Holford Watch: Patrick Holford, nutritionism and bad science

It would take more time than we have to put together a post that could encompass all of the errors and fallacies in Jeni Barnett’s lamentable LBC Radio piece on MMR. Particularly as this is one of those times when there is more to blog about than time available to do it when you have noses to wipe and daylight bulbs to buy for your ailing indoor plants.

However, we’ve finally been roused to put together a quick list of some rebuttals to some of the more obvious canards in Jeni Barnett’s lamentable LBC Radio piece on MMR. We were partly prompted to this by a comment left on Ben Goldacre’s blog by Honesty in Science.

So Ben you believe censorship will not backfire and will not lead to more people questioning of Honesty of the vaccine debate?
When it becomes common knowledge that all debate is being stifled and the reasons why parents do not vaccinate are taboo the shit will really hit the fan.
You will face charges of not being able to defend the science of vaccinations openly and honestly and not able to tpp publically refute the claims of the anti vaxxers.

Honesty in Science, we wonder if you fully understand the party who is being censored and the one who should be censured in this case?

Some shorthand answers for some of the antivax gambits in Jeni Barnett’s extraordinary departure from reality.

A first, formal port of call for people in the UK is the The Department of Health’s Green Book. For people in the US, there is the Pink Book of Epidemiology and Prevention of Vaccine Preventable Diseases. There are less formal summaries of some vaccines and preventable childhood illnesses and the excellent Do Vaccines Cause That?

Toxins gambit covers some of the familiar material about concerns surrounding the use of cell lines in vaccines (aka,by some, as monkey viruses, chicken embryos, foetal cells etc.) as does Toxic myths about vaccines. For some further technical information about thiomersal and aluminium salts in vaccines, see, e.g., Patrick Holford and aluminium in vaccines.

Tracy the homeopath mentioned formaldehyde in some vaccinations although the amounts that are present are within normal biological bounds and we produce the substance ourselves. Formaldehyde is a normal by-product of our own metabolism. Normal blood levels are 2.5ppm or 2.5mg/L (or 2.5 ug of formaldehyde per ml of blood) – compared to that, the amount in a vaccine is within limits, particularly given the half-life in blood of 1.5mins. If you consult vaccine formulations, the average amount to which an infant might be exposed on any one occasion is 0.2mg. Assuming the (not unreasonable) average weight of a 2-month-old of 11 lb (5kg) with a typical blood volume of 85ml/kg, the infant’s circulation usually works out at about 1.1mg, or x5 greater than the amount in a vaccine.

If you consult vaccine formulations, the average amount to which an infant might be exposed on any one occasion is 0.2mg. Assuming the (not unreasonable) average weight of a 2-month-old of 11 lb (5kg) with a typical blood volume of 85ml/kg, the infant’s circulation usually works out at about 1.1mg, or x5 greater than the amount in a vaccine.

Debunking the canards about the cell lines, foetal material etc. There is specific scrutiny of the claim that Simian Monkey Virus might be linked to cancer.

Although many people may have been exposed to SV40 by polio vaccination, there is inadequate evidence to support widespread SV40 infection in the population, increased tumor incidence in those individuals who received contaminated vaccine, or a direct role for SV40 in human cancer.

An epidemiologist’s take on: There’s no autism epidemic, it’s an artifact. Socratic Gadly argues that the apparent rise in autism may be attributed to:

a renaming of a syndrome in the Diagnostic and Standard Manual of Mental Disorders between DSM-III and DSM-IV.
DSM-III has “schizoid disorder with childhood onset.” DSM-IV has, with almost exactly the same symptoms, “Asperger’s disorder.”

Myth of Brave Maverick Doctors Being Stifled and Suppressed

Many of those who cry “We want a study” don’t understand some of the ethical ramifications of going beyond the rigorous tests that have already been done.

The Fallacy of the perfect solution – or stop vaccinating until there is a 100%-guaranteed, free from all possible side-effects for everyone vaccine.

