Archive for the ‘vaccination’ Category
A coronavirus update: new variants
Everyone wearing a mask in this Tokyo airport, but still there are lots of problems, and lots of travellers
So there’s much concern about new variants of the SARS-CoV2 virus, one from the UK, now known as the Kent variant, and one from South Africa. My main source of info on this will be the SGU podcast 809, from January 6.
The Kent strain is more infectious than the original, by 50-60%, though not more deadly. However its infectiousness is fast making it the more dominant strain. The South African variant, though, is causing most concern, as virologists are uncertain about its response to the vaccines now available. It has some of the same mutations that are in the Kent variant, making it also more infectious, but it also has mutations that allow it to evade antibodies targeting previous variants. This won’t make the variant immune to the vaccine, but it will make the vaccine less effective, though exactly how much less effective is the big question currently.
Another major concern is that this new variant can infect people who’ve already contracted and recovered from the virus. As Dr Steven Novella and others on the podcast argue (and this quote is ‘tidied up’ from direct speech):
This is the result of allowing a pandemic to simmer along over time. Mutations are inevitable, though different viruses mutate at different rates. SARS-CoV2 has error-correction mechanisms when it replicates, so that’s why it mutates more slowly. But if an infection in an individual, or an epidemic, lingers long enough, you’ll still get mutations. Part of the problem is that, with so many people infected, for so long, there are a great number of opportunities for new variants to arise. There are thousands of roughly equivalent variants, which are neutral or inconsequential in effect, but now we have two variants that are more mutated, and more consequential. They have a suite of mutations that seem to have developed much faster than the background mutation rate of the virus. It’s thought that this is because in individual patients who’d had the infection for months and were being treated during that time, the increased selective pressure on the virus may have caused this suite of mutations to be formed. This kind of mutation rate has been shown in the lab with respect to antibiotic resistance in bacteria.
The point here for the future is to get to a level of herd immunity through vaccination. Considering that new strains arise regularly, as with the flu (and we don’t yet know how regularly this will happen with SARS-CoV-2), it may be that the vaccine will have to be tweaked regularly to cover these new strains. Time will tell, and of course we don’t yet know how effective the new vaccines will be against these current major variants. In fact we don’t know for sure how long the vaccines, or the antibodies they create, will be effective, regardless of these variants. But mRNA vaccines can apparently be produced, and tweaked, quite quickly, once the variant’s RNA is sequenced.
All of this tells us that the science is generally on top of this. The major problem is political, and social. Trying to get people to do the right thing, to wear a mask, physically distance, avoid large indoor gatherings and to get vaccinated when the vaccine becomes available. This is easier in some regions of the world than in others, and the problems ranges from distrust or ignorance of modern science, to conspiratorial thinking, to rights over responsibilities, to cultures of compliance and non-compliance. Humans are delightfully diverse, or just a mess, and the WHO warns us that this may not be ‘the big one’ in pandemic terms. The year 2021 will not see the end of all this – far from it.
Stop press – a new variant has just been found in Japan in four travellers from Brazil, the Sydney Morning Herald reports. Twelve mutations have been identified, one of which is shared by the UK and South African strains, suggesting a higher infection rate. The travellers are in quarantine in Tokyo airport. Due to a steep rise in cases, a state of emergency has been declared for Tokyo and surrounding prefectures. And so it goes.
Reference
no jab no pay starts now
actually, a fairly unsystematic campaign to protect kids, often from their own parents
Jacinta: I believe the federal government is bringing in new rules penalising parents who choose not to vaccinate their children. Do you know the details, and how do you think the anti-vaccination movement, which is quite strong in Australia, is going to react?
Canto: Well, first I’ll note that when looking up this issue on the net I found a disproportionate number of anti-vaccination or ‘vaccination skeptic’ sites cropping up on Google. It’s very disheartening that the ‘AVN‘, formally deceitfully titled the Australian Vaccination Network, now forced by law to call itself the Australian Vaccination-skeptics Network, comes up first all the time. Other depressing sites that come up include nocompulsoryvaccination and ‘natural society‘. These appear to be US sites promoting the ‘nature is better’ fallacy or some dubious form of libertarianism, and I suppose they have ways of maintaining a high internet profile.
Jacinta: Well, this is the thing, they have a ’cause’ to rally around, whereas the immunologists and doctors who know the science don’t see what the fuss is about, and just assume that everybody respects scientific methods and results. Which is obviously far from the case.
Canto: Well anyway yes the federal government, and the Victorian state government, have created bills to better enforce vaccination, and the Australian government’s measure came into force on January 1. Child care payments and family tax benefit part A supplement will only be paid for children who’ve been immunised or have an approved immunisation exemption.
Jacinta: So, can you get an exemption easily, due to your firm belief that vaccinations cause diabetes, or autism or whatever?
Canto: Only on religious grounds.
Jacinta: Ahh, but can’t the refuseniks claim to be religious, since they have very strong beliefs based on no evidence?
Canto: Ha, well, I’m sure they’ll try. And actually I think it’s going to be difficult for the government to enforce this one.
Jacinta: Why should it be? Surely they have immunisation records through Medicare, it would be easy enough to check.
Canto: And what if the child spent the first few years of life overseas? And what if a parent insists the child was immunised but there’s no record?
