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.
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. So all Meryl’s figures prove is that immunity wanes, 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), 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. 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. 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, and by February 1999 had completely replaced whole-cell DTP on the schedule. By 2003, there were no whole-cell DTP vaccines available or licenced for use in Australia at all. 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”. 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. 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.
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%), 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.
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. This is why most State Governments are now offering free vaccination for anyone who spends time around infants. 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. 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.
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 New parents offered free whooping cough vaccine