medicine

RACGP on homeopathy, the Good Thinking Society, and Homeopathic Owl – O Rly?

The following is a transcript of Evidence, Please on The Skeptic Zone Podcast #346 {Permalink}.

This week, news about that continual thorn in our side, homeopathy!

First up, I’d like to read you a media release from the Royal Australian College of General Practicioners, which was picked up as a news story by several media outlets this week.

From racgp.org.au,

Homeopathy treatment not effective and should not be prescribed

3 June 2015

GPs should not prescribe homeopathic remedies for their patients and pharmacists should not sell or recommend the use of homeopathic products, according to the Royal Australian College of General Practitioners (RACGP).

Releasing its position statement on homeopathy, RACGP President Dr Frank R Jones said GPs practiced in evidence-based medicine and there was robust evidence homeopathy had no effect beyond a placebo as a treatment for various clinical conditions.

“Given this lack of evidence, it does not make sense for homeopathy products to be prescribed by GPs or sold, recommended or supported by pharmacists,” Dr Jones said.

The RACGP position statement maintains that homeopathic alternatives should not be used in place of conventional immunisation.

“It is irresponsible to claim that homeopathic vaccines are a proven alternative to conventional vaccination. The reality is that these alternatives do not prevent diseases or increase protective antibodies and there is no plausible biological mechanism by which these alternatives could prevent infection.

“Individuals and the community are exposed to preventable diseases when homeopathic vaccines are used as an alternative to conventional immunisation,” Dr Jones said.

Another risk of homeopathy is that people delay or avoid seeing a GP – exacerbating their condition through delayed care – and reject conventional medical approaches.

“Spurious claims made by homeopathic practitioners and retailers can mislead people about the effectiveness of conventional medicine and this can result in serious health consequences,” Dr Jones said.

The position statement also outlines that many private health insurers subsidise homeopathy through ‘extras’ cover when alternative evidence-based treatment methods are available.

“Whilst we appreciate and recognise the right of patients who may choose or seek homeopathy, unfortunately all taxpayers are funding homeopathy via the Federal Government’s private health insurance rebate,” Dr Jones said.

“The RACGP is concerned that health insurance premiums continue to rise as significant subsides are paid for homeopathy and other natural therapies. In 2013-14 health insurers paid out $164 million in benefits for natural therapies, an increase of almost 60% from 2010-11.”

Earlier this year the National Health and Medical Research Council (NHMRC) analysed the scientific evidence for the effectiveness of homeopathy in treating a range of clinical conditions. It concluded that homeopathy produces no health benefits over and above that of a placebo, or equivalent to that of another treatment.

While all of this is really good – and an excellent public statement to be making to help the population become more aware of issues surrounding homeopathy… the fact that it doesn’t work, that something that doesn’t work is being sold in pharmacies, that something that doesn’t work is being included in taxpayer subsidised private health cover and is driving up premiums… I can’t help but feel a little stunned that doctors and pharmacists would ever need to be told not to recommend homeopathy. How anyone who has studied medicine – pharmacology in particular – could give a moment’s thought to even allowing patients to select homeopathic treatment without an explanation as to its lack of efficacy – let alone
recommend it – is quite beyond me.

Still, the RACGP’s position statement is, like the NHMRC’s findings, more weight coming down on homeopathy.

Homeopathy in pharmacies is one of my greatest bug bears. It’s easy for people to consider its existence alongside evidence based treatments to be an endorsement for its efficacy, particularly given the credibility of pharmacists.

One argument as to why pharmacies stock homeopathy is that they’re being run as businesses, and there’s a public demand for homeopathic products. Which is frustrating, as they’re businesses which we rely on for vital health information and products (and discount glitter nail polish, an integral item for my personal well being). Pharmacies are businesses, but
they’re also an essential service – one that most of us need to use from time to time, one through which we rely on the services of a university trained professional.

Accepting the business model though, makes me wonder whether part of the push for change could come from consumer demand. Perhaps one day we could get a large enough percentage of the public to say no to homeopathy… and if a pharmacy chain removes it from its shelves, reward them with our custom.

This is highly idealistic, I realise. In the meantime, we do have groups such as Friends of Science in Medicine lobbying for the removal of non-evidence based products from pharmacy shelves – you can see what they’re up to and if you’re so inclined, lend them your support by going to scienceinmedicine.org.au.

"Dilution" by xkcd

“Dilution” by xkcd – https://xkcd.com/765/

Across and up to the UK now, where the Good Thinking Society have been campaigning to have homeopathy struck off of the NHS – that’s the National Health Service, akin to Medicare down here, which funds homeopathic hospitals! The campaign has had a great success so far, with extensive media coverage and Clinical Commissioning Groups – local area groups which organise the delivery of NHS services – reassessing their support for homeopathy – some
announcing that they will no longer be funding such.

As part of the Good Thinking Society’s efforts to examine and publicise what’s going on with NHS funded homeopathy in the UK, our eminent friend Michael Marshall investigated precisely what’s being sold by homeopathic pharmacies which supply the NHS… and came across something rather bizarre… an owl remedy!

Freeman’s homeopathic pharmacy in Glasgow lists all sorts of weird and wonderful remedies on their website, including three different remedies labeled “Owl”! Marsh decided to find out more about the owl remedy, and called Freeman’s.

What followed was a slightly surreal conversation, in which the pharmacy assistant informed Marsh that the remedy was made from owl feathers, and was prescribed by homeopathic “doctors” and practicioners not for owl allergies, but for people who were taking on the characteristics of owls, such as… not sleeping.

The entire conversation is available as a YouTube video, I’ll put a link in the show notes, as it’s well worth a listen – and a watch.

During the conversation, the homeopathic pharmacy assistant stated that homeopathic owl was for doctors and practicioners to prescribe, and not sold over the counter – yet the Good Thinking Society was able to purchase it online without a prescription, nor a warning that one is required. Hmm.

