[p2p-research] Inflamed passions -- Why do vaccines trigger such passionate debate?

[Paul D. Fernhout]

Ryan wrote:
>  Sent to you by Ryan via Google Reader: Inflamed passions via BBC News
> | Science & Environment | World Edition on 10/6/09
> Why do vaccines trigger such passionate debate?

Ryan-

These Google reader posts are hard to read in plain text. I had to hunt 
through the source to find this link:
   "Why do vaccines arouse such passions? "
   http://news.bbc.co.uk/2/hi/health/8293149.stm

 From there: "But it is estimated that within the 53 countries of the WHO 
European region, more than 500,000 do not receive full immunisation and 
32,000 die each year from vaccine preventable diseases."

Well, that about says it, doesn't it? Assuming that is accurate, and 
simplifying a bit (what does not get full vaccination mean?), and putting 
those numbers together in a simple way (demographics may add complexity), 
the lifetime risk of dying of a disease that a vaccine could help prevent is 
at most about 3% (assuming it works at all, and allowing there may be a 
higher permanent injury rate, of course). But, to eliminate that 3% of risk 
of dying, you need to "trust" a doctor to take your perfectly healthy child 
and inject potentially harmful stuff into him or her, and not just once, but 
now, approaching 200 times (if you get recommended annual flu shots for your 
life, and get all the boosters).

Meanwhile, lifetime heart disease and stroke, which can be greatly 
influenced by early healthy diet and early healthy habits, is given little 
attention for young children in the USA. TV is an enourmous killer as far as 
contributing to obesity by sedentary behavior and advertising junk food, but 
how many doctors waiting rooms have a TV in them now? The APA recommends no 
TV to age two, yet, so what does this mean about "well baby visits" in such 
an environment?

Can't we invent a better way to deal with managing the ecology of microbes 
and viruses as it interacts with human health? Can't we come up with an 
approach to holistic societal health that is not so based in creating 
situations where there is profit through deceit or looking the other way or 
focusing on one aspect of health while ignoring all others?
   http://www.patchadams.org/

Granted, vaccine defenders would say the only reason the risk was so low was 
due to vaccines and "herd immunity". But that also is confounded with better 
sanitation and better nutrition and better quarantine procedures, so it's 
not clear what improvements to attribute to what causes. Likewise, it's not 
clear how much compulsory schooling actually spreads disease and why that is 
still a good idea. Similarly, the drop in breastfeeding due to more parents 
working is not good for children's immune systems, but formula is not 
"prescription only" even though it should be, from a public health standpoint.

Every family who chooses not to nurse their child according to WHO standards 
(at least two years) is putting the entire population at risk of disease, 
but, why is that not discussed in such moralistic tones? From WHO:
   http://www.who.int/topics/breastfeeding/en/
"Exclusive breastfeeding is recommended up to 6 months of age, with 
continued breastfeeding along with appropriate complementary foods up to two 
years of age or beyond."

Hint: it interferes with businesses getting cheap labor to have mothers near 
their young children for many years.
   "Cheap Labor Conservatives Issues Guide"
   http://www.conceptualguerilla.com/?q=node/16

How much lower would those rates of disease in the USA be if we disbanded 
compulsory schooling, eliminated compulsory work for nursing mothers, and 
improved our physical infrastructure in other ways? Might, as a society, we 
even save money and have lower taxes by doing these social investments?

But, that entire vaccine discussion gets shifted to some sort of one-sided 
moral high ground touted by those who make their money off of vaccines 
(either selling them, or having vaccinations drive their practices with 
"well baby" visits, where children may be exposed to other diseases in a 
doctor's office).

The bigger health picture gets lost very quickly, both as regards to 
conflicts-of-interest and also as to societal investment strategies (and 
what they assume). Essentially, vaccines are like nuclear power. There are 
all these promises about how wonderful it would be, but in practice, there 
is an ugly side with high risks passed on to society.
http://en.wikipedia.org/wiki/Karen_Silkwood
http://en.wikipedia.org/wiki/Price-Anderson_Nuclear_Industries_Indemnity_Act
"The Act establishes a no fault insurance-type system in which the first $10 
billion is industry-funded as described in the Act (any claims above the $10 
billion would be covered by the federal government)."

How much compensation would be required if a US state was rendered 
uninhabitable? How much compensation would the vaccine industry have to pay 
if the current batch of swine flu vaccine caused cancer in two years? In 
both cases, profits are privatized while the risks are socialized.

We need to distinguish between trusting the scientific method of collecting 
experimental data over time by unbiased observers and trusting specific 
academic scientists who know where their paychecks are coming from.

