A pervasive theme in quackery (aka “alternative” health) is the notion of the brilliant heretic. Believers argue that science is transformed by brilliant heretics whose fabulous theories are initially rejected, but ultimately accepted as the new orthodoxy.

Alternative health practitioners, with no embarrassment at their own presumption, routinely liken themselves to Galileo and Darwin. Today their brilliant theories of homeopathy, therapeutic touch and “vaccine injuries” are rejected but ultimately they will be acknowledged as truth. As usual, their claim is based on a lack of knowledge about science, and ignorance of history.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Galileo and Darwin were considered heretics by religious leaders, not by other scientists.[/pullquote]

As explained in The Holistic Heresy: Strategies of Ideological Challenge in the Medical Profession by Paul Wolpe, alternative health practitioners believe:

[Alternative health] is the inevitable (or desirable) next step in the history of medicine, and like other heroes of medical history who were initially rejected by the orthodoxy of the day … the [alternative health practitioner] is simply ahead of his time. Innovation is always initially resisted … Holistic heretics portray themselves as mavericks, leaders, with every expectation that soon all of medicine will, by necessity, follow in their footsteps.

It is a breathtaking conceit, and it betrays a profound lack of understanding of the history of science.

1. The conceit rests on the notion that revolutionary ideas are dreamed up by mavericks, but nothing could be further from the truth. Revolutionary scientific ideas are not dreamed up; they are the inevitable result of massive data collection. Galileo did not dream up the idea of a sun-centered solar system. He collected data with his new telescope, data never before available, and the sun-centered solar system was the only theory consistent with the data he had collected.

Similarly, Darwin did not dream up evolution. He collected data during his years of exploration on the Beagle, much of it previously unavailable. A theory of evolution was the only theory consistent with the data that he had collected.

In contrast, belief in alternative health has no basis in scientific fact. It has been dreamed up by its various adherents and practitioners. Far from depending on scientific evidence, it eschews the need for scientific evidence.

2. The notion of the heretical maverick betrays a lack of historical knowledge. Galileo and Darwin were considered heretics by religious leaders, not by other scientists. Their ideas swept across the scientific world precisely because of their explanatory power and the data that they had to back them up.

In the world of science, it was already well established that the orthodoxy could not explain what everyone had observed. Long before Galileo, scientists understood that the Biblical theory of the earth-centered universe did not accord with astronomical evidence. Long before Darwin, fossil discoveries had called into question the Biblical creation story.

Mainstream medical science has been astoundingly successful in both theory and practice. The power of the germ theory of disease or the molecular structure of DNA rests on their ability to explain what we observe, are confirmed by experimental data, and result in highly effective treatments and cure.

In contrast, alternative medicine exists independent of scientific observation. Its theories have poor explanatory power and are directly contradicted by copious scientific evidence. The treatments of alternative health are notoriously ineffective. Although anecdotes abound, scientific studies of “alternative” health treatments have yet to identify a single one that works.

3. New theories may be resisted by older scientists because they upset the orthodoxy, but they are not resisted by the scientific world. That’s the point of peer reviewed scientific journals. Scientists present their evidence, and other scientists decide whether that evidence supports a new theory.

For example, early in my medical career a scientist claimed that ulcers were caused not by acid, but by the H. pylori bacteria. The initial reaction of the medical world was disbelief. However, when doctors saw the data, and when the original studies were quickly reproduced by other scientists, doctors accepted the theory, created treatments based on the discovery and moved on.

In medicine, as in all science, the data comes first, the theory follows. In “alternative” health, the theory exists independent of the evidence, and no one even bothers to collect evidence. The idea that alternative health will ultimately be accepted as true is ludicrous.

The idea that heroic geniuses dream up new scientific theories that are initially rejected but ultimately embraced by other scientists is a fairy tale. It betrays a lack of understanding about how science works, and a lack of knowledge about what actually happened to people like Galileo and Darwin.

Proponents of “alternative” medicine often disagree profoundly on treatment methods. Sick? In pain? Try this homeopathic remedy that contains no active ingredients. Stick needles into acupressure points. Wear magnetic foot pads to pull the toxins out of your body.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Illness is not caused by a weak immune system.[/pullquote]

But on one point all proponents of alternative medicine agree. Since the source of all your troubles is a weak immune system, the key to treating and preventing all illness is “strengthening the immune system.” Indeed, this belief is so widespread, it appears that the only people who don’t subscribe to it are people who actually know something about the immune system, doctors, immunologists, microbiologists, etc. The idea that disease can be treated and prevented by “strengthening the immune system” depends on a profoundly flawed, almost cartoon like, view of the immune system itself.

