Tip of the Iceberg

30 07 2010

The NSW Health Care Complains Commission (HCCC) describes the information provided by the Australian Vaccination Network (AVN) as “inaccurate and misleading”. However Meryl Dorey from the AVN claims that “all their information is accurate and fully referenced from medical literature”. Obviously someone is telling porkies, and it isn’t the HCCC.

There simply isn’t enough space on my server’s hard drive to detail all the inaccuracies and lies promulgated by the AVN, so I’ll just concentrate on the most obvious ones. Because if the AVN can’t get basic information correct, what hope do they have when the subject becomes more complicated?

The Immunisation Schedule

Surely for Australia’s self-appointed “vaccine safety watchdog”, this would be the most rudimentary knowledge. So can the AVN manage to give correct information on this basic topic? Let’s take a look. Here is what they claim is on the schedule:

AVN's claim of the vaccination schedule

Let’s check the real Australian Vaccination Schedule. Ignoring the AVN’s nonsensical claims of what constitutes a vaccine or a dose,  and that the AVN have included vaccines given after not by 12 months, their description of the schedule is far from accurate. The Chicken Pox (Varicella) vaccine is given at 18 months, not 12. There is one dose of Meningococcal (at 12 months), not three doses. Finally, there is no influenza vaccine on the schedule at all.

These may seem like minor errors, but let’s not forget that the AVN have claimed on their website that they provide “all the information you need” on vaccination. If they can’t get the schedule right, what hope is there for more complex information?

Vaccine Ingredients

Another of the most basic vaccination subjects would be ingredients. After all, if they don’t know what’s in vaccines, how could the AVN be expected to offer advice on the purpose and effect of those ingredients? Let’s look at the statement on their Diphtheria page:

The AVN's claim about vaccine ingredients

The “mercury” they are referring to is Thiomersal, a preservative used in some vaccines since the 1930s which contains about 1 molecule of mercury per dose. So does “every diphtheria vaccine used in Australia” contain it? No. In fact, it’s not in any currently used diphtheria vaccines, let alone all of them. The first thiomersal-free diphtheria vaccine was licensed for use in Australia in 1997, more than a decade before the AVN wrote this article, and every childhood vaccine used in Australia is thiomersal-free.

Again, one must ask: If the AVN cannot get such basic advice correct, what is the chance that the rest of their information is accurate?

Adverse Reactions

One of the AVN’s biggest claims comes in the form of adverse reactions. Meryl Dorey has claimed that between 1991 and 2009, they have received (and reported to the Government) over 1200 adverse reactions. In fact, they claim to make “more reports than anyone else”. Their 1200 claimed reports average to almost 6 reports made every month. Big claims indeed. But do they add up?

Looking at the Dept of Health Adverse Event Report for the 2.75 year period from January 2000 through to September 2002, we can see that the AVN made a total of 11 reports of adverse events during that period. An average of just one report every 3 months, which is about 5% of the their claimed reporting level. Perhaps of equal interest is that the same report shows that pharmaceutical companies made 143 reports over the same period. So not only are the AVN’s reporting figures highly dubious, they are clearly not the major reporter of reactions. The fact that Evil Big Pharma self-reported over 10 times more reactions than the AVN must be a source of embarrassment for Meryl!

What about their predictions of adverse events? The advice people may rely on when making a decision about whether or not to vaccinate.

In 1998, just before the Australian Government commenced the Australian Measles Control Campaign, the AVN issued a media release claiming that the campaign would result in over 320,000 adverse reactions, including deaths. Following the campaign, it was revealed that there were just 89 reactions, 33 of which were simple fainting!

It’s pretty clear that the AVN are incapable of predicting adverse event levels with even the slightest level of accuracy, or of factually describing reaction numbers afterwards. Two qualities which one would consider mandatory for any group proposing themselves as a useful source of information on vaccination.

Vaccines, Procedures and Regulations

Back in March 2010, the AVN made the following outrageous posting on their Facebook page:

Swine Flu Use-By?

It contains more factual errors than I thought possible in a single paragraph! First and foremost, it’s simply impossible for the claims about H1N1 vaccines being administered past use-by to be true. The vaccine wasn’t even trialled until June 2009, manufacture didn’t begin until July 2009, it wasn’t approved for use until September 2009 and it has a shelf life of 12 months. Therefore even the first batch had not approached its use-by date in March, let alone later production. The child version (Panvax Jr) did not begin production until November 2009, so the first batches of that were a good 8 months away from use-by.

The AVN were immediately corrected, yet almost a month later Meryl Dorey made the same claims again. The first post could perhaps be explained away as an error from someone simply incompetent, but the fact that the claim was repeated weeks later clearly shows that the AVN deliberately make false statements in order to support their anti-vaccination agenda.

