The Truth About TTAV Episode Seven: BUY MY STUFF!

Read this whole series by starting here.

Episode Seven: Natural Immunization, Homeoprophylaxis & Fundamental Freedom of Choice

The Cast

The Claims

Natural Immunization is the Best

  • The film claims that breastfeeding is the best immune defense for babies, but its effectiveness isn’t promoted because it would compromise the pharmaceutical industry’s interests.
    • Passive immunity through breastfeeding only protects infants from infections contracted through the gastrointestinal system. Airborne infections such as measles, chickenpox, influenza, rotavirus, and pertussis, are not covered by the immune passed from mother to child via breastfeeding.
    • Infant formula manufacturers do not manufacture vaccines.
  • The film also claims that healthy vaginal birth is the most important method to ensure a life of gut health for babies. I mean, whatever. Not dying in childbirth is pretty important to c-section mothers. There is some correlation with c-section delivery and asthma, Type-1 diabetes, celiac disease, and obesity, but the causation has not been proven. At this time, none of those conditions is vaccine-preventable. Why are we here? I don’t know.
  • The film claims that essential oils and probiotics provide natural immunity to viruses. But recent research shows that the claims of benefits from probiotics are overblown, and essential oils are a pyramid scheme and as reliable as one.
    • Were allegedly used to curb bubonic plague, gangrene, etc. But quarantine and hygiene likely ended the plague, and aggressive surgeries helped curb the high gangrene death rate, historically. Now we have antibiotics. 
  • The film promotes GcMAF – Gc Protein-Derived Macrophage Activating Factor
    • Claims by James Jeffrey Bradstreet that this diet could cure autism lead to an federal investigation shortly before he died by suicide.
  • It also claims that vitamin A is the cure for measles and reduces. incidence of mortality in outbreaks among children.
    • Children with serious malnutrition who are vitamin A deficient are at higher risk for severe measles infection. Supplementing these children is important, but there is no reason to believe a well-nourished child would see any difference in measles severity with Vitamin A supplementation. We can assume the children of the 1950s U.S. were well-nourished, yet 500 of them died each year before the vaccine was available.
  • The film claims that vitamin C is effective in curbing the spread of viral diseases, like whooping cough, because it energizes the immune system, loosens the secretions in the lungs, and frees the lungs (toxin-neutralizer)
    • Cited famed Dr. Klenner’s research on Vitamin C’s effectiveness, but health theories about Vitamin C have been repeatedly disproven, as early as 1938. But for people who promote natural health, they should realize that taking megadoses of any vitamin is unnatural and often dangerous.
  • The film states that health starts with the diet as feeding children real food, specifically breastmilk, fruits and vegetables, boots immunity, the microbiome and brain and boosting nutrition activates kids’ genetic code and invokes immune responses in a symptomless way (built-in immunology)
    • The idea of boosting immunity is a misunderstanding of how immunity works. Certainly, malnutrition hinders the immune system’s function. But there are two different types of immunity: innate and acquired. The innate immune system (the one that can be hampered by malnutrition) is the rapid-response to new germs the body encounters. The acquired immune system is the one that has been around long enough to recognize and fight off a particular germ. Real boosting immunity is what happens when the innate immune system encounters a germ and revs up: your body might respond with fever, phlegm production, and coughing. Your innate immune system cannot handle big germs like measles and chickenpox without you getting sick.
    • Put simply, measles doesn’t care what you had for breakfast.
  • The film claimed that a Norway study proved that folate taken through pregnancy prevented neurological disorders among children (autism rate was 1 in 1000 vs. 1 in 500 for mothers who didn’t take the vitamin). One study showed that oversupplementation is a risk factor for autism.
  • Finally, the film claimed that mortality rates from VPDs (vaccine-preventable diseases) were eradicated prior to the introduction of many vaccines because of basic improvements in quality of living. This is an extremely common anti-vaccine claim. Here are the facts:
    • Mortality and disease rates are not the same. The rates of mortality from VPDs declined, in part, because of many modernizations, including medical advances.
    • The incidence of VPDs remained somewhat steady even as many deaths from them were prevented. In order to eradicate a disease, the incidence has to drop to zero globally. The only human disease eradicated is smallpox, thanks to vaccines.
    • The drop in incidence in a disease followed the introduction of a vaccine for that disease.
    • Measles incidence dropped in the mid-1960s, chickenpox in the early 1990s, Hib in the early 2000s, and rotavirus in the mid-2000s. Quality of life improvements did not occur neatly at those particular times to coincide with reducing the cases of only one particular disease, except vaccines. Vaccines improved the quality of life.

Homeoprophylaxis (HP) is a Great Thing! (Shop My Store!)

