2/28/2011

Trees in Blossom: Spring!














Fried Chicken Initiatives, Internet Laws, Cognitive Dissonance, and Self-Justification



NEW LAW: "THE FRIED CHICKEN INITIATIVE"

We shall here by invoke "The fried chicken initiative" which means the minute someone casts doubt on someone's intelligence because they are from the south-they immediately lose the argument.--courtesy of Kathleen


Did you notice this new law Kathleen coined up above the mommy-blog banner? I've got, in case you didn't know it, another blog at Science 2.0, which from sheer numbers of readers is my primary blog. My science or autism related pieces go over there, usually with some slight modification  for a wider audience, and the facilitated communication pieces and the vaccine pieces get the most comments because folks who won't comment here will there. Recently one of the pieces on facilitated communication has continued to get attention from someone who really, really, really wants FC to be real, and after a weekend of an absurd tug-of-war where the poster decided to write that since I was in Texas, "she probably thinks the south won the war...or that there were two wars...the civil war and the war between the states...she might even believe the earth was created 4000 BC...or that it's flat." 


You can see how the fried chicken initiative came about, can't you? Yes, appeal to ridicule is such a profound way to argue that I must be wrong on facilitated communication since Texans are renowned for their intellectual prowess. Actually, it's the Texas Board of Education that can't get its collective head out of its collective arse, not necessarily individual Texans who have the problem. 

So another internet law, mirroring Godwin's Law, is created.

I won't belabor the point here that facilitated communication is a fraud; I've made that case repeatedly and backed up the contention with scientific evidence. I will note that even safe-havens of science like MIT, can fall for the woo (thanks Jim Todd, for sharing the link). 

Why does facilitated communication and its watered-down stepchild rapid prompting method  continue to draw such staunch (and often oddly worded) support? Just like the vaccines-stole-my-baby crowd, what's going on is people who are, to borrow, my insistent critic over at Science 2.0, "true believers." I think, that when you can reach people before they've been exposed, give them the science, show them how the ideomotor effect works, that you can keep those folks from being conned or buying into the belief system. Just like education about homoepathy and other woo works well before the fact, so to does demonstrating how easily it is to manipulate a relatively passive individual into being able to type whatever the facilitator wants.

But the need to justify a belief system after the fact is going to get in the way of reaching individuals. They've seen it with their own eyes, after all, finally had their child tell them the all important, longed for "I love you." It's powerful. I suspect, the longer they use FC or RPM, the more cognitive dissonance, the greater the need for self-justification, the less likely they'll alter their positions. Anyone who argues against their beloved position is the enemy.

In other words, it's no different than the anti-vaccine community. The need to be right outweighs the need to have accurate information, and anyone who throws a wrench in the works is to be vilified.

Watch the below video, where the Belgian coma patient is being clearly facilitated; although the media was initially completely gullible and bought into this too-good-to-be-true story, it was later debunked.



Science bloggers who wrote out about this case:


PZ Myers:
http://scienceblogs.com/pharyngula/2009/11/rom_houben_is_still_a_victim.php
http://scienceblogs.com/pharyngula/2009/11/really_this_guy_is_conscious.php


James Randi:


http://www.randi.org/site/index.php/swift-blog/783-this-cruel-farce-has-to-stop.html


Orac:
http://scienceblogs.com/insolence/2010/02/belgian_skeptics_showing_the_world_that.php
http://scienceblogs.com/insolence/2009/11/another_contender_for_the_worst_reportin.php


David Gorski:


http://www.sciencebasedmedicine.org/?p=3938


Novella:


http://www.theness.com/neurologicablog/?p=1286


Lee McPherson:


http://www.themanitoban.com/articles/24468

2/27/2011

Either AoA is Ignorant or Callous. Or Both.

