More thoughts on Portland’s relationship with science.

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photo credit: danielmiessler.com

This post is intended as a companion piece to my story in the current issue of Portland Monthly, Are Portlanders Anti-Science?.

Below, in no particular order, are several anecdotes, ideas and facts that I originally wrote for that story, which were cut from the final text in the interest of clarity and concision.

I’d like to invite readers to use the comments section below to discuss the PM story, or any other related topics. As always, I enthusiastically welcome constructive criticism and dissenting opinions, but let’s all agree to avoid unfounded accusations of conspiracy (I swear, I’m not being paid by Monsanto, pharmaceutical companies, or “Big Fluoride”) or general nastiness, ok? Vigorous debate is awesome, name-calling and personal attacks, not so much. Thanks.

Births, babies and vaccines

Despite priding ourselves on being a health-conscious city, Portland leads the nation in elective home births. This seems to be a growing trend locally, despite the fact that numerous studies show the risk of infant death is much higher for home births compared to being in a hospital. But then again, maybe hospitals aren’t the safest places to have a baby? [EDIT: I was asked to provide more support for the claim that the risk of infant death is higher in home births, and I should have done so. This research article is the best citation I can find on the subject. It’s a fairly recent (2010) meta-analysis that summarizes the results of 7 studies on the subject, which were selected for good methodology. The overall finding of these 7 studies is that home births more than double infant mortality, from .09% to .20%. In the combined study groups, 16,500 infants were delivered by home birth, and approximately 16 more infant deaths occurred than would have been expected if they had been delivered in hospitals.]

My friend Dave and his wife had a child at OHSU hospital in 2013. About 18 hours after their daughter was born, a social worker from Multnomah County came to their room to record the birth. This person was wearing a surgical mask and Dave, concerned for his brand new child, asked if they were sick. “No, I don’t believe in vaccines, so I have to wear this mask.” What? Why would OHSU hire someone who doesn’t “believe” in vaccines to speak to new parents? How many parents go home with both a new baby and new doubts about vaccines?

I spoke to representatives from OHSU about this incident, and they would not comment on specific employees, but they confirmed that, yes, they do permit unvaccinated employees to work in rooms with medically fragile patients and newborns, as long as they wear a facemask. They also said that, hypothetically, OHSU would support a policy that requires employees to be vaccinated, but (as mentioned in the PM article) state law currently precludes common sense policies like that.

I was also told, by State Representative Mitch Greenlick (also a professor of public health) that a lot of the opposition to mandatory vaccine policies (on a state level) comes from nurses unions (?!?) because they believe that such a policy would be used as a pretext to punish nurses and that doctors would not be held to the same standard. I have trouble, however, believing that many doctors would choose not to be vaccinated (yes, I’m aware of “Dr.” Jack Wolfson, but to be fair, he’s an osteopath, not an MD, and in my opinion, osteopath’s are barely ‘real’ doctors—the entire osteopathic tradition, much like acupuncture, is founded on unverified anatomical beliefs that simply don’t correspond to actual human physiology—and many osteopaths practice a lot of nonsensical treatments, like using massage to treat pneumonia and other infectious diseases.) Even if this was true, however, it’s a cynical position and it’s really poor policy (and fairly ironic) for nurses unions to prioritize workplace politics over public health.

Vaccines and school employees

Like hospital workers, school employees in Portland also are not required to be vaccinated. I spoke to representatives from Portland Public Schools about this and they also said that they would like to have such a policy, but cannot because of State law. I asked them what they did to ensure that school employees (not just teachers, but custodial staff, kitchen workers, coaches, bus drivers…) did not put students at risk of preventable diseases. I was told that they have a policy to affirmatively protect student health by removing sick employees from classrooms and directing them to a doctor if necessary. They could not recall, however, the last time this policy was used but were sure it had been “at least several years”.

