclaims.

One writer, Laura Costas, puts front and center 
the need to examine each vaccine in actuality, 
apart from the philosophizing about vaccines in general:

"I would examine [each vaccine type] 
individually, actually. Five years ago when my 
young cousin gave birth she was given a list of 
27 innoculations she was expected to give her 
newborn in the first 2 weeks of his life. Even if 
we allow that the other "inactive" ingredients 
are entirely harmless, do we really think that 
this shock to an infant's immune system is negligible?
Serious, debilitating diseases are one thing, but 
self-limiting or non life-threatening diseases 
are quite another. I question the unquestioned 
use of vaccines, and I certainly question the 
good faith of the people who manufacture them. 
Titers can measure the antibody level in the 
blood, making boosters of questionable value as 
well. Yet every schoolchild must have the boosters or no school!
That the purveyors of the vaccines are also 
involved in bioweaponry is not up for grabs, it's 
a fact. No entity is really keeping watch over 
these people; the agencies whose mandate is to 
protect us are populated and in many cases led by 
former lobbyists for the industry. The 
manufacturers also are the ones doing and 
financing the science. That renders unreliable 
the study, the manufacture and the distribution 
of the vaccines--pretty much the whole ballgame. 
This, as Mitchel points out, is simply capitalism 
at work doing what it always does.

I think the main objection here is 
over-vaccination, not vaccination in general, and 
also the means of production if you will. I think 
putting a perfectly healthy infant on the 
pharmaceutical treadmill in the first two weeks 
of his or her life is complete recklessness. Yet that's the current regime.
I don't think you can separate these objections 
from the evaluation of risks to public health of 
vaccinating or not vaccinating."

At least Jonas Salk, who invented the polio 
vaccine that used dead virus particles, put the 
vaccine into the public domain and gave up the 
patent rights and private profits, for the public 
good. (We should, however, discuss the polio 
vaccines separately. Sparrow refuses to do so and 
mixes it in with her pro-MMR arguments.) Would 
Paul Offet -- the creepy vaccine entrepreuneur 
posing as a public health advocate to increase 
his profits -- put his money where his mouth is, as Salk had done? Ha!

When the U.S. Food and Drug Administration takes 
the profits away from Offet and out of vaccine 
research and production, then watch how fast the 
Vaxxers' tune will change. Apparently, they 
demand the freedom of choice for themselves 
against government fiat, but, like Dr. Sparrow, 
deny that same freedom of choice to MMR vaccine challengers.

The Vaxxers' hypocrisy astounds in defense of 
their profits. They're selling us the Pharm. It's the American way.

Mitchel Cohen

What the Anti-Vax Movement Doesn't Tell You About Measles

Sparrow on February 19, 2015

"No cough, no measles" was one of the many 
mantras and memory aids I learned in medical 
school. Most were designed to reduce tomes like 
Anatomy and Harrison's Principles of Internal 
Medicine to a few rules. Much of the time, it was 
easy to miss the point, especially when the 
subject seemed to be an obscure disease.

Five years into a six-year medical degree at a 
typical Western university, none of us had ever 
seen measles. Nor were we bothered. Apart from 
HIV, microbes like measles seemed prehistoric. 
Public health was out, plastic surgery was in. 
Still, I remembered this particular rule, offered 
by a much-revered professor. But I wondered why 
he was so focused on a cough instead of "Koplik 
spots," the little white dots in the mouth that are specific to measles.

Then I spent ten weeks in a pediatric 
infectious-disease ward in Cape Town. I thought I 
would see "African diseases" like hemorrhagic 
fever and HIV, which I did. But I also saw 
measles, rubella (German measles), scarlet fever, 
syphilis, rheumatic fever, typhoid, tuberculosis 
and many other causes of rash and fever.

Suddenly I could see the point of my professor's 
rule. The very first signs of measles are a fever 
and cough, followed by a runny nose and red eyes. 
The appearance of a rash three or four days later 
is usually what prompts parents to bring their 
child to the emergency room. The problem is that 
at any given time, half the pre-school children 
in the ER have a fever, rash or both. The 
differential diagnosis is hard enough in 
immunized children, ranging from mild roseola to 
devastating meningococcal sepsis; the long list 
includes enterovirus 68, Lyme disease and drug 
rashes. In an unimmunized child, the ailment 
might also be rubella­harmless for the child, but 
catastrophic for unimmunized pregnant patients­or chickenpox.