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Discoveries such as this, while disturbing in a sense, are also incredibly useful. The strange combination of absurdity and bulldust in the homeopathic owl expose caught not only the attention of skeptics and the like on social media, but also that of the Daily Mirror, which ran a story on the Good Thinking Society’s work around homeopathy and the case of the
owl remedy. A huge well done to the Good Thinking Society!

And you know, if you find something similarly bizarre… pursue more information and consider going public! Weirdness can be an excellent way to draw public and media attention to pseudoscience.

Finally, here’s a fantastic tweet which caught my eye from Andy Lewis, whose Twitter handle is @lecanardnoir:

Too right!

You can read more about the Good Thinking Society’s amazing work at goodthinkingsociety.org.

Until next week, have a hoot of a time!

A transcript of this report with links has been posted at my blog, which can be found on evidenceplease.net.

On Taking Health Advice from Gandhi… World Homeopathy Awareness Week 2015

World Homeopathy Awareness Week (WHAW) is approaching once again, to take place from the 10th to the 16th of April 2015.

Last year’s WHAW took place just as the NHMRC’s draft information paper examining evidence on the effectiveness of homeopathy in treating health conditions had been made public, which led to a substantial amount of awareness raising via the media that homeopathy is not an effective modality. Similarly, this year WHAW is taking place the month following the release of the NHMRC’s completed review on homeopathy. This review has lead to headlines stating the findings that homeopathy is no more effective than a placebo, which makes for some fine public awareness of homeopathy from an evidence based perspective.

World Homeopathy Awareness Week’s theme for 2015 is, “Homeopathy For Infectious Diseases’.

There is no evidence for, nor plausible mechanism by which, homeopathy can be of any use in treating infectious disease; and I feel that it is highly unethical and very dangerous to mislead people by claiming such, particularly in the midst of the US’ current measles outbreak, and the ongoing ebola epidemic in West Africa.

The belief that ‘homeoprophylaxis’ (also referred to as ‘homeopathic vaccination’) provides any protection from diseases which ought to be prevented with immunisation leads to parents falsely assuming that they have adequately addressed preventative healthcare. This false sense of safety is both incredibly dangerous and cruel – ‘homeoprophylaxis’ (and homeopathy in general) cheats consumers into believing that they are looking after their own and their childrens’ health.

Speaking of unreliable and non-credible health advice, the organisers of WHAW have uploaded the image below as their cover photo on the Facebook page for World Homeopathy Awareness Week 2015, featuring a pro-homeopathy quote attributed to Mahatma Gandhi.

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Source: WHAW Facebook

Mahatma Gandhi is a widely influential and highly esteemed man; a peace activist, civil rights pioneer and the preeminent leader of Indian independence movement in British-ruled India. His philosophies regarding human rights, non-violent civil disobedience and the nature of humanity are valued by many people worldwide.

Did this qualify him to speak on matters of medicine and health with any authority though? He had no medical training or expertise (he was educated in law), but nonetheless penned a treatise on health matters, in which he noted, “I have arrived at certain definite conclusions from that experience, and I now set them down for the benefit of my readers.”

“A Guide to Health” by Mahatman Gandhi is available as a free ebook, courtesy of Project Gutenberg. It contains some quite fantastic claims and philosophies about the human body and the nature of disease, which I will gently describe as “ill informed”. For example,

The world is compounded of the five elements,—earth, water, air, fire, and ether. So too is our body. It is a sort of miniature world. Hence the body stands in need of all the elements in due proportion,—pure earth, pure water, pure fire or sunlight, pure air, and open space. When any one of these falls short of its due proportion, illness is caused in the body. – p12

On the cause of fever:

As most fevers are caused by disorders of the bowels, the very first thing to do is to starve the patient. It is a mere superstition that a weak man will get weaker by starving. As we have already seen, only that portion of our food is really useful which is assimilated into the blood, and the remainder only clogs the bowels. In fever the digestive organs are very weak, the tongue gets coated, and the lips are hard and dry. If any food is given to the patient in this condition, it will remain undigested and aid the fever. Starving the patient gives his digestive organs time to perform their work; hence the need to starve him for a day or two. – p100

On smallpox:

In fact it is caused, just like other diseases, by the blood getting impure owing to some disorder of the bowels; and the poison that accumulates in the system is expelled in the form of small-pox. If this view is correct, then there is absolutely no need to be afraid of small-pox. If it were really a contagious disease, everyone should catch it by merely touching the patient; but this is not always the case. – p105

Incidentally, Gandhi is highly quotable by anti-vaccination campaigners:

Vaccination is a barbarous practice, and it is one of the most fatal of all the delusions current in our time, not to be found even among the so-called savage races of the world. – p107

On first aid for burns:

If the skin has simply got red by the burn, there is no more effective remedy than the application of a mud poultice. If the fingers have been burnt, care should be taken, when the poultice is applied, that they do not touch against one another. This same treatment may be applied in cases of acid-burns, and scalds of every description. -p132

(Incidentally, for evidence-based guidelines on treating burns and some unfortunate quackery regarding burns, here is an excellent report by another of the Skeptic Zone reporters, Heidi Robertson.)

Gandhi himself ruminated on whether indeed he was qualified or correct in writing on health matters:

One question which I have asked myself again and again, in the course of writing this book, is why I of all persons should write it. Is there any justification at all for one like me, who am no doctor, and whose knowledge of the matters dealt with in these pages must be necessarily imperfect, attempting to write a book of this kind?

