Tag: autism studies

How To Counter Vaccine Hesitancy

There is nothing wrong with having questions about vaccines. And there is certainly nothing wrong with doing a little, or even a lot of research about vaccines.

“We are not against vaccines. Just because we have hesitancies and valid concerns about injecting our baby with specific chemicals and toxins does not mean we are anti anything…

As a soon-to-be-parent [and especially as a first-time-mom] I do feel it my responsibility to have questions, and to listen to my motherly instinct to question things, and do my research.”

Kat Von D

The problem comes when the answers folks get come from misinformation, and it leads them to skip or delay their child’s vaccines, leaving them unprotected.

What is Vaccine Hesitancy?

To counter vaccine hesitancy, you likely first need to understand what it means.

“Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific varying across time, place and vaccines. It includes factors such as complacency, convenience and confidence.”

SAGE Vaccine Hesitancy Working Group

So it means someone who is anti-vaccine, right?

Not exactly.

“Although many may characterize all individuals who eschew vaccines as “anti-vaccine” or “vaccine deniers,” in reality there is a broad spectrum of individuals who choose not to have themselves or their children vaccinated.”

Tara C Smith on Vaccine Rejection and Hesitancy: A Review and Call to Action

Many of the folks who are vaccine hesitant aren’t truly anti-vaccine. They are likely being misled by anti-vaccine myths and propaganda, but at least they aren’t the ones spreading it across Facebook or on their own blogs and anti-vaccine websites.

How To Counter Vaccine Hesitancy

How do you counter vaccine hesitancy?

“It’s unfair for anyone to expect me [or any parent] to take the word of the pharmaceutical companies who have much to gain from and industry worth billions without question – and then have to dismiss any concerns of my own.”

Kat Von D

You learn to answer all of the questions and concerns that these parents might have about vaccines and vaccine-preventable diseases, including the risks and benefits of vaccines and the risks of being unvaccinated.

“Well, if you’re going to inform yourself about vaccines, I think anybody who’s truly informed will realize that getting a vaccine is much better than not getting one. If you’re choosing not to vaccinate your child, it’s because you’re getting, frankly, bad information about vaccines.”

Paul Offit, MD

You also make sure that parents, teachers, nurses, doctors, pharmacists, reporters, and everyone else gets good information about vaccines.

And you call out the misinformation and out-right lies of the anti-vaccine movement, especially when they say that vaccines never work, are always dangerous and full of toxins, or aren’t necessary.

You don’t let parents get manipulated by the anti-vaccine industry, which has gotten very good at selling fear – literally.

Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain because they are all an illusion.
Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain away, because they are all an illusion.

Remember, there is not one anti-vaccine argument or talking point that ever holds water.

Why not?

Because unless you go cherry picking, the evidence overwhelmingly shows that vaccines work, vaccines are safe, and vaccines are necessary.

What to Know About Countering Vaccine Hesitancy

If you are on the fence or scared to vaccinate your kids, let us help you learn why vaccines are safe and necessary and arguments against vaccines never hold water.

More on Countering Vaccine Hesitancy

What Happened to Kennedy’s Vaccination Safety Committee?

Many folks were surprised by the reports that Donald Trump had selected Robert Kennedy, Jr to head a committee on vaccine safety.

RJK, JR has made a number of outrageous claims about vaccines and autism.
RJK, Jr has made a number of outrageous claims about vaccines and autism.

Or maybe it shouldn’t have been a surprise. Kennedy, an environmental lawyer, once wrote a discredited article on the dangers of mercury in vaccines, and like Trump, continues to believe that vaccines are linked to autism.

But what can we expect from a Kennedy vaccine safety committee?

Robert F Kennedy, Jr on Vaccines

Vaccines have been proven safe and necessary time and again. If this vaccine safety commission happens, most people expect Kennedy to push his conspiracy theories to even more people.

In addition to wasting a lot of time and money, Kennedy has the potential to scare parents away from getting their kids vaccinated and protected against vaccine-preventable diseases.

