The Parent Ren, Part II: Patience

A friend of mine pointed out to me that I had written a blog post referencing “The Child” back in 2012. In fact, my wife and I talked about The Child as far back as I can remember being with her. (That’s something I didn’t do with other girlfriends, by the way.) We started off joking about what a “weirdo” our child would be because her and I are weirdos ourselves. Then we moved into more serious talk about having a child after we got married. And then we finally pulled the trigger on having a child a couple of years ago.

Needless to say, it took a little bit for The Child to arrive. It took a lot of patience to wait, too. There were times when we were ready to just forget it all and adopt a child. There were times when we were ready to not adopt at all. But we remained committed to the plan, and here we are. We’re parents.

You’ve probably heard the saying that “good things come to those who wait.” That is true for many things, and it is very true for parenting for us. Because we both waited until our careers were well underway, this little baby sitting next to me will have a step up on her peers with regards to finances and stability. My wife and I are not teenagers or young adults whose lives may still be going from one phase to another. We bought a house. We have a car each. We have three master’s degrees between the two of us.

I know that it’s easier said than done. A lot of people have unplanned pregnancies. A lot of other people have a child and then something big changes in their lives. Then there are those for whom patience is a commodity. They either have to work several jobs to make ends meet, or they can’t make ends meet because of their life situations.

For us, this patience translated into being parents at a time when we understand each other really well. We don’t need to give each other hints as to what the other person needs to do to take care of the baby. We work very well in tandem to take care of that little person, and we are giving each other plenty of breaks and time to nap. Plus, we’re at a place in our careers where we can take time to look after the baby for a few weeks before ramping up activities back to full-time.

Oh, and this patience for having this child also brought with it plenty of friends who are just the most awesome and supportive people ever. Younger us wouldn’t have had that many friends, or friends who have children of their own and offer invaluable advice.

So, yeah, life is good at this point, and I’m sure there will be sleepless nights when the baby gets an earache or is otherwise inconsolable. But the patience that we practiced in becoming parents will surely pay off with all the wisdom we’ve accumulated. Of course, this is just our experience.

Your mileage may vary.

 

Face It, You Think You Know Better Than Me

There’s this person, we’ll call her “Ginny,”* who is an ardently anti-vaccine. She has multiple blogs, multiple social media accounts, participates in protests (traveling far and wide, money for the family be damned), and even thinks she leads a political party. Ginny has no medical or scientific training, per se. The closest she’s gotten is a bachelor’s or master’s or even a doctoral degree in a non-scientific field.

Still, Ginny thinks she knows better than me.

I have a bachelor’s of science in medical technology. To earn that degree, I had to take courses in biology, chemistry, organic chemistry, microbiology, blood banking, hematology, cytology, and so on. During those courses, people with entire lives devoted to those individual subjects tested my knowledge over and over again. Then I took a national certification exam to become a medical technologist. That exam was about 4 hours long and consisted of hundreds of questions.

Still, Ginny thinks she knows better than me.

I have a master’s in public health with a focus on epidemiology and biostatistics. To earn that degree, I had to take courses in epidemiology, biostatistics, health informatics, disease transmission dynamics, health communications, health policy, etcetera. During those courses, people with entire lives devoted to those individual subjects tested my knowledge over and over again. (My GPA for my MPH degree was almost a 4.0. I missed it due to one B in one course.) During the four years that I worked on the MPH part-time, I worked full-time as a medical technologist, furthering my knowledge of all things having to do with clinical laboratory science. I worked closely with physicians and other healthcare providers. I got to see sick people be healed through the use of science-based medicine. Then, once I got my MPH, I joined a state health department under the direction and mentorship of people who have studied and practiced epidemiology for time periods at times longer than my own life.

Still, Ginny thinks she knows better than me.

I’m working on a doctoral degree in public health with a focus on epidemiology. To earn that degree, I’m taking advanced courses in epidemiology, like longitudinal data analysis, advanced epidemiological methods, and even more biostatistics. I’m learning to better discern random coincidences from cause-and-effect relationships. I’m consulting with leading experts in different fields, people who, again, have devoted entire lifetimes to specific subjects. I am also writing a dissertation addressing a public health problem. For that dissertation, I must be able to show that I can tell the difference between a random association between X and Y and a true, causal association between A and B. Experts in the fields of epidemiology and other disciplines will read that dissertation and ask me poignant questions until they are satisfied that my knowledge is that of someone at the doctoral level of education in my field.

Still, Ginny thinks she knows better than me.

