Reducing the incidence of grand claims

This is the second post in our series critiquing the new booklet “The Science of Immunisation”, from the Australian Academy of Science. Here Greg Beattie takes a look at the opening statement from the summary.

“The widespread use of vaccines globally has been highly effective in reducing the incidence of infectious diseases and their associated complications, including death.”

- The Science of Immunisation (Australian Academy of Science)
The claim here is that vaccines reduced cases of infectious disease, and therefore, associated death and disability. This sounds good. It may or may not be true, but it certainly sounds good. One would expect it to be backed with solid evidence. Let’s have a look.

DEATHS
A good part of this has already been dealt with in a recent post by Meryl Dorey. Death-rates in Australia from some of the diseases we vaccinate against were discussed in the post, however, much more Australian data can be viewed in the following four posts I made to a debate on the issue:

PART 1

PART 2

PART 3

PART 4

Death graphs for USA and England can be found HERE, as well as HERE.

But what about developing nations? Well, it’s a bit trickier. Where Australia, USA, England, and Europe have meticulously recorded all deaths (and their causes) since the mid 1800s, the story was entirely different in the developing world. Deaths were rarely recorded. Even when they were there was virtually no information on what caused them. The World Bank overcame this missing data to an extent by conducting sample surveys over the past half century. These surveys estimate the infant mortality rate and the under-5 mortality rate. Here’s what they show in Africa and India:

Child death rates versus vaccination, Africa.

Child death rates versus vaccination, India

As we can see, the big push for vaccines from the 1980s onward (the finer lines shooting upward) appears to have had little if any effect on the trend in death rates in children (the two thick lines running from left to right). After viewing all the above my guess is you’ll feel we have little reason to credit vaccines with any role in saving lives. You’re free, however, to come to your own conclusions about that.

INCIDENCE
But what about incidence? That is, the number of cases of the illness, regardless of whether the affected person died. Did vaccines reduce this? The answer is… who knows? It’s actually impossible to tell: at least, not statistically. To explain, I’ll start by taking you back, almost 70 years, to a special book written by Darrell Huff. Regarded as one of the biggest selling books on statistics ever, “How to Lie with Statistics” was commonly used as an introductory textbook for statistics students.

It covers most of the pitfalls that await us when confronted with claims based on sample statistics. And what are ‘sample statistics’? Well, that’s what we work with when we don’t have the resources to measure the whole population. We take a sample and extrapolate our findings to the wider population. With deaths, we don’t use ‘samples’ because we are working with the whole set. As mentioned above, all are recorded (except in developing countries). With ‘cases’ of illness, however, it’s impossible to work with the whole set. No one knows how many cases of illness occur. We can only take a sample. Of course it’s important that our sample is representative: that is, it represents the whole population. We’ll have a look at this shortly, but first, let’s see what Huff had to say about sample statistics:

“The ‘population’ of a large area in China was 28 million. Five years later it was 105 million. Very little of that increase was real; the great difference could be explained only by taking into account the purposes of the two enumerations and the way people would be inclined to feel about being counted in each instance. The first census was for tax and military purposes, the second for famine relief.”

This was one of many examples he used to illustrate problems frequently lurking behind grand statistical claims. Huff takes us through the things we need to keep in mind, including non-representative samples and biased or poorly collected data, all of which lead to erroneous conclusions. He urges us to take a close look. Is the sample a true representation of the population, or is it skewed? Are the measurements free of bias? Are the investigators free of bias? Regarding ‘incidence’ data, he tells us:

“Many statistics, including medical ones that are pretty important to everybody, are distorted by inconsistent reporting at the source. There are startlingly contradictory figures on such delicate matters as abortions, illegitimate births, and syphilis. If you should look up the latest available figures on infuenza and pneumonia, you might come to the strange conclusion that these ailments are practically confined to three southern states, which account for about 80% of the reported cases. What actually explains this percentage is the fact that these three states required reporting of the ailments after other states had stopped doing so.

Some malaria figures mean as little. Where before 1940 there were hundreds of thousands of cases a year in the American South there are now only a handful, a salubrious and apparently important change that took place in just a few years. But all that has happened in actuality is that cases are now recorded only when proved to be malaria, where formerly the word was used in much of the South as a colloquialism for a cold or chill.”

