Wednesday, April 23, 2014

Vaccines: A Tale of Two Articles

I argue with people online about a number of things. There is one debate that I haven't much gotten into, and that's vaccines. Being a public radio addict and a news junkie, I come down on the side of vaccination. Ultimately, the risks of side effects of vaccinations are outweighed by the damage caused by mass anti-vaccination panics stirred up without sufficient evidence.

But two articles posted by Facebook friends of mine deserve some attention and some dissection:
These articles oppose each other but they share some features in common. Both are unabashedly partisan. Both characterize the opposition of being at least partially sponsored by selfish, moneyed, crypto-criminal elements of economy and market forces, preying upon gullible and helpless Americans. Both are reasonably well-sourced, with links to abstracts and citations; and both make quick conclusions about the import of those citations.

Let's start with the McGovern article.

McGovern is writing for a conservative Christian publication, and as a side effect, frequently appeals to conservatives' sense of being embattled and unfairly judged by the rest. Christians are on a "suspect list" because of shrill accusations by the "mainstream media" and a medical establishment of "worn-thin" credibility.

After a summary of medical articles, in a paragraph subheaded "Blind faith," McGovern's essay ends on a conspiratorial note, citing two anecdotes of pharmaceutical company corruption, although neither of these cases were directly relevant to the vaccine question. She implies that if one cannot trust Big Pharma regarding some matters, they cannot be trusted in others. No dispute from me, but of itself that has no bearing on the vaccine connection. On contentious matters, nobody with vested interests should be taken on blind faith. Who ever argued the contrary? It is needlessly rhetorical to accuse your opponents of succumbing to "blind faith".

What about McGovern's sources?  I am not an expert in peer review, so I am going to assume for now that they are trustworthy. Here are the ones she hyperlinks:

The upshot of the abstracts and McGovern's summaries is that aluminum is bad for you, or in the case of the Tomljenovic article ("Death after Quadrivalent") that the combination of aluminum and vaccine particles specifically is harmful. However, I could not uncover data about dosage or aluminum quantities in any of her presented articles.

I don't need to spend as much time on Raff's article in the Huffington Post. It is not meant to be a measured, careful treatise, but rather an accusatory litany of errors (and their peer-reviewed corrections). I only want to focus on the paragraph that would seem to contradict the main thrust of McGovern's article:
They say that the aluminum in vaccines (an adjuvant, or component of the vaccine designed to enhance the body's immune response) is harmful to children. But children consume more aluminum in natural breast milk than they do in vaccines, and far higher levels of aluminum are needed to cause harm.
I preserved the links as they were. However, the third link has an error in it, and it takes the reader to the 10th citation of this 2009 article. That citation had nothing to do with aluminum. Probably, she was referring to this paragraph from the same article:
Sears' main argument for spacing out vaccines is to avoid giving infants too much aluminum at one time, writing, “When a baby gets the first big round of shots at two months, the total dose of aluminum can vary from 295 micrograms… to a whopping 1225 micrograms if the highest aluminum brands are used and a hep B vaccine is also given. … These doses are repeated at four and six months.” Extrapolating studies of patients undergoing hemodialysis and severely premature infants to healthy newborns, Sears claims that these quantities might be unsafe. However, Sears fails to put aluminum exposure in context. By 6 months of age, infants typically ingest ∼6700 μg of aluminum in breast milk, 37800 μg in infant formula, or 116600 μg in soy-based formula. Furthermore, Sears fails to describe scientific studies that led the National Vaccine Program Office to conclude that the amount of aluminum contained in vaccines did not warrant changing the vaccine schedule.
These authors cite a 2003 article, "Addressing Parents’ Concerns: Do Vaccines Contain Harmful Preservatives, Adjuvants, Additives, or Residuals?"  which has an extensive section about aluminum adjuvants, including the quantities used.

The overall conclusion here is that aluminum in itself is not harmful to humans up to a level far exceeding what vaccinations contain. The comparisons to human breast milk are instructive.

Is it possible that the risks indicated by McGovern's article, and the phenomenon of ASIA, are distinct from those addressed by Raff? Raff's sources seem to show conclusively that aluminum is not dangerous below certain quantities. But one might argue that that is not McGovern's point. The research she cites is not so much about the harm caused by aluminum directly, but rather the potential harm caused when aluminum, combined with the vaccine, triggers an autoimmune overreaction.

Assessing Risks

I'm going to come to the very boring conclusion that both authors may valid points, and the risks warned-of by McGovern should not be ignored. But neither should they be coupled with fear-mongering and the language of the culture war.

The reason I don't argue about vaccines is because this topic seems an odd field for a "culture war" battle. What stake do conservatives or Christians have in defeating vaccines? What's the point? Where is the victory? I am not saying we should have "blind faith" in pharmaceutical companies... but neither should we use every scrap of peer-reviewed journals that suggests possible medical risks as proof that vaccines are autism pills. (Note: this is hyperbole. I do not think McGovern believes this).

All in all, the issue of vaccines should be much less controversial than it is. Are there risks? Let's find them out. Are they statistically significant enough to outweigh the benefits of stopping many deadly diseases in their tracks? Show me the numbers. If ASIA poses a real causal link between adjuvants and neurological damage, then it should be investigated--but carefully, dispassionately, and without suspicion.

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