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Inappropriate Use of Vaccine Studies

Have you ever wondered how anti-vaccine do their vaccine research?

These types of binders of anti-vaccine information are typically filled with vaccine studies that folks end up misusing to scare parents away from vaccinating and protecting their kids.
These types of binders of anti-vaccine information are typically filled with vaccine studies that folks end up misusing to scare parents away from vaccinating and protecting their kids.

While they used to have to rely on Google University for their vaccine research, they now have folks making them ready made binders chock full of misinformation!

Misusing Vaccine Studies

As with their misuse of Google and Pubmed, a lot of the problems with these binders is that anti-vaccine folks cherry pick studies that support what they want to hear.

And in many cases, they read things into studies, thinking they support their views against vaccines, when they really don’t.

You're not gonna catch measles from someone's urine....
You’re not gonna catch measles from someone’s urine….

Is this 1995 study, Detection of Measles Virus RNA in Urine Specimens from Vaccine Recipients, a warning about shedding?

Anti-vaccine folks would sure like you to think so, but the thing is, measles is a respiratory illness.

“In this systematic review, we have determined that there have been no confirmed cases of human-to-human transmission of the measles vaccine virus.”

Greenwood et al on A systematic review of human-to-human transmission of measles vaccine virus

Detecting vaccine strain measles in urine isn’t something to be concerned about because it can’t lead to an infection.

Anyway, you’re not going to get measles from shedding after someone was vaccinated. If you do, you will be the first!

Misusing MTHFR Tests

Have you wondered why anti-vaccine are so concerned about their MTHFR test results?

“In conclusion, the invalid interpretation that the determination of the MTFHR variant is an acceptable reason for vaccine exemptions is not based on the precepts of replication and rigorous clinical testing. It is unfortunate that the loose application of our exploratory report has been misinterpreted and used to inappropriately justify exemption of children from medically indicated vaccines.”

David M Reif, Ph.D. on the Inappropriate Citation of Vaccine Article

Turns out it is because a few anti-vaccine doctors misinterpretated an old study about the smallpox vaccine.

Now that the author of that study has called them out, will they stop?

Other Vaccine Studies That Are Misused

Of course, there are more…

The article totally misinterpretated the study...
The article totally misinterpretated the study…

Remember when anti-vaccine folks thought that the polio vaccine was causing outbreaks of hand, foot and mouth disease?

“Well, that’s actually totally backwards. Our article suggests that FAILURE to get vaccinated with polio vaccine might set you up for Hand Food Mouth disease (EV71).”

It wasn’t…

And then there is the study that had anti-vaccine folks thinking that 38% of the kids in the Disneyland measles outbreak were vaccinated.

This isn't a study about vaccine-associated measles...
This isn’t a study about vaccine-associated measles…

The study was about new ways to detect measles vaccine reactions.

“During measles outbreak investigations, rapid detection of measles vaccine reactions is necessary to avoid unnecessary public health interventions.”

Roy et al on Rapid Identification of Measles VirusVaccine Genotype by Real-Time PCR

These are folks with a fever and a rash after their MMR vaccine.

This is not people with vaccine-associated measles.

Misusing Scientific Research

Remember when they thought that the study, Deaths Reported to the Vaccine Adverse Event Reporting System, United States, 1997–2013, reported that 79% of deaths in VAERS occurred on the day a child received a vaccine?

Did they read the study?
Did they read the study?

That’s not what the study said…

The study simply said that “For child death reports, 79.4% received >1 vaccine on the same day.”

It wasn’t the same day they died though.

“No concerning pattern was noted among death reports submitted to VAERS during 1997–2013.”

Moro et al on Deaths Reported to the Vaccine Adverse Event Reporting System

In fact, the study “did not detect any concerning patterns that would suggest causal relationships between vaccination and deaths.”

What about when anti-vaccine folks say that only 1% of vaccine side effects are reported to VAERS? That has to be true, right?

Not exactly.

That claim is based on an old study about drug reactions and was not specific to vaccines.

“To counter the propaganda by anti-vaccine activists, the research and public health communities have to adjust their communication.”

Stephan Guttinger on The anti-vaccination debate and the microbiome

Does any of this surprise you?

Can we counter this type of anti-vaccine propaganda and keep it from scaring parents away from vaccinating and protecting their kids?

Sure.

But first we all have to recognize that they are doing it!

More on Misusing Vaccine Studies

How Do Anti-Vaccine Folks Think?

Does it sometimes seem like anti-vaccine folks are speaking a foreign language?

It definitely seems like they misunderstand and misuse a lot of scientific terms, like evidence, research, and toxin, doesn’t it?

Anti-Vaccine Glossary

The first step to understanding someone who is truly anti-vaccine and unnecessarily puts their kids at risk for vaccine-preventable diseases, might be to understand how they misunderstand most things about vaccines…

Measles is highly contagious, which is likely why all of the Brady kids got sick.
Anti-vax folks get the message of the Brady Bunch measles episode all wrong…

For example, many of them believe that anecdotes and case studies are strong evidence and on par with the preponderance of evidence that has shown that vaccines are safe, effective, and necessary.

What other terms do they get wrong?

