NOVA on Vaccines: Documentary or Propaganda?

On Wednesday, 10 September 2014, PBS TV broadcast NOVA’s “Vaccines: Calling the Shots”.  It makes the case that everyone should be vaccinated and that doubts and worries about side effects are misplaced, originating with a tiny number of ideological “anti-vaxxers”.

This program is propaganda, not a documentary:
1. Misdirection diverts attention from fundamental substantive points.
2. Authorities are quoted but the scientific issues are neither described nor argued.
3. Questioning specific vaccinations and corollaries of vaccination are misrepresented as opposition to vaccination in general.

Misdirection is illustrated by the choice of experts, in particular Dr. Brian Zikmund-Fisher, a Decision Psychologist at the University of Michigan. What place does a decision psychologist have when the issue concerns the safety of a vaccine? He is shown at several places, described as an expert on risks and decision-making: so his role is to “expertly” declare that the other “experts” should be believed, who asserted the risk of adverse reactions to vaccination to be “negligible”, “minuscule”, and the like
This is argument from authority at its very worst, demeaning viewers as incapable of weighing risks and benefits for themselves. Yet they might be capable of doing that if only the program had presented the evidence regarding both risks and benefits, which it does not. “Trust us — we’re the experts”, in other words. But philosophy has long discarded such argument from authority as invalid, a logical fallacy. In any case, experience has amply shown that experts are quite commonly wrong about matters in their own field of expertise; copious illustrations can be found in a number of places [1].

The program begins with a heart-rending tear-jerker about a baby with whooping cough (pertussin) acquired before the usual time for vaccination. Several later tear-jerking anecdotes feature measles, polio, and cervical cancer. At the same time, “anti-vaxxers” are charged with appealing to emotion with anecdotes instead of arguing science. But it is this program that appeals to emotion and fails to argue the scientific issues.

Despite the unquestioned successes of measles, polio, and smallpox vaccination, some parents are said to be worried nowadays — without scientific justification — about such possible side-effects as autism. The program acknowledges parents’ rights to be worried, but asserts that on the other hand it is the task of public-health doctors and officials to worry about saving lives. Emotion-appealing misdirection again, away from the substantive issue: that people worry about saving lives doesn’t entail that they know what they’re doing.

The claim that autism can result from MMR vaccine is dismissed unequivocally. Highly speculative and very early research is cited suggesting that something happens genetic-mutation-wise at between 10 and 24 weeks of gestation that predisposes to later development of autism: therefore  vaccinations after birth can’t possibly be the cause of autism. I trust that such conclusion-drawing on the basis of slim-to-none actual data is sufficiently parody-like that it needs no further critique. Not mentioned — perhaps the program was made too soon? — is the public acknowledgment by a scientist at the Centers for Disease Control & Prevention that data were fudged to hide the observed possible consequence of autism among some African-American boys vaccinated with MMR [2].

Utterly avoided or evaded are the several scientific questions:

• Are side effects, albeit rare, more common with multiple simultaneous vaccinations than with sequential ones?
  A priori one would regard sequential as safer. After all, vaccines are challenges — insults — to the immune system, intended to summon defensive reactions, and such challenges are known to be dangerous: how HIV causes AIDS remains a mystery [3], and a popular current hypothesis is that it brings about chronic activation of the immune system [4]; and worsening illness of AIDS patients on antiretroviral treatment is ascribed to reconstitution of previously damaged immune systems [5].
• Is there any evidence that multiple simultaneous vaccinations offer superior protection over sequential ones?
  If not, what harm would there be if parents were allowed to make the choice?
• The program’s dogmatic insistence that mercury in thimerosal does not cause autism is not an honest reflection of the published literature [6]. In any case, it is well known that organic compounds of mercury (as well as other heavy metals) can cause brain damage. Recall the long and bitter campaign to eliminate tetraethyl-lead additives from gasoline after incontrovertible evidence that babies were harmed by even the truly minuscule amounts they absorbed from ambient air.
• From what stems the need for preservatives like thimerosal; and for such toxic “adjuvants” as aluminum or squalene? Presumably it would be more expensive and inconvenient to replace preservatives with refrigeration. But what makes a substance a preservative is that it acts by killing biological intruders; since preservatives are biologically highly toxic, it is hardly unreasonable to worry about what they do to babies whose brains and bodies are rapidly developing. Adjuvants are substances that stimulate immune systems unselectively, in other words they offer a strong challenge, a harsh insult, to immune systems. There is nothing unreasonable about worrying over the possible damage from that to babies in particular.

