Examining NVIC’s “If you Vaccinate, Ask 8”

When you go to NVIC’s home page, the image you see is this:

8-questions

 

Clicking on the Ask 8 questions link gives you this:

Ask-8-

 

As you can see, the document opens with a sentence mentioning the amount paid to those injured by vaccines since 1986, suggesting that for the awardees, the risks were “100%”. The document highlights vaccines risks, and encourages parents to “become fully informed about the risks and complications of diseases and vaccines and speak with one or more trusted health care professionals before making a vaccination decision.” It then provides a list of eight questions to ask providers.

 

The next passage alerts parents to “vaccine reaction symptoms” to be alert to:

Vaccine-reaction-symptoms

 

The list includes crossing of the eyes, twitching, onset of chronic ear or respiratory infection and more. The article does warn that not all these symptoms will have been caused by vaccine but says you cannot rule causation by vaccine out and that it’s important for the doctor to write them down and report them to the Vaccine Adverse Event Reporting System (VAERS).

 

The article introduces VAERS and says that “it is estimated that less than 10 percent, perhaps less than one percent of all vaccine-related health problems are ever reported” and encourages parents to report the reaction to VAERS themselves if their doctors won’t, and to also report to NVIC’s “Vaccine Reaction Registry.”

 

Is the article accurate?

 

Amounts paid by NVICP and the claim that for those people the risks were “100%”:

 

The opening claim in the document is doubly problematic.

First, it’s true that  since 1989, when the National Vaccine Injury Compensation Program Started operating, as of October 21, 2014 $3,001,251,232.08 have been awarded to individuals and their attorneys. But just stating that number provides an incomplete, misleading picture. For one thing, the number includes over 175 million dollars in attorney fees, including over $64 million for those whose claims were dismissed. More importantly, the total amount is high because each individual disabling injury can cost millions. If you examine the number of cases, in over 25 years NVICP compensated 3764 cases, or an average of 150.56 per year. This is on a background of many millions of vaccine doses administered (an average of 4 million babies a year, most of which are vaccinated multiple times, and on top of that adult vaccination – for influenza, for other diseases, in the military, in medical and nursing school). A calculation done here found the rate of claims to vaccines to be less than 0.003%.

 

Second, the fact that someone was vaccine injured does not make their risk “100%”. When we assess the risk that something will happen, we calculate the probability of that event, how common it is, how likely to happen. For example, in the vaccine context, the CDC’s Pink Book states that for MMR, 5%-15% of recipients will have a fever following vaccinations, and 5% will develop a rash (p. 189). So a vaccinee’s risk of getting a fever is 5-15%. But in reality, the risk does or does not happen. That does not affect the level of risk. You can be very unlucky and suffer from a rare risk, or very lucky and avoid a substantial risk.

For example, from MMR, thrombocytopenia, low platelet count, happens in one out of 30,000 cases, or at a rate of 0.003%. In other words, it’s very rare, but it does happen. You may have been unlucky and been the one to whom it happened. That’s sad (though this specific side effect usually resolves without incident) and painful. But it does not change fact that the risk is very, very rare – and it does not make your risk 100% (again, as the Pink Book points out, these cases are usually temporary).

 

The Eight Questions:

There is nothing fundamentally wrong with the questions themselves, though they are probably excessive in what they demand from parents. The list is missing, however, questions about the consequences of not vaccinating. Like the whole piece it seems to start from a perspective that the default is not vaccinating, and that any deviation – the choice to vaccinate – should only be done after careful consideration. No similar consideration is recommended before the choice is made not to vaccinate. For example, parents are not asked to consider what they would do if their child contracts a preventable disease. Or infects a child too young to be vaccinated or a child with a medical condition that prevents vaccinating. Or to consider whether they have discussed the choice not to vaccinate with a trustworthy medical professional that can answer their questions.

 

Since the scientific consensus is that the small risks of vaccinating are far outweighed by the benefits of vaccinating, first and foremost for the individual child but also for the larger society, not leading the parents to consider the problems of the choice not to vaccinate is pretty glaring.

 

The Article’s Discussion of Vaccine Reactions

The most problematic part of the article is the discussion of vaccine reactions. In short, the list includes genuine vaccine reactions that do not cause long-term harms, genuine vaccine reactions that are extremely rare, problems that science shows are not caused by vaccines, and behaviors that are common and normal for infants or children. The way the list presents “vaccine reactions” may make almost any parent think their child had a vaccine reaction – often with no basis in fact – and implies vaccines are much more dangerous than the data shows.