The immune system is tremendously complicated, involving as it does innate cellular immunity and humoral (antibody) immunity. Multiple poorly understood organs make up the immune system. Anyone actually know what the spleen is for? And how about lymph nodes and bone marrow? Those are also quite complex. It is the interactions of these types of immunity, within the various organs of the immune system and throughout the body that determine whether and how we can fight off disease.

The alternative medicine view of the immune system is cartoon like in its simplicity. The individual components of the system, and their specific functions are never discussed or even mentioned. Too complicated. The cascade of events that occurs when the body’s outer defenses of skin or other tissues are penetrated by a foreign substance is completely ignored. Also, too complicated.

Instead, the immune system is conceptualized as a unitary entity that it either weak or strong. If you get sick, your immune system must be weak. In order to prevent illness, or to treat it once it occurs, you must “strengthen” your immune system. And how do you do that? The way you do everything in alternative medicine: you eat the right foods, and take vitamins and supplements.

But, of course, illness is not caused by a weak immune system. The specific mechanisms of illness depend on the specific causes. One possible cause is a failure of innate cellular immunity to find and destroy bacteria that penetrate the barrier of the skin. Another possible cause is the inability of the humoral (antibody) system to create antibody fast enough to overwhelm a viral invader. Instead, the invader gets a tremendous head start before the body can fight back and the virus overwhelms the host. Yet another factor is the presence or absence of various immune system organs. For example, it is well known that removal of the spleen leaves people particularly vulnerable to infection by the pneumococcus bacteria.

In every case, the disease results from a complex interaction between the disease causing agent and a specific component of the immune system. Moreover, there is no evidence that nutrition, vitamins or supplements can do anything to change the balance in these interactions, since the fundamental problem is not malnutrition, or vitamin or mineral deficiency.

It’s not as though we don’t know what a truly weakened immune system looks like. Chemotherapy (which preferentially kills fast growing cells) and certain disease like AIDS, knock out one or more components of the immune system, rendering people more susceptible to disease. If enough of the immune system is compromised or destroyed, the individual becomes vulnerable to infections that would otherwise be harmless or never occur in the first place.

In addition to ignoring what a weakened immune system looks like, and imagining that nutrition is the source of “strength” of the immune system, advocates of alternative medicine have another naïve belief about the immune system. They appear to think that the immune system can be overwhelmed by too much information. Ignoring the fact that each individual faces hundreds, thousands or more immune challenges each day, alternative medicine afficianados argue that vaccines, particularly those designed to immunize against more than one disease at a time, “overwhelm” the immune system, particularly what they imagine to be the “underdeveloped” immune system of small children.

Ironically, the truth is exactly the opposite. Vaccines are one of the few things, if not the only thing, that can strengthen the immune system by giving it a head start against a microscopic invader. Humoral (antibody) immunity takes time to ramp up if the body has never seen the invader before. It’s as if the body can’t start making weapons until it has already been invaded. Vaccines act like a picture of the enemy. Vaccines allow the body to “see” what the invader looks like before the invasion, and to stockpile weapons for the coming fight. When the assault ultimately occurs (when the person is exposed to the disease), the counterattack can begin without delay, and therefore it is much more likely to be successful.

As a general matter, a detailed understanding of system function is not necessary for lay people to understand what the system does. People do not need to know about all the different clotting factors to understand that blood should clot when you are cut and that something is wrong if it doesn’t clot. No one would invoke the idea of a “weak” clotting system to explain why a hemophiliac is bleeding to death, and no one would recommend eating the right foods, or taking vitamins or supplements to treat hemophilia.

Unfortunately, a detailed understanding of the immune system has been replaced with a cartoon like caricature of the immune system, leading lay people to believe that it is either weak or strong, and that it can be strengthened by eating right. It is this cartoon like view that makes lay people vulnerable to the claims of alternative medicine practitioners and, therefore, this cartoon like view must be changed.

This piece first appeared in December 2009.

More babies die of infection at homebirth than at hospital birth.

Surprised?

Homebirth advocates often insist that homebirth is beneficial because it avoids exposing babies to infections. That claim always made little sense on its face since the major infectious causes of neonatal death, group B streptococcus and herpes, are found in the mother’s vagina. Now a new paper by Grunebaum et al. confirms that the high death rate at American homebirth includes an increased risk of death from infections that would have been easily prevented or treated at the hospital.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Homebirth increases the risk of neonatal death from infection.[/pullquote]

The paper is Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States.

The authors note:

Midwife-attended home births in the United States (US) are associated with an increase in adverse neonatal out-comes such as a higher incidence of neonatal mortality (NNM), Apgar score of 0 at 5 min, and neonatal seizures or serious neurologic dysfunction, but the causes for the increase in NNM in home birth have not been reported previously. The objective of this study was to evaluate the underlying causes of NNM in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the US.

