Sorry, but anti-vax advocates are idiots and crazies

Fool Rubber Stamp

Rachel Hills has written a thought provoking piece for The New Republic, The Best Way to Combat Anti-Vaxxers Is to Understand Them.

Referencing the work of Jennifer Reich, a sociologist at the University of Colorado Denver, Hills claims:

It is not just anti-vaxxers, after all, who take pride in their ability to critically evaluate information, who do background research instead of trusting their doctor’s advice on faith, or who are skeptical of the motivations of government, pharmaceutical companies, or big business. Nor is it only anti-vaxxers who believe that every individual is unique, and that policies should be adapted to fit those idiosyncrasies, rather than applied one-size-fits-all. (As one mother Reich interview explained it in relation to vaccines: “Everyone has a different immune system. For some people, it may take three shots. [Others get] immunity that first time.”)

In an era of high individualism, ideas like these aren’t outliers or aberrations. They are hallmarks of the liberal middle-classes—the kind of people, say, who might read The New Republic online. And I’ll be honest: they sound an awful lot like me.

In other words:

At its heart, the anti-vaccination movement isn’t a product of ignorance, selfishness, or even fear … although each of these play their part. It is the logical fallout of a society in which knowledge is relative, institutions are fallible, and the individual reigns supreme. In such an environment, the real surprise isn’t that there are people who doubt vaccines. It is that most of us don’t doubt them, even when every social force around us is urging us to do otherwise.

According to Hills, if that’s the case:

All of which begs the question of how we might better respond to anti-vaxxers. One solution might be to rebuild the trust between individuals and medical institutions. It is well established that parents who choose not to vaccinate their children are a privileged group, but the deep suspicion that lies at the heart of vaccine refusal reflects their distance from power, not just their proximity to it. It stems from the same impulse that leads people to believe that the U.S. government creates fake ISIS videos as propaganda tools, or that media barons dictate stories to their journalists over the phone…

She concludes:

Whatever approach we choose, one thing is for certain: Dismissing vaccine skeptics as crazies or idiots won’t solve the growing public health problem their choices present. To do that we need to go deeper; to examine not only the ways in which they are plainly wrong, but the beliefs they hold that are more equivocal—and the unwitting role we might all be playing in allowing those ideologies to thrive.

As much as I admire Hills’ writing and clear exposition of her claims, I disagree profoundly.

Hills is right to focus on parents’ attitudes, rather than their knowledge of science. That’s because anti-vax advocacy is not about vaccine and not about children. It’s about parents wanting to see themselves as educated, empowered and not submissive to authority … with an important caveat. They want to burnish their self-image without doing the hard work of learning immunology.

Yes, neo-liberals (and old fashioned liberals like myself) want to take pride in their ability to critically evaluate information, do background research instead of trusting their doctor’s advice on faith, and are skeptical of the motivations of government, pharmaceutical companies, or big business.” But it is IMPOSSIBLE to critically evaluate information about vaccines if you don’t have a firm grounding in basic immunology. It is IMPOSSIBLE to do research by reading websites written by laypeople for other laypeople. It is IMPOSSIBLE to be educated about vaccines without being thoroughly educated about immunology.

Hills claims that anti-vax isn’t a product of ignorance, selfishness, or even fear, Unfortunately, it is PRECISELY a product of ignorance, selfishness and fear; ignorance of basic immunology, microbiology and statistical analysis, selfishness in eliding the dangers vaccine rejection poses to others, and an absurd, overblown, unreasoning fear of autism.

Hills insists that anti-vaxxers aren’t idiots or crazies and likens them to people who believe the U.S. government creates fake ISIS videos as propaganda tools. But those people are also idiots and crazies. They have literally no idea what they are talking about and have an abiding fascination for conspiracy theories based on absolutely no evidence at all. If Hills was trying to make anti-vaxxers look reasonable, she used a strikingly poor analogy.

Hills concludes that dismissing vaccine skeptics as idiots or crazies won’t solve the growing public health problem their choices present.

I beg to differ.

Anti-vax activism is about parents and how they want to view themselves. It would be very hard for them to present themselves as educated and empowered if everyone else believed them to be ignorant and gullible. Indeed, the tide is turning at this very moment, as anti-vax advocacy is devolving in the public view from being simply one of many reasonable approaches to vaccination to the growing public belief that anti-vaxxers are crazy conspiracy theorists who have been 100% wrong about every claim they’ve ever made. The resurgence of pertussis, measles (and even the furor over Ebola), along with a continuing rise in autism prevalence have combined to make anti-vaxxers look like fools.

Hills is correct that anti-vax advocacy is not about science and is not going to be improved by improving science education, but she’s wrong to claim it is a manifestation of neo-liberalism. Neo-liberalism places great stock in real education, not pretending to be educated by surfing the internet. That’s just lazy boastfulness.

Neo-liberalism values skepticism, which actually means “requiring proof” and not “refusing to believe what experts say.” That’s just foolish.

Neo-liberalism questions government, pharmaceutical companies and big business, but it does not allege that government, pharmaceutical companies, and big business are engaged in conspiracies so massive that they involve all the doctors and public health officials in every country of the world, who are giving their own children vaccines that they supposedly know are toxic. That’s just totally crazy!

Obviously any attempt to increase vaccination rates will need to be multi-pronged, but I suspect that humiliating anti-vaxxers is going to be by far the most effective strategy. I would draw a parallel to racist and homophobic jokes. When they were acceptable, comedians told them and thought those jokes made them seem witty. When racist and homophobic jokes were finally acknowledged to be hateful, and comedians were humiliated for telling those jokes, most stopped telling them. They recognized that those jokes made them look bigoted, not witty.

When declaring yourself to be an anti-vaxxers brings only eye-rolls, condemnation and pity, neo-liberals will start vaccinating their children once again.

  • Rainey

    Stop projecting your own self importance onto people against vaccines. You really think it’s all about ego and looking knowledgeable? We’re not even all parents. I AM AN AUTISTIC PERSON who has directly experienced disabling symptoms associated with autism increasing dramatically following vaccines. I almost died from a Tdap in 1998. I, like so many other anti-vaxxers, am anti-vaxx because of direct personal experience. But you, you think you are so educated, but you missed so many important things about immunology. Read We Want To Live by Aajonus Vonderplanitz, who spent over 30 years in a lab, studying the effects of vaccines on animals and their young. Look deeper than the surface …all those mutant antibodies you are creating with your vaccines, are causing cellular malnutrition for up to 50 years — which is causing all kinds of health problems and more disease. And the more vaccines, the more malnutrition. But you want to vaccinate for every condition under the sun …it’s insane.

  • Red Ear Reviewer

    I see it as a wider problem of children having few rights in the USA. (Any society that allows corporal punishment in public and private schools is WAY behind in acknowledging child rights.)

    When vaccination mandates have been challenged, at least one court has ruled in favor of a policy for medical exemptions only basing the opinion on constitutional principles that children have a “right to a future” and “equal protection under the law.”

    • Who?

      In an environment where the dialogue is about rights, those who come out on top either just take the rights ie do what they want, or advocate- through for example, a social, legislative or judicial process-for themselves.

      Children can do neither.

  • Elizabeth Neely

    my oldest son had no issues with vaccinations, I received untested anthrax vaccinations in the military, I am permanently disabled from them, other women in my company were also injured from them. My child that I gave birth to after my military service was affected badly by them so we had to stop giving them. Do I think all vaccines are bad and dangerous? No I dont, but we need to be careful especially with untested ones. My son was sick for a long long time but he did finally recover. I am still very sick with autoimmune issues, on the bright side I rarely ever get sick with germs..LOL

    • SporkParade

      That’s horrifying that the military was essentially conducting medical testing on members of the service. I think I speak for everyone here, though, when I say that it is totally reasonable to suspend vaccination when it is clear that a child has medical reasons not to be vaccinated, as in your son’s case. The problem is that the herd immunity that originally would have protected your son is being eroded due to false information being spread about vaccines, including the lie that the routine childhood vaccines haven’t been tested for safety. They have been tested extensively. Vaccines are what are known legally as “inherently dangerous,” meaning that someone will inevitably be harmed by them, but the benefits of them being widely available (in this case, the saving of millions of lives) outweigh the risk.

      • Elizabeth Neely

        well I know some anti vaxer’s and I thought that they were really stupid especially when all 8 of their kids got whooping cough and were essentially sick for 2 months…

      • Nick Sanders

        From what I understand, they more or less have to do the tests for some of them on the military if there is to be any testing at all. Because no civilian has any statistically significant likelihood of being exposed to things like weaponized smallpox or anthrax, or to relatively rare diseases from remote parts of the world that only the military is going to be traveling to, so doing regular testing would be completely unethical and unjustifiable, as the subject could not possibly benefit from it.

        Note that I am not justifying poor study ethics, sloppy safety controls, or reckless drug development, only limited test subject pools.

        Edit: Whoops, thought this was a new article by Dr. Tuteur when she posted it on facebook, and never stopped to check the timestamps. Sorry for grave digging.

  • Amy

    Haven’t anti-vaxxers been treated with ridicule all along, though? I think up until now most people have felt that it’s not a threat to society in general that a few crazies refuse to vaccinate their children. It’s becoming ever more apparent that, yes, it WILL threaten the rest of us if it’s allowed to continue. What’s the answer, though? Do we go back to refusing to allow unvaccinated children in schools? Can we force people to vaccinate their children?

    We’ve seen recent research that found that in people with a certain mindset, once they’ve formed an opinion, showing them facts that refute their conclusion only serves to make their belief stronger. They ignore facts, which is why we have people who still insist that President Obama was born in Kenya, or is a secret Muslim, or that 9/11 was an inside job. It seems to me that the anti-vaxxers have the same tendency.

  • sdsures

    OT, kind of:

    I recently discovered that my pediatrician died in 2011. Given the age he was when I last saw him, it wasn’t a surprise, but emotionally it still hurt. He was a gentle man, who always gave patients jelly beans at the end of each appointment. Tributes in his online obit are from patients, and they all remember the candy and his ever-present bow-tie. I wish I had sent him a thank-you note for his care before he died.

    http://passages.winnipegfreepress.com/passage-details/id-175578/name-William_Bowman/

    How he relates to this topic: I was a preemie born at 28 weeks, and he was the doc who became my care provider until I was 18. He helped us navigate through the waters of hydrocephalus and cerebral palsy. I got all my vaccines, but had an allergic reaction to the MMR. Simple, safe solution in them days: give me a safe alternative.

  • Red Ear Reviewer

    For demonstrating anti-vax nuttiness:

    Is there a hidden anti-vax agenda?: See the “documentary” (2011; available on YouTube) called “The Great Culling” which claims that vaccination, fluoridation and “chemtrails” are the plot of some unnamed “elite” to wipe out most of the world’s population in anticipation of the Second Coming…or some such.

  • Red Ear Reviewer

    Reich, the Colorado researcher, has been calling for mandatory education for any parents wishing to opt for a philosophical or religious exemption to vaccination for school attendance.

    Many pro-vaccination activists in my state have ignored (or misinterpreted) the Nyhan study that demonstrates that online vaccination education actually INCREASES the desire of parents to opt out of vaccinating. (Many parents even left the Nyhan study with the impression that photos they had been shown of children suffering childhood diseases were showing the side effects of vaccines!)

    This indicates to me that bias and fears rule the day — even on both sides of the issue.

    Will in-person education sessions with a physician or school nurse be effective in increasing vax rates? As far as I know, there is no good research to guide us. But we do know that West Virginia and Mississippi, with only medical exemptions allowed, have enviable vax rates.

    I agree with Dr. Tuteur that pointing out the insanity of the anti-vax entrepreneurs is the way to go.

    I have been active for the last ten years in promoting community water fluoridation. Anti-fluoridationists are birds of a feather with the anti-vax activists. (Case in point: two years ago the Fluoride Action Network formally aligned with NVIC, with both getting funding from Mercola.)

    In a local, successful fluoridation ballot issue, we made hay out of the fact that the local leader of the anti-fluoridationists suggested replacing fluoride in the water supply with colloidal silver, thus turning the residents of into a community of smurfs!

    It is always a good tactic to allow the anti-science guy talk and talk and talk — the more the better. Get him to talk about all the other topics important to him, why he became interested, etc. When all the nonsense pours out — and I guarantee there will be a lot — the public will be able to judge how reliable his info on vaccines is.

    • Young CC Prof

      To my mind, one advantage of education requirements is that they make opting out at least as inconvenient as actually getting the shots. When exemption procedures are really easy, a certain number of parents will get the exemption simply because they are busy, life is complicated, they are between pediatricians, they’ll get the kid vaccinated next year, etc. If you make people jump through a hoop or two to get an exemption, fewer will take it.

      • Red Ear Reviewer

        When doing any sort of social engineering such as requiring education, it is best to do the research in advance lest we make things worse. Nyhan certainly didn’t expect the results he got.

        At this time, we may be on firmer ground if the state merely requires parents to pick up the immunization opt-out forms at their pediatrician’s office. But the right thing is to work towards ultimately eliminating all personal belief exemptions.

    • Box of Salt

      Red Ear Reviewer “Many parents even left the Nyhan study with the impression that photos they had been shown of children suffering childhood diseases were showing the side effects of vaccines!”

      If this is the case (and you didn’t link to the Nyhan study, so I can’t check), then the material needs to be clarified. This does not mean education won’t work. And, as you pointed out, maybe it’s the venue. Maybe this kind of education does need to be done face to face, with an opportunity to ask questions – not shortcutting the process on line.

      • Red Ear Reviewer

        It’s my understanding that Nyhan used the types of education modules now used/required in Oregon.

        “Effective Messages in Vaccine Promotion: A Randomized Trial”

        http://www.dartmouth.edu/~nyhan/vaccine-misinformation.pdf

        Conclusion: Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination
        intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive. More study of pro-vaccine messaging is needed.

  • Amazed

    OT: Hey, Carolyn Gall showed up in the comments of Ashley Martin’s story. And of course, she implied that the hospital was the reason her “son” (who she was a surrogate for, IIRC) slipped blue and with the cord twice wrapped around his neck from her 50 or 52 year old body when she wouldn’t agree to anything less than a vaginal birth (a detail left out of the story, per Carla Keirns fashion.)

    http://www.popsugar.com/moms/What-Home-Birth-Like-36487613

    Let’s feel neglected together. Old girl returned to the internet but didn’t grace us with an appearance here.

    • Young CC Prof

      Aw, she was fun! Kind of like watching a train crash.

