Monday, April 07, 2008

Vaccination fun!

Earlier I expressed my pleasure with the Fitchburg Pride for having a real reporter who does actual journalism and produced a decent article.

Sadly, the local daily paper can't measure up to the standard set by the free weekly paper.

Case in point: A pox on them: Parents slam school; officials say they are following law, in the Sentinel of course.

This incredibly sloppy and biased piece of stenography (it's certainly not journalism) brings to mind all the things that are wrong not just with the Sentinel, but with so many news outlets in general.

It's a simple story of an incredibly dumb woman who refuses to vaccinate her children and whines that the school treats her unfairly because she's just too stupid to understand what's going on.
Genna and Felix Velazquez made a decision to avoid immunizing their two elementary school-age daughters against Varicella disease, more commonly known as the chicken pox.

The Velazquez family is now concerned their 8-year-old daughter Dianelis Velazquez is being unfairly singled-out by Reingold Elementary School officials because of their decision.
Oh no! Mean old school! They're saying her kid can't be in school because there's an outbreak of Varicella!
The school's decision is based on a state statute that allows schools to quarantine students exempt from immunizations if their [sic] is an "outbreak."

"Basically, it isn't up to the school to determine this policy," Roy said Thursday. "It is the Department of Public Health who dictates the policy."

The law requires a number of immunizations before a child can enter school. If 'sincere religious beliefs' exempt a child from receiving immunizations, the law permits schools to quarantine the student if they are susceptible to an illness.
Oh, I guess it isn't such a mean old school. It's a school that follows the law (and common sense) by not exposing her child to disease and turning her into a likely vector who can then go around infecting everyone else.

I guess we need to change the headline then, because the original was misleading. I suggest: "A pox on them: Parents whine about law; officials follow it".

The whole article is at this same level. Velazquez is bafflingly portrayed as some sort of victim, instead of properly being mocked for being a whiny idiot who chooses to endanger her children because of some moronic religious belief.

Let's look at a few examples.

First is the most obvious one. Velazquez has absolutely no basis for her claim that she's being treated unfairly. Which makes me wonder why the article was even written in the first place. But unfortunately it was, so here are some more examples of sheer ineptitude on behalf of the reporter.
Reingold Elementary officials told the family that Dianelis Velazquez must be out of school from April 11- 22, according to Genna Velazquez.That time would fall in the middle of school vacation, meaning Dianelis Velazquez would be away from school for nearly three weeks in a row.
Huh?

April 11th is this Friday. School vacation takes place from April 21-25. Which means the kid misses a grand total of 6 days of classes. That doesn't sound too bad though, so the reporter chose to focus on the far greater but totally meaningless measure of time "away from school," as if weekends and vacation time should be significant. Even taking that nonsensical measure, the kid's going to be "away from school" from April 11-27, or 17 days. That's two weeks and three days, which no sensible person would call "nearly three weeks."

Velazquez herself is clearly not a very bright woman, and asks lots of questions in the article.
Genna Velazquez knows of two students in her daughter's class that had chicken pox. The family didn't receive notification the first time a student came to school with red pox associated with Varicella, Velazquez said.

"The nurse told me the first case was unconfirmed and that's why they didn't call me," she said. "If this second case is confirmed, why was the student at school today (Wednesday)?"
The reporter didn't bother to find an answer to this question. Nor did she even confirm that the child with the confirmed case (the only one that matters) was actually at school.

If the infected student was at school, s/he probably shouldn't have been. But we have no way of knowing if that's even the case. Not that it matters one bit to Velazquez's crazy-ass claim anyway. It's just irrelevant whining, meant to make you think there's some sort of vast conspiracy to keep Velazquez's daughter out of school.

Another bit from Velazquez that goes without response:
"Anyone who can't prove immunity should go home," Genna Velazquez said. "Why are we protecting students who are immunized if the vaccine works?"
I count three problems in that one quote!
  1. Velazquez's kid is the only one who isn't immunized. Everyone else can prove immunity, because doctors keep records!
  2. They're not "protecting students who are immunized"! They're protecting your daughter because you failed to do so! They're also protecting anyone your potentially infectious daughter comes into contact with.
  3. The "if the vaccine works" bit is clearly meant to make the reader believe the vaccine doesn't work. That's stupid. No vaccine works 100%. The varicella vaccine itself has an efficacy of about 88.5%, and those who do get chicken pox anyway usually only get a mild case. The vaccine works just fine.
As we've come to expect, the stenographer behind the article addressed none of these points.