Take "gardasil" mentioned in the article you cited and how it was tested:
   http://www.corpwatch.org/article.php?id=14401&printsafe=1
"""
   JayaJan Pharmaceutical Research in India was one of the companies with 
which Merck had a contract to test Gardasil. Like most of the industry, 
Merck increasingly outsources its clinical trials to Contract Research 
Organizations (CROs) in areas of the world where trial subjects are 
plentiful, operating costs are low, and regulations lax.
  Some $285 million worth of clinical trials are outsourced to CROs in 
India, according to biopeer.com.  These CROs are a booming $15 billion 
industry whose revenues are rising at 15 percent a year.
   "CROs are known for their speed and efficiency; they can complete a 
clinical trial in two-thirds the time a drug company can, shaving months off 
the process and offering $120 million to $150 million in increased revenue 
per drug." Sam Bidwell an executive with Quintiles a U.S.-based CRO told 
Nature. "Of the top 30 best-selling drugs, we've touched every one."
   Critics point out that CROs can come with built-in problems. Conflicts of 
interest can arise when CROs are paid royalties only after a drug is 
approved rather than being paid a set fee that is independent of how safe or 
effective the drug turns out to be. Problems can also arise because CROs 
know that favorable findings mean that research into a test drug will 
continue, and they may also believe that results that please the hiring 
corporation can lead to future contracts. "[C]ompanies know that the farther 
the compound moves through the research cycle, the more money they can 
raise," Nature reported.
    Merck spokesperson Amy Rose refused say how many trials Merck contracted 
to CROs or what percentage of the Gardasil subjects these contractors 
recruited in the Third World. She also refused to specify how, or even if, 
the company oversees CROs.
   Many consumers assume that the FDA carefully monitors CROs. But the 
agency hobbled by under-funding, politicization, and dependence on industry 
fees has few resources to assess foreign trials and relies on drug companies.
"""

Why is stuff like that not reported in the mainstream?

That article also says:
"""
   By promoting vaccination as a public health imperative mandated by 
government, rather than as a private choice, Merck has opened the door to 
the inherently uncomfortable discussion of whether mandatory vaccination is 
cost effective. Since Gardasil protects against the two strains of HPV that 
cause 70 percent of cancers, women will still need  but may be less likely 
to get  Pap smear tests to catch the signs of cancers caused by the other 30 
percent of dangerous strains.
   "Nationwide, the cost of vaccinating American girls with Gardasil will 
amount to some $800 million a year," New Scientist reported in an analysis 
that, while overly simplistic, raises fundamental questions about public 
health priorities and drug company influence over them.
   New Scientist estimates that Gardasil will save "around 1,200 lives". 
This is an unequivocally desirable outcome, but at $800 million per year, 
the cost of saving each life will be over $650,000. If the goal is to save 
lives, there are more cost-effective ways of doing so." They include 
spreading public health measures including low-cost, readily available Pap 
testing to the non-white, poorer populations that now die in 
disproportionate numbers of cervical cancer.
   The public health equation adds up differently in the developing world, 
which accounts for 80 percent of the world's 275,000 cervical cancer deaths, 
with 30 percent in India alone. Because very few of these women have access 
to Pap tests, or indeed any regular health care, vaccination has 
proportionately greater benefits - if the program is publicly funded and the 
protection proves lasting.
"""

That issue has gotten a bit more discussion in the mainstream press on Gardasil.

Anyway, in this case, why not emphasize better ways to treat cancer, like 
breakthrough therapies? Or why not focus on faster ways to detect cancer? As 
a society, we make choices as to where to focus our time and resources. 
US$800 million a year could fund, at US$20K each in India, about 40,000 
medical researchers every year. Which will ultimately give women in the USA 
better health? Hiring forty thousand Indian scientists researching cancer 
detection and treatment every year for twenty years, or giving every teesage 
girl a couple of shots that may (or may not) prevent some cancers twenty 
years from now?