Apart from the date impossibility issue, the post demonstrates a complete lack of understanding of the vaccines in use and medical procedures. The Government did not (and could never) apply for “special dispensation to extend medical use-by dates”. Such a thought is laughable to anyone with even a vague understanding of the procedures involved. To do so would leave them, the manufacturer, the TGA and anyone administering the product up for enormous lawsuits if anything went wrong. It simply cannot happen.

Secondly, all vaccines and medicines are disposed of as medical (not hazardous) waste, irrespective of their contents. They can, and will, dispose of any vaccines past their use-by date in such a manner.

Finally, the child version of Panvax (Panvax Jr) is thiomersal-free, thereby invalidating their ridiculous argument anyway.

The Bottom Line

To quote the HCCC, the Australian Vaccination Network “provides information that is incorrect and misleading”, and they therefore “pose a risk to public health and safety”.

Parents have a right to expect that an organisation claiming to be an accurate source of information is exactly that. Unfortunately the AVN are no such source. The examples of mistruth, deception and inaccuracy above are just the tip of the iceberg.





Meryl Dorey’s Fear Factor:           Hypocrisy in print.

12 05 2010

In May 2009, the AVN’s Meryl Dorey penned Pertussis: The Fear Factor, an article that could best be described as a work of fiction, and at worst an exercise in deliberate deception. About the only accurate point in Meryl’s article is the loose comparison she makes between seatbelts and vaccines. Quite appropriate, given that they achieve such similar outcomes.

Meryl complains that Governments and Doctors use fear as a tool to encourage parents to vaccinate their children. Personally, I think it’s quite appropriate considering the mortal dangers involved. The subject of her rant on this occasion is Pertussis (Whooping Cough), an extremely dangerous disease to infants which has a shocking mortality rate of almost 1:200 for infants under 6 months of age[1].

Dorey begins with some disrespectful inaccuracies about two young infants who were lost to Pertussis infections in Australia. Out of respect for the parents of Dana McCaffery, who tragically died from Pertussis just two months before Meryl wrote Fear Factor, I won’t delve into Meryl’s claims about Dana. Suffice to say, that the AVN have –on numerous occasions- displayed a callous disregard for the family, a lack of respect for their privacy and an apparent inability to tell the truth.

Lies, damned lies, and statistics.

Meryl’s first salvo fired at Pertussis vaccination is a vague graph ostensibly showing mortality rates of the disease. The antivax crowd often use mortality graphs to ‘prove’ that vaccines are irrelevant. However, mortality is more accurately an indicator of how good we are at fixing people, rather than how good we are at preventing their illness in the first place. Medical treatment moved forward in leaps and bounds in the 20th Century, making many previously fatal diseases somewhat treatable. What the graph doesn’t show is how many infants were airlifted to intensive care wards, or how many suffered through months of agonising coughing fits before their ultimate recovery, or how many have permanent disabilities from their illness.

Meryl loves to quote deceptive statistics and this article is no exception. In an effort to make the vaccine appear ineffective, she uses Australia-wide child vaccination rates combined with total disease notifications to ‘prove’ her case.

This ignores the fact that the vast majority of cases are occurring in adults. Data from the CSIRO shows that in 2005, adults made up almost 90% of pertussis cases in NSW[2]. So all Meryl’s figures prove is that immunity wanes[3], which exactly why Governments are promoting booster shots of this vaccine for adults.

It also ignores the fact that isolated areas with low vaccination rates are where most cases are occurring. The Byron shire, home of the AVN and Australia’s lowest vaccination rates (at just 68% in 2008[4]), also carries the dubious honour of Pertussis infection rates four times higher than the state average, peaking at a whopping 1493 cases per 100,000 population in 2009[4]. These figures are all publicly available, and fully support the statement by Dr Mitchell Smith of which Meryl was so critical: “..We’re seeing a reflection of low immunisation rates in parts of NSW, particularly in the North Coast….” The statement is entirely accurate, no doubt much to Meryl’s chagrin.