On to more problems!
Genna Velazquez called the state Board of Health. They simply explained that a child is contagious after six days of being exposed to the chicken pox.

"She has already been exposed to students with chicken pox," she said. "They are making us take her out at the end of next week, it just doesn't make sense."
Another unchallenged quote. If the stenographer had bothered to go to the Mass. Department of Public Health website she could have found the exact recommendation (pdf) that applies here. Which is:
Susceptibles shall be excluded from work or classes from the 10th through the 21st days after their exposure to the case while infectious with rash (not including the prodrome).
So yeah, that's about the right timeframe, dumbasses.

Okay, I've criticized Velazquez a lot in this post. And she deserves it. Not immunizing your child is one step from child abuse, as far as I'm concerned. Not immunizing your child for religious reasons is a half-step. The poor kid gets no say in any of this, she's just the innocent victim of ridiculously stupid parents and a government that allows virtually any stupid behavior to pass if it's part of your religion.

But Velazquez isn't the real problem. She's just a whiny idiot, nobody cares about her. I feel bad for her (and far worse for her unfortunate children).

The problem is the Sentinel's absurdly horrible article about her. It has all the hallmarks of trying to stir up another pointless controversy, it lacks the most basic fact-checking, it's clearly biased in favor of Velazquez, and it should be an embarrassment to the person who wrote it.

Worst of all, the article exists. This is not a news story. Velazquez doesn't have a legitimate complaint worth reporting on. She's a not-very-bright woman who doesn't understand that when you neglect to immunize your children there may be consequences.

The Sentinel should have done the smart thing and never run this story. If Velazquez contacted them, they should have said "We're sorry, but you're terribly confused" and sent her on her way. Instead they wrote a big horrible article about it, presenting her side almost exclusively, and making themselves look like total idiots in the process.

What you don't print is as important as what you do. The Sentinel has a long history of ignoring the actual news and printing this kind of tripe. Sadly, articles like this are in no way a surprise. Just a huge disappointment.

15 comments:

Lance said...

Funny that this should come up now. I just blogged on a story about a smallpox outbreak in Fitchburg 75 years ago, long after smallpox had been tamped down in most of America.

Why did it happen? People who either refused vaccination or emigrated to town from areas where vaccination wasn't compulsory.

The Unicow said...

Interesting.

I'd like to believe we've reached the point where there wouldn't be a "Citizens Committee Against Vaccination" anymore, but in reality it would probably be even worse now.

brian michael said...

unicow,
I would have expected you'd be more skeptical about a mandated vaccine for a non-life threatening illness such as chicken pox. I mean come on, this is a government mandate of a Merck product. They have a small bit of lobby power, no?

Child abuse? Child abuse is not taking notice of every little thing that enters a babies body. There is plenty wrong with this system and plenty that needs to be questioned. It is true this woman sounds like she is ill-informed though.

Of course I chalk this article up to typical Sentinel "reporting": trying to bait people into spewing anti "liberal" or "tree-hugger" or "hispanic" venom. This woman gives caring skeptics a bad name, and the paper is all too willing to promote it.

The Unicow said...

Brian,

You raise some good points.

I'm generally of the opinion that the government shouldn't dictate what people can or cannot put into their bodies. But disease-factories like schools, nursing homes, etc. have a right to protect the health of their population by requiring certain qualifications to be met for admission.

I see it like a store denying service to people without shirts or shoes on. You shouldn't have to wear them, but you can't come in unless you do.

Unfortunately, I find that a lot of the skepticism specific to vaccination seems to dwell more in the realm of conspiracy theory than real inquiry. (Don't even get me started on the totally unsubstantiated thimerosol/autism link that people get so riled up about.)

From what I can see, the varicella vaccine is safe and has indeed saved lives, even though varicella's mortality rate is quite low anyway. A 92% drop in mortality among 1-4 year-olds with the virus still seems like a pretty good thing.

If you have an argument against varicella vaccination I'd be interested in hearing it.

cheers!

brian michael said...

A few points:

-the long term immunity this vaccine provides is undetermined and one of the benefits of having your child contract chicken pox is a natural immune system booster to the parent. This is the way it has worked since the beginning of time.

-the autism argument is unfortunate as it distracts from the real issue which is a parents right to make informed health care decisions for their child.