News story on a traveler with measles moving around the US: "More than 10 million people are infected with measles worldwide each year, and the disease is the leading cause of vaccine-preventable deaths in small children. Outbreaks are more common in Europe than in the United States, and most U.S. cases come from transatlantic travelers. U.S. law requires that any cases of measles be reported to public health authorities.
"We don't want measles to be imported back into the U.S. once it gets a foothold," Dr. William Schaffner, an infectious disease specialist at the Vanderbilt University School of Medicine in Nashville, told The Associated Press."
One of the myths that the anti-vaccine folks like to spread is the idea that everyone got measles and mumps and were just fine. Stagliano trots it out regularly:


"Were kids dying of measles in America when Leave it to Beaver was airing? How about Arthur the Aardvark and his sister DW contracting Chicken Pox? Did PBS, the station that brought you Mr. Rogers and Elmo, mean to scare children with an episode about a deadly disease or simply explain to them that they too could manage the itch and discomfort of the Chicken Pox. Just last week, I heard a Frank Sinatra song called, "Ev'rything happens to me," where he sings, "I've had the measles and the mumps." When did measles and chicken pox go from entertainment fodder to epidemic fear? And who's behind it?"
Yes, because sitcoms covered it and nothing bad happened in a sitcom, it must mean that there's no danger. Wow. There you go, an explanation that makes sense: folks at Age of Autism think that television shows are real but the reports from the CDC and WHO are not.


According to the WHO,
"Measles is a highly infectious disease. In developing countries, 1-5% of children with measles die from complications of the disease. This death rate may be as high as 25% among people who are displaced, malnourished and have poor access to health care. The disease can also lead to severe health complications, including pneumonia, encephalitis, severe diarrhoea and blindness."


WHO provides these figures on mortality: 


"It remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. An estimated 164 000 people died from measles in 2008 – mostly children under the age of five."
 WHO provides this information on complications:


"Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of five, or adults over the age of 20. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care."


Stagliano and other parents think chicken pox is no big deal, either.


The CDC reports that:


 "In unvaccinated children, chickenpox most commonly causes an illness that lasts about 5-10 days. Children usually miss 5 or 6 days of school or childcare due to their chickenpox and have symptoms such as high fever, severe itching, an uncomfortable rash, and dehydration or headache. In addition, about 1 in 10 unvaccinated children who get the disease will have a complication from chickenpox serious enough to visit a health-care provider. These complications include infected skin lesions, other infections, dehydration from vomiting or diarrhea, or more serious complications such as pneumonia and encephalitis. In vaccinated children, chickenpox illness is typically mild, producing no symptoms at all other than a few red bumps. However, about 25% to 30% of vaccinated children who get the disease will develop illness as serious as unvaccinated children."


Complications, according to the CDC:
"Serious complications from chickenpox include bacterial infections which can involve many sites of the body including the skin, tissues under the skin, bone, lungs (pneumonia), joints, and blood. Other serious complications are due directly to infection with the varicella-zoster virus and include viral pneumonia, bleeding problems, and infection of the brain (encephalitis). Many people are not aware that before a vaccine was available approximately 10,600 persons were hospitalized and 100 to 150 died as a result of chickenpox in the U.S. every year."

You know, having a college degree and affluence doesn't make you an expert in areas outside your degree. And Dr. Jay, Dr. Bob, and Saint Andy prove quite well that being doctors doesn't mean they know what they're talking about, either. So when you go outside mainstream, accepted scientific consensus and spout off crap based on availability heuristic and television shows, I'm going to think you're either intentionally ignorant, callous to the suffering and deaths of children from vaccine preventable diseases, or both.

Boundaries, Changes, Musings


The rosebushes are spreading their leaves.


The daffodils are blooming.






See the asparagus? I ate it immediately!



The chives are overrunning the garden.
The scent is lovely and oniony.


The silverlace is spreading its leaves.


Periwinkle blue to contrast daffodil yellows. 
Sublime.



Spring is busily making itself felt here; warm days, trees beginning to leaf out, flowers unfurling their petals.

Even the fish look eager:

They'll be making themselves to home soon at the local lake, as we let the pond go; it's more time-consuming than one would have thought and way more expensive than I think most people are aware of and five years into it, I'm tired of the time and the expense. And then there's the added problem of what to do with fish that multiply. Will I miss them? I think a bit, but the cost in time and money are greater than the payoff.

Getting ready for the growing season is partly establishing the new boundaries: boundaries for what will grow where, how much will be given over to flowers, what time commitment we want to make. We do this every year, evaluating what changes the previous year has made to the landscape and what our time commitments are at the present time. We used to have a large vegetable garden, but are now down to our permanent asparagus bed; we used to let the entire front and almost all the back go to flowers, but this year, Rick is insisting on keeping the front mowed down. We'll see.