Dorey’s next attempt to manipulate the truth comes in the form of pertussis case-age distribution. In a stunning display of data incomprehension, she claims that pertussis increased in infants following vaccination campaigns. She even has a graph to ‘prove’ it. There’s only one problem. The graph (and the data it’s based on), does not support her conclusion. In fact, it’s a cut-and-paste from a World Health Organisation document detailing the effectiveness and importance of Pertussis vaccination[6]. Meryl doesn’t understand that it’s expected the percentage of cases in the unvaccinated portion of a population (ie: infants) increases. That doesn’t mean the number of cases in that age group increased. What actually happened is the number of cases in older, vaccinated children plummeted, so they represented a smaller percentage of the total. It’s basic maths, but apparently beyond Meryl’s grasp. Since she likes tables, let’s use one to show her how to avoid such errors in the future:

See what I mean? In this example, even though cases for Infants <1 year halved, their proportion increased from 20% to 50%. This is exactly what Meryl’s graph shows, she just doesn’t understand it. Or worse, she is deliberately misrepresenting the results. The studies referenced in “her” graph show that case rates of Pertussis in the United States fell by 99.8% between 1918-21 and 1980-89[6,7].

Lies, damned lies, and more lies.

Meryl writes that “Currently, we in Australia use both the newer acellular pertussis vaccine (DPaT) as well as the older, more crudely-produced whole-cell shot (DPT)”.

The major problem with this statement is that it’s simply untrue. Yep, she’s lying.

The acellular vaccine (DTPa) was first introduced in Australia in 1997[8], and by February 1999 had completely replaced whole-cell DTP on the schedule[9]. By 2003, there were no whole-cell DTP vaccines available or licenced for use in Australia at all[10]. Meryl’s statements that Australia didn’t introduce the acellular vaccine until the early 21st century, and that whole-cell DTP is still being used today are therefore demonstrably false.

So why lie about it? Easy. It allows Meryl to use emotive language, like “crudely produced jam-packed with viral contaminants and … mercury, a known brain poison” etc etc etc. Sounds scary, huh? The fact is that none of this applies to the acellular vaccine, which is the only vaccine used in Australia. Besides that, the links she makes between the old DTP components and assorted conditions are either unsupported by any evidence or actually disproven[11,12,13,14].

Meryl seems to be a big fan of retired Professor Gordon Stewart, quoting his “published studies” on Pertussis vaccination. Leaving aside the fact that the second “study” is actually just a letter to the editor, it should be noted that Prof. Stewart has a rather checkered history, including claims that HIV does not cause AIDS. Surprising then, that even Prof. Stewart thinks there is a place for Pertussis vaccination. You see, Stewart’s statement which Meryl conveniently chopped off actually finished: “…there is a strong case for an intensified eradication policy which might include selective immunisation in high-risk groups and areas”[15]. Finally, Stewart’s study occurred over 30 years ago and involved a vastly different vaccine to that in use in Australia today, making it totally irrelevant in a current context.

But wait, there’s more. Meryl is a master of lying by omission.

Taken in isolation, Meryl’s statement that “Sweden ceased pertussis vaccination in 1979” has some truth to it. She neglected to reveal however, that following massive epidemics of the disease they brought it back in 1996. Within just three years, the re-introduction of the Pertussis vaccine to Sweden saw cases plummet by 80-90% depending on the age group[16]. Another fact Meryl conveniently omitted, was that the old DTP which Sweden used (and found to be ineffective) was completely different to the one used in Australia and other countries in the world. Other whole-cell DTP vaccines were demonstrably effective[17].

Going out with a bang

For her finale, Meryl has brought out the big guns with blatantly false statements like “Whooping Cough is not a vaccine-preventable disease”. Perhaps if Meryl were capable of researching from sites other than whale.to, she might find some of the numerous studies showing not just the efficacy of the pertussis vaccine (at around 84%[17]), but also it’s vital benefit in reducing the severity of the disease, even in patients who have not received a full course of vaccinations. The DTPa vaccine has in fact been shown to reduce pertussis-related hospital admissions for infants by 68.1% after one dose of vaccine, 91.8% after the second dose, and 99.8% after three doses[18].

Dorey’s bold claims of promoting an informed choice are betrayed by her aversion to facts that contradict her pre-conceived opinions.

The fact is that Pertussis vaccination is important and effective, not just for children but for adults as well. A French study found that 80% of infants with Pertussis were infected by their parents or siblings[19]. This is why most State Governments are now offering free vaccination for anyone who spends time around infants[20]. While Pertussis is usually mild in adults, the danger comes from passing the infection onto those children too young to be fully vaccinated. Neither previous infection nor child vaccination offers lifetime protection from Pertussis[3]. This is why it’s vital for adults and adolescents to receive a booster vaccination against this disease.

I find it fascinating that, -in an article written to criticise the use of fear- Meryl not only relies on exactly that, but she does so using factually incorrect information. She lies to invoke fear.