What did they find?

Overall, the midwife-attended home births had the highest rate of neonatal deaths (122/95,657 NNM 12.75/10,000; RR: 3.6 (95% CI 3–4.4), followed by hospital physician births (8,695/14,447,355 NNM 6.02/10,000; RR: 1.7 95% CI 1.6–1.9) and hospital midwife births (480/1,363,199 NNM 3.52/10,000 RR: 1)…

Among midwife-assisted home births, underlying causes attributed to labor and delivery caused 39.3% (48/122) of neonatal deaths (RR: 13.4; 95% CI 9–19.9) followed by 29.5% due to congenital anomalies (RR: 2.5; 95% CI 1.8–3.6), and 12.3% due to infections (RR: 4.5; 95% CI 2.5–8.1).

By and large, labor and delivery issues refer to oxygen deprivation from a variety of different sources: inability to perform a timely C-section through inability to perform an expert neonatal resuscitation. It’s only to be expected that most of the deaths at homebirth are attributed to not being at a hospital.

Congenital anomalies as a cause of death is also an expected finding since that is the major cause of death for term babies in hospitals.

But the fact that infection is the 3rd leading cause of death at homebirth thoroughly debunks the claim of many homebirth advocates that a key benefit of homebirth is avoiding infections. You don’t avoid neonatal infections by giving birth at home because the infectious agents are in the mother’s vagina, not the hospital environment. The difference in infectious deaths at home vs. the hospital is because hospitals prevent infections by prophylactic antibiotics for group B strep and elective C-sections for active herpes.

The results are represented by this graph:

The authors conclude:

Our study shows that the significantly increased risks of neonatal deaths among midwife-attended home births are associated with three underlying causes: labor and delivery issues, infections, and fetal malformations. Each of these underlying causes was significantly increased when compared to midwife-attended hospital births.

The hospital NNM in our study is similar to the NNM reported for 2010 in the US by Matthews and Mac-
Dorman. This study’s significantly elevated term NNM of 12.75/10,000 births for home births confirms
the increased neonatal mortality risks reported among midwife-attended home births by other US home birth studies: Cheyney et al. reported a NNM of 12.3/10,000 from 2004 to 2009 and Grunebaum et  al. reported a term NNM for home births of 12.6/10,000 from 2006 to 2009.

They note that homebirth is much more dangerous in the US than in other industrialized countries:

Other studies on homebirth outcomes such as studies from the Netherlands, Ontario and British Columbia, where homebirths are well integrated in the health system, found no increased risk of adverse perinatal outcomes for planned home births among low-risk women …

American homebirth midwives (CPMs and LMs) lack the education and training of all other midwives in the industrialized world including US certified nurse midwives (CNMs) and midwives in the Netherlands, the UK, Canada, Australia, etc.

American homebirth kills babies. Avoiding the hospital doesn’t merely increase the risk of a baby dying from oxygen deprivation; it also increases the risk of a baby dying of infection.

Some people are willing to suffer for their medical delusions. They refuse conventional medical treatment and that is their right.

Some people are willing to let their children suffer for their medical delusions. That’s child abuse.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]No mother has the right to make her child suffer for her medical delusions.[/pullquote]

How much to those children suffer?

Last year I wrote about Heather Dexter, the mother who boasted about her children’s near deaths from pertussis, whooping cough.

It’s not surprising that Dexter’s children got pertussis. It’s a relatively common bacteria that causes mild illness among older children and adults. It can be deadly to infants and small children and killed many before the advent of vaccines. Now it’s made a comeback and threatening children because their parents are in the grip of a medical delusion that vaccines, one of the greatest public health achievements of all time, are purportedly harmful.

And now courtesy of a different mother, Genna Graham Stead, tetanus is back. According to the mother’s GoFundMe page:

“Remy” is a 9 year old sweet and caring girl … She contracted tetanus, her case is a medical anomaly, she had no wounds, scratches or injuries of any kind. Initially, she was misdiagnosed with TMJ and tetanus was dismissed by 5 other doctors, before finally there was a confirmed diagnosis by the pediatric infectious disease specialist. Tetanus cannot be tested for, it is a clinical diagnosis and with its rarity and only showing minimal symptoms it was difficult to properly diagnose.

No, Remy is NOT a medical anomaly. Everyone is routinely vaccinated against tentanus, with boosters every ten years in adulthood PRECISELY because everyone is at risk of exposure at all times. Chlostridium tetani, the bacteria that causes tetanus, lives in the soil. Although tetanus is typically associated with puncture wounds, the bacteria can get into the body from abrasions that are too small to see.

