Monday, January 02, 2017

Haley v Offit: A Virtual Debate

This video is about 35 minutes long, available on You Tube at: 

It was produced by Richard P Milner of Public Affairs Media as an initial effort toward a larger documentary about vaccines and the controversy that surrounds them. He provides biographical information of Drs Haley and Offit as well, so I won't repeat that here - follow the link if you want more information. 

The format is point/counterpoint, described by the filmmaker as a virtual debate as the both individuals were interviewed separately and their responses edited together. It is unclear if who was conducting the interviews - this project would be stronger if that were disclosed at the beginning of the film. 

At 2:38min Haley offers his first criticism of Offit (and medical doctors/medical training in general) by pointing out that physicians receive very little, if any, training in toxicology. His particular expertise in this area is mercury - relevant because it is present in some vaccines as the preservative thimerasol (in flu shots in particular). 

At 2:55min Offit states vaccines provide the same protection, elicit the same response as spontaneous infection without the risk of infection. He should know better - this is not true, Haley corrects this. Offit conflates the risk of spontaneous infection with measles insinuating that many people would have serious (ie: life-long sequelae and/or death) as a result of spontaneously contracting measles. In doing this he conflates the benefits of vaccines and minimizes their risks (which we really do not have good information about since they have never been studied in a way that would provide accurate information about their risks). 

At 3:40min Haley points out that the USA uses the most vaccines yet we have the highest Infant Mortality Rate among industrialized/1rst world countries. 

At 4:10min Offit acknowledges that better hygeine played a role in the decrease of many infectious diseases but he attributes the greatest decline to vaccination. In all fairness, it is important to note that it is mortality (ie: deaths) that dropped precipitously, not morbidity (ie: illness) prior to the introduction of vaccines. We really do not know if vaccines are (overall) decreasing morbidity or perhaps, even contributing to it as we refuse to do the types of studies that would yield this information even though we could. To define health narrowly as "not displaying symptoms of infectious disease X" is to both re-define health and mis-define health, especially in light of the fact that we are missing information that would help us know what health is or is not (ie: to what extent are vaccines contributing in maintaining good health or contributing to chronic illness by toxic overload or skewing the immune system). 
Haley counters Offits dis/mis-information and the filmmaker shows graphs supporting Haley's statements/countering Offit's regarding mortality declines prior to the introduction of vaccines. 

At 6:35min The filmmaker displays a slide showing deaths from Scarlet Fever and Typhoid - both of which declined precipitously without the introduction of any vaccine. Death rates from Scarlet Fever were declining even before the introduction of penicillin/antibiotics. 

At 7:00min Haley posits we might be better off not spending billions/year on vaccines and instead invest that money in better hygeine and nutrition. It is not clear if he is advocating that for the USA or in other countries where the sanitation infrastructure is not as well developed. It seems to me that the primary place where there is a need for better sanitation is hospitals - staff and train the housekeeping department well (and pay them well too!), provide adequate licensed nursing staff so providers have time to actually wash their hands between patient contact. I think there is an over-reliance on the alcohol based hand sanitizers - they just cannot replace soap and water. 

At 7:29min Offit cites the Ben Franklin quote "An ounce of prevention is worth a pound of cure". Haley agrees with him but clarifies he is trying to prevent children from being poisoned! 

At 7:35min Offit brags about safety systems for vaccines, citing VAERS (Vaccine Adverse Event Reporting System) which is widely and reasonably believed not to capture the vast majority of adverse events following vaccines as it is a passive system and so many physicians do not even believe adverse events happen subsequent to vaccination - just lots of "coincidences", and who would report a coincidence?! Those who do believe patient histories of adverse events following prior vaccination and use their medical judgement in not administering further vaccinations are subject to witch-hunts (aka: Dr. Bob Sears, a California pediatrician who is under threat of losing his license in the post-SB277 era)

At 8:18min Offit again states his opinion that vaccines are "very safe". I've already stated twice just in this blog post that we do not have accurate information about vaccine safety. We could, but we do not. Offit has a right to his opinion just as we all do, but the factual foundation of his opinion is not "evidence based". He does acknowledge that vaccines can have side effects but follows that by saying he thinks their benefit outweighs any risk (again, an opinion for which there is precious little basis of support). Haley counters by stating we have no business injecting known neuro-toxins (aluminum and mercury) into infants. Haley also raises the point that vaccines contain animal - pig/cow/chicken/dog and human DNA as well. 

At 9:10min Offit is asked if vaccines cause autism - he of course, says "No, vaccines do not cause autism". He then goes on to state that "Biologically it doesn't make sense that they would" (cause autism) ... this is an assumption of incredible hubris. It is not the statement of a scientist who is persuing truth. In science you do not know something until you test and collect data, repeatedly. We have not tested vaccines in a way to elicit information that would confirm or deny his statement that vaccines do not cause autism. This could be done, but the government and health authorities in charge of vaccine safety refuse to so this kind of study. Haley states his theory that those who develop autism are genetically susceptible people who have been exposed to toxins - that autism is primarily a disease of environmental exposure. 