  • Esther

    Somewhat OT, but look what else is being blamed for autism: http://www.telegraph.co.uk/men/active/mens-health/11334800/Circumcision-doubles-autism-risk-study-claims.html
    Looks like everybody needs to blame autism on their personal pet cause…

    • rational adult

      Looks like Dr. Amy’s satirical “does breastfeeding cause autism” post from last week was sadly prescient. You are so right that everyone looks for corralaries between autism and their own causes. Since I’m passionate about environmental issues, you can all look forward to my upcoming study linking carbon emissions to autism.

    • The Computer Ate My Nym

      Sigh. I don’t like the idea of routine circumcision at birth. I think it’s unnecessary surgery on a child and that it’s better to wait until the kid’s old enough to decide for himself (or herself as occasionally male bodied people are female) whether to have the procedure or not. But I can’t think of any biologically plausible explanation for how circumcision could increase the risk of autism and strongly suspect that if the correlation is real (and I’m not saying it is without reading the original paper and preferably seeing the results reproduced by an independent group) then I would strongly suspect confounders.

      • SporkParade

        It’s actually a much easier procedure for a newborn than for an older child or an adult, both in terms of the surgery itself and in terms of the recovery. That doesn’t mean that those of us from circumcising cultures understand why anyone who wasn’t divinely commanded to would do routine circumcision, but there is a case to be made for doing it earlier rather than later.

        • sdsures

          I’m Jewish and my husband is not. Since we live in the UK, RIC isn’t the thing here. Of course we’d circ our son (no kids yet) if a medical necessity cropped up, but otherwise? No need. It’s just that simple.

        • Roadstergal

          Yes – my husband is very grateful to his parents for having had a procedure with no long-term negative effects done at a time when it gave him and his future partners the maximum lifetime protection from disease that it can confer. Much like the women who have had CSs and are happy about it, he has no patience for the people who try to convince them that he is ‘damaged’ in some way because it’s not ‘natural’. Neither do I.

          That’s the issue that makes this one complicated. Maximum benefit and minimum risk is when it’s done neonatally.

      • Life Tip

        Related to circumcision, but mostly about people using the internet for healthcare advice: An acquaintance of mine just posted on Facebook that her non-circumcised son appears to have some sort of painfully inflamed/infection/oozing pus/all sorts of gross descriptions (posted on the internet, poor kid). Someone responded that she should put athletes foot cream on it. And acquaintance responded with an “ok thanks!”.

        Really? If you think your son’s penis is infected, call the doctor for God’s sake.

      • Nick Sanders

        Well, I can think of about a thousand bad jokes about “thinking with the wrong head”. But then autism is associated with too many neurons, not too few, so the pedant in me just sighs and gives up.

        Edit: Whoops, thought this was a new article by Dr. Tuteur when she posted it on facebook, and never stopped to check the timestamps. Sorry for grave digging.

    • fiftyfifty1

      Yikes, just what Europe is looking for right now with the recent events: another reason to demonize Muslim immigrants.

      Interestingly, I am sure that if the same study were done in my area (Midwest/USA) they would also find a correlation between infant circ and autism. Why? Because our area has a large East African Muslim immigrant population that for unknown reasons also has a very high autism diagnosis rate. We also have 2 other large immigrant groups that don’t circ and have very low rates of autism diagnosis. I bet I could write a very persuasive paper.Of course I would need to intentionally leave out the fact that autism is found at a higher rate in both the boys and the girls of the East African community, and that the 2 non-circing immigrant groups have very low utilization/contact with health care (and thus are likely extremely underdiagnosed).

      • Guesteleh

        This reminded me of something I’ve been mulling over for a while. Often when circumcision is being debated people will make snide references to Americans doing it simply because it’s a cultural norm. But you could argue that Europeans have a strong resistance to circing despite the documented health benefits because circumcision is associated with Jews and Muslims, both groups that are vilified in parts of Europe. Point being that biases cut both ways and the fact that Europeans haven’t traditionally practiced routine infant circumcision isn’t really an argument against doing it.

        • LibrarianSarah

          Unfortunately, I’ve seen far too many Americans, both on the internet and in “real life,” try to argue for something by saying “Europe” does it or argue against it something saying that “Europe” forbids it. There is just so much wrong with this line of reasoning. First Europe is an entire god damn continent that is fill with a multitude of countries, with their own unique laws, customs and languages. The likelihood of them all agreeing on ones specific thing that is not a universal moral feature or failing (murder is bad etc) is infinitesimal. And even if all of Europe was in agreement, who gives a fuck? At what point did European automatically mean good and American automatically mean bad?

          • Who?

            I always thought there was at least an element in the US that’knows’ Europe is full of communistic, social security reliant, tax loving, anti-war, overgroomed softies, so whatever they do the US should do the opposite.

            Which makes your point really nicely-both are big places, with big ranges of views, and making broad assumptions about either is risky.

            It’s like when people talk about ‘Africa’ like it is a country not a continent.

    • Anonymous

      Just read the article, not the study. I can see some very, very obvious problems with it.

      By this reason, middle eastern countries should have much higher rates of autism than other countries of parity population sizes. Can someone elaborate as to whether or not this is the case because I believe it isn’t. At least the article says correlation does not equal causation.

  • Stacy48918

    Related update:

    Good news! Looks like within the next 2 weeks I should have an order from a judge saying I can vaccinate my kids! 😀

    • Mishimoo

      Awesome! I’m so happy for you.

    • Kq

      Omg congratulations! You have been so amazing through this. Seriously, watching your journey has been incredible. You’re a hero in my book!

    • Who?

      Well done sticking to your guns on this, all crossed the court process goes as you anticipate.

    • Amazed

      It was just a matter of time, Stacy! Once you chose your course, there was no going back, this much was evident, and thankfully most judges aren’t self-proclaimed (anti-)vaccine experts.

      So happy for you anyway.

      • Stacy48918

        What’s interesting is that in all his filings EX claims not to oppose vaccines, which is…nuts. He wouldn’t even let me vax our cat. But whatever. If he’s going to say that to not appear crazy it makes it easier for me. The judge certainly seemed very sympathetic.

        • Amazed

          Quite interesting indeed! But if it works in your favor, more power to you.

          Keep doing the best for your family and society by vaxing your fluffy and unfluffy kids! And keep writing here, your perspective is a very interesting one. You speak from so many PoVs.

        • Who?

          That’s all good news, but mind he isn’t playing a long game, building a picture of you as the difficult one, and here you are now dreaming up all these stories about how he does and doesn’t behave.

          Strategy is your friend in this space, get some good advice on managing what sounds like it might be his.

          • Stacy48918

            Oh I definitely think he’s playing games. But because *he* offered the statement that he doesn’t oppose vaccines we just went with that – “He says he’s ok with vax, so why can’t we go?” We haven’t talked about his previous beliefs – no sense talking about it if I can get what I want without rehashing all that.

            We’ll see. I have a very good lawyer. His was…unimpressive…at best.

          • Who?

            Glad to hear you have a good lawyer, let’s hope his isn’t foxing. And the vax sounds like it is going in the right direction.

            I’m really moved by your story, will be watching with interest and best wishes for a continued good outcome.

          • Cobalt

            Any lawyer worth anything would tell an antivax parent to hide that crazy. EX is going to have some trouble getting legal weight behind any argument that goes against normal medical care, and even a mediocre lawyer knows it.

        • Trixie

          Wow, that’s nutso. Does he not think rabies is real?

          • Stacy48918

            Honestly, I have no idea. He’s an idiot and a crazy. There’s no sense trying to figure him out rationally.

    • Trixie

      I’m just now seeing this, Stacy. That’s awesome!

  • Wren

    Is there any good reason a person would show up as immune to rubella when tested in early pregnancy, then not immune when tested during the next pregnancy, less than 2 years later? I had that happen and just wondered. They tested me two or three times the second pregnancy as I had been immune before and there was rubella in the community at that time (thanks Wakefield).

    • araikwao

      Immunity can wane over time, which is why HCPs are supposed to get boosters every…?10yrs (it’s 5 for diptheria/tetanus/pertussis, can’t remember for MMT, sorry)

      • Young CC Prof

        Random question about vaccines. Would it be totally crazy if a woman wanted an MMR booster before getting pregnant solely to produce higher titers and therefore better immunity to measles for the newborn? Would that even work?

        • Taysha

          I don’t think that would work, tbh. The levels of immunity passed on through the mother are not that high, and I don’t think you can pass measles immunity on. The rubella immunity is just for pregnancy protection to my memory.

          But it doesn’t hurt to ask a physician

  • Mac Sherbert

    Sorry, if this has already been posted/talked about. (My True Feelings Regarding My Home Birth Experience — http://www.popsugar.com/moms/What-Home-Birth-Like-36487613)

    “I was misled, lied too, and manipulated. Informed consent? Hah. I wish.”

    • realitycheque

      “I was told that my ‘weak pelvic floor’ caused everything to go south
      during my labor. Now I’m left with the added guilt of my own body
      causing his horrific birth.”

      Ugh, these people make me so angry!

  • Box of Salt

    Disneyland measles updates: At least 19 cases across 4 states.
    http://seattletimes.com/html/localnews/2025426551_measlesdisneylandxml.html
    http://abcnews.go.com/Health/wireStory/measles-cases-reported-ties-disneyland-28115021
    Two infants too young to be vaccinated, two people whose vaccines didn’t take, and the remainder are either unvaccinated or incompletely vaccinated – thank you, Bob Sears, for fooling parents into thinking a “delayed” schedule provides enough protection for your child (/sarcasm).

    Several of the patients sought treatment at various hospitals and medical centers while contagious, potentially spreading infection, and the

    We are now seeing the consequences of some people’s poor choices.

    • Box of Salt

      Ooops. Disregard “and the” not edited out of the penultimate sentence.

    • Bugsy

      It’s disturbing. Where’s the “dislike” button when you need it?

      • deafgimp

        Well, I presume you’re agreeing with the post, in that you agree that you’re now seeing the consequences of poor choices. In that case, you’d want to “like” it.

        • Bugsy

          I agree that we are seeing the consequences of poor choices. As a mom, it kills me when ever kids are harmed…even more so when it’s avoidable. That’s the part I dislike.

    • rational adult

      I really don’t understand where my delayed vax friends are coming from at this point. To me it’s like buying the carseat, installing the carseat, putting infant in the carseat, but not bothering to buckle her in.

      • EmbraceYourInnerCrone

        If they are like mine they don’t understand how a normal immune sytem works and when I try to break it down for them they come back with “The current schedule/combined vaccines areto hard on a small child’s immune system” We need to go slower” Umm, no the average kids immune system probably deals with a lot more multiple challenges every day than are present in any combines vaccines. I’m lucky my kid is 20 now so it doesn’t affect her as much but if she were young I would make sure she didn’t hang around these unvaxxed kids. I still badger her about getting her flu shots and the DPT booster. Colleges are almost as bad as preschools for being petri-dishes full of sick kids.

  • Mishimoo

    Something I’ve been wondering for a while: I no longer seroconvert when vaccinated for Rubella. I used to have decent titres for it, but somehow my body ‘forgot’ it was immune. I’ve had booster shots and they did nothing. I’m not on any medication, and I think it’s just because my body is weird. My mother insists that it’s because I was exposed to Rubella while in-utero. Is it even possible for that to impact on my immunity?

    • Guestll

      I don’t either. Titres were taken before ART and they were low. Repeat vaccine. Titres again low. Repeat vaccine. Titres still low. I’ve been exposed to rubella a few times during work travel, pre-pregnancy, never got it. Worth noting that I had the full series as a child and had them repeated when I moved to the US on a Visa because my pediatric records had been destroyed in a fire. So, like, lotsa rubella vax.

      I can’t answer your question, I just think it’s odd. Maybe someone with knowledge of the issue can chime in.

      • attitude devant

        Me three. I actually HAD rubella as a child ( I predate the vaccine) and I have been vaccinated several times. I still test non-immune.

        • In my experience of working in a Women’s Health Center, concentrating on antenatal care [especially high risk pregnancies] for 8 years, I saw many women who repeatedly tested negative for rubella immunity. Apparently it’s idiopathic [means no one knows why] and all that can be done is to try and make sure [1] that the pregnant woman isn’t exposed to rubella, and that she [2] gets a shot after she gives birth.

          If you can, just before you begin trying to become pregnant, get a titer done and if necessary a booster, before stopping contraceptive use. The danger period, for the fetus, is if the mother develops an active case of rubella during the first trimester. But that’s not useful advice for “accidental” pregnancy.

        • Maya Markova

          According to CDC, low antibody titer against rubella does not necessarily indicate lack of protective immunity:

          “Although vaccination produces lower antibody levels than natural disease, both serologic and epidemiologic evidence indicate that the vaccine induces long-term — probably lifelong — immunity, in most persons (55). Most vaccinated persons who appear to lose antibody show an anamnestic immune response upon revaccination, indicating that they are probably still immune (56)”
          http://www.cdc.gov/MMWR/preview/mmwrhtml/00053391.htm

          To be honest, I cannot even figure out why antibody levels are given importance in this case – knowing that the vaccine absolutely must contain live virus, I thought its goal was to create cell-mediated immunity.

          • attitude devant

            Thank you ! I did not know that!!

  • (No longer) Pregnant Guest

    Question: How risky is it for my (vaxxed on schedule, healthy) 16 month old to be spending time with unvaxxed kids? (Most her own age, some a little older) On principal, I’d love to avoid them, but we’d end up pretty lonely if we cut them all out of our life.

    • Guesteleh

      Not everyone seroconverts after getting vaccinated. One of the kids infected in the Disneyland outbreak was vaccinated (but only one–all the other were too young or unvaxxed). Without a titer test you won’t know if your kid has immunity or not. Safer to avoid unvaxxed kids if you can, especially if yours are only part of the way through a vaccine series. OTOH, if you live in a community with a lot of unvaxxed kids your child is probably going to get exposed.

      • (No longer) Pregnant Guest

        I live in NYC. I’m fairly certain that a few of the kids in our building aren’t vaxxed, and I know one or two of the kids in the Mom group we go to are unvaxxed as well. They go to the famous (crazy!) anti-vax pediatrician. But we love the rest of the people in the group. It’s so frustrating! I asked my ped about this, and he offered the second dose of MMR earlier than scheduled (I guess you can do it as early as 15 months?), but didn’t seem too worried.

        • Guestll

          There’s a little girl in my daughter’s Montessori class who is recovering from cancer. Her parents made the very brave decision to treat her as a normal child with health issues and she attends when she can — when there are no sick kids. What amounts to snuffles and snot in my 3.5 year old can be very serious for this little girl.

          All of the kids in my daughter’s school are fully vaxxed. The director sent out a note before this little girl started in September — they have everyone’s vax records but wanted to ensure that every student was 100% UTD, because this girl is medically fragile and we wanted, in the words of the director, “to welcome her to our little school and make her as safe as we possibly can.”

