Posts Tagged ‘vaccination’
covid19: ivermectin, the Moderna vaccine, vitamin D
Canto: So we were looking at the role of increased VWF and megakaryocytes in the blood, causing embolisms and clotting, and how to prevent or reduce such responses to the virus.
Jacinta: On the subject, Dr Seheult looks at a paper about the anti-malarial drug ivermectin and ‘CD147-mediated vascular occlusion’, CD147 being a protein attached to red blood cells (RBCs), which is apparently the entry pathway for malaria, and may also be a binding site for the S-protein of SARS-CoV2. However, binding to a CD147 protein on an RBC will not be a pathway for SARS-CoV2 as these blood cells don’t have nuclei, and so no mechanism for the virus to replicate. Still it’s possible, or likely, that this binding does take place, affecting the RBCs in such a way that they tend to aggregate. This is where ivermectin (IVM) comes in as a possible treatment:
The potential for major dose-response gains is evaluated based upon studies indicating that IVM shields SARS-CoV2 spike protein and that this spike protein binds to the CD147 transmembrane receptor, as well as to ACE2. The abundant distribution of CD147 on RBCs suggests a possible ‘catch’ and ‘clump’ framework whereby virally-mediated bindings of RBCs to other RBCs, platelets, white blood cells and capillary walls impede blood flow, which in turn may underlie key morbidities of covid19.
Now all of this is quite speculative as yet, and they quote an unpublished retrospective study with positive results from IVM treatment. Another study in Nature presents a systematic review of IVM use in covid19 and other infections – it’s apparently a medication which has ‘a good safety profile with low adverse effects when orally prescribed’. Clinical trials are necessary to appraise its use against covid19 however.
Canto: Yes they point out that in vitro studies often involve higher dosages, and so results may not be replicable in vivo, where safety requires a lower dosage range. So now to the Moderna vaccine trials. Here’s the news from a July 14 article:
Moderna’s Covid-19 vaccine led patients to produce antibodies that can neutralize the novel coronavirus that causes the disease, though it caused minor side effects in many patients, according to the first published data from an early-stage trial of the experimental shot.
The data was published in the New England Journal of Medicine, as a preliminary report. As Seheult points out, this is a new type of vaccine, an mRNA vaccine, rather than a vaccine that introduces a protein into the body to stimulate the production of antibodies. In this vaccine the mRNA harnesses the mechanisms of the cells as the virus does, to produce the proteins that produce the immune response. Me think it mazing.
Jacinta: Yes, this is reporting on dosage variation and response, and the data is pretty detailed, but the conclusions at this stage – and the vaccine is called the ‘mRNA-1273 vaccine’ – are that it ‘induced anti-SARS-CoV2 immune responses in all participants, and no trial-limiting safety concerns were identified’. So it’s steady as she goes at this stage.
Canto: Quite exciting really – until someone gets really hurt. As you say, they tried different dosages, (25, 100 and 250 micrograms) and from the graphed results it seems fairly clear that they’ll go on in the next trial using the 100 microgram dose, which balances positive effects with negative effects in the most effective way, effectively. Effects seem to have been minor even in the highest dosage.
Jacinta: And remember we’re almost two months behind the times here. Phase 3 trials were expected to begin in late July early August I think. That’s the real test, but even that won’t guarantee an entirely safe vaccine for everyone. Nothing can.
Canto: Interesting that they required the subjects to have two injections each to get the best response. And as to side-effects, there were some severe ones at the 250μg dosage but very few at 100μg.
Jacinta: There will inevitably be problems, I foresee that, and the anti-vaxxers will make a meal of any negative responses. In any case it’s unlikely that a virus will be available till next year.
Canto: So now to update 97, which starts with a revisiting of vitamin D, which it seems a lot of health experts are raving about at the moment.
Jacinta: So it’s a lipid-soluble vitamin, which means it retains its value in cooked foods, it’s stored in the liver, and when you’re exposed to ultraviolet light, it can transform cholesterol derivatives in the body to a form of this vitamin. Really sunlight exposure seems to be the best way of improving vitamin D levels.
Canto: So this update looks at a paper published in early July, called ‘Vitamin D status and risk of all-cause and cause-specific mortality in a large cohort: results from the UK Biobank’. The results are a bit technical, but over a nine-year period for this cohort of older subjects, ‘higher 25(OH)D [that’s the active type of the vitamin] concentrations are non-linearly associated with lower-risk of all-cause, CVD [cardiovascular disease] and cancer mortality’. They recommend a particular threshold level of the vitamin as ‘an intervention target to reduce the overall risk of premature death’.
