I’m glad you see it as important to assess the risks and benefits of particular interventions. With that in mind, perhaps you might share the evidence which convinced you to argue (in Food is Better Medicine than Drugs) that IgG home allergy tests are useful for diagnosing “food sensitivities”. We would also be fascinated to know how you determined that the various supplement regimes suggested in the book are safe and effective.

You claim that because I wrote “assuming dvnutrix is aka Ben Goldacre” that you cannot take my “assertions” on trust and that this provides evidence of “little thought” on my part. But you have confused “assumptions” with “assertions”. Telling someone you are making an assumption, as I did, is a way of asking a question. It was a perfectly reasonable assumption but I was leaving it open for you to confirm or deny. The lack of thought here doesn’t seem to be my problem. Further I’m not sure why I, who use my own name, should be considered less trustworthy than someone with a pseudonym.

My original point about sub-editors was a bit of a joke. It referred to your excessive concentration on minor details. It is important to get your facts right of course but in the nine points that I responded to there was just one incorrect figure – 8 rather than 6 deaths. What is crucial is to distinguish between facts that affect the main thrust of the argument – and those that don’t. I will certainly correct the figure if I return to this topic (thanks) but it makes no difference to the case that this is not a condition that has a high mortality rate.

I don’t quite know how to respond to your claim: “You did not make any substantive points in your response.” For instance you said originally that the rise in fits following the ProQuad was inconsequential; I showed that an FDA panel had considered it serious enough to water down its “preference for the combo vaccine”. That seems pretty substantial. Or do you not understand the significance?
Otherwise my response demonstrated that the points you raised to justify your original liberal smattering of insults – “distorted interpretations”, “gaullimaufry” (absurd medley) “spreading misinformation” – were not grounded in the facts – there were perfectly legitimate references for my claims, papers supposedly obscure were not, sources were authoritative etc.

You suggest that my aside about you “shooting yourself in the foot” was just the sort of point scoring I had accused you of. The difference is that it was tied to a specific example – the FDA and ProQuad. You however didn’t deal with a single point of mine and simply again scattered broad spectrum slights: “little concern for your readers”, “attempt at self-justification”, “not understanding the criticism or the references”.

I know your style depends on portraying yourself as informed and evidence based and scientific and everyone else is idiotic, confused and probably with a self-serving agenda but you must know that is not only just wrong but that it does nothing to create a sensible debate. Also you should be aware that allegations of projection are a two-edged sword.

On the topic of Ben Goldacre – you might take a leaf from his book and start a blog – that way you would be able to provide the references that are missing from any newspaper items even if the newspaper in question won’t take them as yet. However, we are hoping for movement on that front as we seem to be persuading even Science: So What? to re-think their policy on this issue.

You do seem to rely on sub-editors to catch your factual errors – that is not really their job or their responsibility.

You did not make any substantive points in your response however, since you are returning to the matter, we shall, of course, dedicate a post to your response at our leisure and not over the Bank Holiday w/end. We’re sorry that you misconstrued our desire to respond to you as a gesture of respect with intellectual sloppiness, however, one considers the source and doubts the sincerity of that affectation of your critiquing our response in this manner. We invite you to respond to our fuller response. As for the point scoring, let us demur on that and refer you to your earlier comment and the alleged foot shooting: we also advise you to consult a good definition of the psychological phenomenon of projection.

I’m very unimpressed by your response. When you strip out shoolmasterly phrases about read the critique more thoroughly and how it’s a shame I’m not catching errors, there is nothing there. I’ve got a limited amounts of time to spend raking through the entrails of my old articles but I thought it worth it because you made a number of serious points about my piece and I felt the least I could do was to respond seriously.

If I am to expect the same kind of lazy point scoring in reply if I respond to your critiques of “Food is Better Medicine than Drugs” then I will have to decline.

Perhaps you might ask Daily Mail to carry links to relevant research and sources: it is profoundly irritating to read assertions in so many health or science pieces and it would make it easier to check if there were links, maybe in the style of New York Times.

You might notice how much a recent post by Patrick Holford has improved since he included some references to support some assertions that he had made in the original version. There are still some problems with it but it is improving. Sometimes, this is what accepting well-informed critique can do.

While you are here it would be interesting if you respond to the errors in your co-authored book, Food is better medicine, because we have long been curious just which of you is responsible for various errors – and why they weren’t caught by the ‘team of expert reviewers’.

However, having read your attempt at self-justification that seems to rely upon not understanding the criticism or the references, I have a greater understanding of why some of the errors in the book have persisted.