My defence is this. The “science” of medicine is itself based upon imperfect knowledge, most of it being mere quackery. But this book, at any rate, has been prompted by the purest of motives. The attempt is here made not so much to show how to cure diseases as to point out the means of preventing them. And a little reflection will show that the prevention of disease is a comparatively simple matter, not requiring much specialist knowledge, although it is by no means an easy thing to put these principles into practice. Our object has been to show the unity of origin and treatment of all diseases, so that all people may learn to treat their diseases themselves when they do arise, as they often do, in spite of great care in the observance of the laws of health. -p143

Unfortunately, pure motives are not enough when it comes to dispensing health advice, nor was Gandhi’s necessarily qualified to pass judgement that most science based medicine is ‘mere quackery’. It is also pertinent to remember that Gandhi wrote this treatise in 1921 – our body of knowledge in the field of medicine has grown immensely over the past century.

I invite you to have a fossick around “A Guide to Health” (his thoughts on chastity and childbirth were too long to include in this post, but they’re quite amazing) and come to your own conclusions as to whether you think he is a reputable source of health advice.

I ask you to then consider whether the endorsement of homeopathy cited by WHAW holds much gravitas when you’re aware of Gandhi’s ideas on health and medicine in general.

Finally, please take into account what is possibly the icing on the cake here… I have not been able to find any evidence that the quote used by WHAW can reasonably be attributed to Gandhi. Neither have these skeptics on stackexchange, or commenters on this post of Orac’s. Likewise, @zeno001 has been searching for an original source for the quote, to no avail (but he has listed some examples of Gandhi mentioning homeopathy, seemingly not in a favourable light)*.

The only place I’ve found the Gandhi quote “Homeopathy… cures a larger percentage of cases than any other method of treatment and is beyond doubt a safe, economical and a most complete medical science” (or any variations thereof), has been on pro-homeopathy sites – not in any independent archives of Gandhi’s writings or speeches. As such, I think that it’s a fair call to label the quote as unverified.

So to summarise, the WHAW organisers have used an unverified quote from a source whose health advice is highly questionable, to promote awareness of a modality for which there is no evidence of efficacy in treating disease greater than that of a placebo.

World Homeopathy Awareness Week 2015. Once again helping to raise public awareness that homeopathy is bulldust.

* Updated 24/03/2015, thanks to zeno001 for the additional information.

Adult Pertussis Boosters – Please Help Protect Babies from Whooping Cough

There has been some incredibly sad news this week.

Four week old Riley John Hughes from Perth, Australia, has died as a result of contracting whooping cough (pertussis).

Baby Riley John Hughes (Source: Facebook)

Baby Riley John Hughes (Source: Facebook)

I cannot fathom what Riley’s family have gone through over the past weeks, caring for their son as he was ill, then holding him as he passed away. The loss of a newborn is a tragedy I have no words for, especially to a cause that we as a society have the capacity to minimise risk for. As with other families who have lost a baby to whooping cough, my heart and all of my support are with the Hughes family, now and in the future.

The capacity that humans have to get through unimaginably awful circumstances is something which I am in awe of. In an unfathomable show of strength and caring, I have witnessed people who have undergone the most terrible losses make the decision to campaign publicly in the hope of affecting change.

Two such people, the parents of Dana McCaffery, who have campaigned extensively for the prevention of whooping cough since losing their beautiful four week old daughter in 2009, brought my attention to the profound importance of vaccination, and inspired me to join others in the fight to prevent the lives of children being placed at risk by this disease.

The parents of Riley John Hughes have also made the decision to go public with their tragic story, in the hope that Riley’s passing will promote public awareness of the danger of whooping cough.

From a post on the Light for Riley Facebook Page, set up by Riley’s family as a contact point with the public and media, Riley’s father Greg has written,

“We’re desperate to ensure the passing of our child has not been in vain and to try and assist other families who may be potentially suffering from similar circumstances,”

“Long term we’d ideally like to be the drivers of change within this country surrounding the treatment, management and long term eradication of this horrific disease.”

Riley’s family have also set up a fundraising page in conjunction with Princess Margaret Hospital, to honour their son’s memory and raise money to be used by PMH to help fight whooping cough, respiratory illness and other preventable diseases.

Following the news of Riley’s death, the NSW Minister for Health, Jillian Skinner, announced that free pertussis vaccines will be made available to pregnant women in their third trimester. Shortly after, WA Health Minister Kim Hames announced to in Parliament that a no cost pertussis vaccine program for pregnant women was being fast-tracked and will be available in two weeks’ time. This will bring New South Wales and Western Australia in line with Queensland and Victoria, who have already implemented free maternal vaccination for women in their third trimester – a strategy which provides both protection to the mother, so that the risk of her contracting whooping cough and passing it on to her newborn is greatly minimised, and protection to the newborn child through passive antibody transfer in-utero.

This is very welcome news, and I hope that the remaining Australian states and territories will follow suit (the Northern Territory offers free pertussis vaccines to parents and close family members of children under seven months old, but no maternal third trimester immunisation). Still, I believe that we need to do more to prevent the spread of whooping cough.

When my son Oscar was born in 2009, New South Wales provided free pertussis vaccines not only to parents of newborn children, but to family members who were likely to come into contact with the child during those most vulnerable few weeks. All of my son’s grandparents and his aunt took this opportunity to access the whooping cough vaccination, which provided us with protection known as the cocooning effect – surrounded by immunised people, he was less likely to be exposed to pertussis.

Sadly, this strategy was unable to completely reduce the risk of my children being exposed to whooping cough. My daughter Daphne arrived in 2011, meaning that both of my children were born during the 2009-2012 whooping cough outbreak, and I was concerned when my children were out in public – particularly as I live in an area with one of the lowest vaccination rates in Australia. Several local playgroups are attended by families who openly don’t vaccinate, and I wasn’t willing to risk my children being exposed to whooping cough; particularly before they turned six months old and had completed their course of three vaccinations (the acellular pertussis vaccine is given at two, four and six months of age, as per the Australian National Immunisation Program Schedule).