Jacinta: Yes it certainly was a large cohort – over 365,000 subjects in a retrospective study. And Dr Seheult highlighted a comprehensive review article, ‘The immunological effects of vitamin D on human health and disease’, which I plan to read in full, in order to live forever, but the key element for now is the effect of vitamin D on innate immunity. It ‘exhibits direct antiviral activities against many respiratory viruses by disrupting viral envelopes and altering viability of host target cells’. Further to this it has a section on ‘endothelial fuction and vascular permeability’. It’s pretty technical but the bottom line, they reckon, is that vitamin D3 is a helluva good product, in the correct form, for stabilising the endothelium, and Dr Seheult speculates that this is why it’s associated with a lower risk of mortality in covid19. It also appears to be associated, in the 1,25(OH2)D3 form, with increased endothelial production of nitric oxide. They make these interesting concluding remarks – ‘it is evident that vitamin D and its metabolites exert pleiotropic effects on the vascular endothelium that are protective against vascular dysfunction and tissue injury as a result of local and systematic inflammation’. Pleiotropic meaning multiple effects from a single gene. Vitamin D also has an effect on adaptive immunity – the helper and memory T cells, important as we don’t know whether these will develop a memory with respect to covid19.
Canto: The question of re-infection.
Jacinta: Indeed. But the review goes on and on about the positive effects of high vitamin D levels as a risk reducing factor in a range of conditions. And it goes specifically to covid19 which is, or starts as, an acute respiratory infection. Here are some fascinating results:
A prospective cohort study in healthy adults living in New England showed a two-fold reduction in the risk of developing acute respiratory tract infection (ARI) in those with serum 25(OH)D levels of 38ng/mL (95nmol/L) or more. A case-control study in children aged less than 2 years reported that children requiring hospitalisation for ARI had significantly 1.7 times higher odds of vitamin D deficiency as compared with those with mild ARI. This indicates the protective effects of sufficient vitamin D status against respiratory viral infection.
And they go into the reasons why vitamin D might be protective, which I won’t detail here, but on covid19, they very reasonably claim that ‘one should maintain adequate vitamin D intake to achieve the desirable serum 25(OH)D level of 40-60ng/ml in order to minimise the risk and severity of covid19 infection’.
Canto: Yes I notice they’re generally emphasising that 40ng/ml lower limit, which so many people are below.
Jacinta: Yes, as they say, it’s been documented that about 60% of children and adults have circulating levels of less than 30ng/ml of 25(OH)D. So they reckon it reasonable that presenting covid19 patients will have insufficient vitamin D levels and so should be given supplementation on admission to hospital. However, overdosing on vitamin D can be an issue, so be very aware of dosage levels in consultation with your physician, if you’re self-medicating.
Canto: Which I’m not sure if you should be doing.. please take my advice…
References
Coronavirus Pandemic Update 96: RNA Vaccine; Ivermectin; von Willebrand Factor and COVID-19
Coronavirus Pandemic Update 97: Vitamin D & COVID-19 Immunity, The Endothelium, & Deficiencies
the science of Covid-19: the virus, symptoms, spread, vaccine, incubation period, crude case fatalities
So I’m now embarking on a series devoted entirely to the virus that’s shutting so many of us in our homes, feeling slightly (or considerably) fearful, for our lives as well as our livelihoods, feeling both frustrated and fascinated, both mystified and enlightened about human behaviour, governmental responses and the like.
First, some people call this virus Covid-19, some call it SARS-CoV-2, and most just call it coronavirus. But most well-informed people know by now that coronaviruses are quite commonplace RNA viruses (numbering in the hundreds). They’re relatively large and get their name from the corona or crown of proteins that spike out from the virus membrane. The official name of this new coronavirus is SARS-CoV-2 (that’s severe acute respiratory syndrome), and Covid-19 is the name of the disease or condition that the virus causes.
This is the third coronavirus in the last 20 years to infect large numbers of humans. Coronaviruses are zoonotic – they spread from animals to humans, becoming more potentially lethal in the process. The others were SARS in 2002 and MERS (Middle East respiratory syndrome) in 2012. The immediate species origin of this new strain is still unclear. According to leading epidemiologist Dr Edison Liu, sequencing has shown that it arose from a bat coronavirus, but it probably passed through a series of vectors before passing to humans. It appears to be less lethal than SARS or MERS, but its spread has been far more rapid. In an interview on the Jackson Laboratory website (JAX), Liu explains that the Covid-19 epidemic occurred at the same time as an influenza epidemic, and while the symptoms are very similar, Covid-19 has about ten times the mortality rate. The essential symptoms are fever, shortness of breath and coughing. Acute symptoms appear to result from a mix of direct viral damage and intense immunologic response in some cases.