The worst feature of the program comes with its discussion of what it describes as an unusual amount of confusion and controversy over the anti-HPV vaccine that prevents cancer: cervical cancer in women, throat cancer in men. There are no ifs, ands, or buts: HPV causes cancer and HPV vaccines are safe.

In this program, the confusion is generated deliberately, one must infer, since the producer set out “to make a film that was largely in support of vaccination” [7].

Argument from authority is exemplified by Dr. Amy Middleman invoking her role as “mother and pediatrician” to set everyone straight. She acknowledges reports of adverse events after HPV vaccination but points out — quite correctly — that none have been proven to be associated “in a causal way”.
Misdirection once more: HPV hasn’t been shown to be associated with cancer “in a causal way” in the first place; there is no proof of a causative relation between HPV and cancer:

• The established relationship is simply that HPV infection was found in many cases of cervical cancer. But such correlations never prove causation.
• There are about a hundred strains of HPV [8], but only a few seem “associated” with cervical cancer.
  Association is evaluated by “statistical significance”. The criterion for that typically used in medicine (and in social science) is that p ≤ 0.05: the probability is less than 5% that the apparent associations is owing to chance and means nothing substantive. In other words, 5 of every 100 possible “associations” can be ascribed to purely random chance. Therefore, if one is seeking possible causes for cervical cancer and canvasses all the conceivable ones, 5% of them will show up as “statistically significant” when they are not significant at all: one might call them false positives. Given 100 strains of HPV, one would expect 5 of them to be “statistically significantly associated” by chance with any given illness. In point of fact, only 2 strains (16 and 18) are claimed to cause 70% of all cervical cancers. This is anything but strong let alone convincing let alone conclusive evidence that HPV has anything at all to do with cervical cancer.
• The program acknowledges that HPV is so common that 80% of Americans are infected at any given time. Some 25,000 cases annually of cervical cancer and throat cancer are associated with HPV. That is an incidence of about 25,000 in an infected population of about 250,000,000, in other words 1 case in 10,000. What sort of indication of causation is this?
  Here the program was criminally negligent in failing to point to the difference between measles, polio, smallpox, and the like on the one hand, where infection brings immediate reactions and often serious illness even to death, and on the other hand a dogmatic claim that because 1 in 10,000 people infected with HPV will eventually experience a cancer, therefore it was caused by HPV.
• That HPV causes cervical cancer in women but throat cancer in men seems very odd. Why shouldn’t women get throat cancer at the same rate as men? The program made no attempt to discuss this assertion.
  The obvious explanation lies in statistics. The claimed “causes” of both cervical and throat cancers are simply statistical correlations that turned up by chance because so many possible associations were canvassed. Since both are chance correlations, there is no reason why they should be for the same cancers.
• Even if there were substance to the dogmatic statements by Middleman and others that “HPV causes cancer”, whether HPV vaccines might then prevent cancer could only be decided far in the future if sufficiently large numbers of vaccinated and unvaccinated people were to be followed for many decades. In the meantime, significant numbers of people suffer damaging “side” effects [9].

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[1] For example, A. M. Low, What’s the World Coming To? Science Looks at the Future, J. B. Lippincott, 1951; Christopher Cerf & Victor S. Navasky, The Experts Speak : The Definitive Compendium of Authoritative Misinformation, 1984 and several later editions.
[2] See Celia Farber’s blog for continuing coverage of this whistleblowing, including documentation: “CDC Whistleblower Thompson Text Exchange With Mrs. Wakefield: “..Your husband’s career was unjustly damaged…” and earlier posts.
[3] The Pathogenesis of AIDS
[4] Paiardini & Müller-Trutwin, “HIV-associated chronic immune activation”, Immunological Reviews, 254 (2013) 78-101; Highleyman, “Inflammation, Immune Activation and HIV”, BETA, Winter/Spring 2010, 12-26
[5] Section 4.7.15 and associated references in The Case against HIV 
[6] YES: Thimerosal CAN induce autism
[7] David Templeton, NOVA documentary tackles debate over vaccines 
[8] HPV/Genital Warts Health Center 
[9] Deadly vaccines; U.S. Court Awards $6 Million in Damages to Gardasil Victims