 

Vaccine reactions that do not normally cause long-term harms include local reactions to the shot, persistent crying, or fever. The article does not mention that they do not cause long-term harm.

 

Very rare vaccine reactions: For example, as already mentioned, thrombocytopenia can happen from MMR – in on in 30,000 cases. The article does not mention how rare the side effect is, or that it is, more often than not, temporary. By omitting information of that kind it makes vaccines seem much more dangerous than they actually are.

 

Things not caused by vaccines: Science suggests that a number of the problems listed under the heading of “vaccine reactions” are not, in fact, caused by vaccines. For example, large scale studies found no link between vaccines and asthma (see also here and here). Some of the behaviors described – the references to loss of skills, repetitive movements and head banging – seem to be covert references to autism or regressive autism, given the way they are used by other anti-vaccine activists. But the evidence is that vaccines do not, in fact, cause autism (see here, here and here). Other problems that may cause regression – for example, Rett Syndrome – are genetic in origin, not caused by vaccines. There is no evidence – and it is not even mentioned in the professional books – that vaccines cause loss of memory, restlessness, hyperactivity or inability to concentrate. One group of researchers looked at whether thimerosal-containing vaccines are related to neuropsychological outcomes, including many of those. They examined children aged 7-10 and found no effect.

 

Presenting these problems under the heading of “vaccine reactions” is highly misleading.

 

Behavior normal in Infants and Children: Some behaviors are known to be normal in young children or infants. For example, babies under four months naturally cross their eyes occasionally.[1] Similarly, infant naturally twitch.[2] And as most parents could point out, restlessness in young children is not a vaccine injury; it’s normal. These behaviors, however, can cause concern, especially with young, inexperienced parents. Listing them under “vaccine reactions” can mislead parents into thinking they were, in fact, problematic – and blaming the vaccines for them. Hardly a service to the parents.

 

In short, the entire list can potentially frighten parents more than the evidence about vaccine risks warrants. It can also prime parents to believe that anything that went wrong after the vaccine – sometimes a long time after – was because of the vaccine, predisposing them to see vaccine injuries where they do not exist. The admonition to report any of these that happen after the vaccine to VAERS can also inflate the number of events reported to VAERS by having many reports for things not caused by vaccines. Since NVIC also routinely uses unverified VAERS reports – the numbers and content – to make claims about the numbers and types of injuries caused by vaccines (e.g. here – and for the discussion of the inaccuracies and limitations of this article and the use of VAERS in it, see here) this inflation can allow them to make vaccines appear more dangerous than they are in other contexts, too.

 

Are less than 10%, Perhaps less than 1%, of Vaccine Problems Reported to VAERS?

 

NVIC provides no sources for these estimates in this article. The only sources the bloggers on this site have seen for the 10% claim were references to NVIC’s own articles. The 1% number is taken from an article by former FDA Commissioner David Kessler, where he does claim there is substantial under-reporting of adverse events. But Kessler was not talking about vaccines; he was talking about medical adverse events generally, and in fact, distinguished vaccines from other medical adverse effects. Here is what he actually said about vaccines: “Aside from adverse events associated with specified vaccines (listed in the National Childhood Vaccine Injury Act) most reporting by health providers is voluntary.” He then suggests that this voluntary reporting means that FDA only gets a fraction of the events. In short, he is expressly leaving vaccines – to which federal reporting requirements apply, and which already had a reporting system of the type he was proposing – out of the discussion.

In other words, the claim of underreporting to the extent mentioned in NVIC is unsupported.

 

There is, in fact, some credible evidence of less drastic underreporting of adverse events from vaccines. But there is also evidence of substantial over reporting – reporting of things not related to vaccines. See also here and here.

 

In short, the article misleads readers by overestimating and misrepresenting vaccine risks and misusing the VAERS reporting system. It offers a set of questions aimed at deterring parents from protecting their children against diseases using vaccines, and reinforces that with a very misleading set of alleged vaccine reactions.

 

 

[1] Archer SM, Sondhi N, Helveston EM. Strabismus in infancy. Ophthalmology 1989; 96:133; Robert M.   Kliegman, et al., Nelson Textbook of Pediatrics 2579 (Elsevier 19th ed. 2011).

