Sunday, June 14, 2009

MMR and a lack of trust

I am sick to fucking death of hearing about the MMR jab. Rhetorically Speaking points out that Peter Hitchens, after admitting that he knows fuck all about it, should shut the fuck up.

Dr Crippen has also gone on about how the MMR scare was a total fraud and that Dr Andrew Wakefield is the most evil man alive.

The reality is very simple: concerns were raised over the safety of the MMR jab—those concerns were not beyond the realms of possibility.

The government said that there was no problem but—and here is the fucking crux of the matter—no one trusts the fucking government on health issues (remember Gummer feeding a beef burger to his daughter?).*

And few people trust doctors either, since their representative bodies have been peddling lie after lie after lie, and still the so-called "decent ones" pay their dues to their disgusting, authortarian trade unions.

What should have happened is that the government should have authorised the single jabs: this would have been more expensive but would have avoided the sharp increase in measles rates (costing the NHS more in the long-term). The government expressly refused to pay for this course of action.

Given that the government did not allow single jabs, what should have happened is that the doctors who were so concerned about immunisation rates should have lobbied the government to allow the single jabs.

They did not do so, because the only thing that doctors' representative bodies are interested in is curtailing our freedoms as regards drink, drugs and cigarettes and they were too busy doing this to give two shits about important things such as herd immunity. Because they are all absolute stinking cunts.

So, might I highly recommend that everyone just shut the fuck up and get on trying to immunise as many kids as possible? Thank you.

* It's worth pointing out that BSE (and TSEs in general) is another area where consensus is fucking everything up. Huge amounts of money are still being poured into the investigation into prions as transmissive agents when, in fact, the transmissive agent is clearly a fucking virus. Laura Manuelidis' research, however, is being starved of cash in favour of a theory that not only makes cock-all sense but which has not been proven in over twenty years of experimentation.

Because, unfortunately, most scientists, researchers and politicians are colossal wankers with about as much concern for society (rather than, for instance, their own research budgets) as AIDS**, i.e. they need people to fuck each other to survive. I don't blame them for that but, like Fake Charities, everyone seems to think that these people are somehow immune from self-interest.

** I have ranted about this before, but it really pisses me off when I see AIDS written as Aids—especially when, in the same article, HIV is entirely capitalised. AIDS is an acronym, you wankers: it stands for Acquired Immune Deficiency Syndrome.

36 comments:

Anonymous said...

In my humble opinion, the tosser known as Tony Blair refused to tell the public whether his son Leo had separate jabs or the mmr. This gave credibility that there was something more to it and hence the public (quite rightly) thought fuck that why should I believe these wankers.

Harvey said...

Dear Mr Devil
I regret to inform you that you are wrong on the single vaccine jab issue. Bulk vaccination of the herd is the most effective way of preventing disease spreading. Infective agents do not - sadly - care about the libertarian views of individuals. They fall however on the sword of mass immunisation.

Apart from this one issue I remain a libertarian and supporter of your blog.

Dr Harvey Smith

Devil's Kitchen said...

Dear Dr Harvey,

I regret to inform you that the efficacy of the MMR jab is completely by-the-by.

A single measles jab would be more efficacious than none at all.

As it is, we are now faced with a sharp rise in the rate of measles because the government did not authorise single jabs.

If the government had cared about herd immunity, they would therefore have authorised the single jab, since this would have avoided the issue of parents not having any jab at all.

Which was precisely the point of my post. There is no libertarian argument in here at all.

DK

P.S. I did not have the MMR, and wentsuffered both measles and mumps although, not so far, rubella.

Ivor Bigot said...

those concerns were not beyond the realms of possibility

Oh yes they fucking were. One highly flawed report by a severely compromised individual, which should never have seen the light of day. However the real problem here was the MSM, Ben Goldacre quite rightly refers to their efforts as a hoax, given the sheer level of disregard for blatant facts shown by them.

I'm not trying to defend the government (heaven forbid), but the Hello generation seem to put far more faith in the redtops than any ministerial pronouncement.

For any who want a more thorough disection of the whole sorry episode, I can highly recommend his book "Bad Science". which has a whole chapter on this. Excellent for silencing dithering parents ;-)

IB

Gareth said...

Leaving aside the actual hoo-har over MMR itself - for a Government committed to giving people choices why didn't it make the separate jabs regime available?

Separate jabs are better than none but no jabs is what they have encouraged.

