Friday, 25 April 2014

Anti-Vaccination Celebrity who twists the truth

Actress Jenny McCarthy spoke against vaccines publicly for years but now says she has been pro-vaccine
By Frank Bruni, Published The Straits Times, 24 Apr 2014

New York - What do you call someone who sows misinformation, stokes fear, abets behaviour that endangers people's health, extracts enormous visibility from doing so and then says the equivalent of "Who? Me?" I'm not aware of any common noun for a bad actor of this sort. But there's a proper noun: Jenny McCarthy.

For much of the past decade, the model-actress has been the panicked face and intemperate voice of a movement that posits a link between autism and childhood vaccinations and that badmouths vaccines in general, saying that they have toxins in them and that children get too many of them at once.

Because she posed nude for Playboy, dated actor Jim Carrey and is blonde and bellicose, she has received platforms for this message that her fellow nonsense peddlers might not have. She has spread the twisted word more efficiently than the rest.

And then, earlier this month, she said the craziest thing of all, in a column for The Chicago Sun-Times.

"I am not 'anti-vaccine'," she wrote, going on to add: "For years, I have repeatedly stated that I am, in fact, 'pro-vaccine' and for years I have been wrongly branded."

You can call this revisionism. Or you can call it "a complete and utter lie", as the writer Michael Specter said to me. Specter's 2009 book, Denialism, looks at irrational retorts to proven science such as McCarthy's long and undeniable campaign against vaccines.

McCarthy waded into the subject after her son Evan was given a diagnosis of autism in 2005. She was initially motivated, it seems, by heartache and genuine concern.

She proceeded to hysteria and wild hypothesis. She got traction, and pressed on and on.

In 2007, she was invited on Oprah and said that when she took Evan to the doctor for the combined measles-mumps-rubella vaccine, she had "a very bad feeling" about what she recklessly termed "the autism shot". She added that after the vaccination, "Boom! Soul, gone from his eyes". In an online Q&A after the show, she wrote: "If I had another child, I would not vaccinate."

She also appeared on CNN in 2007 and said that when concerned pregnant women asked her what to do, "I am surely not going to tell anyone to vaccinate". Two years later, in Time magazine, she said: "If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the measles."

I've deleted the expletive she used before the second "measles". And on The Huffington Post a year after that, she responded to experts who insisted that vaccines didn't cause autism and were crucial to public health with this declaration: "That's a lie, and we're sick of it."

I don't know how she can claim a pro-vaccine record. But I know why she'd want to.

Over the last few years, measles outbreaks linked to parents' refusals to vaccinate children have been laid at McCarthy's feet.

The British study that opponents like her long cited has been revealed as fraudulent. And she and her tribe have gone from seeming like pitifully misguided dissidents to indefatigably senseless quacks, a changed climate and mood suggested by what happened last month when she asked her Twitter followers to name "the most important personality trait" in a mate. She got a bevy of blistering responses along the lines of "someone who vaccinates" and "critical thinking skills".

Seth Mnookin, the author of the 2011 book The Panic Virus, which explores and explodes the myth that vaccines cause autism, noted that McCarthy had a relatively new gig on ABC's The View that could be jeopardised by continued fearmongering. What once raised her profile, he said, could now cut her down.

As she does her convenient pivot, the rest of us should look at questions raised by her misadventures.

When did it become okay to present gut feelings like hers as something in legitimate competition with real science? That's what interviewers who gave her airtime did, also letting her tell the tale of supposedly curing Evan's autism with a combination of her "Mommy instinct" and a gluten-free diet, and I'd love to know how they justify it.

Are the eyeballs drawn by someone like McCarthy more compelling than public health and truth?

Her exposure proves how readily television bookers and much of the news media will let famous people or pretty people or (best of all!) people who are both famous and pretty hold forth on subjects to which they bring no actual expertise.

Whether the topic is autism or presidential politics, celebrity trumps authority and obviates erudition.

There's also this: How much time did physicians and public officials waste trying to neutralise the junk in which McCarthy trafficked?