Consider:
   http://www.ascendfoundation.org/cost.html
"""
The financial costs of cancer are great both for the individual and for 
society as a whole. In the year 2002, the National Institutes of Health 
estimated overall annual costs for cancer as follows: Total Cost: $171.6 
billion Direct Medical Costs: $ 60.9 billion (total of all health 
expenditures) Indirect Morbidity Costs: $ 15.5 billion (cost of lost 
productivity due to illness) Indirect Mortality Costs: $ 95.2 billion (cost 
of lost productivity due to premature death) Over one-half of the direct 
medical costs associated with cancer are for treatment of breast ($6 
billion), lung ($5 billion), and prostate ($5 billion) cancers. These 
estimates are annual aggregate expenditures expressed in 1990 dollars. The 
cost of cancer screenings, including mammograms, Pap smears, and colorectal 
exams, adds another $3 to $4 billion to overall cancer costs.
   In 2002, the federal government spent approximately 4.9 billion dollars 
on cancer research. This may or may not sound like a lot, until you compare 
it with the 60 billion being spent on merely treating the symptoms of 
cancer. ASCEND believes wholeheartedly that we can never expect a different 
result if we continue to do the same things that have not worked 
successfully enough over the past 30 years. We contend that the following 
things must occur if we are to truly end cancer in our lifetimes:
   In conjunction with the increase in government spending, we believe that 
researchers must be held to a higher standard for producing meaningful 
results. We do not consider more drugs that poison patients’ bodies and do 
not result in a substantial increase in life expectancy or cure to be 
meaningful results. The only ones winning the game the way it is currently 
being played is the drug companies whose CEOs will all tell you that their 
number one priority is to make profits for the shareholders. We need a much 
greater sense of urgency on the research side.
   While the proposed budget for cancer research is 5.5 billion in 2003, our 
government must get much more seriously aggressive if we are serious about 
ending cancer and not just managing the status quo. We proposing a doubling 
of that budget immediately with a commitment to double it every 2 years 
until it either matches the money spent on treatment or the cancer incidence 
rates are cut in half.
   Creation and strict enforcement of laws that require specific labeling of 
products containing chemicals cancer. Let the consumers be informed!
   Legislation that commits our government to eliminating all known 
carcinogens from our food and water
"""

Because of the wage differential in India, spending that money abroad with 
Indian researchers would effectively more than double the amount of research 
being done on cancer. Just from eliminating one vaccine. Now, if people 
really care about women's health (and the health of everyone) and one talks 
about statistics, which is a better use of that money?

Likewise, if one really cares about cancer, then why does this NIST program 
have only about 20 staff members, not 20 thousand or even twenty million 
staff members, given a lot of cancer is caused by industrial pollution?
   http://www.mel.nist.gov/programs/slim.htm
"The United States needs to prepare for a future where products are 100% 
recyclable, manufacturing itself has a zero net impact on the environment, 
and complete disassembly and disposal of a product at its end of life is 
routine."

Our society has serious structural problems in its priorities.

But rather than address them, the mainstream media focuses on vilifying 
those looking at alternatives or those who choose to distrust a status quo 
that is making such terrible decisions.

I've seen all sorts of estimates of the banking bailout, but how much 
research on cancer could several trillion US dollars buy?
   "Adding Up the Government’s Total Bailout Tab"
http://www.nytimes.com/interactive/2009/02/04/business/20090205-bailout-totals-graphic.html

But instead, people are asked to "trust" the same sort of organizational 
paradigms that did that to inject healthy children with stuff at birth and 
afterwards.
"Hepatitis B Vaccine Continues to Kill Infants "
http://articles.mercola.com/sites/articles/archive/2003/07/09/hepatitis-b-vaccine-part-three.aspx
"""
The 2002 immunization schedule encourages the routine use of hepatitis B 
vaccine for all infants before hospital discharge. These recommendations are 
inexcusable.
   The central nervous system of a newborn infant is particularly 
susceptible to toxic influences. This is one of the reasons why the 
hepatitis B vaccine is such a problem. If it were given later in life, as is 
done in many other countries, it would not be as much of a problem. ...
   Hepatitis B is a rare, mainly blood-transmitted disease. In 1996, only 54 
cases of the disease were reported to the Centers for Disease Control and 
Prevention (CDC) in the 0 to 1 age group. There were 3.9 million births that 
year, so the observed incidence of hepatitis B in the 0 to 1 age group was 
just 0.001 percent.
   In the Vaccine Adverse Event Reporting System (VAERS) there were 1,080 
total reports of adverse reactions from hepatitis B vaccine in 1996 in the 0 
to 1 age group, with 47 deaths reported.
   Think of that in terms of probability: the possibility of contracting the 
disease is exceedingly difficult for children and only 1.25 percent of those 
who are exposed will actually develop the most serious complication!
   This type of "protecting the needle in the haystack" medicine is absurd 
at best, dangerous at worst. ...
   So what can you do? Please tell every pregnant woman you know about this 
issue. They need to know the facts BEFORE they are in the hospital so they 
have time to make an informed decision. If they are still convinced their 
child needs hepatitis B vaccine, beg them to make sure their child does not 
receive the vaccine as a newborn. Delay the vaccine until the child is 
really at a possible risk for the disease, like late adolescence.
"""

So, I guess there are two levels of debate as far as passions. One is the 
science and risk assessment, brought down to a time when new parents are 
especially time constrained and emotionally vulnerable. The other is about 
the trust demanded in organizations that have proven they are often driven 
by profits and greed (at least, in the USA) and who privatize profits and 
socialize risks.

So, between those two levels, there is a lot of room for passionate debate. :-)

--Paul Fernhout
http://www.pdfernhout.net/