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Communicating Vaccine Science to the Public Paul A. Offit, MD The Children’s Hospital of Philadelphia The University of Pennsylvania School of Medicine. Vaccines are easily damned. MMR Causes Autism. Wakefield, A.J., et al. Lancet 351: 637-641, 1998. MMR-Autism: Scientific Studies I. - PowerPoint PPT Presentation
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Communicating Vaccine Science to the Public
Paul A. Offit, MDThe Children’s Hospital of Philadelphia
The University of Pennsylvania School of Medicine
Vaccines are easily damned
MMR Causes Autism
Wakefield, A.J., et al. Lancet 351: 637-641, 1998.
MMR-Autism: Scientific Studies I
Taylor, B, et al. Lancet 1999;351:2026-29
Dales L, et al. JAMA 2001;285:1183-85
Kaye JA, et al. Brit Med J 2001;322:460-3
Madsen KM, et al. N Engl J Med 2002;347:1477-82
Peltola H, et al. Lancet 1998;351:1327-8.
MMR-Autism: Scientific Studies II
Makela A, et al. Pediatrics 2002;110:957-63
DeStefano R, et al. Pediatrics 2004;113:259-66
Farrington CP, et al. Vaccine 2001;19:3632-5
Fombonne E, et al. Pediatrics 2001;108:e58
Taylor, B, et al. British Med J 2002;324:393-6
Impact of Wakefield paper
Hospitalizations and deaths in the United Kingdom and Ireland
Parents of more than 125,000 children in US choose not to vaccinate—outbreaks in US
Current outbreak in the European region
Thimerosal Causes Autism
Thimerosal-Autism: Scientific studies
Hviid A, et al. JAMA 2003;290:1763-66
Andrews N, et al. Pediatrics 2004;114:584-91
Herron J. Pediatrics 2004;114:577-83
Verstraeten T, et al. Pediatrics 2003;112:1039-48
Barbaresi W, et al. Arc Ped Ado Med 2005;159:37-44
Schecter R, et al. Arch Gen Psychiatry 2008;65:19-24
Too Many Vaccines Given Too Soon Causes Autism
Too Many Vaccines: Scientific study
Smith MJ and CR Woods, “On Time Vaccine Receipt
in the First Year Does Not Adversely Affect
Neuropsychological Outcomes,” Pediatrics 125
(2010): 1134-1141.
Defeating Epidemiology
The journalistic mantra of balance
Epidemiological studies cannot detect rare events
“Vaccines might cause autism in a small group of genetically susceptible individuals.”
Power of epidemiological studies
Paralysis (GBS) and swine flu vaccine
Intestinal blockage and rotavirus vaccine
Omnibus Autism Proceeding
Epidemiological studies don’t prove anything
Epidemiological studies and proof
Null hypothesis: MMR does not cause autism
Reject or not reject the null hypothesis
Cannot accept the null hypothesis
Epidemiological studies and proof
Flying like Superman
WMD in Iraq
Traveling to Juneau, Alaska
Anecdote trumps epidemiology
Cultural Biases
Media’s job is to entertain, not educate
20/20 story about HBV
Sylvia Chase told story of how HBV caused SIDS, rheumatoid arthritis, and MS
Studies had already been performed
Confrontation with executive producer
The media defends the weak against the powerful
Players in vaccine-autism controversy
If you care about children with autism, you support the notion that vaccines are the cause. Lawyers, politicians, fringe scientists, and journalists care.
Doctors, public health officials, mainstream scientists and pharmaceutical companies don’t care.
Players in autism controversy are miscast
Doctors and scientists who oppose notion that vaccines cause autism are standing up for the little guy
Those who claim that vaccines cause autism hurt children by scaring parents about vaccines, proffering dangerous therapies, and diverting limited resources
The media loves mavericks
“While Galileo was a rebel, not all rebels are Galileo.”
Norman Leavitt
The media falls into the single-study trap
Wakefield, A.J., et al. Lancet 351: 637-641, 1998.
The media doesn’t understand science
What is Science?
Science is the systematic enterprise of gathering knowledge about the world and organizing and condensing that knowledge into testable laws and theories
Wilson, Edmund O. in Consilience
What is Science? Formulate a hypothesis and establish
burdens of proof. Proofs are subjected to statistical analysis.
Science includes rigorous controls that allows one to isolate the effects of one variable.
What Science Isn’t Science isn’t scientists or scientific bodies or
accumulated knowledge
Science is a way of thinking about or approaching a problem
Although scientists get it wrong all the time, science is enormously self-correcting; but fluidity of science can be disconcerting
Explaining Cause and Effect
The Lay of the LandBelief Percent of population
Astrology 50ESP 46
Witches 19Aliens already landed 22Commune with dead 42
Ghosts 35
Causality
Inability to accept randomness
Whole-cell pertussis vaccine and the birth of the modern American anti-vaccine movement
Nature of coincidence (The Occult)
Conflicts of interest
Ad hominem attacks If you don’t have the data, discredit the
messenger
Appeal to personal considerations rather than logic or reason
Science vs. politics (this isn’t a game)
Easy appeal to toxic, environmental hell
Easy to scare people;harder to unscare them
What’s at Stake
Beyond scientific illiteracy
Scientific denialism
Global warming, fluoridation, evolution
Some suggestions Stand up for science (not easy)
No venue too small
Don’t let bad information go unchallenged
Don’t assume other people are doing it
We are paid by the public