Jacinta: Mmmm, I think these are minor difficulties, and I belief it has a support level of over 80%.
Canto: Yes so we’ll have to wait and see what plans the AVN have to try and sabotage it. Other state governments, in Victoria, Queensland and possibly elsewhere, are introducing measures in harmony with this, so it does seem to deal a serious blow to the refuseniks. And of course it’s hoped, or expected, that it’ll bounce the fence-sitters off the fence and so increase community immunity.
Jacinta: And that reminds me, I was reading somewhere about anti-vaccination hotspots. Any info on that?
Canto: Well yes, they’re the places to look to for trouble. The low-down on all that can be found at this slightly unlikely source, Mamamia, an entertainment and lifestyle website – and good on them. It also has a graphic from the Department of Health that reveals the alarming rise in ‘conscientious objectors’ to vaccination in Australia over the last 15 years, from 4000-odd in 1999 to over 36,000 in 2013.
Jacinta: So does it mention anywhere in South Australia?
Canto: Yes, and I’ve noticed that these hotspots are often in quite affluent regions…
Jacinta: Depressing.
Canto: Yes, the Adelaide Hills region, which I would think is generally quite affluent, has one of the highest objection rates, with 86% of children under 5 vaccinated compared with the state average of 91.5%. But then they say that many other areas are under 85%, including Port Adelaide, Holdfast Bay – that’s the Glenelg region, and Playford. So a mix of semi-affluent and relatively disadvantaged regions. Hard to make sense of it, but I think there’s a distinction to made here between the refuseniks and those who just don’t get round to vaccinating their kids.
Jacinta: Right, and that wouldn’t necessarily come out in the data.
Canto: Yes, some are slackers and some are refuseniks.
Jacinta: And some might be fence-sitters who might be spurred into getting their kids vaccinated by this stick approach.
Canto: Yeah we’ll have to wait and see whether the unvaccinated numbers go down over the next few years.
Jacinta: Which makes me wonder, how do they know that those figures you quoted before – some 36,000 – were ‘conscientious objectors’?
Canto: Well they probably don’t for sure, but it’s highly unlikely that those numbers have gone up by almost a factor of 10 in fifteen years due to sheer complacency. I mean, is it plausible that in the last 15 years or so we’ve become 10 times more slack as a nation about our children’s health? No, there’s something much more disturbing going on. Mamamia quotes a Melbourne virologist, who claims that in some pockets of the nation our immunisation rates are lower than South Sudan.
Jacinta: Oh well done. I’m guessing they enforce vaccination in South Sudan, or I might be suffering from the delusion that most African governments are brutal dictatorships. Anyway, what are the biggest or worst hotspots nationally? I’m thinking Nimbin.
Canto: Yes, that area – Nimbin, Byron Bay, Mullumbimby, that whole northern New South Wales coastal area has vaccination rates down between 60% and 70%. Mullumbimby is the town with the highest objection rate in Australia, and the lowest immunisation rate, at under 50%. Steiner schools are popular in this region, unsurprisingly, and they’re openly promoting refusenik behaviour. But there are many other problem regions, such as Queensland’s Gold Coast and Sunshine coast. Noosa on the Sunshine coast also has very high objection rates.
Jacinta: These are quite wealthy areas I suppose. Any idea why this is happening?
Canto: Well, I can only speculate, but I think, with wealthy people, there’s a greater degree of resistance to government measures, obviously in the case of taxation, but also with health matters. They’re rich, they’re healthy, they feel they’re already immune, and that if they just maintain a healthy lifestyle they’ll be fine. Clearly they’re not particularly informed about the benefits of vaccination, or choose to believe those benefits are exaggerated. I suspect that the further we remove ourselves from the bad days of TB, diphtheria, mumps and measles, the more we’ll get this creeping belief that vaccines are over-rated. The positive thing, though, is that we still have some 83% of parents in favour of some kind of punitive measure for those who don’t or won’t vaccinate their kids. But I do suspect that percentage will reduce over time. We humans have short memories and an over-supply of hubris, it seems to me. Or perhaps we’re just a bit over-confident with respect to our survival mechanisms. We’re like teenagers, we rarely listen to our parents – they’re history, after all. We need a few life-blows to counter our cockiness.
Jacinta: Hmmm, grim but probably true. Anyway, the government has acted and that might reduce the number of fence-sitters, even if it polarises the issue a bit more.
