Sunday, 26 September 2010

The Changing Face of Anti-Vax

Lady Mary Wortley Montagu was a very well-travelled eighteenth century aristocrat whose husband was appointed ambassador to Istanbul. Fortunately for us, she was also a prolific letter writer. Her legacy is still in print today.

Lady Montagu had been scarred badly by a bout of smallpox in her youth. She was fortunate; many who contracted smallpox at the time, like her own brother, died.

So when she found out about a Turkish procedure to safeguard against severe smallpox, she had her son treated. She went on to introduce the habit to some of the upper classes in England, the Royal children among them. This was against considerable resistance from the medical profession of the time, but I’ve written about exactly how useful they were in that era here.

‘Variolation’ is the introduction of a small quantity of the milder of the two forms of smallpox – Variola minor – into a subject. Given that the dose was tiny, that it was of the mild form of the disease and that it may have been administered via a cut in the skin (rather than by inhalation), the effect was to produce antibodies against future infection, but not the full-blown disease.

Edward Jenner later used cowpox pathogens to achieve the same result. Both of these procedures are inoculation – introduction of live pathogens – rather than vaccination which uses ‘dead’, attenuated or partial viruses.

I write ‘dead’ in quotes because I seem to remember that the concept of life as applied to viruses has some considerable philosophical encumberances. It’s fascinating, but we don’t need to worry about it for the purposes of this blogpost.

Smallpox has now been eradicated. It probably exists somewhere in a military laboratory. Let’s hope the custodians are on our side.

Major efforts are being made in polio eradication too and the fight has gone well but for several setbacks, one of which was a conspiracy epidemic in Nigeria where people thought that vaccination made girls sterile. Memes can kill.

In the UK variolation was made illegal in 1840, but that was OK because the same act of Parliament provided for a free vaccine which had been developed since Lady Montagu’s day. In 1853 vaccination of small children became mandatory, and other acts covering other classes of person came in later.

In the late 19th/early 20th century, there were get-out clauses of varying efficacy for those with conscientious objections to vaccination. But by then, they were far less likely to suffer anyway, since they would have benefited from the prophylactic effect of herd immunity – everybody else’s vaccinations.

In the USA in 1905, Jacobson vs Masachusetts reached the Supreme Court where it was determined that states had the authority to impose compulsory vaccination. Sometimes, the rights of the few must submit to the rights of the many.

Which seems to have created quite a backlash at the time. I was in New York a couple of weeks ago and went to a couple of flea markets in the Chelsea district. It’s between the old meatpacking district and Hell’s kitchen. If you don’t think that sounds too salubrious, it wasn’t. Now however, it’s been yuppified and you can buy vintage brass sconces for $275 (They were pretty, but I didn’t).

Instead, I went for a few copies of ‘The Quest’: September 1926, February and April 1927’s editions. ‘The Quest’ had been published in Brooklyn for ten cents a copy, and its mission had been ‘against compulsory vaccination and animal cruelty’.

This really was a niche publication. I’ve Googled it and have had a very hard time finding out much about the magazine or the publisher. But I can tell you that Louis S Siegfried seems to have published at least one other other anti-vax publication (Spivak, John L. The Medical Trust Unmasked: The Story of a Gigantic Conspiracy - Louis S. Siegfried,1929, 1930, 1961 – a first edition seems to go for about USD25) and may have spent some time in jail for his beliefs.

Here is an article he wrote asking ‘Is Vaccination Harmless’.

In the April 1927 pamphlet we read the case of Mrs. Carolyne Burns who refused to have her son vaccinated. The Department of Education had complained that he could not attend school. Mrs Burns said:

“I demand the right of a public school education for my boy and I can’t see why he shouldn’t get it. I object to vaccination and I won’t submit my boy to such a dangerous practice.
It is un-American and unconstitutional to force this pus into the system of a healthy child … the school won’t accept him and I won’t have him vaccinated. What can I do?”

Mrs Burns was found not guilty – although quite how, I’m not sure.

February 1927 has a page on ‘What Physicians say about VACCINATION’, opposite a page which entreats people to ‘Stop Pus Squirting’.

Page 5 covers the furore surrounding a leading article in the Lancet (September 4th and October 9th 1926?) in which a causal link was claimed between death due to encephalomyelitis (inflammation of the brain and spinal-cord) and vaccination.

It’s a fascinating piece of social history. I’ve put a couple of pdfs here so you can read if you’re interested.

The three oft-repeated errors in ‘The Quest’ are argument from authority (there appear to have been plenty of anti-vax doctors willing to write), confusion of correlation with causation and conspiracy theories citing vested interests who were allegedly pushing vaccines for financial gains.

Plus ca change, huh?