Myth: babies delicate immune systems are overloaded by vaccines. As Dr Paul Offit demonstrates:

“Children have an enormous capacity to respond safely to challenges to the immune system from vaccines,” says Dr. Offit. “A baby’s body is bombarded with immunologic challenges – from bacteria in food to the dust they breathe. Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean.” In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 10,000 vaccines at once.
The bottom line: It’s safe to give your child simultaneous vaccines or vaccine combinations, such as the five-in-one vaccine called Pediarix, which protects against hepatitis B, polio, tetanus, diphtheria, and pertussis (also known as whooping cough. Equally important, vaccines are as effective given in combination as they are given individually.

For those who prefer listening, Dr Ginger Campbell recently interviewed Paul Offit about vaccine safety and his book, Autism’s False Prophets.

As for Jeni Barnett’s spectacularly ill-informed nuggets about asthma and vaccination, the evidence from various studies (such as this) is lending weight to the conclusion that vaccination is protective and associated with less severe asthma and even reduced incidence of asthma in younger and age-appropriately-vaccinated children.

Our results show that MMR-vaccinated children are less often hospitalized with asthma diagnoses and use less anti-asthma medication than unvaccinated children. This effect was most pronounced among the youngest children and children who were vaccinated age-appropriately…

The strong advice that is parents of atopic children should immunise them.

In children at heightened risk for atopy, common childhood immunization in the first year is not associated with an increased risk of more severe eczema or allergic sensitization. Parents of atopic children should be encouraged to fully immunize their children.

We have previously written on the issue of asthma and vaccination. Anderson and Carroll have recently published an up to date review of Virus Vaccines and Children With Asthma. Their findings are in line with other researchers: “Current evidence suggests that virus vaccination is well tolerated and does not lead to an increased incidence of asthma or atopy in children receiving vaccines”.

We enjoy the privilege of the freedom of speech but responsibility to use that wisely should be a corollary. There is a substantial influence of education and income on the uptake of MMR vaccines and the disproportionate influence of media such as television – a convincing argument as to why people like Jeni Barnett should be more cautious before spreading misinformation. Update Feb 12 Dr Aust has a good assessment of the media influence of Jeni Barnett’s platform and rhetorical devices. He discusses some valuable research that examines precisely the confluence of factors that influence decisions about vaccination participation and presents a detailed list of them. Dr Aust remarks, “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”.

Formal studies of the demographics of vaccine uptake include: Factors associated with uptake of measles, mumps, and rubella vaccine (MMR) and use of single antigen vaccines in a contemporary UK cohort: prospective cohort study and Anatomy of a health scare: Education, income and the MMR controversy in the UK (pdf)

As Dr Ben Goldacre highlighted, the NYT was the subject of the fascinating Phillips et al study: Importance of the lay press in the transmission of medical knowledge to the scientific community.

In 2000 Pareek and Pattison assessed The two-dose measles, mumps, and rubella (MMR) immunisation schedule: factors affecting maternal intention to vaccinate (pdf). They revealed that:

Mothers consulted a wide variety of sources to obtain general information about the MMR vaccine, including health professionals, friends, family, and the media…In contrast, mothers predominantly acquired their information about the side effects of the MMR vaccine from various sections of the media rather than from health professionals, with television the most commonly cited source of information about side-effects (31.4% in Group 1 and 37.9% in Group 2).

Summary and links to all the Institute of Medicine studies that indicate the safety of immunisation. AP Gaylard has usefully produced a table of what Dr Paul Offit styles as “Studies exonerating MMR”, drawn from Offit’s book, Autism’s False Prophets (Gaylard has thoughtfully provided the full references and links to online content, where available.)

What happens if you stop a vaccination programme? You get a resurgence of disease, that’s what: the CDC has a simple summary. Not only that, you start exporting the virus to other countries which makes it harder to track the associated morbidity and mortalities.

The woeful state of Andrew Wakefield’s research was pitilessly exposed in the Autism Omnibus Hearings by Dr Nick Chadwick and Professor Stephen Bustin inter alia. The Unigenetics lab results were the bedrock of Andrew Wakefield’s research but its laboratory conditions at that time mean that its results were worthless which has implication for validity of Wakefield’s research and is an obvious explanation as to why it has not been replicated. Both Dr Michael Fitzpatrick and Orac explain why Bustin’s testimony was devastating for the petitioners’ case because their expert witnesses relied upon the results from Unigenetics (it should be emphasised, however, that Bustin’s testimony was in line with that of other experts who were familiar with the problems at Unigenetics).