Early tetanus is a difficult diagnosis in the best of times; it’s made even more difficult by the fact that most doctors have never seen a case of tetanus. It was nearly non-existent before parents were gripped by vaccine delusions. That’s why when Remy developed “lockjaw,” she was thought to have TMJ, joint pain in her jaw.

Tetanus is a terrible disease.

Tetanus … is an infection characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. These spasms usually last a few minutes each time and occur frequently for three to four weeks.Spasms may be so severe that bone fractures may occur.Other symptoms may include fever, sweating, headache, trouble swallowing, high blood pressure, and a fast heart rate. Onset of symptoms is typically three to twenty-one days following infection. It may take months to recover. About 10% of those infected die.

Remy’s suffering is intense. She is awake but paralyzed.

Remy is on a ventilator to control her breathing, as the muscle spasms can restrict her airway. She is in a twilight paralyzed state, she is conscious and can hear everyone around her. She can squeeze our hand to answer questions and nod yes or no. The spasms are triggered by bright light, loud talking or excitement so she wears an eyemask and earplugs to subside the surroundings. She has a “projection” of 6 weeks in this state depending upon the control of the muscle spasms. When the doctors determine they can wean her off of the sedation, they will determine if she is still having the muscle spasms, if she is not then we can remove the ventilator and proceed with recovery and rehabilitation.

And that’s just the acute phase of the illness. She will probably need 6 months of rehabilitation to fully recover.

How is Remy being treated?

The treatment is extensive, they administer Tetanus Immune Globulin to isolate the toxin …

In other words, Remy is receiving antibiodies made by someone else; she can’t make enough of her own antibiodies fast enough because her mother wouldn’t allow her to get the tetanus vaccine. So much for natural immunity.

Her stepmother is furious.

…[I]f she would have been vaccinated like we asked and we’re battling you on she wouldn’t be in this position. None of us would. Now her father who has a 5 day old baby has to make a decision on whether he sits in the hospital and watches his precious, innocent daughter suffer a preventable disease or be at home helping his wife and bonding with his brand new baby… I’m devastated for my husband and step daughter. Yet you haven’t even shown any remorse and declined the vaccine they recommended as part of this treatment. Sorry but people need to know the truth. Yes Remy is the main focus here and we want to get her better. Thanks for everyone’s prayers. She’s in God’s hands which is the best place to be. We love you Remy. ❤❤

Anti-vaccine advocacy is a form of child abuse. Ignorant adults suffering from the delusion that they are “educated” about vacciness deprive their children of basic health care and those children suffer and die as a result.

There should be no exemptions for vaccination of children except if the children themselves have a medical contraindication. No mother has the right to make her child suffer for her delusions.

Like most sanctimommies, Jen Kamel of VBAC Facts is ostentatiously suffering from sadness:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]There’s a sucker born — hopefully vaginally —every minute.[/pullquote]

It breaks my heart when I hear of a first time mom having a cesarean at 9cm simply because she went two hours without cervical change. Such a waste…

Kamel follows with a parade of horribles, including:

Will she have an easy recovery?

Does she have friends and family to support her emotionally, physically, and maybe bring her a warm meal?

Will she mourn her cesarean? If so, will she stuff those feelings deep down because, as she is told over and over, it doesn’t matter how the baby gets here?

Will her partner be a safe place or will they, too, tell her it was “for the best?” …

Kamel is grooming women to believe that a C-section means they are defective. To wit:

Will she believe her body is broken? …

Kamel hopes so, because she plans to profit from women’s despair.

You can mitigate your sad fate by simply sending Kamel $330 — 3 easy payments of $110/no refunds — for Kamel’s insights about VBAC at VBACFacts Academy, Kamel’s version of Trump University.

It’s Marketing 101: convince people that they have a problem they didn’t know they had, then sell them the “solution.”

Who is Kamel and why would you care about what she thinks? As far as I can determine, Kamel’s professional education and experience is limited to commercial real estate. She has no medical, nursing or midwifery training. She’s cared for ZERO pregnant women; she’s delivered ZERO babies.

Kamel comes from the “Seen on TV” school of marketing:

Kamen apparently thinks her potential clients are morons. A  PDF of her slides is worth $30? Her handouts are worth $60? Membership in her Facebook group is worth $100? They are worth nothing because the exact same “insights” are available FOR FREE on any natural childbirth website including VBAC Facts itself.

I bet I can save you the $330 by summarizing the entire 6 hour video series in a few sentences:

Kamel believes vaginal births are best. If you had a C-section it was unnecessary. Regardless of your personal health history you are an ideal candidate for a VBAC. Ignore anyone who tells you otherwise.