The virus is spread primarily by coughing and sneezing, and from the time of contact with it until the time of symptoms is approximately four to seven days. The virus passes from the body in about 14 days on average – hence the recommended minimum quarantine period.
Liu had this to say about a vaccine. Vaccine development generally takes 12 to 18 months, not only to prove its efficacy but to scale up production to the required level. Animal models are needed to test the efficacy of any antiviral treatment. Covid-19 enters our cells through the ACE-2 receptor (angiotensin-converting enzyme 2). Mice, which are often used as test animals, don’t take up Covid-19 through their ACE-2 receptor, but scientists at Iowa University have developed an animal model for infection, in which the human ACE-2 receptor has been engineered into the animal (a mouse). So the effectiveness of antiviral drugs can be tested on these animals, which can apparently be provided en masse, with the Jackson Lab as a premier provider.
The invaluable worldometer website has regularly updated stats on total cases (about 1.1 million as of today, April 4), total deaths, total recovered, death rates and much else, as well as a country-by-country breakdown. It also has well-sourced and referenced info on symptoms, incubation period and other useful stuff. The incubation period is defined as the time from exposure to the development of symptoms. Worldometer sets this period as 2 to 14 days, according to data from WHO, China’s National Health Commission and the USA’s Center for Disease Control. Note that this period is longer than that stated earlier, in information from Jackson Laboratory CEO Edison Liu. Similarly a Chinese online community for physicians and healthcare workers has reported an incubation period of ‘3 to 7 days, up to 14 days’. However, rare outliers have been reported, with incubation periods up to 27 days. The WHO has considered these might be due to second exposures – incidentally raising the issue of re-infection. However, most experts feel that re-infection is unlikely, and this appears to have been borne out as the global spread advances.
Over the past day I’ve listened to two Sam Harris podcasts on Covid-19, interviews with experts conducted in early March – already long ago, it seems. The second, which I listened to first, was with Dr Amesh Adalja, of the Johns Hopkins Center for Health Security. He made an educated guess of the death rate for Covid-19 at 0.6%, based on his analysis of South Korean figures. This is approximately six times the rate for seasonal flu (though it should be mentioned that the most recent seasonal flu has been the most fatal for children in many years), but somewhat lower than many of the predictions of other experts. He also seemed, at that point, less concerned about the need for social distancing and other mitigating measures than others, but it seems that the rapid spread of the virus and growing public concern has rendered obsolete his nonchalance in this area. Also, stop press, a New Scientist article posted yesterday (April 3) has this to say on the South Korean data:
Crude case fatality rates are so-called because they don’t take into account the fact that some of the people counted in the infected numbers have not recovered yet and may still go on to die. Early in March, for instance, South Korea had a crude case fatality rate of just 0.6 per cent. That has risen to 1.7 per cent.
As to the fatality rate of Covid-19 at present, this is difficult to assess, largely due to ‘severity bias’, which means that many milder infections may be going untested, with only the more severe cases capturing the attention of the health care system, or even the infected. New Scientist reports ‘a wide range of estimates, from as low as 1 in 1000 to as high as 1 in 30’. It seems clear from current figures that death rates vary wildly from region to region, and country to country, but the reasons for this are still very unclear. To give some examples of the variation, the current crude case fatality rate for the UK is around 9%, for Italy it’s nearly 12%, but for Germany it’s only 1%. Here in Australia, it’s considerably less even than that, and no doubt governments around the country will be keen to take the credit. But there seems to be more to this variation than government action/inaction. This question along with many others will be explored in future posts.
References
https://www.jax.org/coronavirus
https://www.worldometers.info/coronavirus/#countries
https://www.worldometers.info/coronavirus/coronavirus-incubation-period/
https://samharris.org/podcasts/191-early-thoughts-pandemic/
some more stuff we’ve learned about vaccines
Vaccinology, I would say that it’s not rocket science. It’s a lot harder than rocket science.
Alan Schmaljohn, virologist, 2014
Canto: So, reading The Vaccine Race, by Meredith Wadman – maybe we should just do book reviews? – I find myself getting excited, or confused, by a passage, and wanting to do more research, and then forgetting about it…
Jacinta: It’s probably pretty normal to forget 95% of what you read within a week or so of having read it. You just hope the things you retain are the principal things.