“The CDC is a subsidiary of the pharmaceutical industry. The agency owns more than 20 vaccine patents and purchases and sells $4.1 billion in vaccines annually.”

Robert F Kennedy, Jr

This is one of RFK, Jr statements about vaccines.

Surprisingly, some parts of this statement are true.

The Centers for Disease Control and Prevention (CDC) does own some vaccine patents. And the CDC does buy about $4.1 billion in vaccines each year.

They don’t sell those vaccines though. They are distributed through the Vaccines for Children program to children who can’t afford vaccines.

Other Robert F Kennedy, Jr Vaccine Conspiracy Theories

What else does Kennedy believe?

While many anti-vaccine folks believe in Big Pharma conspiracies, Kennedy takes it to an extreme and believes that they have a “broad reach” and that “virtually all the institutions that are supposed to stand between a rapacious industry and vulnerable children have been compromised,” including “Congress, the regulatory agencies, FDA and CDC, the IOM, the NIH, the AAP, the science journals, the university science departments and the press.”

Kennedy has also stated, or to be more precise, misstated that:

  • “Pharma’s stranglehold on the journals keeps independent vaccine safety science from ever getting published. Just this month, the Swiss journal, Frontiers in Public Health, cancelled publication of the first vaccinated/unvaccinated study. The study showed that vaccinated children had less measles and rubella, but four times as many neurological disorders—including autism –and 30 times the incidence of allergies.” – The very small study had been only provisionally accepted and was rejected upon further review. It wasn’t even the first vaccinated/unvaccinated study. That would be the “Vaccination Status and Health in Children and Adolescents Findings of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS),” which looked at “whether unvaccinated children and adolescents differ from those vaccinated in terms of health.” And not surprisingly, they do. The unvaccinated kids get more vaccine preventable diseases. So what happened to the study? Like many retracted anti-vaccine studies, they republished it in another journal.
  • “…there is an overt conspiracy by a small group within the CDC vaccine division. It’s explicit. You can watch it unfold if you read the Simpsonwood transcripts and the related emails…” – Kennedy wrote extensively about Simpsonwood, the 2000 Scientific Review of Vaccine Safety Datalink Information conference, in his article Deadly Immunity, which was so full of obvious errors (some described them as lies), that it was eventually retracted. In addition to the obvious errors, Kennedy “quote mined the IOM report to make it seem that it said the exact opposite of what it really said.”
  • “…the CDC’s best and most recent science shows that autism spectrum disorder rates in Scandinavia dropped 33 percent following the removal of thimerosal in 1993.” – the article Kennedy cites is actually about recurrence risk, how likely you are to have another child with autism and “supports the role of genetics in ASDs,” and although rates seemed to decrease after a peak, they were still the same as before thimerosal was removed
  • “Vaccine mercury exposures to children today are comparable to exposures in the 1990s, and, for the first time, thimerosal vaccines are being administered to pregnant women in America.” – this is perhaps Kennedy’s most ridiculous claim. I think he mostly bases it on the fact that pregnant women get flu shots, but with the availability of thimerosal free flu vaccines (70% of flu vaccine dosages available this year) and the fact that only about 40% of pregnant women get the flu vaccine during flu season, it is impossible to think that “vaccine mercury exposures to children today are comparable to exposures in the 1990s,” when the hepatitis B, DTaP, and Hib vaccines could all have thimerosal and were all given to infants multiple times.
  • Kennedy has compared getting vaccinated to “a holocaust” and in his mind, there is a conspiracy among the CDC, doctors, and the press that is “akin to what happened to the Catholic Church during the pedophile scandal. The institution suddenly became more important than the children it was supposed to protect. Only a few individuals were actively involved in raping children and shuffling known pedophile priests to unsuspecting dioceses.” – he apologized for the holocaust statement, but not for anything else he has ever said.
  • “I want to apologize to all whom I offended by my use of the word to describe the autism epidemic. I employed the term during an impromptu speech as I struggled to find an expression to convey the catastrophic tragedy of autism, which has now destroyed the lives of over 20 million children and shattered their families.” – of course, his “apology” was just as offensive to many people
  • “First of all, vaccines are not subject to the safety rigors undergone by other pharmaceuticals in the FDA approval process. There are no large scale, double-blind, placebo-controlled studies.” – there actually are
  • “…in the one 1930 human study of thimerosal that predated its use in vaccines, all the subjects injected with thimerosal died.” – all of the subjects had meningococcal meningitis, a now vaccine-preventable disease that is life-threatening even today
  • “Verstraeten’s original analysis of those datasets found that thimerosal exposures increased autism risk by 760%. The CDC now knew the cause of the autism epidemic.” – it didn’t, although this is a common anti-vaccine conspiracy that involves the CDC hiding data about thimerosal, vaccines, and autism