At 11:05min Offit acknowledges that parents make the observation that their child developed autism subsequent to vaccination but he denies the assocation. He relies on "association does not equal causation" and states we do the kind of studies to answer that question (except we don't!) - his contention that we do these sorts of studies is a lie. We do not. 
Haley talks about the toxicity of mercury - fair enough, that is his area of expertise. But there are plenty of other ingredients of concern in vaccines. It isn't just mercury. 

At 12:10min The interview asks Offit about studying an unvaccinated population (in or near Chicago). Offit hems and haws and concedes we **could** do a prospective study (in which you take two groups of similar people and 1 group gets the intervention/vaccine and the other does not) but then states this would be "unethical". This is a lie based on an assumption - and it is anti-science. 

For example: 
  • It was assumed to be unsafe for a woman to labor after having a cesarean.                 Now we know that is is safe to do so. 
  • It was assumed that women should not eat or drink in labor.                                     Now we know it is safe to do so.
  • It was assumed women "needed" an episotomy because this would reduce the risk of pelvic prolapse.                                                                                                          Now we know that is not true. 
  • It was assumed use of electronic fetal monitoring in labor would reduce rates of cerebral palsy.                                                                                                            Now we know that is not true. 
At 12:25min Offit insists it is not ethical to not give children vaccines because they can die of "vaccine preventable" diseases. Truly, it is not ethical to mandate products that are shielded from all liability, especially when the quality of evidence about their safety is so weak. In light of the drops in morality prior to the introduction of vaccines one wonders why he tries to make an argument from mortality! 

At 12:45min Haley refutes Offit's statement that it would be unethical to do a prospective study, though Haley doesn't insist on this - he does point out that the government does have data on unvaccinated children but he alleges they refuse to look at the rate of autism in this group. What Haley is saying is true - increasingly so in an era of electronic medical records and vaccine specific databases. 

At 13:27min Offit brings up autism in the Amish community ... and Haley refutes this by pointing out these (ie: those with autism) are actually vaccine-exposed. 

At 14:30min Haley brings up surveys of unvaccinated and that these generally reveal the unvaccinated to be in better health. Surveys are interesting, and can yield data that may show trends or associations and they can be a way to generate hypotheses but by design they cannot provide the kind of answers so many are wanting. 

At 15:00min Offit states thimerasol has been removed from the majority of vaccines (except for flu vaccines and some DTaP vaccines - he also says the flu vaccine is used only in those who are two or older, though that is no longer true as flu vaccine is recommended for infants 6 months and older). Haley corrects Offit's statement and reports that thimerosal is used in the manufacturing process of several vaccines even though it is no longer added to the end product as a preservative. But because thimerosal is used in the manufacturing process it is still in vaccines, just not at the same level as when it is used as a preservative. 

At 17:00min Haley states that thimerosal has not necessarily been removed from many of the vaccines in the CDC recommended schedule. He alleges that this is a talking point to reassure anxious parents, but that it may have been little more than slight of hand. 

At 17:30min The interviewer brings up with Offit the reports of experimental exposure of brain tissue to mercury (video of this is spliced in). The interviewer asks if he is aware of this. Offit explains this away by stating that animal models are not always predictive of responses in children. How convenient. And once again, anti-science. He states assumption as fact. 

At 20:00min Haley describes an experiment he did on rats exposing them to mercury and the effect this had on tubulin, a structure in brain cells. Mercury caused it to disintigrate and form tangles - something seen in Alzheimer's Disease. He goes on to relate how researchers in South Korea have shown mercury to be involved in making beta-amyloid plaques (another feature of Alzheimer's) and that mercury is implicated in Tau hyper-phosphorylation as well. Why would anyone want to be exposed to any amount of this?! But that is begging the question. 

At 22:00min The interviewer brings up the Burbacher study. Offit goes on to state there is no evidence that it is toxic to have mercury in your brain. 

At 22:45min Offit makes the absurd claim that the most sensitive way to determine if there is harm from mercury in vaccines is through an epidemiological study. Earlier he stated that association does not equal causation ... yet it is here that he wants to posit that lack of association equals safety! In other words, he wants to have his cake and eat it to. It is magic. If an epidemiological study cannot show causation, only association, then it likewise cannot prove safety. The only way to do that is with a sufficiently powered randomized double-blind controlled trial - the strongest type of prospective study. 

At 22:56min Offit says vaccines have been tested (in children) for safety, redundantly. This simply is not so. Where is even one randomized controlled trial, double-blinded with a true placebo (inert substance as a comparison to the vaccine)? Such a study does not exist because it has not been done - let alone a study comparing the whole CDC recommended schedule against a non-vaccinated group to compare the effects/long-term sequelae on health. 