As my work has begun to take up more and more space in my life, it's become apparent that other boundaries need to be drawn so that I am not constantly responding to students around the clock, and so I'm working on streamlining that. Hah, I'll need good luck with that, but I think part of that is simply not being constantly wired into the computer and at the constant beck and call of email. Working in my garden will help that.

The garden changes day by day, and although it's often less noticeable, our lives change as well, each day. We need to be able to stop and assess these changes and redraw boundary lines, make sure that issues are dealt with as they arise, that we alter our course as needed, that we stop to eat the fresh asparagus newly sprouted from the ground. Do you know, I missed the asparagus last year, was too "busy" to get out there first thing in the morning and enjoy a breakfast of freshly snapped off asparagus shoots? How sad is that? Not so this year.

Hmm, excuse me while  I go crunch some now.

2/26/2011

Navigating the Autism World: Minefields at Every Turn (FC is still Bunk)

Some of the most naturally appealing stories in the autism world (and our wider world) are those stories that reinforce the myth of the self-made man (a concept I coincidentally taught this week in American Literature). We like movies like Rudy, All the Right Moves, and the Mighty Ducks series because they feed the myth, the feel-good notion that no matter how far behind one is, how disadvantaged, that plucky teamwork, determined effort, and good fortune will be enough to overcome all obstacles, make the team, win the game, and the woman (or man), and get out of the miserable situation you were originally in.


It's not just the staunchly biomedical and "pro safe" vaccine camp who champion stories of miraculously overcoming the odds, though, through tremendous intervention. One difference, however, is that the champion in the story is usually the parent, in the biomedical side, who valiantly did everything to overcome the odds, who tried every treatment, climbed every mountain, hit all the Sound of Music high notes, in order to recover their lost child. Other camps within the autism community may instead champion the autistic individual himself (which can rightly be argued as placing the focus where it belongs).


It's unfortunate but true that even in areas of the autism community where evidence-based practices, scientific research, and a respect for neurological differences are the norm, that a too-good-to-be-true story is applauded and carried on as true without the usual skepticism and requisite of proof.


And where the focus is completely on autism as being a different way of being, the woo is just as likely to be heavy as it is on the biomed camp and facilitated communication gets not only a free pass, but a jump start and carried across the finish line. There is something romantic about the idea that people who are severely impaired, unable to speak, unable to perform academically, are simply locked in their bodies, and that with just the right tools and help they'll demonstrate the inner genius, the gifted poet, that is hidden to the larger world.


There's just enough kernel of truth to the concept of locked-in syndrome that this is an easy area, ripe for exploitation, both by well-meaning parents and educators as well as those who see a good con when they find one.


Reasonable people, watching videos of individuals being facilitated, who are acquainted with the research, aware of the ideomotor effect, and interested the safeguarding of the rights of the severely disabled, cannot in good conscience support facilitated communication. There are plenty of assistive technologies that are available and will help the nonverbal person to communicate without ever taking the chance of a facilitator co-opting the communication of the disabled person. 


James Randi wrote in January, regarding the recent $1.8 million settlement to the father who was falsely accused of sexually molesting his autistic daughter:  "The notion that FC is a legitimate treatment is still entertained by the na├»ve, and enthusiastically encouraged by Syracuse University, by Professor Douglas Biklen – a sociologist and professor of special education there – and by others who have chosen to ride this dreadful mare all the way to Hell."


 We have an obligation as parents to children on the spectrum to demand proof where treatments are concerned. We have an obligation to protect our children and their unique voices, however they are able to communicate. We have an obligation to not let our own desires concerning our child override our child's personhood. Some of the most negating things a parent can do is place words into their child's mouth, to not see and respect the child for who he or she is, to not think that whatever the level of impairment, the child has innate value and the right to respect and to be accepted just as they are.


When we advocate beyond our children, when we are promoters of evidence-based practices, we should be careful not to fall into the feel-good trap of promoting stories that may, indeed, be too good to be true. It's hard to resist the pull of feels-good story, the lure of a miraculous tale of success despite the odds. If you watch CNN's Sanja Gupta for any amount of time, you see he's never met a too-good-to-be-true story he couldn't help but accept. It's understandable that our desire for something to be true can trump that inner skeptic who asks wait a minute, show me.