          One mother realized that her son was behind on one shot or something, and immediately got it for him before the girl started in the class. That’s what a community does, that’s what responsible people do. That’s public health in action.

          Ugh, ranting, but I loathe anti-vaxxers with every fibre of my being.

          • Box of Salt

            Guestll “That’s what a community does, that’s what responsible people do.”

            Thank you for restoring my faith in humanity.

            I didn’t think the story would turn out that way when I first read “Montessori” – the local ones in my area have the worst vaccine uptake (I’m in CA, where the state breaks it down to the school by school level once a year).

          • Smoochagator

            Yeah, I didn’t think it was going to go that way when I read “Montessori.”

          • Smoochagator

            I gave birth just a month ago and have asked all family and friends who want to visit the newborn to make sure they have had the flu shot and are up-to-date on their pertussis booster.

            Most of our friends have just not visited. One family has repeatedly complained about not being allowed to meet the baby. This same family had the flu just a week and a half after the baby was born, so you know that if I had allowed them to visit, my NEWBORN would also have the flu. These people aren’t anti-vaxxers – apparently they just don’t think the flu shot is necessary.

            Contrast that with a good friend that, as soon as I mentioned our visitation requirements, immediately made an appointment to see his doctor and get his pertussis booster.

          • Bombshellrisa

            I have been there-I went so far as putting it on a sign I taped to our front door. One sister in law talked about my “overly elaborate rules” but I held firm. My mom and dad get the flu shot every year and had a pertussis vaccine a couple years earlier when my nephew was born and were willing to have another booster before my son was born. I was grateful. I hate that I get the whole “new mom paranoia” bit when I insist that without a flu shot an current on all other vaccinations you won’t be visiting me or holding my newborn.

      • Sullivan ThePoop

        Now the number of infected is up to 19. 2 were fully vaccinated and 2 had one dose of MMR

        • Box of Salt

          I posted a link above (ABC news).
          If you google, numbers will vary according to source and timing.

          • Young CC Prof

            That number could presumably still rise higher, not even counting secondary cases. This is all going down right now.

          • Box of Salt

            YCCP, I have no doubt we will see secondary cases. The 2008 San Diego measles outbreak started with an intentionally unvaccinated child who spread the disease both at his school and a doctor’s office waiting room:

            http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e222a1.htm

          • EmbraceYourInnerCrone

            Lets hope it doesn’t have the scale of the 2012-2013 meales outbreak in Wales:
            http://www.wales.nhs.uk/sitesplus/888/page/66389

            That one took 8 months from start to finish and the final tally was in the neighborhood of 1200 (1 death and around 80 hospitalizations from what I remember.
            Apparently the highest number of cases were in the 1 to 4 years age group…

      • Bugsy

        Are titers routinely available? My son has had his first MMR. Are GPs accustomed to requests for titers?

        • Guesteleh

          I don’t know. I had titers done when someone in my office got shingles to see if I needed the varicella vaccine (turned out I was immune). I’d talk to your pediatrician about your concerns.

        • Sue

          In Aus, it’s not routine to test kids for seroconversion after normal childhood shots. Adults are tested to see whether boosters are needed, and risk- prone occupations like HCWs are routinely tested. I still have rubella and Hep B immunity from shots over forty and twenty yrs respectively.

  • Guesteleh

    OT: I’m over at Improving Birth’s Facebook page and they are handling the reactions to Ashley Martin’s story surprisingly well. No mass deletions ala Midwifery Today or VBAC Facts Didn’t expect that. Some of the commenters, though…shudder.

    • Trixie

      Yeah, they are.

  • deafgimp

    This woman would rather give up a foster child than vaccinate her family with a flu shot. http://www.nydailynews.com/life-style/health/wash-foster-mom-prefers-surrender-kid-flu-shot-article-1.2071718

  • Sue

    Update on planned Tenpenny tour of Aus: several venues have now cancelled, making it clear that they had been unaware of what the talks would be about.

    • attitude devant

      Go Aussies!!!

  • deafgimp

    I’m happy regarding the doctors (GP, family, pediatrician) I’ve read about lately who are refusing to have children as clients if their parents refuse to vaccinate them.

  • Young CC Prof

    I think the neoliberalism that Reich refers to is the total indifference to the idea of herd immunity that so many antivaxxers display. The community is not their problem, the safety of other people’s children is irrelevant to them.

    Some people call that neoliberal, some call it sociopathic.

    • Sue

      Good point. In a sense, some parents are “having it both ways” – they are happy for other parents to take the tiny risk of vaccinating their kids because the unvaxed are also protected (to some extent) by the herd.

      I suspect these people would think differently if they lived in impoverished countries where the risk was higher.

      • DaisyGrrl

        You’d think so, but my city’s last measles outbreak was brought to us courtesy of an unvaxed local child who picked up a case of the measles while visiting the Philippines. I have no idea what his parents were thinking, but there it is.

        • Box of Salt

          End of the year travel advisory from the CDC:

          http://wwwnc.cdc.gov/travel/notices/watch/measles-philippines

          “As of November 29, 25 US travelers who returned from the Philippines have become sick with measles Most of these cases were among unvaccinated people.”

        • Who?

          Oh yes but how could our super healthy, dosed up on superfoods and supplements child get an infection? Everyone knows that clean water and better health overall are what has stopped measles, not nasty vaccinations.

          Turns out that isn’t quite right, apparently.

  • Bugsy

    From “Don’ts for Mothers,” published in 1878:

    “Don’t fear the vaccination of your child. It is one of the greatest blessings ever conferred upon mankind. Smallpox, before vaccination was adopted, ravaged the country like a plague, and those who did escape with their lives were frequently made loathsome and disgusting objects by it.”

    How sad that 137 years later, we’re still having the same debate…

    • Mishimoo

      Vaccination worked so well for smallpox that in order to adequately explain how awful it was to a friend, I had to do a google image search.

    • SporkParade

      Ben Franklin discusses variolation against smallpox in his autobiography. He regretted not variolating his son, even though variolation used actual smallpox and was accompanied by an actual risk of death, because his son caught smallpox and died anyway.

  • staceyjw

    OT Dr Amy- have you seen this now disgraced OB? He has a long list of inappropriate behavior, but the straw the broke the camels back was his leaving a lavishly women to go have sex w another patient!
    Sounds just like a Dr Wonderful we know…
    But I bet the “sisters in chains” won’t back this guy, because he is not an NCB zealot. This awful behavior is excused, ignored, or denied, if the (MALE ) OB is an NCBer, while a doc doing identical stuff will be used as an example of how OBs are horrible.

    I’m glad he was suspended and is facing serious trouble.
    http://m.nydailynews.com/life-style/health/n-m-doctor-suspended-sex-patients-article-1.2021686#bmb=1

    • Guesteleh

      Ewwww. He was the incoming president of the New Mexico Medical Society! Yuck!

  • Some Guy

    “That’s because anti-vax advocacy is not about vaccine and not about children.”

    This is just silly. The anti-vaxxers I am familiar with have had a personal experience of their children getting vaccines and becoming autistic. These are terrible coincidences, but the individual stories are great at stirring up fear in parents. These people genuinely believe the anecdotes, and think “better safe than sorry”.

    “But it is IMPOSSIBLE to critically evaluate information about vaccines if you don’t have a firm grounding in basic immunology.”

    No, it’s not impossible to critically evaluate information about vaccines without being an immunologist. The people who recommend the vaccines (General Practitioners, Pediatricians) are not immunologists. By your own logic, you can’t have a stance on vaccines since you aren’t an immunologist.

    “Indeed, the tide is turning at this very moment, as anti-vax advocacy is devolving in the public view from being simply one of many reasonable approaches to vaccination to the growing public belief that anti-vaxxers are crazy conspiracy theorists who have been 100% wrong about every claim they’ve ever made.”

    Riiight. The tide is obviously turning, as the number of people that go unvaccinated increases. Clearly, the way to reduce that number is to keep doing what we are doing.

    • Cobalt

      “No, it’s not impossible to critically evaluate information about vaccines without being an immunologist. The people who recommend the vaccines (General Practitioners, Pediatricians) are not immunologists. By your own logic, you can’t have a stance on vaccines since you aren’t an immunologist.”

      Evaluating the information and evaluating the source are different things. If That Dude walks up to you and says vaccines cause X, you can disregard that information, not because you are or aren’t an immunologist but because you know it’s from an unreliable source.

      • Some Guy

        You don’t need to be an expert to evaluate any type of information. Libraries exist and the internet exists. While you may not be educated enough to develop vaccines, you can educate yourself enough to know that X% of people developing autism during a trial is background noise and not a causal link. You can also compare the amount of the “harmful” ingredients in vaccines with their prevalence in other sources that are considered safe.

        To say that you can’t have a view on a topic because you aren’t an expert is simply elitism.

        • just me

          Uh, no. Complicated science is not just a topic. I’m sorry. I have degrees in one of the hardest sciences–chemistry. You can’t tell me that someone without such education can just do a couple Google searches and understand something related to chemistry enough to have a conversation with me. I’ve taught basic college chemistry and the amount of material needed just for a basic basic understanding is astounding. You’ve just barely touched the surface even with an entire semester of college level chemistry. I use this as an example. I don’t feel this is elitist at all. I marvel at the number of people who really don’t understand science and market diets treatments etc. based on their extremely limited understanding.

          • Some Guy

            Somehow you equated “educating yourself” with “a couple of Google searches”. There is no magical information that you only get from college; all of the information is there if you care to learn it. I can go on Amazon and buy all the text books you learned from in college. Depending on your college, I could even watch the lectures from the same professor on the same topic. People with chemistry degrees do not have a monopoly on understanding chemistry.

          • Amy Tuteur, MD

            You are having a serious problem with logical thinking. No one is claiming that people with formal education have a monopoly on knowledge. I’m claiming that people who get their information from other people on the internet are both ignorant and gullible … and you are proving my point.

          • LawMom

            Dr. Amy is right on the money. Some Guy, you don’t have an educated base of knowledge from which to form an opinion. Surfing the internet doesn’t count as “educating yourself.” Yes, you can buy chem textbooks and watch lectures and take some mock tests, and then you might have some basic information about chemistry. But, you haven’t done that and neither have most of the anti-vaxxers who pretend to know what they are talking about.

          • Julia

            Um, how do you know what Some Guy’s background and education is? I think he’s right to some degree: you don’t actually need to know immunology to reject the vaccine-autism link; instead you can just as well look at epidemiological data and reject it on that basis.

            It is also possible to educate oneself on the internet fairly reasonably as long as you seek out reliable sources – I’m a biochemist turned neuroscientist (without ever having had any coursework in neuroscience) and I’ve very successfully “educated myself” on many topics using PubMed and textbooks.

            Many commenters on this blog have become quasi experts on the issues discussed here without a medical education. And I think most of us have opinions based on what we read in the NYT and hear on NPR without a degree in political science.

          • Amazed

            Yes, to most of your post. But I, a commenter on this blog, would not presume that I am better educated than Dr Amos Grunebaum while anti-vaxxers who in most cases are about as (quasi) experts in vaccines as I am in the issues discussed here think they know better than Dr Paul Offit and Dorit Reis.

          • Sue

            There is a major difference between having opinions in matters of judgement ( like politics) vs having opinions about scientific evidence.

          • Amazed

            Indeed, yet I constantly see the difference diminished because Google is your best teacher. And I can see the danger in that going in two directions: without formal education, people often don’t know which sources are reliable; and without formal education, people won’t know the information that ISN’T published in the net.

          • Sue

            Agreed -and also this: in order to fully understand what you are reading, you need both the underlying knowledge and the professional-practice context.

            Another example would be Oncology. To truly understand cancer treatment takes clinical and scientific knowledge that starts with the very basics of cell biology and organic chemistry, progressing through histology an pathology and pharmacology, through to interpretation of risk data etc etc – or you can intelligently read stuff and gain a superficial understanding, without realign what you don’t know.

            You don’t need this level of understanding to accept treatment, of course, but you do need it to second-guess your Oncologist.

          • Guesteleh

            Going from biochemistry to neuroscience isn’t the same leap as being a layperson trying to understand immunology. I’m a layperson who has written about science for nearly 13 years and while I can quote from scientific papers and have a better grasp of certain concepts than the average person, I’m in no way qualified to read a paper, assess the methodology or determine whether or not it’s a well-constructed study.
            Talking to real scientists for years has been a humbling experience. Scientists aren’t always right but that doesn’t mean I know better. The way we rely on the expertise of mechanics to fix our cars, we rely on the expertise of medical professionals when it comes to our health. And I think that’s where a lot of the fear and anger comes from–having to rely on the expertise of others when it comes to matters of literal life or death.

          • fiftyfifty1

            “And I think that’s where a lot of the fear and anger comes from–having to rely on the expertise of others when it comes to matters of literal life or death.”

            Except that people bitch about stoopid greedy mechanics all the time too.

          • Mishimoo

            “How dare they want me to do stuff to my brakes/tyres/steering, they should still be fine! I just came in to get my air-con regassed and they’re trying to upsell all of this unnecessary stuff to me!!”

            I wish I were joking, but that is rather common at my husband’s work when the mechanics are faced with a car that needs major work to be safe.

          • DiomedesV

            Sort of. But then, when I want to be certain about something discussed here or with respect to my own care, I consult the OBs I know IRL.

          • Some Guy

            How is it you know so much about me?

          • Some Guy

            What exaclty am I ignorant about? Does reading scholarly research count as “getting informatin from other people on the internet?” If you don’t believe accurate information can be found on the internet, you must be new to the internet.

          • fiftyfifty1

            “People with chemistry degrees do not have a monopoly on understanding chemistry.”

            Yet, strangely enough, every single one of the (many) people I know who do understand chemistry has a chemistry degree. Go figure.

            Or to paraphrase John Cage:
            There are people who say ‘It’s so easy, I could do it.’ Of course they could, but they don’t.

          • Roadstergal

            I think that one of the big differences between reading textbooks versus getting your degree in science is having to defend your ideas against other smart people who know a lot from books, papers, experiments, and experience. It’s one thing to read books and learn some things. It’s another to have your knowledge poked and prodded and challenged and have to really think about it a lot, all the time. (I find it to be a rush, and I couldn’t do any other job; it keeps me honest and it keeps my brain working.)