  • Homeoprophylaxis is homeopathic immunization. Homeopathy is a method by which a substance is diluted down by water to such a degree that no active ingredient is left. Often the water is then shaken with a sugar pill and sold as a cure—or a vaccine—for something. The idea is that the medicine becomes stronger the more dilute it is because water has memory.
  • Homeopathy commonly uses the phrase “Like to cure like,” which means that any substance which can produce symptoms in a healthy person can cure symptoms in someone who’s sick. Which is nonsense.
  • The film says homeoprophylaxis has never caused deaths in anyone who uses the method. I mean, sure. It’s sugar pills with nothing in them.
  • These homeopathic nosodes supposedly prevent disease without “toxic” effects
    • Vaccines are not toxic.
    • Claims that you can use them to detox from vaccines are laughable. Your liver and kidneys detox for you. 
    • Nosodes are worthless.
  • The film claims a Cuban study showed that homeoprophylaxis was more effective in reducing the incidence of a swamp-related disease than pharmaceuticals.

Fundamental Freedom of Choice! 

  • Like many anti-vaxxers, the film disdain’s California’s SB 277, the bill that requires all children enrolled in schools be vaccinated unless medically contraindicated.
  • The film claims that Richard Pan was pressured by pharmaceutical lobbyists to push SB 277
    • In reality, Dr. Pan is a pediatrician who understand vaccines because he has seen what they do first hand.
    • Allegedly received $95,000 from pharma lobbyists before the bill passed, but I am not finding them among his top donors.
    • I mean, this film just spend a chunk of time being a commercial for homeoprophylaxis. They want to go to this direction?
  • The film claims the bill is an attack on parental rights. Of course, parents do not have the right to endanger communities, including school communities. 
  • The film claims that vaccine requirements will soon extend beyond education and employment; will be required for driver’s licenses, public events, etc. There is no way to debunk this because I can’t show something that isn’t happening. Prove to me that unicorns don’t exist. Ha! There! I win. 
    • Schools are reasonable places to require vaccine for entry because children are the most at risk for many diseases, the primary vectors of many diseases, and spend much time in close proximity to each other at school.
    • Healthcare settings, where vulnerable people congregate and where illnesses can also abound, are reasonable places to require vaccination for employment.
  • Healthy People 2020 – plans to get everyone vaccinated. Or more people, with the primary goal of reducing diseases.
  • Choose one of their crackpot theories that is the most offensive:
    • Plans to take away the right to vaccine refusal!
    • Plans to have extensive registries!
    • Mandatory vaccinations are completely contrary to America’s founding principles!
    • Forced vaccinations are legally assault and battery!
    • Can’t use one fundamental right to restrict another right; non-medical exemptions are at risk!
    • Losing informed consent makes us slaves!
  • The film proclaims that the anti-vaccine has united people of all backgrounds
    • In reality, most anti-vaccine activists are wealthy and white
    • They believe that they are a protected minority and their movement is akin to Black Lives Matter movement. This is a strategy that remind me of the Russian bot strategy recently discussed.
    • They call themselves “vaccine safety advocates,” claiming they’re against the toxins in them. This is where the film started, but I think the contents of this episode have proven that they are vaccine conspiracy theorists with something to sell you.

That’s it folks. Ultimately, this series ended with a commercial for things you can buy instead of vaccines. For this reason, I refer to the anti-vaccine movement as primarily fear-based marketing to promote alternative remedies.

Here’s what you need to know. The vast majority of experts across the world working in public, private, and educational organizations agree that vaccines are safe and save lives. There are some outliers, and scientific outliers are usually wrong. 

I’m going to go watch Fried Green Tomatoes now.

You’re banning me!

Like so many of you, I have been banned from Dr. Bob Sears’ Facebook page. While it isn’t headline-making news, I wanted to write about the comment that got me banned because it highlights, once again, that Dr. Bob is anti-vaccine.

The problem began when he posted something on his Facebook page that stirred in me the inability to stay silent:

“DEATH IS THE ONLY LEGITIMATE VACCINE EXEMPTION . . .”

. . . said the former doctor of one of my patients-to-be. I kid you not. My wife, Cheryl, who manages the office, sometimes picks up the new patient messages on our voicemail. She never has me listen to any of them because, well, that would be stupid. But she grabbed me the other day and said, “You have to listen to this. You’re not going to believe it.”

I didn’t. Believe it, that is.

A mom actually called our office and said she needed a new pediatrician because her old one wouldn’t even discuss vaccine medical exemption with her. Now, of course, that part’s believable. There are hundreds of thousands of doctors nationwide who won’t even discuss these exemptions. And if they choose not to offer informed consent for invasive medical treatments for their patients, that’s their decision. It’s also a patient’s right to leave their care.

But this doctor took it a step further. Well, a giant leap further. The message on our phone actually was “My doctor said death is the only legitimate vaccine exemption . . . and I disagree. So I’m looking for a new doctor.”