In other words, VBAC Facts Academy is a scam on par with Trump University.

Who’s foolish enough to pay for this crap? Beats me.

Like hucksters everywhere, Kamel seems be channeling the ultimate huckster, PT Barnum. Her motto appears to be:

There’s a sucker born — hopefully vaginally —every minute.

If there’s one thing that anti-vaxxers are sure about it’s that natural immunity is better than vaccine induced immunity.

They’re wrong. Claiming that natural immunity is better than vaccine immunity is like claiming that walking to San Francisco from Boston is better than traveling by airplane. Yes, if you walk you can be sure you won’t be in a plane crash, but the odds are extremely high that you would never get to San Francisco.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Vaccination produces immunity faster and far more safely.[/pullquote]

What’s wrong with natural immunity?

Visit any cemetary from the pre-vaccine age; it’s filled with people who died precisely because natural immunity couldn’t save them. Pre-vaccine cemetaries are filled with people who died of influenza, of diphtheria, of measles, of tetanus, of pertussis. But they’re also filled with people who died simply because they got a minor cut that became infected and, in the absence of antibiotics, the infection continued to spread unimpeded until it entered the bloodstream (sepsis) and killed the unfortunate individual. Natural immunity couldn’t save them.

Consider the Black Death. Literally 2 out of 3 people died because natural immunity could not save them.

Consider the leading causes of death in the US in 1900. Pneumonia and influenza led the list; tuberculosis was second, diarrhea and enteritis were third. Diphtheria was tenth.

Today, pneumonia and tuberculosis can be treated with antibiotics and influenza, infant diarrhea and diphtheria can be prevented by vaccines.

The situation for children was even more dire.

Life expectancy around 1888 was less than 50 years, infant mortality approached 200 per 1000 births, and neonatal mortality was about 50 per 1000 births. The infant mortality rate in 1880 in New York City, a particularly crowded urban area, was as high as 288 per 1000 live-born infants, primarily related to various infectious processes. Infectious diseases such as diarrhea, diphtheria, scarlet fever and tuberculosis dominated as the major causes of morbidity and mortality among children…

But wait, you say: didn’t basic sanitation measure contribute to a decrease in mortality from infectious diseases? Of course they did, but that’s just another acknowledgement that natural immunity was insufficient; preventing exposure in the first place — NOT natural immunity — was the best way to save lives.

Why is vaccine induced immunity so much better than natural immunity? For the same reason that taking a plane to San Francisco is better than walking: it’s faster, safer and far more convenient.

Speed is the key advantage. Individuals who have been vaccinated can produce an immune response much faster than those who must wait for natural immunity to develop.

We’re not born with natural immunity; we make antibodies in response to a threat. For example, we are not born with antibodies to the chickenpox (varicella) virus. When exposed to the varicella virus, though, we can learn to make antibodies to it. It takes time, but gradually we can produce enough antibodies to fend off the disease.

Unfortunately, we don’t always get the time we need. We can make antibodies to smallpox, for example, but many individuals are overwhelmed and killed by the virus long before they could make enough antibodies to fend it off. Those who do win the race and manage to produce enough antibodies to survive are now permanently protected. That’s because the immune system retains the ability to make the specific antibodies against the smallpox virus. Whereas it may take days to produce smallpox antibody when first exposed, a second exposure will be met with rapid and massive production of antibody, generally preventing the individual from getting sick at all.

So for natural immunity to work, you have to get the disease, and you might die before you are able to make enough antibody to protect yourself. What if you could learn to make the protective antibodies without actually getting sick? That’s the theory behind vaccines.

In order to make antibodies to a virus (or bacterium) the body needs to “see” the virus. In other words, it needs to have direct exposure to the virus, but that virus doesn’t have to be functional, and it doesn’t even have to be whole. A virus can be inactivated (live attenuated) or killed and still produce an immune response. It can also be broken down into its constituent parts and the parts can produce an immune response. Any future exposure to the live virus (though contact with others who have the disease) will be met with rapid and massive production of antibody, preventing the individual from getting sick at all. A vaccine is merely an inactivated or dead form of the virus, letting you learn to make antibody without getting sick in the process.

Vaccines do not produce perfect immunity. The dangerous part of the virus might be the part that evokes the most powerful immune response. Rendering the virus harmless by inactivating it, killing it or breaking it up, may remove that part and the immune response to the less dangerous parts might be weaker. So actually getting the disease may produce a better immune response than the vaccine … but ONLY if you survive the disease.