Ironically, Kennedy is the nephew of President John F Kennedy, who signed the Vaccination Assistance Act in 1962 (Section 317 of the Public Health Service Act). President Kennedy’s vaccine law started as a three year program to help get kids vaccinated against polio, diphtheria, tetanus, and pertussis, and has been continuously reauthorized ever since.

What Happened to Kennedy’s Vaccination Safety Committee

Kennedy never did get appointed to head Trump’s vaccine safety commission.

“In both of those two meetings he asked me if vaccines weren’t a bad thing because he was considering a commission to look into ill-effects of vaccines,” Gates recalled, noting that Robert Kennedy Jr. had been urging Trump to launch such an effort. Gates said he told Trump, “that’s a dead end, that would be a bad thing, don’t do that.”

In fact, Trump never even created a vaccine safety commission, perhaps because he got some good advice from Bill Gates.

What to Know About Robert F Kennedy, Jr’s Vaccination Safety Committee

Plans for a Vaccine Safety Commission, which would help Robert F Kennedy, Jr gain a bigger audience for his ideas about thimerosal and autism, seem to be on hold.

More on Robert F Kennedy, Jr’s Vaccination Safety Committee

Has the Vaccine Court Compensated over 70 Families for Autism?

Has the Vaccine Court ever compensated the family of an autistic child?

Kind of.

Hannah Poling is autistic and her family was compensated by the Vaccine Court. But she wasn’t compensated for autism.

“Because she had an existing encephalopathy (presumably on the basis of a mitochondrial enzyme defect) and because worsening of an existing encephalopathy following measles-containing vaccine is a compensible injury, Hannah Poling was compensated.”

Why was Hannah Poling compensated?

Hannah Poling was compensated because she had a table injury.

Has the Vaccine Court Compensated over 70 Families for Autism?

Remember the Autism Omnibus Proceedings?

Those were the test cases that represented three different theories of how vaccines could possibly be associated with autism. None of them were upheld by the Vaccine Court and none of the families were compensated.

“The devil is in the details. You can call autism many different things and it looks very much differently to different folks. But at the end of the day, the Vaccine Court has awarded over 70 families that their children now have autism and these children developed encephalitis, which is brain inflammation, that turned into autism. 70 families. And your viewers can google Hannah Poling and Baxter Bailey. Those are two of the most popular cases. And the U.S. government said to them, your child received autism because of this. I mean, they were awarded. So, it’s in the books.”

Liza Longoria Greve on KOCO News 5

So how could anyone be saying that over 70 families of autistic children have been compensated by the Vaccine Court?

"Reaching out for the other side" of some arguments simply allows them to push myths and propaganda.
“Reaching out for the other side” of some arguments simply allows them to push myths and propaganda.

I guess folks can say whatever they want, especially when the media doesn’t understand the idea of false balance and gives them a platform, after all, that’s how you explain much of propaganda of the anti-vaccine movement.

How can they say that encephalitis turns into autism?

Again, folks can say whatever they want, but this is actually a little different from what they usually claim, that autism is encephalitis.

Of course, it isn’t.

70 Families? Google It

So what happens if you ‘google it‘ and actually research Liza Longoria Greve’s claim?

We already know about Hannah Poling… Again, she has a mitochondrial disorder and autism and she was compensated because it was thought that she had an adverse event to getting vaccinated because of her mitochondrial disorder.