Canto: Yeah well, I was probably hoping the book would help me get my head around how vaccines work, as well as providing juicy and inspiring tales of heroism and malpractice in the history of vaccine development, and it has helped, but I think I’d need to read half a dozen such books and watch a dozen videos before it penetrated my thick skull…
Jacinta: Yes, for example, when I found myself reading, well into the book, about Leonard Hayflick’s human diploid cells, taken from the lungs of an aborted foetus, which were used to provide a sort of base for creating vaccines against all sorts of diseases, most notably rubella, I thought ‘obviously the author has explained human diploid cells, probably in great detail, before, but I can’t recall a whit’…
Canto: That’s what comes of reading too many books at once, and spreading your focus. You know it’s a myth that women can multi-task better than men, but the major finding of research is that multi-tasking is bad for everyone. Let’s resolve to read books one at a time, from start to finish.
Jacinta: Resolved. Anyway, diploid cells are just standard human cells, with 23 pairs of chromosomes. The only other human cells are haploid sperm and eggs, with 23 unpaired chromosomes. Hayflick’s cell line, gathered in the fifties, was ‘cleaner’ than the cells previously used from other animals, such as monkey kidney cells, which contained many viruses. I used the index.
Canto: So these cells were taken from the lungs of a foetus, and Hayflick was able to produce a cell line from them, that’s to say a line of almost endlessly reproducing cells, I’m not sure how that worked, but these cells, which had to be free of every virus or pathogen, would then be somehow injected with, say, the rubella virus, in some sort of reduced form, so as to produce antibodies in those who are vaccinated. The trick with vaccinology, it seems, is to produce a safe vaccine with no side effects, or minimal side effects, but with enough potency to produce a reaction, thus producing antibodies to the antigens in the vaccine. The vaccine must contain antigens, must have some potency, otherwise it’s useless. And every immune system is subtly different, so producing a one-size-fits-all vaccine is in many respects a monumental undertaking. I may have this completely wrong by the way.
Jacinta: Probably only partially wrong, let’s not be absolutists. What about this difference between killed vaccines and live vaccines. Can we talk about that?
Canto: Well first I want to understand how a ‘cell line’ is produced. How were Hayflick’s famous WI-38 (human diploid) cells produced in a constant stream from the lungs of a single legally aborted foetus in 1962?
Jacinta: Let me try to summarise Wadman’s description of the process from this online article. The tiny lungs were minced up and then placed in a container with a mix of enzymes that separated them into individual cells. These cells were separated again into small glass bottles, and a ‘nutrient broth’ was added, causing the cells to divide. thus began the most thoroughly described, studied and utilised human cell line to date, from which was created vaccines for rubella, rabies, adenovirus, measles, polio, chicken pox and shingles.
Canto: A nutrient both? You mean ‘at this point a miracle happens’?
Jacinta: Well, this was a well-established miracle, only previously it was done with non-human cells, and still is. Monkey and canine kidney cells, chicken embryo fibroblasts, hamster ovary cells… Of course using human cells was bound to be controversial.
Canto: So – obviously the cells in these tiny lungs would’ve gone on dividing had the foetus survived, so microbiologists had worked out a way, of making this happen – mitosis, isn’t it? – outside the host. How long have they been able to do this?
Jacinta: Well the first vaccine was created by Edward Jenner in the late eighteenth century, but they weren’t actually culturing cells then. Cell culture is a broad term meaning a process of growing cells – obviously by cell division – outside of their natural environment, usually in a lab. A cell line (e.g. Hayflick’s WI-38 cells) is ‘a population of cells descended from a single cell and containing the same genetic makeup’, to quote Wikipedia. Cell culture started with the maintenance of cell tissue independent of the host animal in the late nineteenth century, but techniques advanced rapidly in the 1940s and 50s to support virology and the manufacture of vaccines. A key event was the growing of poliovirus in monkey kidney cells in 1949, for which John Enders, Tom Weller and Fred Robbins won the Nobel Prize. Their methods were used by Jonas Salk and others to produce the first polio vaccine.
Canto: But the problem with using monkey kidney cells was that they potentially carried their own viruses, right? Which may or may not be harmful to humans, and how would they know? Without using human guinea pigs?
Jacinta: Human subjects, yes. And there’s also the question of the potency of the virus being used, presumably to stimulate the production of antibodies. Is it just a question of stimulating enough antibodies? And isn’t there an obvious danger of infecting subjects with the virus itself? Presumably a killed virus solves that problem, but is it really effective?