As Fred Volkmar, a professor at Yale University's medical school, said to me: "It diverts people from what's really important, which is to focus on the science of really helping kids with autism."

New York Times

Autism Has Increased (Like 373% In 14 Years). But Here Are Some Facts About Vaccines.

It's foolish and dangerous to avoid vaccines

By Andy Ho, The Sunday Times, 27 Apr 2014

Parents in Singapore don't worry too much about diseases that vaccines prevent, like measles, which was well on its way to being eradicated from the world. The World Health Organisation (WHO) reported a 78 per cent drop in deaths from measles worldwide between 2000 and 2012. This was in large part due to progress in Africa, India and other developing regions.

In developed nations, however, progress has been stymied by the rise of "vaccine denialism". As a result of fraudulent research linking the MMR (Measles, Mumps & Rubella) vaccine to autism, some parents in the West now refuse to have their children vaccinated.

Denialism has now spread to the educated class in many countries, including Singapore, if online discussion is any indication.

Vaccine denialism translates into utterly preventable deaths. Earlier this year, a young man in Wales and a teenage girl in the Netherlands, both not vaccinated, died of measles. Last year, there were 2,000 measles cases in Britain, the most in 19 years; and 175 cases in the United States, the most in 17 years.

Meanwhile, there has been a major measles outbreak in the Philippines, with 2,417 cases last year. Since January this year, 23 Singaporeans who travelled to the country have come back infected. Cases from the Philippines have also turned up in Australia, Britain, Canada, Japan, New Zealand and the US recently.

So far, 80 people in Singapore have come down with measles this year - half of whom had not been vaccinated - a great rise against the 40 cases in 2012 and 31 cases last year.

Parents may remember measles as just a fever and rash. Mainly a respiratory infection, it kills one or two out of 1,000 cases.

The gravest complication is encephalitis, which afflicts one in 1,000 cases. Here, the brain is inflamed and swollen, so the patient has severe headaches, clouded thinking, fits, and problems with movement. If the brain swells enough, the skull basically crushes the organ, leading to death in 15 per cent of measles encephalitis.

Some 20 to 40 per cent of those who survive measles encephalitis suffer neurological deficits for life, like deafness, blindness or mental retardation.

Crucially, a minority of those infected before they are one year old will develop in childhood and adolescence - but even up to 27 years afterwards - an incurable condition. This is subacute sclerosing panencephalitis (SSPE), in which the child seems to recover fully from measles. But because its immune system reacts abnormally to the virus, brain and spinal cord nerve cells are perpetually swollen, so they gradually break down.

This degenerative brain disorder is fatal, usually within a year or two after diagnosis.

The patient develops abnormal behaviour, muscle spasms, unsteady gait and fits, as well as suffers from memory loss, impaired speech and so on.

British studies suggest that 18 of every 100,000 babies infected under age one will develop SSPE but only 1.1 per 100,000 of those infected after age five do so.

The more cases of childhood measles, the more likely there will be cases of encephalitis and SSPE. In contrast, the risks with the vaccine are negligible: fever, a mild rash, one in 3,000 risk of fits, and one in 30,000 chance of developing a bleeding tendency for a little while. But there is no deafness, encephalitis or SSPE with MMR.

Prior to 1963, when the US licensed the first measles vaccine, almost every child had measles by age 15. By 1968, there were almost no measles cases in the US. Singapore mandated the vaccine from 1985.

As the vaccine was first tested in 1958, anyone born in or before 1957 is assumed to have had measles and thus immune. No one else is immune unless vaccinated and all it takes is one child on a flight from Manila or London, say, for an outbreak to start. So MMR is reasonable insurance.

MMR denialism began in Britain with fear-mongering by Andrew Wakefield, a doctor now struck off the British medical register for his 1998 study, a fraudulent case series linking MMR to autism. It was published in the top medical journal, The Lancet.

None of his cases tallied with the actual patient case notes. The British Medical Journal engaged an investigative journalist to detail Wakefield's plan to enrich himself by discrediting MMR and have a lawyer sue vaccine makers.