Natural immunity is great in the same way that walking across the country is great. Theoretically everyone could walk across the country, but in reality most people cannot. Theoretically natural immunity can protect people from infectious diseases, but in reality it often cannot. Of course vaccines have risks just like airplane flight has risks, but the risks are minuscule and the benefits are enormous.

Natural immunity is very important, but rather imperfect. Vaccine immunity is better. As with airplane flight vs. walking, you end up in the same place, but you are far more likely to get where you want to be (immune and alive) and you get there much faster.

There’s often a lot of backlash to my posts, but the recent post, Vaccination is far more baby friendly than breastfeeding, has drawn a particularly vituperative response.

Consider this tweet from Amandha Dawn Vollmer:

Dr. Amy Tuteur is a well know [sic] evil CUNT that continuously promotes the satanic medical agenda …

Apparently both anti-vaxxers and lactivists are experiencing such profound distress in the form of cognitive dissonance that their heads are exploding.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Coming face to face with the fact that vaccines save far more lives than breastfeeding ever could is mentally excruciating.[/pullquote]

What is cognitive dissonance?

Leon Festinger proposed cognitive dissonance theory, which states that a powerful motive to maintain cognitive consistency can give rise to irrational and sometimes maladaptive behavior.

According to Festinger, we hold many cognitions about the world and ourselves; when they clash, a discrepancy is evoked, resulting in a state of tension known as cognitive dissonance. As the experience of dissonance is unpleasant, we are motivated to reduce or eliminate it, and achieve consonance (i.e. agreement).

Why are anti-vaxxers and lactivists wrestling with such profound cognitive dissonance over the fact that vaccines have far greater health benefits than breastfeeding? It’s because anti-vaxxers and lactivists often share beliefs. They are 100% certain both that vaccines are dangerous and that breastmilk is magically protective.

Coming face to face with the fact that vaccines have saved far more lives than breastfeeding ever could is mentally excruciating.

Although there are some who believe (without any scientific or historical evidence) that vaccines don’t work, the majority of anti-vaxxers acknowledge that vaccines work to save lives from vaccine preventable diseases (VPDs). They assert that the risks of vaccines outweigh the benefits of vaccines. That’s because they fabricate and grossly exaggerate the risks of vaccines and they minimize the benefits on the theory that if they haven’t seen diphtheria/pertussis/polio/etc. then diphtheria/pertussis/polio/etc. are no longer a threat to health.

Most anti-vaxxers extoll the benefits of breastfeeding for “strengthening immunity” and thereby preventing the same diseases that vaccines prevent. They often see breastfeeding as a substitute for vaccination, failing to understand that most maternal antibodies to vaccine preventable diseases are ImmunoglobulinG (IgG) antibodies and are too large to pass in breastmilk. Not only are vaccines better at preventing VPDs, breastfeeding literally CANNOT prevent against most VPDs.

Moreover, most anti-vaxxers believe that breastfeeding should be promoted with all possible public health measures, up to and including pressuring and shaming women into breastfeeding. They view women who can’t or choose not to breastfeed as selfish, ignorant and lazy. If that’s true, and the benefits of vaccination are greater than the benefits of breastfeeding, that makes anti-vaxxers even more selfish, ignorant and lazy, a simply intolerable thought.

Lactivists come at this issue from a slightly different angle. They, too, believe that the benefits of breastfeeding require public health measures to promote breastfeeding by pressure and shaming. That’s why they strongly support The Baby Friendly Hospital Initiative, which is designed to do just that. But if vaccination has far greater benefits than breastfeeding, their efforts are misplaced. Instead of pressuring women about breastfeeding, we should be pressuring them about vaccination.

In addition, a substantial proportion of lactivists are anti-vaxxers, making the cognitive dissonance particularly debilitating.

That explains the vociferous response accusing me not merely of being empirically wrong but insisting that I am being satanically evil. I have made them feel bad and foolish about their core beliefs regarding vaccination and breastfeeding by showing them how truly incompatible they are with each other.

And that makes me very happy indeed!

What does it mean to be educated in a particular discipline?

Whether that discipline is architecture, anthropology, or law, being educated generally means years of study, thousands of hours of experience, and intimate acquaintance with the specialist literature.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]When a layperson claims to be “educated” about vaccines you can be sure that a stream of absolute nonsense will follow.[/pullquote]

Medicine is like that, too. It involves four years of college, four years of medical school, 3-5 years of hands on training for 80+ hours per week, countless textbooks and intimate knowledge of the relevant medical literature. No layperson is educated in medicine. A PhD in immunology or a related science involves four years of college, 5 years of postgraduate work, a dissertation and intimate knowledge of the relevant scientific literature. No layperson is educated in immunology. The idea is simply ludicrous.