[2] Visser AM, Jaddoe VW, Arends LR, et al. Paroxysmal disorders in infancy and their risk factors in a population-based cohort: the Generation R Study. Dev Med Child Neurol 2010; 52:1014.

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NVIC, Hepatitis B and accuracy

When you go to the NVIC “about” page, this is what you see:

NVIC-about-page

 

I want to draw your attention to the “Our Mission” section:

Our Mission

The National Vaccine Information Center (NVIC) is dedicated to the prevention of vaccine injuries and deaths through public education and to defending the informed consent ethic in medicine.

 

As an independent clearinghouse for information on diseases and vaccines, NVIC does not advocate for or against the use of vaccines. We support the availability of all preventive health care options, including vaccines, and the right of consumers to make educated, voluntary health care choices.

Note the balance in the paragraphs above. Note that there is absolutely no mention of the “prevention of injuries and deaths from infectious disease.” Keep these words in mind as through the following discussion.

Under the Vaccines tab , one finds a list of “Diseases & Vaccines”:
Vaccines and diseases nvic
We wish to highlight one phrase from the above:

Below are links to specific disease and vaccine information. Each topic contains information from peer reviewed science, resources and federal agencies to assist consumers in making an educated vaccination decision.

Let us examine accuracy of the information NVIC provides. This time, we will look at the information about Hepatitis B and the vaccine that prevents it.
Summary of NVIC’s Hepatitis B Article
The article  describes Hepatitis B as “a viral infection that infects the liver and requires direct contact with infected blood or other body fluids for transmission.” It claims that most infections do not persist, though it acknowledges that those that do can lead to liver disease, liver cancer and death and that it has a high death toll world wide. But it also claims that hepatitis B is not common among children in the United States and was not common before the vaccination campaigns. It says that Hepatitis B “is not highly contagious in the same way that common childhood diseases like pertussis and chicken pox are contagious,” and highlights sexual activity, blood transfusions and drug abuse as the primary modes of transmission, though it does mention infection of a newborn via an infected mother.

 

NVIC-Hep-B-page

 

NVIC’s article argues that “the primary reason that the CDC recommended hepatitis B vaccination for all newborns in the United States in 1991 is because public health officials and doctors could not persuade adults in high risk groups (primarily IV drug abusers and persons with multiple sexual partners) to get the vaccine.”

 

The article describes the vaccine creation as “genetic engineering of DNA.” In terms of risks of the vaccine the article claims that “As of March 2012, there was a total of 66,654 hepatitis B vaccine-related  adverse events reported to the federal Vaccine Adverse Events Reporting System (VAERS), including reports of headache, irritability, extreme fatigue, brain inflammation, convulsions, rheumatoid arthritis, optic neuritis, multiple sclerosis, lupus, Guillain Barre Syndrome (GBS) and neuropathy. There have been more than 1500 hepatitis B vaccine-related deaths reported, including deaths classified as sudden infant death syndrome (SIDS).”

 

The second part of the page includes an article by NVIC co-founder Barbara Loe Fisher, but this post focuses on the description of the disease and the vaccine.

 

What is the Article Claiming?

The article is suggesting that children are not at high risk of the disease unless the mother is infected (and even then, there is little discussion of the meaning of the risk). It suggests that the vaccine was adopted because authorities were unable to vaccinate the adults at risk, not to protect children. It at least implies that, in the United States, most people overcome the disease quickly.

 

It also suggests that the vaccine is highly dangerous, with a high risk of very serious adverse events.

 

Are the Claims Accurate?

Hepatitis B and Children:

One can argue about what is common, but before the vaccine thousands of children were infected with hepatitis B each year. One source says that “Before 1982, an estimated 200,000–300,000 persons in the United States were infected annually with HBV, including approximately 20,000 children.”  In a detailed article examining multiple sources of data, researchers demonstrated that before the vaccine about 16,000 children got the disease each year. Contrary to NVIC’s claims, only about half got it through an infected mother; the other half got it from other sources (id).

 

What the article is downplaying is the fact that Hepatitis B is a very hardy virus that’s much more contagious than HIV, perhaps a hundred times more contagious. The virus can survive a week in microscopic drops of blood. In adults, infection with Hepatitis B is often asymptomatic; a child or infant may be living with someone who is unaware that he or she is infected with Hepatitis B. The child then may be exposed to its harms through microscopic drops of bodily fluids that get onto household items. A child may also be exposed to Hepatitis B from microscopic drops of blood on the playground or in other places.