A little bit more about fluoride

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photo credit: OregonLive (this guy works at the food co-op in my neighborhood)

In addition to conspiracy theories, the opposition to fluoride in Portland was based on many bad arguments, such as an oft-repeated desire to “keep chemicals out of our drinking water” despite the fact that water itself is a chemical, and nobody seems to mind that we already add chlorine, ammonia and sodium hydroxide to our water in order to disinfect it and prevent corrosion of pipes. (Side note: the irony award goes to an anti-fluoride protestor who was seen standing on MLK avenue, holding a sign that said “Fluoride is Poison”, while smoking a cigarette…cognitive dissonance much?)

Another common claim of fluoride opponents, such as Clean Water Portland, the main opposition group, was that fluoride would “add a substantial amount of arsenic to the city’s tap water”. While technically this claim was true, it was also entirely misleading and was clearly a disingenuous attempt to scare people—which is a pretty sleazy tactic typically employed by cynical, dishonest actors, not people with truth on their side.

Estimates from Clean Water Portland’s own research claimed that fluoridation would “potentially” increase arsenic levels in drinking water by as much as 0.12 parts per billion. That might sound dangerous, but the natural arsenic level in our water is already ten times that high, and many common foods such as rice, apple juice, fish and tea contain hundreds or thousands of times as much arsenic. Eating a single tuna sandwich would give you more arsenic than drinking 9,000 glasses of fluoridated water, even at the alarmist levels CWP claimed.

More examples of bad public policies in Portland

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photo credit: Portlandia

Failing to consider scientific information leads directly to bad public policies. For example, the local environmental movement recently celebrated a “major victory” in banning plastic bags in Portland, despite the fact that doing so didn’t meaningfully improve the environment. Yes, paper bags are made of a renewable resource and biodegrade faster, but compared to plastic bags their manufacture requires about four times as much energy and creates far more pollution and greenhouse gases.

I don’t really have any strong objection to “banning the bag” (it’s pretty much a wash from an environmental perspective) but it’s really a shame that the local environmental community (which I consider myself part of) spent several years and a lot of money on this issue. The opportunity cost was staggering—instead of making progress on important environmental problems like carbon dioxide emissions or pollution in our rivers, most of the community was consumed with passing feel-good legislation that failed to make any real impact on our environment.

Similarly, last year the Portland Water Bureau, wasted 38 million gallons of drinking water because some idiot urinated in a reservoir. Of course that’s gross, but it only resulted in the water being roughly 0.00000197% urine (which is mostly water anyway) and it poses no actual danger to people who drink the water. Bizarrely, at the same time, we accept the known risk of waterfowl swimming and defecating in the same reservoirs, which is a well-known health risk.

All scientists get paid for their research

This isn’t specifically relevant to Portland, but it’s a point that I think bears mentioning here: all scientists work for money, whether it’s a salary from a company, or a grant from the federal government. Consequently, we all face pressure to produce results that conform to the prejudices of our funding sources. For example, if a biologist studies a species of butterfly and gets her funding from the Nature Conservancy, she might face a problem if her work shows that the butterfly species is doing well—because, of course, the NC depends on public donations to fund their work, and it’s hard to raise money if you are telling people that everything is fine.

This isn’t a fatal problem though, because the hallmark of good science is reproducibility, not a single published study. If other scientists can reproduce findings, using the same methodology, then they are good results and will be accepted by the community—it really doesn’t matter if the original study was funded by Monsanto, the NSF or Greenpeace (who have an annual budget of about $400,000,000.00 and really should fund more research and less propaganda). Nonetheless, in public debates about things like vaccines and GMOs, I constantly hear research dismissed as “industry funded” as if that somehow changes the validity of the results.

(Side note to folks who make this criticism: who should fund research into the safety of vaccines and GMOs? Should taxpayers have to subsidize the work of for-profit companies and spend public money to prove that these products are safe? Or should the for-profit companies bear the financial burden?)

I don’t want to whitewash concerns about dishonest results though—it’s certainly true that a lot of medicines have been approved for public use based on flawed results, and that many negative findings are simply not reported to the FDA. This problem should be addressed with legislation that requires public reporting of all studies, as well as publicly funded comparison studies that compare the efficacy of new, expensive drugs to older, cheaper ones.