Gimpy has posted on some of the issues of homeopathy that Jeni Barnett raised in her faux-naif fashion. Dr Peter Fisher, representative for medically-qualified homeopaths who are in the Faculty of Homeopaths, has said that Hahnemann, the founder of homeopathy, would approve of childhood vaccination despite the ill-informed claims to the otherwise by people such as Patrick Holford who claim that parents might safely consider homeopathic vaccination for meningitis.

Touching on the myth of “measles is a trivial illness” – no, it isn’t. Once more and with feeling, it isn’t. Just to emphasise this point, look through Dr Aust’s post: Measles: Spot the Worrying Trend with its remarkable illustrations of the chilling billboard advertisements in Germany that advise the uptake of vaccinations and warn of the potential consequences of preventable childhood illnesses. Martin Robbins of The Lay Scientist also provides a comprehensive run through of why Measles is dangerous.

Please post some of the other canards that we haven’t addressed and a link to a rebuttal if you have it – or even if you don’t.

Related Reading, Links, Analysis and Rebuttals

DBH of The Great DBH Rant has gone through the transcripts and concluded: Jeni Barnett Anti-Vaccination Drivel – Irresponsibility at its best..

jdc of jdc325 offers a comprehensive MMR Round-Up with information about the number of cases of measles and also the state of the scientific evidence that lends support to the safety profile of childhood vaccinations. jdc’s earlier post MMR Scaremongering from Jeni Barnett: LBC Use Legal Chill Tactics has been updated to provide a good discussion of the potential complications and sequelae that may result from measles, mumps or rubella.

The Fabulous Unity of the Ministry of Truth provides an entertaining and on-point rebuttal of many of Jeni Barnett’s more fatuous comments: Jeni Barnett – Pig Ignorant and Proud. Unity explores Jeni’s implication that she has no need to know the ingredients of MMR to state that it is harmful because she doesn’t know the ingredients of cigarettes but knows that they are Not A Good Thing:

How is it that Jeni knows that cigarettes are harmful. It is, perhaps, because she’s a parent? Because at some point during the actual of childbirth a hormone is released which imprints the knowledge that cigrarettes are harmful in the memory of the mother?

Or is that the case that she, I and everyone else knows that cigarettes are harmful because research undertaken by scientists over the last forty years and more has established the evidence which links cigarette smoking to lung cancer, heart disease, etc.

The knowledge that cigarettes are harmful is not something we acquire naturally by osmosis, it is something we discover by carrying out scientific research. We establish what is and isn’t the truth by looking for evidence.

The evidence relating to cigarette smoking tells us that, yes, it is harmful.

The evidence relating to the MMR jab tells us that Andrew Wakefield was an unprincipled charlatan who should never be allowed near a research facility for the rest of his life and that there is no evidence to support any of claims made about the MMR vaccine linking it to autism or Crohn’s disease.

Please read the whole, it is a gem and gives some superb examples for teaching the identification and deconstruction of logical fallacies.

AP Gaylard of A Canna’ Change the Laws of Physics has an outstanding discussion of the notion of informed consent: Ignorant refusal. Gaylard identifies one of the cruxes of Jeni Barnett’s misguided defence when she repeated the mantra that:

In the guise of providing people with information to help them reach a balanced decision, anti-vaccine campaigners often provide un-evidenced assertions; rely on debunked work and baseless conspiracy theories (as seen in Barnett’s reported comment, “there are all sorts of other figures that have been withheld from us, and I don’t know what they are because they’ve been withheld!” Classic).

More than that, they studiously ignore good quality evidence which contradicts their beliefs.

They are actually advocates of ignorant refusal. They end up supporting the right to choose only in the presence of ignorance: their public pronouncements promote continued ignorance.

So, what does the balance of evidence really say about the safety of MMR?

Gaylard then goes on to give an excellent synopsis of the balance of evidence.

The Milligan has returned to the corpus delicti and picks through the nasty mess: Jeni Barnett and her anti-vaccination drivel.

Brian Deer has some news on Andrew Wakefield and his research that may well be relevant to discussions of what was known and when and the standards of evidence that underpinned what Ben Goldacre characterises as the MMR hoax perpetrated by the mainstream media.

BPSDB