Because the British media sensationalised Wakefield's claims, many parents were taken in, leading to plummeting vaccination rates. In certain regions of the country, these fell to 50 per cent. Measles, considered already conquered in Britain, became endemic again in under a decade.

Likewise in Europe that has, in recent years, even exported cases to other countries, including Africa.

To prevent measles outbreaks, 90 per cent to 95 per cent of the population must be vaccinated. (The rates in Singapore have been consistently above 95 per cent so we may still be safe - for now.)

When enough numbers in a community are vaccinated, the non-immune are less likely to become infected because the bug cannot thrive out there. These non-immune cases are those who cannot be vaccinated because of their compromised immune status; those in whom MMR never took; kids whose parents forgot to get them the shots; and, kids of denialists.

Denialists put all children at risk since vaccines are never 100 per cent effective. In general, up to 10 per cent of vaccinated kids may be non-immune.

But since at least 90 per cent of the population must be immune for this "herd immunity" to work, even a modest fall in vaccination rates may put all kids at risk.

This is why despite the high vaccination rates in Singapore (required for school enrolment), outbreaks can still occur.

The WHO reports that field investigations of recent measles outbreaks confirm that most cases involved non-vaccinated persons.

The more contagious the disease, the higher the percentage of vaccinated is required to protect the non-immune - and measles is one of the most contagious viruses ever. But now there are wilful non-vaccinators, including expatriates, in our midst who are creating pockets of the non-immune.

In the West, even where it is mandated, exemptions may be permitted by the authorities, like school districts, for what are called "philosophical objections" to vaccines. These denialists are generally educated, affluent parents whose Google research has transmuted them into experts on vaccine risks.

They ignore the multiple well-designed studies that have repeatedly shown, at great costs in time, effort and money for over over a decade now, that MMR is safe and not linked to autism.

How to stop more parents from becoming denialists? Only aggressive public education can do so, which may need to be undertaken with some urgency.

Vaccines licensed here meet safety standards

WE THANK Ms Estella Young ("Inoculate ourselves against culture of vaccine denial"; last Saturday), Dr Leong Choon Kit ("Measles: Guard against complacency"; Tuesday) and Ms Li Dan Yue ("Educate parents on measles risk"; Forum Online, Tuesday) for their feedback, which emphasised the importance of measles vaccination in conferring on our children effective protection against the disease.

We reassure the public that all vaccines licensed in Singapore meet safety, quality and efficacy requirements and are monitored closely for side effects. Many scientific studies have found no link between childhood vaccines and autism, a view supported by the World Health Organisation.

The MMR (measles, mumps and rubella) vaccination is recommended under the National Childhood Immunisation Schedule for the prevention of measles.

Parents should take their young children for both doses of MMR vaccination on time. MMR vaccinations are fully subsidised at polyclinics and, since June 1 last year, parents may also use Medisave for their children's MMR vaccinations at private general practitioner and paediatric clinics.

In Singapore, it is compulsory for parents and guardians to have their children vaccinated against measles. Proof of vaccination is required for enrolment into childcare centres. Vaccination certificates must also be submitted as part of primary school registration.

Such measures have been effective in keeping the risk of a community outbreak of measles low among those vaccinated.

As direct caregivers, parents are in the best position to ensure that their young children are vaccinated on time. Where appropriate, the Government proactively plays a supportive role by educating, encouraging and reminding parents to fulfil this responsibility in their child's best interest.

The National Immunisation Registry, maintained by the Health Promotion Board, for instance, will send a reminder letter to the parents if a child misses any vaccination.

Through such cooperation between parents and the health authorities, we have kept the MMR vaccination coverage among Singapore residents consistently high at 95 per cent over the years. We will continue to emphasise to parents the importance of ensuring that our young are given the best protection against measles through vaccination.

Jeffery Cutter (Dr)

Director, Communicable Diseases Division
Ministry of Health

K. Vijaya (Dr)

Director, Youth Preventive Services Division & School Health and Outreach Division,
Health Promotion Board
ST Forum, 26 Apr 2014

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