Tag: Stanley Plotkin

Dr. Bob Puts the Nail in the Coffin of the Herd Immunity Argument

Dr. Bob Sears, who actually wrote a book about vaccines, seems to think that he and his podcasting sidekick have put the nail in the coffin “of trying to use the herd immunity argument to justify coerced vaccinated.”

Dr. Bob seems to think that herd immunity doesn't apply to vaccines.

The meme he shared even includes the hashtag stating that herd immunity doesn’t apply to vaccines.

Dr. Bob Puts the Nail in the Coffin of the Herd Immunity Argument

While arguing against the idea of herd immunity and for coerced vaccination are common among anti-vaccine folks, neither is true.

Herd immunity is real and no-one is going to force anyone to vaccinate their kids. Vaccine mandates do not mean forced vaccination.

What about the idea that “all vaccines wane within about 2-15 years, leaving vaccinated children & adults unprotected?”

If that were true, then wouldn’t everyone who got sick in latest outbreaks be vaccinated? Why are most folks unvaccinated?

So we are either getting a lot of outbreaks because of waning immunity or your titers are getting boosted because you are getting exposed to so much natural disease. Got it?

While waning immunity is an issue for some vaccines, like mumps and pertussis, the primary and secondary failure rates are still not as bad as Dr. Bob suggests, which is why, in an outbreak, the attack rate of disease is always higher among those who are unvaccinated and unprotected.

The numbers don't always add up correctly when anti-vax folks try to do math.
The numbers don’t always add up correctly when anti-vax folks try to do math.

Is herd immunity the main argument that’s made when experts suggest we need stronger vaccine laws? I always thought the main argument is that folks should just vaccinate and protect their kids, but maintaining herd immunity so that your intentionally unvaccinated kids don’t put everyone else at risk is a good reason too.

Does everyone see the problem with Melissa Floyd’s math? This probably won’t be on the SAT, but you still want to get this right…

Like many others are doing right now, she used state level data. Since many of the folks who don’t vaccinate their kids cluster together in the same communities and schools, the “2% of those filing for exemptions” end up making up 10, 20, or even 30% of some school’s student population.

“This means if you are a primary non-responder, you are walking around every day with a false sense of security, clinically unvaccinated for that particular disease.”

Melissa Floyd

This is the whole point of herd immunity!

Because vaccines aren’t 100% effective, we can walk around all day without actually thinking about it much, hoping that we can rely on the fact that most other people are also vaccinated and protected. That keeps disease out of our community or herd.

The system typically breaks down though, not because vaccines aren’t effective enough, but because too many folks don’t get vaccinated.

“A 2011 article in “Vaccines”, edited by Stanley Plotkin, says, “Much of the early theoretical work on herd immunity assumed that vaccines induced solid immunity against infection…” Theoretical… Assumed…”

Melissa Floyd

She should have read the whole article, or at least used the whole quote…

“Much of the early theoretical work on herd immunity assumed that vaccines induce solid immunity against infection and that populations mix at random, consistent with the simple herd immunity threshold for random vaccination of Vc = (1-1/R0), using the symbol Vc for the critical minimum proportion to be vaccinated (assuming 100% vaccine effectiveness). More recent research has addressed the complexities of imperfect immunity, heterogeneous populations, nonrandom vaccination, and freeloaders.”

Herd Immunity: A Rough Guide

It doesn’t say what she thinks it says…

“Indeed, one might argue that herd immunity, in the final analysis, is about protecting society itself.”

Herd Immunity: A Rough Guide

So why haven’t we eradicated measles like we said we would?

“What’s funny is after the measles vaccine was licensed in 1963, the medical community declared a goal of eradicating measles by 1967. But 1967 came and went and it still wasn’t gone, 1977, 1987, 2000… the dates kept getting pushed, and the result was always the same. Meanwhile they continued to increase the hypothesized “herd immunity threshold”, eventually winding up at the extremely high 95% you hear today. “

Melissa Floyd

That’s actually a good question.

What happened to the previous goals of eliminating measles?

“In 1966, the USA began an effort to eradicate the disease within its own borders. After a series of successes and setbacks, in 2000, 34 years after the initial goal was announced, measles was declared no longer to be endemic in the USA.”

Orenstein et al on Eradicating measles: a feasible goal?

Along the way, we have gone from an estimated 100 million cases and 5.8 million deaths in 1980 and an estimated 44 million cases and 1.1 deaths in 1995 to “just” 7 million cases and 89,780 deaths in 2016.

“Under the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020.”

Measles

While there is doubt that we can truly eradicate measles with the current vaccine, we can certainly control and eliminate measles if folks stop listening to anti-vaccine propaganda and they get vaccinated and protected.

More on Dr. Bob and His Herd Immunity Arguments

About those Stanley Plotkin Videos…

Stanley Plotkin is typically described as “a prominent figure in the history of vaccinology, whose work on vaccine development has led to a significant reduction in morbidity and mortality from infectious diseases in the second part of 20th century. “

Why?

For one thing, he developed the rubella vaccine that we still use today.

He also worked on vaccines against CMV, polio, chicken pox, rabies, and rotavirus.

What Did Stanley Plotkin Say While He Was Under Oath?

That’s not why anti-vaccine folks are talking about him these days, or maybe it is…

Mostly, they are misinterpreting comments he made during a videotaped deposition.

“Lori Matheson is fighting her ex-husband, Michael Schmitt, for the right to decide if their two-year-old daughter should be vaccinated.”

