criticism

Don’t Ask the AVN, See Your GP

There have been a couple of rather alarming posts on the Australian (anti-)Vaccination Network’s Facebook wall recently, from parents who suspect that their child has been infected with or exposed to a vaccine preventable disease.

Here is the first, in which a parent suspects that her son may have measles:

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My immediate reaction upon reading this was to urge the poster to get their son to a doctor to have the diagnosis confirmed and appropriate treatment suggested, but as I am not welcome on the AVN’s Facebook page, I had to watch from the sidelines as the following unfolded.

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The AVN admins downplay the seriousness of measles, do not urge Peta R to see a doctor and accuse those commenters who encourage Peta R to seek proper diagnosis and appropriate treatment of fear mongering.

Meryl Dorey herself advises Peta R to not panic, but “go with it – celebrate the fact that if he has measles, he will never get it again and his immune system will be better for it.”

This is at least logically consistent on one level – Meryl truly does seem to believe that measles is not only benign, but a “Gift from the Goddess” (see this excellent post on Losing in the Lucky Country outlining Meryl’s views on measles). I’ll also point out again that the AVN sells a delightful children’s book titled “Melanie’s Marvellous Measles”, which has been written about rather eloquently on PEI Curmudgeon’s Blog.

Unfortunately, as is generally the case on information regarding vaccine preventable diseases, the AVN have it wrong. Measles causes people to feel very ill, up to one third of people with measles develop complications (such as ear infections, diarrhoea and pneumonia), around one in a thousand develop encephalitis (source: NSW Health Measles Fact Sheet).

While it is true that many cases of measles cause no long term damage, this is not a safe assumption to make of all cases of measles, particularly when no medical professional has assessed the severity of the symptoms, discussed management with the caregivers and prescribed a treatment plan.

Taking a step back though, the above advice was being provided without a confirmed diagnosis of measles. Peta R’s son could have had a different viral rash, or something else entirely.

Fortunately, Peta R did take her son to the doctor and it was confirmed that he did not have measles. I am thankful that she made the decision to seek expert assessment and that her son was okay – following the AVN’s advice, this story could have had a much more distressing conclusion.

The comments on this thread continued (screenshots of full thread are available here – please see ‘Further Reading’ for information on ‘homeopathic immunisation’), when somebody noticed that there was discussion on Stop the AVN’s Facebook page on the ethics and legality of the advice being provided by the AVN to Peta R, and whether it was worthwhile reporting to the HCCC. In response to this, one of the AVN’s admins posted the following:

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Here, courageous anonymous AVN admin RR makes light of SAVN’s concerns that a child’s life may be put at risk due to their negligent advice to Peta R.

The full thread is viewable here (and in response to the anti-fluoride comments, here is an excellent article on concerns about the safety of fluoridated drinking water by Science of Mom)

The inappropriateness of comparing a small child with a suspected case of measles with RR’s imaginary headache aside, (which, incidentally, I’d advise she saw a doctor about if it persisted, was accompanied by unusual symptoms or concerned her at all), this seems to suggest that the AVN don’t feel that they have any more weight behind their advice than somebody’s layperson neighbour. Perhaps they don’t – they certainly lack the expertise and standards of ethical conduct to be giving health advice. The problem though, is that the AVN represent themselves as having expertise in the fields of healthcare and vaccination. They are recognised by the HCCC as a Health Service Provider and they have been granted permission to fundraise by the OLGR as an organisation who provide educational services. As such, I think that it is fair to expect them to conduct themselves with the responsibility that that entails – which, in this case, should have been to urge Peta R to take her child to a doctor.

Here is the second recent instance of a parent asking the AVN about her child’s health. She is certain that her partner has whooping cough and they have an unimmunised four month old infant who has been exposed. This time, the parent has worded her post so that she is not specifically asking for advice on her child’s case – she requests anecdotes from people who have experienced similar situations.

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This one is chilling.

I noticed that shortly after this was posted, Facebook was saying that one comment had been made, but none were visible. This is generally a sign that a comment has been deleted, which suggests that an AVN admin was present to delete a comment, but chose not to answer Maree P’s question.

An hour and a half later, this reply appeared, from a newly created Facebook account (suggesting that Charlotte J is not one of the AVN’s regulars, or is posting from a pseudonymous account):

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This advice is sensible – and the suggestion that Maree P take her child to a doctor is precisely what the AVN should have said instead of deleting a comment and remaining silent. Mercifully, this comment seemed to have been made after the admins had logged off for the night, so it remained undeleted and without the AVN’s derision until morning.