-It takes only common sense to understand that a babies system is small and they can be very sensitive to anything entering their bodies. I view the amount of vaccines and the timetable for them as reckless. Anything that can be cut from that schedule because it is a treatable illness should be if an informed decision deems it so.

- the NEJM article is full of stats and I find them to be difficult to truly quantify as there are many more factors that play into public health other than age, sex, race, locale.

-Call me naive, but I don't think that Merck or any of the others have a real interest in what is best for the populous.

-From this chart: http://content.nejm.org/cgi/content/full/352/5/450/F1
does show a real decline but I find the period before the decline to be of interest. Clearly this was not a public health emergency, the mortality rates had a consistent up and down.

-Dr. Robert Sears advocates a different approach to vaccines, which you should take a look at:
http://tinyurl.com/65zhxz

Cheers back to you Unicow!

The Unicow said...

Several things here, but I'm trying to get some work done so this will be quick.

Re: Long term immunity.
Yes, it's possible that some people will need boosters of the varicella vaccine. That's common though, I'm not sure you can count it against he vaccine. Also, about 20% of people who get chicken pox later have it resurface as shingles, so it's not like "natural immunity" is any great thing either.

Re: Autism.
Agreed.

Re: Babies are sensitive.
I agree in part. Babies are a whole lot bigger than viruses, and probably get more foreign junk in their systems from sucking their own toes than from a vaccination. But in general, keeping the number of live vaccines (of which varicella is one) to a reasonable level makes sense to me.

Re: Merck sucks.
Yes, they do. But that doesn't matter. Even a sucky company can produce a good product.

Re: Not a public health emergency.
Agreed, it's not an emergency. But wouldn't we still be better off without it?

Re: Robert Sears
That link took me to the chart. Something got screwy.

More later. Interesting discussion.

brian michael said...

the Dr. Sears link again:
http://tinyurl.com/3xnqev

The Unicow said...

Thanks for the fixed link.

I checked out the "Alternative Vaccine Schedule" and have two thoughts about it.

1) On the surface it sounds very reasonable, and if it's just a different proposed schedule for getting the same vaccines, that seems harmless enough (to a layman like me anyway).
2) Is there any evidence at all to suggest this is better than the standard schedule?

It's part two that gives me trouble. I see lots of vague concepts, but no research or evidence. Were these things just absent from the parts of his website I checked out? Because I don't see a rational basis for many of his suggestions.

I also have some concerns about the guy in general, from other stuff he says on his site. He's a bit nuts on mercury, though he tries to couch it in a "we need more research" context. There's already a lot of research, how much more does he need?

He's not nearly as nutty as most of the anti-vaccine activists I've seen, but nor would I say he's firmly grounded in science.

This list is pretty handy, though. A bit less info than I'd like, but obviously he wants you to buy his book to get that extra stuff.

brian michael said...

Dr. Sears is not nut, he really is the premier doctor when it comes to vaccine choice though. He is in no way anti-vaccine. Most likely the holes you refer to are due to the fact that he has a book that has much more info than is posted on the website. In The Vaccine Book he goes deep into many compelling pros and cons.

But don't you see the real issue is that parents are blindly doing whatever they are told to do? And doing it to what is probably (or should be) their most cherished thing in the world.

The Unicow said...

But don't you see the real issue is that parents are blindly doing whatever they are told to do? And doing it to what is probably (or should be) their most cherished thing in the world.

Sure, and that's not desirable. But it's what people generally tend to do, especially with medical care.

If I go to my doctor with an infection and he says "take this pill," chances are I'm going to take the pill. Not because I'm stupid, but because he knows medicine and I don't. He's got an entire field of knowledge that should back up the assertion that taking the pill is a good idea. As long as I have confidence in that knowledge, no problem.

Now, if I had conflicting evidence that says taking that pill is actually a bad idea, I wouldn't take it. Or at the very least, I'd find out a lot more about it first and only take it if the bad aspects are outweighed by the good ones.

It's laudable to want people to ask questions and look into these things. I want them to do the same, though I doubt many people will heed our call.

Really, I think our main difference is that you see something there that makes you think that taking that pill (vaccine, whatever) is a bad idea. I don't see it the same way, so until some new information presents itself I'm quite comfortable going with what has already been shown to work.

Simple as that, I suppose.

ReallyRachel said...

I'm not an anti-vaccine proponent, but I am strongly against government taking informed consent out of the picture. Measles, mumps, rubella vaccines save lives. Smallpox vaccines saved lives. Pertussis vaccines (which the good doctors forgot to give me - bigtime oops) save lives. Chickenpox is a different animal.