I wasn’t only concerned about unvaccinated children and low herd immunity in my local area though; many adults in Australia do not have immunity to whooping cough – be it through not knowing that pertussis vaccines are available, not being aware that adult immunity wanes after 5-10 years and that boosters are required, or not realising the potential outcomes of contracting pertussis… sustained serious illness and the risk of passing it on to others.

Indeed, Riley Hughes’ family members had been vaccinated against pertussis. This minimised his risk of exposure, but was not enough to protect him.

According to the 2009 Adult Vaccination Survey, carried out by the Australian Institute of Health and Welfare, only 11.5% of adults in Australia have received a pertussis booster.

The people at Tiny Hearts Paediatric First Aid have launched a petition to increase the availability of pertussis booster vaccination at low or no cost for all adults in Australia, and have suggested that people who are concerned about low adult pertussis vaccination rates contact their state health ministers – a call to action which I am firmly behind.

While I acknowledge the difficult job that those creating and implementing public health policy have, performing cost-benefit analysis to determine where limited public health money shall be spent, I strongly conclude that resources are urgently required to increase public awareness of the importance of adult pertussis boosters, and that they need to be accessible to all. Neither cost, nor lack of awareness should be barriers to preventing the unnecessary tragedy of infant death due to whooping cough.

As the importance of adult pertussis booster vaccines is not widely understood, nor are vaccines currently freely available, I would like to ask that you help spread the word – by sharing this post, the graphic above compiled by Northern Rivers Vaccination Supporters, or the videos below (the first a segment from The Project, the second an interview with Toni McCaffery on Today Tonight) which outline Riley’s story and the importance of pertussis boosters for adults.

Additionally, if you have not had a pertussis booster within the last five years and are able, I hope that you will consider speaking with your GP about a booster vaccination. Not only will it provide you with protection from a nasty illness which can persist for several months, with greater numbers of adults in our society immunised against whooping cough, transmission rates will fall. Please help minimise the risk of another baby being lost to this horrible disease.

Melanie’s Marvelous Measles, a pro-disease book for children by Stephanie Messenger

This report appears in The Skeptic Zone Podcast #330 {Permalink}

"Marvelous"

“Marvelous”

In the wake of the current US measles outbreak, which began at Disneyland in California and has so far has resulted in 121 infections and thousands more people exposed across seventeen states (figures current for 15/02/2015), public and media attention has been directed toward the issues of vaccination and the anti-vaccination movement.

As we witness the very real effects of lowered herd immunity due to vaccine refusal, vocal support for vaccines has been prominent, as has criticism of anti-vaccination misinformation. In particular, public attention has again been drawn to “Melanie’s Marvelous Measles“; a picture book which attempts to reassure children that it’s a good thing to experience measles infection, written by Australian vaccination opponent Stephanie Messenger.

The blurb on the back cover gives a good summary as to what the book is about:

“Melanie’s Marvelous Measles was written to educate children on the benefits of having measles and how you can heal from them naturally and successfully. Often today, we are being bombarded with messages from vested interests to fear all diseases in order for someone to sell some potion or vaccine, when, in fact, history shows that in industrialized countries, these diseases are quite benign and, according to natural health sources, beneficial to the body.”

You know… this book is troubling on so many levels. When I decided to cover it in my report this week, I initially wondered whether I’d have to present you with ten minutes of stunned silence.

The story within follows Tina, who arrives at her first day back at school after the winter holidays to find that her friend Melanie is absent. Their teacher, heavily pregnant, advises the class that Melanie is at home with measles. Some children are concerned and worried about catching measles.

“Tina heard Jared tell Travis, the boy beside him, that he wouldn’t get the measles because he had been vaccinated.
Travis said that he wasn’t vaccinated, but didn’t mind, until Jared then told him angrily, “Well, you’re going to die if you don’t get vaccinated.”
Travis thought about this for a minute and said to Jared “Well, I know that isn’t true because I haven’t had any vaccinations and I am still alive!”
Jared didn’t know what to say to that!”

And why should Jared? He’s a kid… a fictional one at that. However, adults – adults who write books for children – certainly should know better.

Of course kids who aren’t vaccinated aren’t necessarily ‘going to die’… the nuances of risk are utterly lacking in this book. It’s also a little heavy handed in portraying a vaccinated kid in a negative manner – more on this later.

Tina returns home after school and chats with her mother about Melanie, measles and the other children’s reactions. Tina’s mother, who has not vaccinated Tina after attributing an illness Tine’s older brother experienced to his vaccination, reassures Tina that the measles don’t hurt. She tells Karen that children get spots on their body and can feel very hot for a day or so, and that for most children it is a good thing to get measles, as many wise people believe measles make the body stronger and more mature for the future. Tina then asks her mother why the other children were scared. Her mother replies,

“They are scared because they don’t know much about measles and most people fear things they don’t know anything about. It’s a bit like being scared of the dark.”

irony!

Tina’s mother then tells her about pox parties, and “natural lifelong immunity”

This has always puzzled me greatly. If measles and chickenpox are absolutely fine to experience, why on earth do some anti-vaccinationists declare immunity gained by experiencing an illness to be a good thing? Bizarre.

The story continues. Tina asks her mother if she can go and visit Melanie in the hopes of catching her measles. Her mother feels that this is a great idea and suggests bringing carrot juice and melon to help Melanie recover.

Yep, they’re having a pox party for two.

Melanie greets Tina at the door and proudly shows off her spots, reassuring Tina that they don’t itch or hurt at all. Melanie’s mother is nonplussed at the efficacy of the measles vaccine Melanie recieved and mentions that Melanie has the worst case of measles the doctor had seen in years.