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Tristan W is a regular commenter on both the AVN’s Facebook page and blog. I don’t know whether he assumed that Charlotte J was associated with a skeptic group or was just skeptical of the AVN’s position on vaccines and healthcare, but he often uses the term ‘skeptic’ as one of derision (as do many core AVN members). I’ve never understood it – to my mind, to be anti-skeptic is to be against critical thought and analysis and the pursuit of truth.

The suggestion that somebody stating that an unimmunised infant who has been exposed to whooping cough is in danger and that the parents should seek medical advice is fear-mongering and causing undue panic is, I believe, inaccurate. There are few non-confronting ways to tell a parent that their child needs to be assessed by a doctor as soon as possible, Charlotte J’s plea was emotive but not hysterical, nor an overreaction to the situation described. If it needs to be stated, whooping cough is an incredibly dangerous illness, particularly to very young babies. Whooping cough can kill one in 200 babies who catch it, between 2008 and 2012 eight precious babies have died in Australia (anecdotally, I know of another tragic loss since the article linked to was written).

I find it quite bizarre that the AVN and its supporters are so ready to call those who disagree with their dismissive attitude toward obtaining proper diagnosis though comprehensive clinical assessment from a qualified health care professional fear-mongers and panic merchants, given their own propensity to disseminate rather alarmist (and highly inaccurate) claims about vaccines causing autism, cancer and death. Indeed, there are alarmist and inaccurate claims made by Meryl Dorey in the above comments regarding antibiotic use.

Meryl’s position on whooping cough seems to be shifting – she now concedes that it can be fatal, an assertion at odds with her previous infamous statement made in April 2009, “You didn’t die from it 30 years ago and you’re not going to die from it now.” (the context of this quote is outlined in this post on The Skeptic’s Book of Pooh Pooh, and its veracity is examined here on A Drunken Madman’s blog). Incidences of death due to whooping cough are something Meryl has struggled with repeatedly in the past – Reasonable Hank demonstrates further inconsistencies with Meryl’s statements here.

In the comments above, Frankie M makes some very reasonable and appropriate points and is attacked. It makes me wonder how many of the AVN’s supporters (or potential supporters) are criticised and banned for questioning the position and responses of the AVN.

Credit where it is due though, Meryl did advise Maree P to take her child to a GP, albeit not with much urgency. I very much hope that Maree P did see a doctor and that her child managed not to contract whooping cough. This thread was deleted from the AVN’s page, so I have no further news.

I’ll wind up this post with a response to a comment on admin RR’s thread by Peta R:

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Indeed, our opinions are our own – some hold a lot more weight than others though; personally, I’m very comfortable with trusting the experts’ opinions when it comes to matters too complicated for non-experts to adequately assess (see: Further Reading).

As for why anyone would pour such time and energy into something they disagree with – to put it very simply, it is because the AVN can influence parents to put their (and others’) children’s lives at risk by refusing vaccinations. Tragically, I imagine that many of the AVN’s core members and supporters feel the same way – that they too are fighting to protect the safety and wellbeing of children. Some of their intent is perhaps noble. Sadly, this has no bearing on the fact that they are wrong – wrong about the facts surrounding vaccine preventable diseases and, by my estimation, wrong in their belief that it is ethically acceptable to downplay the importance of seeking professional medical advice when a child is suspected of having or has been exposed to a harmful and potentially lethal disease.

It is unfortunate that anybody would consider the AVN to be an appropriate source of advice and information when their child is sick. While the AVN represent themselves as knowledgeable on matters of health and vaccine preventable diseases (despite their lack of training, association with any regulatory body or adherence to an ethical code of conduct), they assume a great responsibility to those who seek their advice. In downplaying the seriousness of vaccine preventable diseases and being dismissive of the importance of seeking the opinion of medical professionals, it is easy to imagine the AVN finding themselves responsible for some very tragic consequences in the future. The AVN must be held to account.

If you would like to become involved or show your support for those opposing the AVN’s conduct, you are welcome to visit and join Stop the Australian (Anti)Vaccination Network on Facebook.

Update: As a result of complaints regarding the AVN’s conduct outlined in this post, the AVN have issued a Quack Miranda Warning. I have written about it here.

Update: Here is another case of the AVN failing to urge the caregiver of a sick child to take them to hospital.