And Baxter Bailey? You don’t find anything if you look for Baxter Bailey, but you will eventually find information about Bailey Banks, who was compensated for (acute disseminated encephalomyelitis) ADEM, which led to Pervasive Developmental Delay (PDD). He wasn’t compensated for autism though.

Baily Banks was not compensated for autism.
Baily Banks was not compensated for autism.

What about the other families she is talking about?

A little more googling and you find that she is likely talking about an article,  Unanswered Questions from the Vaccine Injury Compensation Program: A Review of Compensated Cases of Vaccine-Induced Brain Injury, that was published in the Pace Environmental Law Review in 2011 by Mary Holland, in which she reports finding “eighty-three cases of autism among those compensated for vaccine-induced brain damage.”

Instead of proof that vaccines cause autism though, Holland’s paper was little more than a “misleading recasting of VICP decisions.”

And vaccines are still not associated with autism.

What to Know About Vaccine Court and Autism

The vaccine court has never compensated anyone for so-called vaccine-induced autism.

More on Vaccine Court and Autism

Can I Give My Kids Tylenol When They Have Their Vaccines?

Many parents ask about acetaminophen (Tylenol) when kids get their vaccines.

Is it okay to give kids Tylenol when they get their shots?

The Tylenol and Vaccines Controversy

As you can probably guess, there is no real controversy about Tylenol and vaccines.

Instead, what we are talking about are the myths surrounding Tylenol and vaccines that anti-vaccine folks have created, including that:

  • giving Tylenol right before a child gets their shots somehow increases the risk that they will have side effects
  • giving Tylenol right after a child gets their shots somehow masks the symptoms of serious vaccine damage
  • giving Tylenol after the MMR vaccine is associated with developing autism

Fortunately, most parents understand that like other anti-vaccine misinformation, none of these statements are true.

Why do some folks believe it?

Well, there have been studies warning people about giving Tylenol before vaccines. It had nothing to do with side effects though. They suggested that a vaccine might be less effective if the child got Tylenol before his vaccines. It is important to note that they never really found that the vaccines didn’t work as well, as all of the kids in the study still had protective levels of antibodies, they were just a little lower than kids who didn’t get Tylenol.

Other studies have found the same effect if Tylenol was given after a child got his vaccines. Although interestingly, other studies have found that giving Tylenol after vaccines does not affect antibody titers.

“Antibody titres to diphtheria and tetanus toxoids and pertussis bacteria of the placebo (n = 25) and acetaminophen (n = 34) groups did not differ significantly from each other. It is concluded that acetaminophen in a single dose schedule is ineffective in decreasing post-vaccination fever and other symptoms.”

Uhari et al on Effect of prophylactic acetaminophen administration on reaction to DTP vaccination

Giving Tylenol after the MMR vaccine is not associated with autism.
Giving Tylenol after the MMR vaccine is not associated with autism.

The only thing that this had to do with side effects though, is that the kids who got Tylenol had a little less fever.

Could giving Tylenol mask something like encephalitis, which some anti-vaccine folks think can be vaccine induced?

Nope. It typically can’t even keep someone from getting a febrile seizure.

What about the association of MMR, Tylenol and autism? Although one study did suggest that to be true, the study, a parental survey, was found to be “fatally flawed.”

Can I Give My Kids Tylenol When They Have Their Vaccines?

So, can you give your kids Tylenol when they get their vaccines?

The better question is, should you give your kids Tylenol either before or after they get their vaccines?

Have some Tylenol or Motrin on hand after your kids get their vaccinations, just in case they need a dose.
Have some Tylenol or Motrin on hand after your kids get their vaccinations, just in case they need a dose. Photo by Vincent Iannelli, MD

Notwithstanding the very small chance that giving Tylenol might cause decreased immunogenicity (lower antibody production) if you give it before your kids get their vaccines, since there is a good chance that they won’t have any pain or fever and won’t even need any Tylenol, then why give it?

Skip the “just in case” dose and wait and see if they even need it.