Or it might be measles, in which case you need to 
know. Fast. Because measles is the most 
contagious disease on earth. Among unimmunized 
people exposed to the measles virus, some 90 
percent will contract the disease. Anyone with 
measles is contagious for several days before the 
rash even appears; the cough effectively spreads 
tiny droplets of the virus, which can remain in 
the air for several hours, long after an infected 
person has left the room. In an unvaccinated 
community, each person who gets measles spreads 
it on average to twelve others. Complications 
like pneumonia and meningitis can be permanent, 
deadly, or both, especially for 
immune-compromised patients such as those with 
cancer. And in the ER, one of these kids might be in the next bed.


to enlarge)

Older Americans remember measles as a common 
childhood disease that just had to be suffered 
through, but in fact it is still frequently 
deadly in low- and middle-income countries. And 
because the virus weakens the body's natural 
immune system, children who survive measles get 
more infections and have a higher risk of dying 
from them for several months afterwards.

So a doctor needs to be able to diagnose measles 
at "hello," not wait for the results of two blood 
tests taken two weeks apart to see whether 
antibodies are rising while the child spreads 
measles, as happened at Disneyland. I rapidly 
learned to recognize measles at ten paces, and 
realized that the idea of using Koplik spots as a 
diagnostic aid was better suited to passing exams 
than clinical practice. Toddlers with measles 
tend to be extremely irritable (another clue) and 
not madly cooperative about opening their mouths 
on request for viewing. Nor would you want to get 
that close, if you're uncertain whether your parents had you immunized.

So the crucial question becomes: Cough, or no 
cough? If there's no cough, it's not measles. 
Period. Which is good, as excluding measles early 
averts both parental and departmental panic. But 
if an unimmunized child or adult is coughing, 
take it very seriously. Ensure that the child is 
kept away from places where he or she could 
spread the disease to others. Educate parents on 
how to treat the symptoms. And get the child out 
of the ER as quickly as possible before he or she 
infects other patients and staff.

These steps are all the more vital now that 
measles, long forgotten, is "back" in the United 
States and far too few doctors know how to 
recognize it. And not only is measles 
proliferating; so are the nasty allegations about 
the danger of the vaccine by anti-vaxxer 
ideologues and unscrupulous politicians, even 
though the vaccine is not only safe, but mass 
measles vaccination is also the single best public-health intervention we have.

As doctors, there are a few things that we know 
are fundamental to our well-being. Most of these 
are public-health measures that enable us to live 
much longer and better lives, even to grow 
taller, than 200 years ago. These measures of 
mass salvation include water purification, 
toilets and sanitation, garbage collection and 
disposal, and vaccination to protect children 
from infectious diseases like smallpox, polio and measles.

Smallpox was a seriously nasty disease, with a 
fatality rate of 30 percent. For those who 
survived, the pocks were permanent, and not 
pretty. Eradication of this vicious virus was the 
result of achieving global herd immunity, a feat 
of international cooperation and cost-effective 
investment in a global good. Herd immunity comes 
from mass vaccination and eliminates the virus. 
It protects the entire community­particularly 
children and adults who can't safely be immunized 
and babies who are too young (a child must be 6 
to 9 months old before the immune system is 
sufficiently developed for the vaccine to work). 
When the global campaign began in 1967, there 
were 10 to 15 million cases of smallpox each 
year. Places that had attained herd immunity, 
such as Europe and North America, had to maintain 
it to prevent imported cases from India and 
Africa from triggering an epidemic while rigorous 
surveillance to diagnose every last case and mass 
vaccination campaigns around the world created 
global herd immunity. Ten years later, the virus 
died out. Smallpox eradication is the public 
health success story of the twentieth century, 
and because of it, we are now determined to try 
to eradicate other infectious diseases, such as polio and measles.

Polio, perhaps the most frightening disease of 
the twentieth century on account of its invisible 
spread and devastating effect, crippled tens of 
thousands of children each year before the 
discovery of a vaccine sixty years ago. Americans 
can be rightly proud of the March of Dimes, an 
enormous effort driven by American mothers, which 
raised tens of millions of dollars to find a 
vaccine. The global campaign to eradicate polio 
required massive international cooperation, 
overcoming Cold War divisions, to bring the 
number of global polio cases today down to a few 
hundred a year­tantalizingly close to eradication.

Measles, like polio and smallpox, is a horrible 
disease. Second only to smallpox in the total 
number of deaths it has caused over the past two 
millennia, it's still a major killer of children 
under 5 years of age in the developing world. The 
development of a vaccine was widely welcomed. It 
is usually delivered jointly with vaccines for 
mumps and rubella, known in combination as MMR. 
One shot provides at least 95 percent protection and offers enduring immunity.