Further Reading:

Health Information and Health Products Online Fact Sheet – Better Health Channel

Measles Fact Sheet – Better Health Channel

Whooping Cough (Pertussis) Fact Sheet – Better Health Channel

Homeopathic Vaccine Regulation – La Trobe University News

Homeopathy and Vaccination Fact Sheet – National Centre for Immunisation Research and Surveillance

No, You’re Not Entitled to Your Opinion – a brilliant article by Patrick Stokes on the false equivalence between experts and non-experts promoted by giving all opinions equal merit. Seriously, if you’ve not read it, do. The comments are fascinating and there are special guest appearances by Meryl Dorey and other prominent AVN supporters.

An Open Letter from Toni and David McCaffery – the link that Charlotte J posted, two amazing parents raising awareness of the dangers of whooping cough after losing their precious daughter Dana.

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Five responses to claims made by the Australian (anti-)Vaccination Network.

I would like to briefly address some assertions that I have witnessed being made by the Australian (anti-)Vaccination Network (AVN). The following five quotes are representative of recurring claims.

"Because every issue has two sides"

1) “Every issue has two sides” (from the banner at the top of the AVN’s website, above)

Indeed – and some sides are just plain bulldust!

In the case of whether vaccination is safe, effective and our best chance at protecting ourselves from vaccine preventable diseases, on one side is scientific consensus, the educated opinion of the medical fraternity, public health policy and the majority of informed laypeople. On the other are a few rogue scientists, conspiracy theorists, misled and misinformed individuals and charlatans.

Insisting that anti-vaccination spokespeople be heard whenever the subject of vaccination comes up is demanding false balance. It is equivalent to ensuring that a flat-earther be invited to speak at a geography conference or teaching intelligent design in science classes. The scientific consensus is in and it has been in for a long time. Any controversy regarding whether vaccination is the safest and most effective method of preventing vaccine preventable diseases is being manufactured from an ill informed and non-evidence based position.

2) “We are not anti-vaccination – we are about choice” (‘Doctors unite to smash the anti-vaccine group‘, The Daily Telegraph, 22 July 2012)

…just as long as that choice is to refuse vaccination.

I have looked long and hard, as have others, and have been unable find one example on the AVN’s website of a situation in which the AVN would find vaccination to be an acceptable proposition. The AVN sells a t-shirt in their online store which reads “Love them. Protect them. Never inject them.”

A Titan Arum by any other name would smell as rank, the AVN are anti-vaccination.

I presume that the AVN’s insistence that they are pro-choice is a PR exercise. I would like to know precisely why they wish to distance themselves from the movement that they are a part of.

I suspect that their decision to label themselves ‘pro-choice’ instead was to help cultivate a desired image of the AVN as oppressed freedom fighters. I feel that Meryl Dorey’s Twitter account “nocompulsoryvac” and blog posting handle “nocompulsoryvaccination” support my hypothesis.

As such, I would like point out that there is no threat to peoples’ right to refuse vaccination for themselves or their children in Australia. Parents may choose to forfeit a financial incentive or government benefit when they refuse to vaccinate their children. In some instances adults may need to choose a career which doesn’t require them to be vaccinated for the safety of themselves and others. However, Australian health policy does not enforce compulsory or mandatory vaccination and I know of very few people who feel that it should.

3) “Vaccination is neither 100% safe nor 100% effective and parents need to be fully informed before making a decision for their children.” (‘Public Health Unit Turns Down the Offer to Speak at Vaccination Seminar | Vactruth.com‘ AVN blog post (comments), 16 June 2012)

I concur, let’s have a biscuit!

I have never heard anybody make the claim that vaccination is either 100% safe or 100% effective. When weighing up the risks associated with vaccination against the risks in not vaccinating, vaccination is inarguably the much safer option. Likewise, the efficacy of vaccination in preventing vaccine preventable diseases (or ensuring a much milder case of the illness is contracted in some cases when exposure occurs) is incomparable against the non-existent preventative powers of not vaccinating at all.

I agree that parents should be making an informed decision when considering vaccinating their children. However, that information should be correct and come from a credible source, such as their GP or the Immunisation Handbook, rather than shonky misinformation websites such as that of the AVN, whale.to or naturalnews.com.

4) “How many children are we willing to sacrifice before the altar of vaccination in order to ‘protect’ society?” (‘Can children be considered collateral damage‘, AVN blog post, 24 March 2011)

None. No light-hearted opening line for this one.

I assert that the suggestion of ‘sacrifice’ is an inaccurate and unreasonable appeal to emotion. Any harm caused by vaccination is a tragedy and those involved in the development of vaccines work
tirelessly to improve the safety of vaccines in order to bring them as close as they can possibly be to being 100% safe.