 

The risk of being infected is higher than NVIC is suggesting. NVIC is also incorrect about the course of infection for children. While NVIC is right that most adults do not develop chronic hepatitis B, that’s not true for children. When an infant contracts hepatitis B, there is a 90% chance that the infant will go on to develop the chronic version. Children under five have 30-50% of getting the chronic version (see: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/hepb.pdf). High rates of individuals with chronic Hepatitis B infection will go on to develop liver disease or liver cancer.

 

In short, NVIC’s article substantially underestimates the risk of the disease to infants and children, and the importance of protecting them against it.

.

 

The Hepatitis B Vaccine and its Risks:

 

If NVIC is inaccurate about the risk of Hepatitis B infection, are the claims about the risk of the vaccine any more accurate? The image below is NVIC’s risk statement about the Hepititis B vaccine:
HepB-VAERS

 

Note that NVIC makes the claim for the dangers of the vaccine by using reports to the Vaccine Adverse Event Reporting System (VAERS). It uses VAERS in two ways: enumerating the number of reports relative to the vaccine; and listing the range of physical ailments the reportees attribute to the having received the vaccine.

 

Both of these usages are, at best, problematic; at worst, they are clear intentional fear-mongering.

 

Here is why: the Vaccine Adverse Reports System is a passive reporting system: anyone can report anything, and while there is no doubt some level of underreporting to it, the evidence is that many of the reports in it are for things not actually caused by the vaccine (see here and here).

 

 

We repeat: anyone can report anything to VAERS, and without verification, all the report shows is that someone filed a report (and see here).

The NVIC article has this sentence:

There have been more than 1500 hepatitis B vaccine-related deaths reported, including deaths classified as sudden infant death syndrome (SIDS).

 

This reference to SIDS as an adverse event following Hepatitis B vaccination bears close examination. SIDS rates peak at the age of 2-6 months, ages in which certain vaccines, including Hepatitis B, are given. It’s hardly surprising, with millions of children vaccinated, that some cases of SIDS would occur right after the vaccine. In fact, an Australian study showed that it’s bound to happen by coincidence alone every year. It’s natural for parents in that situation to think receipt of the vaccine caused their child’s death, but that’s not what the evidence shows. Studies that examined rates of SIDS in children found, in fact, that vaccinated infants have a lower rate of SIDS. That doesn’t mean vaccines reduce the chances of SIDS; there may be other factors, and the causal mechanism is unclear. But the finding is powerful evidence against the claim that vaccines cause SIDS.

 

 

NVIC does not explicitly say that the reports show the vaccine caused all these scary things, such as SIDS, or that the vaccine caused over 66,000 injuries, but by listing the reports without warning readers of the limitations of the system it is clearly implying that. At the very least NVIC has to know that many readers will assume that. Presenting the information in such a way is highly misleading.

 

In contrast, the Centers for Disease Control and Prevention (CDC) describes the Hepatitis B vaccine’s adverse reactions as including local reaction, fatigue, headache, and mild fever. Very rarely there can be an allergic reaction to the vaccine. The Vaccine Education Center of the Children’s Hospital of Philadelphia lists similar problems – most commonly local reactions or low fever, very rarely a severe allergic reaction – putting the rate of a severe allergic reaction at one per 600,000.

 

 

In short, NVIC’s discussion of Hepatitis B underestimates the dangers of the disease, misrepresents the risk it poses to children in the United States, and overstates and misrepresents the risks of the vaccine. It is not a good source of information about this vaccine and this disease.

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“49 Doses” poster

49 doses 149 dose 2

This two-page document on NVIC’s site opens with a large picture of smiling children and mothers, and the title “49 Doses of 14 Vaccines Before Age 6? 69 Doses of 16 Vaccines By Age 18? Before you take the risk, find out what it is.”

The title is followed by ranges of ages with a list of the vaccines administered at each age. The bottom of the page claims that vaccines contain different ingredients, including “lab altered live or inactivated viruses and bacteria, chemicals, metals, proteins, antibiotics and human, animal and insect DNA and RNA.”

The second page of the document is split into two columns. The left side reads “If You Vaccinate Your Child, Learn How to Recognize the Signs and Symptoms of Vaccine Reactions” [capitalization and emphasis in the original] and lists several alleged vaccine reaction. For each “reaction,” there is a matching quote under the title “Mother’s Description.” This column ends by listing other reported reactions, including regressive autism, asthma, arthritis, diabetes, sudden death, and others.  It mentions the Vaccine Injury Compensation Program (VICP) and urges reporting of vaccine reactions.