reveries of a solitary wa*ker: wa*k 2
bulldog Tommy about to land a bookish blow
The Darwin book continues to be a rollicking good read, I’m into the post Origin period, where shit hits the fans and Darwin’s fans, led by that young Turkish bulldog Tommy Huxley, shovel shit on the opposition, captained by soapy Sam Wilberforce and the brains of high Anglicanism, Dicky Owen – the most gifted naturalist of his age, to be fair. What’s fascinating is that the Origin precipitated the last great politico-religious struggle in England, a very drawn-out affair which crossed the Atlantic and continues in the US to this day, but in England it has been a slow-acting poison to conservative Anglicanism. Liberal Anglicanism, essentially a bridge to atheism, has swallowed natural selection with a sort of diffident, dumb grace, flexible as to their god’s ever-changing plan. As a semi-student of history though, I can well understand Darwin’s own diffidence about publicizing his theory. It was bad enough for the time, had it been a century earlier (impossible of course given the eighteenth century state of knowledge) he would absolutely have been martyred for it. As it was, during the couple of decades between formulating his theory and going public, the public, especially the disaffected Chartist ‘rabble’, had become increasingly keen for a weapon to strike down the High Clergy and the swanningly civilised aristos, and apes for ancestors, monkeys for uncles, even gorillas for girlfriends, fitted the bill perfectly. Darwin, of course, presented his case as dispassionately as humanly possible, with nary a mention of human descent, and afterwards kept his head down in Downe, obsessing over pigeons and orchids and sexual selection (actually chipping away very effectively at the god-did-it argument), while Tommy Huxley, Joe Hooker and co fought the good Darwinian battle in the big smoke with consummate derring-do (don’t believe a word of this by the way, as if you would). Darwin was anything but a fighter – he had vomiting fits at the very thought of confrontation – but in his oddly reclusive way he was always the leader, because unlike many of his supporters, even the closest ones, he knew he was right. His aim, his obsession, with all his apparently arcane researches, was to keep adding to the mountain of evidence.
There are many intriguing things about Darwin. He was vain but genuinely humble, highly-strung and emotional but profoundly analytical, a hypochondriac and yet a real invalid for stretches of his life, and of course a revolutionary who hated revolutionaries. As a young, footloose, disgustingly well-heeled intellectual, he could think of nothing better than to make a pleasant living as a naturalist-clergyman, like many a gentleman among his family’s connections. By his career’s end, the naturalist-clergyman was becoming a relic, probably more due to his own productions than to any other cause.
The founding father of eugenics, atheism, Nazism, bestiality and please don’t get me started
And this leads to a consideration of his most profound impact, outside the confines of science, what makes him the most controversial and contested, and in some circles reviled, figure of the past two hundred years, and that is his, and his theory’s, complete denial of human specialness. A specialness which is at the heart of the Abrahamic religions, without which not.
This recognition of human relatedness to other species, the bringing of humans back to the pack, wasn’t an anti-Christian urge by any means, it was more a result of his obsessive interest in solving the problems of adaptation and basic survival of creatures such as barnacles, earthworms and pigeons. This obsession gave him great respect for the sometimes barely fathomable complexity and ingenuity of even the most ‘basic’ life-forms. He saw human complexity as a continuation of that adaptive process, but biologists and many other scientists were, at that time, unable to shake off notions of human exceptionality. Owen, Wallace, Luis Agassiz, Asa Gray, Charles Lyell, St George Mivart and others of Darwin’s time, all had qualms about, or simply rejected outright, the implications for humanity of Darwinian natural selection, and these represented the scientific mainstream, essentially. Darwin himself was able to weather the storm through the support of strong allies such as Hooker and Huxley, his own ability to avoid and deflect controversy, his inaccessibility at Downe, his long-suffering but profoundly loyal wife, and his habit of retreating into the messy fine detail of his studies. He also, through voluminous correspondence – he would’ve loved the world of email and Facebook – built up a huge network of scientific boffins, breeders and farmers, with whom he was unfailingly polite and charming while exploiting their specialist knowledge. So he was able to adapt very well to the challenges thrown at him.
eeek
I’m writing here as if delivering a lecture, and I do wish I could reach more people. I don’t have too many contacts with a penchant for science, or for history, but then I don’t have many contacts. But enough complaining (mea culpa after all), I note that the vaccination controversy drags on, with too many people standing on their ‘right’ to not vaccinate their children, which shows up the problems with the rights concept, which I’ve always considered artificial but a useful fiction which has helped to build a more humane global society, and speaking of globalism the battle to save the lives of Australians under the death penalty is almost over, but we should continue the battle to the end because it’s a bad law and national sovereignty be damned, and that should be the same for any national under any national or state law. Which makes me wonder, I’m not a lawyer, but what would happen if an Australian citizen was charged with a capital offence and sentenced to death in the notorious US state of Texas? Maybe they only kill US citizens, that’d keep them out of international trouble, but what we need to keep working on is an international code of ethics and an international law and I do think we’re creeping towards it slowly slowly.
capital punishment – green doesn’t do it, red does, and yellow’s moving away
some thoughts on humanism and activism
What Australia needs
I’ve been a little more involved in ‘movements’ in recent years, though I’m not usually much of a joiner, and I’ve always been wary of ‘activism’, which is often associated with protesting, personning the barricades (doesn’t have quite the aggressive ring to it, does it?), even a bit of biffo – if largely verbal, by preference. I’ve just been hungry for a bit of stimulus – salon culture, witty and cultured and informative exchanges with people cleverer than myself. But since I’ve been occasionally asked to engage on a higher, or deeper level, in ‘the culture wars’, on the side of reason, atheism, secularism, humanism, whatever, my thoughts on the matter have started to crystallise, and they’re hopefully in evidence in my blog writing.
I don’t mind calling myself an activist for humanism, or for other isms, but I think we should be activists for rather than against. Now it might be argued that to argue for one thing is to argue against another, so it doesn’t really matter, but I think it matters a great deal. It’s a matter of trying to be positive and influencing others with your positivity. Secular humanism has a great case to promote, as do reason, self-awareness and ‘skepticism with sympathy’.