I can’t wait to hear the whole story. I hope this patient comes in soon. We’ll see if we can find something in her child’s medical and family history that qualifies for an exemption short of death.

Dr. Bob

Everyone I have spoken to has two reactions to this post.

  1. That sounds like something that never happened.
  2. Does that mean Dr. Bob is going to sell this woman an illegitimate medical exemption?

But my reply actually gave Dr. Bob the benefit of the doubt:

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“I hope that when this parent comes in, you share with her that the contraindications to vaccines are discrete and that if her child does not fit into any of those contraindications, she is not eligible for a medical exemption.”
I also directed Dr. Bob to the list of contraindications to vaccines. This comment does not attack Dr. Bob nor does it treat him or anyone else disrespectfully. It simply points out that there are only so many contraindications to vaccines, and that a medical exemption outside those contraindications is inappropriate.

It is possible the reason for my ban was the only other comment I left on that thread. Unfortunately, I did not get a screen shot, but it was in reply to a woman who was replying to my friend’s comment, a reply filled with references to Thalidomide and smoking as proof that vaccines are terrible. Here is her reply to me:

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I cannot imagine I was banned for pointing out that Thalidomide was never approved by the FDA (fun Women’s History Month fact) or that measles and chickenpox parties, like smoking, used to be acceptable health practices, but now that science has moved on, they no longer are.

But it is significant to me that the commenter above, and others like her, were left on the page to comment freely. The woman above, for example, began her reply to my friend with this dig about her as a mother and about how she gave birth:

Do you have biological children? If so, did you have them without any drugs? If you do, or did then that true bond would not allow you to push for all these vaccines and boosters in your flesh and blood. Other countries have excellent scientists who are against so many vaccines in such a short time. I bet you only had a fraction of the vaccines that babies are subjected to these days

Yes, you read that correctly. If you had a pain-free birth, you don’t love your children and that’s why you vaccinate them.

That comment, along with the mountain-loads of misinformation posted by Dr. Bob’s fangirls, was left untouched and uncorrected by Dr. Bob because it plays into the fear of medical interventions and other doctors he promotes in order to drum up his own business and grow his own brand.

Do me a favor, friends, and call him on it–because I no longer can.

 

 

 

Mandates, Ben Franklin, and Vaccine Injury

On Monday (President’s Day), I flew to Philadelphia to be part of a panel at the Franklin Institute discussing whether or not we should mandate vaccines. The other panelists were Dr. Paul Offit (you may have heard of him) and Dr. David Ropiek. It was an exciting conversation, I learned a ton, and I was grateful to the good people (both for and against mandates) who drove through the evening’s sleet and snow storm to attend.

As you can imagine, before the event began, it was the sources of some controversy. One chiropractor/blogger went to great lengths to explain why the esteemed Franklin Institute should not provide a forum for such a discussion. Most of her letter, of course, was an exhortation about how awful Paul Offit is and how much she disagrees with his science-based approach to vaccines. Her letter, of course, had no effect on the evening at all, but I mention it because we knew going in to the evening that the audience would include people who were not only opposed to vaccine mandates but also opposed to the very existence of vaccines at all.

As a side note, as much as Paul Offit is vilified, he really does deserve none of it. He is as kind a person as you could imagine, spending the time before the event asking how my children were doing and providing updates about his children. He truly cares about children not in the abstract, but about your children and mine (and his).

Because we were prepared for backlash, no questions were taken live. Instead, people used the Twitter hashtag #TalkFI to submit their questions. And that brings me to the one question I want to answer more completely.

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Tweet: What do you say to parents who do have a vaccine injured child?

To provide a little bit of context, the question was presented to the panel as “What do you say about mandates to parents who say that their child is vaccine injured?” Phrased that way, the question really could have come from anyone–pro-vaccine, anti-vaccine, vaccine-ambivalent. I did not know that I was answering someone who found what we were saying offensive.

So my answer was, in essence, “Vaccines don’t cause autism.” And why was that my answer?

  1. Vaccines don’t cause autism.
  2. 90% of the time, when someone asks me about “vaccine injury,” they mean autism. Parents whose children have had adverse reactions to vaccines that match what the science tells us to expect usually do not refer to their children as “vaccine injured.”

From there, Dr. Offit took up the question and gave a fantastic explanation about what a true adverse effect from vaccination entails and how honestly rare it is. His answer was far more eloquent than my blunt response, and I think it provided parents some real insight into why it really is okay to require that children who attend school are vaccinated.

But what about mandates? The problem with a panel discussion is that often one panelist brings up a point that launches a new discussion before the answer can be completely discussed. So here is what I would say to a parent whose child suffered a real and debilitating adverse event after vaccines.