1) You dispute my claim that some experts question whether we need a vaccine against something so mild especially when it raises the risk of shingles, saying “it depends on whom you style as experts.” The ones I quote include an infectious diseases expert who has just retired from Western General Hospital, Edinburgh and the UK Health Protection Agency (HPA). Pretty reliable I’d say.
2) You rightly query whether the 50 deaths from chickenpox per year 1 quote is for UK, Europe etc. It is actually world wide (Seward, J. F., and W. A. Orenstein. 2006. Commentary: The case for universal varicella immunization. Pediatr. Infect. Dis. J. 25:45–46.). You’d make a good sub; the fact simply reinforces one of my key points that this is a very mild condition, a major reason why a vaccine is unnecessary
3) You attempt to dilute my comments about the multiple American vaccine containing chickenpox – Proquad – which doubled the number of fits, by going into a very informed discussion of fits and how they are not that uncommon and usually harmless and that the doubling was from a very low base.
All true but again you shoot yourself in the foot. That doesn’t alter the fact that ProQuad did double the rate and others beside me thought this important. An AP report on Feb 28 2008 stated that as a result of this finding the federal advisory panel on vaccines had watered down its “preference for the combo vaccine.” Previously the panel had said that giving ProQuad was preferable to giving single shots. In other words it now considers the combination vaccine no better than individual shots – a highly contentious issue as far as MMR is concerned and very relevant since if a chicken pox vaccine was introduced it would most likely be added to the MMR.

4) Then we come onto the cloudy issue of how many extra cases of shingles there might be if a vaccination was introduced; figures vary a lot as I think I made clear. You ask for source for the 90% incidence – it’s Yih,W. K., D. R. Brooks, S. M. Lett, A. O. Jumaan, Z. Zhang, K. M. Clements, and J. F. Seward. 2005. The incidence of varicella and herpes zoster in Massachusetts as measured by the Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing varicella vaccine coverage, 1998–2003. BMC Public Health 5:68.
I’m happy with giving sources but this was a newspaper article not a Cochrane review which is why I didn’t review the literature as you seem to require. However I did also quote both the infectious diseases expert and the HAD who both predicted an increase. It does seem to me on all these points you have a bit of a “wood for the trees” problem. Once again my main point stands – if you vaccinate against a pretty mild disease you will very likely increase the incidence of a nastier condition in the elderly. Is that worth it?

5) You say “65% by the age of 85 is an extraordinary statistic”. It comes from the Herpes Viruses Association, ( http://www.herpes.org.uk/shingles/#shingles.) who have an impressive list of patrons and should know. Around here you comment – “Jerome Burne’s gaullimaufry of conflicting numbers … seems strangely slanted towards frightening rather than informing.” Actually, if you are worried about frightening people, what do you suppose will happen when the case for introducing the vaccine is being made? That is where the scaring comes in.

6) Thank you for telling me about “Scopie’s law” and the Whale site, which I have never seen. Trouble is that all your rather laboured point about the Goldman paper being so obscure and so hard to find that you had to go to this loony site to find it doesn’t do you any favours. It was published in a perfectly respectable journal – the International Journal of Toxicology – and is available on PubMed. Have a look – Int J Toxicol. 2006 Sep-Oct;25(5):313-7. The paper give high figures for possible shingles incidence which you dismiss with: “Goldman does not give a clear source for his figures.” Again not true. He quotes figures from the Varicella Active Surveillance Project (VASP) and has a number of references.

7) You have another quibble about my “alarming reference to shingles-related “blindness”; supposedly another example of scary unreliable data. Wrong again. See just one example: FDA Consumer magazine May-June 2001 which talks about shingles can affect the ophthalmic nerve “possibly causing temporary or permanent blindness.”

8) On the issue of number of deaths in the UK from chickenpox I do admit to an error – the figure given in the 2007 UK surveillance report which you refer to and which Dr Richard Halvorsen quotes from is six. The figure I gave was eight – no idea how it crept in. But while again I acknowledge your sub-editing skills, it makes absolutely no difference to the argument. The bulk of the cases, sad as they are, were suffered by children with chronic disorders. Vaccinate them by all means but is that a sound basis for a national program?

9) I’m delighted for you to continue to sub my articles – you must be my most assiduous reader. But it would be grown up and in the spirit of scientific enquiry if in future you laid off the gratuitous insults, they just make you look a little silly.

There are legitimate questions, as we have indicated previously.

Have you no compunction that one of your supportive commenters on that post is homeopathy4health who recently banned logic from her blog?

Andrew’s comments are no longer allowed on this blog. This is because he has a tendency to write opinions based on logic and not from experience or facts. He is a programmer by profession.

http://insidevaccines.com/wordpress/2008/03/20/eradicate-chickenpox-sure-why-not/

The assumption that we’ve got it all figured out–we can vaccinate against chickenpox, eliminate the illness, save lives, and not have a significant increase in shingles…hubris comes to mind. All vaccines have side-effects, so there is also an assumption that the side-effects will be rare and not as serious as the occasional complications of the illness.

Vaccine programs = insane optimism IMO.