When you say…Anti-Vaccine folks think…
researchI googled it and found something on an anti-vaccine website that confirms what I already thought
peer reviewI had my anti-vaccine friends, some of whom are actually in charge of the journal, take a look at it
personal storiescan only be anecdotal vaccine injury scare stories, but never about regretting a skipped vaccine or personal stories about vaccine-preventable diseases
aluminummercury
consensusmy anti-vaccine friends on Facebook
shillsanyone who supports vaccines
pediatriciana vaccine pusher
sciencepseudoscience
learn the risklearn the exaggerated risks of vaccines that I’m going to scare you about
expertanyone who agrees with me
unavoidably unsafevaccines can’t ever be safe to anyone in any circumstance ever
toxinanything and everything that sounds sciency
placebopure saline
chemicalanything that isn’t natural, not understanding that everything is a chemical
scientistanyone who took a science class in high school or college
doctortypically a chiropractor
medicinenon-evidence based therapies that don’t involve Big Pharma, aren’t covered by insurance, and are likely very expensive
riskcan only come from a vaccine, never from skipping or delaying a vaccine or from a vaccine-preventable disease
sheddingwhat happens when someone gets a vaccine
vaccine injuryanything and everything bad that happens to you in the days, weeks, months, and years after you get vaccinated or in the days, weeks, months, and years before you were born because of the vaccines your parents or grandparents received
religious vaccine exemptionI just don’t want to vaccinate and protect my kids, so will lie and say it is about religion
vaccine preventable diseasesince many anti-vaccine folks don’t really think that vaccines work, they might act more confused if you use this term
informed consentwhen I tell you all of the bad stuff about vaccines, most of which isn’t true, and leave out any talk of benefits
leaky gutexplains every major problem kids have after getting vaccinated
MAPS doctorsthe new DAN doctors
VAERSa list of vaccine-injuries
herd immunitydoesn’t exist, but can only happen from natural immunity
hiding in the herdwhat used to protect unvaccinated kids, until more and more folks started listening to us to our anti-vaccine propaganda
package insertscan be used to scare parents about SIDS and autism
do your researchgo to an anti-vaccine forum or website
cherry pickingwhat does picking cherries have to do with vaccines???
natural immunityeasy life-long immunity without any consequences
vaccine choiceI want to do it my way, no matter how many choices I have
germ theorygerms don’t cause disease and if they did, vaccines didn’t stop them, it was better nutrition and sanitation
homeopathyvaccines don’t work, weekly chiropractic adjustments can keep you healthy, and natural immunity is best, but buy some homeopathic vaccines anyway
essential oilsdefinitely not being sold as part of a multi-level marketing scheme
monkey poxjust smallpox renamed
Guillain-Barré Syndromejust polio renamed
roseolajust measles renamed
SIDSa vaccine injury
vitamin Ka vaccine to be avoided
cognitive dissonancehow we sleep at night after skipping or delaying vaccines and leave our kids unnecessarily unprotected from life-threatening diseases
Andrew Wakefield“…Nelson Mandela and Jesus Christ rolled up into one.”

Get it?

It’s why many people have a hard time talking to friends and family members who are anti-vaccine. And even visits to the pediatrician to talk about vaccines don’t always go so well.

More on the Anti-Vaccine to Science Translator

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

 

Using Pubmed to Do Research About Vaccines

A lot of the vaccine research that folks do is on PubMed.

Using PubMed to Do Research About Vaccines

And that’s not necessarily a bad thing.

“PubMed comprises more than 27 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.”

All of the studies that say that vaccines are safe, that vaccines work, and that vaccines are necessary are in PubMed.

So are the studies that show that vaccines are not associated with autism, SIDS, and other so-called vaccine induced diseases, like ASIA.

Unfortunately, there are also poorly done studies in PubMed that do purport that vaccines are associated with autism and that ASIA is a real thing.

Can You Use PubMed to Do Research About Vaccines?

Kelly Brogan didn't make history in getting a case report published in a low impact journal who's editorial board includes a Reiki Master, chiropractors, and naturopaths.
Kelly Brogan didn’t make history in getting a case report published in a low impact journal who’s editorial board includes a Reiki Master, chiropractors, and naturopaths.

Just like anyone can put up a website or Facebook page and say whatever they want, almost anyone can get a study or article published in a journal and get it indexed in PubMed.

While PubMed is an index with over 27 million citations, it doesn’t do anything to evaluate those citations to see if they include studies with design flaws, conflicts of interest, or are simply fraudulent.

That means that you need to know that a study does not get a badge of legitimacy for simply being in PubMed!

And it does not automatically mean that the evidence and conclusions from the article are of high quality just because it is listed in PubMed.

So use PubMed to find articles to help you do research about vaccines, but then read the article from beginning to end, not just the abstract, and make sure it is an article you can trust:

  • Was it published in a legitimate journal, like Vaccine or Pediatrics, and some of these high-impact journals? (good)
  • Was it published in a predatory journals?  (bad)
  • Does it involve simply looking at VAERS data?  (usually bad)
  • Is it written by folks with a conflict of interest that makes the article biased?  (bad)
  • Has it already been refuted by other people because it wasn’t designed properly or had other major flaws?  (bad)
  • Is it written by people who have expertise on the topic they are writing about? (good)
  • Has it been retracted?  (very bad)
  • 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)?
  • Is it a case control study, cohort study, and randomized controlled trial, which lie somewhere in between case reports and reviews on the hierarchy of evidence scale?

Are you ready to get educated about vaccines?

That’s great, but PubMed shouldn’t be your first stop, or your only stop.

As you do your research or get bombarded with a list of links or abstracts from PubMed, remember that there is a hierarchy of evidence to consider before deciding if a paper or study is really evidence of anything. And finding a case report, study on rats, or an invitro study won’t win you an argument about vaccines when there are randomized control trials and systemic reviews on the other side.

What to Know About Using PubMed to Do Research About Vaccines

PubMed is a giant index of journal articles, but simply being in PubMed doesn’t mean that an article or study is reliable or of high quality, whether it is about vaccines, a vaccine-preventable disease, or any other medical topic.

More on Using PubMed to Do Research About Vaccines