When a lay person proudly and arrogantly claims to be “educated” about vaccination, she certainly doesn’t mean that she went to medical school or graduate school, has hands on experience caring for thousands who have been vaccinated and unvaccinated, or has read the immunology literature.

So what does she mean?

She means that she has adopted a cultural construction of “education” that has little if anything to do with actual knowledge of the topic. It means that she has ignored those who have actual education and training and crowd sourced her decisions by reading books, blogs, websites and message boards written by other lay people who are often equally ignorant.

Why have anti-vaxxers confused defiance for education?

The paper ‘Trusting blindly can be the biggest risk of all’: organised resistance to childhood vaccination in the UK explores cultural construct of being “educated.” When an anti-vax advocate claims to be “educated,” she is not talking about actual scientific knowledge. Rather she is referring to her defiance of professionals are educated.

Clear dichotomies are constructed between blind faith and active resistance and uncritical following and critical thinking. Non-vaccinators or those who question aspects of vaccination policy are not described in terms of class, gender, location or politics, but are ‘free thinkers’ who have escaped from the disempowerment that is seen to characterise vaccination…

This characterization of anti-vaxxers can be unpacked even further; not surprisingly, anti-vax advocates portray themselves laudatory and other parents as fools and “sheeple.”

…[I]nstead of good and bad parent categories being a function of compliance or non-compliance with vaccination advice … the good parent becomes one who spends the time to become informed and educated about vaccination…

…[Anti-vaxxers] construct trust in others as passive and the easy option. Rather than trust in experts, the alternative scenario is of a parent who becomes the expert themselves, through a difficult process of personal education and empowerment…

In the anti-vax world, trusting experts is a mark of credulity, while ignoring expert advice is a sign of independent thinking and self-education. But, of course, since anti-vaxxers don’t really know anything about the topic, they are inevitably forced to rely on the advice of charlatans and quacks.

The person who proudly claims to be “educated” on vaccination offers as proof the fact that she ignores the expert advice of pediatricians, immunologists and virologists and embraces the teachings of … washed up Playboy Playmate Jennifer McCarthy. In her delusion, she fail to appreciate the irony: far from being “educated,” she is shockingly credulous. Consistent with the Dunning-Kruger effect (described in the aptly named paper Unskilled and Unaware of It: How Difficulties in Recognizing One’s Own Incompetence Lead to Inflated Self-Assessments), the anti-vaxxers who think they know the most about vaccines actually know the least.

If the goal of being “educated” isn’t acquiring knowledge, what is it? The ultimate goal is to become “empowered”:

Finally, the moral imperative to become informed is part of a broader shift, evident in the new public health, for which some kind of empowerment, personal responsibility and participation are expressed in highly positive terms.

So anti-vax is about the parent and how she would like to see herself, not about immunology, medicine or public health. In the socially constructed world of anti-vaccine advocates, parents are divided into those (inferior) “sheeple” who are passive and blindly trust authority figures and (superior) anti-vaxxers who are “educated” and “empowered” by taking “personal responsibility”.

A lay person’s claims to be “educated” about a health topic is nothing more than defiance. When someone tells you she is “educated” about vaccines, beware! There is no surer mark of ignorance on the topic of vaccines than the arrogant claim of being “educated.”

Adapted from a piece that first appeared in August 2009.

There’s a simple thing that every mother can do to keep her baby as healthy as possible. That’s why we should have a ten step hospital based program to support it.

No, it’s not breastfeeding; it’s vaccination, which saves a thousand times more lives in practice than breastfeeding ever could in theory.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]No mother would refuse to vaccinate if she only understood the benefits and got the proper support.[/pullquote]

Therefore, it is a thousand times more important to promote vaccination than to promote breastfeeding. No mother would refuse to do it if she only understood the benefits and got the proper support. That’s why I propose an immediate overhaul of the Baby Friendly Hospital Initiative to promote vaccination instead of breastfeeding.

The Ten Steps to Successful Vaccination are:

1. Have a written vaccination policy that is routinely communicated to all health care staff.
2. Train all health care staff in the skills necessary to implement this policy.
3. Inform all pregnant women about the benefits of vaccination.
4. Insist that every mother sign a vaccine contract that emphasizes that anything other than full vaccination on the CDC schedule threatens baby’s health.
5. Mandate frequent visits by a vaccination consultant to provide constant support for vaccination.
6. Help mothers initiate all recommended injections within one hour of birth.
7. Show mothers how to obtain vaccinations even if they are separated from their infants.
8. Accept no refusal to vaccinate unless medically indicated.
9. Encourage vaccination on demand by the pediatrician.
10. Foster the establishment of vaccination support groups and refer mothers to them on discharge from the hospital or birth center.