It's not just the folks who have had chickenpox who get shingles. The first generation to have the chickenpox vaccine is now also getting shingles. How many of them might have avoided this potentially dangerous disease that can cause blindness and be devastatingly painful (voice of experience), had they not been vaccinated and therefore the varicella virus permanently implanted into their bodies?

Adults who interact with children who are active with chickenpox benefit from a boost in immunity that can prevent reactivation of varicella (herpes zoster). Very few pediatricians get shingles because of recurrent exposure to the virus.

Having experienced the terrible pain and morbidity associated with shingles, which can be a serious disease in adults, and having had chickenpox (twice) and parented two children who had uncomplicated cases of chickenpox, my personal opinion is that this just might be a case of too much Merck and too little personal choice.

And can someone please explain to me why there is no mandatory quarantine of the INFECTED child? Sending a kid to school with chickenpox, pinkeye, the flu, tummy bug or a bad cold is not just bad manners, it's dangerous for kids who don't have the greatest immune systems.

And anyone who automatically takes what the good (busy) doctor prescribes without checking out the actual approved uses of the drug, its potential side effects and interactions is playing with fire. Doctors are too busy these days to thoroughly investigate the plusses and minuses of all the new drugs coming out, and most of them receive their information from pharmaceutical company reps with no healthcare education or background. So before you swallow that cute little pill remember that while your doctor may have signed the Rx pad, his/her information on the drug most likely came from a salesperson on commission.

"In every medicine there is a little poison."

P.S. My kids (now in their late 30s) were vaccinated for everything. Had I had it to do over, I would have asked more questions and would have been more selective. I would have weighed risk vs. benefit on the varicella vaccine ... not sure what my decision would have been.

The Sentinel again missed an opportunity to present a well-researched article on a legitimate issue and instead delivered its usual half-assed page filler. Nice to see that the new publisher is continuing a longstanding tradition of mediocrity. Good thing we have The Pride!

Shalom

brian michael said...

"Really, I think our main difference is that you see something there that makes you think that taking that pill (vaccine, whatever) is a bad idea. I don't see it the same way, so until some new information presents itself I'm quite comfortable going with what has already been shown to work."

OK...but as adults we have the choice to refuse the pill from the docs - with this mandated vaccine and very few doctors who will listen to anything contrary to their "advice" we don't necessarily have the ability to choose what we find to be the best course of action for our children.

The Unicow said...

Rachel:

It's not just the folks who have had chickenpox who get shingles. The first generation to have the chickenpox vaccine is now also getting shingles.

While true, this appears to happen at a much lower rate than among people who acquire varicella "naturally": "The VAERS rate of herpes zoster after varicella vaccination was 2.6/100,000 vaccine doses distributed ... The incidence of herpes zoster after natural varicella infection among healthy children aged less than 20 years is 68/100,000 person years...

Additionally, these cases of shingles tend to be milder and appear to lead to fewer complications like postherpetic neuralgia.

As long as we're giving personal stories, I got chicken pox at age 13. As you're probably aware, the older you are, the worse it is. Thanks to it, I have countless permanent little scars all over my body (happily my face was mostly spared).

I don't think about them much anymore, but they surely have had a negative effect on me (more back in those awkward years than now, but still). I find it bizarre when people claim this isn't a serious disease. It can be extremely serious. Mine wasn't even near as bad as it can get, and I'm literally scarred for life.

The point about pills wasn't meant to suggest you should just blindly take whatever the doctor gives you. The point was that having confidence in a well-established and extensively-tested body of knowledge (not really the actions of one particular doctor) is totally reasonable, unless you have some solid evidence suggesting that body of knowledge is wrong. I have been unable to find any solid evidence that giving the varicella vaccine does more harm than good.

Brian:

You should absolutely have that choice, as long as it's an informed choice and you're willing to accept the consequences of it (and pass those consequences to the child).

Even if I disagree strongly with the choice that may result in, I agree that it should be yours to make. The fact that Mass. has a religious exemption but not a philosophical exemption is unfortunate.

brian michael said...

good can come of late chicken pox too:

I got it at 18! and missed all of graduation rehearsal and got so much sympathy from teachers that I got most of my final exams waived!

The Unicow said...

Yikes, 18?

That must have sucked! I mean, final exams being waived aside, there's no way that was fun!