Could it be they had agreed with the supplier or suppliers of the combined jab that the separate jabs would not be provided? I wouldn't be surprised if this were the case.

cabalamat said...

concerns were raised over the safety of the MMR jab—those concerns were not beyond the realms of possibility

At the time they were raised that might have been true. It isn't true now.

The claim that MMR causes autism has no basis in reality; it is about as intellectually respectable as holocasust denial or creationism.

JuliaM said...

"The claim that MMR causes autism has no basis in reality.."

As the Devil took great pains to point out, that no longer matters.

The cat is out of the bag, isn't going back in anytime soon, and all the efforts of the government to cram the MMR down parent's throats is now totally counterproductive, simply further cementing the idea that it's a big conspiracy.

Regardless of the 'best' approach, they should now throw open the only approach that people will accept.

Instead, they stick to their guns because they would rather not lose face. So, now whose intellectually respectable?

cabalamat said...

JuliaM: As the Devil took great pains to point out, that no longer matters. The cat is out of the bag, isn't going back in anytime soon, and all the efforts of the government to cram the MMR down parent's throats is now totally counterproductive, simply further cementing the idea that it's a big conspiracy.

Some people think MMR is a big conspiracy. They are wrong, and shouldn't be pandered to.

I don't care how many people are misinformed this way, because, y'know, science isn't democratic. Reality isn't democratic, either.

Public policy should be based on science and reality, regardless of whether that pisses off a few misinformed idiots. Or would you rather that the government made important decisions by consulting their horoscope? After all, lots of people believe in horoscopes.

Anonymous said...

cabalamat,

Goodness gracious, there was me thinking that that was just what the government were doing, using horoscopes. Their doings might make slightly more sense.
As to trade unions, I see that the doctors are complaining again, worried they might catch "swine fever" so the want protection, ie more money.

Derek

ENGLISHMAN said...

When i were a lad,if mumps or measles were diagnosed in any children in the street ,all of the mothers would send thier children round to catch it,thus aquiring an immunity and removing a devastating illness in later life and strengthening the stock,and it did not cost a penny,still we know better now dont we?

Umbongo said...

cabalamat

"Public policy should be based on science and reality, regardless of whether that pisses off a few misinformed idiots"

You'll be telling us next that climate change - the extent of man's influence on which remains (outside the BBC and the political class) debateable - requires a return to the stone age.

FlipC said...

Purely out of curiosity where would you expect the government to locate the large amounts of single vaccines required? Even those private individuals willing to pay had difficulty due to the high demand.

Chalcedon said...

When I was a lad the causative agents of CJDand Kuru were called "slow viruses" and had never been isolated. I always thought Pruisner's work was bollocks and that a virus must be around with a genome. This protein folding business never cut it for me. With modern molecular techniques it was only a matter of time. but prions have become a new orthodoxy. I just wish scientists would remain sceptical and not blithely assume the veracity of a good story just because it was a good story.

Matt said...

DK,

On this matter, you are talking through your arse mate!

JuliaM said...

"Public policy should be based on science and reality, regardless of whether that pisses off a few misinformed idiots. "

And when it's more than 'a few', and is threatening your herd immunity as a result?

"Purely out of curiosity where would you expect the government to locate the large amounts of single vaccines required? Even those private individuals willing to pay had difficulty due to the high demand."

You mean, if there's a big fat government contract available, they won't make more...?

"DK,

On this matter, you are talking through your arse mate!"


Well, there's nothing like refuting an argument with well-thought-out reason.

And that's nothing like, etc, etc....

Matt said...

"Well, there's nothing like refuting an argument with well-thought-out reason."

I have been refuting it for years but its like talking to the wall.

The triple MMR is proven to be more effective that single vaccinations. There is no evidence that single vaccines are safer. Which part of that can't you fucking understand!

Public health policy is formulated according to the evidence.

Are you suggesting that we should provide an inferior vaccination service just because of ignorent fuckwits and their erroneous beliefs?

I hope that is well-thought-out enough for you!

JuliaM said...

"I have been refuting it for years but its like talking to the wall."

Do you ever ask yourself why that should be?

"Are you suggesting that we should provide an inferior vaccination service just because of ignorent fuckwits and their erroneous beliefs?"

What's the alternative, given that it's now affecting your much-vaunted 'herd immunity'?

HolfordWatch said...

Single jabs - Part 1.

Major charities have reviewed the issue of single jabs and they recommended that the government should not offer them.