Melanie’s family doctor… must be rather limited in his experience, if an active and happy child with a rash is the worst case of measles he’s seen in years. Common measles symptoms include fever, malaise, runny nose, dry cough, conjunctivitis and rash… complications can include middle ear inflammation, diarrhoea and vomiting, respiratory infections, pneumonia, miscarriage and premature labour in pregnant women (such as Tina and Melanie’s teacher), encephalitis (which occurs in around one in a thousand measles cases – 10-15% of people with encephalitis die, 15-40% end up with degrees of permenant brain damage). There’s one complication of measles that Melanie’s family doctor wouldn’t have been able to spot though – subacute sclerosing panencephalitis, or SSPE. It’s rare, affecting around one in a hundred thousand cases of measles, but nasty… SSPE is progressive inflammation of the brain that causes loss of personality and intellectual disability. SSPE usually begins around seven years after measles infection.

It’s hard to fathom how anybody could be aware of these facts and still classify measles as a benign short-lived children’s illness… and one to actively seek out exposure to.

Back to the book, Tina’s mother talks about the ability of ‘plenty of vitamin A’ to prevent measles and assist recovery from measles. The girls play with dolls, hug and display wonderful manners.

A week later, Melanie is back at school with no rash. Tina and her mother are incredibly disappointed that Tina hasn’t contracted measles – Tina’s mother attributes this to Tina’s immune system being in good condition, because she eats lots of raw fresh food, drinks plenty of water and plays outside.

As much as it’s feeling like shooting fish in a barrel to point out the inaccuracies in this book… I find the downplaying of how highly infectious measles is is one of the most troubling elements in Melanie’s Marvelous Measles. Measles is airborne and lives a long time outside the human body… a person can become infected with measles by entering a room that somebody carrying it has been in two hours prior. It is estimated that nine in ten people without immunity who have contact with someone who is carrying measles will contract it. Measles symptoms usually occur 10-12 days after infection… all of this means that measles can spread like wildfire – particularly in areas of low herd immunity.

The book ends with the news that Jared, our vaccinated strawman, did get the measles. Tina attributes this to Jared eating so many sweets and chips, and sanctimoniously wishes, “I hope the measles make his body stronger and more mature and that he learns to eat more fresh foods so he can take better care of his body,”. The accompanying image is of an annoyed Jared laying in bed covered in spots with a hamburger, chips (labeled ‘MSG enriched, GM Full, I kid you not), cheezels, soda, cupcake, chocolate bar on his bedside table.

The emphasis on nutrition is heavy here – as is the suggestion that good foods can prevent disease as effectively as we know vaccines can. Of course good nutrition affects general health, but as my friend Alison so eloquently put it recently, “Diseases don’t care if you’ve eaten kale or McDonalds.”

The last page features Tina beaming up at her mother, juice in hand, fruit beside her, and exclaiming, “Maybe I’ll be lucky enough to catch measles next time someone we know has them!”

There’s a dedication in the front of the book, which I’m thinking some of the book’s intended audience, children from four to ten years old, would read if they were reading independently. It states,

“Dedication . . .
This book is dedicated to Jason, my first born son. In his short life he taught me to be a more responsible parent, and with his death from vaccinations, came my life purpose.”

It seems that Stephanie Messenger has experienced terrible grief in her life, which has led her on the path she pursues. However, I question whether it is responsible to associate infant death with vaccination in a book for children – at all, but especially when the dangers of measles are downplayed so greatly – the risks of vaccination versus the diseases they prevent are utterly skewed. If I were a kid, who trusted in this book and the adult who gave it to me, I would be terrified of vaccines and fairly blase about measles. Which is perhaps the aim of this book – but goodness, I find it troubling. Kids trust their caregivers to provide them with accurate guidance in life and this book does anything but.

Mainstream media outlets, news websites and forums have been linking to Amazon’s listing of Melanie’s Marvelous Measles – and the torrent of negative reviews which Amazon users have been leaving.

Now, I don’t know how many of these people who have reviewed the book have actually read it, or whether many are just responding to its very existence. Some of the reviews are rather poignant – amongst the anger, frustration, mockery and black humour, there are some salient points which I feel bear repeating, such as this review from “Seabisquick”:

“My infant daughter went blind after contracting measles from an unvaccinated child, and yet there’s no braille version of this wonderful book for me to give her someday to explain to her how awesome the disease that took her sight away is.”

Also this, from someone identified as “AD”:

“Wow! I will have to buy this for my Dad. He and my uncle had Polio as toddlers and both were left with permanent disabilities. Now, in their golden years, they get to suffer from Post-Polio Syndrome as an added bonus! Preventable diseases truly are “marvelous” – just ask my Dad!”

A five star review from “M. J. Willow”:

“I’m so glad this book is out! Here I was thinking the two weeks of my childhood spent in a darkened room with blinding headaches and a burning fever were not fun. It was the early sixties and the measles were all the rage, but I was too young and ignorant to realize I was experiencing a miracle. This book has opened my eyes. I had to read it through some thick eye glasses though. They’re almost as fun to wear as the little, plastic sunglasses I had to keep on when I watched tv with my viral pals, The Measles. To this day the measles protect me from getting too much sun as the sensitivity to light has never left me.

Just to be a part of history and to have lived under a quarantine that stretched out to almost a month when my mother took ill with my marvelous measles is an honor I didn’t recognize. Lucky for me though! I had immunity to the disease! Good thing my mother wasn’t pregnant then. At least, I don’t think she was. I have no siblings.

I must apologize to my children for withholding such a glorious experience from them. Vaccines were available and free for the taking when they were young. I can’t believe I fell for that. Hopefully, they will forgive me for denying them this life-changing experience.”

And finally this, from user “TampaGirl”:

“What a dirtbag move to steal the title of author Roald Dahl’s book “George’s Marvelous Medicine”– Roald Dahl’s daughter died of measles. This so-called author is just a leach on society, children, and the memory of Dahl’s little girl.”