13 thoughts on “More thoughts on Portland’s relationship with science.

  1. Fantastic. Enjoyed both pieces. In your opinion, what is it about Portland that makes us seem to be so much less scientifically literate than the rest of the country?

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    1. Thanks for checking it out, I’m glad you enjoyed it. And your question is interesting, though I’m not sure I completely agree with the premise. I do totally agree that something is unique about Portland with respect to attitudes toward science, but I don’t think we are particularly less scientifically literate than other places. I think it has more to do with knee-jerk skepticism of mainstream ideas, which is fed by the personal politics of many Portlanders.

      There is a unique combination of anti-government sentiment from both the left and the right in this part of the country–some interesting research shows that Oregon fits into a little cluster of states, with Washington and California, that are both socially liberal and libertarian (http://www.cato.org/blog/where-are-libertarians) and I think that both of those ideologies (speaking vary broadly) tend to promote skepticism of authority and received knowledge. I think those attitudes kind of prime the Portland community to question things that “mainstream Americans” take for granted.

      That’s often a really healthy attitude, but when we’re making decisions on important public policy issues, it can be dangerous–particularly when those issues are really complex and require specialized training to understand.

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  2. Science if you want to bother to read

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    1. Thanks for posting, but those papers you’re linking to are junk–most of them aren’t real studies and have been thoroughly debunked. And many of them aren’t really about autism or vaccines anyway–they are just toxicology studies that used totally unrealistic doses of chemicals to try to create damage and scare people: (https://angryautie.wordpress.com/2013/09/18/the-definitive-reference-debunking-vaccine-autism-myth/ and http://lizditz.typepad.com/i_speak_of_dreams/2013/08/-those-lists-of-papers-that-claim-vaccines-cause-autism-part-1.html). The world of actual science is messy and often inconclusive, and many, many bad studies make it into publication. Anybody with an agenda (autism/vaccines, don’t believe in global warming, think the moon landing was fake…) can cherry pick a bunch of references that purport to justify their position, but that’s not science, that’s misusing science to be dishonest.

      I’m not sure if you’re sincere (and ignorant) or just trying to muddy the debate with disinformation, but linking to a bunch of junky studies isn’t very helpful because it creates a fake veneer of credibility where no real factual information exists. Excellent studies, with large sample sizes and good methodology have looked at this question repeatedly and found no link. It’s just not there, no matter how much disinformation you want to spread about it. There’s simply no good evidence of the claim, and frankly even if there was (which to be clear, there isn’t), a marginal increase in autism is a very small price to pay for protecting kids from horrible diseases that killed millions (and still do in parts of the world without vaccines.)

      There are a lot of areas where scientific ignorance (or willful rejection of science) is just unfortunate and stupid, but when you try to discredit vaccination you are doing real harm in the world. You are putting children at risk and your actions have consequences. I strongly urge you to reconsider your stance and join the evidence based community.

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      1. The studies are as good as any you can submit as a counter. They also do not have scientists turned official whistleblowers claiming that now their data is fraudulent. They also were not completed by a scientist who absconded with over one million dollars of tax payer money. In addition, they were not funded by the CDC and the pharmaceutical industry.

        I never thought about vaccines until I watched what happened to my grandson. My grandson received a vaccine that was taken voluntarily off the market the year after he got it, a 4 in 1.. Kaiser came out with a study two years later saying that the vaccine caused too many seizures and they removed it from use at their facilities.

        He regressed horribly after receiving that vaccine and became very sick. The doctor did a blood draw at 13 months. My grandson developed a pale optic nerve in his left eye (went blind), he developed Vitilgo, lost his language, he had 93% lymphocytes, 3% neutrophils, and encephalitis occurred, he had seizures, massive diarrhea and all of this occurred at the same time. And his doctor did not tell his parents. Instead, they covered it all up. It was not till we sought his medical records that we realized what had happened to my grandson. We has strong suspicions, but it was not until we gathered all his medical records that we confirmed what had happened. I believe they covered this information all up because on the day they took his blood sample when he was so sick at 13 months, they gave him 3 more vaccines. And by the time we were able to put two and two together it was too late. You only have three years from the time of vaccination to file at the Vaccine Court. We did not gain his medical records until after the time frame had expired.

