Amy Wallace in Wired on Dr Paul Offit and the Anti-Vaccination Movement: Superb, Engaging Science Journalism

amywallace200px.jpgOne of the most engaging and clearly-written pieces of science journalism over the last year or so was published in Wired magazine last week. Amy Wallace’s, “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All,” is part interview with rotavirus vaccine developer, pediatric infectious disease physician, Dr Paul Offit, and description of the anti-vaccination movement in the United States.
Wallace’s work is the centerpiece of a collection of smaller articles providing science-based information about vaccination that also refutes common anti-vaccination myths including “How To Win An Argument About Vaccines” and “The Misinformants: Prominent Voices in the Anti-Vaccine Crusade”.
Wired’s follow-up discussion of the issue includes, “A Short History of Vaccine Panic,” for those of us who “have a day job” and not enough time to read Paul Offit’s 2008 book, “Autism’s False Prophets.”
I have to admit that it wasn’t until I began blogging four years ago that I realized just how vocal the anti-vaccination movement was in the United States. I come from a time (just on the tail end of the Baby Boom) where I still have relatives who were afflicted with polio and other now-preventable infectious diseases. The devastation of these childhood illnesses makes the risks (yes, I agree there are some risks) of vaccination itself inconsequential.
Vaccination is a risk-benefit proposition but one where someone else’s view affects us all. Lack of vaccination compromises “herd immunity” that keeps us all safe, for example, from diseases like smallpox that have been eliminated from the face of the earth. For example, I wrote most recently about a whooping cough outbreak in southwestern Colorado and prior calls in Durango for vaccination as a socially responsible act, much like cutting brush on one’s property to protect a neighbor’s house in a wildfire.
Others, such as my colleague, Orac, have commented on Wallace’s article for its scientific and medical accuracy. However, I wanted to focus on the effectiveness of the writing as a scientific communication tool because much of the article gives the reader a concise view of issues and psychology that often take typical bloggers thousands of words to express (and still less effectively!).

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Why the PharmKid will get her flu vaccine

Prof Tara Smith thought it important enough to come back from her hiatus to explain why she’s doing the same for her kids.
That’s why.
Addendum (20 Sept 2009): In my rush to put up a very quick post on Friday, I just saw that Revere at Effect Measure put up a detailed post on why we should always get the regular seasonal flu vaccine regardless of the current H1N1 pandemic.

Oprah teaming with Jenny McCarthy will kill children

I wanted to contribute to today’s discussion of anti-vaccinationist, pseudoscience-pawning Jenny McCarthy being given not only an appearance on Oprah but, as reported by Orac, a deal with Oprah’s production company for her own show.
The public attention that Jenny McCarthy’s rants have gotten were bad enough. But, now, to have the soapbox of one of the most influential names in society?
I had to go outside the science blogging community with this. So, I wrote to the Philadelphia attorney who writes the award-winning blog, Field Negro.

Good evening, Counselor,
I know that your view of Oprah has modulated over the years but I’m hoping to get your take on this. I believe you thought her squarely in the house but you recently said (April 19) in your post explaining to yuppie black friends the Malcolm X field negro/house negro speech: “Note, since this post I have changed my opinion [since three years ago] about Oprah. I think girlfriend is on the patio now and has at least one leg in the fields.”
Well, you may want to reassess after today.
Today, many in the network at ScienceBlogs have blogposts on the threat to human health by Oprah parading anti-vaccination, pseudoscience wackaloon, Jenny McCarthy.’s frontpage will have links but you are a very busy man.
This one post by my physician colleague will give you all you need to know:
To give McCarthy the bully pulpit that is Oprah’s show is to sentence thousands of children to death from childhood diseases for which we have low-cost protection in vaccines. Moreover, by encouraging parents not to vaccinate their children, other children may be put at risk – a practice I consider to be a form of biological terrorism.
I’m not being overly dramatic, Counselor. As a scientist of a certain age, I have relatives that were afflicted with polio and ancestors that died of measles and smallpox. Today, these diseases are preventable. However, the hysteria created by Jenny McCarthy now being given the high-profile imprimatur of Oprah cannot do anything but cause vaccines to be withheld from children and deadly diseases to return and flourish.
Given your own platform, I humbly request that you publicize this public health travesty to HFNs, Afrospear, and other readers to protest Oprah’s complicity in this unconscionable anti-vaccination movement. This is not just a science issue, it is a societal issue – one that will irreversibly affect the futures of large numbers of children with debilitating and fatal diseases that are easily prevented.
Respectfully submitted,
Abel Pharmboy
Terra Sigillata
This e-mail is: [X]blogable [ ]ask first [ ]private

UPDATE (6 May 1:15 pm EDT) : This post has been Twittered this morning by Suzanne Somers.
Also, Arthur Allen just put up a great article in Slate, “Say It Ain’t So, O,” that closes with the following:

What’s a little sad about this episode is the fact that once upon a time, big stars like Humphrey Bogart, Louis Armstrong, and Elvis Presley stood up for vaccination campaigns to protect the lives of children. (Actress Amanda Peet recently stepped up to counter McCarthy’s message, saying that people should get their advice on autism and vaccines from doctors, not actresses. But Peet seems to lack McCarthy’s entrepreneurial verve and hasn’t drawn the same level of attention.)
In those days, parents and children clamored for vaccination. Especially children in places like the South Side of Chicago or rural Mississippi (where Oprah was born in 1954), who suffered higher rates of polio in the late 1950s because their parents couldn’t afford the new vaccine.
Over the past year, new outbreaks of measles, whooping cough, and other vaccine-preventable diseases have occurred in communities with parents who choose not to vaccinate their kids.
Oprah, think of the children.