Indeed, the title “Melanie’s Marvelous Measles” does bear resemblance to the title of Roald Dahl’s book “George’s Marvelous Medicine”.

Which leads me back to the media coverage relating to the current US measles outbreak. Circulating widely at the moment is an open letter which Roald Dahl wrote to parents in 1988, in which he urges them to vaccinate their children and speaks about his own experience of losing his seven year old daughter Olivia to measles in 1962.

It’s a heartbreaking but important read, and has been republished on many websites over the past few weeks; I’ll put a link in the show notes to its publication on Snopes, which also includes Dahl’s harrowing recollection of his daughter’s last day, and his wife Patricia Neal’s perspective on losing Olivia and the effect it had on Roald Dahl.

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“For Olivia 20 April 1955 – 17 November 1962”, in the front cover of The BFG by Roald Dahl.

So much of this is sad… that there’s an outbreak of measles in a country where it was considered eradicated, that some parents need convincing in order to vaccinate their children, that dangerous anti-vaccination misinformation – some directed at children – exists at all. Based on what I’ve been observing over the past month and a half since the US outbreak begun though, more and more members of the public are standing up for vaccination and criticising misinformation – and the media are acknowledging this sentiment.

While it’s lousy that it’s taken an outbreak to catalyse this wave of public support for vaccination, and the outbreak is unfortunately far from over, hopefully the pro-vaccination sentiment will strengthen as a result and some parents who are complacent or on the fence regarding vaccinating their children may reconsider their positions.

The #StopTenpenny Campaign against anti-vaccination seminars in Australia – Podcast Report

On The Skeptic Zone Podcast #325 {Permalink}, Evidence, Please has a report on the #StopTenpenny campaign against anti-vaccination seminars in Australia by US anti-vaccine campaigner Sherri Tenpenny.

Below are the links I’ve mentioned on the report, plus a transcript below the jump.

Social Media:

#StopTenpenny on Twitter
Stop Sherri Tenpenny from entering Australia Facebook Page

Blog Posts and Facebook Statements:

Reasonable Hank, “2015 anti-vaccine tour of Australia – the Tenpenny caravan of hurt
Diluted Thinking, “Anti-vaccination Seminars in 2015 by Stephanie Messenger
Diluted Thinking, “Healthy Lifestyles Naturally (HLN) – Seminars
Reasonable Hank, “Getting to know Sherri Tenpenny – a guide
Reasonable Hank, “Venues confirm being misled by anti-vaccine Messenger – Tenpenny tour
Stop the Australian (Anti)Vaccination Network, Statement regarding SAVN views and intentions are regarding Tenpenny’s visit

Media Reports:

4th January 2015
The Daily Telegraph, Jane Hansen, “Pro-vaccine lobby fight to stop US anti-vaccination campaigner Sherri Tenpenny lecturing in Australia

5th January 2015
Mamamia, Amy Stockwell, “This woman is a danger to children. And she’s coming to Australia.
The Daily Mail, Louise Cheer, “Should this woman be allowed to preach her anti-vaccine warnings in Australia? Parents’ outrage over American doctor’s child health seminars
news.com.au, Jane Hansen, “Uproar as US anti-vaccination campaigner Sherri Tenpenny announces trip to Australia
The Guardian, Michael Safi, “US anti-vaccine activist Dr Sherri Tenpenny plans Australian tour in March
The 7:30 Report, Jane Cowan, “Anti-vaccination lobby to blame for US return of preventable diseases say doctors” (video)

6th January 2015
3AW Radio, “Victorian Health Minister slams anti-vaccine movement
SBS, Shanthi Benjamin, “Calls for government to deny visa to US anti-vaccine activist
The Age, “Vaccine row about to boil over
Sunshine Coast Daily, Adam Davies, “Push to ban anti-vaccination campaigner from Aussie tour
ABC PM Radio, Bridget Brennan, “Controversial anti-vaccination campaigner to visit Australia
The Project TV, “Ms Information – the campaign against an anti-vaccination campaigner who plans a speaking tour in Australia

Times Live, Katharine Child, “No vaccine for Mandela-itis
The Age, Julia Medew, “Doctors want to bar anti-vaccination campaigner
ABC, Bridget Brennan, “Calls to deny visa to American anti-vaccination campaigner Sherri Tenpenny to speak in Australia
Junkee, Meg Watson, “Why You Should Join The Campaign To Stop Anti-Vaxxer Sherri Tenpenny Coming To Australia
Health of Ukraine, “Scandal in Australia : the inhabitants of the country are outraged at lectures about the dangers of vaccines” (in Russian)
Herald Sun, Phillipa Butt, “Health Minister urges organisers to cancel event featuring anti-vaccination activist Sherry Tenpenny
The Age, Nick Galvin, “ABC’s 7.30 under fire over anti-vaccination campaigner James Maskell

7th January 2015

New Zealand Herald, Daily Mail, “‘Deny her a visa’ – Australian outrage over anti-vaccination activist’s speaking tour
Queensland Health, Dr Sonya Bennett, “Queensland Health’s response to anti-vaccination discussions
The Guardian, Weekly Beast, “7:30 falls into vax wars
ABC News, “Sherri Tenpenny: Who is the controversial anti-vaccination campaigner planning to visit Australia?