Canto: Yes, Wadman’s book has been fascinating on the politics of the vaccine race, but I’m still left much confused – probably due to stupidity or inattentiveness – as to how some vaccines work better than others, and how a cell line – I know it’s essentially about exponential growth – can produce enough material for millions of vaccine doses.
Jacinta: Yes it’s about exponential growth, and it was once thought that, given the right conditions, these cells could go on multiplying ad infinitum, to immortality so to speak, but it was Hayflick who showed this not to be true in a much-cited paper. Even so, the number of replications of individual cells assured a sufficient supply of cells for generations. And since then, much more has been discovered about cell ageing and its causes, what with telomeres and telomerase, but that’s another story. As to why vaccines developed from the WI-38 cells have been so much less problematic than others, it clearly has much to do with their being ‘clean’ human foetal cells, with no other lurgies lurking.
Canto: So let me get this clear. The WI-38 cells are provided to different labs that are wanting to create a vaccine for, say, measles. Or that have already created a vaccine, or at least have isolated the virus – but then of course viruses can’t be isolated, they need cells to survive in. So they get the WI-38 cells, and then they inject them with the virus – killed or attenuated – and then they start trialling it on rats or mice or something, trying out different strengths of the virus, without really having much idea whether the dose will translate to humans, so they must find some willing volunteers (or, in the early days, orphaned or intellectually disabled kids) to experiment on, making sure they err on the conservative side initially, then upping the dosage? I’m no doubt simplifying and speculating wildly here.
Jacinta: yes and I’m no wiser than you, but it’s a good thing we have people taking these risks, and working so hard in this field – with clearer ethical guidelines than before – because millions of lives have been saved by vaccines, and so much has been learned about our immune system in the process of developing them.
Wadman, Meredith. The Vaccine Race. Doubleday 2017.
https://www.historyofvaccines.org/content/articles/human-cell-strains-vaccine-development
http://www.nature.com/news/medical-research-cell-division-1.13273
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
the most absolute way to lose credibility
now I know not buy a used car from this guy
Daniel Dennett, in his most recent writings, excerpted in the second issue of The new philosopher (a mag which will be a part of my regular reading from now on) made this interesting point:
When you’re reading or skimming argumentative essays, especially by philosophers, here is a quick trick that may save you much time and effort, especially in this age of simple searching by computer: look for “surely” in the document, and check each occurrence.
Not always, not even most of the time, but often the word “surely” is as good as a blinking light locating a weak point in the argument. Why? Because it marks the very edge of what the author is actually sure about. (If the author were really sure all the readers would agree, it wouldn’t be worth mentioning).
Dennett goes on to prove the point with some examples. He performs a useful service here, for “surely” and similar terms like “clearly” seem anodyne enough to pass under our radar. The term “absolutely“, not so, and as such, it’s far less sophisticated. In fact, it’s one of the most obvious signposts for BS that we have, and it should send any worthwhile skeptic’s antennae bouncing off the ceiling. The anti-vaccination guru screams that vaccination is absolutely the worst medical intervention in human history, the creationist that evilution is absolutely contrary to their god’s plan, and the climate-change denier asseverates that there’s absolutely no credible evidence…
Step no further, for here lurks the big bad demon of absolutely committed ideology. It’s not the sort of term you read in the philosophical articles Dennett has been targeting, but of course it’s everywhere on the internet, and in the generally unsophisticated arena of political debate.
So I was amused to hear our current human rights commissioner Tim Wilson falling into the trap, like a drunken stumblebum falling off a well-signposted cliff. Wilson was on a panel of the ABC’s current affairs program The drum, and one of the topics discussed was the impact that the anti-vaccination movement was having on the incidence of measles in the USA. Wilson’s response was essentially pro-science, and so condemnatory of the anti-vaccination trend, though he also invoked the interesting argument that this was to protect children, while adults should be free to be as anti-science as they liked, and presumably free to promote the kind of anti-science agenda that’s causing all the problems in the first place.
But while it’s a thorny question as to whether or not good science should be enforced in some way, it was Wilson’s response to another panel commentator that really tickled me. The commentator pointed out the parallels between the anti-vaccination movement and climate change deniers – a fairly obvious point, I would’ve thought – and Wilson jumped in with the claim that ‘there are absolutely no parallels…’
Considering the fairly obvious parallels, Wilson’s remark (which he wasn’t able to elaborate on due to to it being made just as the final credits were about to roll), was a massive red flag, which immediately prompted me to check his bonafides on anthropogenic global warming.