        My oldest daughter was Valedictorian of her high school and had a full ride scholarship to Notre Dame where she graduated in Bio Chemistry. She has a second degree in laboratory science from OIT. My younger daughter is a dentist and graduate from OHSU she currently works in pediatric dentistry. She is shocked by the numbers of chronically ill children she deals with everyday. She claims around 70% of the children in her practice are plagued with chronic health issues, many that used to be subject to the elderly. My daughter that is a laboratory scientist, tests for many of the diseases you are talking about. She said that Hep B is so rare in children she rarely if ever sees it, yet we are busy making sure that babies receive that vaccine. Her fear is not for childhood diseases, but of untreatable bacteria.

        Both daughters and my grandson’s father who also happens to be a very good scientist ( he dropped out of engineering school because of his autistic son) They all believe that vaccines caused my grandson to develop autism. You see, they see science and vaccines as not black and white but rather as gray. They say that anyone claiming that the science is done and the subject is closed is not truthful. Science is never absolute any look at history will verify that.

        I am 58. I had all of the diseases you speak about pretty much short of Polio. I had Measles, Mumps, Chicken pox, Rubella along with my 11 siblings,who all grew up in Portland. we all survived and I never thought twice about it. My mother and father grew up in the depression. My mom always told us of disease and what she feared. I will list them in order of fear. TB, Polio, Scarlett Fever, Rheumatic fever, and Diphtheria. And pretty much all but one here are bacteria just as my daughter has said she is concerned about.

        You are a puppet spewing the propaganda fed to you. I am tired, I have cried to many days over illness of my grandson. His blood work is precarious, we watch and test it regularly. He has a positive ANA and our fear is that he will develop some kind of cancer or lupus. No one can give us a reason or any answers. No reasons, no answers just people like you, who as a scientist can definitely tell me that vaccines are not the fault.

        I know that someday you will eat your words. You will backtrack and swear that you did not mean any harm, but you and other so called scientist will forever be attached to this lie and the harm that it caused to whole generation of children.

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        1. Nora, I’m certainly sorry to hear about your grandson, but your comment well-illustrates the danger of trying to make public policy based on anecdotes. Many people associate vaccines with neurological and developmental conditions in children because preexisting problems often become apparent around the same time as the vaccine schedule picks up (1-2yrs old). In pretty much every case I’m aware of, the timing is purely coincidental–it’s just hard to notice most neurological issues in infants.

          I’m sorry that your family blames vaccines for his medical condition, but if things like that regularly resulted from vaccination the data would show it. What the data does show is that many, many more children died (or were permanently harmed) by diseases that are now routinely prevented by vaccines. Nothing is without consequence, and there have certainly been cases of contamination of vaccines and other mistakes that have caused harm. These events are rare though, and once again, on balance many more children are protected by public vaccination. Essentially your argument is the equivalent of suggesting that we should take seat-belts out of cars because very occasionally somebody is killed by one–while simultaneously ignoring the many, many more lives they save.

          And as far as the rest of your criticisms of the CDC, pharmaceutical companies, and the medical-science establishment in general, how are you treating your grandson’s medical issues now? You say you fear he will develop cancer or lupus, and if so, will you take him to a hospital and give him potentially life-saving medicines? You know it’s the same pharmaceutical companies, the same CDC, the same research scientists and the same scientific journals that handle the rest of medical science right? If you believe it’s a corrupt conspiracy, I assume you would also reject the rest of modern medical care for yourself and your family?

