Tag: BMJ

The BMJ Asks If Injections Are Part of the “Mystery” of Acute Flaccid Myelitis/AFM…

Yes, the BMJ, formally the British Medical Journal, just published a piece, Are injections part of the “mystery” of acute flaccid myelitis/AFM? Is the CDC interested in finding out?

Those familiar with the BMJ understand that this is not a real editorial or article though.

It is one of their Rapid responses to another article – basically a letter to the editor. Unfortunately, some folks use these Rapid responses as evidence for their anti-vaccine talking points and arguments.

The BMJ Asks If Injections Are Part of the “Mystery” of Acute Flaccid Myelitis/AFM…

We know vaccines are not associated with AFM.

It is no mystery that AFM isn’t associated with vaccines – experts review patient vaccination records.
It is no mystery that AFM isn’t associated with vaccines – experts review patient vaccination records.

The AFM patient summary form asks for a vaccination record and current studies have found no association with recent vaccines.

“They also say that they are continuing to investigate the possibility of an association, but the AFM Patient Summary Forms that they supply to US state health departments contain no questions about injections or vaccinations.”

Allan S. Cunningham on Are injections part of the “mystery” of acute flaccid myelitis/AFM? Is the CDC interested in finding out?

We know that vaccines are not associated with AFM.

“According to patients’ vaccination records, all but one had been vaccinated according to Advisory Committee on Immunization Practices recommendations. The median interval between receipt of the last vaccination and onset of neurologic symptoms was 1.9 years (range = approximately 2 months–7 years).”

Acute Flaccid Myelitis Among Children — Washington, September–November 2016

But it is understandable that some folks are still trying hard to push the idea that vaccines are associated with AFM, as to some of them, everything is a vaccine injury.

What is really baffling though, is why does BMJ give them a platform to spread their wild ideas and misinformation?

More on the BMJ

Why Do Some People Think That Vaccines Cause AFM?

So we know that vaccines don’t cause acute flaccid myelitis.

Consider a five-year-old in Maryland who recently came down with symptoms of AFM.

Was he recently vaccinated?

Nope. It had been some time since his four-year-old vaccines. Almost a year. And he had not gotten a flu vaccine yet.

What he did have were worsening symptoms about two weeks after he had seemed to get over a cold, something he has in common with most other kids with AFM.

“To try to pin a tragic yet uncommon neurological condition caused by enteroviruses on vaccines is dangerous and puts more kids at risk.”

Scott Krugman, MD

As with this case, the CDC reports no correlation with vaccines in the cases that they have investigated.

And remember, some of these kids have been unvaccinated!

That makes you wonder why some folks actually think that vaccines are associated with AFM, doesn’t it?

Why Do Some People Think That Vaccines Cause AFM?

That’s right, as you are likely suspecting, the usual suspects are pushing anti-vaccine propaganda and promoting the idea to scare parents away from vaccinating and protecting their kids.

“…there are many other reasons to suspect vaccine-related mechanisms of causation for AFM in the U.S., a primary one being that the scientific literature has documented paralysis as an adverse reaction to vaccination for decades!”

The Non-Polio Illness That “Looks Just Like Polio” by Lyn Redwood, RN, MSN, President, Children’s Health Defense

If any of these kids had recently gotten the oral polio vaccine, then sure, an adverse reaction to the vaccination would be at the top of the list of possible causes. After all, we know that VAPP can occur after OPV, but that vaccine hasn’t been used in the United States since 2000, when we switched to IPV.

Why do these folks think that they have it all figured out?

Vaccines are not causing AFM because of needle puncture wounds or tonsillectomies.
Vaccines are not causing AFM because of needle puncture wounds or tonsillectomies.

The AFM outbreaks happen at the beginning of the school year, when kids are all getting their shots, right?

Nope. They happen during the summer and early fall, peaking in August. And despite what some folks think, most parents don’t wait until the end of summer, just before school starts, to vaccinate their kids. Plus, most kids don’t even need vaccines before the start of the school year. Kids typically only get vaccines before starting kindergarten and middle school.