But because of vaccination lapses, measles is now 
on the rise. There were twenty-three separate 
outbreaks in the United States in 2014, involving 
644 individual cases­a record number since 
measles was eliminated from the US in 2000. So 
far in 2015, there have been 141 cases in 
seventeen states, 80 percent of which are linked 
to Disneyland. Blaming it on Mexico and porous 
borders, as some opportunistic politicians have 
done, has no basis in reality; there were only 
two cases in Mexico in January, both imported 
from the United States. Globally, the number of 
deaths rose from 122,000 in 2012 to 146,000 in 
2013, reversing a twelve-year downward trend. In 
November 2014, the World Health Organization 
(WHO) gave up on meeting its target for measles control.

It gets worse. Measles is so contagious that it 
is used as the indicator disease to show deficits 
in immunization coverage of all 
vaccine-preventable diseases­which means the 
problem goes well beyond measles. We should 
hardly be surprised, then, that last year saw WHO 
announce a Public Health Emergency of International Concern for polio.

Why is this happening?

In Syria, the government's efforts to withhold 
routine childhood vaccinations in areas 
considered politically unsympathetic to the 
dictatorship was one of the reasons for the 
popular uprising. Small wonder that polio 
returned to Syria and that there have been more 
than 10,000 cases of measles in 2014. Parents are 
desperate for vaccines, and last year medical 
workers braved Assad's barrel bombs to vaccinate 
1.4 million unimmunized children in northern 
Syria for polio, achieving 92 percent coverage, 
equivalent to the rate in the United States. 
Similarly in West Africa, people are begging for 
Ebola vaccines. Yet in the United States the 
anti-vaccination movement has seen increasing 
numbers of parents refuse measles and other 
vaccines "on behalf" of their unprotected children.

That misguided movement began with the 
unconscionable malpractice of Andrew Wakefield. A 
doctor who has since lost his license, he and his 
coauthors of a 1998 article in The Lancet made up 
a syndrome consisting of diarrhea and 
developmental disorder ("regressive autism") that 
he tried to link to the MMR vaccine for the sole 
purpose of financial gain. He was not at the time 
a practicing doctor, and had no expertise with 
autism, but he manipulated parental fears and an 
editor's penchant for controversial papers to 
secure publication in The Lancet, a respected 
medical journal. Extraordinarily, despite his 
financial conflict of interest, despite having 
fabricated the syndrome and falsified the data to 
"fit" his criteria, his paper passed peer review.

That paper was then used to support litigation 
against three companies that produced the MMR 
vaccine, and to lobby for use of Wakefield's own 
measles-only vaccine. Wakefield went on to make 
more than more $600,000 in the process of the lawsuit alone.

In his 1998 paper, Wakefield alleged that eight 
children developed autism six days after 
receiving the MMR vaccine. I remember the paper 
well, because I was a pediatric fellow in London 
at the time. I and every other pediatrician were 
immediately besieged by parents demanding 
measles-only vaccines. We were staggered by 
Wakefield's ridiculously small, uncontrolled and 
clearly biased study about a syndrome that none 
of us had heard of, even though the MMR vaccine 
had been widely used since 1968. But it was also 
hard to imagine that The Lancet would publish 
something with such obvious global ramifications 
unless there was irrefutable scientific evidence 
uncontaminated by financial interest.

It took six years for The Lancet to admit 
Wakefield's financial conflict of interest but it 
did not retract the paper until 2010. Meanwhile, 
the rise of measles in the United Kingdom and 
United States reflects the damage done, and the 
consequences extend well beyond the West. In 
Nigeria in 2014, Ebola was successfully stopped 
and polio seems to have been eliminated, yet this 
country houses the greatest number of kids not 
vaccinated for measles after India. Parents keen 
on protecting their children from polio are known 
to refuse the measles vaccine, not because of 
myths about "a Western conspiracy of 
sterilization" or fears that vaccinators are 
"spies for the CIA" (after the CIA's clumsy 
attempt to use a fake hepatitis B campaign to 
access Osama Bin Laden's compound); rather, they 
are familiar with the anti-vaccine movement 
incited by Wakefield, asking, "If parents in 
California aren't getting their kids vaccinated, why should we?"

Vaccination rates of 94 percent are needed to 
prevent measles transmission in high-risk areas 
such as child-care centers and schools. Yet in 
Orange County and West Hollywood, many schools 
have documented childhood immunization rates of 
less than 92 percent, with some schools having 
rates as low as 38 percent­levels seen in 
developing countries. The Lancet could help by 
publishing not just a retraction but also an 
unequivocal editorial discarding the myth once and for all.