What about afterwards?

If your kids have pain or fever and are uncomfortable, then you should likely give them something for pain or fever control, such as an age appropriate dose of either acetaminophen or ibuprofen. Will that cause lower antibody production? Maybe. Will that mean that their vaccines won’t work. That’s doubtful. It certainly won’t lead to increased side effects though, unless they a reaction to the dose of Tylenol itself.

Should you give a pain or fever reducer after a vaccine “just in case?” Again, there is a good chance that your kids might not need it, so it is likely better to wait and see if they do, instead of giving a dose automatically after their shots.

There is even some evidence that giving acetaminophen or ibuprofen before vaccines, or as a routine dose right after, especially with booster shots, doesn’t really prevent side effects that well anyway. They work better if given on an as needed basis instead, and these kinds of doses are less likely to be associated with decreased antibody production.

What to Know About Tylenol and Vaccines

Giving a pain or fever reducer either before or after your child’s vaccinations likely won’t affect how it works, but since it often isn’t necessary, it is likely best to only given one, like Tylenol or Motrin, if it is really needed.

More on Tylenol and Vaccines

What Is Vaccine Injury Denial?

Few people deny that vaccine injury is real.

Vaccine injuries, while rare, are certainly real.

That’s why we have table injuries, the Vaccine Court, and the National Vaccine Injury Compensation Program.

What Is Vaccine Injury Denial?

Again though, vaccine injuries are rare.

“Vaccine Injury Denialism is rampant across the mainstream media, where child-abusing vaccine pushers like the New York Times, Washington Post and CNN deliberately contribute to the holocaust of vaccine injuries now devastating humanity’s children. Sadly, the same denialism about the alarming growth in medical injuries caused by vaccines is also endemic across universities, science journals and medical schools, where doctors are indoctrinated into a kind of “Flat Earth” denialism of vaccine injury reality.”

Mike Adams on Vaccine Injury Denialism is the denial of fundamental human dignity

Claims of vaccine injury denial come when we are skeptical or don’t believe that anything and everything is a vaccine injury.

Barbara Loe Fisher's NVIC even claims that Shaken Baby Syndrome can be a vaccine injury.
Barbara Loe Fisher’s NVIC even claims that Shaken Baby Syndrome can be a vaccine injury.

For example, in some circles, if you point out that vaccines do not cause asthma, ADHD, autism, Celiac disease, diabetes, eczema, food allergies, infertility, multiple sclerosis, POTS, SIDS, or transverse myelitis, etc., then claims of vaccine injury denial begin to fly.

That shouldn’t be surprising, as these and other so-called vaccine induced diseases make up the bulk of the vaccine injury stories that scare many parents.

“IMAGINE YOU LIVE IN A COUNTRY in which a minority of people are taken in the middle of the night, and beaten, kicked, poisoned, half-drowned… they are crippled for life, maimed, and they are expected to accept a doctor’s or a judge’s view that “It wasn’t the Gestapo” or “It’s not even an injury”.

Imagine that minority amounted to tens of millions of people.

Now imagine that these victims are lured into traps by their own doctors with promises of medicine that will prevent illness – but in reality the doctors are paid for every patient they manage to convince to show up – and the doctors determine which injuries they caused and which were just “coincidences”.

Now imagine the media is primed to tell the world that no such injuries ever occur. Now your neighbors are denying it, calling you crazy for thinking there is a link…”

James Lyons-Weiler on Should Vaccine Risk/Injury Denial Be Prosecutable Offenses?

But doctors and the media, and your neighbors for that matter, don’t deny that claims of vaccine injury are real because of some grand conspiracy or simply because they want to.

It is because of research and science, understanding the difference between correlation and causation, and more research. And we understand that vaccines are both passively and actively monitored for side effects.

Vaccine injuries, although real, are rare.

The only denialism about vaccines that is important, is among those who deny that vaccines work and that they are safe and necessary.

What to Know About Vaccine Injury Denial

Anti-vaccine folks like to claim that anyone who doesn’t believe that vaccines cause all of their vaccine-induced diseases are part of a conspiracy of vaccine injury denial.