I am sorry that your child had a reaction to a vaccine. In an attempt to protect your child, a medication caused harm, and that was certainly both unintended and unfortunate. Because your child cannot receive this vaccine, or potentially any vaccines, a medical exemption will keep him in school. I will work very hard to make sure all the children around him who can be vaccinated are vaccinated because if a vaccine can injury your child this way, it is possible a disease can do something much worse.

That’s my complete answer. It’s important to note that parents whose children have suffered real adverse effects confirmed by science and evidence often agree that other children should be vaccinated to protect their children. David Salamone is one such child. He contracted polio from the Oral Polio Vaccine and has been permanently disabled since. And yet, he says:

I’m not against vaccinations. I’m pro-vaccinations. We had thousands of people contracting polio prior to the vaccination. We came out with the vaccination, and that number decreased significantly. So less people are getting sick, less people are getting affected, and that’s a good thing.

None of this, of course, will make any difference to the people who came out to the Franklin Institute to confront Dr. Offit or who wrote letter to them ahead of time protesting the forum at all. At the end of the evening, after trying to refute on Twitter the points we were making, Carol had one last point:

Screen Shot 2016-02-18 at 9.10.12 AM
Tweet: It’s more than one in a million. Don’t allow them to keep lying.

Could I have given any answer to appease her? No. I look at the evidence about vaccines and think, “This makes sense, and we must shape our policies based on what we know and how we can best protect children.” Vaccine opponents like her look at the evidence about vaccines and say, “This evidence doesn’t line up with what I believe, so there must be other evidence people are hiding. We must make policies based on the evidence we cannot see.”

Policies made to appease people who have beliefs that fly in the face of evidence or who have fallen prey to the misinformation of the anti-vaccine movement are unwise. They are policies that appease the fears of adults rather than protect children against the real and dangerous threat of disease. And while fear can be a powerful motivator, protecting our vulnerable must be more powerful.

P.S. Don’t forget to use the hashtag #BeLikeBen this week to highlight Ben Franklin’s commitment to public health. And if you’d like to watch the entire panel discussion, here you go:

Be Afraid of the Many, Many Vaccines

Dr. Bob Sears wants you to believe he is a vaccine supporter. He so supports vaccines that once, while in the midst of lobbying against the elimination of vaccine exemptions in California, he asserted:

I give vaccines every single day in my office. I am pro-vaccine and understand that vaccines work and have reduced and eliminated many serious diseases. And that’s not just spouting a party line – I firmly believe that, and that’s why I give them in my office.

After all, you cannot be against vaccines if you give them in your office–every day! To be fair, it is possible to believe that vaccines should not be mandatory for school entry and still be a proponent of immunization. But don’t tell that to his fans and followers. One complained on his Facebook page:

Dr’s at Dr. Bill’s office should be made aware of this. I was bullied by a dr there, and won’t be back. She said they were completely safe and that the disease was worse than any side effects from vaccines.

Oh hey! Wait just a minute there! Vaccines are safe and the diseases they prevent are a bigger risk? Surely, pro-vaccine Dr. Sears would respond in a way that assured this parent that, yes, vaccines are safe. The diseases they prevent are worse than any side effects from vaccines. After all, that’s what someone who believes that”vaccines work and have reduced and eliminated many serious diseases” would say.

That’s not what happened.

Screen Shot 2016-02-09 at 12.12.49 PM

Admittedly, this comment is still treading the line. He wants to be liked by the anti-vax moms and he wants to be liked by the other 99% of the people in the world, too.

But please watch Dr. Bob carefully. He is constantly and eagerly disseminating the misinformation created by the anti-vaccine movement, as he did today on his Immunity Education Group page. This page is geoblocked and available only in the U.S., so here is a screen capture for the rest of the world.

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I asked the eminent Dr. Cox what he thought of this poster, and he told me it is filled with wrong.

  1. Number of injections: Any parent who follows the CDC schedule would look at this and think, “I really do not remember my child receiving 50 injections.” And that parent would probably be right. I checked my own child’s immunization records and noted that the DTaP, IPV, and Hib vaccines were combined into one injection. There are several combination vaccines that minimize the number of pokes a child receives.
  2. 1983 schedule: I was born, ahem, a couple of years before 1983, and my complete immunization record is longer than the list above. Why? Because I didn’t receive all my vaccines in 1983. I did receive a second dose of the MMR before I went to college (and I am fine). I also received (and continue to receive) influenza vaccines.
  3. Liability: If a pharmaceutical company manufactures a vaccine in a way that is negligent, they can be held liable, and you can sue them in civil court. The possibility of this happening is pretty remote, given the amount of FDA oversight vaccine manufacturing goes through.
  4. The doses red herring: If your child receives four pneumococcal vaccines months apart, what is the possible harm? I honestly do not understand the hand wringing over boosters. Such worrying is like letting your child sneeze on your face once and shrugging it off, but then become concerned when he sneezes again because…what? You are going to become extra sick then? Since the ingredients in vaccines are present in such minuscule amounts, booster shots are not really a concern there, either. The fear-mongering about that number, though, is itself boosted when Dr. Bob adds together doses.
  5. Forgetting the diseases: I mentioned above that I was born a tiny, little bit before 1983. I did not have to suffer measles or fear polio because of vaccines. However, a meningococcal outbreak swept through my school, and I am grateful for the vaccine. I know a young man who died from chickenpox, and I am grateful for that vaccine. I have heard absolute horror stories about Hib epiglottis, and I am grateful for that vaccine. I was hospitalized with pneumonia as a toddler, and I am grateful for that vaccine. Rather than saying, “Look at all those vaccines,” I say, “Look at all those diseases we can prevent.”