But the outbreaks do coincide with the when kids get their flu shots, right?

How many kids get flu shots in June and July?

If it was flu shots, the peak would be in October and November, when most kids get their flu shots and we would continue to see cases through December and January.

Many anti-vaccine websites and Facebook groups are pushing the idea that vaccines cause AFM.
Many anti-vaccine websites and Facebook groups are pushing the idea that vaccines cause AFM.

Of course, there is absolutely no evidence that flu vaccines, or any other vaccines, cause AFM.

What about the journal article that Brandy Vaughan posts as evidence?

“By reviewing vaccine-associated inflammatory diseases of the central nervous system, this study describes the current knowledge on whether the safety signal was coincidental, as in the case of multiple sclerosis with several vaccines, or truly reflected a causal link, as in narcolepsy with cataplexy following pandemic H1N1 influenza virus vaccination.”

Vaccine-associated inflammatory diseases of the central nervous system: from signals to causation

Even if you just read the abstract, as many folks do, you get a good idea where they are going with the article. It talks about how the claims of an association between multiple sclerosis and vaccines were proven to be purely coincidental.

Remember, correlation does not imply causation.

With AFM, you don’t even have much correlation to imply causation though!

Most cases occur just before we start giving flu vaccines and they don’t occur every year or in every state.

But doesn’t the article mention myelitis?

“Most of the published associations are based on individual case reports or small series of patients.”

Vaccine-associated inflammatory diseases of the central nervous system: from signals to causation

It does mention myelitis, just like it mentions MS – where an association has been shown to be purely coincidental.

Remember, case reports are not good evidence.

“…there are many other reasons to suspect vaccine-related mechanisms of causation for AFM in the U.S., a primary one being that the scientific literature has documented paralysis as an adverse reaction to vaccination for decades!”

The Non-Polio Illness That “Looks Just Like Polio” by Lyn Redwood, RN, MSN, President, Children’s Health Defense

But isn’t acute flaccid myelitis listed as a possible side affect in the package inserts for our vaccines?

Uh, TRANSVERSE myelitis and ACUTE DISSEMINATED ENCEPHALOmyelitis are not the same as acute flaccid myeltitis.
Uh, TRANSVERSE myelitis and ACUTE DISSEMINATED ENCEPHALOmyelitis are not the same as acute flaccid myelitis.

While it should be clear that AFM isn’t the same as ADEM and TM, it is very important to understand that even when those other conditions are listed in a package insert, it is in the section that is marked “without regard to causality.”

This isn’t evidence that vaccines cause AFM!

But didn’t the BMJ publish a study about Vaccines and the U.S. Mystery of Acute Flaccid Myelitis?

BMJ seems to allow anyone to publish responses to their articles online...
BMJ seems to allow anyone to publish responses to their articles online…

Nope. What they did is let someone publish what is essentially an online letter to the editor. And anti-vaccine folks are spreading it around like it is an actual BMJ study…

Surprised?

You shouldn’t be.

This is how anti-vaccine propaganda works.

Why are vaccine injury lawyers talking about AFM?
Why are vaccine injury lawyers talking about AFM?

It’s no coincidence that anti-vaccine folks are trying so hard to associate the outbreaks of AFM with vaccines. What better way to scare folks and make them think that vaccines are dangerous?

AFM is all that anti-vaccine folks are talking about these days...
AFM is all that anti-vaccine folks are talking about these days…

How are ‘we’ working on a vaccine for AFM if we don’t even know what causes AFM???

But that’s how many anti-vaccine folks think. Everything is a vaccine injury. Everything is a conspiracy.

Don’t believe them. Vaccines are safe and necessary.

More on Anti-Vaccine Propaganda About AFM

 

Crisis at the Nordic Cochrane Centre

This could be it for the Nordic Cochrane Centre.

“I regret to inform you that I have been expelled from membership in the Cochrane Collaboration by the favourable vote of 6 of the 13 members of the Governing Board. No clear reasoned justification has been given for my expulsion aside from accusing me of causing “disrepute” for the organization.”