More on Vaccine Injury Denial

What Is the Evidence for Alternative Vaccine Schedules?

There is plenty of evidence that the standard immunization schedule is safe and effective.

What about the alternative vaccine schedules that some folks push?

Is there any evidence that is safe to delay or skip any of your child’s vaccines?

Alternative Vaccine Schedules

Many people think of Dr. Bob Sears when they think of alternative vaccine schedules.

Bob Sears appeared on Fox & Friends in 2010 for the segment
Bob Sears appeared on Fox & Friends for the segment “Vaccines: A Bad Combination?”

He created both:

  • Dr Bob’s Selective Vaccine Schedule
  • Dr Bob’s Alternative Vaccine Schedule

He didn’t invent the idea of the alternative vaccine schedule though.

Well before Dr. Bob appeared on the scene, Dr. Jay Gordon had been on Good Morning America with Cindy Crawford to discuss vaccines and how she had decided to delay vaccinating her baby.

Where did she get the idea?

After the segment, Dr. Jay stated:

“They edited the segment to make me sound like a vaccination proponent. We also have to understand the impact of a person as well-known as Cindy Crawford delaying vaccines for over six months.”

Jay Gordon

Dr. Jay has long talked about only giving infants one vaccine at a time and waiting until they are “developmentally solid” before vaccinating.

1983 historical immunization schedule
When Bob Sears came out with his vaccine book, Jenny McCarthy was also pushing the too many too soon myth and rallying folks to go back to the 1983 schedule that left kids at risk for meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease.

Similarly, other folks have pushed ideas about delaying and skipping vaccines before Dr. Bob, including:

  • Donald Miller and his User-Friendly Vaccination Schedule – no vaccines until age two years and no live vaccines and when you begin vaccinating your child, give them one at a time, every six months (first published in 2004)
  • Stephanie Cave – starts at 4 months and delays many vaccines
  • homeopaths with immunization schedules that say to wait until six months and then start giving nosodes every five days
  • chiropractors with immunization plans that say to get regular chiropractic adjustments instead of vaccines
  • Paul Thomas‘ vaccine friendly plan
  • Jenny McCarthy and Generation Rescue’s Turn Back the Clock immunization plan which recommends substituting the latest schedule with the 1983 immunization schedule or a schedule from another country, like Denmark, Sweden, Finland, or Iceland.

Of course, Dr. Bob is the one who popularized the idea of the alternative vaccine schedule in 2007, when he published The Vaccine Book: Making the Right Decision for Your Child.

That’s when parents started to bring copies of his schedule into their pediatrician’s office, requesting to follow Dr. Bob’s schedule instead of the standard immunization schedule from the CDC.

What’s the Evidence for Alternative Vaccine Schedules?

There is no evidence that following an alternative vaccine schedule is safe for your kids.

“No alternative vaccine schedules have been evaluated and found to provide better safety or efficacy than the recommended schedule, supported by the Advisory Committee on Immunization Practices of the CDC and the Committee on Infectious Diseases of the AAP (the committee that produces the Red Book).

Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”

American Academy of Pediatrics

What’s the first clue that these so-called alternative vaccine schedules have absolutely no evidence behind them?

They are all different!

Paul Thomas, for example, doesn’t even offer his patients the rotavirus vaccine. Dr. Bob, on the other hand, has it on his list of vaccines that “that could protect a baby from a very potentially life-threatening or very common serious illness” and is sure to give it at 2, 4, and 6 months.

How slow should you go?

Both Dr. Bob and Dr. Paul give two vaccines at a time with their schedules, but Dr. Jay and Dr. Miller say to give just one at a time.

“Would any scientist give SIX vaccines at once to a baby? Asking for trouble. One at a time makes so much more sense.”

Jay Gordon

And while some start their schedules at 2 or 4 months, others delay until 6 months or 2 years.