Ginny thinks that a slew of scientific literature clearly states that vaccines are bad and that vaccines cause autism. Those papers state no such thing. If you read them with the expertise of someone who has been doing a lot of biological sciences, epidemiology, and biostatistics, you would see that the vaccine-autism association is spurious at best. You would see that there are a lot of confounding factors that explain that observed association and dispel any cause-and-effect association between vaccines and autism. Furthermore, you would see that vaccines save lives. They may not be perfect, but they’re short of a miracle when it comes to their ability to stop serious and deadly infectious diseases in their tracks.

So why does Ginny think she knows better than me?

Ginny thinks that she knows better than me because, at one point in her life, she saw her child be diagnosed with autism. That diagnosis came after her child received their vaccines. She then, by her own admission, went online and found like-minded parents who comforted her and supported her idea that it was the vaccines. Then she found papers that she didn’t quite understand but said stuff that read closely to “vaccines cause autism.” To make matters worse, she then ran into the fraud perpetrated by Andrew Wakefield. Ginny probably thought, “Hey, a British doctor agrees with me!”

Ginny then swore to worship Andrew Wakefield unquestionably and forever, as if he was a cross between Jesus and Nelson Mandela.

So here we are, at the end of the age of expertise. It doesn’t matter that I went through all those obstacles to learn what I did, or that my learning has been validated by exams and tasks. It doesn’t matter that 99.999% of all scientists agree that vaccines don’t cause autism and that we need to continue to use them. It doesn’t matter because there are blogs like “Age of Autism” to explain to the incredulous masses that those of us who work on these things for a living are actually paid by Big Pharma to sit at home and write in our blogs, or that we are not who we say we are, or that we eat children at Thanksgiving.

Ginny and friends, and friends, all believe what they want to believe because they can find at least one person with enough letters after their name who believes what they believe. Never mind that Andrew Wakefield was paid to conduct his fraudulent research. Never mind that he applied to get a patent for a vaccine that would have benefited from his fraudulent research. Never mind that mountains of evidence against him have been found, confirming his “elaborate fraud.” No, to Ginny, none of that matters because one day her child was diagnosed with autism, and that was a fate worse than death to her. That, of all the things in the world that her child could have been, she could not deal with.

Face it, Ginny, you think you know more than I do, but not because you actually do. You think you know more than I do because there is enough storage in cyberspace for at least one lie to support your fears. You think you know more than I do because you’re the parent of an autistic child and I’m not. You think you know more than I do simply because.

sherlock_painful

*Before you — yes, you — get bent out of shape thinking that you are “Ginny,” please know that Ginny is an amalgam of all anti-vaccine people. Ginny is not a specific person.

Antivaxxers Trumping CDC

I’ve always been impressed by the cognitive dissonance exhibited by many in the anti-vaccine community. But it wasn’t until this election cycle thatI comes to understand exactly what they’re doing and why they’re doing it. When I see Donald Trump, a sweat stain that just wont come off your favorite country, tell a lie and then almost immediately say that the lie he told was part of a conspiracy to discredit him. Antivaxxers do this all the time. They’ll say that vaccines cause autism, and then, when confronted with the evidence that vaccines do no such thing, antivaxxers will quickly yell at you and tell you that you’re part of a conspiracy to hide the truth. If the antivaxxer happens to be a parent, pointing out to them that they’re lying or misrepresenting the evidence quickly comes with an accusation that you’re making fun of their child or their situation, or that you’re not a parent and thus have nothing to say on the matter.

Now, this is the part where I tell you that I’m not making fun of anyone… At least not intentionally. I’m sure that parenting is difficult all on its own with a neurotypical and physically able child. So I’m sure that a child with special needs of any kind must be at least a little more difficult. Sadly, for some parents, it is intolerable to the point that they are convinced when people like Andrew Wakefield sell them the idea that killing their child is preferable to a life of challenges. Again, I am not making fun of you if you are an anti-vaccine parent. And, most importantly in this entire discussion, I am not making fun of your child.

A couple of days ago, antivaxxers decided to have a rally in front of CDC headquarters in Atlanta, Georgia. True to form, they brough on the conspiracy theories that the government is in cahoots with the pharmaceutical industry to, among other things, kill and maime children through vaccines. They made wild claims as well, like their claim that most children will be autistic in the near future from all the vaccines. (The scientific evidence points more and more to a consistent 1% to 3% rate of autism in the general population at all times.) They claimed that there is no such thing as Suddent Infant Death Syndrome (SIDS) because it’s all about the vaccines. And, when random people walked by, they assailed those people with their stories of horror allegedly brought on by vaccines.