Peter Gøtzsche on A moral governance crisis: the growing lack of democratic collaboration and scientific pluralism in Cochrane

Or at least for Peter Gøtzsche and his association with the Cochrane Collaboration, which he co-founded in 1993.

I’m not sure how he thinks that there was no clear justification for his being expelled though.

Crisis at the Nordic Cochrane Centre

Most folks understand why Peter Gøtzsche was expelled from the Cochrane Collaboration…

They remember that he recently published a poorly done analysis in BMJ Evidence-Based Medicine, The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias that was critical of a Cochrane Review on the HPV vaccine, Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors, which concluded that the HPV vaccines work and that they are safe.

While Gøtzsche’s analysis prompted the Cochrane Collaboration to initiate an investigation, they concluded that his analysis “substantially overstated its criticisms” and that the allegations were “not warranted and provided an inaccurate and sensationalized report of their analysis.”

Is that it?

Nope.

Many people are also familiar with the Nordic Cochrane Centre because of their involvement in continued complaints about the HPV vaccine. Complaints that were not approved by the Cochrane Collaboration and that were not an official Cochrane viewpoint!

“…we highlight here how academic colleagues, under the purported banner of a respected authority, raise concerns about the HPV vaccine but they cite an evidence base of small and poor quality studies and ignore the extensive wealth of global literature that vividly demonstrate the excellent efficacy and safety record of the vaccine.”

Head et al on Inadvisable anti-vaccination sentiment: Human Papilloma Virus immunisation falsely under the microscope

Complaints that had already been investigated and dismissed by the European Medicines Agency and refuted by many other studies.

“This week at its meeting in Edinburgh, Cochrane’s Governing Board considered, as planned, the findings of an independent review and additional complaints related to the conduct of a Member. The Board’s conclusion was communicated to the individual concerned and is part of an ongoing process. The Co-Chairs of the Board will provide further details once this process is complete.

Following this, four Board members (Gerald Gartlehner, David Hammerstein Mintz, Joerg Meerpohl and Nancy Santesso) decided to resign as Cochrane trustees with immediate effect.”

Message from the Governing Board

Unfortunately, Gøtzsche’s being expelled led to others leaving the Cochrane Governing Board, including two appointed trustees who volunteered to step down to to comply with Cochrane’s Articles of Association.

Although they may not have been defending Gøtzsche's opinions or behaviors, four other board members resigned in solidarity.
Although they may not have been defending Gøtzsche’s opinions or behaviors, four other board members resigned in solidarity.

We can hope that this is the end of the matter, as Cochrane will soon have an election for new board members.

Peter Gøtzsche is out at the Cochrane Collaboration.
Peter Gøtzsche is out at the Cochrane Collaboration.

Will he be kept on at the Nordic Cochrane Centre, which he founded? Will the Nordic Cochrane Centre be allowed to keep ‘Cochrane’ in their name?

The Nordic Cochrane Centre is primarily funded by the Danish Government, and what do they get besides all of the anti-HPV vaccine stuff?

“Antidepressant drugs are another major killer that people could do well without.”

Peter C Gøtzsche: Prescription drugs are the third leading cause of death

Peter Gøtzsche seems to be against cancer screening, psychiatric drugs, and thinks that Big Pharma has corrupted health care. Is that the “plurality of opinions, views, and perspectives” that folks want at Cochrane or anywhere else in medicine?

Unfortunately, I bet this isn’t the last that we have heard from him.

More on the Crisis at the Nordic Cochrane Centre

Andrew Wakefield Is Not A Fraud?

Most folks have a good idea of who Andrew Wakefield is and what he did.

Who's to blame for low immunization rates and continuing outbreaks?
Who’s to blame for low immunization rates and continuing outbreaks?

Still, some folks seem to be pathologically optimistic that he didn’t actually do anything wrong.

Andrew Wakefield Is Not A Fraud?

You remember Andrew Wakefield, right?