It is all too easy to co-opt a person's communication with facilitated communication. This young woman below put together a stunningly simple explanation of FC. Reasonable people watching this video have to give serious consideration to the idea that it is ridiculously easy to co-opt the communication of other, especially a passive participant and that parents and well-meaning educators may be letting their desires over-ride what an individual can actually do.







If that's not enough, I'd encourage you to examine video footage of FC and look carefully at how it's being done. Where is the facilitator? How is the facilitating being done? Where is the individual being facilitated looking? Has the facilitation been independently verified? Are complete answers being provided with one button push? 


Other FC/RPM articles I've written and co-written:



Questionable Autism Approaches: Facilitated Communication and Rapid Prompting Method


2/25/2011

The Red, White and Black Club: Two of These are NOT Like the Other

Buy on Amazon

Mnookin's site


Deadly Choices

Offit's site


Vaccine Epidemic Book

Vaccine Epidemic's site


All three of these books came out on the heels of each other. Two, as most readers familiar with the subject area know, are books that analyze the anti-vaccine movement and how it poses a danger to society. The third book, published by Skyhorse Publishing who also published Wakefield and Stagliano's books, has a very different take on vaccines and view vaccines as the danger.

What struck me as these books arrived, was how very similar they were in packaging: bold capitalized black titles on a bright white background with red print to make a fiery counterpoint to the starkness of the black an white. It's not just the message, you know: it's the packaging.

And that concept: that it's the packaging that matters most, can't be missed with any of these works. All three books have significant portions of text dedicated to footnotes to substantiate the claims made in the works. Of the three, Mnookin's prose is the most pleasing, and the easiest to read.Offit is the most credentialed author: this is his field of expertise, and portions of it are familiar reading for those who have traversed this ground with Offit in his other works. One writer, Orac, criticized Offit for not placing Wakefield more front and center in Deadly Choices, but having spent previous time and attention to Wakefield's role, I was satisfied with the amount of attention of Offit gave Wakefield: about five pages. 

Offit details the rise of anti-vaccine movements both in present day and in the past, here in America and in England and looks at the commonalities between the past movements and the present movements. He closes strongly, with a look at the story surrounding one of Dr. Robert Sears' patients who spread measles to others in San Diego in 2008 and the anger of parents whose children were exposed and quarantined and whose children caught measles. While Offit does not share that it was Sears' patient, Mnookin does, and the irony that the doctor who wrote a book on vaccines and an alternative schedule contributed to an outbreak that cost, according to Mnookin, "more than 10 million to contain" cannot be missed.

Both Offit and Mnookin's books work well together, covering much of the same ground, but with different emphases. Together they provide a compelling argument that the anti-vaccine movement is one that is not predicated on scientific evidence but on fear and emotion instead. Their perspectives are clear and decisive, and leave no room for doubt. The same can be said about the authors and contributors that comprise Vaccine Epidemic, many of whom are also familiar to readers aware of the autism-vaccine controversy. 

All three books aim at a wider audience than the autism community; all three books have similar aims: to convince the reader of the rightness of the authors' positions. Mnookin's book is more far-reaching and incorporates other areas of interest where people's fear and panic lead them to believe in things that do not exist, like Morgellons. Mnookin's aim is the broadest: to explain how and why people come to believe the things they do, how they allow panic to spread like a virus, and how the internet has allowed this to happen. Offit has suited up to do battle again against a foe that will not disappear. He pushes the emotion buttons where appropriate, and he brings credibility to his perspective by clearly indicating what the dangers of vaccines are, how the CDC responds to those dangers, and what improvement could still be made. He does not ever suggest that vaccines are entirely safe: he is realistic and honest about the risks. Vaccines carry risks; we should continue to work towards more safe and effective vaccines, but those risks do not include autism and they are far less than the risks of the diseases themselves.

In contrast to these two works, Vaccine Epidemic is a veritable who's who in the anti-vaccine community: Wakefield, Tenpenny, Boyd Haley of the mining chelator fiasco, and prominent autism-as-vaccine injury bloggers and others contribute chapters to this work. While Offit and Mnookin's books close with the hope that knowledge and reason will ultimately prevail and that the suffering and death caused by infectious diseases will be prevented because reason and knowledge prevail, Vaccine Epidemic ends with a chapter by Wakefield in which he insists that there's been a massive conspiracy to cover up the link between autism and vaccines, and he invokes JB Handley's "big hungry lie" and engages in pitching his book to readers, with a flashy closing that replays in similar fashion but much more grandiosely than Mnookin and Offit: "The day will belong to Reason."

