To someone in the medical field, very little has been more in vogue to discuss lately than the supposed vaccine "debate". I say "supposed" (and put "debate" in quotations) because, considering the evidence, there really should be no debate. In science circles the vaccine "debate" is often likened to the flat earth vs round earth "debate" or the evolution vs creation "debate". Unbelievably there are some loons who believe the earth is only 6000 years old, and if you look hard enough you'll even find some geologists and astronomers who support that position, despite overwhelming evidence to the contrary. Similarly there are even fewer loons (fortunately) who believe the earth is flat despite this:
While I readily admit that medicine, like any other science, never considers itself settled, there simply should be no further vaccine "debate". Vaccines DO work and they do NOT cause autism (evidence is below), though they do have fleetingly rare serious side effects. The fact (not hypothesis, not theory, FACT) is that vaccines have revolutionised preventative medicine and healthcare in general. Unfortunately, in addition to the hardcore antivaxxers who are, for one bogus reason or another, completely against vaccines, there are also individuals who seem to enjoy stirring the pot to supposedly "improve the dialog". These are disingenuous people who purportedly hold themselves above the fray, supposing themselves higher or better than the strictly pro-vax and pro-disease (excuse me, anti-vax) folks, because they just want to ask questions and discuss.
Kevin Geary is one of those people. On February 9, 2015 medium.com published an opinion piece by Mr. Geary titled "Bringing Much-Needed Sanity to the Vaccine Debate". While this sounds like it should be a logical, objective, scientific approach to the topic, it is nothing of the sort. Instead, Geary resorts to hypotheticals, logical fallacies, overriding literalism, and "questions" in an attempt to justify and validate the antivax argument, which deserves to be neither justified nor validated. Someone tweeted his article to me asking my opinion on it, and I brought my evaluation to his attention quite by accident (not realising that his Twitter ID was included on my tweet):
@soudipop A terrible piece filled with half-truths & intentional misdirection. He even references NVIC in 1 of his comments. @RebootedBodyMr. Geary immediately replied:
— Doc Bastard (@DocBastard) February 21, 2015
@DocBastard @soudipop You're welcome to write a rebuttal but a blanket ad hominem attack shows lack of intelligence.I criticised his content, not the author or how he wrote it, so of course what I wrote was in no way an ad hominem attack. I pointed this out to him:
— Rebooted Body (@RebootedBody) February 21, 2015
@RebootedBody You obviously don't know what "ad hominem" means if you think that's what that was. I said your article was terrible, not you.His response was no better than "Whatever!"
— Doc Bastard (@DocBastard) February 21, 2015
@DocBastard still irrelevant. Not an argument. Jut another empty Internet opinion.An empty internet opinion? You challenged me to write a rebuttal Mr. Geary, so there was only one possible response:
— Rebooted Body (@RebootedBody) February 21, 2015
I'll preface this by quoting a few comments Geary made to the readers of his article:
This article is not a claims-making article. It’s a question-raising article. Because there’s too much over-confidence and too little inquisition in this debate.
First of all, I haven’t declared a side.
Sentences ending in question marks are typically “speculation.” Statements that end in periods are often conclusions.In other words, he claims not to be making arguments on either side, simply asking questions. That's a very feeble (and thinly-veiled) way of trying to protect yourself by making it seem like you aren't taking sides, even though you unambiguously are.
Geary starts by saying that he wanted to avoid the vaccine "debate" but for some reason felt that he had to engage. He uses questions, hypotheticals, and illogical analogies to make his points. Hey, he is saying, I'm not saying vaccines DON'T WORK, I'm just saying WHAT IF they don't work?
At the outset, he apparently feels that people on both sides of the "debate" have problems with critical thinking (a point of almost laughable irony):
As the title says, I want to bring sanity to the discussion. That doesn’t mean I want to change your position on vaccines…it means I want people to stop acting irrationally.It sounds good and I had high hopes . . . until he actually started his argument. And it starts deeeeeep.