There is also the fact that the folks who create these schedules admit that there is no evidence for what they are doing…

“No one’s ever researched to see what happens if you delay vaccines. And do babies handle vaccines better when they’re older? This is really just a typical fear that parents have when their babies are young and small and more vulnerable. Since I don’t know one way or the other, I’m just happy to work with these parents, understand their fears and their worries, and agree to vaccinate them in a way that they feel is safer for their baby.”

Bob Sears on The Vaccine War

But there has been research on delaying vaccines.

Unvaccinated kids aren’t healthier – they just get more vaccine preventable diseases. Most of which are life-threatening, even in this age of modern medicine, with access to good nutrition and sanitation.

So whether you only get one or two vaccines at a time; delay until four months, six months, or two years before you get started; skip all live vaccines or just wait until your child is “developmentally solid” to give them;  or go with some other non-standard, parent-selected, delayed protection vaccine schedule, the only things that you can be sure of is that there is no evidence to support your decision and that you will leave your kids unprotected and at risk for getting a vaccine-preventable disease.

“…when I give your six-week-old seven different vaccines with two dozen antigens, I am supposed to try to convince you that the adverse reactions you have heard about are just coincidences.”

Jay Gordon

Better yet though. Find a pediatrician who will listen and answer your questions about vaccines, concerns about vaccine myths and misinformation, explain that no vaccine is optional, and not just simply pander to  your fears.

What to Know About the Evidence for Alternative Vaccine Schedules

There is no evidence that skipping or delaying any vaccines with an alternative vaccine schedules can keep your kids safe from vaccine preventable diseases.

More on the Evidence for Alternative Vaccine Schedules

Hierarchy of Evidence and Vaccine Papers

Evidence is evidence, right?

Nope.

There is a hierarchy of evidence, from weakest to strongest, that help folks make decisions about science and medicine.

That’s why you can’t just search Google or PubMed, read abstracts, and say that you have done your research.

Hierarchy of Evidence

For any study, you have to review and judge the quality of the evidence it provides.

A meta-analysis with over 1.2 million kids found that vaccines were not associated with autism, while Wakefield's retracted case series included only 12 children.
A meta-analysis with over 1.2 million kids found that vaccines were not associated with autism, while Wakefield’s retracted case series included only 12 children.

Is it a case report (a glorified anecdote), case series, or animal study (lowest quality evidence)?

Or a systemic review or meta-analyses (highest quality evidence)?

“The first and earliest principle of evidence-based medicine indicated that a hierarchy of evidence exists. Not all evidence is the same. This principle became well known in the early 1990s as practising physicians learnt basic clinical epidemiology skills and started to appraise and apply evidence to their practice. Since evidence was described as a hierarchy, a compelling rationale for a pyramid was made.”

Murad et al. on the New Evidence Pyramid

What about case control studies, cohort studies, and randomized controlled trials?

They lie somewhere in between on the hierarchy of evidence scale or pyramid.

And there are other factors to consider when judging the reliability of a study.

“Ultimately, the interpretation of the medical literature requires not only the understanding of the strengths and limitations of different study designs but also an appreciation for the circumstances in which the traditional hierarchy does not apply and integration of complementary information derived from various study designs is needed.”

Ho et al. on Evaluating the Evidence

For example, you might also have to take into account the sample size of the study.

A study can be underpowered if it doesn’t have enough subjects. Unfortunately, even an underpowered study will give you results. They likely won’t be statistically significant results, but folks don’t always realize that.

Even a meta-analysis, usually considered to be at the top of the hierarchy of evidence pyramid, can have problems that make their results less useful, such as not using appropriate inclusion criteria when selecting studies and leaving out important studies.

All in all, there are many factors to look at when reading a medical paper and considering if the results are valid and should influence what you do and how you think. This is especially true when looking at low quality vaccine papers, many of which the anti-vaccine movement uses to scare people, even though they are often poorly designed, and several of which have been retracted.

What to Know About the Hierarchy of Evidence

Learning about the hierarchy of evidence can help you better evaluate medical studies and vaccine papers and understand that there is more to doing your research about vaccines than searching PubMed and reading abstracts.

More on the Hierarchy of Evidence