I would urge interested readers to download and study the Sense Position Statement on the issue of MMR because it also responds to the calls for single jabs.------------
"An immunisation strategy can only ever be effective if there is mass uptake, meaning that choice between single vaccines and MMR cannot be part of an effective vaccination programme. One of the difficulties with MMR uptake is that, while the prevalence of measles, mumps and rubella in the UK is low, the incentive to vaccinate can appear less. From the perspective of an individual parent, the risk of their child contracting an infectious disease can seem small compared with the risk of possible (or perceived) adverse reactions to immunisation. However, this is only true if vaccination levels remain high. It is actually the counter-argument to this view that is the rationale for vaccination programmes - that the risk of vaccine damage is extremely low compared with the risk of the ill-effects of contracting the disease.
At the same time, low uptake of rubella vaccination could actually have worse consequences than no uptake. If there were no vaccination against rubella, then most people would catch rubella in childhood and would subsequently be immune. A low uptake of vaccination would mean that the virus would still be able to circulate, but that fewer children would become immune in childhood. Outbreaks of rubella would be less common than the epidemics that would occur with no vaccination, and so a cohort of unvaccinated and un-immunised children would increase each year and get older, with the burden of the disease shifting to those who are most at risk. Thus the impact of an outbreak in terms of congenital rubella syndrome births could be greater."-----

tbc

HolfordWatch said...

Single jabs, Part 2, cont.

------"For MMR vaccination to be effective, uptake needs to be above 95%: this is why boys as well as girls need to be vaccinated. From 1970 to 1988, schoolgirls were vaccinated against rubella, and this did have some success in reducing the number of rubella births. However, the real breakthrough came in 1988 when MMR was introduced for all children. This reduced rubella births by a further 90% - there were 447 congenital rubella births between 1971 and 1980 and 38 between 1991 and 2000…
Thanks to vaccination, rubella damage is now rare. However, this means that many people do not realise how dangerous rubella can be. In the United States, people from the Amish community have exercised their right for their children not to be immunised against rubella. As a result, in 1995, one baby in 50 born to Amish parents was born severely rubella damaged…
It has been be argued that even if the Government believes MMR to be safe, they should provide single vaccines as an alternative because then more children would be vaccinated. However, there is absolutely no evidence to support the suggestion that allowing single vaccines would lead to a greater uptake of MMR, and a significant amount of evidence to show that it would have the opposite effect. Single vaccines would be less effective than MMR and there is no evidence that they would be safer. Sense believes that it is unethical to promote six invasive procedures instead of two without sound scientific support, and when there is evidence that such a strategy would have negative effects. [They then give their reasons and some very good, supportive figures.]…
parents may opt not to vaccinate their children, particularly their sons, against rubella. This would lead to increased risk to pregnant women. Unvaccinated boys can catch rubella and go on to infect pregnant women, including their own mothers. This is exactly what happened before MMR was introduced….
[Reprise of what happened the last time single vaccines were offered because of a (groundless) vaccine scare.] In the 1970s, following a decrease in uptake of the diphtheria, tetanus and pertussis (DTP) vaccine, single vaccines for pertussis (whooping cough) were offered, with diphtheria and tetanus vaccines given separately. What happened was that over half of parents chose to vaccinate their children without the pertussis component. Coverage fell from 80% to 30%, there were three epidemics of pertussis, thousands of hospital admissions and around a hundred deaths. It took nearly fifteen years for vaccine uptake levels to recover…
[Sense list of recommendations] The Government should continue to offer MMR and should not make single vaccines available as an alternative."----------

There are very strong reasons to promote the use of MMR or multivalent vaccines rather than single jabs: Sense makes a good fist of outlining one particularly good case.

HolfordWatch said...

DK wrote: "The reality is very simple: concerns were raised over the safety of the MMR jab—those concerns were not beyond the realms of possibility."

They were pretty infeasible. Had people known about: the sexed-up results; the less than random assortment of children; the state of the facilities at Unigenetics; the problems at the Kawashima Labs; Nicholas Chadwick's findings; the opinions of Prof.'s Bustin, Rima, Rust, Simmons and Griffin; the fact that as early as 1992, it was clear to immunologists and microbiologists that Wakefield thought that he had identified the measles virus in various biopsy tissues but they told him that it wasn't - he seems not to have listened to them; the involvement of legal funding; the application for a patent for Wakefield's own vaccine alternative etc. - then Wakefield's results and later publicity-seeking activities would probably not had such an impact.

Matt said...

"Do you ever ask yourself why that should be?"

Ignorent fuckwits!

"it's now affecting your much-vaunted 'herd immunity'?"