          • Amy

            You’re pretty effectively illustrating one of the great lies of the for-profit education industry today. True education requires live interaction with either the topics (in the form of labs), an instructor (either in person or through electronic communication), and ideally fellow students. You’re simply not going to learn as much by ordering all the books and memorizing their contents and/or watching a bunch of online lectures. That makes a lot of money for the content providers, but it doesn’t guarantee you’ll learn anything. In a classroom setting, students can ask questions, they can ask the instructor to clarify a point, they can discuss with classmates. And THEN they have to turn in work to demonstrate what they’ve learned. I suppose two or more like-minded individuals could get together and study all the books they order off Amazon, but it’s ludicrous to think that’s going to confer anywhere near the expertise that college-level study does.

          • Medwife

            I will never ever underestimate the importance of labs. That’s why I can’t picture distance learning working with most sciences.

          • Young CC Prof

            Ug. There’s a battle about that exact question at my school. Certain administrators are demanding fully online degree programs, science faculty are standing firm on physical lab time for all lab science classes.

          • Elaine

            I took some hybrid courses at community college where the didactic part was online and we came to campus once a week for lab. That seemed to be a decent compromise as long as the didactic portion was done well (which it wasn’t always).

          • Dr Kitty

            Anyone who has ever dissected a cadaver or been in an operating theatre will know why labs matter.

            If you think anatomical drawings are realistic representations of actual anatomy, nothing disabuses you of the notion faster than trying to stick labelled pins into a dissected cadaveric forearm…

          • fiftyfifty1

            And even better…when you spend hours dissecting the brachial plexus and you cannot, no matter how hard you try, see what the illustration says is supposed to be there. So your group finally calls over the prof and it turns out you cadaver has an completely atypical brachial plexus with a number of major “mistakes” in what judging from musculature and scar patterns must have been his dominant arm. And the prof has only seen something like it once before in his 40 years teaching. And aha!! you learn that there can be exceptions to the rule.

          • Dr Kitty

            http://www.anatomyatlases.org/AnatomicVariants/Introduction.shtml

            “We are not entirely sure what is normal. It is still not clear exactly what the word normal means in terms of human anatomy.”

            One of my favourite anatomy quotations, from the Introduction to the Illustrated Encyclopedia of Human Anatomic Variation.

            My group’s cadaver had weird lumbricals and tendon attachments. Our anatomy demonstrator just shrugged and said “nobody gives embryos a copy of Netter”.

          • just me

            Ok. Molecular symmetry and group theory. Character tables. Discuss. I checked and there’s is actually a wiki page on this.

          • The Bofa on the Sofa

            One of my proudest moments in graduate school was when I ran the projection operators to figure out the available phase space for dissociation to allow for coupling the electronic states of the reactant and product. I was able to show that only the totally symmetric dissociation pathways were electronically forbidden, and everything else was just an avoided crossing. With that, I was able to create a multireference mo description that showed how the electronic transition was a continuous process.

            IIRC, I was working with p-chlorobenzyl anion, so working in the world of C2v. Drop to Cs and the analysis is a lot easier, because then you only have in-plane vs out-of-plane motion (a’ vs a”) to worry about.

          • Medwife

            Ahh yes, phase space. That’s a space in which all possible states of a system are represented, with each possible state of the system corresponding to one unique point in the phase space. So like, a big rec room.

          • The Bofa on the Sofa

            In terms of motion, it is the space that contains all the possible trajectories. Adds an extra dimension.

            Personally, I tend to think more about motion than states.

          • Medwife

            Welp, that’s how far Wikipedia got me.

          • Sue

            Bofa, would you pls explain phase space with an accessible pop culture analogy?

          • fiftyfifty1

            Just give Some Guy a couple more hours to do a little internet research on that and he’s sure to return here able to have an intelligent conversation with you on the matter.

          • Kq

            This assumption is based on the idea that just anyone knows how to critically think. We do not teach critical thinking in schools, and vast swaths of America are very limited in that ability. Furthermore, you assume a high level of self direction, synthesis of information and reading comprehension. Again, things a shocking number of Americans lack.

          • Puffin

            Between lectures, studying, assignments, and lab work, which works out to an average of about 60 hours a week during term and 20 during breaks as I pre-study (because I am top of my classes) I have spent nearly 10,000 hours on my post-secondary science education. By the time I graduate with my MD, it will be double that. I have yet to meet an anti-vaxxer who has done anywhere near that amount of study. My education is supplemented with training from experts in how to design and analyze scientific research, which requires a strong grounding in statistical analysis in addition to my science knowledge. Reading a few blogs, even taking a couple MIT courseware courses or spending some hours on Khan academy really isn’t the equivalent. I spent the better part of a decade teaching myself advanced science before I started university, and even then it was NOTHING compared to what I have learned since I started.

            So, yeah, I actually do know more than Bob AntiVax who reads a few primers on vaccines, knows a couple words like “adjuvant” and “humoural immunity” and thinks himself educated.

          • Dr Kitty

            I’ve managed to do a medical degree. I have reasonably good physiology/biochemistry/anatomy knowledge.

            I still find the physics and maths in “The Science of Discworld” books, which are meant for a general audience fairly hard going, and I have to re-read them frequently in order for the stuff to stick and not get mixed up in my head.

            I can only assume that if this is what I’m like with subjects I am interested in but have limited understanding of,, the average person in the street struggles in a similar fashion to understand immunology, physiology and biochemistry.

            Even people who are able to tell you that vaccines make antibodies often can’t tell you what an antibody is or how it works.

          • demodocus’ spouse

            or have some variation of my highly inaccurate version “itty bitty whatsits that ‘recognize’ a virus a person’s been exposed to so other itty bitty whatsits can turn into the Incredible Hulk and GO SMASH BAD BUG!”

          • DiomedesV

            Sure, but could you pass the exam? Could you write a thesis on an original topic of research in that field? Get it past a dissertation committee? Publish it in a peer-reviewed journal?

            There are two steps to learning. Actually reading the material, then demonstrating comprehension. You’ve only listed the first half.

            I encounter people like you all the time (I’m in field that is “controversial” for a small subset of the population). It’s a lose-lose. They want to “argue” with me but everything they say is laughably elementary. I try not to pull rank, because that’s “elitist.” If I correct them, I’m “talking down to them”. If I just go over their head, I’m being an asshole. I just try not to engage. But when it’s my family it’s hard not to.

            Look, most people have some area of expertise in their lives. Usually it’s their profession. What’s your area of expertise? Do you really think anyone can just go to the library, read a couple of books and just engage on the exact same level as you? Or worse yet, consult Bob the Internet and claim to be “educated”? Don’t lie, you know they can’t.

          • Some Guy

            Let’s get back to reality. Are you saying that it takes a college education in the relevent field to discuss vaccines, their effectiveness, and their connection (or lack thereof) to autism? I’m not talking about going on the internet to be a doctor; I’m talking about gaining enough knowledge to have an intelligent conversation and make informed decisions on a topic.

          • birthbuddy

            What about when you start your search with pre-conceived ideas?

          • Box of Salt

            Some Guy “I’m talking about gaining enough knowledge to have an intelligent conversation and make informed decisions on a topic.”

            You obviously have not spent much time reading the comments posted all over the internet by folks advocating against vaccines.

            There are a lot of people out there who are heavily invested in the idea that vaccines cause more harm than good. Many of them do not in fact have the background knowledge to have a meaningful discussion about any of the topics you listed – but they think they do. They regurgitate ideas they’ve read on websites written by other equally confused individuals, by those marketing “alternative” ideas (e.g., Mercola), or from sites with a clear agenda and cherry-picked references. They don’t question the sources that support their beliefs, partly because they don’t have the background knowledge to ask the questions.

            Do you need to have an advanced degree in the relevant sciences to have conversations about the topics you mention? No. Do you need to have at least paid attention to your grade school science teachers, and retained some of the information you used to pass the exam? Yes.

            And there’s one other thing you need while you’re having these conversations, which most of the vocal anti-vaccine internet posters don’t have.

            You need to understand the limits of your own knowledge.

          • Who?

            Intelligent conversation with whom? The anti vax crowd-intone ‘toxin’, ‘autism’, ‘big pharma’ and you’ll be all set. The interested undecided-you can talk about your opinion, what influenced you and how you made decisions for yourself and your family. Regular people who vaccinate, same as for the interested undecided.

            Someone had a lovely example about learning a foreign language by going to university for years and living abroad-we don’t hear lots of people claiming to have done their research and therefore finding themselves suddenly able to speak fluent japanese, why on earth would the same ‘process’ ie hitting what you fancy on the internet, with no entrance criteria, review, examinations or formal process, make you fluent in the language of immunology? Why would you want to be?

          • Amy Tuteur, MD

            Let’s! I asked you to explain how vaccines work so we could test your self-proclaimed “knowledge.” You’ve ducked that basic taak. Could it be that you don’t even know how vaccines work?

          • Some Guy

            I’m on my phone and can’t find the reply, but I responded that vaccines prompt the immune system to create antibodies. Perhaps I didn’t answer in enough detail to satisfy you, but it is intellectually dishonest to claim I avoided the question

          • Some Guy

            Let’s step away from vaccines, so I can give you a personal example of what I’m talking about.

            My wife had a rough pregnancy, and we had two “experts” pointing us in different directions. The former and experienced L&D nurse that was now doing home infusion was adamant that we insist the OB induce the pregnancy. The OB dismissed that suggestion and told us to wait. I was in a position of getting conflicting advice from two knowledgeable sources.

            I researched the risks associated with induction. I noticed my OB/GYN was a member of ACOG, and I went on their site to read the official guidelines on when and why to induce. I learned about the Bishop score, understood what the different factors are, and then learned what score suggested what action. I read the studies that were cited to support the recommendation. After that, I purposely tried to find studies that supported the position of the L&D nurse, and evaluated those against the recommendation.

            When I didn’t understand a term or phrase, I sought to understand it. While this doesn’t qualify me to be an OB/GYN, I can certainly hold an intelligent conversation about this topic, and make an informed decision.

          • Amy Tuteur, MD

            No, let’s not.

            Explain how vaccines work. Surely you must be able to do that if you are as “educated” as you claim.

          • Some Guy

            I’m not doing it for a third time. It’s becoming clear you aren’t interested in an intelligent conversation about this. I gave you a clear and relatable example of researching a medical topic to self-educate and make informed decisions. I also answered your vaccination question; twice.

          • Amy Tuteur, MD

            LOL!!

            That’s #14 from Skeptico’s Handbook of Woo:

            “After the debate has been going for a while you should say you’ve provided [explanations] to support your position, even though you haven’t. You can then periodically refer to these [explanations] as though everyone now agrees you supplied them. Few people will remember you haven’t.”

          • Some Guy

            Third time….

            Vaccines prompt the immune system to create antibodies. Are you going to ignore this comment as well? Vaccines can be dead or modified versions of a virus. They can also be similar viruses or substances that result in the body creating effective antibodies.

            I supported my position with a recent example of how I researched a medical topic. The same methodology applies to researching vaccinations with the same result. Surprisingly, you ignored that example completely, even though it is completely relevent. Are you able to refute my example, or do you want me to explain vacinations yet again?

          • Amy Tuteur, MD

            That’s not an explanation; that’s a definition. I want to see an explanation of HOW vaccines work, what biochemical mechanisms, cell types, etc are involved, what aids the process, what inhibits it, etc.

          • Some Guy

            To what end? Do you think this information isn’t publicly available? I can spend all the time to research this, and you’ll just keep asking more complex questions until you can claim victory when I have exhausted the time I allocate to internet arguements.

            The real “controversy” isn’t how they work anyway; it’s what they contain and the adverse effects. I would start by looking at the recommendations by the big health organizations, and examine their references. Then look at the refences by the anti-vaxxers. Do I dead end at a no-name website? It’s probably BS. Have I heard of the university or reseach institution? Have others? Is the study well-cited? What do others say about the study, does it match what is there? Has the organization or individual produced other research that is used and respected?

            Examining sources, and taking the time to understand the concepts can yield good information. I gave you my approach. If you still disagree, the onus is on you to point out how my methodology is flawed. All of that information is out there, and it’s understandable if you put in the effort. To be honest, my only concerns before vaccinating my newborn were the prevelence/severity of the ailments, the effectiveness of the vaccines, and the prevelence/severity of adverse effects. My basic biology class was enough of a background for that decision. I don’t care if they work by magic; only that they are safe and work.

          • Amy Tuteur, MD

            To what end? To show that you are an ignorant fooling who is a walking, talking example of the Dunning-Kruger effect: those who know the least erroneously think they know a lot.

            If you can’t explain exactly how vaccines work it’s because you DON’T KNOW how vaccines work. And if you don’t know about how vaccines work, there is no reason to take your criticism of vaccines seriously.

            You have demonstrated my point for me, that anti-vax advocacy is about parents wanting to see themselves as educated, empowered and not
            submissive to authority … with an important caveat. They want to burnish
            their self-image without doing the hard work of learning immunology.

            You’ve been blathering that you don’t need formal education about immunology, but apparently you do, since you don’t have a clue and you know it.

          • Some Guy

            When you resort to personal attacks, you have lost. I have not criticized vaccines, and I enthusiastically vaccinate my child. You seem unable to show a flaw in my methodology (and won’t even attempt to do so). You also continually resort to unsubstantiated personal attacks to “prove” your point. I have tried to treat you with respect despite your continued insults.

            Your behavior is becoming similar to that of the subjects of your post. If you could support your positon, you would address the example provided. Instead, you spend your time misrepresenting my position, writing about my supposed ignorance, and touting your intellectual superiority.

            If your education gives you such a better understanding, tell me how my methodology fails.

          • Amy Tuteur, MD

            It is not a personal attack; it is a series of factual statements:

            1. Anyone who lacks a working knowledge of basic immunology is unqualified to assess vaccine safety.

            2. You lack a working knowledge of basic immunology.

            3. You are unqualified to assess vaccine safety.

            I realize that you consider a knowledge of basic immunology to be irrelevant. You’re entitled to believe that. You were wondering why no one takes your “knowledge” seriously. I’ve explained that.

            It’s no different than pointing out that you are unqualified to assess the structural integrity of a bridge unless you understanding the principles of structural engineering. A little reading on the internet does not qualify you to be taken seriously.

          • Some Guy

            “To show that you are an ignorant fooling who is a walking, talking example of the Dunning-Kruger effect”

            That is a personal attack, and disrespectful.

            “I realize that you consider a knowledge of basic immunology to be irrelevant”

            That is a misrepresentation. It’s not irrelevent; just unnecessary. You don’t need basic immunology to look at the effectiveness or rate of adverse effects. If I am wrong, please tell me how.

            Lastly, you have, again, neglected tell me how my methodology would fail to produce the required knowledge. Perhaps I would take your “factual statements” seriously if you could defend them. Simply labeling something as fact does not make it so.