All three of these books are packaged similarly. One can even imagine them sitting side-by-side on bookstores' shelves, but two of these book are not like the other. And despite the shared hope that reason will prevail, the authors of Vaccine Epidemic are defining the outcome of reason prevailing entirely differently than Mnookin and Offit are.

Is the anti-vaccine movement (or Habakus and Holland's preference of pro-safety terminology despite the openly anti-vaccine sentiments of Sherri Tenpenny) dangerous to society at large? If it remains a marginalized, fringe group, the dangers they pose are buffered by community immunity. Some, like those exposed by the lone Robert Sears' patient, suffer because of the actions one family's decision to engage in risk assessment. 

If vaccination rates decrease, if community immunity collapses under the weight of people who are swayed by the inflammatory rhetoric of people who make their living off of fear, then we will have a brand new set of questions to answer: where does my right to choose medical interventions end and the public health's needs begin? What right do I have as a parent to decide which vaccines my children receive and when?

Until that day arrives, working at combating misinformation is something that we must continue to do. Seeking ever-better and more exhaustive science into vaccine safety and efficacy is something all reasonable people can get behind. Understanding the real risks and the real benefits of vaccination and making truly informed consent is something reasonable people can get behind. Conflating the idea that true informed consent means people wouldn't vaccinate is not, however, and while the rhetoric that Vaccine Epidemic cloaks itself in is an appeal to rugged individualism as patriotically American, it overplays its hand by including individuals who are unashamedly anti-vaccine, misinformed, disgraced, and discredited in its pages.

In the end, will most readers take the time to read all three of these works, pick through the notes, work to ascertain where the truth is? Perhaps not. It's a significant investment of time and energy.

I think, though, that Mnookin's and Offit's works will be more compelling. But that may be the optimist in me.


Disclosures:

I was not paid for these reviews.
I did, however, receive all three books to review free of charge.
I have communicated via email with Dr. Paul Offit over the last two years. He has been kind in answering questions promptly.
I have communicated via email with Seth Mnookin and I follow his tweets (I also follow Dr Jay "Nimby" Gordon, so make of that what you will).
I have written negatively on Haley, Wakefield, Tenpenny, and Ginger Taylor before.
I think, based on the studies to date, that the science does not back up a link between autism and vaccines.
I think that vaccines for those who can safely do so are an important tool in the prevention of disease and that we have a moral obligation to protect our children and those who cannot be safely immunized. Yes, I am willing to take one for the team.


Additional disclosures:

All royalties from Offit's book go to the Autism Science Foundation.

2/23/2011

Spring has Sprung


The Enkindled Spring

BY D. H. (DAVID HERBERT) LAWRENCE
This spring as it comes bursts up in bonfires green,
Wild puffing of emerald trees, and flame-filled bushes,
Thorn-blossom lifting in wreaths of smoke between
Where the wood fumes up, and the flickering, watery rushes.

I am amazed at this spring, this conflagration
Of green fires lit on the soil of the earth, this blaze
Of growing, these sparks that puff in wild gyration,
Faces of people streaming across my gaze.

And I, what fountain of fire am I among
This leaping combustion of spring? My spirit is tossed
About like a shadow buffeted in the throng
Of flames, a shadow that's gone astray, and is lost.






Lines Written in Early Spring

BY WILLIAM WORDSWORTH
I heard a thousand blended notes,
While in a grove I sate reclined,
In that sweet mood when pleasant thoughts
Bring sad thoughts to the mind.

To her fair works did Nature link
The human soul that through me ran;
And much it grieved my heart to think
What man has made of man.

Through primrose tufts, in that green bower,
The periwinkle trailed its wreaths;
And ’tis my faith that every flower
Enjoys the air it breathes.

The birds around me hopped and played,
Their thoughts I cannot measure:—
But the least motion which they made
It seemed a thrill of pleasure.

The budding twigs spread out their fan,
To catch the breezy air;
And I must think, do all I can,
That there was pleasure there.

If this belief from heaven be sent,
If such be Nature’s holy plan,
Have I not reason to lament
What man has made of man?