I’m not sure whether the vaccinations I received as a child were administered under a legal compulsion. It wouldn’t have made a difference though. My grandmother’s and mother’s generations saw whooping cough, polio and tuberculosis first hand. They couldn’t believe their luck that these conditions and others could be prevented safely and for free.

But it seems we’re now taking our good health for granted. Despite the evidence that vaccinations are safer than outbreaks, anti-vax is on the rise in a generation which has not experienced much epidemic disease.

Andrew Wakefield’s 1998 'Lancet' paper drawing a link between autism and vaccination has been discredited, but large swathes of the confident middle classes – ‘over-Googled people’, as they were described to me at a US vaccination drive recently - are refusing to have their children protected.

I love vintage publications and enjoy reading the voices from history. It's interesting to see that anti-vaxers have gone from being doctors (in Lady Montagu's day), to anti-federal individualists, some with religious interests (early 20th century) to middle-class worriers with benzadrine-type levels of Google usage.

But wouldn't it be nice if the anti-vax message of ‘The Quest’ wasn’t still so current?

Tuesday, 21 September 2010

You Only Get Answers to the Questions You Ask

This simple thought seems too obvious to state, but here we go: the very approach to an issue can dictate the type of result you gain.

Stephen Jay Gould’s elegant essay, ‘Male Nipples and Clitoral Ripples’ provides the perfect illustration. It was first published in ‘Bully for Brontosaurus’ and you’ll never regret buying an SJ Gould. So go on.

The conundrum of the male nipple is insoluble if you ask ‘why?’ They are, after all, they are of no obvious use in males. But start with ‘how?’, and we have the more useful insight that they are specialised sweat glands whose prototypal form was present in males and females before becoming more fully developed in one sex for lactation.

Male and female foetuses develop along similar lines for their first few weeks. Later, hormones start to influence differentiation into male and female. Too late to erase the nipples though. Males are left with vestigal nips with no purpose other than to indicate chill-factor, or delight that Man U has just scored.

Similarly, the Victorian female (and all her daughters, up to the 1960s) was beset with the notion that she needed to have a vaginal orgasm to be ‘mature’. Thanks Freud. After all, the purpose of an orgasm was to provide sexual satisfaction, and proper grown-up sex is penetrative sex with a penis. The function must surely follow the intent. This is the answer to the ‘why?’ question.

Except a lot of women – most actually – think their ‘G’ spot is just south of Narnia on the map, and get their climaxes from their clitorises. Or is that clitori? Who knows? Anyhow …

If you ask ‘how?’ … sort of rerun that thingy with the male nipple. Different types of tissue develop in different ways under the influence of hormones in-uteri to produce morphologically distinct males and females.

Our Victorian and early 20th century grandmothers probably suffered unusually compared to everybody else, before and since. After all, without a formidably authoritative, ideologically-driven, guilt-inducing impediment, the simple expedient of “Oy, rub this” has probably sufficed for years. We may not all have a magic button in our vaginas, but contriving sex for female orgasm isn’t that hard with an understanding partner.

So we can see that the ‘how?’ and ‘why?’ questions are of vital importance, because they are often a good indicator of the a-priori assumptions of the questioner: ‘how’ is usually asked by scientists, and ‘why?’ is asked by mystics and magicians. And the answers to the ‘why?’ often create a lot of needless guilt, scapegoating and looking for G-spots.

Peter Tatchell made a Channel 4 documentary ‘The Trouble With The Pope’ to explore the issues surrounding opposition to the Pope’s state visit to the UK in September 2010.

In it, Tatchell discusses with Fiona O’Reilly of ‘Catholic Voices’ the notion that homosexual people suffer with “a strong tendency towards intrinsic moral evil”, as Joseph Ratzinger while Cardinal put it. O’Reilly explained that (45:45):

‘What is the purpose of sex … In the Catholic understanding, sex is ordered to the creation of children and the strengthening of the union between a man and a woman. If that is the starting point, then it makes sense”

And she’s right … if you assume that it really is the starting point.

But I think that we can see from male nipples and clitoral ripples that it isn’t necessarily the starting point, unless you want it to be.

Religion is suffused with the notion that there is a meaning, which is why religious people go looking for it. There is an assumption of purpose. In ‘England’s Child Witches’ I wrote:

‘People in charismatic African churches are not looking for the ‘how’ – they know perfectly well that microbes cause diseases and cars mechanically fail. They are looking for the ‘why’: why me; why not my enemy; why now; why here. It’s a question that empiricism can’t answer without leaving the empty and unsatisfying answer: “shit happens, sometimes more to you than other people”.’

The scientific method is counter-intuitive to human beings. It takes a great deal of education to think that way. Purpose-based explanations, on the other hand, are natural. They come without prompting to children. Our evolutionary history has probably favoured people who can draw meaning from events.