Then there’s polio. Here’s what Huff had to say about polio figures BEFORE the first polio vaccine came into use:

“You may have heard the discouraging news that 1952 was the worst polio year in medical history. This conclusion was based on what might seem all the evidence anyone could ask for: There were far more cases reported in that year than ever before.

But when experts went back of these figures they found a few things that were more encouraging. One was that there were so many children at the most susceptible ages in 1952 that cases were bound to be at a record number if the rate remained level. Another was that a general consciousness of polio was leading to more frequent diagnosis and recording of mild cases. Finally, there was an increased financial incentive, there being more polio insurance and more aid available from the National Foundation for Infantile Paralysis. All this threw considerable doubt on the notion that polio had reached a new high, and the total number of deaths confirmed the doubt.”

Of course Huff couldn’t know the fate that awaited polio notifications afterward. The first polio vaccine was introduced in the same year the book was published, and after a few years in which polio numbers rose (yes, you read that correctly) the case definition for the illness was changed. It became more restrictive. This was the first of a series of revisions which led to a drop in cases being notified. This rendered the data gathered prior to the changes totally irreconcilable with that gathered after.

Huff’s conclusion:

“It is an interesting fact that the death rate or number of deaths often is a better measure of the incidence of an ailment than direct incidence figures — simply because the quality of reporting and record-keeping is so much higher on fatalities. In this instance, the obviously semiattached figure is better than the one that on the face of it seems fully attached.”

So what exactly are ‘incidence’ figures? How did we collect them, and why were there so many problems with them? Well, all good questions. Basically, we don’t have true incidence data. Instead we use something quite different, called notifications. We asked doctors to ‘notify’ certain illnesses when they saw them, so we could track cases. In other words, we asked them to send a record to their local health authority whenever one of their patients turned up with what looked like one of the diseases. But for a start, one obvious problem is these ‘notifications’ only included cases which visited a doctor. In the USA it’s been estimated only 3% of adult whooping cough cases are reported to the system. But even more concerning, doctors didn’t always consider it important to report cases they did see. One study in the USA, where reporting is mandated by law, found the rate ranged from 9% to 99%. The likelihood of a case being reported to the system depended largely on publicity.

Notifications had one purpose only: to enable a quick response to outbreaks. They were never meant to be used for retrospective assessment the impact of vaccination programs. One only needs to look at the history of whooping cough notification in Australia to confirm this. When mass vaccination for whooping cough commenced in the 1950s ALL STATES except South Australia stopped collecting notifications. Why would health authorities stop collecting figures which were supposed to record the great change?

But there are other major problems with the data. Some of these also apply to deaths figures, although to a lesser extent. First there was the problem of diagnosis. Doctors could seldom be sure which illness their patients had. Often it was a choice between whooping cough and bronchiolitis, croup or whatnot. Or between measles and roseola, rubella, rocky mountain spotted fever, and a host of others.

To complicate matters doctors were taught to use the vaccination status of a patient to help them make the decision. Textbooks would encourage them to diagnose other illnesses if the patient had been vaccinated. Governments (through their health bureaucracies) also encouraged this, and continue to do so. In this example the UK National Health Service exhorts doctors to check the patient’s vaccination history before diagnosing measles, mumps, rubella and whooping cough.

This is a no-no in statistics. It’s a cut and dried example of bias, obviously slanting the data and supporting the notion that vaccines reduced case numbers. How much did it slant the data? We’ll never know. All we know is it’s one of those big problems Huff warned us about.

Finally there was the problem of changing case definitions, as mentioned above with polio. We hear a lot about laboratory confirmation nowadays, but it wasn’t always so. For example, prior to the 1990s measles was diagnosed clinically: that is, it was decided after physical examination by a doctor. Since then, however, a measles case needed to be tested in a laboratory to ‘prove’ it was measles. When inexpensive testing first became available during the 1990s it was found that only a few percent of the cases initially diagnosed as measles passed the test ( link http://nocompulsoryvaccination.com/2010/10/17/lies-damned-lies-and-statistics/ ). Again this led to the impression something had brought about a ‘real’ decline in measles.