First of all, this is wrong. According to the dictionary (you know, Mr. Geary, that big book that contains definitions of words and also exists online and would have taken you 0.289 seconds to look up), "consensus" meansLet’s fix the misuse of the word “consensus.” The Definition: An idea or opinion that is shared by *all* the people in a group
If that literalism wasn't bad enough, he then dives straight into a typical antivax trope:
Why it matters: There have been countless times in history where the majority of scientists and researchers agreed…and were wrong.He relates the story of Dr. Ignaz Semmelweis, a Hungarian doctor who argued that hand-washing could drastically reduce puerperal fever. His hypothesis was rejected by doctors of the time (mid 1800s) because of a lack of evidence. The alternate form of this trope is:
The analogy Geary is quite obviously trying to make without being too overt, of course, is that vaccines simply haven't been studied enough, so the link to autism just hasn't been found. Geary is very clearly saying "Science has been wrong before, so maybe they're wrong about vaccines too!" But remember, he's just asking questions. I'll address this a bit later, so for now I'll move on to his next bit of too-literal nonsense:
Wrong again. Yes, that's what "eradicated" means, and no measles is not eradicated from the planet. But that's only a small part of the story, because thus far vaccines have eradicated two diseases completely - smallpox and rinderpest. Rinderpest was a disease of cattle. WAS. Due to vaccines, it's gone now. And smallpox, which killed approximately 500 million people in the 20th century alone, has been eradicated. Because of vaccines, IT IS GONE. Let me repeat that: a disease which killed HALF A BILLION PEOPLE JUST LAST CENTURY is GONE due to vaccines. Read that yet again and let it absorb into your brain. That's what "eradication" means, Mr. Geary.While we’re at it, let’s make sure we’re using the word “eradicated” correctly.The definition: destroy completely; put an end to.How it’s used in the vaccine debate: It was significantly reduced.According to the CDC, Measles has never been eradicated, though the term is thrown around pretty loosely.
Geary also seemed to miss that measles WAS considered regionally eradicated from the Americas in 2002. And the incidence of measles decreased by over 99% from 1990 to 2002. Is measles completely gone? Of course not. But it is pretty damned close, and a complete eradication is fully possible were it not for antivax sentiment. Several other devastating diseases could possibly be eradicated off the face of the planet with vaccine programs, including mumps, rubella, polio, and malaria.
Geary isn't just satisfied with being overly literal and just plain wrong, he also likes to appeal to your sense of freedom and fear:
He actually argues that people shouldn't be locked up and forced to undergo these shots. No one (no one sane, at least) advocates forceful vaccinations. I would expect that type of silliness from grade schoolers.Let’s get something else out of the way: violence can’t be your answer.Not everyone advocates for vaccinating people against their will, but many do. One of the [legitimate] fears among those who don’t vaccinate is that vaccine advocates will use the power of government to force vaccination compliance. Sell your position with reason, don’t cram it down people’s throats (or lock them in rooms and inject their children with it).
Next he delves into another antivax trope, that antivax parents just want what's best for their children:
Yes, because only thinking parents reject the opinions of the vast majority of doctors and scientists, right? This is the whole "I've done my research!" argument that antivaxxers are so proud of and use so commonly. Sorry Mr. Geary, but reading stuff online (especially on the NVIC website, which you reference in one of your comments), does not constitute "research". Research is done by scientists in labs and by doctors and researchers in the community. The research has been done (and is still ongoing), and it shows overwhelmingly that vaccines are safe and effective. Speaking of which . . .Reality: Both sides want the same thing.An unfortunate charge often wielded by vaccine advocates is that those who choose not to vaccinate are “reckless,” “stupid,” and “thoughtlessly endangering others.”Vaccine advocates are vehemently protective of their family…and so are the parents who choose not to vaccinate. Both sides want the same thing: to make the best decision possible for their family. A key difference is that it often takes more thought to reject the status quo than it does to accept it.