But before checking out Wilson, let me state the parallels. First, both the vaccination debate and the AGW debate are loud and passionate. They also both exhibit the age-old truism that there’s an inverse relation between passionately-held positions and knowledge of the subject. Third and most important, they are both debates over what is essentially settled science. In the case of vaccination, the science tells us that vaccinations have led to the prevention and reduction of multiple diseases around the world over many decades, and that the negative effects of vaccination, if any, are far outweighed by the lives saved and the suffering minimised. In the case of AGW, climate scientists are in consensus that the globe is experiencing a warming event, and that this warming event, as measured through atmospheric and oceanic temperatures, is being significantly contributed to by human activity, and emissions of CO2 in particular.
Wilson’s impressive resumé here tells me that he’s ‘currently completing a Graduate Diploma of Energy and the Environment (Climate Science and Global Warming) at Perth’s Murdoch University’ and that he’s an ‘international public policy analyst specialising in international trade, health, intellectual property and climate change policy’, so he’s presumably well acquainted with climate science, which makes his ‘absolutely’ claim all the more odd. Digging deeper though, we find that for some time he was the policy director of the Institute of Public Affairs (IPA), a well-known free market think tank. Free marketeers are not always keen on accepting AGW, as it tends to interfere with business…
Wilson himself has been pretty careful about his public comments on AGW – at least I can’t find any outrageously silly remarks from him, but in 2010, while he was the IPA’s director of climate change policy, the organisation brought out a publication called Climate change: the facts, which is largely anti-climate science propaganda, as is evidenced by the fact that none of the contributors agree with the overwhelming consensus of climate scientists, i.e. that AGW is a serious problem that we need to act upon. Some of the authors accept AGW but minimise its extent and its negative effects while others simply deny its existence. The publication includes as authors the wholly discredited Ian Plimer, and the quite literally insane Christopher Monckton, who has no scientific training whatsoever. It also includes ‘old guard’ scientists such as Garth Partridge, Richard Lindzen, Bob Carter and William Kininmouth, all well into their seventies, and with links to the fossil fuel industries. One contributor, Willie Soon, has since been found to be a hireling of the fossil fuel lobby, to the tune of over $1 million. Others, such as Nigel Lawson, the eighty-something-year-old ex-Chancellor of the Exchequer under Thatcher, just make the publication look more embarrassingly irrelevant than it might have been for propaganda purposes. One has to wonder why the book was published – it must surely have harmed the climate deniers’ cause amongst the fence-sitters at whom it was presumably targeted.
The quality of the work can be judged by its brief introduction, written by John Roskam, current executive director of the IPA. Take this excerpt:
We don’t believe ‘the science is settled’. As a think tank committed to the ideals of free and open enquiry and debate we are not afraid to stand against the mainstream of prevailing elite opinion.
Why is the word elite in there, in a book supposedly dedicated to debating the facts? Scientists are always debating, criticising each other’s published work, suggesting alternative interpretations of raw data – that’s a standard scientific process. Skepticism as to results is a sine qua non of scientific enquiry. But they never describe those they disagree with as elites. That would suggest that something else was at play. It seems particularly inappropriate when the writers themselves are Lords, ex-leaders of government, and linked to some of the world’s largest corporations, while those accused of elitism are usually living on an unreliable stream of grants and scholarships.
Welcome, though, to the world of climate change denial, which, far from presenting alternative facts, is largely fact-free. Although I’ve not read Climate change: the facts, I expect it will present the same variety of views, many of them contradicting each other, that Naomi Klein describes in the first chapter of her book on the politics of climate change, This changes everything. Her description – which hits you like an icy cold shower – is of a conference dedicated to climate change denial run by the USA’s Heartland Institute, another right-wing think tank, though much bigger and more bullish than the IPA. And surprise surprise, a number of the Australian book’s contributors were speakers at that conference. As it turns out, right-wing think tanks are almost solely responsible for the slew of anti-AGW propaganda that assails us today, and of all the contentious scientific issues, this one divides most neatly along politico-ideological lines.
So this helps to explain why Tim Wilson says he finds ‘absolutely no parallels’ between AGW and the vaccination ‘debate’. For him, though not for climate scientists, the science is not settled. But, being educated on the matter, he also knows that what he wants to be true, really isn’t. So, to cover what he knows to be bullshit, he resorts, quite unthinkingly, to the word ‘absolutely’. What a fine mess bad faith gets people into, and how painfully obvious it all is.
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.