I’ve learned from years of teaching students from scores of different countries and cultures that we all can be excited by learning new stuff, that we’re amused by similar things, that we all want to improve and to be loved and appreciated. The ties that bind us as humans are far greater than those that divide us culturally or in other ways. I’ve also learned that the first principle of good teaching is to engage your students, rather than haranguing or badgering them. This may not seem easy when you’re teaching something as apparently dry and contentless as language and grammar, but language is essentially a technology for communicating content, and if we didn’t have anything meaningful or important to communicate, we’d never have developed it. So the key is to engage students with content that’s relevant to them, and stimulating and thought-provoking enough that they’ll want to communicate those thoughts.
I suppose I’m talking about constructive engagement, and this is the best form of activism. Of course, like everyone, I don’t always ‘constructively engage’. I get mad and frustrated, I dismiss with contempt, I feel offended or vengeful, yet the best antidote to those negative feelings is simple, and that is to throw yourself into the lives, the culture, the background of your ‘enemy’, or the ‘other’, which requires imagination as well as knowledge. I mis-spent a lot of my youth reading fiction from non-English backgrounds – from France and Germany, from Russia and eastern Europe, from Africa and Asia. It was a lot cheaper than travelling, especially as I avoided a lot of paid work in order to indulge my reading. Of course I read other stuff too, history, philosophy, psychology, new-wave feminism, but fiction – good fiction, of course – situated all these subjects and issues within conflicted, emotional, culturally-shaped and striving individuals, and provided me with a sense of the almost unfathomable complexity of human endeavour. The understanding of multiple backgrounds and contexts, especially when recognising that your own background is a product of so much chance, creates multiple sympathies, and that’s essential to humanism, to my mind.
However, there are limits to such identifications. Steven Pinker discusses this in The better angels of our nature (the best advertisement for humanism I’ve ever read) by criticising the overuse, or abuse, of the term ’empathy’ and expressing his preference for ‘sympathy’. Empathy is an impossible ideal, and it can involve losing your own bearings in identifying with another. There are always broader considerations.
Take the case of the vaccination debate. While there are definitely charlatans out there directly benefitting from the spread of misinformation, most of the people we meet who are opposed to vaccination aren’t of that kind, usually they have personal stories or information from people they trust that has caused them to think the way they do. We can surely feel sympathy with such people – after all, we also have had personal experiences that have massively influenced how we think, and we get much of our info from people we trust. But we also have evidence, or know how to get it. We owe it to ourselves and others to be educated on these matters. How many of us who advocate vaccination know how a vaccine actually works? If we wish to enter that particular debate, a working knowledge of the science is an essential prerequisite (and it’s not so difficult, there’s a lot of reliable explanatory material online, including videos), together with a historical knowledge of the benefits of vaccination in virtually eradicating various diseases. To arm yourself with and disseminate such knowledge is, to me, the best form of humanist activism.
I’ll choose a couple more topical issues, to look at how we could and should be positively active, IMHO. The first, current in Australia, is chaplaincy in schools. The second, a pressing issue right now for Australians but of universal import, is capital punishment.
The rather odd idea of chaplaincy in schools was first mooted by Federal Minister Greg Hunt in 2006 after lobbying from a church leader and was acted upon by the Howard government in 2007. It was odd for a number of reasons. First, education is generally held to be a state rather than a federal responsibility, and second, our public education system has no provision in it for religious instruction or religious proselytising. The term ‘chaplain’ has a clear religious, or to be more precise Christian, association, so why, in the 21st century, in an increasingly multicultural society in which Christianity was clearly on the decline according to decades of census figures, and more obviously evidenced by scores of empty churches in each state, was the federal government introducing these Christian reps into our schools via taxpayer funds? It was an issue tailor-made for humanist organisations, humanism being dedicated – and I trust my view on this is uncontroversial – to emphasising what unites us, in terms of human rights and responsibilities, rather than what divides us (religion, nationality, gender, sexual orientation etc). To introduce these specifically Christian workers, out of the blue, into an increasingly non-Christian arena, seemed almost deliberately divisive.
Currently the National School Chaplaincy Program is in recess, having been stymied by two effective High Court challenges brought by a private citizen, Ron Williams, of the Humanist Society of Queensland. As far as I’m aware, Williams’ challenge was largely self-funded, but assisted by a donation from at least one of the state humanist societies. This was a cause that could and should have been financed and driven by humanists in a nationally co-ordinated campaign, which would have enabled humanists to have a voice on the issue, and to make a positive contribution to the debate.
What would have been that contribution? Above all to provide evidence, for the growing secularism and multiculturalism of the nation and therefore the clearly anachronistic and potentially divisive nature of the government’s policy. Identification with every Christian denomination is dropping as a percentage of the national population, and the drop is accelerating. This is nobody’s opinion, it’s simply a fact. Church attendance is at the lowest it’s ever been in our Christian history – another fact. Humanists could have gone on the front foot in questioning the role of these chaplains. In the legislation they’re expected to provide “support and guidance about ethics, values, relationships and spirituality”, but there’s an insistence that they shouldn’t replace school counsellors, for counselling isn’t their role. Apparently they’re to provide support without counselling, just by ‘being there’. Wouldn’t it be cheaper to just have their photos on the school walls? The ‘spirituality’ role is one that humanists could have a lot of fun with. I’ve heard the argument that people are just as religious as ever, but that they’ve rejected the established churches, and are developing their own spirituality, their own relationship to their god, so I suppose it would follow that their spirituality needs to be nourished at school. But the government has made a clear requirement that chaplains need to be members of an established religion (and obviously of a Christian denomination), so how exactly is that going to work?