How do you mean "my" much vaunted. Those not vaccinated benefit from the immunity of those who are vaccinated.

HolfordWatch said...

Englishman: "When i were a lad,if mumps or measles were diagnosed in any children in the street ,all of the mothers would send thier children round to catch it,thus aquiring an immunity." If that were entirely true, why do you think that parents would have consented to giving their children to the measles vaccine when it was introduced? Even to the point of queuing for it?

If we are just trading anecdotes, I have a relative who is deaf because of measles (not that unusual a sequelae). You wouldn't necessarily have met adventitiously deaf or blinded children of her generation because there was no statutory obligation to educate children with disabilities until 1970. Some didn't get an education - others went to special schools where they achieved nothing like their potential.

Some details changed but let's say that I recently took a history from a woman in her late 50s. She graduated from Cambridge with a 1st class degree in maths a few years ago. I asked her why she had chosen to study late in life. She hadn't been able to attend school much when she was a child because of chronic chest problems following measles and mups - she left without qualifications. Her life might have been very different.

A man in his 40s - life opportunities restricted by heart murmurs - secondary infection subsequent to mumps.

Up until comparatively recently, a substantial number of children who died with leukaemia died because they contracted preventable childhood illnesses rather than from the leukaemia as such. Children with some congenital heart defects were more likely to die from preventable childhood illnesses than from the defect itself.

These children, even if they couldn't be vaccinated, are the sort who would have benefited from the herd immunity of others being vaccinated.

I'll post something about the remarkable immunosuppressive impact of measles in another comment.

JuliaM said...

"How do you mean "my" much vaunted. Those not vaccinated benefit from the immunity of those who are vaccinated."

Until there's more of the former and less of the latter....

"There are very strong reasons to promote the use of MMR or multivalent vaccines rather than single jabs: Sense makes a good fist of outlining one particularly good case."

And when, despite all your 'promoting', people just refuse to trust the medical authorities, what then?

HolfordWatch said...

Is it possible for there to be a better-thought out response to the Sense document that your apparently offhand dismissal of it?

I doubt that that document is that well-known - I certainly use it in every discussion of single jabs that I come across. Oddly, it does tend to be ignored - or responded to so quickly that I sometimes doubt that it has been read, far less given any consideration (I posted extracts, the original document is lengthy).

HolfordWatch said...

I would direct interested readers to The Expert on Measles, Dr Diane Griffin. Dr Griffin is the editor of the definitive Field’s Virology and her status is such that she has contributed the chapter on measles for the last 3 editions. She gave testimony at the Autism Omnibus Hearings in the US. She details the remarkable immunosuppressant effects of the measles virus (see pg. 2738 onwards, Day 11 Autism Omnibus Hearings pdf). It seems that measles not only challenges the immune system itself, it suppresses response to other challenges so most deaths from measles are related to secondary infections.

-----
"So there is a period of time which is initiated during this acute phase that children are more susceptible to other infectious diseases. So this is a very clinically important complication or outcome or by-product of measles and all of the data suggests that it’s clinically related, as I say paradoxically, to the fact that the immune system is so activated and so engaged in making a response to measles that it is not appropriately positioned to respond to some new challenge that comes along at this same time… [pg. 2768]…
So a number of viruses that are particularly pathogenic, actually, have figured out how to block the interferon response in order to have a better chance of really causing a more severe disease. And wild-type measles seems to be among those viruses that can do that…[pg 2772]
We forget in the US what a serious disease [measles] was and why it was such an early target for the development of a vaccine, because the [mortality] is substantial. And the mortality is substantial, even in developed countries. It’s less in developed countries but it’s substantial. And if everyone gets it, that’s a lot." [pg. 2797]
-------
And it is generally acknowledged that measles is so contagious that every child with measles infects 15 others (pdf) which rather highlights Dr Griffins’ warnings that the no. of children who contract it is so high that even a comparatively low mortality rate can produce a high number of deaths.

As No Sleep ‘Til Brooklands says:
----"I can imagine that in an alternate universe somewhere the NHS has withdrawn the MMR vaccine, citing a 12-subject preliminary study claiming a link to autism, in which the doctor involved reportedly tweaked his results. In that universe, The Mail is running screaming headlines about every subsequent child death from measles, and columnists are suspicious that the decision to withdraw was merely financial, that the NHS and Government have simply decided that letting a few kids die of measles is ‘cost-effective’."-------

Anonymous said...

I think the science here is simple, sufficient and settled.