This is the video of one such interaction:

The man in the video is clearly just trying to cross the street but is assailed by this woman, a woman who calls her son “mentally retarded after his vaccines.” The man asks her to “go away” a couple of times, but she just keeps it up. She then goes as far as to take a picture of him — because that’s a normal thing to do in these situations, apparently — and he flips her off.

Well, that flipping off just drove the antivaxxers insane. They started complaining on social media and on their blogs that this guy needed to be found and made pay for flipping off this woman. They launched into conspiracy theories about him being a paid actor or someting

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You’re being manipulated alright…

This is all par for the course for antivaxxers. They try to intimidate public health workers (or people whom they think are public health workers) and then claim to be victims if those they are intimidating respond in any way. They lie about conflicts of interest and other improprieties but then claim to be the victims if someone points out to them that they’re selling supplements and scams. Or they cry that they’re being censored when they themselves don’t allow any kind of comments contrary to their beliefs on their blogs.

Antivaxxers are, in my humble opinion, and it’s a good opinion… A lot of smart people are saying I have a good opinion. And, let me tell you, folks, my opinion is so good that your head will spin. My opinion… By the way, if you go ask for someone else’s opinion, their opinion will not be as good as mine, okay? I’m just saying. Because no one can give you an opinion like mine. And, when you’re not famous, they’ll let you grab them by their opinion any time. Anyway, my opinion is that antivaxxers — who are horrible people — antivaxxers are just like Trump. If they don’t lie, they bend the truth. If they don’t bend the truth, they make something up. And if they don’t make something up, they claim it’s all a conspiracy.

 

The dumpster dives and fuzzy math of RFK Jr. and friends

Do you remember Robert F. Kennedy? I don’t. I was born way after his assassination in the 1960s. The only reason I know who he was is because I studied history and learned that he was the brother of President John F. Kennedy, serving as the US Attorney General in that and the subsequent administration, and then becoming a Senator. They also named a stadium in DC after him, and several games of the 1994 World Cup were played there. That’s it. That’s all I know.

Now, do you know who Robert F. Kennedy Jr. is?

He is the son of Robert F. Kennedy, and he has become the darling of the anti-vaccine movement as of late. See, Mr. Kennedy Jr. seems to be hung up on the idea that mercury in vaccines causes autism. He holds on to the idea against all scientific evidence and against the evidence that mercury was removed from childhood vaccines in the early part of this century but the prevalence of autism kept rising. (It kept rising for a myriad of reasons, none of which had anything to do with vaccines and/or mercury in vaccines.) Also, there is mercury in vaccines like there is chlorine in table salt. It’s a chemistry thing.

Oddly enough, when Seth Mnookin, a writer, decided to take on the anti-vaccine movement, the anti-vaccine movement quickly pointed to Mr. Mnookin’s past use/abuse of heroin. They wrote on blogs and on comment boards that Mr. Mnookin’s addiction disqualified him from writing about the benefits of vaccines. But, when it was pointed out to them that Mr. Kennedy Jr. (RFK Jr.) also had a problem with heroin, the anti-vaccine crowd called him “courageous” for working through his problems with heroin and, well, for being anti-vaccine. They lauded him with praise for his anti-vaccine views and for taking the time to air those views with his big last name.

RFK Jr. has taken advantage of this, and he has made some waves (not a lot) as of late in the anti-vaccine world. He’s done speaking engagements, released some documentary, and gone as far as saying that there is a “vaccine holocaust” going on. He would later apologize for his choice of words, but it is clear that he really seems to believe that vaccines are causing incredibly high levels of death and disability.

Just yesterday, in a Colorado News Site, RFK Jr. published an anti-vaccine rant so strange that it needs to be analyzed for more than scientific fallacies. It needs to be analyzed to see if RFK Jr. lives in the same dimension as the rest of us. In his rant, he wants the audience to “do the math” about the meningitis vaccine that is being recommended for college students. For him, meningitis is not a big deal:

“Meningococcal meningitis is exceedingly rare. There were only about 390 cases in the U.S. last year. In a population of 319 million, that adds up to one case in 817,949 people. There were only three meningococcal meningitis cases in Colorado last year — one resulting in death.”

Yes, to him one death is not a big deal. I wonder if he would say that to the face of the parents of the person who died? Of course not. Anti-vaccine loons are cowards, not necessarily stupid. Of course, to RFK Jr., even contrary to the evidence it’s all about the money and the mercury:

“With billions of dollars in annual revenue at stake, vaccine makers are pushing meningitis vaccine mandates across the country. Vaccine issues are always complex, but advocates of the meningitis mandate should consider some simple math.”