So why would Dr. Bob post such an inaccurate and terrible graphic–one that misrepresents the CDC schedule, rewrites history, misrepresents the law, and makes no mention of actual disease prevention? If he gives vaccines in his office every day, doesn’t he realize that vaccines can be combined and that we are grateful we can prevent all these diseases?

I honestly don’t know why Dr. Bob gives vaccines in his office every day. He just doesn’t seem to like them very much.

 

Why You Shouldn’t Shop for Medical Exemptions

Recently, filmmaker Leslie Manookian wrote a post for vaccine hesitant parents about how to pester physicians into giving them an inappropriate medical exemption. This interest in medical exemptions stems from the newly passed law in California that eliminates all non-medical exemptions. Parents who are now too scared to vaccinate their children are forced to make some tough choices. (Well, tough for them because of their misperceptions of the risks of diseases and vaccines.) They can either vaccinate their children or homeschool them.

Anyone following the anti-vaccine movement can understand how an otherwise reasonable but vaccine-hesitant parent feels about this choice. For them, the choice feels like deciding between certain death or certain economic doom. After creating the fears about vaccines, woopreneurs like filmmaker Leslie Manookian (and Bob Sears) have stepped in to capitalize on this fear by offering parents a way out of the vaccinate-or-homeschool conundrum. Thus Manookian’s “How to Claim a Medical Exemption in CA.”

Of course, the decision to shop for a medical exemption is unwise. To get a greater understanding about medical exemptions and how unwise they are, I asked two friends to weigh in. I talked to Dr. Anna Saporito, a family physician from New York, and Dorit Reiss, a professor of law in California.

Manookian claims:

More and more research is showing that individuals with a variety of conditions and genetic mutations are more susceptible to vaccine reactions.

These conditions and disabilities include already existing or a family history of previous vaccine reaction, eczema, food and environmental allergies, asthma, gut issues such as Crohn’s and IBS, autoimmune disease such as diabetes, lupus, MS, rheumatoid arthritis, ASIA, and others, chronic ear, sinus, strep or other infections, Lyme disease, PANDAS, POTS, learning disabilities, speech delay, ADD, ADHD, autism, seizures, bipolar, schizophrenia, thrombocytopenia, genetic variance, impaired methylation, detoxification impairment, and more.

Of course, most of us recognize this claim as fishing for an exemption. After all, can you imagine asking a doctor to forego vaccines for your child because he is prone to strep throat? (Why isn’t there a vaccine for that?) My supposition about this laundry list was right, according to Dr. Saporito, “There are actually very clear guidelines written by the ACIP and CDC outlining medical contraindications for vaccines.” You’ll notice that almost everything listed in Manookian’s litany is missing from the CDC’s guide to who cannot be vaccinated. In fact, many are actually listed on the CDC’s Commonly Misperceived as Contraindications list, including autoimmune diseases (such as diabetes, lupus, MS, etc.). Other items on her list are not included because learning disabilities and neurodevelopmental disorders are not contraindications to vaccines.

Manookian moves on to claim that parents can demand allergy and genetic testing before being vaccinated (with the assumption that something will pop and be used as reason for a medical exemption.) Again, Dr. Saporito notes that this approach is not warranted:

There is no evidence that genetic testing would provide any useful information in the prediction of vaccine reactions. Allergy testing might make sense, but not genetic testing. (If SCID [severe combined immunodeficiency] is suspected, that should be tested for, but usually that diagnosis is already known.) The American Association of Allergists and Immunologists have great guidelines about allergies and vaccines.

It is important to note that the American Association of Allergists and Immunologists’ document discusses how to test for allergies to vaccines after a vaccine is administered. It is not a standard of care to test children without a history of allergies for possible allergic reactions to vaccines they have never received.