I Wandered Lonely as a Cloud

BY WILLIAM WORDSWORTH
I wandered lonely as a cloud
That floats on high o'er vales and hills,
When all at once I saw a crowd,
A host, of golden daffodils;
Beside the lake, beneath the trees,
Fluttering and dancing in the breeze.

Continuous as the stars that shine
And twinkle on the milky way,
They stretched in never-ending line
Along the margin of a bay:
Ten thousand saw I at a glance,
Tossing their heads in sprightly dance.

The waves beside them danced; but they
Out-did the sparkling waves in glee:
A poet could not but be gay,
In such a jocund company:
I gazed—and gazed—but little thought
What wealth the show to me had brought:

For oft, when on my couch I lie
In vacant or in pensive mood,
They flash upon that inward eye
Which is the bliss of solitude;
And then my heart with pleasure fills,
And dances with the daffodils.

Words: Meanings and Miscommunication



Does changing a word, reducing its usage, change the world? Does it change attitudes? Or do we use new words in place of old words to convey the same dismissive, derisive attitudes? If we rid the world of the word r*tard, will that be enough to get the intellectually disabled the acceptance and equality that is their right as fellow human beings?

Meanings, and the attitudes behind the meanings, matter. When young people today use that word so casually in their conversations (and boy do they use it!), do they mean harm? It's doubtful when they use it they're stopping to think about those with challenges; it's certainly obvious that they're not thinking of them and how that might make someone with an intellectual disability feel. No, it falls off the tongue carelessly with no thought. And the common usage has only increased over the years; any given day at the college, I'll hear it a handful of times as I pass through the common areas.

Do I stop them? Do I confront each student and gently explain that's hurtful? No, I don't, because I did, initially, when they used it directly in front of me, and it didn't help get them to use the word less. There's got to be a better way than directly addressing it. 

Condemnation of individuals who use the word thoughtlessly is not helpful, either. It is a commonly used word, like moron, idiot, imbecile, and even those in the disability community who should be sensitive to language and how it's used, use those three words, even if they avoid the R word.

I'd tell you that my use of dumbass is better, morally superior, but it's not. The attitude behind those words, used so casually in conversation that even when we don't mean to, have a tendency to slip from our tongue without deliberate forethought, is the same. The words are meant to convey a specific cluster of attitudes, and those attitudes are clearly communicated when we use any of those words.

It's a dismissive attitude, one that instantly signals that the person it's being used against is or has done something stupid. It's a way of rendering them less, less than smart, less than. It's not nice, and even softening it, to say that even dumbasses have feelings, does not lessen the fact that the terms are meant to sting.

I could commit a logical fallacy, point to its common usage and say that makes it okay, but it doesn't, not if you're on the receiving end of that attitude. It's only okay if you're the one dishing it out (and that's because you're dishing it out).

I'm not sure there's a solution here; people do some spectacularly stupid things, even the smartest people. There ought to be a way to convey those failures of cognition without a derisive attitude that somehow still conveys the humanity, the value, and the validation of that humanity and value. I fear it's so much easier and so much more satisfying to just slip into the use of those words that convey that attitude than it is to painstakingly break down the claims being made, bit by singular, spectacular failing bit.

The problem is we're human, hypocrisy is inevitable, and lapses in theory of mind and the golden rule are going to happen.

I'm all for ending the use of the "R" word, but it's the attitude behind the word that has to be changed, and whether we use that particular word or not, I'm willing to bet that underlying attitude is one we all employ at one point or another.

http://www.specialolympics.org/spread-the-word-to-end-the-word.aspx (my link button is acting up, so here's the site).

2/21/2011

The Horror: Dr. Jay Against Preventing Infectious Disease "just because...we can"

Over at Orac's today, Dr. Jay continued to demonstrate his failure to think critically. After a string of comments that should be somewhat embarrassing, Dr. Jay offers this stunning failure: "And, I think it's wrong to vaccinate against an illness just because . . . we can. We should be more judicious in our use of this medical intervention."


Why "should be more judicious in our use" of vaccines? Why would we want to have children suffer diseases when their suffering can be prevented? Here are four of the diseases vaccines protect against. I wonder which ones of these diseases Dr. Jay thinks kids should get?