In summary, it is perhaps impossible to know how much, if at all, vaccination influenced the rates of infectious disease. However the claim that it has substantially done so forms the backbone of the whole case for vaccination. Death trends appear to offer no support for this claim, and we have no properly collected incidence data. Without good evidence we’re left with little reason to vaccinate our children or ourselves.

Greg Beattie is author of “Vaccination: a Parent’s Dilemma” and “Fooling Ourselves on the Fundamental Value of Vaccines”. He can be contacted via his website: www.vaccinationdilemma.com  

About nocompulsoryvaccination

Public Officer - Australian Vaccination-skeptics Network, Inc.
This entry was posted in Accountability, Medical Error, Medical ethics, Pertussis/Whooping cough, Polio, Vaccination. Bookmark the permalink.

24 Responses to Reducing the incidence of grand claims

  1. Karin says:

    This analysis, which appears to heavily focus on mortality rates, does not adequately address the issues. Resubmit your treatise with graphs showing the reduction in the incidence of infectious diseases! Infant and under-5 mortality rate reductions are more a product of better nutrition, better obstetrics care and advanced medical care in general. The real detriment to unvaccinated patients contracting a preventable disease is the many outcomes of the disease itself. Long term consequences exist for many preventable diseases like reduced lung capacity, deafness, neurological symptoms and even sterility. Sick children can spread their disease to debilitated elder members of their family who cannot fight off the infection. Other children will be infected who either are not vaccinated or, for various medical reasons, cannot be vaccinated. On top of all that, there are significant avoidable health care costs associated with caring for infectious disease.

    • greg p says:

      The “issue” and the Grand Claim Relates to mortality. Stay focused.

      • Karin says:

        “The widespread use of vaccines globally has been highly effective in reducing the incidence of infectious diseases and their associated complications, including death.”

        “…including death.” doesn’t really appear to be the primary focus or “Grand Claim” of the statement to me! Note that “reducing the incidence” and “associated complications” (ALL of them) do come first. So… You’ve taken the “mortality” ball and run with it in spite of the much larger issues of disease incidence and potential long term complications.

  2. Colin says:

    Quick look first reference just an example 1947 NY Smallpox program …. Millions of vaccinations in response to a small outbreak, all occurring over a few weeks. Retrospective analysis – no increase in mortality from all cause in the subsequent period. Hard to imagine if the vaccine was so toxic

    http://wwwnc.cdc.gov/eid/article/10/5/03-0973_article.htm

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5239a1.htm

    You will also note these are referenced so you know where the data has come from. Unlike the Philipines 1920 quote.

    Its quite clear your not interested in facts though so I am done here. And totally unsurprised that you have yet to provide one credible reference to back your claims

    • greg p says:

      So now the New York Times is an esteemed Medical Journal with it’s “fuzzy numbers”?
      With article 2, I suppose most deaths are of “cardiac” cause. The heart stops and you are dead. But there must have been some concern about heart attacks and the smallpox vaccine at that time.
      The curious case of the pulled vaccine stash raises an eyebrow, so I do not think the safety angle was too well covered by this commercial newspaper.
      Anyway this vaccine or collection of vaccines seems to have done less damage than previous ones.
      In this case there was no epidemic to fight and cases were isolated well before the campaign finished so there is nothing to be learned about the effectiveness of the vaccine here.
      Vaccines were a part of the WHO smallpox eradication program. It was a wonderful success if you can trust the reporting of the time. Basically I believe it was. The big question is what part did vaccines play? I know at least three vaccines were used. Which one came out on top? Did vaccines aid or hinder the eradication process? There was enough physical intervention in the disease propagation process to do the job by itself and cover up for vaccine failure. Education of locals and their health officials would have also had a profound effect.
      But vaccinators appear to think these teams went around the world just vaccinating people and are well supported by our mainstream media.
      This blog is about people making grand claims that they cannot back up.
      We have seen awful pictures in this thread to encourage fear and irrationality Thank you fro the opportunity to present my thoughts. Whats that siren doing outside??

  3. Colin says:

    Please explain small pox greg

    • Greg Payne says:

      Colin, If you are implying that smallpox/cowpox vaccines may have saved any lives then this is an excellent forum to state your case.
      gp

      • Colin says:

        Smallpox was a horrendous disease .. upto 12 pc mortalitity. Millions of people dying from it and not to mention the outbreaks that occured to indiginous populations that were introduced to it via settling westerners. Would you suggest something other then vaccination had to do with its irradication? Small pox vaccine wasnt without side effects. But, many decades of international effort went into it being controled and now it only exists in a lab. Personally I think its one of the great acheivments of mankind. Do you honestly think it was erradicated by clean living?