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          1. You are truly a mouthpiece for propaganda. Your concern is feigned for my grandson and dismissed as impossible. Let me suggest to you that there is no neurological regression where by a child loses his language, his bowels, his eyesight, his skin color, and where his blood develops lymphocytosis and neutropenia ands encephalitis all at once. You are wrong and it does not take a genius to point it out.
            If you were honest you would be concerned about all of the brain damaged children. Everywhere I go, I find brain damaged children. Just today as I took my grandson in for another blood draw there was another grandmother, who mentioned she too had a grandson with autism and she too believed that vaccines were the cause. It is getting harder and harder to dismiss the sheer numbers. You and your fake science make me ill.
            The one significant difference you are not accounting for when it comes to doctors and pharma beyond vaccines, I can sue them all! Merck with Vioxx big losses from law suits. Merck with Gardasil no lawsuits. All they have to face is a government run charade of a court paid for by the public! Which one would you choose as a company looking to maximize profit with as little liability as possible? Vaccine manufactures face no liability nor do the doctors that administer them. Vaccines are in line for a big promotion with the help of scientist like yourself. There are some 300 vaccines in the pipeline and adults are the next target. You already probably know this I am sure, the “cradle to grave” motto from the not so bright front group for the CDC ” NACCHO” pretty much gives away the plan.
            One more thing you said that there was no data to support what I said about that vaccine my grandson received. Well you are wrong. In 2014 the manufacturer of that 4 in 1 vaccine added ADEM to the list of possible side effects from the vaccine. ADEM pretty much describes what happened to my grandson.

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            1. Nora, I’m not really interested in having a conversation with somebody who accuses me of being part of a conspiracy. So, I’m not going to engage with you after this. But I will say a few things. First, it confuses me that you are citing information provided by a pharmaceutical company when it supports your opinion, but otherwise you think they are lying and trying to harm children? It seems pretty clear that you are cherry-picking information because you already know what you believe, evidence be damned.

              I am truly sorry about your grandson. If he was indeed harmed by a vaccine that’s a shame, but such events are very, very rare. Yes, sometimes people are harmed by vaccination–that’s true of every medicine and pretty much everything else in life. That’s not evidence that vaccines are a bad idea, it’s just evidence that the world is a big, messy and sometimes unfortunate place. And yes, from a public health perspective, negative outcomes from vaccines are a small price to pay for the millions of lives that they have saved. We could easily find a bunch of grandparents who have lost grandchildren to vaccine-preventable diseases if we wanted to engage in argument by anecdote–but that doesn’t interest me.

              What does interest me, as a father and a concerned citizen, is developing evidence-based public policies that protect vulnerable people in our society. Vaccines are an important part of public health, they have been used for many decades. They have an incredibly strong safety record. It’s pretty simple to see that child-mortality from vaccine preventable diseases has declined dramatically across the developed world over the past century–and the same is true of cancer, heart disease and a host of other ailments. We are much, much better at helping prevent and treat disease today than we were a few decades ago–because most of the time doctors and medical researchers get it right. Accusing those people, who are trying to save lives, of being part of a conspiracy to hurt children is pretty despicable in my opinion. But it’s a unfortunately common tactic for folks who don’t have facts on their side–I hear the same rhetoric from folks who oppose GMOs, don’t believe in global warming, think the moon landing was fake, and horde gold because they believe in Agenda 21. You’re in good company Nora.

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              1. Do not associate me with those who do not believe in global warming. I was driving VW bugs and the first Celica model to come to the US before you were born. I also happened to be alive when the first man walked on the moon. I also listened everyday to the hearings on Watergate. It was live and incredible TV for a kid to learn all about how much government can be corrupted. I also was alive and participated in demonstrations against Vietnam. Like Vietnam protest, those of us speaking out about vaccines right now are the first wave of demonstrators. But you wait as more and more people understand just what is going on and they understand just what is at stake, they will join us and this crazy industry lead government will end. You suggesting that this schedule of vaccine today is necessary is pure nonsense. Those of us that remember know that once upon a time boys actually were not hyper. Children did not have ASD, ADHD, PDD-NOS, Eczema, Crohn’s Disease, cancer, diabetes, Lupus, Peanut Allergies, Asthma, Narcolepsy (my daughter the dentist actually has a patient with this disorder) and on and on. The new normal is that half of the kids will be chronically ill and unable to function so a failed system of vaccinating children can do what? and protect us from what?