University of Colorado student died of opium tea overdose

After writing this post, I came across Alex’s obituary and guestbook on By all accounts, Alex was a great kid – loved and admired by many – an accomplished hockey player and musician with a love for the mountains. This could have been you or I, or worse, one of our own children.
Breaking my heart this morning is news from Boulder that last month’s death of 20-year-old CU student, Alexander McGuiggan, was from consumption of “opium tea.”

Police department spokeswoman Sarah Huntley said investigators believe McGuiggan and others had acquired poppy plants — which are available legally over the Internet — and were boiling pods to make intoxicating tea.
Police believe McGuiggan knew that the tea he was drinking was made of opiates, Huntley said.
“What he may not have been as aware of was the dangers of what he was ingesting,” she said.
The Boulder County Drug Task Force is investigating other people who may have been involved in “the procurement of the tea, and the making of the tea,” Huntley said. Those people could face charges, she said.

A previous report has been that the student and friends were boiling up poppy seeds, but I was suspicious as those lack significant amounts of opiates. Instead, as Ryan Morgan of The Boulder Daily Camera reports accurately, the students appear to have obtained seeds for Papaver somniferum, and grown plants, and extracted the latex from mature pods. Opium is an alcoholic tincture of the pod latex and is comprised of approximately 10% morphine, 0.5% codeine, and other lesser naturally-occurring opioids (the plant synthesizes these opiates of the “benzomorphan” class in a biosythetic pathway beginning with the amino acid, L-tyrosine.).
The sad fact is that we’ve known for over 200 years that this is a bad idea: based upon growing conditions, harvest time, and extraction method, the resulting concoction can provide an extremely variable dose of these compounds. Used medicinally as one of the strongest analgesics (“painkillers”) we know, in higher doses the opiates can impart a warming sense of euphoria but, at even higher doses, suppresses the respiratory control center of the brain stem, resulting in death.

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NIAAA’s ‘Rethinking Drinking’

fulton.jpgI’m very proud today to see one of my formative professors, Dr Fulton Crews, quoted extensively in a USAToday article on a new, web-based alcohol awareness initiative, “Rethinking Drinking,” from NIH’s National Institute for Alcohol Abuse and Alcoholism (NIAAA) Division of Treatment and Recovery Research.

While many associate heavy drinking with liver problems, it can also increase the risk for heart disease, sleep disorders, depression, stroke and stomach bleeding. Consumed during pregnancy, it can cause fetal brain damage, says Fulton Crews, director of the Bowles Center for Alcohol Studies at the University of North Carolina-Chapel Hill School of Medicine. It’s also linked to cancer.
“We know if you’re a heavy drinker but not alcohol dependent, your risk of oral cavity cancer and also breast cancer are increased,” Crews says.

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More fallout from New Mexico garbage truck E. coli-gate – up from the comments

Tularosa_edited-1.jpgHere’s an update on E. coli-gate in Tularosa, NM:
Okay, so it’s more than fluid – it’s about a pint of sludge left in front of each house where the garbage truck stopped. But this is ridiculous:

[Tularosa resident Ken] Riedlinger took samples from the sludge puddle to the Diagnostic and Technology Center in Alamogordo and they found a huge amount of E. coli, he said.
“The upper tray reported it’s infinite, the numbers were too great to count,” Riedlinger said. “This is massive, massive E. coli. This is deadly stuff.”
E. coli is a bacterium found in the lower intestine of warm-blooded animals, Riedlinger said, reading from an Internet report. Some strains of E. coli can lead to infection and death if ingested.

We here at Terra Sigillata World Headquarters were fortunate to have been visited by, not a garbage truck, but rather a couple of commenters who spoke with great authority on the issues at hand.
I first saw that jre from Lyons, Colorado, also commented at the KRQE-TV website but then also left a comment here:

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E. coli in fluid dripping from New Mexico garbage truck

Dear PharmMom,
Your daughter-in-law found this one on your local TV news station:

TULAROSA, N. M. (KRQE-KBIM) – Fluid leaking onto city streets from a contract garbage truck has tested positive for the E. coli bacteria, according to the town’s mayor.
Alamo Disposal has been picking up the trash for many in Tularosa for the last three years. Recently resident and city officials noticed something leaking from a truck into the middle of the street.
Tularosa Mayor Ray Córdova then inspected the vehicle and smelled something extremely foul coming from it. That’s when he told residents to take samples of the fluid so he could send it off to a lab for testing.
Those tests came back positive for the E. coli bacteria. . .
. . .On Thursday Alamo Disposal owner Art Cardiel said the leak came from a crack in the truck. However he also said believes the E. coli is coming from the bacteria in people’s trash and not the truck itself.
“In this area, a lot of people grow their own fruit because there’s a lot of water,” Cardiel said. “Now how am I supposed to have any control over what I put in my truck that comes out of their trash cans?”
“I’m abhorred about it,” Córdova said. “I don’t like it, and I don’t want it. . .
. . .”I spoke to him on the phone and said this has got to stop,” Córdova added. “I said can’t even allow your trucks into the city limits if that’s what they’re doing.”
The New Mexico Environmental Department has given the owner 10 days to fix the crack in his truck.
But the mayor and trustees will meet on Sept. 23 to decide if they want to terminate the contract.
There have been no reports of any residents coming down with E. coli from the fluid.

Two sentences: 1) The E. coli is coming from the dog and cat poo that is dumped into household trash. 2) The fluid is harmless unless you drink it or put it on a piece of fruit.
The article is currently followed by 15 comments of various degrees of comedic creativity. For example, when has anyone not smelled a foul odor coming from a garbage truck?

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ZOMFG!!! Pharmaceutical terrorism!

Naw. This is more likely a case of an older person flushing some old prescription drugs down the toilet:

In a February interview with The Associated Press, Mayor Robert Cluck said trace concentrations of one pharmaceutical had been found in treated drinking water, but he declined to name it. He said revealing the name in the post-9/11 world could cause a terrorist to intentionally release more of the drug, causing harm to residents.
“I don’t want to take that chance,” Cluck said. “There is no public hazard, and I don’t want to create one.”
. . .Drinking water in Arlington, Texas, tested positive for trace concentrations of the anti-anxiety medication meprobamate, city officials revealed Monday in response to a series of public records requests. . .
. . .In water samples taken in October 2006, concentrations of the drug measured around 1 part per trillion. [emphasis mine]

The hysteria surrounding “toxins” and “terrorism” derives in large part from the tremendous strides made over the last decade or two in the sensitivity of analytical chemistry instrumentation and methodologies. But just because someone could detect something in the water supply doesn’t mean there are toxicity concerns.

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NPR’s The People’s Pharmacy on bisphenol A, endocrine disruptors

200px-Bisphenol_A.svg.pngBisphenol A (BPA) is currently one of the major lightning rods for controversy in consumer products and public health research. The compound is used in the manufacture of plastic bottles, polycarbonate (PC) in particular, as well as in the lining of many food and beverage cans. The compound has been recognized since the 1930s as having estrogenic activity but it appears to have developmental, carcinogenic, and neurotoxic effects at concentrations well below those at which it binds to the two forms of estrogen receptor.
US governmental advisory committees can’t even agree on BPA. Public health blogger revere at Effect Measure posted last October about two conflicting reports from the US National Toxicology Program on the developmental risks of BPA – the contentious comment thread following the post is illustrative of the confusion surround BPA even among scientists. This 2005 review in Environmental Health Perspectives makes for a good introduction before delving into the current literature.
So if the scientists are confused, well guess what the public thinks? To shed light on this topic, award-winning medical journalists Joe and Terry Graedon will focus the next two shows of their NPR-syndicated The People’s Pharmacy radio show on BPA and the larger issue of endocrine disruptors. This week’s (1 March) guests are:

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Avery Comarow attacked by America’s Natural Physician™

[Note: I originally posted this last Thursday under another title but it got lost in other events of that day. As I find it ironic that Mr Comarow has been attacked by an alternative medicine practitioner and advocate, I find this story worthy of reposting.]
A few weeks ago the skeptical blogosphere was up in arms about an article in US News & World Report by Avery Comarow on alternative medicine services in US academic medical centers. Mr Comarow is a senior medical writer for USN&WR and best known as editor for the last 18 years of the magazine’s annual feature, America’s Best Hospitals.
To my med blogger colleagues, Mr Comarow’s article came off as unjustifiably sympathetic toward alternative medicine being practiced in major academic medical centers. Mr Comarow has two blog posts of his own on this story, here and here, the latter of which responded to the unanticipated deluge of critical comments on his story.
Truth be told, I was interviewed on background by Mr Comarow and felt that some of my most critical comments did not make it into the piece, due most likely to the complications with citing me as a pseudonymous source. While I am not a physician, I have been involved with integrative or alternative medical centers at four different US academic medical centers. However, my feeling (and my feeling alone) was that his primary intention was to get inside the mind of the patients, understand why they were pursuing alternative therapies, and grasp why major evidence-based medical centers were establishing centers of alternative/integrative medicine whose standards of proof were below that of each respective health system.
Interestingly, the accompanying video commentary on the article (here), was cited by a commenter on Science Based Medicine as follows: “The US News & World Report article has a video segment by the senior health editor. He seems to be more skeptical than the article’s author.”
The irony: the video segment was done by the same Avery Comarow who wrote the article.
So, you’d think that at least the alternative medicine community would be singing the praises of Mr Comarow’s article. You would be wrong. From Bottom Line Secrets:

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