Monthly Archives: May 2017

Anti-vaccine advocates present on Bill 87: Torrents of misinformation

Bill 87 has been controversial for a number of reasons. One of the only pieces of the bill that everyone has seemingly agreed on is the requirement that any parent refusing vaccines for their child based on conscience of religious belief must attend a mandatory education session held by public health.

Reasonable, no? Who could possibly disagree with this?

The anti-vaccine crowd, of course. Each of the first three committee meetings of the Standing Committee on Bill 87 has featured a speaker delivering an oral submission rife with myths and misinformation on vaccines, aimed at swaying the legislature to remove the amendment.

Before I get into the specifics of their presentations, I want to deliver a very clear message to the members of this Standing Committee and to all of our political leaders. Your roles as elected officials involve seeking out expertise and using their information to guide public policy. Public health officials, physicians, and other health professionals have specific expertise that must be utilized, and decisions cannot be influenced by those who push misinformation, conspiracies, and who adhere to no scientific or academic standards.

Here are the presentations from April 12 and April 26. Those who spoke out against vaccines were Elisabeth Hall, Gisele Baribeau (Concerned Parents of London and Area – on Vaccines), and Heather Fraser (Vaccine Choice Canada).

Ms. Hall told her story of her two daughters with chronic eczema, psoriasis, asthma, allergies, tics, IBS and “chronic breathing issues”. She described (in her own words) “starting down the rabbit hole” of researching vaccines and “began to understand that vaccine injury is real”. She stated that “parents who are choosing to follow a different schedule than the recommended schedule are very well educated individuals with a high level of education”.

Let quote Tom Nichols’ from his terrific book “The Death of Expertise”:

The parents most likely to resist vaccines, as it turns out, are found among educated San Francisco suburbanites in Marin County. While these mothers and fathers are not doctors, they are educated just enough to believe they have the background to challenge establish medical science. Thus, in a counterintuitive irony, educated parents are actually making worse decisions than those with far less schooling, and they are putting everyone’s children at risk.

She adds “It appears the purpose for these education sessions could have an ulterior motive behind it.” Yes, the motive is to improve the health literacy of the population and to increase vaccine coverage in our community. No one is hiding this. She likely believes that any actual facts presented at these sessions are “coercion”, while in reality they would be providing citizens with high-quality medical information as is our duty as health educators.

She then engages in a horrifying back and forth with NDP Health Critic and MPP France Gelinas about checking for antibody titres. Warning to immunologists, infectious diseases experts, and frankly anyone with any expertise in this field. You will need a good dose of Gravol to get through this…

Mme France Gélinas: This is an interesting concept. Frankly, I never thought about that, that somebody would already have the immunity through some of the mandatory vaccines. Do you know of any other jurisdictions that do that, that test people before they have a universal vaccination program?

Ms. Elisabeth Hall: No. Nobody does a routine titre test, something where it’s a regular test, like you go to the doctor’s and you do a pap smear or something. You know you’re supposed to do that every couple of years at a certain age. We’re not routinely checking at all. In fact, I called OHIP and I asked them if the titre test was covered by OHIP, because I wanted to know if it was free and covered or if I had to pay for it. They did not know what a titre test was, so then they told me to call my doctor.

That’s how rare this test is. As you can see, not many people know about it. But if we are routinely checking for titres, we can see if the vaccine is working, because we know that sometimes vaccine manufacturers have maybe set an efficacy of 95% but then they came back and said a couple of years later, “Oh, sorry, it was only 60%.”

We can see that titre tests would be very important if you want to actually protect a community and protect individuals, because antibodies can transfer through breast milk. They can also come into contact—there have been people who have had titre tests who have never actually experienced the symptoms of the disease and had the antibodies for the disease.

Mme France Gélinas: Did you go to your family physician? Did you ask—if you were to be referred, is it covered?

Ms. Elisabeth Hall: Yes, it is covered.

Mme France Gélinas: But we’re not using it because nobody knows about it.

Ms. Elisabeth Hall: Exactly.

Mme France Gélinas: How did you come to know about that?