Finally, I asked Dr. Saporito her stance on parents shopping for doctors who are more willing to provide medical exemptions for conditions that are not contraindications and whether or not family physicians are more likely to provide a spurious exemption:

The science is quite clear that vaccines are safe. I have vaccinated myself and my own child for this reason. I find it suspect that the doctors who offer this “service” of vaccine exemptions often do no take insurance. It seems there is more of a profit motive than a motive towards public and personal preventative healthcare, something I signed up for when I took my medical oath. In fact the AAFP [American Academy of Family Physicians] just this month came out against non-medical exemptions for vaccines.

From a medical perspective, the answers about medical exemptions to vaccines are as clear-cut as the case for vaccines themselves. However, I did want to find out about a legal perspective. What could happen, legally, to a parent or a doctor who presents a school district with a spurious medical exemption to vaccine requirements?

Dorit Reiss, who is becoming the foremost legal expert concerning vaccine issues, told me:

Manookian’s post is assuming someone can just pressure or get a doctor to give an exemption on false premises. First of all, I think doctors can and should consider reporting parents who are asking them to act dishonestly. The physician’s signature on a medical exemption should be based on true concerns/facts.

A parent getting a medical exemption based on things that don’t justify it doesn’t deserve the exemption.

But what about the doctors? What issues might they face if they become a mill for false medical exemptions?

The reality is that the doctor can probably get away with some of that. There is no mechanism in place for oversight now, and if doctor only gives a few, no one will look.

If a doctor is suddenly giving a lot of medical exemptions, there are a number of things that can happen. First, the Department of Health can try denying them as unjustified – which will probably be challenged in a court, and the department might lose. Second, the Department can bring a complaint with the medical board – and prove the problem. Third, the law can be changed to provide a penalty for abuse.

The doctor has to specify the conditions for exemptions. If a doctor is found to have lied, that could be a reason for disciplinary action.

Arguably, if a doctor provides an argument based on something that clearly shouldn’t be a contraindication that’s also reason for potential action. Most of the conditions Manookian lists aren’t caused by vaccines and are not contraindications. For example, a doctor choosing to help a parent not to protect a child with asthma from pertussis is arguably violating their responsibility.

The legal issues surrounding inappropriate medical exemptions for vaccine requirements, but there is enough gray area that parents should reconsider shopping for a family physician who will give them an exemption when none is warranted. Of course, the greatest disincentive to seeking an inappropriate medical exemption is the consequence of disease for a child left unprotected.

For a parent who has fallen prey to anti-vaccine scare tactics, skirting ethics and the law might seem a risk worth taking, but the real risk comes from the diseases that have historically sickened, maimed, and killed children.

What Does the Latest Anti-Vaccine Failure Mean?

By now, it’s old news that the efforts to get a referendum on the ballot that would overturn the new California vaccine law have failed. The law, SB277, eliminates all non-medical exemptions to school entry vaccine requirements, so that students (without certain IEPs) must be homeschooled if they do not have all of California’s required vaccines.

Opponents to this bill were predictably upset when it passed, and they immediately launched an effort to try to get on this November’s ballot  a measure that would overturn SB277. In order for the anti-SB277 referendum to appear on the ballot, they needed 365,800 people to sign a petition asking for the referendum to be placed in front of voters. According to initial counts, they landed at least 100,000 signatures short.

To put  the petition drive into perspective, California has over 17 million registered voters and a population of 38 million people. As further perspective, a ballot measure that will appear in November in California would restrict how stores use plastic bags. In other words, out of 17 million people, less 2% of registered California voters were motivated to allow unvaccinated children unfettered access to public, private and charters schools. And more were motivated to vote about how the state regulates plastic shopping bags.

You would not have guessed that this would have been the outcome had you followed the legislative hearings surrounding SB277 this spring and early summer. After heated and passionate testimony at committee hearings on both sides, California allows the public to come forward and state their position about the bill to the committee. The lines for those supporting the bill were impressive. It’s not often that people stand publicly and offer their support for a bill.

But the anti-vaccine lines were long. They came to hearing after hearing after hearing, wearing their red shirts, and their lines wound around the building and into the hallways. Their statement of opposition took hours.

In the end, California had a legislative body that was motivated by measles outbreaks sparked in Disneyland and by a science-savvy state senator who knew how to explain vaccines to his colleagues.

And it turns out that the legislators in California were right not to be swayed by the many passionate voices opposing SB277. Because although they were loud, they were a tiny fraction of the voting population in the state–less than 2% of registered voters. And an even smaller percentage of actual California residents.

What does that mean? It would be tempted to declare that it means that we are right and they are losers and we win and they lose so go suck it, Trebek. It is tempting, but it’s wrong. It does not mean that we can be boastful and get our swagger on about a win in California.

It means that there are at least 300,000 people in California who have been scared witless by the lies of the anti-vaccine movement. Their fear makes them very loud, but they are still a tiny minority. It means that now is the time to reach out to them, to befriend them, and to reassure them that they can vaccinate their children and send them to school, and that the risk of something bad happening is very, very, very low.