          • Box of Salt

            Some Guy: please, drop the shovel.

            “If your education gives you such a better understanding, tell me how my methodology fails.”

            This is how (for, for crying out loud! the third time):

            You need to understand the limits of your own knowledge.

          • Some Guy

            What shovel? I am defending my point that you can evaulate this type of decision with personal research. With a proper education on the topic, you should be able to show me the limit. Are vaccines safe? Just look at how many people had unsafe things happen to them. Understanding the theory behind medicine does not give you information on safety. You can know what “should” be safe, but you don’t know until if it is “actually” safe until trials.

            To say that normal people (who understand math) can’t look at a trial to determine safety is a lie.

          • Amy Tuteur, MD

            Please do some research on the Dunning-Kruger effect, then get back to us.

          • Some Guy

            I’m familiar with it, thanks. It’s sure easier to simply imply I’m wrong than to make any attempt to refute my points, huh? Are you saying clinical trials don’t indicate safety as well as effectiveness? If not, why did you respond?

          • Box of Salt

            Some Guy “It’s sure easier to simply imply I’m wrong than to make any attempt to refute my points”

            What points?

            Vaccines are safer than diseases.

            If you disagree, please post with citations.

          • Some Guy

            The point that you can conclude vaccines are safe by researching with the methodology I previously outlined.

          • Box of Salt

            OK then Some Guy,
            are you ready to defend your position (vaccines are safe) against those who disagree with it, on internet comment sections? The folks who disagree think they followed same methodology you think you did.

            Think about it.

          • Some Guy

            I am ready, and I do. For example, Thiomersal was a controversial preservative supposedly linked to autism. When Thiomersal was removed from the MMR vaccines, the incidence rate of autism did not decrease.

            Many people also point to the recanted study that started the whole controversy. I point them to the fact that it has been recanted, and that Wakefield had a more plausible ulterior motive than “big pharma”.

          • Poogles

            “For example, Thiomersal was a controversial preservative supposedly linked to autism. When Thiomersal was removed from the MMR vaccines, the incidence rate of autism did not decrease.”

            Wrong. If this is an example of your vaccine knowledge I am very unimpressed. The MMR vaccine is an attenuated live virus vaccine, and as such, has never had thiomersal in it. The controversy surrounding the MMR had nothing to do with the “mercury” but with Wakefield’s now-thouroughly-discredited work connecting the MMR with autism and “gut issues”.

          • Cobalt

            Would that be the ‘use the internet to find credible sources, such as actual educated experts in the field, and accept their conclusions’ method?

          • Some Guy

            You do realize that the doctors recommending vaccines, treatments, and medications are relying on those same experts; right?

            You don’t need to be at the level of an actual researcher in the field to be informed. The people who recommend these things directly to patients are usually not researching.

          • Cobalt

            The doctors are relying on their education and professional guidelines, both of which are based directly on research and clinical experience.

            That’s why doctors are credible sources in their specialty. Their education and actual clinical experience will trump even the most careful evaluation of a paper by an uneducated person or the most convincing anecdote.

            You don’t have to be an expert in everything to make sound decisions. You just have to be able to find an expert (some people are very bad at this) and be willing to accept expert advice (and/or are also very bad at this).

          • Some Guy

            I just can’t agree with your appeals to authority. If I followed your advice, I’d have to stick with the first specialist I meet because I couldn’t possibly have the knowledge to question their decisions.

            In reality, there are good specialists and bad specialists. One of the great things about technology is that you can fact-check them to determine whether or not the science supports their recommendations.

          • Cobalt

            You can use your research to find good questions to ask your doctor, and possibly weed out a doctor that is actually a total quack. Related to your induction example, if the OB said no inductions ever before 45 weeks, that goes against published guidelines and is a red flag. That’s why published guidelines. Note: not everything is published, not everything published is good, and you still cannot Google past a few decades of clinical experience.

            You will not get educated enough to be able to independently evaluate new research or know all of the variables that go along with choosing a particular treatment method over another.

          • Box of Salt

            Some Guy “You don’t need to be at the level of an actual researcher in the field to be informed.”

            But you do need to have enough background knowledge to understand the specialist jargon in the publications.

            Your average liberal arts college educated Googling parent doesn’t have that.

            Can you, Some Guy, tell me what an LD50 means without looking it up? Can you figure out why I chose that term to question your understanding?

          • Box of Salt

            Some Guy, your comments show that the conversations here have crossed your limit (i.e., comments about Bishop Score, which I’m not arguing because I know I don’t have the background knowledge).

            “Are vaccines safe? Just look at how many people had unsafe things happen to them.”

            Wrong. You, as a “normal people (who understand math)” should understand this: it’s not about “how many.”

            Look at the denominator. Rate matters.

          • Some Guy

            Brevity is my downfall I suppose. How many people had unsafe things happen, compared to what is normal, with a big enough sample, controlling for other factors.

          • Box of Salt

            Some Guy,, can I ask you a personal question?

            How old are you? If you aren’t comfortable with providing a specific answer, would you be willing place your age within half a decade? E.g: I was born in the back end of the 1960s.

          • Some Guy

            I am in my 30’s, but I’m not sure what that has to do with anything?

          • Box of Salt

            Some Guy
            repeating “How many?” does not change the fact that rate matters.

          • Some Guy

            Can’t you give me the benefit of the doubt? “How many” doesn’t have to mean a strict total, it can also mean “how many per thousand”.

          • Who?

            I’m no scientist but I think that you have been shown the limit over and over again, you unfortunately aren’t (perhaps due to your temperament) able to recognise it.

            Could you do ‘research’ on the internet and become fluent in a foreign language in a week or two, or six months, or a year? No? Then you can’t do ‘research’ on the internet and become fluent in medicine, immunology or anything else either. You have a lot of respect for your own abiltiy, perhaps develop some for the years of work and effort experts in all sorts of fields put in.

          • Some Guy

            You don’t believe you can learn a foreign language without formal education? Perhaps that shows your limit of finding information.

          • Who?

            I know you can’t learn it off the internet, and become fluent, in a couple of months, no matter how good you are at finding stuff. You might, if you had done some study, and travelled and been immersed, have a working use of a language in a couple of months, but that isn’t what we’re talking about. And that isn’t fluency either.

            Like I tell my clients, information isn’t knowledge. It’s just stuff.

          • sdsures

            Math is one thing; statistics is another.

          • fiftyfifty1

            Well at least he’s not anti-vax or anti-OB. He likes to flatter himself that he chose to take the recommended advice of vaccinations and chose to follow the OB’s advice rather than the infusion nurses’ based on “education”. He seems to flatter himself that he knows more than he does and might just as well have rejected the vax schedule and his OB if his “educated” opinion had differed from theirs in the end. Some people just like to flatter themselves. Others are fine admitting that the experts are experts for a reason, and are fine trusting their advice. Whatever floats your boat. I just hope that his “educated” opinions continue to agree with the experts and that his Dunning-Kruger’s doesn’t lead him down the path of woo some day.

          • Box of Salt

            Some Guy,

            I’m going to repeat the conclusion from what I posted last night because I suspect you missed it:

            You need to understand the limits of your own knowledge.

            Based on my reading of your comments, I believe *you* do.

            The problem is that there are a lot of people out there in internetland that don’t.

          • Some Guy

            I agree, and accept that as a caveat. I took issue with the word “IMPOSSIBLE” as a means to shut people out of the conversation. Anti-vaxxers are usually bad at stastics (focusing on anecdotes), and bad at evaluating sources.

          • An Actual Attorney

            I don’t think that’s the game SG is playing here. From what I followed Z all he said was that it doesn’t require being an immunologist, or even an md, to understand basically how vaccines work. And it takes even less education to figure out what makes an expert. I think he’s backing up your point, Amy, that the anti vaxers are really determined to be and remain stupid.

          • fiftyfifty1

            Actually I think that is the game he is playing. SG claimed he was able to evaluate medical information. Cobalt replied “Evaluating the information and evaluating the source are different things. “. SG disagreed that he was merely evaluating the source and claimed “You don’t need to be an expert to evaluate any type of information” and claimed you could find out whatever you needed on the internet or in libraries. Later he says that he knows that unspecified other people have come to wrong conclusions after researching on the internet but never him and “When the lives of my loved ones depend on making good decisions, it was easy for me to dive in deep to really understand.”

            So basically, he’s a case of Dunning Kruger who so far has been lucky enough to agree with the experts on 2 factors: vaccinations and when to induce his wife.

          • An Actual Attorney

            I guess you are right.

          • fiftyfifty1

            The Bishop’s score doesn’t “suggest what action”, it merely helps predict the likelihood that an induction will result in a vaginal birth. What you use to “suggest what action” is the clinical picture.

          • Some Guy

            You are criticizing a very brief overview, and nit-picking my wording. I’m curious at how you think predicting the likelihood of success cannot be said to suggest an action.

            “What course of action do you suggest?” Well, x is y% successful in your situation and carries z% risk. That is certainly a suggestion.

          • fiftyfifty1

            I’m not at all nit-picking your wording. The Bishop’s score is a prediction tool, not a decision making tool. The fact that you think the difference is not a big deal shows how little you understand. Your OB needed to make a decision about when the baby needed to come. The baby’s needing to come does not depend on the Bishop score.

          • Some Guy

            Do you not use prediction tools to make decisions? Understanding the Bishop score helped me understand factors used to make a decision. The ACOG document about this even described it as a guideline to use for patient recommendations.

          • fiftyfifty1

            How many times do you need to be told that the Bishop score has nothing to say about whether a baby needs to be born or not? One of the “experts” you decided to look to for advice (the infusion nurse) said the baby did need to be born. The OB said the baby did not need to be born. What does the consistency, length, position and dilation of your wife’s cervix have to do with the baby’s needs? Absolutely nothing. Now if and when it has been decided to have the baby, then one may choose to look at the Bishop score. A terrible Bishop’s plus a dire time frame may influence a decision to choose a surgical birth rather than a trial of labor. Or in a different situation where there is time for a TOL it may give a woman her odds so she can plan for her recovery details. Or a clinician may decide to spend more time on ripening agents. But these are all secondary details. A poor Bishop score should never be used as an excuse to change clinical decision making from “time to be born” to “Oh I guess not”.

          • Some Guy

            Again, brief overview of a situation in whih you don’t have all the information. I don’t feel like divulging additional medical history, but our multiple trips to the Labor and Delivery section of the hospital where on-call OBs would disagree on what to do included this factor.

          • fiftyfifty1

            And the point I am making is that this information may be readily available, but without context it means nothing. And the only way to get context is to have the sort of comprehensive education the one cannot get on the internet.

          • Some Guy

            What about the internet prevents one from getting the proper context? The way things are linked and cross-referenced specifically helps to give context. While some people look at symptoms and conclude they have a rare tropical disease, nothing prevents you from discovering that it’s almost impossible if you haven’t traveled.

          • fiftyfifty1

            “What about the internet prevents one from getting the proper context? ”

            The problem with a self-directed education, as opposed to a formal education is exactly context. Experts in a field are familiar with all the relevant information including peripheral fields that must be studied and “exceptions to the rule”. If study is self directed, you won’t know what you are missing, you won’t know exceptions to the rule, and if you have misconceptions about what you have read, you get no feedback that you are wrong.

            To use your own example: While some people look at symptoms and conclude they have a rare tropical dz, nothing prevents you from discovering that it’s almost impossible if you haven’t traveled. But it will indeed take an expert will know that there have indeed been outbreaks in your area recently due to an immigrant index case or perhaps it may take an entirely different expert to realize that the illness your buddy thought was a tropical illness is actually an atypical presentation of an autoimmune illness.

          • Dr Kitty

            Look, if someone googles the weird thing going on with their mouth and says “I think I have palatal fasiculations” that is one thing.

            But that isn’t how most people use the Internet when it comes to their health.
            Every headache is a brain tumour, every bout of gastroenteritis is a gluten allergy, every mole is melanoma.

            Most people don’t have the knowledge to correctly diagnose themselves. They just don’t.
            I know because I see it A LOT, and for every person who comes in with the right diagnose and a sensible plan of action, there are at least 20 who come in with very, very wrong ideas.

          • Some Guy

            You say “most people”, but my issue is with the word “IMPOSSIBLE”. While most people may not be able to discuss medical topics like that, it’s not impossible to do so.

          • Dr Kitty

            No, it isn’t impossible for someone to become an expert patient in their own disease.

            It is impossible for someone to learn how to diagnose illnesses accurately.
            Medicine is largely about pattern recognition. Learning the patterns, learning the variations in the patterns, the look-a-likes, the critical differences.
            That takes experience.

            I know what medical textbooks give you- textbook presentations.
            I know what practising medicine gives you-learning that people aren’t textbooks.

            Everyone can do “central crushing chest pain is a heart attack” or ” losing power down one side is a stroke”, lay people can’t accurately diagnose the cause of abdominal pain, rashes or non specific symptoms from reading on the Internet.
            They might be lucky and get the right answer, but that is what it will be, luck.

          • Some Guy

            I completely agree that doing your own research does not give you the hands-on experience necessary to be a doctor.

            I’m only taking issue with the notion that we outright dismiss people based on some arbitrary measure of education. Ideas ought to stand on their own if they can be defended.

          • Kq

            I think there’s something you’re missing as someone who isn’t (I assume) a regular reader of this blog. The vast majority of anti-vaccination, pro-“natural” birth, anti – science commenters we get here have all “educated themselves” and have “done their research” and have come to ignorant, stupid and wrong conclusions. There is a tin of pseudoscientific misinformation on the internet that masquerades as “legitimate” and reliable information. It isn’t. So your broad generalizations that “anyone can educate themself” aren’t going to go over well. We have *seen* what self-education results in. Some people certainly can educate themselves, but they are not the majority.

          • Young CC Prof

            Here’s an example of the difference between expert patient and expert doctor.

            I had ongoing ankle pain for some time. The simple stuff didn’t work, but at length I found a specialist who proposed a diagnosis and surgical treatment.

            Once pointed in the right direction, I was able to read on my own and determine that the diagnosis seemed at least plausible given what I was experiencing. I was also able to find several papers that measured outcomes from the proposed surgery. I determined that I liked what those papers said, and I trusted the surgeon’s expertise. In the end, I consented to the surgery and it was highly successful

            Reading the papers helped me make a good decision and feel confident in my decision. However, no matter how long I read stuff, I would not have been able to come up with the diagnosis, or figure out how to actually perform the surgery.

          • Sue

            “What about the internet prevents one from getting the proper context”? Because the context includes all the underlying assumed knowledge – pre- clinical, clinical, statistical, evidentiary, current best practice, current controversies, info gained from case review meetings, M&M meetings.