Ms. Elisabeth Hall: I’ve been researching for a year and a half consistently, almost every day for, like, three hours.

Mme France Gélinas: It took a lot of work.

Ms. Elisabeth Hall: Yes, many sleepless nights.

Mme France Gélinas: Did you have such a test done on your children?

Ms. Elisabeth Hall: I haven’t done a test, no, because they’re fully vaccinated—and they were injured by vaccines. So I haven’t done a test yet, but I probably will, just to see if the vaccines actually even worked.

Mme France Gélinas: Very interesting. Thank you.

“Nobody does a routine titre test”. Yes we do. Regularly. She called OHIP and they didn’t know what a titre test was. Who was she speaking to? A secretary? The janitor? What is that supposed to prove? “Not many people know about it”. This is a straw man fallacy to end all straw man fallacies. Everyone knows about titres. Everyone orders titres. This is not a new thing. But here’s where she is totally off base. She is subtly implying that we should order titres on children before giving them vaccines. Here’s the problem with that. If you check a titre after giving one dose of MMR, you may see a positive titre and be falsely led into thinking that you don’t need a booster. Your immunity will quickly drop off and you will soon be left unprotected. We check them in certain cases in adults to avoid immunizing if not necessary, but this is not applicable to children.

“I’ve been researching for a year and a half consistently, almost every day for, like, three hours.” Googling frantically and looking for information that specifically supports your prior belief system is not researching. It’s confirmation bias. And I must say that I am incredibly disappointed in MPP Gelinas for feeding directly into the conspiratorial narrative that Ms. Hall was creating.

MPP John Fraser gave Ms. Hall the most opposition, defending the need for health protection. Ms. Hall then adds “If someone wants an exemption, they have to have maybe had an injured child that’s—maybe their family history has the MTHFR gene that enables them to detox from toxins. They might have this gene, and they might want a medical exemption.” Someone bringing up the MTHFR is a big pseudoscience flag, as it’s being used by the alternative medicine community to explain away just about any health concern. Here’s a terrific summary of the MTHFR issue from Skeptical Raptor.

Heather Fraser from Vaccine Choice Canada spoke about her experiences with her son with eczema, asthma, and peanut allergies, and attributed them to vaccines. She authored a book, The Peanut Allergy Epidemic where she “explains that vaccination is the precipitating cause of this pediatric epidemic” (again, there is no evidence to support this claim). She holds an MA in Art History, BA in Art History & Criticism and a degree in Education, Visual Art & English. No expertise in medicine, public health, immunology, or infectious diseases. But here is the pièce de résistance. Her book’s foreword was written by Robert F. Kennedy Jr. Yes, the same Robert F. Kennedy who was recently announced by Donald Trump to coordinate a vaccine safety commission for the president. RFK Jr. has long been criticized for his anti-vaccine views, including continuing to push the disproven claim that MMR is linked to autism. Here is a great article from Scientific American detailing RFK Jr’s questionable past.

She cites Dr. Peter Vadas to support her position that vaccines can lead to allergy. She is likely referring to this video from 2001. What she conveniently omits is that Dr. Vadas has since been very clear on his position of the safety of vaccines, and his comments have been repeatedly taken out of their context.

 

She goes into detail about adverse event reports that has seen, listing all of the reported conditions in an attempt to strike fear into the legislators. There are significant problems with using reporting systems as a measure of vaccine safety, as Scott Gavura details in this article. Most of the cases of vaccine injury she cites are likely an example of the post hoc ergo propter hoc fallacy, which states “states “Since event Y followed event X, event Y must have been caused by event X.” e.g. The rooster crows immediately before sunrise; therefore the rooster causes the sun to rise.

It is easy for me to go through their presentations line by line and point out their scientific and logical flaws, but my hope is that politicians and the public can familiarize themselves with the patterns and techniques used by the anti-vaccination movement to be able to quickly recognize these fallacious arguments. None of their arguments are new, they simply recycle the same talking points that have been corrected and disproven time after time.

So again, a message to our elected officials. I understand that you are trying to remain diplomatic during these types of proceedings, but you cannot allow blatant misinformation to go unchallenged in a public forum. You must stand up for facts, science, and intellectualism.