It means that the death of the referendum efforts are not the end. If we consider it the end, we push the Red Shirts back into their lines and their gated groups and send them back to the echo chambers where they will hear nothing but lies and frightening rumors concerning immunizations. We ask vaccine hesitant parents to wall off their unvaccinated children with other unvaccinated children. And we risk creating new clusters of children who are vulnerable to outbreaks of diseases.

We aren’t done. Don’t pack up your belongings just yet. We have some real work to do.

Stealing from Dr. Bob

It’s hard not to be sarcastic about Dr. Bob Sears. His work promoting untested alternative vaccine schedules and stoking fears about vaccines (and autism and gluten and so forth) doesn’t seem to be enough for Time Magazine.

Dr. Sears writes: "DR PAN STOLE MY AWARD."
Dr. Sears writes: “DR PAN STOLE MY AWARD.”

Of course, Dr. Bob is joking. He’s always joking. That one time when he wrote a highly sexist Facebook post about how mothers and fathers parent differently?  “And to avoid offending both of you dads who read my blog, realize that this is a satirical poke at an unjust and inaccurate stereotype that has been unfairly thrust upon us men (insert emoticon that depicts me winking at moms everywhere).”

It’s always just satire–a joke with a winking emoticon. And so we can be assured that this, too, must be satire. Dr. Bob can’t really see himself as a hero of vaccination, can he?

After all, what is his record? According to Dr. Bob, he is pro-vaccine:

I give vaccines every single day in my office. I am pro-vaccine and understand that vaccines work and have reduced and eliminated many serious diseases. And that’s not just spouting a party line – I firmly believe that, and that’s why I give them in my office.

If the threshold for a vaccine hero is someone who does what every single other pediatrician and family physician in the country does, then all the doctors that give vaccines are heroes. And there is some merit to that, but it would be hard to feature them in Time. It would be an awfully thick magazine.

Of course, Dr. Bob doesn’t want to be remembered for preventing infectious diseases. He wants to be remembered for being nice to parents. He likes making parents like him (thus the sexist satire–oh wait). In a HuffPo article, Dr. Bob claims that he is one of the few doctors who respect parents by giving in to their fears and creating an alternative vaccine schedule for them. The need for doctors like him is apparently so great that he’s created a list of doctors who will eschew science in order to elicit warm fuzzy feelings from parents:

I’ve been creating a growing list of Vaccine Friendly Doctor’s on my website who WILL listen and respect these patient’s wishes and who will provide an alternative vaccine schedule for patients who want to vaccinate differently.

Earlier in that article, he claims that the AAP recommends creating alternative vaccine schedules for parents. This claim, of course, is untrue, as a recent statement about on-time immunization from the AAP shows: “There is no ‘alternative’ immunization schedule. Delaying vaccines only leaves a chil​d at risk of disease for a longer period of time; it does not make vaccinating safer.”

So actually, Dr. Bob isn’t doing what every pediatrician and family physician across the country is doing. Almost all of them (save those listed by Dr. Bob) are following a standard of care and AAP guidelines by giving those vaccines to their patients on time. And for patients who are nervous or hesitant, they are still recommending on-time immunization and doing their best to navigate parental fears while being aware of the needs of the child to be protected against disease. That last part, where we protect children, is lacking from Dr. Bob’s insistence that we respect parents’ fears.

Still, Dr. Bob bravely runs a Facebook page–wait, two Facebook pages, and writes his books and sells his supplements. Meanwhile, Dr. Pan, stealer of magazine hero awards, has not sold supplements. While being one of those doctors who follows the standard of care and the AAP guidelines, Dr. Pan, a state Senator, has also taken on legislation amidst outbreaks of measles to prevent future outbreaks and create healthier, disease-free schools.

Dr. Bob earns profits from his books and his supplements. Dr. Pan, meanwhile, received death threats from anti-vaxxers. He is facing efforts to recall him from office. Anti-vaxxers have portrayed him as Hitler. In fact, some of Dr. Bob’s supporters have gone full Godwin on Dr. Pan:

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On the other hand, Dr. Sears has used the California legislation to travel the state, speaking to parents about ways to circumvent the law. Dr. Gorski uncovered evidence suggesting Dr. Sears might be selling illegitimate medical exemptions for vaccines at these events:

At one point, a woman approached and told Dr. Bob that her pediatrician whom she otherwise liked would not issue an exemption, asking if he would see her for a one-time visit. His response? “I would be happy to provide that service.” He also confirmed that a one-time medical exemption visit is $180 and that he’d be willing to issue such an exemption and send the child back to his primary pediatrician.

In short: the legislation Dr. Pan crafted based on best medical practice earned him taunts, threats, and recall efforts. But this legislation that Dr. Bob opposed has earned him more earning potential.