The right-handed side of that asks “Is the Childhood Vaccine Schedule Safe?” It describes an increase in chronic disease in the United States and correlates it to the increase in the number of vaccines. This section includes a quote from an Institute of Medicine Report that “key elements of the entire [child vaccine] schedule – the number, frequency, timing, order and age of administration of vaccines – have not been systematically examined in research studies.”

The final paragraph discusses influenza and TDaP vaccination in pregnancy, asserting that the FDA determined there are no adequate controlled studies examining whether or not the vaccines are safe for the pregnant woman or her developing fetus.

 What is NVIC claiming?

NVIC’s claims are three-fold. First, they are claiming that we give children too many vaccines at too young an age. Second, they are claiming that vaccines carry substantial risks. Those risks include the reactions and the chronic diseases and disorders listed in the document. Finally, they claim that the current schedule, the administration of combinations of vaccines, and the practice of vaccinating women in pregnancy have not been properly studied or tested.

Are the claims accurate?

Too Many Vaccines:

We vaccinate young children against fourteen diseases, giving each vaccine in multiple doses, to provide the most effective immunity. Each of these diseases carries potential risks, up to and including death and hospitalization.

If we can prevent a dangerous disease in a safe manner, we should. So the question is whether vaccines are safe. NVIC implies that they are not–because there are too many doses, because the ingredients are unsafe, and because they carry substantial risks of adverse events.

Examining whether or not we give children too many doses, scientists have pointed out that babies face much more extensive challenges from their environment. We live in a world full of germs, and from the moment he is born, each day a baby’s immune system fights off literally thousands of them. In comparison, the challenge vaccines pose is minuscule, and far easier for a baby to handle, as scientists have calculated.

While the number of vaccines we give has increased, technological advances allow us to give vaccines that pose a much smaller challenge to a baby’s immune system,  vaccines that often include only one or a few single proteins from a bacteria or virus, and vaccines that are called subunit vaccines. The challenge today’s vaccines pose to the immune system is therefore smaller than the challenge the older vaccines posed.

Therefore, the claim that there are too many vaccines on the schedule can be dismissed as inaccurate.

As to vaccine ingredients, it is natural to be concerned about a list of scary-sounding chemical names. While vaccines contain the ingredients listed in the poster, each ingredient is serves an important purpose, and the amounts of each ingredient in vaccines are too small to cause any issue. See here and here for more information.

Do Vaccines Carry Substantial Risks?

Nothing in life is 100% safe. A child can choke on a Cheerio, get food poisoning from spinach, or hepatitis A from organic berries. Vaccines, too, can cause harm, but the evidence is that serious side effects from the vaccines on the schedule are extremely rare. They are much smaller than the risks of the diseases. The process for putting vaccines on the schedule, with its extensive testing and careful expert evaluation, is designed to make sure that vaccines are only on the schedule if their risks are minimal and far outweigh their benefits.

By listing a number of scary conditions – for example, regression or brain inflammation – and not mentioning that if vaccines cause them at all they are extremely rare, NVIC misleads its readers.

NVIC’s poster also makes claims about problems not caused by vaccines.

We addressed in our previous post the fact that vaccines do not cause autism. That fact is, however, worth repeating. Similarly, studies with tens of thousands of children examined whether vaccines cause asthma (1), diabetes (2), and allergies (3). The studies found no link. Again, the best science we have shows that vaccines are not connected to any of these chronic problems. Drawing a connection between these chronic diseases and vaccines, against the evidence, is inaccurate.

The Vaccine Schedule Generally, Multiple Vaccines, or Vaccines in Pregnancy are not tested:

NVIC implies that the vaccine schedule has not been properly studied,using, without context, a quote from an Institute of Medicine report from 2013. But the same report concluded: “Upon reviewing stakeholder concerns and scientific literature regarding the entire childhood immunization schedule, the IOM committee finds no evidence that the schedule is unsafe.”

Highlighting an isolated quote and ignoring the conclusion of the report is not an accurate representation of the committee’s conclusions.

There are, in fact, multiple studies of different combinations of vaccines. Some examples are here, here and here. And see this article. Before getting a vaccine on the market, manufacturers must do concomitant studies showing it’s safe with the schedule. Recently, such a study was done for the not yet licensed meningococcal B vaccine.