While humour, along with High Court challenges and pointed questions about commitment to real education and student welfare, would be the way to ‘get active’ with the school chaplaincy fiasco, the capital punishment issue is rather more serious.
The Indonesian decision to execute convicted drug pedlars of various nationalities has attracted a lot of unwanted publicity, from an Indonesian perspective, but a lot of the response, including some from our government, has been lecturing and hectoring. People almost gleefully describe the Indonesians as barbarians and delight in the term ‘state-sanctioned murder’, mostly unaware of the vast changes in our society that have made capital punishment, which ended here in the sixties, seem like something positively medieval. These changes have not occurred to the same degree in other parts of the world, and as humanists, with a hopefully international perspective, we should be cognisant of this, aware of the diversity, and sympathetic to the issues faced by other nations faced with serious drug and crime problems. But above all we should look to offer humane solutions.
By far the best contribution to this issue I’ve heard so far has come from Richard Branson, representing the Global Commission on Drug Policy (GCDP), who spoke of his and other commissioners’ interest in speaking to the Indonesians about solutions to their drug problems, not to lecture or to threaten, but to advise on drug policies that work. No mention was made about capital punishment, which I think was a good thing, for what has rendered capital punishment obsolete more than anything else has been the development of societies that see their members as flawed but capable, mostly, of development for the better. Solutions to crime, drug use and many other issues – including, for that matter, joining terrorist organisations – are rarely punitive. They involve support, communication and connection. Branson, interviewed on the ABC’s morning news program, pointed to the evidence showing that harsh penalties had no effect on the drug trade, and that the most effective policy by far was legalisation. It’s probably not a story that our government would be sympathetic to, and it takes us deeply into the politics of drug law reform, but it is in fact a science-based approach to the issue that humanists should be active in supporting and promulgating. Branson pointed to the example of Portugal, which had, he claimed, drug problems as serious as that of Indonesia, which have since been greatly alleviated through a decriminalisation and harm-reduction approach.
I hope to write more about the GCDP’s interesting and productive-looking take on drug policy on my Solutions OK website in the future. Meanwhile, this is just the sort of helpful initiative that humanists should be active in getting behind. Indonesians are arguing that the damage being done by drug pushers requires harshly punitive measures, but the GCDP’s approach, which bypasses the tricky issue of national sovereignty, and capital punishment itself, is offered in a spirit of co-operation that is perfectly in line with an active, positive humanism.
So humanism should be as active as possible, in my view, and humanists should strive to get themselves heard on such broad issues as education, crime, equity and the environment, but they should enter the fray armed with solutions that are thoughtful, practicable and humane. Hopefully, we’re here to help.
on vaccines and type 1 diabetes, part 3 – causes
As mentioned earlier, it’s not precisely known what causes diabetes type 1, more commonly known as childhood diabetes. There’s a genetic component, but it’s clearly environmental factors that are leading to the recent apparently rapid rise in this type.
I use the word ‘apparent’ because it’s actually hard to put figures on this rise, due to a paucity of historical records. This very thorough and informative article, already 12 years old, from the ADA (American Diabetes Association – an excellent website for everything to do with the evidence and the science on diabetes), tries to gather together the patchy worldwide data to cover the changing demography and the evolving disease process. At the beginning of the 2oth century childhood diabetes was rare but commonly fatal (before insulin), and even by mid-century no clear rise in childhood incidence had been recorded. To quote the article, ‘even by 1980 only a handful of studies were available, the “hot spots” in Finland and Sardinia were unrecognized, and no adequate estimates were available for 90% of the world’s population’. Blood glucose testing in the early 20th century was far from being as simple a matter as it is today, and the extent of undiagnosed cases is hard to determine.
There’s no doubt, however, that in those countries keeping reliable data, such as Norway and Denmark, a marked upturn in incidence occurred from the mid 20th century, followed by a levelling out from the 1980s. Studies from Sardinia and the Netherlands have found a similar pattern, but in Finland the increase from mid-century has been quite linear, with no levelling out. Data from other northern European countries and the USA, though less comprehensive, show a similar mid-century upturn. Canada now (or as of 12 years ago) has the third highest rate of childhood diabetes in the world. The trend seems to have been that many of the more developed countries first showed a sharp increase, followed by something of a slow-down, and then other countries, such as those of central and eastern Europe and the Middle East, ‘played catch-up’. Kuwait, for example, had reached seventh in the world at the time of the article, confounding many beliefs about the extent of the disease’s genetic component.