The purpose-based explanation is likely to create a lot of unhelpful false positives (I walked past that tree and fell over, so that tree is probably unlucky). But a false negative would be more dangerous (I ate that lobelia, but the projectile vomiting was probably a coincidence). Wherein lies the relative value of the system.

Some Catholic theologians, including the present Pope, have concluded that gay people are “intrinsically morally evil”.

But they should not kid themselves that they are starting from first principles with their reasoning. By the time they have asked ‘why?’, a preference for mystical thinking has already been settled upon and the conclusions will bear the marks of such a choice.

Sunday, 19 September 2010

Protesting the Pope

Spent a great day at Protest the Pope yesterday.

The march progressed via Picadilly from Hyde Park Corner to Downing Street, had an attendance of around 20,000 (figure unconfirmed) and was organised and supported by the British Humanist Association, National Secular Society, Peter Tatchell among many others.

Fox news reported we were led by "gay activists and radical feminists, with some nasty banners" (thanks @zeno001 for the clip), but the BBC was a bit more even-handed.

A distinguished roll of speakers provided us with thoughts and often humour. Johann Hari opened by informing the police that a person complicit in cover-ups of paedophilic abuse was a short distance way and would be easy to arrest.
Richard Dawkins speech is here.

Here are some pictures:

Ben Goldacre

Geoffrey Robertson QC, author of 'The Case of the Pope: Vatican Accountability for Human Rights Abuse'

Richard Dawkins

Johann Hari

I wrote about the culture of the Catholic Church in the wake of the child abuse scandal in Priests, Pederasts & Privilege.

And since I'm not exactly Annie Leibovitz, you may like to look at some superior content from @DaveTheDrummer and Paulo Ferrarini

Thursday, 16 September 2010

Funny Who You Bump Into …

So I got on a plane to attend to a work related matter, thinking that there would be no time for scepticism for a week or two.

But it’s funny who you meet when you least expect to.

I’ve been to more Comicons (San Diego, CA) than I can remember, but that was a while ago. And this was my first DragonCon (Atlanta, GA). It turned out to be a heart-warming collision of the geek universes – fantasy and science – that I hadn’t suspected existed in such a concrete form prior to this.

There was a full-on Skeptic presence with a program including James Randi, D J Groethe, George Hrab, Richard Saunders, Kylie Sturgess, Rebecca Watson and many others. There was a table for Skepchick, the local Skeptics and CFI.

Sorry Rebecca, tried to catch you but kept missing you.

However, I managed to say hello to James Randi twice, and got a piccie.

The sciencey/skeptic vibe wasn’t just propaganda though. Along with all the T-shirts (eg. illustration right) I could see two very practical and humanitarian strands at DragonCon.

One is well established. There have been blood drives at US conventions for a few years. Comicon and DragonCon have a friendly rivalry to see who can collect most of the red stuff.

Comicon’s ‘Robert A Heinlein’ blood drive has collected 8,736 pints of blood over the last 33 years. Attendance this year was at the venue’s capacity of 125,000 and donations were generous.

But they may have been trumped by DragonCon: despite the smaller attendance of 40,000, they had nearly 2,000 units by Sunday afternoon and thought they may be on for this year’s Elizabeth Bathory award.

Actually, I just made that award up, but I think they deserve it. ‘Life South’ is the non-profit blood centre which runs the drive. The blood stays in the tri-state community (Alabama, Georgia and Florida) and is much needed in the summer months when donations usually drop.

Well done guys.

The second strand is newer and also much needed. The ‘Hug Me I’m Vaccinated’ campaign provides free TDAP boosters for against tetanus, diphtheria and pertussis (whooping cough). At the same venue there was free HIV testing and next year they plan to add flu jabs.

Whatever scary stories you hear about the cost of American medicine, children’s vaccinations are available for free … if you want them. The government has a large budget allocation for free vaccines and complete vaccination is running at about 85%.

However, the US has suffered as much as the UK from anti-vax propaganda. Jenny McCarthy, Bill Maher (Bill how could you? – you’re so funny, especially about religion) and Oprah have added celebrity momentum to Andrew Wakefield’s discredited theories.

So ‘over-googled people’ think they’re doing their kids a favour by leaving them vulnerable to serious diseases that we could have left in the last century. The US has hot-spots of low vaccination rates and contagious disease outbreaks, such as measles in San Diego in 2008.

‘Hug Me I’m Vaccinated’ is created, run or contributed to by three organisations: The Women Thinking Free Foundation; The Centre for Disease Control and Skepchick.

By half way though Sunday, two hundred vaccinations had been given, such an enthusiastic take-up that the guys thought they may run out.

What a fun Labor Day weekend!