      • Colin, just saying that there was a terrible disease that killed lots of people and now, it no longer does, is an indication that you need to examine the history of smallpox and other infectious diseases. For example, where did bubonic plague go? It killed half of Europe and now it’s gone – can vaccination claim responsibility for that decline in mortality? How about scarlet fever, or typhoid or cholera? Vaccination is not responsible for the fact that very few people die from these diseases today. Yellow fever and TB likewise. To quote one of the favourite pseudo-skeptic sayings – correlation does not equal causation. You need to find out whether the introduction of smallpox vaccination in Europe led to an increase or a decrease in mortality from smallpox (hint – it was a huge increase) and whether the decline in smallpox mortality was in correlation to an increase or a decrease in vaccination compliance (another hint, post-Jenner smallpox mortality only started to show serious signs of declining when fewer people got vaccinated).

      • gpayne2012 says:

        From http://whale.to/vaccines/smallpox7.html

        Smallpox Vaccination in the Phillipines 1905-1920

        In the Philippines, prior to US takeover in 1905, case mortality from smallpox was about 10%. In 1905, following the commencement of systematic vaccination enforced by the US Government, an epidemic occurred where the case mortality ranged from 25% to 50% in different parts of the islands. In 1918-1919 with over 95% of the population vaccinated, the worst epidemic in the Philippine’s history occurred resulting in a case mortality of 65%. The highest percentage occurred in the capital Manila, the most thoroughly vaccinated place. The lowest percentage occurred in Mindanao, the least vaccinated place owing to religious prejudices. Dr V de Jesus, Director of Health, stated that the 1918-1919 smallpox epidemic resulted in 60,855 deaths. .

      • Colin says:

        We are not talking about very few people now dying from smallpox. It has been eradicated with the last case in the 1970’s … please explain how this happened but for immunisation. A solely human born viral disease that has been around for thousands of years .And please use references that are valid. I have no idea of the vlidity of the Phillipines reference, but you have to look past amazing successes to find the failures. I suppose you prefer girls to get cervical ca rather then gardisel ?sp. Or indiginous cape york kids to get HiB menigitis rather then immunisation. The successes of Immunisation are legion. I dont know what world you live in but cholera, tyhpoid, TB and Yellow fever are alive and well. Bubonic plague still around was largely blunted by public health measures that reduces the vectors of transmission.TB and HiV ravage the poor parts of the world that you seem so keen to reference in the above article. While your at it explain why deaths from tetnus are headlines when we used to see hundreds a year in australia before immunisation.. it is essentially untreatable with high mortality. Did we just stop getting tetnus prone wounds?

      • Colin – the number of people who died from smallpox has nothing to do with what we’re discussing. You are claiming that smallpox vaccination was responsible for the decline in mortality from the disease. I am asking you to provide proof of that.

        And Bubonic plague is still around by ‘blunted’ by public health measures? First I’ve heard of that. Again, can you provide any references?

      • Colin says:

        Really, you seem more interested in misinformation which makes this discussion kinda pointless. Yes there were different strains of Smallpox that became more prominent in the 20th century. Variola minor is what you are refering to with decreased mortality. Variola major was much more deadly, yet both were eradicated with vaccination. I’m pretty sure I didn’t say vaccination effected the mortality of the disease. I did however point out that it erradicated the disease. Hence, an huge amount of people that would have suffered and huge amount of people that would have died from this terrible affliction have not. So yes it is fair to say IMMUNISATION SAVES LIVES, unless of course you are going to point out they will eventually die of something else?
        As for references … i though you had researched all this stuff, or do you just look for the things that support your preformed point of view?

        http://www.cdc.gov/mmwr/preview/mmwrhtml/00033022.htm

        A significant outbreak in 1994

        And if you want more recent ( I appreciate this popular media but a case report none the less), there are plenty more but it gets kinda pointless … i could link stuff pointing out the sky is blue too

        http://www.opb.org/news/article/rare-case-bubonic-plague-shows-lake-county/

        So again can you supply any reputable references to support the erradication of smallpox was caused by something other then vaccination?