References:

[1] Comparison of the Effects of Diseases and the Side Effects of Vaccines http://www.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-quickguides-sideeffects

[2] Pertussis in New South Wales, 1993–2005: the impact of vaccination policy on pertussis epidemiology
http://www.publish.csiro.au/?act=view_file&file_id=NB07068.pdf

[3] Wendelboe AM, Van Rie A, Salmaso S, Englund JA.
Duration of immunity against pertussis after natural infection or vaccination.
Pediatr Infect Dis J 2005; 24: S58–61. doi:10.1097/01.inf.0000160914.59160.41
http://journals.lww.com/pidj/Abstract/2005/05001/Duration_of_Immunity_Against_Pertussis_After.11.aspx

[4] Some aspects of the Public Management of Pertussis in NSW. Page 8.
AM Brown, Tandyhaven Consulting.
(Not available online)

[5] Artur M Galazka, Susan E Robertson
“Pertussis”
http://whqlibdoc.who.int/publications/2004/9241592303_chap2.pdf

[6] Gordon, John E. M.D.; Hood, Robert I. M.D.
Whooping Cough and Its Epidemiological Anomalies
http://journals.lww.com/amjmedsci/Citation/1951/09000/Whooping_Cough_and_Its_Epidemiological_Anomalies.11.aspx

[7] Karen M. Farizo, Stephen L. Cochi, Elizabeth R. Zell, Edward W. Brink, Steven G. Wassilak and Peter A. Patriarca
Epidermiological Features of Pertussis in the United States, 1980-89
http://www.jstor.org/pss/4456361

[8] Summary of changes, Australian Immunisation Handbook 6th Edition, 1997
http://vaccinateyourchildren.files.wordpress.com/2010/05/immunisation-schedule-1997-from-6th-edition-handbook.pdf

[9] Australian Immunisation Handbook, 7th Edition, 2000. Page 171
http://vaccinateyourchildren.files.wordpress.com/2010/05/immunisation-handbook-7th-edition-2000.pdf

[10] Australian Immunisation Handbook, 8th Edition, 2003, Page 134.
http://vaccinateyourchildren.files.wordpress.com/2010/05/immunisation-handbook-8th-edition-2003-part3.pdf

[11] Anderson HR, Poloniecki JD, Strachan DP, et al.
Immunization and symptoms of atopic disease in children: results from the International Study of Asthma and Allergies in Childhood.
American Journal of Public Health 2001;91:1126-9.
http://ajph.aphapublications.org/cgi/content/abstract/91/7/1126

[12] Vennemann MM, Höffgen M, Bajanowski T, Hense HW, Mitchell EA.
Do immunisations reduce the risk for SIDS? A meta-analysis.
Vaccine: Volume 25, Issue 26, 21 June 2007, Pages 4875-4879
http://www.ncbi.nlm.nih.gov/pubmed/17400342

[13] Shields WD, Nielsen C, Buch D, Jacobsen V, Christenson P, Zachau-Christiansen B, Cherry JD.
Relationship of pertussis immunization to the onset of neurologic disorders: a retrospective epidemiologic study.
http://www.ncbi.nlm.nih.gov/pubmed/3263484

[14] Immunisation and the sudden infant death syndrome. New Zealand Cot Death Study Group.
E A Mitchell, A W Stewart, and M Clements
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1511439/

[15] http://www.ncbi.nlm.nih.gov/pubmed/55731

[16] P. Olin, H.O. Hallander Swedish Institute for Infectious Disease Control
Marked Decline in Pertussis followed reintroduction of Pertussis vaccination in Sweden: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=84

[17] Greco D, Salmaso S, Mastrantonio P, Giuliano M, Tozzi AE, Anemona A et al.
A controlled trial of two acellular vaccines and one whole-cell vaccine against pertussis.
N Engl J Med 1996; 334: 341–8. doi:10.1056/NEJM199602083340601
http://content.nejm.org/cgi/content/full/334/6/341

[18] Juretzko P, von Kries R, Wirsing von Konig CH, Weil J, Giani G.
Effectiveness of acellular pertussis vaccine assessed by hospital-based active surveillance in Germany.
Clin Infect Dis 2002; 35: 162–7. doi:10.1086/341027
http://www.journals.uchicago.edu/doi/pdf/10.1086/341027

[19]  Baron S, Njamkepo E, Grimprel E. Begue Ps, Desenclos J-C, Drucker J, Guiso N.
Epidemiology of pertussis in French hospitals in 1993 and 1994: thirty years after a routine
vaccination. Pediatr Infect Dis J 1998; 17: 412–8. doi:10.1097/00006454-199805000-00013
http://www.ncbi.nlm.nih.gov/pubmed/9613656

[20] New parents offered free whooping cough vaccine
http://www.cs.nsw.gov.au/mediacentre/mediareleases/2009/090327.pdf









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