If you do not immunise to m,m or r, then you get an increased rate of infections. If you get infections, you get severe side-effects of infection at a fairly low frequency. In the UK population, "fairly low frequency" translates into an awful lot of suffering, disabled kids and deaths. Even though it is stochastic, and even though it happens at low incidence, it is inevitable.

As regards single jabs, the practical experience is that people don't complete all three.

So DK's view is that a single jab will raise immunisation rates. You know, if a doctor or scientist were to make such a speculative case, on the basis of the complete lack of evidence that DK relies upon, DK might well give them a damn good fisking.

err, and that is apart from the problem that you couldn't get enough vaccine for the whole population at short notice.

per

JuliaM said...

"Is it possible for there to be a better-thought out response to the Sense document that your apparently offhand dismissal of it?"

You are misunderstanding me (I suspect deliberately).

I have no doubts about the Sense report. But I'm not the target audience you need to convince.

And for every condescending 'Oh, you stupid people!' post you make here and on other threads, you lose more of the audience you are trying to reach.

The young parents with kids needing vaccination who see merely hectoring, or threats, rather than anything they can trust.

JuliaM said...

"I think the science here is simple, sufficient and settled."

It appears that enough people don't believe (or trust) you to make it a growing problem.

So, now what?

Anonymous said...

Have you ever heard of the Darwin Awards? I have no problem with these people removing their offspring from the gene pool

Devil's Kitchen said...

Some people here seem to be missing the point, so could I please ask someone in the know — HolfordWatch? — a quick question: is the measles single jab (assuming completion, etc.) any less effective in and of itself than the triple vaccine?

I would assume not — though I am no expert — since it would surely be the same strains of virus used?

DK

the a&e charge nurse said...

Devil - as you admit yourself the issue, as you present it, has got NOTHING to do with scientific evidence and everything to do with choice (we'll leave aside traumatising children with needless injections for the moment, or the fact that multiple jabs increase complications associated with sticking needles into muscle: cellulitis, dry abscess, etc).

The principle you seem to be advocating is that if pressure groups whinge often enough, and long enough then inferior treatment (more costly, more painful, greater risk of complications, etc) is the order of the day.

Next you'll be telling us that people with HIV should refuse to use condoms unless they are strawberry flavoured, or people with TB should decline long term antibiotics unless a two week holiday is thrown in to off-set the inconvenience of taking tablets for 6 months.

By the way you don't tell us which services should be cut to pay for the neurotic MMR refuseniks not to mention the additional health costs incurred from babies damaged in-utero by rubella virus.

SaltedSlug said...

It appears that enough people don't believe (or trust) you to make it a growing problem.

So, now what?



Well based on the historical record of vaccine abstention, when enough of these people's children are deaf, blind, infertile or dead they will re-assess their priorities.

cabalamat said...

JuliaM, responding to "Public policy should be based on science and reality, regardless of whether that pisses off a few misinformed idiots.":

And when it's more than 'a few', and is threatening your herd immunity as a result?

Clearly loss of herd immunity is a bad hing that ought to be avoided. Parents who don't immunize their children are causing negative externalities on others. The best way, in general, to deal with behaviour that causes negative extetrnalities is to tax it according to the amount of nxternality it produces.

In this instance, a simple solution would be to withhold some or all of child benefit payments from parents who don't immunize their children. This would rapidly bring immunization rates up to 99.99%

JuliaM said...

"In this instance, a simple solution would be to withhold some or all of child benefit payments from parents who don't immunize their children."

We can't seem to do this for criminals, and you are suggesting we do it for people who simply don't believe the government orthodoxy of the day? But who might accept a different (inferior) option?

Congratulations, you've created a martyr movement. And made the situation worse...

the a&e charge nurse said...

JuliaM said ......... "people who simply don't believe the government orthodoxy of the day ".

Substitute the phrase 'government orthodoxy of the day' for 'consensus amongst international scientific community' then we might be getting somewhere.

This is the problem in a nutshell: a small army of supposedly intelligent people talking absolute crap when they really should know better.

FlipC said...

@JuliaM "You mean, if there's a big fat government contract available, they won't make more...?"

Yep as if by magic they'll instantly expand production or change some of the existing MMR producing equipment to produce single jabs in the hopes that the government will maintain a contract for it and the fuss won't just blow over in a few years time.

The point about supply and demand is that when it requires substantial change or investment you need to guarantee that the demand will be sustained.

Besides if that had happened this blog entry would be about how the government is wasting our money on over-priced single jabs when the far cheaper and perfectly safe triple shot is still being made and sold.