And,

“The CDC has approved three vaccines targeting the A, C, Y and W135 strains of meningitis: Menactra, Menveo and Menomune, which still contains significant mercury concentrations in multi-dose vials. These vaccines are effective in providing immunity to those strains of meningitis in only 85 percent of people who receive them.”

These statements are very telling. First, it is the Food and Drug Administration (not CDC) who approve vaccines to be used. CDC only recommends the vaccine, along with the ACIP, based on the best available evidence. And note that “only 85 percent” statement. It’s the Nirvana Fallacy that anti-vaccine people like to use a lot. To people like RFK Jr., if it’s not 100% safe and 100% effective, it is no better than the pus oozing out of a lanced cyst.

Never in his rant does RFK Jr. admit that meningococcal meningitis is rare because of the vaccine, because of what we have learned about it through some very horrible cases, and through the work of the very people he vilifies: public health workers.

Then RFK Jr. dives into full-on crazy when he talks about serogroup B meningococcus and the vaccine against it:

“Thirty percent of the meningitis cases are the B strain, which typically occur in college-aged kids and against which the three vaccines are completely ineffective.

The FDA recently approved two B strain meningococcal vaccines, Trumenba and Bexsero.Vaccine makers are pushing government officials to add them to the recommended schedule for the fall semester. Critics have faulted the government’s expedited safety and efficiency testing for the new B strain vaccines citing glaring lapses in safety protocols including the absence of inactive placebos. In addition, both new B vaccines are “pregnancy category B,” meaning that they should be administered to pregnant women only when necessary. Neither vaccine has been tested for carcinogenicity, mutagenicity or effects on male fertility.”

So vaccines that are effective in 85% of people and against 60% of cases of meningococcal meningitis are worthless? Not only that, but note that he states that “critics” are worried about the vaccine. Who are those critics? He and his anti-vaccine friends are the critics. Everyone else who lives in reality doesn’t “fault the government’s expedited safety and efficiency testing” because they were still good studies. Also, the vaccines don’t need to be tested for “carcinogenicity, mutagenicity, or effects on male fertility” because their predecessors already were tested for all those things. That, and we (epidemiologists) look at the post-market use of the vaccines and have not found them to be any kind of carcinogenic threat. (They don’t cut off testicles, either, because that’s about the only way a meningococcal vaccine could cause male infertility.)

These are just “scare words” used by RFK Jr. and others to try and put doubt into the minds of the uninitiated. If you are a parent, and you work two jobs to keep the household afloat, and you don’t have time to sit down and read the latest epidemiological data on vaccines, but you happen to read RFK Jr.’s rant, you might have some doubts. You might even go searching for more information with his name attached to it. And that is exactly what they want. They want the doubtful parent or person to join their cult. Because they are a cult. I have no doubts about that.

To further put doubts in people’s minds, RFK Jr. completely misrepresents the information contained in vaccine package inserts:

“According to their package inserts, Menactra and Menveo produce “serious adverse events” in 1 percent of recipients. Menomune, with its hefty mercury load, sickens 1.3 percent of those receiving it. According to the CDC Pink Book, 0.3 percent of those with “serious adverse events” from meningitis vaccines will die. So here is the math calculation that thoughtful student governments in Colorado must consider: If you inoculate Colorado’s 400,000 college students with the older vaccines, you can expect 4,000 serious adverse events and 12 dead. We do not yet know the effects of widespread vaccination of the hastily-expedited B vaccines, but according to their package inserts, about 2 percent of students who receive the B vaccine will be sickened or hospitalized with a serious adverse event. This could translate into an additional 8,000 sick students and 24 deaths, for a total of 12,000 sick and 36 dead in the attempt to possibly avert three meningitis cases.”

Package inserts are legal documents, not scientific ones. They are designed to tell us, the consumer, everything that happened with the vaccine before, during, and after testing it, including what happened after marketing the vaccine. Those deaths mentioned are many times the result of meningitis cases in people who were exposed, were offered the vaccine as a last line of protection, and still got sick because the vaccine didn’t take in time. Other cases are events that happened in the days, weeks, or even months after the vaccine was given. But, because lawyers are so litigious, they demand that the manufacturers include this information in the package inserts.