While the majority of adverse reactions to the whole cell pertussis component of Triple Antigen were mild and had no long term effects (these included fever, irritability, persistent crying and local site reaction), immunologists worked to produce an acellular pertussis vaccine which has been associated with far fewer reactions. Likewise, the incredibly rare occurrence of paralytic poliomyelitis (one in two point four million) from the oral polio vaccine was considered unacceptable. Because of this, the inactivated poliomyelitis vaccine was developed.

Again, consider the risks associated with vaccination alongside the risks inherent with non-vaccination. Opting out of vaccination (without a genuine medical contraindication) is choosing the much higher risk of not vaccinating. There is no completely safe option, only one with a comparatively low risk – a low risk which is being reduced with every development which improves the safety of vaccines we use.

5) “I find the hostile attitude towards parents of vaccine injured children particularly astounding, as parents of children that have been killed or disabled have always been treated with an outpouring of compassion, understanding and empathy.” (‘‘Anti Vaxxer’ the new dirty word?‘, AVN blog post, 31 July 2012)

Meryl Dorey and a number of her colleagues identify as parents of vaccine-injured children, but I assert that framing criticism of the AVN as ‘attacks on parents of vaccine-injured children’ is a cheap and inaccurate attempt to demonise anybody who publicly disagrees with them.

I appreciate the diverse experiences of parents of children with special needs. I do have some insight into family life with children with disabilities, as I grew up alongside my younger brother, who has severe autism and developmental delay. I acknowledge that I cannot claim to empathise with parents of children with special needs though and I sincerely hope that when I speak with those who do have a child with a disability I am considerate and receptive.

I acknowledge that sadly, adverse reactions to vaccines do occur and that there are children and adults with genuine vaccine injuries. I do question whether the cases of allergies, asthma, autism and other conditions which the AVN’s members are attributing to vaccination have been confirmed as vaccine related by medical professionals, given that there is no credible evidence that vaccination causes any of the above conditions. However, I do not single out individuals publicly, nor do I make contact and question or criticise them directly.

Many parents of children with special needs – including parents who have gone through the tragedy of an adverse reaction to a vaccine – are still able to accept that vaccination is our safest and most effective option in preventing vaccine preventable diseases (and my hat is off to them). Of the few who choose to reject the overwhelming majority of credible evidence supporting vaccination, there is a sub set who then spread anti-vaccination misinformation and propaganda. They are joined with others who, for reasons other than something so personal as parenting a special needs child, believe that scientific consensus is not credible and vaccination is either unsafe, ineffective or both.

I would like to clearly state that my criticism of the AVN and my desire to hold them accountable is because they are an organisation which, if left unchallenged, spread misinformation which can cause doubt as to the safety and efficacy of vaccination, scaring parents away from having their children vaccinated. Unvaccinated children are at risk of serious illness and in some instances, death. The lower the vaccination rate, the greater the risk that an infant too young to be vaccinated, a child with a compromised immune system due to cancer treatment or organ transplant or others who cannot be vaccinated will be exposed to a vaccine preventable disease.

I do not attack parents of vaccine injured children, I criticise the actions of an organisation which, given legitimacy, put the most vulnerable members of our community at risk.

(See my previous post: “This is criticism, this is not abuse“)

At the time of posting, all links to the AVN’s website are inactive. From Meryl Dorey (full text here):

“Last night, ABC’s media watch put out a dreadful story calling for the media to stop reporting the other side of the vaccination issue. The result was that so many people came to the AVN’s website, the server was overloaded and the site taken down. We have upgraded our server and should be back online within 24 hours, but it is obvious that there is a real need and desire in the community for balanced information on this issue.”

Being inclined to consider two sides to every story, Ms Dorey, I would like to suggest that instead of jumping to the conclusion that your website being overloaded and collapsing was because “it is obvious that there is a real need and desire in the community for balanced information on this issue.”, you ruminate on whether perhaps part of that flood in website traffic was comprised of individuals wishing to see for themselves just how ‘baloney’-heavy the misinformation you’re espousing really is.

In lieu of the usual ‘Further Reading’ section to this rather opinion-heavy post, I thoroughly recommend viewing (or reading the transcript of) the Media Watch segment on WINNews Illawarra, the AVN and false balance in reporting which ran on ABC TV last night. Further background information to this story is provided in Reasonable Hank’s post “ABC News teaches WIN News a lesson in responsible public health broadcasting“.

This is criticism, this is not abuse.