While he might be joking, Dr. Bob’s assertion that Dr. Pan “stole” something from him has the kernel of truth that all satire (good or bad) has. Dr. Pan didn’t steal any prestige or accolades from Dr. Bob, but he did steal some publicity that would have been profitable to cash in on. Perhaps for that we can be glad.

Faux Pro-Vax Gambit

Anti-vaxxers do not like to be labeled as anti-vaccine. They see it as an ad hominem attack, though it is rarely meant to be. It is meant to describe what they are: against vaccines. As media attention moves away from legitimizing anti-vaccine sentiment and more toward exposing it as a threat to public health, anti-vaxxers have become more sensitive to being labeled as such.

Some have come up with their own labels. The favorites are “pro-vaccine safety” and “pro-choice.” The second is especially maddening because they want to have a choice over whether or not their children are protected against disease and a choice about whether or not their communities have high enough immunization levels to protect the most vulnerable. It is a choice born of privilege and of ignoring the needs of others.

Some simply dismiss it outright. Lucija Tomljenovic, a biochemist who has published papers promoting anti-vaccine myths, made this comment on a BMJ article:

I am NOT anti vaccine, I am anti bad science.
The reason so many dismiss even the possibility that vaccine can cause
damage is because they believe this to be true. This is religion and not
science.

Of course this is complete nonsense. People who promote the science behind vaccines do so because they have followed the science.

A prime example of the pro-science, pro-vaccine camp looking critically at the science is demonstrated in this article by Tara Haelle discussing a study that dubiously connected the Hib vaccine to leukemia protection:

couldn’t find evidence of this dramatic reduction in government health statistics.

When I turned to outside experts, I discovered my confusion was justified.

I asked Dr. Walter Orenstein, associate director of the Emory Vaccine Center, if he could help or recommend others. He sent me to Dr. Art Reingold, head of epidemiology at the University of California, Berkeley, School of Public Health, and Dr. Martha Arellano, an oncologist specializing in leukemia at the Winship Cancer Institute of Emory University. Arellano also suggested I speak with Dr. Edmund Waller, an immunologist and oncologist also at Emory’s Winship Cancer Institute.

Every one of them conveyed the same message: Nothing in this paper proves that the Hib vaccine reduces leukemia risk, much less helps prevent ALL.

Tomljenovic is not alone in eschewing the anti-vaccine label despite evidence that she is. After all, even Dr. Bob says that he “gives vaccines every day,” even though he has aligned himself with the anti-vaccine forces in California.

But the most maddening are those who come right out and claim that they are pro-vaccine. It’s a gambit meant to disarm the other person in a conversations. It looks like this:

I am a pro-vaccine parent who strongly opposes SB 277.

My child, now 20, received all of her childhood vaccines, with my informed consent.

Her pediatrician and I decided together to delay the hepatitis B vaccine until puberty, because it addresses a disease that is spread via needles and sex, and she was at almost no risk of coming in contact with it.

The above quote demonstrates the crux of the argument. Basically, “I must be pro-vaccine because I vaccinated my children. Except for this one bad vaccine. I didn’t do that because [insert various anti-vaccine myths and follow with lots of conspiracy theories.]”

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Basically, the Faux Pro-Vaccine Gambit is an introduction, a way of distracting you and throwing you off-balance so that when the anti-vaccine myths follow, you might not know what to do. But it’s possibly the worst gambit out there because the person using it has children who are protected against vaccine-preventable diseases to a degree, but wishes to cast fear, uncertainty, and doubt in order to encourage someone else to leave their children fully unprotected.

It’s the ultimate “I care about my children, and I really don’t give a damn about yours.” And it makes me furious.

It is really dangerous, though, when it is coupled with legislation. Advocates should be aware that people are contacting legislators claiming to be pro-vaccine and against legislation that aims to increase vaccination rates. They are liars, and they are muddying the waters.

So what can you do?

If you are online and encounter a faux-pro-vaxxer, ignore the fact that they claim to be pro-vaccine. Engaging in a discussion about immunization means debunking the misinformation, not taking apart the person. Anyone who promotes incorrect information needs to be corrected, especially in public, so that others are not misled by falsehoods.

If you are contacting a legislator, know that others are claiming to be pro-vaccine. If you are working closely with legislators on the matter, you might prepare them for this gambit. Be aware, however, that letting a legislators know that you are pro-vaccine probably does not mean much to them. Be prepared to use other labels for the anti-vaxxers with legislators such as “opponents to the bill” or “opponents to raising immunization rates.” Then, whether or not they vaccinated their children is an entirely moot point.

And know that whatever people claim, if they follow it up with anti-vaccine misinformation, they are not for vaccines. They are against them. In other words, they are simply anti-vaccine.