So if you’re a vaccine advocate, I certainly hope you’ve done extensive research. Otherwise, you’re not just injecting your loved ones with something you know relatively nothing about, you’re doing so at the behest of a group of people you largely know nothing about.Do I "research" my car's inner workings when the "Check Engine" light comes on? Or do I just take it to an expert that I trust to take care of it? Though I drive my car daily, I know pitifully little about internal combustion engines, but fortunately my mechanic is an expert. Similarly most people know pitifully little about human anatomy, physiology, and immunology. Fortunately your doctor (who has done his "research" and is extensively educated on the subject) is such an expert. Sometimes trusting the experts is just the right thing to do.
Then Geary goes so deep that I can barely see the top of his head above the muck:
Ah yes, the typical antivax "Doctors are in BIG PHARMA'S pocket" trope. He doesn't come right out and say that doctors get paid by BIG PHARMA (Oh no, he's just asking questions, remember?), but he certainly insinuates it strongly enough. He claims to be merely asking questions, but it is only an attack on doctors, the pharmaceutical industry (which is no bastion of innocence, admittedly), and medicine in general, which he only insubstantially tries to hide.Question One: Do doctors receive any benefits from vaccine manufacturers?Question Two: Does the government receive any benefits from vaccine manufacturers?Question Three: Do researchers and educators receive any benefits from vaccine manufacturers?Those are important questions, wouldn’t you say? Do you know the answer? Just be honest with yourself.
He then continues his attack on vaccine manufacturers:
Again, he claims, it's just a question, not an attack. Of course anyone with more than 17 brain cells can see right through this and see it as the attack that it is. The federal law to which he is referring is the National Childhood Vaccine Injury Act of 1986 which was aimed at protecting vaccine manufacturers so that the supply of vaccines would remain stable. In the 1970s several lawsuits were brought against manufacturers of the DPT vaccine, and even though there was no scientific evidence to support the claims, large awards were granted, vaccine prices skyrocketed, several vaccine manufacturers halted production, and vaccine shortages ensued. To prevent the industry from collapsing, the law was enacted in the interest of public health. Of course Geary's reason for attacking the manufacturers is plainly obvious.Speaking of: Is it legitimate that the government passed a federal law prohibiting lawsuits against vaccine manufacturers?It’s not a statement, just a question.If you’re a vaccine advocate, it would help your case if vaccine manufacturers weren’t themselves immune from the repercussions of putting out a potentially dangerous product. Then you could at least make the argument, “Hey, if your kid dies or gets seriously injured, at least you’ll be rich.”But it begs the question: why is the government in the business of protecting a “big bad corporation?”
Is it ever legitimate for the government to remove the risk of litigation from a company? The answer, if you care at all about your own wellbeing, is no.Geary doesn't seem to know (or care about) the purpose or history of the law. It looks like you need to do your research, Mr. Geary.
Unfortunately for Geary, his antivax sentiment becomes more and more transparent as his attack piece goes on:
Notice how he calls it "hysteria" and puts "outbreak" in quotations, thereby trying to minimise it. Apparently 170 cases (approximately) isn't quite good enough for him. What he fails to mention is that the complication rate of measles is MUCH higher than 0.2%, and that the hospitalisation rate in this outbreak is 25%. The death rate is so low because of the success of modern supportive care. What he also fails to mention is the fact that as recently as 2013, measles still killed well over 145,000 people worldwide, and that the measles vaccine has prevented an estimated 15.6 million deaths since 2000. And that's JUST the measles vaccine. When you factor in diphtheria, pertussis, tetanus, mumps, rubella, polio, H. flu, and all the other preventable infectious diseases, the number of illnesses, complications, hospitalisations, and deaths prevented (not to mention the money saved treating those infections) is simply remarkable. I suppose Geary "forgot" to mention any of that.What I’m going to argue is that the “putting others at risk of death” argument defeats itself based on statistical significance. Most of the hysteria and current vaccine debate is in regards to the current measles “outbreak,” so we’ll use that as an example. The death rate among those infected is typically 0.2%, or close to equal that of your chances of dying in a car accident.