            As a medical specialist (non-OB), I wouldn’t presume that I could second-guess an OB just by reading up – I don’t have the same professional experience.

            I do, however, have some insight.

          • DiomedesV

            So, if you’re reading medical papers online, how do you decide whether or not the authors used the correct statistical tools to address their questions? You know that a p-value isn’t the only thing of relevance, right?

            It takes training in statistics and analysis to know whether a paper is even telling you what the authors claim. I’ve read many a paper that simply failed to provide the evidence the authors claimed for it. I’ve even read papers where the most reasonable interpretation of the data was the exact opposite of the authors’ claims. But it was published.

          • Some Guy

            I outlined my methodology above, but I look at the reputation of the researcher and institution, then evaluate the dissenting opinions against the data.

            I readily agree that you need to understand statistics and analysis to read a paper like that. Even if think vaccines work by casting spells, you can determine their safety with math and common sense.

          • DiomedesV

            I’m not talking about vaccines. I’m talking about your example of being an “educated” medical consumer by going online and researching induction, reading papers, etc. I simply don’t believe you have the tools to evaluate what you’re reading.

            The reputation of the researcher is not irrelevant, but just so you know, every field has people that are very well known but whose work is regularly called into serious question by their colleagues. In my field, one of the most prolific and (until recently) respected young researchers produced many papers that were called into serious question at the time. But his reputation continued to increase and many people outside of our field would have considered him a super star (and for all intents and purposes, he was/is). It’s all started to finally fall apart, but only after the publication of many problematic papers. And he still gets stuff published, largely on the virtue of his reputation and standing, stuff that has some pretty basic failings. How would you know all of that if you’re not in the field?

          • Some Guy

            I’ll agree that I’ll never be in a position to call out an individual researcher. I also agree with your points about it the possibility to be mislead. However, I think those same pitfalls exist even for those with the relevant education.

            I typically try to wait until a finding has been confirmed by multiple studies. It’s not perfect, but I see it as a valid approach to gathering information.

          • Dr Kitty

            The “action” in question was whether or not the baby needed to be delivered imminently or not.

            The Bishop’s score helps decide if that imminent delivery should be by CS or induction.

            If the baby doesn’t need to be delivered, the Bishop’s score is irrelevant.

            That is what fifty was getting at.

            Your MW said baby needed to be delivered, your OB said no.
            That was the issue in question.

          • Some Guy

            Again, it was a brief overview. You clearly misunderstand the circumstances of the situation as I never mentioned a midwife. She had health issues and needed home infusion; the nurse doing infusions was a former labor and delivery nurse (handles the pregnancy in a hospital before the OB catches the baby). I did the research, and came to agree with the OB. The issue was my wife was suffering, and we had to decide whether an induction was possible, safe, and the best course of action.

          • fiftyfifty1

            Dr. Kitty does not misunderstand you. This is British English/American English thing. In the UK they don’t have a position called “L&D nurse”. The closest role that they have in the UK is what they call “midwife”. The UK “midwife” has less training than an American CNM, and does both the nursing duties of an American L&D nurse and also catches the baby if all is straightforward.

          • Dr Kitty

            Right…

            But that REALLY wasn’t clear from your post, was it?
            What you wrote seemed to indicate that a decision whether or not to induce was based on Bishop’s score.
            Which it shouldn’t be.

            If you make the decision that the baby needs to be born you use the Bishop’s score to determine whether IOL is worth doing, and how, or whether you skip straight to the OR.

            The decision that it is safe to wait has nothing to do with Bishop’s score.

            But what you’re saying is that the nurse felt your wife should deliver because she was sick and tired of being pregnant, and your OB thought that as imminent delivery wasn’t clinically indicated and waiting was better, then was able to convince you of that by telling you that IOL was likely to fail because of an unfavourable cervix.

            But of course, I can only judge based on what you actually write, as I am not psychic.

          • Some Guy

            I didn’t intend to go into the details of this case. I only wanted to demonstrate that I was able to research that information and incorporate it into my decision making. Everybody seems to be missing the forest for the trees.

            I know what the Bishop score is, and for what it is used. I was able to gain insight into these decisions, and have an intelligent conversations about them. When the lives of my loved ones depend on making good decisions, it was easy for me to dive in deep to really understand.

            I did look into vaccines for myself. I looked into the ingredients, the illnesses, and the adverse affects. The reason I’m not against vaccines is that I went in wanting the truth, not a confirmation of my bias. It is possible to do that, even if many others fail.

          • DiomedesV

            That was certainly not what you said. You assured everyone that you could buy all the textbooks and watch a bunch of lectures online and then Presto! You have the same expertise in chemistry as someone who actually made it their field of study.

          • Some Guy

            I was demonstrating that the information is available for those who want to self-educate. I then clarified that we are talking about this in the context of making decisions like whether or not to vaccinate.

          • Bugsy

            Yep – completely correct. It amazes me when people assume that you can acquire the same knowledge self-taught from the internet as you can from actual university courses taught by experts in the field. I enjoy the internet, am fascinated by the debates and by the people with whom I interact virtually. However, does it come close to equating to my undergraduate/graduate school workload? Not in the least. The amount of knowledge I’ve acquired in the past year of web browsing would perhaps equate to a week’s worth of education during my university days…at best.

            That being said, having worked so hard academically gives me additional respect for experts in fields beyond my own.

          • Elaine

            I agree completely as a person with a science-related doctorate as well. The other really frustrating part of this is that people who have not gone through all the intense training to get an advanced education in their field are so clueless about what it entails. The problem I have with anti-vaxxers is the Dunning-Kruger effect; they are so clueless that they do not even get how clueless they are, and they get mad when you try to point it out to them. Then there is the occasional one who does have a science doctorate and yet somehow manages to be a total moron.

            I am a much more relaxed person since I quit reading the vaccine boards on MDC.

          • Bugsy

            Yep. My degree is in liberal arts, so here’s the liberal arts spin on it: the people who claim that a few weeks with Rosetta Stone equates nicely to the years I spent studying Japanese for my undergraduate major, followed by time actually living in Japan. Yep, I’m sure that the two are equal.

        • Amy Tuteur, MD

          “To say that you can’t have a view on a topic because you aren’t formally educated in it is simply elitism.”

          To impute value to your view on a topic that you know nothing about (and if you don’t have a firm grounding in basic immunology, you know nothing about it) is just the wishful thinking of the ignorant. To accuse people who know more than you of elitism is just pathetic whining.

          • Therese

            Is a firm grounding in immunology just in order to understand that vaccines are effective or will it do anything to convince parents that vaccines are safe? Just from my anecdotal experience, most anti-vaxxers accept that vaccines work, they just fear the risks of the vaccine are greater than the risks of the disease. Will a more firm grasp in immunology do anything to convince such a parent to vaccinate?

          • fiftyfifty1

            “Will a more firm grasp in immunology do anything to convince such a parent to vaccinate?”

            Not exactly, because the average parent is so uneducated in science that they would need multiple classes of remedial general science before being able to take even a basic immunology class.

            Here’s some examples of things parents think:

            “Immunizations harm the immune system and they work on the principle of if you are harmed you will grow back stronger, but The Scientists have made too many shots that are too strong and too close together, so they cause permanent harm to your immune system before you have a chance to grow back stronger”

            “Immunizations work by introducing toxins to the system to try to teach the body how to clear away toxins. But really it’s just poisoning our kids.”

            “Immunization work to try to teach the immune system, but since it is not taught in a natural fashion, immunizations can never work.”

            Seriously, this is the sort of shit that people produce and think themselves “educated” on the topic.

          • The Bofa on the Sofa

            “Immunizations involve injecting toxins into the bloodstream.”

          • Sue

            It’s even worse than that, Bofa. DIRECTLY into the blood stream.

          • Amy

            That is just pitiful.

          • Medwife

            Well, I was younger than most anti-vax parents, but basic science and health education worked for me. I was raised anti-vax but by the time I was a freshman in high school I was “converted” enough to insist to my mom that I WAS going to be fully vaccinated ASAP.

        • Guestll

          I think you probably are educated enough to develop vaccines. I know I am. http://www.theonion.com/articles/pharmaceutical-industry-reeling-as-more-moms-makin,36028/

        • Cobalt

          There’s a big gap between having a view on something and being able to critically evaluate information about it.

          All it takes to have a viewpoint is to have heard something. A rationally defensible viewpoint requires information from credible sources. True critical evaluation requires actual education, which is best acquired from experts in the field.

          • Some Guy

            It’s a good thing experts in the field publish their work so that you can consume that information without paying tuition.

          • Amazed

            All experts? All their work? I’ll be really grateful if you show me the links to the latest research (entire research, and for free) of the cuneiform tablets of the Hittite Old Kingdom. I was always interested in that and since I graduated, life took me in a course where I didn’t have the time or effort to keep my knowledge in that area to the level I’d like it to be.

          • Some Guy

            Who said it was free? Let’s be reasonable; I’m talking about topics of public interest which affect personal decisions and public policies.

          • Amazed

            I understood what you meant perfectly. I just took issue with a statement you made. “You don’t need to be an expert to evaluate any type of information. Libraries exist and the internet exists.” Any type of information.

            You’d better believe me when I say I can sell you a huge bucket of hogwash where certain topics are concerned – and yes, the Hattite Old Kingdom is probably one of them. All it takes is some basic knowledge (mine is still a little better than basic), logical reasoning, and the ability to sound convincing. Libraries and internet stand no chance because they usually save and publish anything. Without the basic knowledge to distinguish facts from interpretations and downright wishful thinking, a reader is lost.

            The problem is, to many peope the science behind vaccines is just as detached as the Hattite Kingdom is. Which leads me to my second problem with your posts: I get the impression that you DO have some knowledge in a related field. Which is not the case for most people, me included. I get the basics of the way vaccines work but since I haven’t taken as much as a single course in biology, chemistry, and the likes since I graduated high school, libraries and internet cannot help me get educated before filling a very huge gap in my knowledge. Which takes much more time and efforts and leads to inferior results compared to formal education. And doesn’t guarantee I won’t get a whole litany of lies into my head since the internet has the nasty habit of publishing anything someone writes. Like Ms VBAC (non) Facts Jen Camel. Judging by the way she’s promoted in the web space, one would think she has at least 30 years of experience personally catching VBAC babies and is actually an expert.

            Same with vaccines.

          • Amy Tuteur, MD

            Papers in the field are for experts to communicate with one another. Textbooks are for people learning the basics. So tell us, how many immunology chapters of textbooks have you read from beginning to end? Zero?

            Let’s start with something simple to test what you know. How do vaccines work?

          • Some Guy

            I never claimed personal expertise on immunology, just that the information is publicly available. Vaccines work by prompting the immune system to create antibodies.

    • Amy Tuteur, MD

      Read carefully. I didn’t say you need to be an immunologist. I said you need to have a firm grounding in basic immunology … and you do.

      • Some Guy

        I apologoze. I took that phrase to mean a formal education in it. We are in agreement if that phrase just meant a decent understanding of how immunizations actually work

    • Guestll

      The rate at which children are going unvaccinated in Western countries appears to be on the decline, especially in states who’ve passed more stringent exemption laws.. See California and Washington, for example.

      In the immortal words of Roger Waters…the tide is turning.

    • Box of Salt

      “the number of people that go unvaccinated increases.”
      Really? The percentage of people covered looks fairy steady to me, according to this graph:
      http://www.childtrends.org/wp-content/uploads/2014/01/17_fig1.jpg
      from this report
      http://www.childtrends.org/?indicators=immunization

      It’s recovered from a significant drop-off around 2009, when Jenny McCarthy (and her misguided views) was at her loudest.

    • Stacy48918

      “personal experience of their children getting vaccines and becoming autistic”
      Correlation. Not causation. If you want to appear “educated” you could start by understanding the definitions of those 2 words.

      A link between vaccines and autism has NEVER been proven in multiple studies in multiple nations with MILLIONS of children.

      • Some Guy

        Did you just stop reading after that sentence? Way to take it out of context.

        • Staceyjw

          My favorite mansplainer! So glad to see you’re here to educate us silly ladies (and few men too dumb to know better to listen to ladies).

          • sdsures

            Why is it every time a male commenter says something on here, he gets snarked at?

          • fiftyfifty1

            Every time?! Bofa constantly comments and hardly ever gets snarked on (i.e. only when he deserves it).We have a few other semi-regular male commenters who seldom if ever get snarked.

            I do think that stacy48918 misread Some Guy, and I don’t agree with Staceyjw that Some Guy was mansplaining. But to say that male commenters always get snark is simply not true.

          • The Bofa on the Sofa

            Bofa constantly comments and hardly ever gets snarked on (i.e. only when he deserves it).

            To paraphrase Roberta Flack, “Snark that to me one more time, once is never enough…”

          • sdsures

            And who decides when he deserves it? What are the criteria?

          • fiftyfifty1

            There is a secret group of some of the senior female commenters here. When a junior female wishes to post something snarky toward a man, she has to submit her comment to our panel and if we decide he deserves it, we allow her to drop her normally required ladylike tone and post the comment. It sounds like you have a lot of strong opinions about tone. Perhaps if you stick around for 2 or 3 more years you may be asked to join our secret censorship panel, you never know.

          • The Bofa on the Sofa

            If you have to ask, you are not part of the panel.

            That’s all you need to know.

          • sdsures

            As there is a private group on Facebook for people who are fed up with NCB but don’t want their posts appearing on their friends or families’ feeds, I’ll assume you’re not being sarcastic.

          • fiftyfifty1

            Oh no, our censorship group is far far more secret than that. And we mete out severe punishments to those who try to elide our control and post a comment with wrong tone. Just try and see if you dare.

          • sdsures

            I’m not the one complaining about Dr Amy’s tone. It’s NCBers you’re thinking of. Now, can we drop this silliness and get back to discussing vaccinations?

          • Kq

            Fiftyfifty1 Have you forgotten the first rule of Censorship Club?! YOU DO NOT TALK ABOUT CENSORSHIP CLUB!

          • Sue

            Sssshhhhhhhhh!

          • MLE

            I have been here 3+ years and haven’t gotten my invite :(. Also I have seen long-time female commenters here given hell for one thing or another many a time. ALSO how do we know Some Guy is really a guy??

          • Young CC Prof

            The Shadow knows.

          • Who?

            Yes there is pretty equal opportunity hell-giving I think. And who knows who anyone is on the internet?

            Perhaps you haven’t recognised your invitation? There could be secret signs and cyphers for the deserving to recognise…

          • The Bofa on the Sofa

            I have a secret code that I use to indicate those comments that deserve a snarky response. Don’t listen to fiftyfifty1. She might think that it they are the ones deciding, but ultimately, I am the one that is triggering the response.