        And can you also provide any credible evidence to suggest that the eradication of smallpox has not saved lives?

      • greg p says:

        Colin, I am finding you posts a little confusing. You refuse to try and check the Phillipine reference and say something about “amazing successes”.
        Please share a documented reference of one of those “amazing successes”?
        That is with regard to a specific smallpox immunization program.

      • punter says:

        Colin, how often do you think the variola virus was isolated in 1800? How often do they look for it today in patients with some sort of pox? The answer to the first is never and the answer to the second is just about never too. Think about this for a second, how did the authorities know that they had eradicated the virus in the 1970s? How could they have been sure that despite all their efforts there weren’t millions of asymptomatic people wandering around with the virus inside them? The answer is they couldn’t possibly. Indeed they didn’t even wait until there was nobody left with symptoms at all before they declared eradication.

        They made it all up (there were various political reasons to do so). From that point on the whole “you never see smallpox anymore” was nothing but a self-fulfilling prophecy. There were plenty of outbreaks of children dying from a pox condition but each time the WHO or CDC simply decided that it couldn’t have been smallpox because, well, smallpox doesn’t exist anymore does it?

        That is why before the advent of the smallpox inoculation there had never been a single case of fatal chicken pox (at least I haven’t been able to find one), but afterwards, all of a sudden a disease which, by definition, had always been mild, became a terrible killer. It wasn’t a coincidence, medical textbooks instructed doctors to diagnose a different form of pox if the patient had been vaccinated for smallpox.

        By the way, this is the whole point that Greg was making in his post. But you didn’t understand it. And I dare say you don’t want to.

      • Colin says:

        So your unproven and unreferenced theory is that a disease that has plagued humanity for thousands of years and was characterised by widespread death and social disruption and made people look like this :

        morphed into a disease that causes no illness or is purposely mislabeled as chickenpox which looks like this :

        And just happens to test positive serologically to Varacella …. a completely different virus

        All of this occurred coincidently over 40 to 50 years of international widespread and then targeted immunisation programs.

        One significant hole in this theory is that varacella immunisation which has become widespread in the USA has been associated with a rapid decline in deaths from Chickenpox in the USA. This would be unexpected if this was misdiagnosed Variola.

        http://pediatrics.aappublications.org/content/128/2/214.full

        It is deceptive to say that deaths from chickpox did not occur until after smallpox vaccination was introduced. I say this, as chickenpox was only differentiated from smallpox in 1767 by William Heberden. At this stage smallpox vaccination was already being used, and variolation had been in practice for centuries.

        So in essence to validate your theory, all the available evidence which is legion (i like that word), is fabricated by the CDC the WHO the Medical establishment and “Big Pharma”.

        Can you reference anything of value, because this is becoming kinda pointless and pretty much explains why these concepts remain on the fringe.

      • Colin, I’m jumping in the middle here but I asked you to provide proof that vaccination is the reason why smallpox is no longer the problem that it once was and you show us images of someone with smallpox! We are discussing an issue of science – not faith. You are appealing to authority and not providing any evidence to back up your assertion – only anecdotes. Please show the proof. The proof that smallpox vaccination was not life saving and may even have been counter-productive is available from government graphs and data – so where is your evidence that it prevented outbreaks and saved lives?

      • Colin says:

        And to Greg,

        I question the validity of random stat’s that somebody said and did not reference in the 1920’s. If the source of the data is clear, the information can be validated. It also comes from a site with a long list of links with nothing that approaches referencing a reputable journal.

        So unless you are questioning that smallpox was eradicated how was the immunisation program not a success. Please supply some documented cases of smallpox post 1979.

        Unless you can post any credible evidence I doubt I will continue this chat, It has however clarified my understanding of your thought processes.

      • Greg Payne says:

        Colin, so somewhere in the “evidence” from the CDC, WHO, the Medical Establishment, and big Pharma, which is “legion” – you must be able to find a report where a smallpox vaccination campaign did not coincide with misery and death. Where less people died of smallpox than before said campaign?
        You may try England in the earlier part of the 20th century when it was made mandatory? How long did that last? Was that one your “amazing success” stories?
        I would also like you to point out what was incorrect about the Philippine reference.