Finally, NVIC suggests that the influenza and TDaP vaccines, now recommended in pregnancy, have not been adequately studied for safety in pregnancy. But there are many studies of the flu vaccine during pregnancy. There is also a growing body of studies of the safety of TDaP in pregnancy, including at least one large scale study.

Conclusion:

This poster included a number of misleading claims and inaccuracies. We urge readers, again, to reject the unsupported or invalid claims and to keep the problems in mind when they read other materials by NVIC.

29360_4085031283616_1593902438_n


Footnotes:

[1] Balicer, R D., Grotto, I., Mimouni, M., Mimouni, D. Is Childhood Vaccination Associated With Asthma? A Meta-analysis of Observational Studies. Pediatrics. Vol. 120 No. 5 November 1, 2007.  http://pediatrics.aappublications.org/content/120/5/e1269.full; DeStefano F, Gu D, et. al. Childhood vaccinations and risk of asthma. Pediatr Infect Dis J. 2002 Jun;21(6):498-504. http://www.ncbi.nlm.nih.gov/pubmed/12182372; Hviid A, Melbye M. Measles-mumps-rubella vaccination and asthma-like disease in early childhood. Am J Epidemiol. 2008 Dec 1;168(11):1277-83. doi: 10.1093/aje/kwn253. Epub 2008 Oct 8. http://aje.oxfordjournals.org/content/168/11/1277.long.

[2] Grimaldi-Bensouda L, Guillemot D, et. al; the PGRx-AID Study Group. Autoimmune disorders and quadrivalent human papillomavirus vaccination of young female subjects. J Intern Med. 2013 Nov 8. http://www.ncbi.nlm.nih.gov/pubmed/24206418; DeStefano F, Mullooly JP  et. al. Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus. Pediatrics. 2001 Dec;108(6):E112.  http://pediatrics.aappublications.org/content/108/6/e112.long; D. Elliman. (1999). Vaccination and type 1 diabetes mellitus: Currently no evidence of a link, but more studies are needed as vaccines change. British Medical Journal, 318(7192), 1159-1160. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115570/; T. Jefferson & V. Demicheli. (1998). No evidence that vaccines cause insulin dependent diabetes mellitus. Journal of Epidemiology and Community Health, 52(10), 674-675. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1756616/.

[3] McKeever TM, Lewis SA, Smith C, Hubbard R., Vaccination and allergic disease: a birth cohort study, Am. J. Public Health. 2004 Jun; 94(6): 985-9; H. P. Roost et al. (2004). Influence of MMR-vaccinations and diseases on atopic sensitization and allergic symptoms in Swiss schoolchildren, Pediatric Allergy and Immunology, 15(5), 401-407. doi:10.1111/j.1399-3038.2004.00192.x.  http://www.ncbi.nlm.nih.gov/pubmed/15482514; P. A. Offit & C. J. Hackett. (2003). Addressing parents’ concerns: Do vaccines cause allergic or autoimmune diseases? Pediatrics, 111(3), 653-660. doi:10.1542/peds.111.3.653. http://pediatrics.aappublications.org/content/111/3/653.full.pdf; H. R. Anderson, J. D. Poloniecki, D. P. Strachan, R. Beasley, B. Bjorksten, & M. I. Asher, Immunization and symptoms of atopic disease in children: Results from the international study of asthma and allergies in childhood, Am. J. Public Health, 91(7), 1126-1129 (2001) http://www.ncbi.nlm.nih.gov/pubmed/11441744.

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NVIC, Paul Offit, and the “Hear This Well” Campaign

Welcome to the Let’s Be Honest blog, where we hope to deconstruct the claims of the United State’s largest anti-vaccine organization, National Vaccine Information Center. Little by little, we hope to reveal the agenda and the falsehooods NVIC promotes in order to help the public decide how to interpret their claims.

Case File #1: Hear This Well, Paul Offit?

On Wednesday, September 24, 2014, NVIC posted on its Facebook page a photo of Paul Offit. Overwritten on the photo were the words: “A baby’s immune system could handle as many as 10000 vaccines. Vaccine Zealot, Paul Offit.” The caption did not match the photo and was on an entirely different topic: “Meet Billy. He’s 18 and vaccine injured. Listen to Billy describe how he likes to spend his time. His mother feels that she’s one of the lucky ones– at least he can speak to her…” with a link to the Hear This Well website.