The article is admirably careful not to rush to conclusions about causes. It may be that a number of environmental factors have converged to bring about the rise in incidence. For example, it’s known that rapid growth in early childhood increases the risk, and children do in fact grow faster on average than they did a century ago. Obesity may also be a factor. Baffled researchers naturally look for something new that has entered the childhood environment, either in terms of nutrition (e.g. increased exposure to cow’s milk) or infection (enteroviruses). Neither of these possibilities fit the pattern of incidence in any obvious way, though there may be subtle changes in antigenicity or exposure at different stages of development, but there’s scant evidence of these.
Another line of inquiry is the possible loss of protective factors, as part of the somewhat vague but popular ‘hygiene hypothesis’, which argues that lack of early immune system stimulation creates greater susceptibility, particularly to allergies and asthma, but perhaps also to childhood diabetes and other conditions. The ADA article has this comment:
Epidemiological evidence for the hygiene hypothesis is inconsistent for childhood type 1 diabetes, but it is notorious that the NOD mouse is less likely to develop diabetes in the presence of pinworms and other infections. Pinworm infestation was common in the childhood populations of Europe and North America around the mid-century, and this potentially protective exposure has largely been lost since that time.
The NOD (non-obese diabetic) strain of mice was developed in Japan as an animal model for type 1 diabetes.
The bottom line from all this is that more research and monitoring of the disease needs to be done. Type 1 diabetes is a complex challenge to our understanding of the human immune system, and of the infinitely varied feedback loops between genetics and environment, requiring perhaps a broader questioning and analysis than has been applied thus far. Again I’ll quote, finally, from the ADA article:
In conclusion, the quest to understand type 1 diabetes has largely been driven by the mechanistic approach, which has striven to characterize the disease in terms of defining molecular abnormalities. This goal has proved elusive. Given the complexity and diversity of biological systems, it seems increasingly likely that the mechanistic approach will need to be supplemented by a more ecological concept of balanced competition between complex biological processes, a dynamic interaction with more than one possible outcome. The traditional antithesis between genes and environment assumed that genes were hardwired into the phenotype, whereas growth and early adaptation to the environment are now viewed as an interactive process in which early experience of the outside world is fed back to determine lasting patterns of gene expression. The biological signature of each individual thus derives from a dynamic process of adaptation, a process with a history.
However, none of this appears to provide any backing for those who claim that a vaccine is responsible for the increased prevalence of the condition. So let’s wade into this specific claim.
It seems the principle claim of the anti-vaxxers is that vaccines suppress our natural immune system. This is the basic claim, for example, of Dr Josef Mercola, a prominent and heavily self-advertising anti-vaxxer whose various sites happen to come up first when you combine and google key terms such as ‘vaccination’ and ‘natural immunity’. Mercola’s railings against vaccination, microwaves, sunscreens and HIV (it’s harmless) have garnered him quite a following among the non compos mentis, but you should be chary of leaping in horror from his grasp into the waiting arms of the next site on the list, that of the Vaccination Awareness Network (VAN), another Yank site chock-full of of BS about the uselessness of and the harm caused by every vaccine ever developed, some of it impressively technical-sounding, but accompanied by ‘research links’ that either go nowhere or to tabloid news reports. Watch out too for the National Vaccination Information Centre (NVIC), another anti-vax front, full of heart-rending anecdotes which omit everything required to make an informed assessment. The best may seem to lack conviction, being skeptics and all, but it’s surely true that the worst are full of passionate intensity.
There is no evidence that the small volumes of targeted antigens introduced into our bodies by vaccines have any negative impact on our highly complex immune system. This would be well-nigh impossible to test for, and the best we might do is look for a correlation between vaccination and increased (or decreased) levels of disease incidence. No such correlation has been found between the MMR vaccine and diabetes, though this Italian paper did find a statistically significant association between the incidence of mumps and rubella viral infections and the onset of type 1 diabetes. Another paper from Finland found that the incidence of type 1 diabetes levelled out after the introduction of the MMR vaccine there, and that the presence of mumps antibodies was reduced in diabetic children after vaccination. This is a mixed result, but as yet there haven’t been any follow-up studies.
To conclude, there is just no substantive evidence of any kind to justify all the hyperventilating.
But to return to the conversation with colleagues that set off this bit of exploration, it concluded rather blandly with the claim that, ‘yes of course vaccinations have done more good than harm, but maybe the MMR vaccine isn’t so necessary’. One colleague took a ‘neutral’ stance. ‘I know kids that haven’t been vaccinated, and they’ve come to no harm, and I know kids that have, and they’ve come to no harm either. And measles and mumps, they’re everyday diseases, and relatively harmless, it’s probably not such a bad thing to contract them…’
But this is a false neutrality. Firstly, when large numbers of parents choose not to immunise their kids, it puts other kids at risk, as the graph at the top shows. And secondly, these are not harmless diseases. Take measles. While writing this, I had a memory of someone I worked with over twenty years ago. He had great thick lenses in his glasses. I wear glasses too, and we talked about our eye defects. ‘I had pretty well perfect vision as a kid,’ he told me, ‘and I always sat at the back of the class. Then I got measles and was off school for a fortnight. When I went back, sat at the back, couldn’t see a thing. Got my eyes tested and found out they were shot to buggery.’