“To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one.”

J. B. Handley

He is the guy who published the 1998 paper in Lancet in the UK that started folks thinking that the MMR vaccine is somehow associated with autism.

In 1998, a major medical journal based in the UK, The Lancet, published a report headed by Andrew Wakefield, who was at that time a gastroenterological surgeon and medical researcher. The report implied a causal link between the measles, mumps, and rubella (MMR) vaccine and the development of autism combined with IBD in children, which Wakefield described as a new syndrome he named “autistic entercolitis”.

Andrew Wakefield’s Harmful Myth of Vaccine-induced “Autistic Enterocolitis”

But he didn’t actually say that the MMR vaccine caused autism in that paper, did he?

No, he saved that for the press conference for the paper.

If not for the press conference, which in itself was unusual, and all of the media attention over the next few years, his small study, which was “essentially a collection of 12 clinical anecdotes,” would have gone nowhere.

But there was no “Wakefield Factor” on immunization rates in the UK, was there? Didn’t measles cases continue to go down in the 10 years after his Lancet paper was published?

MMR vaccination rates had dropped below 80% by 2003, when the first measles outbreaks in the UK began. They didn't fully recover until 2012.
MMR vaccination rates had dropped below 80% by 2003, when the first measles outbreaks in the UK began. They didn’t fully recover until 2012.

Despite the heroic efforts of some folks to manipulate the data, it is clear that MMR vaccination rates dropped and measles cases jumped in the years after Wakefield’s MMR scare.

But even if his paper scared people away from vaccinating and protecting their kids, he was never really found guilty of fraud, was he?

While the findings of the General Medical Council panel that took away Wakefield's medical license never used the word 'fraud,' they described things that are fraudulent.
While the findings of the General Medical Council panel that took away Wakefield’s medical license never used the word ‘fraud,’ they described things that are fraudulent. The words dishonest and misleading come up a lot too.

How do you define fraud?

“The Office of Research Integrity in the United States defines fraud as fabrication, falsification, or plagiarism.13 Deer unearthed clear evidence of falsification. He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal.

Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No.”

Fiona Godlee on Wakefield’s article linking MMR vaccine and autism was fraudulent

Brian Deer wasn’t the only one calling Wakefield a fraud.

But those charges from the General Medical Council were later all overturned, weren’t they?

While charges against John Walker-Smith, a co-author of Wakefield’s study, were dropped on appeal, that doesn’t exonerate Wakefield in anyway. Remember, John Walker-Smith was actually against blaming the MMR vaccine and unlike Wakefield, he and another co-author actually published their own press release stating continued support of the use of the MMR vaccine.

But the other coauthors have stood by the results of the paper, haven’t they?

“We wish to make it clear that in this paper no causal link was established between MMR vaccine and autism as the data were insufficient. However, the possibility of such a link was raised and consequent events have had major implications for public health. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon these findings in the paper, according to precedent.”

Retraction of an Interpretation

They stood by the idea that it is important that research be done so that gastrointestinal problems in autistic children can be recognized and treated. Almost all of them retracted Wakefield’s interpretation of the paper though.

Yeah, but other studies have proven Wakefield to be right though, haven’t they?

No, they haven’t. In fact, other labs could not even replicate Wakefield’s original study.

Why wasn't Wakefield ever charged in a criminal court?
Why wasn’t Wakefield ever charged in a criminal court?

But Wakefield’s Lancet paper wasn’t retracted because it’s findings were wrong…

Yes it was!

“Following the judgment of the UK General Medical Council’s Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were “consecutively referred” and that investigations were “approved” by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.”

Retraction—Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children

Still think Andrew Wakefield isn’t a fraud?

Every time there is a measles outbreak, anti-vaccine folks pop up to defend Andrew Wakefield. The problem is that they get virtually everything about him wrong!

Their false narratives and myths attempt to rewrite history and make you forget that he doesn’t just scare parents away from vaccinating and protecting their kids, he hurts autistic kids and their families.

More on Andrew Wakefield Myths