ABC News, “Sherri Tenpenny: Sydney venue cancels seminar of US anti-vaccination campaigner” (Republished on Mamamia)
SBS News, “A controversial American anti-vaccination campaigner may be prevented from entering Australia.
ABC News , “Sydney venue cancels seminar of US anti-vaccination campaigner

8th January 2015

The Age, Eryk Bagshaw, “Sherri Tenpenny: US anti-vaccination campaigner’s Sydney and Melbourne shows cancelled
Sydney Morning Herald, Julia Medew, “Venues cancel events featuring US anti-vaccination campaigner Sherri Tenpenny
Medical Observer, “Doctors protest anti-vax speaking tour” (Login required)
3AW Radio, “Talking Health –  Sally Cockburn interviews Meryl Dorey and John Cunningham” (audio only)

9th January 2014

The Daily Mail, “More venues cancel anti-vax seminars
The Today Show, “Prof Peter McIntyre refutes Dr Tenpenny anti-vaccination beliefs” (video)

The Today Show, ‘The Grill’, “Misinformation tour by anti-vaccination activist” (video)
The Guardian, Oliver Milman, “Anti-vaccination campaigner compares critics to Charlie Hebdo attackers

11th January 2015

Sydney Morning Herald, “Anti-vaccination views are misguided – but not illegal
Daily Life, Jacqueline Maley, “Anti-vaccination advocate’s tour in tatters after most venues cancel
Sunrise TV, “Health experts urge parents to vaccinate kids” (video)

Skeptical Coverage:

Doubtful News, “Tenpenny’s anti-vaccination tour hits a snag in Australia (Update)
Society for Science Based Medicine, “They Do Not Shrug Down Under

Petitions:

change.org, “Petition to Refuse Sherri Tenpenny’s Visa into Australia
The Parenthood, “Petition to STOP anti-vax. campaigner Sherri Tenpenny #StopTenpenny

Event Links:

EventBrite Event Listing and Ticket Sales
GanKinMan Foundation
GanKinMan Foundation FB Page
Birth, Baby and Beyond FB Event

 

Report transcript:

(more…)

Anti-Vaccination Advocates on the Front Line of Public Health

I have a confession to make, people. Sometimes I read the comments. And sometimes I even join in.

Earlier today, ABC News posted a news article on their Facebook page regarding Federal Health Minister Peter Dutton’s meeting with his state counterparts to discuss a possible decision to withhold Family Tax Benefit payments from parents who refuse to vaccinate their children, for non-medical reasons. It’s a complicated issue and one that Dr Julie Leask has addressed in the news article itself.

ABC News’ Facebook moderator invited comments from Facebook users on the topic, prompting much discussion, both advocating and opposing vaccination itself, and agreeing with or criticising the proposal to withhold benefits from families who choose not to vaccinate their children. Having a little free time on my hands, I had a look over the comments and made a few myself; predominantly providing rebuttals to anti-vaccination rhetoric and suggesting that people discuss any concerns that they may have about immunisation with a qualified health professional.

Here’s a fairly typical example of the sort of comment that those who oppose vaccination make on such threads:

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Usually I’ll respond to this sort of statement with an explanation of herd immunity, that unimmunised children increase the risk of vaccine preventable diseases entering our community, the importance of protecting children for whom vaccines are medically contraindicated (be it due to medically diagnosed allergy, an immunocompromised state due to cancer therapy or organ transplant, or being too young to yet be immunised), that vaccines aren’t one hundred percent effective (often noting that seatbelts aren’t either, but it’s sensible to take the high level of protection that we can get over none at all).

We’ve got a couple more fallacies here. “Straight up poisons” sounds fairly terrifying, but doesn’t take into account the rigorous testing vaccines go through, nor the doses at which vaccine ingredients are administered. Break down our foodstuffs and you’ll find scary sounding chemicals in many fruits and vegetables in minute amounts; some of which also occur naturally in our own systems.

To suggest that anybody is proposing that parents will be “forced” to immunise children is also disingenuous. The current proposal is to withhold a payment as an incentive, the option to refuse to vaccinate would still be available.

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Earlier, I mentioned that I often suggest to people that if they have concerns about immunisation, they should discuss them with a qualified health professional. Here, Deb has informed us that she is indeed speaking as a health professional.

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In fact, she is a nurse. The sort of person we should reasonably be able to trust for sound advice and information on vaccines. A practitioner of evidence based medicine.

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Here are some odd generalisations regarding lifestyle choices! Thankfully, many parents who ensure that their kids get outside and play and give them… food stuff that is actually food stuff… also choose to vaccinate.

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Which epidemics? Were vaccinations around during these epidemics also?

Sanitation is a marvel for public health, but it is not responsible for the significant lowering of vaccine preventable diseases. More information on this frequently repeated myth from WHO.

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A healthcare practitioner who buys into the “Big Pharma” business?

It troubles me. Out of curiosity, and using publicly available data, I found Deb’s LinkedIn profile. Her name (she uses a pseudonym on Facebook, but her Facebook URL contained her surname), photo and job description matched, so I am quite confident that I’ve identified her correctly. She works as a clinical nurse in what she describes as a “large, busy, Metro ED Department”.

Her refusal to have the influenza vaccine leaves her prone to contracting it… and working in an emergency department, she is likely to have a high risk of exposure to the virus. If she is at work while contagious, there’s potential for her to pass it on to some very ill and vulnerable patients under her care.

What is also deeply disturbing to me though, is that somebody on the front line of public health – in a position of authority on healthcare – would hold views that so strongly reject many tenets of evidence based medicine. We should be able to trust clinical nurses to know better.

 

 

19:20 – 12/04/2014 Edited to add: Two more of Deb’s posts on the ABC News thread, presented without comment.

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Although the discussion on ABC News’ Facebook page is a public one and Deb uses a pseudonym, I have chosen to pixelate her photograph and surname for this post, as I am noting her as an example of a health professional who espouses anti-vaccination views, rather than an individual to be exposed.

Anti-Abortion Protesters and Breast Cancer Lies in Melbourne.