Anecdotal evidence! Well, it’s well known that blindness and serious eye defects are a major complication of measles, which remains a killer disease in many of the poorest countries in the world. In fact, measles blindness is the single leading cause of blindness in those countries, with an estimated 15,000 to 60,000 cases a year. So pat yourself on the back for living in a rich country.
In 2013, some 145,700 people died from measles – mostly young children. In 1980, before vaccination was widely implemented, an estimated 2.6 million died annually from measles, according to the WHO.
Faced with such knowledge, claims to ‘neutrality’ are hardly forgivable.
on vaccines and diabetes [type 1], part 2
Okay, before I look at the claimed dangers of vaccines in general, I’ll spend some time on diabetes, which, as mentioned, I know precious little about.
Diabetes mellitus, to use its full name, is a metabolic disease which causes blood sugar levels to be abnormally high. Some of the immediate symptoms of prolonged high blood sugar include frequent urination and feelings of hunger and thirst, but the disease can lead to many serious complications including kidney failure, heart disease and strokes. Diabetes is generally divided into type 1, in which the pancreas fails to produce enough insulin, and type 2, in which the body’s cells fail to process the insulin produced. Type 2, which accounts for some 90% of cases, can lead to type 1. There’s a third recognised type called gestational diabetes, a sudden-onset form occurring in pregnant women, which usually disappears after giving birth. As I’m not sure whether the claim about the MMR vaccine was related to type 1 or type 2, I’ll examine both.
type 1 diabetes and vaccination
A factsheet from Australia’s National Centre for Immunisation Research and Surveilance (NCIRS), a joint service of Westmead Hospital and Sydney University, and part of the World Health Organisation’s Vaccine Safety Net system of public information websites, summarises type 1 diabetes thus:
This is thought to be an autoimmune disease, where the immune system malfunctions to cause destruction of the insulin-producing cells in the pancreas. This is the usual type of diabetes in children, and requires treatment with insulin injections. Without insulin, people with Type 1 diabetes will die. Diabetes is thought to be due to an interaction between inherited and environmental factors, not all of which have been identified.
It goes on to describe an ‘unexplained’ increase in cases in Australia and many other (but not all) countries. There are regional variations in rates of increase, with higher rates in Northern European countries, lower in Asia and Africa, probably due to genetic factors. A number of environmental factors that may also contribute to the incidence of the disease have been studied, including breast feeding, infections, immunisation, nitrates and vitamin D. Breast feeding slightly reduces the risk of contracting diabetes, and drinking cow’s milk may increase the risk. As to infections, few have been proven to cause diabetes – though one of them, interestingly, is mumps. Diabetes incidence is affected by seasonal variation, and it’s likely that seasonal viral infections may trigger the onset of diabetes in some people. It’s also possible that some strong medications may compromise the immune system and so cause or promote the onset of the disease. High levels of nitrates in drinking water have been shown to increase the incidence.
The factsheet is entitled ‘Diabetes and vaccines’, so it deals head-on with the vaccination issue, and its conclusion is uncompromising: ‘No, there is no evidence that vaccines cause diabetes’. It cites 15 separate studies in its reading list, three of which are authored or co-authored by a Dr John Classen. These three are the only studies to suggest a link. Here’s the NCIRS response:
There have been a number of studies which have searched for links between diabetes and immunisations. The only studies suggesting a possible increase in risk have come from Dr John B Classen. He found that if the first vaccination in children is performed after 2 months of age, there is an increased risk of diabetes. His laboratory study in animals also found that certain vaccines, if given at birth, actually decrease the risk of diabetes. This study was based on experiments using anthrax vaccine, which is very rarely used in children or adults. Dr Classen also compared diabetes rates with vaccination schedules in different countries, and interpreted his results as meaning that vaccination causes an increased risk of diabetes. This has been criticised because the comparison between countries included vaccines which are no longer used or used rarely, such as smallpox and the tuberculosis vaccine (BCG).
The study also failed to consider many reasons other than vaccination which could influence rates of diabetes in different countries. Later, in 2002, Dr Classen suggested that vaccination of Finnish children with Hib vaccine caused clusters of diabetes 3 years later, and that his experiments in mice confirmed this association.
Other researchers who have studied the issue have not verified Dr Classen’s findings. Two large population-based American studies failed to support an association between any of the childhood vaccines and an increased risk of diabetes in the 10 years after vaccination. The highly respected international Cochrane Collaboration reviewed all the available studies and did not find an increased risk of diabetes associated with vaccination.
Dr Classen, it turns out, is an established anti-vaxxer who has more recently tried to prove a link between vaccines and autism.
I should point out also that the above factsheet, which is a few years old, doesn’t include a more recent study, on a very large scale, which showed a significant decrease in the incidence of type 1 diabetes with various vaccinations, including MMR.
Classen, though, wasn’t looking at the MMR vaccine, his claims were about the Hib vaccine, which prevents invasive disease caused by the Haemophilus influenzae type b bacterium. It also significantly reduces the incidence of early childhood meningitis. The NCIRS factsheet doesn’t even mention MMR, stating that the vaccines being debated are Hib, BCG (for tuberculosis) and hepatitis B.