OMA Council: Motions, motions, motions

There was no shortage of drama and excitement around this weekend’s OMA Council, the main events of which you can likely read about elsewhere on the blogosphere.

I want to focus on a slightly more mundane issue, but one which I think is vital to the success of future Councils and for continued engagement of Council delegates.

First a bit of background. At Spring and Fall Council, individual delegates to Council are encouraged to submit Members’ Period Motions for Council to vote on, which if passed, would then be advisory (not binding) to the Board of Directors. Prior to being presented, the motions are reviewed by the Resolutions Committee who provide advice on phrasing, content, and whether the motion is deemed out of order for procedural reasons.

At previous Councils, the number of motions put forward had been modest, and there had been relatively no issue in getting through all of the motions. With so many new and engaged delegates to this Council, the number of motions approached 80. To put this in perspective, during the time set aside at this Council specifically for motions (which was similar time to past Councils), we managed to get through 38 motions. There was hope that time could be found at the end of Council to get through additional motions, but unfortunately despite the Chair’s best efforts to move the program along, the remainder of the motions were not heard.

It truly wasn’t anyone’s fault that the motions weren’t heard, it was simply a perfect storm of unprecedented interest in putting forward motions coupled with a busy program updating Council delegates on a chaotic period since the spring.

That being said, although no one is to blame for the situation, we need to course correct in advance of the next Council meeting. Close to 40 motions were unheard during this meeting, put forward by physicians who felt them important enough to be heard and who will likely feel they may still be relevant at Fall Council. Add those to the avalanche of new motions likely to be generated between now and then, and we’re quickly creating our very own organizational waiting list. So very Canadian of us.

So what to do?

First we need to reflect on what has spurred the interest in motions, and what the true intent of some of these motions are. Are they regarding an issue the delegate has raised unsuccessfully and repeatedly through existing OMA channels, and is looking for a Council stamp of approval to spur the Board to action? Is it an issue that is more symbolic? Is it an issue that the delegate thought of while in the shower on Saturday morning and thought it would be a good idea to see what Council thought? While we shouldn’t stifle debate or engagement, given the limited time that we have as a Council, it may be appropriate to give delegates some guidance on alternative strategies to moving an issue forward rather than putting forward a motion.

The number of motions is at least in part a symptom of delegates’ sense (correct or not) of not being listened to by the OMA, and that the Council floor is their opportunity to have their voice heard and ideas evaluated by colleagues. Consideration has to be given to dedicating a section of the current online forums to idea generation and board/delegate member feedback on those ideas. I know that a few delegates set up an online group for Council delegates to discuss motions openly prior to Council, but I wonder whether the OMA should be setting up a similar platform for discussion and board evaluation and uptake between Council meetings to drive down the biannual swell of interest.

Another issue that has to at least be given consideration is to limit the number of total motions any specific delegate can put forward. There were no motions that I specifically found superfluous, but I think in a time where there is this much interest, we need to consider equity in allowing as many delegates as possible to put forward their best motions.

My last point is around the presentations themselves, and the discussion from delegates that followed. In this new era of engaged membership (the Chair himself remarked that he could not recall so many delegates staying until the end of the meeting), it behooves the Chairs of each committee to deliver a well-prepared, concise presentation to maximize the time for other issues. I would humbly suggest that the Health Policy presentation be moved out of the Sunday afternoon slot, as virtually no one in that room had the stamina to discuss what should be one of the most important topics of the weekend. Delegates should also be reminded that whenever possible, discussions that can be held privately should be held privately for the sake of efficiency. Consideration should also be given to alternating committee presentations with Member’s Motion Periods to sustain the attention of delegates (credit Dr. Deepa Soni for this idea).

I am confident that we will see many of these changes adopted prior to Fall Council, as the Chair and Vice-Chair were clear that they were looking for feedback from delegates. While I don’t want to see the pendulum swing too far such that the entire Council is spent deliberating hundreds of motions, I think we could make some definite progress in terms of efficiencies to ensure that the motions that need to be heard at Council get the audience they deserve.