A month ago, shortly before the president of the deceptively named anti-vaccination group the Australian Vaccination Network Meryl Dorey and author of anti-vaccination books Greg Beattie were to commence a tour of country New South Wales to hold a series of seminars, I wrote the following letter to the venues these seminars were to be held at (predominantly service and RSL clubs) to alert them to the AVN’s behaviour and my concerns as to the consequences of anti-vaccination misinformation being taken as fact.

Dear XXXXXXX,

I am writing to ask whether yourself and those in your organisation are aware of the nature of the Australian Vaccination Network, who are conducting one of their ‘Vaccination and Health – Your Right to Choose’ seminars at your establishment on the evening of August the XXXXXX.

The AVN promote themselves as being pro-choice on the issue of vaccination, yet all of the information they present is strongly against vaccination and is supported by discredited and/or unscientific studies, anecdotal evidence, out of context quotations and cherry-picked data.

We are currently seeing surges of vaccine preventable diseases throughout the country due to lowered herd immunity and I am greatly concerned that parents misled by the seminar to be held at your premises will endanger the health, and indeed lives, of their children and others in the wider community (in particular, those who cannot be immunised due to illness) by choosing not to have their children immunised.

Respectfully yours,

Jo Alabaster

July 29 2012

I am publishing this here because I stand by my message and my conviction that I was reasonable, fair and not infringing on the rights, safety or civil liberties of anybody in saying it.

In the past few days, the AVN have set up a new section on their website, entitled ‘Dossier of Attacks on the AVN‘, in which they feature myriad claims of attacks, abuse and harassment of the AVN and its members by a ‘mob of abusers’ guilty of ‘cyberbullying’ (the dossier likens their critics’ actions to the recent attacks on Charlotte Dawson). One section is entitled ‘Censorship and Suppression‘ and features two letters, much like my own, to venues that have hosted AVN events in the past.

I disagree that such letters constitute harassment or abuse and reject them being framed as such. Certainly they are critical of the AVN and challenge both the misinformation that the AVN spreads and the lack of integrity shown by the AVN in rejecting the notion that they’re anti-vaccination, but criticism and challenges do not constitute abuse or harassment. Particularly when the AVN operates in the public arena and particularly when their claims left unchallenged can have a detrimental and tragic effect on public health.

Regarding my repeated claim that the AVN are anti-vaccination rather than pro-choice, I would like to draw your attention to a T-Shirt that the AVN has designed and sells which reads, “Love Them, Protect Them, Never Inject Them“. How much more blatantly anti-vaccination can you get? Well, this much more – here’s a substantial list of examples of the AVN’s anti-vaccination stance.

While I am writing, I would also like to address a straw man which I see the AVN using often when making claims that they are being victimised, that their critics are ‘attacking parents who do not vaccinate’.

Parents who do not vaccinate who make their decision based on the misinformation and scaremongering perpetrated by anti-vaccination groups such as the AVN are one of the main reasons that I feel it is important to challenge, criticise and publicly discredit the anti-vaccination movement. I feel that it is a wretched shame that they have been scared and misled into endangering their children and compromising others in the process. The culprits in this situation are not these parents, but those who spread the misinformation that persuaded them not to vaccinate. Harry Phillips on Stop the Australian (anti)Vaccination Network’s Facebook page says it wonderfully here (or he did, before the screenshot was removed by Facebook following a complaint that it ‘violated community standards’. It can now be viewed here. Harry has also been banned from Facebook for 24 hours as a result of this complaint of rather questionable legitimacy. [10:40am 02/09/2012]).

Unchallenged, the AVN is more likely to seem credible to those it is trying to persuade (which, I assume, is why they have banned over two hundred people from their Facebook page, many of whom criticised them, questioned them or presented information that the AVN did not agree with – how’s that for ‘censorship’?). So I will criticise and I will challenge, in public, as will so many others. This is not abuse or bullying, this is an attempt to protect the public against dangerous lies which threaten our health.

Perhaps the AVN would do well to consider why their claims come under so much scrutiny, why so many are passionate about discrediting them. It isn’t because we’re paid by ‘big pharma’, brainwashed by the media or government, naive, corrupt, bullies or on a bandwagon. It is because, simply, vaccination is the safest and most effective method by which we can protect ourselves and our children from infectious disease. Every parent who is convinced by the AVN not to vaccinate is putting their child at risk of vaccine preventable disease and endangering those most vulnerable in our society who cannot be vaccinated due to age or illness. When enough people are convinced not to vaccinate, herd immunity drops and epidemics occur. No conspiracy, naivety or spitefulness is inherent in criticising the AVN, just the above facts.

NB: Any actual threats or abuse should be referred to the police for investigation. I do not condone such behaviour.