Oh, but Geary isn't done. Aping the comments of paleo-cardiologist Jack Wolfson who doesn't believe in protecting those who can't protect themselves ("I'm not going to sacrifice the well-being of my child. My child is pure."), regarding herd immunity he says:
Putting the science about herd immunity aside, this argument is faulty because its premise is that I should alter my behavior for the good of the collective.
Geary makes it plainly obvious that he doesn't care about infants who are too young to get vaccinated or immunocompromised people who have no ability to fend off these infections which, in them, would be much worse. As a doctor, I care. As a father, I care. As a decent human being, I care.
But wait, it gets worse:
Yes you read that right - Geary actually argues (oops . . . I mean he asks a question) that if you are trying to optimise your child's immune system by vaccinating, then you also must mandate vaginal birth (because there is some data suggesting caesarian section can affect immune function later in life) and breast feeding (which also helps the developing immune system). Well Mr. Geary, my daughter was born via caesarian section because of a nuchal cord. Without the C-section she would have died. Would that have been ok with you? And when my son was born a few years later (also via C-section), if Mrs. Bastard had tried a VBAC (vaginal birth after delivery) there was a real (though small) risk that my wife's uterus could have ruptured, thereby putting her and my son's lives at risk. Mandated vaginal birth? Are you really that foolish? Oh wait . . . you were simply asking a question, not taking sides or making statements. I must have forgotten.This is a debate about immunity, is it not? If it is, then how can you not mandate vaginal birth and breast feeding until the age of two (minimum), the two primary components of the development of a healthy immune system—an immune system that can reduce the spread and severity of disease along with injury and death rates?
What Geary doesn't realise is that nothing is absolute, especially in medicine. No one would mandate a vaccine for someone who is allergic or has some other hard contraindication. And before you mention religious exemptions, no major religion on Earth actually prohibits vaccinations. Fact.
To be fair, Geary then makes two statements with which I agree:
True. And“Vaccines aren’t natural, so I’m opposed to them.”You can be against the use of vaccines, but this not a legitimate argument. It doesn’t require much discussion, it’s a textbook logical fallacy.
With Autism specifically, there is a correlation between Autism rates and vaccine rates. But correlation does not equal causation.Also true. Maybe he's finally gotten something right! But just when I thought he might be turning it around, he dives right back into the antivax dungheap:
The general statement that vaccines cause Autism is unacceptable. Is it a specific vaccine? Is it a combination of certain vaccines? Is it the full vaccine schedule? If it’s not a guarantee that Autism will occur (and it’s not a guarantee that vaccines are 100% safe), then what is the underlying trigger?Again with the question marks - he's just asking questions, right? Surely he can't be suggesting it actually is a specific vaccine or "too many too soon", despite the overwhelming evidence to the contrary, right? RIGHT?
But we’re talking about something that has known safety issues and reactions other than Autism, so it’s something that should be looked at more closely.Oh, I guess he is suggesting exactly that. And that makes it plainly obvious that he completely missed the study in the journal Vaccine which looked at over 1.25 million children and found:
- no relationship between vaccination and autism
- no relationship between vaccination and ASD
- no relationship between MMR and autism/ASD
- no relationship between thimerosal and autism/ASD
- no relationship between mercury and autism/ASD
See, there’s a lot of things to sort out. While I can’t say for sure that the use of vaccines has never caused a case of Autism, I also can’t say that it has. I’m not sure anyone can confidently say yes or no on either side, can they?Yes, we can.
Finally Geary sums it all up with what I can only call the Jenny McCarthy defence:
Perhaps we need to increase our mutual desire for data and decrease our rampant confidence?Again with the question mark. Yes Mr. Geary, we can in fact say confidently that vaccines DO NOT CAUSE AUTISM. The question has been asked and answered, asked and answered, asked and answered. And just like when my children ask for the 93rd time if they can have another cookie, asking the question again will not change the answer.