Wait, what? Some mothers think there are legitimate reasons not to vaccinate their babies? There are no legitimate reasons; it’s just a sign that they haven’t received enough vaccination support from hospital personnel, their peers and society at large.

Wait, what? Some mothers think that vaccination harms their infants? Who cares what they think? Public health officials have spoken on the issue of vaccination and mother’s observations of their own infants are irrelevant.

Wait, what? Some mothers think this is an issue of personal freedom? It most certainly is not. Vaccinating a child does not simply protect that child, but it provides a measurable benefit to society.

Lack of peer support for vaccination is a serious problem in and of itself. There are webpages and Facebook groups that encourage parents not to vaccinate or to diverge from the CDC schedule. Such webpages and Facebook groups must be ruthlessly suppressed along with public shaming of anyone who doesn’t support routine childhood vaccination.

Let’s face it: those who vaccinate according to the CDC schedule love their children more than those who do not. Only a lazy, selfish mother would listen to anti-vaccine quacks instead of the CDC.

I even have a motto for the NEW Baby Friendly Hospital Initiative:

Breastfed Is Good,
Fed Is Better, but
Vaccinated is BEST!

Why waste time promoting breastfeeding when we could be promoting vaccination and saving far more lives?

Anti-vaxxers don’t know much about vaccines. Even worse, they don’t know much about chemistry and biochemistry, which means that they can’t understand why they are so wrong about even their simplest claims.

Consider their erroneous claims about the “neurotoxins” in vaccines including mercury and aluminum. Those claims are based on confusion about the most basic distinction in chemistry, the difference between an element and a compound.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The characteristics water are very different from the characteristics of its two elements hydrogen and oxygen.[/pullquote]

What’s the difference between an element and a compound and why does it matter?

Elements are the building block of all matter in the universe. Each element consists of only one kind of atom.

What’s an atom?

You’ve probably seen a picture like this before.

It shows the structure of an atom. Protons and neutrons are located in the center and electrons orbit around the center. The number of protons in the center determines the identity of the element. All atoms with one proton are elemental hydrogen; all atoms with two protons are elemental helium; and so on.

All the known elements are listed in the periodic table of the elements, in order of the number of protons.

Why are the elements arranged in this way? It’s because elements in each vertical row share important characteristics in how they combine with other elements to form compounds.

What’s a compound?

A compound consists of atoms of two or more different elements joined together and has properties that are different from its component elements.

A compound is different from a mixture. I can make a mixture of two gasses, hydrogen and oxygen. The hydrogen and oxygen are not connected with each other and the hydrogen atoms and oxygen atoms will retain their distinct characteristics.

If I introduce a spark to the mixture a chemical reaction will occur: hydrogen atoms will bind with oxygen atoms to form a compound, H2O or water. Although water is made up of hydrogen and oxygen, it no longer has the properties of either hydrogen or oxygen. For example, you couldn’t possibly breathe water and survive, even though water contains large amounts of oxygen. The characteristics of the compound water are different from the characteristics of its two elements hydrogen and oxygen.

But that’s not all. Other compounds can be made from the same elements hydrogen and oxygen. Hydrogen peroxide has the chemical formula H2O2. Though hydrogen and oxygen are gasses, peroxide, like water, is a liquid, but it’s a very different liquid from water. You don’t need to be a chemist to tell the difference between washing out a cut with water and washing it out with hydrogen peroxide.

So the elements hydrogen and oxygen have distinct properties but compounds made from them have very different properties from their constituent elements and from each other depending on the ratio of the elements within them.

An even more dramatic example of this principle is table salt. Salt is the compound NaCl, sodium chloride. Sodium is explosive and chlorine gas is poisonous. Either can cause serious harm or death, yet it’s difficult to imagine a less dangerous substance than table salt, a compound of dangerous elemental sodium and dangerous elemental chlorine.

What does this have to do with vaccine safety?

The principle that we’ve just explored, that compounds have very different characteristics than their constituent elements, has critical implications for anti-vax claims. Anti-vaxxers point out correctly that elemental mercury and elemental aluminum are neurotoxins. But that tells us NOTHING about whether mercury compounds and aluminum compounds are harmful or safe. Indeed, the mercury compounds that used to be present in vaccines (and are still present in some flu vaccines) and aluminum compounds in vaccines are quite safe even though mercury and aluminum are not.

This is obvious to anyone who understands basic chemistry, but can be quite mystifying to those who don’t.

Insisting that vaccines contain neurotoxins because they contain mercury or aluminum compounds is like insisting that you can breathe water because it is an oxygen compound. It’s not merely a reasoning error; it’s a sign of ignorance.