At 23:20min Haley describes a study in rabbits injected with radioactive-labeled thimerosal that demonstrated the mercury may have left the blood but it did not leave the rabbit - it just concentrated in various tissues. 

At 24:30min Haley brings up the issue of Poul Thorson - a research who is on the FBI's Most Wanted List due to allegations he committed fraud with US government research money. He did autism research for the CDC. 

At 25:30min Haley alleges the CDC and its scientists gerry-rig statistics in their studies in order to get the results they want (#CDCwhistleblower anyone?) He states he and other authors detail this in a paper that is currently available ... the filmmaker fails to provide a reference for this. 

At 26:08min A congressional statement is posted about the results of a congressional investigation "Mercury in Medicine" (2003 - more than 13 years ago). The statement is an accurate, and devastating summary: 
"To date, studies conducted or funded by the CDC that purportedly dispute any correlation between autism and vaccine injury have been of poor design, under-powered, and fatally flawed. 
The CDC's rush to support and promote such research is reflective of a philosophical conflict in looking fairly at emerging theories and clinical data related to adverse reactions from vaccinations." 
At 26:50min Offit tries to posit the theory that "the dose makes the poison". The problem with this statement is that there is no evidence that mercury, in any form, is safe at any dose. He exposes himself as being anti-science once again - while this may be true of some things (Haley makes the comparison of 1 beer vs 10 beers) this is not necessarily true of all things (ie: mercury). We don't know what we don't know. Offit does not state theories as questions to be answered but tries to make assumptions facts. 

At 27:36min Haley brings up the concept of synergistic toxicity - a theory that is very relevant to vaccination as vaccines contain multiple components that are biologically active, all of which could be synergistic toxins - or this could be a variable in that we are giving multiple doses of vaccines simultaneously - a practice that has never been studied in a way to acertain safety or expose risk. 

At 28:30min Offit brings up the subject of safety of aluminum in vaccines and says that it has not been as well studied as mercury. Hardly a ringing endorsement of a substance that is injected into newborns on the day of birth (in the Hep B vaccine - how exactly is it necessary to "protect" a newborn from an infection obtained by sex or sharing of needles?) 

At 29:35min the interviewer brings up (with Offit) the subject of auto-immune disease. Offit deflects from vaccination to campylobacter of all things and that this is associated with Guillan-Barre Syndrome (GBS. He then moves on to Lyme disease. Neither of these bacteria have a vaccine, so why does he bring them up? It seems his case would be stronger if this were true of infections for which there is a vaccine. He ends this bizarre rabbit trail by stating there is no evidence vaccine do this. Except that there is - people have developed GBS subsequent to vaccination, as well as arthritis (it is listed as a possible side effect of the MMR vaccine). 

At 32:15min Offit claims the vaccinated are not at greater risk of asthma (among other problems) compared to the non-vaccinated. How he can say this when the study has not been done is something I don't understand. While vaccination may not be the only variable in many chronic diseases like asthma, it is anti-science to exclude them as a variable at all.

At 32:24min Haley describes a Canadian study looking at 2 groups of children - one got a vaccine at 2 months, the other at 4 months (he does not state what vaccine was being studied, nor is the citation provided either verbally or visually) but he relates the results demonstrated that asthma rates were higher in the group of children who got the vaccine at 2 months compared to the group that got it at 4 months. 

At 32:31min Haley accuses Offit of cherry-picking studies to "prove" vaccine safety. I think it would be difficult to accuse those who question vaccines of doing this as few studies are being designed and executed in a way that we would approve (see the quote from the Congressional investigation above). 

At 32:50min Offit denies there is an epidemic of autism. Apparently the one thing he does not agree with the CDC about. 

At 34:19min A series of 4 factual statements refuting Offit's claim that there is no epidemic of autism. One case of an infectious disease can be all that is necessary to declare an epidemic ... but a diagnosis affecting at least 1 in 68 (and increasing) is not an epidemic?! 
How convenient. 

What follows on subsequent screens are statistics for a variety of health conditions that the filmmaker relates as being related to mercury - perhaps, perhaps not. It remains to be determined what role mercury may play in the list - it may well be a variable but it is unlikely to be the only, or primary, variable. 

At 35:00min - one of the more alarming statistics is shown. That >50% of our children have a chronic illness. Not to overstate the obvious, but that isn't health. This is yet another domain in which we have normalized deviance. Our children may not be sick with measles for 1 week but they are sick with something else the rest of their lives. Not a great trade off. 

It ends with an appeal to support the filmmaker in finishing this project as he wants to interview more experts in a similar format for a larger, longer documentary. 

I encourage you to watch for yourself - what do you think? 

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