Karen's Offit NVIC screenshot

What is NVIC claiming?

NVIC’s claims are two-fold here. In the photo, they are claiming that Dr. Paul Offit, because of his overzealousness for vaccines, has asserted that babies can receive 10,000 vaccines at once. The claim in the caption is that vaccines cause autism, as “vaccine injury” is their code for autism and the Hear This Well campaign is one attempting to respond to one reporter’s comment about a study disproving the vaccine-autism connection that some people don’t “hear well” that vaccine do not cause autism. Multiple anti-vaccine groups and organizations have been trying to push the Hear This Well campaign, but it has garnered almost no traction outside their ranks.

How accurate are their claims?

Let’s look at the claims about Dr. Paul Offit first. NVIC claims that Dr. Offit is a “Vaccine Zealot,” but who is he really? Dr. Offit is the co-inventor of one of the Rotavirus vaccines currently in use today. He has authored several books, including books about autism, vaccines, and alternative medicine. At time, Dr. Offit has spoken against the use of vaccines, such as his argument that we not immunize people in healthcare against smallpox. All in all, Dr. Offit’s views are in line with the views of the CDC, the AAP, and almost every other doctor and medical scientist in the world. Those who disagree with him are a very small minority and are almost always part of an anti-vaccine organization. So the term “Vaccine Zealot” could be classified as unfair and inaccurate.

Did Dr. Offit Really claim that babies can receive 10,000 vaccines are once? According to the History of Vaccines blog, this claim has been taken out of context and is meant to address whether or not a baby’s immune system is up to the challenge of handling a vaccine:

In a kind of thought experiment he worked out in a 2002 Pediatrics article, [Dr. Offit] estimated that a child’s immune system could theoretically respond to the antigens in 10,000 or more vaccines at once. He made clear this was a theoretical position based solely on immune cell potential. (Giving 10,000 vaccines at once would be harmful in many ways: just the amount of water in that number of vaccines would cause death.) Offit has since been taken to task for this statement on anti-vaccine sites like Age of Autism, where commentors often claim that he advocates that many shots at once, or by others volunteering to give him that many shots.

Dr. Offit’s actual explanation addresses how many antigens are in a vaccine compared to how many antigens babies are exposed to on a regular basis. It was never meant to assert that babies could or should receive 10,000 actual vaccines, so this claim is clearly inaccurate.

And what about the claim that vaccines cause autism? The story that NVIC has linked to is certainly an emotional plea from a parent who believes her child not to be autistic but to be “vaccine injured.” Is there any credence to that?

The most recent research into the causes of autism suggest that autism begins before a child is born–before that child would ever receive a vaccine. National Public Radio reported on this study:

Brain tissue taken from children who died and also happened to have autism revealed patches of disorganization in the cortex, a thin sheet of cells that’s critical for learning and memory, researchers report in the New England Journal of Medicine. Tissue samples from children without autism didn’t have those characteristic patches.

Organization of the cortex begins in the second trimester of pregnancy. “So something must have gone wrong at or before that time,” says Eric Courchesne, an author of the paper and director of the Autism Center of Excellence at the University of California, San Diego.

Furthermore, for nearly 20 years, scientists have been studying multiple theories about how vaccines could cause autism, and those studies have failed to support at all the notion that vaccines cause autism. In other words, all of the best science we have to date shows that vaccines do not and could not cause autism.

The parent narratives about vaccines causing autism can be convincing, but the science does not support those narratives. Furthermore, it could be that these parents who are convinced their children’s autism was caused by vaccines are the victims of hearing other similar reports, and their memories of the events leading to a diagnosis are themselves faulty.

Since the science about vaccines and autism is convincingly against NVIC’s claims, these claims can be dismissed as inaccurate.

Final Evaluation

In this September 24 Facebook post, NVIC has presented several misleading points and other clearly false assertions. We encourage you to dismiss these allegations and to keep in mind this misleading post when evaluating all other NVIC promotional materials.

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Let’s Be Honest About The NVIC

The National Vaccine Information Center (NVIC) is one of the most widely-known sources of information on vaccinations in America.

This site will carefully and factually examine the many claims made by the NVIC regarding the safety and efficacy of childhood and adult vaccines.

The intention of this site is to use published research and thoughtful discussion to take a look at the information provided by the National Vaccine Information Center, in order to assist people in making the appropriate choices regarding vaccination.

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