The Philadelphia Children’s Hospital’s Vaccine Education Centre (whose director, Dr Paul Offit, is one of the world’s leading immunologists and experts on vaccines), cites a long list of studies – have a look yourself – which together find no evidence of a causal connection between diabetes (mostly type 1) and various vaccines. I’ve yet to find any published studies, even poorly conducted ones, that claim a specific negative connection between the MMR vaccine and diabetes. If anybody out there can point me to such a study, I’d be grateful.
So, while I wait for someone to get back to me on this (ho, ho), I’ll explore what immunologists and epidemiologists are saying about the rise of type 1 diabetes in recent decades in my next piece.
on vaccines and diabetes, part 1
A picture lies better than 1000 words
The other day, when I grumbled about anti-vaccination views during after-work drinks, a colleague said she was ‘semi-anti-vaccination’, specifically in relation to the connection between the MMR (measles, mumps and rubella) vaccine and diabetes. When I expressed skepticism, she challenged me on my knowledge of the science, which admittedly isn’t great – and I made matters look pretty bad for myself by egregiously claiming that children couldn’t be vaccinated before two years of age, instead of two months, a mistake I wouldn’t have made if I’d had kids of my own to vaccinate (or not), like most of my workmates.
When I inquired about this mysterious connection, I was curtly informed that it was nothing vague, but crystal clear causation. The link so often made between diabetes and increased sugar in our diets was bogus, I was told, because the timing didn’t make sense. Presumably the timing of the rise in diabetes did match the introduction of the vaccine, though such a correlation, if it exists, is far from proving causation. Proof would require that some component of the MMR vaccine was having a direct effect on our immune system in such a way as to increase susceptibility to the disease. If this were true, it would be absolutely sensational news, demanding domination of newspaper headlines worldwide. Extraordinary claims, as they say, require extraordinary evidence
Now, I must say that my sceptical antennae were immediately raised when I heard this claim, because I hadn’t heard it before, and as a regular reader of science magazines and relatively up-to-date popular science books, and a regular listener to science and scepticism podcasts, I’m reasonably sure I’m more scientifically literate than the average layperson. I’m aware, of course, of the vociferous anti-vaccination crowd and their claims of a causal connection between vaccines and autism, asthma and just about everything else that currently ails us. And I’m familiar too with the medical and immunisation experts, such as Doctors Paul Offit, Steve Novella and David Gorski, who are fighting the good fight against the tide of misinformation with evidence-based science. However, I’m perfectly willing to admit to a possible blind spot re diabetes, as it hasn’t personally affected me or anyone close to me.
I must say, though, that my ‘sceptical training’ enabled me to turn up this article from the Scientific American website within 5 seconds of looking (the first 4 seconds were spent avoiding the many innocuous-sounding websites that I knew to be fronts for anti-vaccination propaganda). The article reports on a review, conducted by the US institute of medicine, of over 1,000 published research studies on the adverse effects of eight vaccine types (including MMR). These vaccine types constitute the majority of vaccines against which claims have been made to the USA’s National Vaccine Injury Compensation Program (VICP). The report concludes that ‘vaccines are largely safe, and do not cause autism or diabetes’. Specifically on the MMR vaccine, the report had this to say:
The committee found that evidence “favors rejection” of discredited reports that have linked the MMR vaccine to autism and, along with the DTaP vaccine, to type 1 diabetes.
The DTaP vaccine covers three deadly bacterial diseases – diphtheria, tetanus and pertussis, or whooping cough.
End of story? Well, there’s always the possibility of a medical conspiracy, or of sloppy and complacent scientific analysis – doubtless influenced by Big Pharma. Needless to say, I’m very doubtful about this.
The final chapter of Dr Ben Goldacre’s landmark book Bad Science is entitled ‘The media’s MMR hoax’. It deals essentially with the claimed link between the vaccine and autism, but it has much of value to say about health scares in general and the role of the media in promoting them, either deliberately or inadvertently. For example, the MMR-autism connection scare was almost entirely confined to Britain at first, though it has since spread to the USA and Australia. It is almost unheard of in non-English-speaking countries, in spite of their using the exact same vaccine. Conversely, in France in the 1990s, the hepatitis B vaccine was being linked by some members of the public, supported by some in the media, to a rise in multiple sclerosis. No such link was being made outside of France, though the vaccine was the same everywhere. And there are many other examples to show that these scares are more culturally than scientifically based.
The anti-vaccination movement has a long and, it must be said, inglorious history, with the same sorts of arguments, and the same sorts of results, occurring from the beginning. Goldacre cites this interesting Scientific American article from 1888:
The success of the anti-vaccinationists has been aptly shown by the results in Zurich, Switzerland, where for a number of years, until 1883, a compulsory vaccination law obtained, and smallpox was wholly prevented– not a single case occurred in 1882. This result was seized upon the following year by the antivaccinationists and used against the necessity for any such law, and it seems they had sufficient influence to cause its repeal. The death returns for that year (1883) showed that for every 1,000 deaths two were caused by smallpox; In 1884 there were three; in 1885, 17, and in the first quarter of 1886, 85.
But, hey, measles is hardly smallpox, is it? It’s harmless. Is it worth disrupting our ‘natural immune system’ with vaccines just to protect ourselves against a few character-building ailments? Isn’t our over-reliance on vaccines potentially catastrophic for our bodies?
Well, I’ll delve more into such claims, and into diabetes more specifically, in my next piece.