So what does the Pink Book really say about that 0.3% of serious adverse events who die? This:

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Scary, right? If all those kids get the vaccine, surely, as RFK Jr. states, we will see “36 dead in the attempt to possibly aver three meningitis cases.” But where did these numbers come from? Did they come from a trusted, unbiased source of information on vaccine reactions? In a word, no. They came from VAERS (my emphasis in bold):

“From licensure of MenACWY-D in January 14, 2005, through September 30, 2011, VAERS received 8,592 reports involving receipt of MenACWY-D in the United States; 89.0% reports involved persons aged 11 through 19 years. MenACWY-D was administered alone in 22.5% of case reports. The median time from vaccination to onset of an adverse event was 1 day. Males accounted for 40.6% of the reported events. The most frequently reported adverse events were fever 16.8%, headache 16.0%, injection site erythema 14.6%, and dizziness 13.4%. Syncope previously has been identified as an adverse event following any vaccination, with a higher proportion of syncope events reported to VAERS having occurred in adolescents compared with other age groups (89). Syncope was reported in 10.0% of reports involving MenACWY-D. Among all MenACWY-D reports, 563 (6.6%) were coded as serious (i.e., resulted in death, life-threatening illness, hospitalization, prolongation of hospitalization, or permanent disability).
Among those reports coded as serious, the most frequent adverse events reported included headache (37.5%), fever (32.5%), vomiting (23.6%), and nausea (22.2%). Cases of Guillain-Barré Syndrome (GBS) were recorded in 86 (15.3%) reports coded as serious, although the diagnosis has not been validated by medical records for all reports. A total of 24 (0.3%) deaths were reported, each of which was documented by autopsy report or other medical records and occurred in persons aged 10 through 23 years.
Among the 24 reports of death, 11 (45.8%) indicated that the cause of death was meningococcal infection (nine with a serogroup included in the vaccine and two with a nonvaccine serogroup). Among the other 13 (54.2%) reports of death, which occurred from the day of vaccination to 127 days following vaccination, stated causes of death were cardiac (five), neurologic (two), infectious (two), behavioral (i.e., suicide) (two), rheumatologic (one), and unexplained (one). There was no pattern among these reports. Except for the finding of GBS, which was further evaluated and is discussed below, no signals were identified in VAERS after MenACWY-D vaccination.”

Note the last part about “no signals”. This means that the proportion of deaths reported through VAERS — except for the death from Guillain-Barre — were not any higher than expected in a population of similar size and characteristics. That is, on average and in the long run, the same number of deaths would have occurred without the vaccination. Doing some “simple math,” yes, you could see a certain number of deaths occurring in the college population that would receive the meningococcal vaccine, but it would not be higher than expected for all causes. Like a good anti-vaccine loon, RFK Jr. just did some VAERS dumpster-diving without giving his audience the full picture of what he wrote.

So unless we are to believe that the vaccine — which has no living organisms because of the “mercury” in it — caused meningococcal infection in 11 of the deaths reported to VAERS, and that the vaccine causes suicides and cardiac arrests or infections, what then is the evidence that we’ll see “36 deaths” from vaccinating all of the students in Colorado? None. But the evidence, or lack thereof, has never stood in the way of anti-vaccine loons.

If you want to read the full, honest and scientific discussion on why we need students in close-contact with each other, in dorms and in schools, to get the meningococcal vaccine, please read the discussion and rationale from the Advisory Committee on Immunization Practices. To read and believe what RFK Jr. and his group are selling is dangerous. It’s dangerous because meningococcal outbreaks are much, much more expensive than vaccinating everyone will ever be, both in terms of money and lives. Finally, consult your healthcare providers for decisions on whether or not to vaccinate. Heck, don’t even listen to what I have to say/write… But please don’t listen to RFK Jr. and the other celebrity anti-vaccine loons.

Featured image courtesy of J Brew on Flickr, CC by-SA 2.0

The enemies you’ll make

NOTE: This blog post was written on December 28, 2014.

A few days ago, I told you about all the awesome people I’ve met and will meet in my path through life. Unfortunately, because of my professions (first as a lab tech, then as an epidemiologist) and because of my current work towards a Doctor of Public Health degree, I’ve also managed to pick up some enemies. Yes, “enemies” is a strong word, but there is no better way for me to describe some of these people. They have tried to get me fired from earlier jobs, tried to find out where I live, and have said all sorts of interesting things about me online.

They won’t say it to my face for some reason. They also won’t put it in writing in emails when I’ve emailed them and asked them to repeat what they wrote online.

One of the more active anti-vaccine people that I have encountered is one “Jake Crosby“. He used to be a blogger with “Age of Autism,” an anti-vaccine blog devoted to blaming autism and other ailments to vaccines. The contributors to that blog get offended when they are called “antivaxxers,” but they also don’t reply when asked which, if any, vaccine they would approve of. Mr. Crosby acts a similar way, but he takes it one step further. Continue reading