I am currently staying in Melbourne to attend laboratory classes and have been catching the tram in to the city morning and afternoon to get to university. A couple of mornings ago as I was looking out the window, I noticed some anti-abortion picketers with banners and signs standing at either side of the gates to the Fertility Control Clinic in East Melbourne. They were displaying signs decorated with the pink ribbon symbol and slogans claiming that abortion increases women’s risk of developing breast cancer. On my way home, I was prepared to disembark from my tram so that I could take a photograph of the banners that the picketers had set up and ask them a few questions on where they were obtaining data to support their claim, but when I passed the fertility clinic, I saw that they had gone. They were not present when I went past the next day either.

I wish to note that as disagreeable as I find the distressing messages voiced by anti-abortion picketers, I am an advocate for freedom of speech and I do not want to take away their ability to peacefully state their views; though I do appreciate the argument for exclusion zones around abortion clinic gates and would proudly volunteer to be an escort for women who use the clinic’s services, given the appropriate training.

What I do very much object to though, is when they – or anyone, for that matter – tell lies about health risks in order to scare people in to doing as they wish.

There is no credible evidence to support the claim that having an abortion or experiencing miscarriage increases the risk that a woman will develop breast cancer. When I first saw the protesters this morning and tweeted about their appropriation of the pink ribbon symbol, @danientifically (who I recommend you follow if you enjoy tweets from reasoned, compassionate people with a fine sense of humour) asked the Cancer Council Australia how they felt about it. They kindly responded with this link, which contains a brief run down of credible information regarding the myth of a link between abortion and increased risk of breast cancer.

Having had time to look into it since, I’ve found that anti-abortion protesters have been using this myth for quite some time – and as such, there is much literature citing evidence which refutes their claim. From the American Cancer Society:

In February 2003, the US National Cancer Institute (NCI) held a workshop of more than 100 of the world’s leading experts who study pregnancy and breast cancer risk. The experts reviewed human and animal studies that looked at the link between pregnancy and breast cancer risk, including studies of induced and spontaneous abortions. Some of their findings were:

  • Breast cancer risk is increased for a short time after a full-term pregnancy (that is, a pregnancy that results in the birth of a living child).
  • Induced abortion is not linked to an increase in breast cancer risk.
  • Spontaneous abortion is not linked to an increase in breast cancer risk.

The level of scientific evidence for these findings was considered to be “well established” (the highest level).

The American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice also reviewed the available evidence in 2003 and again in 2009. ACOG published its most recent findings in June 2009. At that time, the Committee said, “Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.”

In 2004, the Collaborative Group on Hormonal Factors in Breast Cancer, based out of Oxford University in England, put together the results from 53 separate studies done in 16 different countries. These studies included about 83,000 women with breast cancer. After combining and reviewing the results from these studies, the researchers concluded that “the totality of worldwide epidemiological evidence indicates that pregnancies ending as either spontaneous or induced abortions do not have adverse effects on women’s subsequent risk of developing breast cancer.” These experts did not find that abortions (either induced or spontaneous) cause a higher breast cancer risk.

The picketers’ stance against abortion is presumably a moral one, at times supported by religious belief, and I’m sure that they have moral arguments that they feel they can back up their position with. Certainly, moral positions can (and in my frank opinion, should) be backed up with fact – but when the fact being used is a blatant falsehood, I am very much compelled to call that out. Especially when those falsehoods are being used to distress people who may be feeling vulnerable.

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As a person who is strongly pro-choice and an advocate for bodily autonomy, it can be very easy to demonise anti-abortion picketers – especially given the outcomes of their protests; both the harm they cause individuals and the political influence that they hold. The use of graphic images disgusts me, harassment and attacks on both women seeking abortion and abortion providers should be dealt with strongly via the legal system. Something I try to keep in mind when I see them however, is that they genuinely do believe that their view is right – that they are fighting to save the lives of vulnerable beings. Alongside anti-vaccination campaigners who truly believe that vaccines are harming children, and religious prosthelytisers who honestly hope to save our souls from eternal damnation, the majority of anti-abortionists do believe that they are trying to stop a terrible and unjust harm that occurs within our society. It is rare that a passionate campaigner for a cause does so to do evil.

As such, I suspect that it is entirely possible that some anti-abortionists may know that the abortion/breast cancer myth is a falsehood. When I discussed my thoughts on the matter with Felix (who lacks a Twitter account for me to link to), he relayed to me an experience he had years ago, when a friend was trying to convert him to Christianity. Felix went and had a discussion with his friend’s minister and questioned the minister’s claims that homosexuality presented dangers to people’s health. When confronted with somebody willing to question the credibility of his claims, the minister actually outright admitted that they were false, but he felt that telling a lie was an acceptable and minor wrong when looking at the bigger picture; the fate of a person’s eternal soul. Likewise, perhaps some anti-abortionists realise that their claim regarding breast cancer is less than credible, but feel that it is justifiable to use it as a scare tactic in the hope of preventing women from having abortions.

It is a complex situation and I do not believe that I have the requisite knowledge or skills to have a productive conversation with anti-abortion protesters and be able to convince them that their claims regarding breast cancer are scientifically unsound and can not be ethically employed as a part of their argument. However, what I am capable of to a degree is publicly stating that their claim regarding abortion and increased breast cancer risk is incorrect – and in publicising that they are perpetrating a falsehood, I hope that anybody who has been misled by anti-abortion propaganda on this topic can be assured that it is an outright lie.

NB: I have chosen to use the term “anti-abortion” to describe what is also referred to as the “pro-life” movement, as I consider it to be a more accurate descriptor. 

Further reading:

Breast Cancer Risk Factors – A Review of the Evidence Cancer Australia

Is Abortion Linked to Breast Cancer?American Cancer Society

Abortion – Breast Cancer Hypothesis – Wikipedia

The Truth About Abortions and Breast Cancer – Cosmopolitan Magazine