Michigan anti-vaccination case to goes to court

A videotaped deposition in a case involving parents who disagreed about vaccinating their daughter…

Even though it isn't his exact quote and anti-vaccine folks don't give you the full context of what he was talking about, it is clear that Dr. Plotkin simply meant that you can't prove a negative.
Even though it isn’t his exact quote and anti-vaccine folks don’t give you the full context of what he was talking about, it is clear that Dr. Plotkin simply meant that you can’t prove a negative.

What do anti-vaccine folks think he said?

“I would say it is logically true that you cannot say, you cannot point to proof that it doesn’t cause autism. ”

Stanley Plotkin, M.D.

No, he isn’t saying that vaccines are associated with autism.

“I could not say that as a, as a scientist or a logician. But I can say as a physician that, no, they do not cause autism, because as a physician, I have to take the whole body of scientific information into consideration when I make a recommendation for a child.”

Stanley Plotkin, M.D.

All he is saying is that you can’t definitively prove a negative.

One of the different things in communicating the fact that there is no link is that science and English are not really the same language. So when a scientist says, “We have no evidence that there’s a link between vaccines and autism,” what they’re really saying is, “We are as positive as someone can humanly be that there’s no link.”
Seth Mnookin explain it well – One of the different things in communicating the fact that there is no link is that science and English are not really the same language. So when a scientist says, “We have no evidence that there’s a link between vaccines and autism,” what they’re really saying is, “We are as positive as someone can humanly be that there’s no link.”

For example, just because I have never seen a black swan, I can’t use that as proof that black swans don’t exist somewhere. After all, I haven’t been everywhere.

“…scientists can be at a real disadvantage in this debate because they, by their nature, are careful in how they present their conclusions.”

Vaccines: Last Week Tonight with John Oliver (HBO)

What else do anti-vaccine folks have a problem with?

Remember the rubella vaccine he developed?

“After a detour to obtain credentials as a pediatrician, I returned to Wistarto work on rubella. Those years were fraught with advances and reverses, controversy and eventually vindication. The pandemic of CRS babies in 1964-65 was an important stimulus to research on the vaccine. “

Stanley Plotkin’s On the Occasion of the Presentation Of The 2002 Albert B. Sabin Gold Medal

During the rubella epidemic of 1964-65, there were 12.5 million rubella virus infections, which “resulted in 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with congenital rubella syndrome.”

And that’s just in the United States.

The controversy?

“There were only two fetuses involved in making vaccines. When fetal strains of, fibroblast strains were first developed, I was involved in that work trying to characterize those cells; but they were not used to make vaccines.”

Stanley Plotkin, M.D.

It is well known (this isn’t some shocking truth as some are trying to push) that some vaccines are made with fetal embryo fibroblast cells (the WI-38 and MRC-5 cells) from cell lines that are derived (they can replicate infinitely) from two electively terminated pregnancies (abortions) in the 1960s.

Those two fetuses weren’t the only two fetuses ever used in research though, they were just the only ones used to actually make vaccines.

“Human diploid cell strains (HDCSs) are batches of cells that are currently used for different purposes, including culturing viruses for the manufacturing of vaccines”

A brief history of human diploid cell strains.

They had to get to the point where they knew how to make vaccines in human cell lines though and that’s what he is talking about in the deposition.

“Q. In any event, so we have 76 in this study. Would you approximate it’s been a few hundred fetuses?


A. Oh, no, I don’t think it was that many. Probably not many more than in this paper. And I should stipulate that we had nothing to do with the cause of the abortion.”

It took some experimentation to find the right kind of cells and the right methods, but ultimately, they found that fetal embryo fibroblast cells were the best to use to grow many viruses.

Copies of those same cells are still used today.

What about the other “issues” brought up in the deposition?

Did he experiment on orphans, people who were mentally handicapped, or those who lived in third world countries?

“I don’t remember specifically, but it’s possible. And, again, I repeat that in the 1960s, that was more or less common practice. I’ve since changed my mind. But those were, that was a long time ago.”

Stanley Plotkin, M.D.

Those were different times, but Dr. Plotkin’s vaccine studies weren’t unethical and weren’t like what was done at Willowbrook, in which children were purposely exposed to hepatitis, with the justification that most of them ended up getting it anyway.

Surprisingly, in the early 1970s, there was still some debate about the ethics of doing experiments on children, and as you can see, using ableist language to describe children with a disability.
Surprisingly, in the early 1970s, there was still some debate about the ethics of doing experiments on children, and as you can see, using ableist language to describe children with a disability.

And from those times, experts developed the rules for how things are now done.

Ironically, anti-vaccine folks are pushing this stuff about Plotkin, but don’t understand why leaving kids completely unvaccinated and unprotected in a study is unethical.

“One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.”

National Catholic Bioethics Center FAQ on the Use of Vaccines

Or why it’s immoral to push anti-vaccine propaganda or put others at risk to get a vaccine-preventable disease.

“Results indicate that the total number of cases of poliomyelitis, measles, mumps, rubella, varicella, adenovirus, rabies and hepatitis A averted or treated with WI-38 related vaccines was 198 million in the U.S. and 4.5 billion globally (720 million in Africa; 387 million in Latin America and the Caribbean; 2.7 billion in Asia; and 455 million in Europe). The total number of deaths averted from these same diseases was approximately 450,000 in the U.S., and 10.3 million globally (1.6 million in Africa; 886 thousand in Latin America and the Caribbean; 6.2 million in Asia; and 1.0 million in Europe).”

Olshansky et al on The Role of the WI-38 Cell Strain in Saving Lives and Reducing Morbidity

Dr. Plotkin’s work has helped save millions of lives.

“His achievements in vaccinology are on a scale that truly can be measured in lives saved and lives restored.”

On the Occasion of the Presentation Of The 2002 Albert B. Sabin Gold Medal

And that’s why anti-vaccine folks are attacking him.

More on Stanley Plotkin