    • Sonia Bardy

      You get a biology degree, there is a high chance you are exposed to some immunology classes. You get an advanced science degree related to health sciences, and there is an even higher likelihood of studying immunology. While not a Dr, I can almost guarantee you that med students are trained in basic immunology. Which is what Dr Amy was referring to basic immunology, not being an immunologist.

    • Sue

      We need to distinguish between those who benefit from pushing anti-vax conspiracies and those who are vulnerable to them.

      I suspect a lot of vulnerable parents are struggling with kids with developmental issues, and are clutching at an external locus of blame.

      The people who are still pushing the conspiracies, despite the growing evidence against them, appeal to the parents’ need for empowerment through protest against the medical establishment. The anti-vax organisers profit through financial gain and personal following – they paint themselves as some sort of heroes of the oppressed.

      It is this latter group that needs to be exposed and shamed, not the vulnerable ppl under their influence.

      • Some Guy

        That’s essentially where I was going with it. The majority of anti-vaxxers are in it for emotional reasons. They see these stories about coincidences, or experience it themselves. It’s not because they are smug conspiracy nut jobs, they are concerned parents swayed by bad information.

        • Sue

          So, we need to think about this phenomenon much as we think about home birth. The term “anti-vaxer” should be used much in the same way as we use NCBer here – referring to the radical and extreme driversf the movement, who benefit and profit from conning others.

          This group SHOULD be held up to ridicule – not just for their dangerous misinformation but also for their ignorant hubris and simplistic paternalism – exactly what they criticise the medical profession for. We also need to expose their motivations, including financial, so that toss who are vulnerable to their influence can come to see them for what they truly are.

          Again, very much like HBMWs – taking advantage of the vulnerable. That deserves ridicule. Being vulnerable to their messages deserves empathy. But not excuses.

        • fiftyfifty1

          I probably have a wider view of the motivations of non-vax parents, because I’m a physician who has to deal with them. I would say they fall into 3 camps:
          1. Conspiracy theory prone nut jobs.
          2. Rebels without a clue/smug/nobody’s the boss of me
          3. Not very smart and scared

          #3 is easy to fix with a little reassurance and TLC. #1 is probably unfixable once the seed has been planted. #2 types are into appearances, so yes can respond to public opinion telling them they aren’t so cool after all.

          • Guestll

            I know a guy (musician in my husband’s band) who is all three. Chemtrails/vaccines/fluoride + I’m so altie + Didn’t make it past grade 10. Trifecta of ignorance, and he reproduced.

          • Stacy48918

            “Chemtrails/vaccines/fluoride”
            Sounds like my soon-to-be-ex!

          • Bugsy

            I wonder if he’s the same one we know? Also in a band, didn’t finish high school, a father and now trying to protect his family from chemtrails, GMOs, medicine and plastics…

          • SporkParade

            Our anti-vaxxer is organic/GMOs/vaccines/home remedies. She and her husband also hunt because they “know where the meat is coming from,” unlike store-bought, with all its pesky health and safety regulations.

          • Dr Kitty

            As long as they know how to butcher and hang the meat properly and freeze it to kill parasites before they then cook it thoroughly there shouldn’t be an issue…

            Improperly butchered meat, though….ewwwww

            My vegetarian for environmental reasons relatives in Australia only eat kangaroo, which I can understand.

          • fiftyfifty1

            How is kangaroo? What does it taste like?

          • Dr Kitty

            I’ve only eaten a kangaroo steak that I cooked (panfried with garlic and balsamic vinegar) it was like venison, really good.
            I was in Australia, in the outback doing an elective as a medical student and it was the nicest, cheapest meat I could afford.

          • Dr Kitty

            Oh, the cooking method and balsamic were borrowed from Aussie nurses in the nurses’ home I was staying in.

          • Bugsy

            Lol, I don’t think our anti-vaxxer hunts, but he does fish from the “bounty of the rivers” in his east coast state. The irony of it is that while he is concerned about things like nuclear radiation from Japan, he has no concerns over the fact that he’s fishing out of highly polluted rivers and lakes.

            They sound like two of a kind.

          • EmbraceYourInnerCrone

            Ah, the bounty of the rivers, the same rivers, at least around here that had brass mills and textile mills and weapons factories dumping waste water and heavy metals in them for most of the 19th century. Yeah your couldn’t get be to eat any fish caught near the mouth of any river around here. Especially any of the bottomfeeders. The state and feds have cleaned up a lot. But there’s still a lot to be cleaned

          • Guest

            I am “vaccine” hesitant. I definitely do NOT fall into the first 2 categories. But I do not see myself as stupid. My middle son had a horrible reaction to the MMR shot. It terrified me. Now every time I have my children vaccinated I hold my breath. I would be horrified to know that because of my fear my physician was thinking this “tsk tsk this woman falls into category 3. She’s not so smart and scared.”

      • KarenJJ

        I’ve come across a lot of anti-vaccination sentiment in families with auto-inflammatory syndromes due to the bad flares that can happen to people with auto-inflammatory syndromes after receiving vaccinations.

    • KarenJJ

      “The people who recommend the vaccines (General Practitioners, Pediatricians) are not immunologists. ”

      They were in our case. We weren’t going to get the MMR for my daughter due to the advice of one immunologist (contraindication with a medication), but got a second opinion from a paediatric immunologist. After my saying that we were advised against vaccination, she warily said “Immunologists really like vaccinations”. Once we got more into the discussion and she realised it was a colleague that had told us it was contraindicated and not some nutter on the internet and that we were welcome to getting it done she took it further for us and investigated for us and she got her MMR. I’m very grateful because we’ve had a couple of measles cases recently in our suburb.

  • Meredith

    I’ve surprised myself by agreeing with your argument. I say surprised myself because usually I’m all about understanding both sides, empathizing with other viewpoints, etc.. I clearly vaccinate (I read this blog after all), but I expected to think your harshness was counterproductive. However, after reading the entire post, I think you are right. If we continue to make non-vaccination a preposterous, silly decision rather than an understandable one, the vaccine rates will go up. No one wants to look a fool.

    • anotheramy

      And if anti-vaxxing is seen as preposterous, it’ll save vaxxing parents needless anxiety of “what if…”, probably save physician s’ time in discussing this with parents, and save parents time “researching” online.

    • Elaine

      Most of the people I know who are deep in the woo are also more than willing to bear the raised eyebrows of the rest of the world as badges of distinction. At a certain point they just say “Yep, we’re that family” and laugh off everyone else’s opinions. Maybe some people on the fence will be convinced to come back to vaccination if not vaxxing is painted as extreme, but a lot of people are beyond the reach of that tactic.

      • Meredith

        I think you are absolutely right about current parents. Most won’t change their minds once they’ve decided vaccination is bad. I was thinking more of yet to be parents, even of future generations. Those who had never thought about vaccination at all until getting pregnant and who now and in the future are doing their “research.” It would be helpful for the pro-vaccination voices to be as loud and as adamant as the anti-vaxx ones.

      • Life Tip

        I think you are right about their reaction, but I think they only have that “yep, we are that family” reaction because they have their echo chamber babycenter/MDC/mommy blogs to run back to. And they know they can tell their story and everyone will say how smart they are, how much better they are than other parents, and they will continue to feed off each other’s ignorance.

      • SporkParade

        Perhaps, but I don’t think our targets should be the people who are deep in the woo because there is simply no reasoning with them. The message needs to be aimed at the parents who say, “Well, I was going to vaccinate, but now there are these people saying I really, really shouldn’t, and I am questioning my decision.”

  • Therese

    I’m not sure. How do we know that shaming anti-vaxxers won’t just result in them keeping quiet or even lying about vaccinating, which will only make it harder for the rest of us to avoid them? If someone truly believes that vaccines would threaten the health and life of their children, I’m not sure any amount of shaming is going to work. Would you let anyone shame you into doing something you thought was dangerous for your kid? Of course, if they are only doing it to be cool, then yes, those people would be convinced to vaccinate, but I think a lot of people are anti-vaxxers out of actual fear.

    • Red Ear Reviewer

      The trick is to get them to shame themselves. Chances are VERY good that your local anti-vax activist learders hold numerous bizarre notions. Get them to talk publicly about everything they fear and hold dear. When they start talking about detoxing, have them explain how they do that, etc.

  • GiddyUpGo123

    The problem with Hills’ argument is it suggests that anti-vaxxers might actually be reasonable people. But my question to her is this: have you ever once ever sat down and had a reasonable conversation with an anti-vaxxer, calmly and logically explained to her the dangers and inherent wrongness of her beliefs, and then had her actually change her mind as a result of that conversation?

    I’m sure there are a few instances of that happening, but I have personally never known or heard of any anti-vaxxer changing her opinion in light of even the most compelling evidence, with one exception: when her own child becomes sick with a vaccine-preventable illness.

    Anti-vaxxers may not be idiots and crazies (actually they are, but let’s just say they may not be) but they are definitely one other thing: they are unreasonable and illogical. Trying to understand them isn’t going to change them.

    • Puffin

      I had a coworker who was quite anti flu shot, and I asked her why, dispelled her misconceptions (I do have advanced training in immunology and medical microbiology) and she is now quite strongly in favour of flu shots and reaches out to other people to get them to get theirs. The flu shot, in particular, is one I try to talk to people about because many people don’t understand it well so there is a broad base of misinformation about it, including with people who otherwise stick to vaccine schedules. Since influenza is actually a pretty dangerous illness to several parts of the population, it’s super important to get as much uptake as possible to help limit spread.

      • GiddyUpGo123

        I think adults who don’t get vaccinated suffer a lot less from zealotry than adults who don’t vaccinate their kids. I can’t get my husband to get a flu shot either, not because he’s opposed to it but because he “doesn’t have time.” Don’t even get me started. I think he figures because our kids always get their flu shots and I always get mine that he’s only risking himself by not getting his. There are a million reasons why he’s wrong, of course, but this is also a guy who wanted to take all the smoke detectors out of our house because they were annoying him (they go off whenever he burns the toast). His reasoning: “I’ve never known anyone who died in a house fire.” He only agreed to keep them installed when I threatened to take the kids and move to a hotel, because hotels have smoke detectors.

        Sorry, I went off on a tangent there for a minute.

        • Puffin

          I totally get it. My husband only gets his flu shot because I take him with us. “Surprise! We’re all at the pharmacy to get our flu shots. Roll it up, dear.” We had a house fire a couple years ago and it was our smoke detectors that gave us the additional notice which helped everyone get out on time. The extra minute or so it gave us meant my husband was able to make one crucial decision (closing a certain door to cut off oxygen) which saved our house. I applaud you for the strength of your convictions.

        • Cobalt

          I know a whole family that died because they didn’t have working smoke detectors (kitchen smoke and shower steam kept setting them off, so they took the batteries out). The fire started in the middle of the night, and was almost a full blaze before beams breaking woke them up. The mother was the last to lose consciousness, while on the phone with 911. She already knew the two of the kids were dead (smoke inhalation). She woke up in the hospital, but didn’t recover.

          SMOKE ALARMS MATTER

          If they’re in an inconvenient, high-false-alarm location, move them. Don’t disconnect them!

          • GiddyUpGo123

            That’s awful. I guess if I was that mom, though, I wouldn’t have wanted to recover knowing my kids were dead.

            My husband is a really smart guy, but he’s really stupid when it comes to safety. If he had disabled the smoke alarms, I’d have made good on my promise to move out with the kids. The thought of living without them is terrifying. In fact when we set them off with burned toast, I actually kind of like it because it lets me know they are working.

          • deafgimp

            I’m deaf and I don’t wake up to flashing lights. Dying in a house fire is one of my greatest fears.

          • MLE

            what about one of those vibrating alarms?

          • Trixie

            Hasn’t technology solved this problem yet? Maybe the new Nest alarm paired with a smartphone on vibrate?

          • KarenJJ

            They have and I’ve just had a quick look, but like all hearing technology it’s hideously expensive.

            http://www.printacall.com.au/category/smoke-alerts/

          • Young CC Prof

            There are electric massaging pads that you can put on chairs. You could put one under your sheet, then have someone wire it to the smoke alarm?

          • KarenJJ

            Same and I think I need to look into this more. At the moment I rely on my husband to wake me but if he can’t be here one night I don’t know that I’d sleep.

          • D/

            I’m considering adding a pillow/bed shaker accessory myself … National Fire Protection Association lists source companies here.

            http://www.nfpa.org/~/media/Files/Safety%20information/Safety%20tip%20sheets/SmokeAlarmsDisabilitySafetyTips.pdf

          • deafgimp

            I can’t put one of the bed shakers under every couch and chair that I am sitting in at the time. I’m training a service dog but this one might be a wash out.

          • deafgimp

            Also, I can’t even start to afford to pay for something like a Nest, especially not to replace all of my alarms with one.

          • D/

            I’m thankful in that respect to just be *very* hard of hearing rather than completely deaf. I can hear smoke detectors when awake, but they will not wake me once I’m asleep without my hearing aids in, nor will strobe lights.

            Until the last two years our never-trained Jack Russell was a natural born little service dog for me … Would come get me or wake me for alarms and the phone, if someone knocked at the door, the cats were in a fight or whatever. Now I’m oblivious to all that without her. I miss her terribly as the good little friend she was, and even more so as my hearing further deteriorates and I’m forced to recognize how much she kept me from feeling quite so oblivious.

            I understand what you’re saying about the idea of “wearing devices” all the time … just being to the point of having to wear hearing aids themselves is still pretty overwhelming for me (including financially). Haven’t at all decided what my solution(s) will be.

          • me

            There are some that vibrate. Maybe look into that. That would scare the crap out of me!

            FWIW, our smoke detectors are “too sensitive” too. So, yeah, when I’m broiling or cooking something at high temp (and know there will be a small amount of smoke), if I can’t open a window (too cold) I will take the battery out. While I am cooking. Once the cooking is done, the battery goes back in. It’s not that hard.

          • deafgimp

            Basically you’d have to wear a bracelet or carry your phone with you 24/7. I can’t wear stuff on my arms due to nerve damage, and who the hell wants to carry a phone all the time? I have to have a pocket to wear it to bed, to boot and that just ain’t happening.