      • Punter says:

        The fact that they test positive for some protein is neither here nor there given that nobody has ever proven either of the two proteins to cause pathogenesis and only the astonishingly credulous would believe that they have been applying these tests without fail on every single case of the pox since Adam was a boy. Doctors find what they want to find. There are multitudes of people with such proteins on them and no symptoms and multitudes of people with such symptoms but none of these proteins can be found. In other words the tests are every kind of meaningless.

        And I love your description as me being deceptive. Not a mate of John Cunningham are you? Heberden differentiated the two because he wanted people to know the difference between a severe disease and a harmless and unimportant one. But Samuel Johnson had already beaten him to the punch in 1755 with his fictionary describing chicken pox as mild and harmless. Like I said, chicken pox was mild BY DEFINITION before the advent of the smallpox vaccine and then doctors were instructed to diagnose chicken pox, regardless of the severity of the condition, if the patient had been vaccinated for smallpox.

        And no, the fact that chicken pox deaths have been decreasing is simply more of the same logic. Since the chickenpox vaccine, doctors have been less likely to diagnose chickenpox for exactly the reasons Greg has described. Of course mortality overall has been decreasing but as mentioned in the other posts on mortality, it is ridiculous to put that down to vaccination.

        And I love how you say that inoculation has been around a long time. This is true, but if you think it was a significant force then why don’t you superimpose it on worldwide mortality/morbidity data since it began and we will see if your case stacks up shall we? Do you rally want to make the argument that smallpox vaccine has been around for a thousand years (or whatever) and smallpox cases just kept rising and rising but then, all of a sudden, it went into a rapid decline in the late 20th century, ergo, the vaccine must have saved us? I wouldn’t have thought that to be an argument you would be too keen to use on others. But you use it here because you are desperate to shoehorn the facts into your beliefs.

        And I don’t have to prove that all these agencies made it up. It is obvious they did. But if you are so sure of their integrity, then why don’t you ask them? Ask them how they could possibly be so sure that there wasn’t a single person somewhere in the world carrying around a smallpox virus but remaining asymptomatic. I assume you accept that there is such a thing as asymptomatic carriers don’t you? Either they had some way of knowing this or they just have made it up. There is no alternative. I can’t imagine how they could have possibly known, but given your enormous faith in the system I can’t imagine you would have any issues about asking them right?

      • Greg Payne says:

        Uh Oh, not the thought police? ;-)
        I was not saying I knew of any cases of Smallpox post 1979.
        Smallpox certainly appears to have disappeared, probably to reappear via some psycho bio-warfare lab later on.
        I believe this happened through education, isolation, treatment and vigilance.
        The cessation of vaccination in the early 70’s would have also contributed to these observations.

      • punter says:

        Greg P, smallpox has not been eradicated. There have been many outbreaks such as in Jharkhand, India last year. But each time the WHO will declare that it could not have possibly been smallpox to save themselves from admitting their failure. Of coursr Colin would say that ti suggest that a bureacracy would seek to cover its arse is a conspiracy theory. Would never happen apparently.

  4. Dean says:

    Touche Punter! I’d also like to add (just a personal story, without heaps of figures): I met my first ever patient with polio last week (never seen it in my life up until last week) – she had multiple fractures in her affected limb which were resistant to any type of bone strengthening agent. She walked with calipers and for long distances used a scooter for mobility. She didn’t die from polio – but said it wasn’t fun having it. Point is – vaccines save lives and prevent long term morbidity as well – these death figures are not statistics, nor do they measure the impact on prevention of long-term morbidity. I’d like Greg to please post some figures on this.

  5. punter says:

    Aaah, but this is only incidence. If you looked at the mortality data (which is more important) then you would see that vaccines definitely saved millions of lives. And don’t tell me that that didn’t happen either because I am a skeptic and am only able to absorb one unpopular opinion at the time.

    In addition, I saw a video where an economics student got up and said that – because of a really strong vibe he had – that there was definitely less people with sore throats today than there were 100 years ago and all my fellow skeptics said that that proved beyond a shadow of a doubt that Greg was a charlatan. So he must be. Plus the economics student was really cool standing up in front of an audience and telling the people there what they had heard a million times before. Cooler than Fonzie.

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