Measles:


"The number of measles cases reported during January 1--July 31, 2008, is the highest year-to-date since 1996. This increase was not the result of a greater number of imported cases, but was the result of greater viral transmission after importation into the United States, leading to a greater number of importation-associated cases. These importation-associated cases have occurred largely among school-aged children who were eligible for vaccination but whose parents chose not to have them vaccinated. One study has suggested an increasing number of vaccine exemptions among children who attend school in states that allow philosophical exemptions (6). In addition, home-schooled children are not covered by school-entry vaccination requirements in many states. The increase in importation-associated cases this year is a concern and might herald a larger increase in measles morbidity, especially in communities with many unvaccinated residents.


In the United States, measles caused 450 reported deaths and 4,000 cases of encephalitis annually before measles vaccine became available in the mid-1960s (1). Through a successful measles vaccination program, the United States eliminated endemic measles transmission (1). Sustaining elimination requires maintaining high MMR vaccine coverage rates, particularly among preschool (>90% 1-dose coverage) and school-aged children (>95% 2-dose coverage) (7). High coverage levels provide herd immunity, decreasing everyone's risk for measles exposure and affording protection to persons who cannot be vaccinated. However, herd immunity does not provide 100% protection, especially in communities with large numbers of unvaccinated persons. For the foreseeable future, measles importations into the United States will continue to occur because measles is still common in Europe and other regions of the world. Within the United States, the current national MMR vaccine coverage rate is adequate to prevent the sustained spread of measles. However, importations of measles likely will continue to cause outbreaks in communities that have sizeable clusters of unvaccinated persons."


Mumps:
"Before the mumps vaccine was introduced, mumps was a major cause of deafness in children, occurring in approximately 1 in 20,000 reported cases. Mumps is usually a mild viral disease. However, serious complications, such as inflammation of the brain (encephalitis) can occur rarely. Prior to mumps vaccine, mumps encephalitis was the leading cause of viral encephalitis in the United States, but is now rarely seen.
Serious side effects of mumps are more common among adults than children. Swelling of the testes is the most common side effect in males past the age of puberty, occurring in up to 37 percent of post-pubertal males who contract mumps. An increase in miscarriages has been found among women who develop mumps during the first trimester of pregnancy.
Before there was a vaccine against mumps, mumps was a very common disease in U.S. children, with as many as 300,000 cases reported every year.  After vaccine licensure in 1967, reports of mumps decreased rapidly. In 1986 and 1987, there was a resurgence of mumps with 12,848 cases reported in 1987. Since 1989, the incidence of mumps has declined, with 266 reported cases in 2001. This recent decrease is probably due to the fact that children have received a second dose of mumps vaccine (part of the two-dose schedule for measles, mumps, rubella or MMR).  Studies have shown that the effectiveness of mumps vaccine ranges from 73% to 91% after 1 dose and from 79% to 95% after 2 doses and that 2 doses are more effective than 1 dose."

"Rubella, whose name means "little red," was thought to be a type of measles until 1814, when German researchers described it as a completely different illness. From 1963-1965, a rubella epidemic swept across the globe. In the United States alone, there were about 11,000 fetal deaths and 20,000 infants born with congenital rubella syndrome, a group of birth defects that can occur in an infant when its mother is infected with rubella during pregnancy."


"Pertussis is most severe for babies; more than half of infants younger than 1 year of age who get the disease must be hospitalized. About 1 in 5 infants with pertussis get pneumonia (lung infection), and about 1 in 100 will have convulsions. In rare cases (1 in 100), pertussis can be deadly, especially in infants."

"Pertussis can lead to hospitalization, pneumonia, dehydration, weight loss, sleep disturbance, seizures, and, rarely, encephalopathy or death.1 These complications vary depending on patient age (Figure 26). Most pertussis related hospitalizations occur in the first year of life.4 Young infants are at the greatest risk of secondary bacterial pneumonia, the most common cause of pertussis-related deaths.4,7 Acute dehydration and malnutrition occur in patients with cough that limits food and fluid intake. Cerebral hypoxia from severe paroxysms1 can cause seizures and encephalopathy. Refractory pulmonary hypertension can be a late sequela in infants with pertussis.1,7"


I can understand some of the folks at Age of Autism and the like not getting the dangers. I do not, however, get how a pediatrician could wish "natural immunity" and possible death on children. I'm deeply disappointed in Gordon and I can't help but wonder how the AAP would feel about his position regarding vaccines and not safeguarding his patients.