          • toni

            I feel your pain. Mine texts and drives all the time and eats food that require two hands ( huge, messy burgers usually). Got sick of hearing myself telling him off so now I just drive us all everywhere. Once when our son was about 2 months old we were driving on a busy road and he was crying. My husband was yelling at me to make him stop so I said pull over and I’ll feed him but he refused and told me to just get him out and nurse him while we drove! I said absolutely not and he basically called me an overprotective ninny and swore a lot. Never did pull over. About three weeks later we were side swiped at an intersection, my husband got a broken arm and i got broken ribs, hip, punctured lung etc. Toby was uninjured thanks to his car seat. Imagine if I had been nursing him at the time! Husband has not ordered me to take him out of the car seat whilst in transit since but I think it is totally ridiculous that something that like had to happen for him to realize what a stupid suggestion that was.

          • Trixie

            And carbon monoxide detectors.

        • Mishimoo

          My husband was kind of meh about the flu shot for himself because “It’s just the flu.” Then he caught it a few years ago and was really sick for 6 weeks. Not quite sick enough for hospital, but sick enough that he was miserable and very regretful.

          Now he starts bothering me to find out when the new ones come out each year, because at least it covers some strains and reduces his risk of being that sick again. He also knows that he definitely needs to keep up on his vaccinations now because he works with more of the public (older people and babies) and it’s not fair to risk sharing stuff.

      • Young CC Prof

        In the fall of 2009, one of my students’ children were scheduled to be offered the H1N1 vax at school, and she said she wasn’t going to have them vaccinated.

        The next week, she came in with a news article that said 10,000 Americans had died of H1N1, and vaccinated her kids.

        People who are legitimately asking questions may indeed change their minds when presented with answers.

    • Amy

      And I would argue that in the few cases where a reasonable conversation does change an anti-vaxxer’s mind, they probably weren’t all that vested in the movement to begin with. I flirted with vaccine rejection when my first child was a newborn, precisely because I was inundated with the entire spectrum of crunchy woo. At the same time, I’m a highly educated person with a strong background in math and science, so it was only a flirt, never a full-on romance with the NCB, Mothering Magazine crowd. Took a couple of weeks, tops.

      • Cobalt

        There’s nothing wrong with asking questions. It’s throwing out all the science based answers that gets you into trouble. There’s been so much fuss over vaccine safety that many parents are asking questions, they just don’t all ask those qualified to answer.

      • Bugsy

        I agree. I also flirted with that crowd, and am embarrassed to admit that I held off on my son’s 6-mo meningitis vaccine out of fear. It took Dr. Offit’s Coursera course on vaccines for me to scramble to get my son up-to-date as fast as possible. However, I wasn’t an extreme anti-vaxxer – just a new mom trying to sort out all of the ideas being thrown at me.

    • OBPI Mama

      I used to be anti-vax and changed over. It took a couple tetanus scares with my son (rusty farm equipment mishaps) to start making me REALLY question my stance… after the tetanus thing, then it was whooping cough that started getting me question more, then reading The Vaccine Book (which I know has inaccuracies, but it seemed like such a nice middle ground for someone who was once anti-vax and starting to think) changed my mind completely. I’ve read a few of Dr. Offit’s books and have appreciated them and learned a lot.
      But I’ve been burnt and humbled by many “natural” things in life, while many other anti-vaxers I know are still very proud and know everything. I’m actually thankful for the bumps in the road causing me to change my stance.
      So keep advocating pro-vaxers! You might help change 1 person’s mind… it might be out of 100, but 1 person is pretty good still!

  • Amy M

    They don’t just fear autism, they’ve added “autoimmune diseases, immune-mediated disorders and cancer” to the list too. Plus, dead babies in the vaccine, so if you are a staunch pro-lifer, they try to trick you into thinking you are supporting abortions or going to hell or whatever.

    I got the impression that some portion of the anti-vaxxer crowd ended up there because they saw it as a fad, and jumped on the bandwagon. All of their friends were doing it, kinda thing. Could people like that be persuaded to think 1) not vaxxing is lame and they suck for not doing it (the shame campaign Dr. Amy said) and 2)now harmless XYZ (eating kale, dancing skyclad, wearing hoodies backwards) is now all the rage and they can turn their attentions to that INSTEAD?

  • lilin

    ” but the deep suspicion that lies at the heart of vaccine refusal reflects their distance from power, not just their proximity to it.”

    Wrong. It absolutely reflects their proximity to power. It reflects their ability to grab a microphone for no other reason than they have contacts in the media, and as white and wealthy people they know that someone is going to listen to what they say. It reflects their confidence that if something goes seriously wrong with their kids, medical professionals will scramble to help them out not just to save the kid but because they have money and the ability to make trouble if they get less than sterling care. It reflects their knowledge that they won’t be singled out as the “dirty people” who spread infection when their kid kills or renders infertile some other member of the population. Or the ignorant hicks who don’t know any better.

    Basically, they’ve got the ability to out-shout most other people in the world and a nice big cushion to fall on should a crisis happen.

    • Cobalt

      The leaders, but not necessarily the followers. The anti-vaxxers I know are very rural and very poor. For them it’s distrust of government and big city people that don’t hunt deer.

  • Bugsy

    “Anti-vax activism is about parents and how they want to view themselves. It would be very hard for them to present themselves as educated and empowered if everyone else believed them to be ignorant and gullible.

    This. Having been cut off by an anti-vaxxer for my unwillingness to allow my child to play with her unvaccinated son, I completely agree. I have no doubt that her choosing to not vaccinate was based on a need to look educated and empowered above all else. Then here I come, an old friend who disagrees (gasp) with her extreme parenting. There was no way she could perceive my contradictory decision to be _my_ prerogative for the best interests of _my_ child – instead it was an attack that criticized her education, her parental decisions and her very belief system.

    …but then again, so much of the all-natural movement strikes me as a belief system that requires total allegiance, not unlike a religious cult.

  • Trixie

    I’m done with pretending to tolerate the middle class delayed vaxxer moms I know in real life. Telling me your 2 year old hasn’t had MMRV yet because you follow Dr. Sears will not get you respect for your alternative parenting choice. I will (and have done so) back away slowly, clutching my child, and tell you that sorry, no, we aren’t going to be having a play date after all. It’s not an acceptable lifestyle choice and I refuse to act like it is.

    • Bugsy

      Completely agree.

    • Puffin

      Yup. It’s not one of those “whatever works for your family” things. My first memories involve having pertussis because the high dose steroids I needed meant my vaccine was not particularly effective when it swept through our poorly vaccinated community. My son spent months battling secondary pneumonia after influenza. I have severe asthma and almost died on my parents a few times. I love how anti-vaxxers basically don’t care if the kids who are how I was die. They just say “well if you’re healthy these diseases aren’t a big deal” which is both untrue (my son was perfectly healthy when the flu hit him hard) and basically a big “fuck you” to anyone with chronic disease, cancer, HIV, other immune deficiencies, on immune suppressive drugs, old people, newborns, and people recovering from serious medical events. To anti-vaxxers, these lives don’t matter and they have no responsibility whatsoever to help take care of their community. “My kids are healthy so I won’t allow even a 1:1,000,000 risk to them to help protect your kid.”

      It angers me. A lot. They are burning the ladder of herd immunity behind them so that those coming after can’t climb it.

      • The Bofa on the Sofa

        hey just say “well if you’re healthy these diseases aren’t a big deal” which is both untrue (my son was perfectly healthy when the flu hit him hard) and basically a big “fuck you” to anyone with chronic disease, cancer, HIV, other immune deficiencies, on immune suppressive drugs, old people, newborns, and people recovering from serious medical events.

        Of course. They deserve it, doncha know?

      • Trixie

        Yeah. Don’t even get me started on the mom who sent her daughter to preschool knowing she had diarrhea and a fever. There’s another little girl in the same class who’s on chemo right now. Not going to pretend that was socially acceptable. She should be humiliated.

      • GiddyUpGo123

        My neighbors got pertussis. They were all vaccinated, but I think at the end of the effectiveness for their vaccines. Our school, however, is filled with unvaccinated kids so I’m pretty sure their 13 year old brought it home with him from school. The husband in that family would wake up every morning with a coughing fit so severe that it would end with him vomiting. He did that every single morning for months. No one will ever convince me that pertussis is a “mild” disease.

        • Puffin

          “The hundred day cough” I have heard it called. I knew one woman (from my time at MDC before I knew better) who broke ribs coughing due to pertussis while nine months pregnant. Anti-vax, of course. Her infant was born into a house full of unvaccinated people with pertussis, to a mother who didn’t get a booster during pregnancy to give the kid any protection. I don’t know what happened but I desperately hope the baby was okay.

        • OBPI Mama

          I am just getting over bronchitis and the pain of constant coughing for 2 weeks (and being pregnant… oh, ligaments) is AWFUL! I’ve felt faint, I’ve bawled my eyes out from the pain and constant-ness of the coughing, and I just. can’t. imagine. my child going through whooping cough. I shudder to think I was once willing to let it happen to them…

        • Amy M

          We just had some new friends over today, a little girl who is in my sons’ class and her mom. I mentioned that the boys are up to date on their vaccines, in case it worried her, and mentioned the Disneyland measles outbreak. This was totally a gambit to make sure the girl was up to date (she is), but it led to a great conversation.

          She agreed with me, about how vaccination is everyone’s business. I told her how my boys (6 this month) were born a little early, and if some pertussis-infected kid coughed on them when they were infants, they would have been at significant risk for death. We live in an area with high vaccination rates, but it was one of my fears back then—all it would take would be one infected toddler. Likewise, I wouldn’t want my kids to be vectors for life-threatening illness.

          • Liz Leyden

            My daughter’s 6-month vaccines had to be delayed because of her surgical schedule. She is caught up now, plus flu shots and RSV prophylaxis (3 shots down, 2 to go!). However, I live in Vermont, which has some of the lowest vaccination rates in the country. Because of her heart problem, there’s a very good chance that a respiratory illness will lead to a hospital stay. If things get bad enough, it would mean an unexpected trip to Boston. We can’t put her in day care for that reason.

            A play group meets walking distance from my house. I want to go *so badly*, but I’m wondering if I should, especially with flu and whooping cough going around.

      • namaste863

        I wholeheartedly agree. I actually came across just this argument on a Facebook group called Stupid Things Anti-Vaxxers Say ( I am extremely passionate about vaccinating). Some bullshit argument about the strong not needing to risk themselves for the weak. I am a Social Worker who works as part of an organ transplant team. My life’s work is working with immune surpressed people. I have twelve names, faces, and life stories of people who are personally put at risk by this fuckery.

        • Guesteleh

          Some bullshit argument about the strong not needing to risk themselves for the weak.
          From graduates of the Ayn Rand School of Heartless Self-Aggrandizment and Justification.

        • me

          I tried searching for that FB group but couldn’t find it 🙁
          Do you by chance have a link to their page? I would love to follow (if only to counteract a lot of the shit that ends up in my feed because of my nutty SIL).

      • Bugsy

        Yep. In the past year, my father was diagnosed with cancer and a friend’s immunocompromised 4-year-old spent time in the ICU for RSV that developed into pneumonia. Two people close to us who could be at risk should my child inadvertently pick up something from an unvaccinated child.

        …and antivaxxers wonder why we keep our kids away from them?

  • Puffin

    Making something socially unacceptable is a great way to make it happen less. Like smoking, drunk driving, driving without a seatbelt or kids in a car seat. These things still happen, but you’ll catch a hell of a lot of flack for it. In fact, it was the fact that smoking is so socially unacceptable that eventually resulted in me quitting since I was pretty ashamed of it, which is entirely the point.

    The human tendency to want to belong has its uses. The problem has been that anti-vax groups have made themselves out to be extra special places where super smart people are so people wanted to belong to that group. But the tide is turning and I agree completely that it is the rejection of those attitudes which will lead to their eventual return to the sidelines.

    • Roadstergal

      “drunk driving, driving without a seatbelt or kids in a car seat”

      It’s interesting that you bring those up, because I’ve seen posters here make good statistical cases that these are less risky choices than home birth. But you would get holy hell for doing the former and a lot of kudos and attagirls for doing the latter. Social pressure is a strong thing.

      • Puffin

        Car seats are my favourite analogy for vaccines. Like infectious disease used to be, car accidents are a major cause of death for young children. Properly used, car seats are safe, effective, and can contribute to the safety of people around the child (not a projectile, less of a distraction.) As car seat technologies and compliance increase, children are safer on the road. There is a small, but non-zero, risk that a car seat may hurt or kill your child even if used properly. The straps may snap, the plastic may give out due to a defect, the locking mechanism may give way, resulting in the child being ejected. The child may be trapped in a sinking/burning car due to the hard-to-open-quickly mechanisms. This is rare, but it happens. There are no parents (that I am aware of) arguing that no one should use car seats because their child died due to one.

        Like vaccines, car seats are the best technology we have to protect our children from something that poses them great danger.

        Like car seats, vaccines should be mandatory for all children unless there is a medical reason that makes them more dangerous to the child than what they protect against.

        • Mishimoo

          Exactly! My friend’s dad was in a car accident where, according to the medical team at the time, he’d have died if he’d been wearing a seatbelt. Does he go around advocating for no seatbelts? Nope, he makes sure that everyone in his car is buckled in properly and are in proper seating. Same with the people I knew that have a kid with a vaccine injury – their son can’t have any more vaccinations, so to try and keep him safe, they are very loudly pro-vax.

      • Young CC Prof

        In 1960, before basically all modern auto safety features, the cumulative risk of motor vehicle death from birth to age 15 was 1 in 800 as per CDC data. That’s rather close to the death rate from measles alone.

  • Lisa C

    It is so true. All one has to do is read some of the threads on baby center’s none / select / delayed vaccines to see how deep the ignorance / foolishness really is.

  • Guesteleh

    I think the Disneyland measles outbreak is doing a lot to turn the tide. Two infants were infected and the spread isn’t over. Only one of the cases so far involves a person who was vaccinated, which I’m sure the crazies will seize on as proof that vaccines don’t work but I think the general public isn’t buying it.

  • Cobalt

    One crazy idiot who is surprisingly quiet about vaccination is The Alpha Parent. What’s up with that?

    • Sarah1035

      She doesn’t want to split her base supporters. In my experience most anti vaxxers are lactivists, but not all lactivists are anti vaxxers. Some latch on (pun intended) to doing EVERYTHING to protect the health of babies including vaccination

      • Cobalt

        She needs called out on her vaccine stance.

        • Sarah1035

          She also needs a moral compass and a sense of compassion.

        • Trixie

          There’s a long list of things TAP needs.

          • Cobalt

            She’s hopeless. But if she has to talk about vaccines, she might shock half her audience into THINKING, which is good for the world as a whole.

  • Cobalt

    “skepticism, which actually means “requiring proof” and not “refusing to believe what experts say.””

    So well said.

    • Stacy48918

      Much like with climate change and other issues, these people aren’t “skeptics”, they are DENIERS.