Using vaccination as a political tool is contrary 
to the public good. Yet some politicians seem 
unable to assert collective responsibility over 
individualism: Chris Christie dithers about 
balancing parental choice and public health, 
while Rand Paul offers uniformed opinions and 
contradictory behavior. The White House spokesman 
said that "people should evaluate this for 
themselves," though he urged a bias toward "good 
science." Seriously? Should we also start 
debating the value of safe drinking water and 
sanitation? Throwing mud means lost ground, which measles relentlessly gains.

In medical school, I couldn't see myself in a 
career in public health. (I instead became a 
critical-care pediatrician.) Public health seemed 
a "done deal" that everyone could see the value 
of. I returned to it ten years later, a convert 
to public and global health. Kids are the most 
vulnerable, with their poorly developed immune 
systems. They are also vulnerable to the 
politicization of the public good, the only ones 
without a direct say in the debates about their welfare.

And vaccines alone don't save lives: vaccinations 
do. There's little point in having vaccines if 
parents are allowed to refuse vaccination not 
only "on behalf" of their own children, but also, 
effectively, on behalf of other parents' babies 
who are too young for vaccination, to say nothing 
of kids born with immune disorders, for whom the 
vaccine is ineffective. Parents are 
understandably confused, but the increasing 
polarization isn't helping. Amid the controversy, 
it's easy to miss the point: a very serious 
disease is getting on with its job of invading, 
infecting and re-colonizing the country, and we 
are losing control of it. The public good of herd 
immunity can afford an occasional free-rider, but 
when large numbers of people place their own 
ideologies and idiosyncrasies above public 
health, it's children who suffer the consequences.

It is particularly because of those children that 
we need to take infectious disease more 
seriously. Pandemics didn't happen until the 
earth's population reached a critical mass. We 
think of rats on ships spreading bubonic plague 
in the Middle Ages, but it was the far deadlier 
human-to-human pneumonic version that travelled 
far and wide. (Both have now reappeared in Madagascar's prisons.)

Nor it is enough to focus on national health. In 
an increasingly crowded and connected world, we 
need to think of public health not simply locally 
but globally. Air travel now means it is 
impossible to stop viruses from spreading around 
the globe. Germs are frequent flyers. Building 
the homeland walls higher won't help­the only 
reliable antidote is building global public 
health. We have to pay attention to the neglect 
of infrastructure in West Africa, where Ebola 
erupted, and the Syrian military's deliberate 
destruction of public-health systems in 
opposition-held areas, where polio emerged. SARS 
became a global threat when China suppressed word 
of its emergence. MERS now threatens from the 
Persian Gulf. All of these diseases can easily 
spread to the West with profound implications. 
Just look at the effect of a few cases of Ebola in the United States.

Returning to measles, if the threat of that 
deadly disease isn't enough for you to reject 
anti-vax folklore, here's a little known fact 
about the benefit of vaccination. The measles 
vaccine doesn't only protect against measles. 
Because it contains a small amount of a live 
virus, the immune system must rev up to fight it, 
which in turn reduces mortality from other 
infectious disease­including pneumonia, sepsis 
and others­by 50 percent. This protective effect 
lasts until a vaccine is administered with a 
killed rather than a live virus, such as the one 
for diphtheria and tetanus. So do you want to 
protect your kids? Give them the measles vaccine.

And all of us should get educated. Education is a 
social vaccine against sustained ignorance that 
blocks effective and responsible responses to 
public-health threats. But education alone is 
insufficient to overcome self-interest. We all 
need to act for the public good. Because when 
public health is at stake, it's the children who 
take the fall. Individuals and institutions that 
are allowed to prioritize personal preference or 
financial and political gain ahead of children's 
health are irresponsible and unethical, and they 
should not call the shots. In the short term, 
children's health and lives are at risk; in the 
long term, we jeopardize the local and global 
control of these previously conquered diseases. 
Prevention is not only better than cure­which 
isn't an option for most of these diseases­it's 
also more cost-effective. Current and past 
pandemics reveal that when public health is 
neglected, history repeats itself in an entirely predictable way.

Our common desire to protect the health and 
well-being of children was always the best reason 
to eliminate these diseases, and it remains our 
best hope of bringing us all back to common 
ground. Public health is about common sense and 
common goods. Let's not allow spin doctors and 
myths to prevail over our shared aim of 
protecting the world's children from the world's oldest and deadliest diseases.