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                1. Yet more evidence that the ‘link’ between vaccines and autism is simply not there: http://www.cnn.com/2015/04/22/health/mmr-vaccine-autism-study/index.html

                  And the actual study for folks who like reading journal articles: http://jama.jamanetwork.com/article.aspx?articleid=2275444

                  I’m sure you’ll dismiss this as just another conspiracy Nora, but I put it up here for the open minded folks who actually pay attention to empirical evidence.

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  3. Jason, this article might be of interest to you with regard to vaccines and whooping cough. It provides the history of the vaccine and could provide you with valuable insight:
    http://www.iom.edu/~/media/Files/Activity%20Files/Disease/VaccineFinancing/FineBackgroundPaper.pdf
    In the PM piece, you wrote that your wife was angry about a teacher, who hadn’t received a Tdap booster, exposing students to whooping cough. Was the teacher infected with whooping cough? If so, why was the teacher in the classroom? Frustration over pertussis could be rightfully directed at the established ineffectiveness of the acellular pertussis vaccine.
    Perhaps it isn’t that Portlanders are anti-science, but that Portlander’s have grown wary of propaganda and misleading statements supposedly based in science. The HPV vaccine is an example of this. Why is the Oregon Health Authority so intent on having all 11 year olds vaccinated with it? The CDC itself reports that 90% of HPV infections clear on their own with no further consequence. Any diligent parent should be curious about this, but questioning vaccines seems to be highly discouraged.

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    1. I’m not really sure what you are trying to say here, but I’ll respond to a couple of the points you raise.

      1. The pertussis vaccine is highly effective (nothing is 100% effective because our immune systems all respond differently) and vaccination has resulted in >90% decrease in incidence of pertussis and associated mortality: http://www.who.int/biologicals/vaccines/pertussis/en/ The acellular version of the vaccine is slightly less effective, but also has fewer side effects (red itchy swelling at injection site, fever–nothing major) in older adults, whom it is common prescribed for.

      2. The story you link to is interesting, but it’s about a political crisis that was fostered by the media, not a real medical problem–yes, there were some very rare adverse reactions, but on balance, the DPT vaccine saved many, many more lives than it harmed. As your citation says, “In 1975, in response to the deaths of two infants within 24 hours after DTP vaccination, Japanese health authorities temporarily suspended the routine use of pertussis vaccine in infants, and soon after recommended that immunization against pertussis start instead at age two years. What followed was a decline in immunization coverage and a dramatic increase in pertussis cases and deaths among Japanese children…Great Britain, like Japan, experienced a rapid increase in pertussis cases and deaths.”

      3. The reason the teacher was at school with pertussis (as I understand it) was because she had not been diagnosed and thought it was just a mild cold that wouldn’t go away. When symptoms go worse, she went to the doctor, was diagnosed and was told not to go back to the classroom. No voluntary policy can be totally effective and relying on teachers to self report (particularly in early stages of infection, when symptoms are mild) is a foolish idea that clearly failed.

      4. And as for your question. “Why is the Oregon Health Authority so intent on having all 11 year olds vaccinated with it [HPV vaccine]? The CDC itself reports that 90% of HPV infections clear on their own with no further consequence.” Maybe it’s because the point of the vaccine isn’t to prevent HPV, but to prevent the cancers it causes? HPV does usually clear on it’s own, but your question simply ignores the 10% of people who do have future consequences like vaginal, cervical and anal cancers. The use of the vaccine reduces the incidence of these cancers dramatically. As the National Cancer Institute says, “Widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds.” http://en.wikipedia.org/wiki/HPV_vaccines#Efficacy That seems like a pretty good reason for OHA to support the HPV vaccine to me. Do you disagree?

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  4. Jason, your opinion on this issue is settled, which makes further discussion futile.
    You are correct that no vaccine is 100% effective. If you believe that the DPT was discontinued due to a couple of deaths and a media storm, more power to you.
    It’s very unfortunate that the teacher was infected with whooping cough. She must have disclosed to you that she wasn’t up to date on her booster, or is that something that you are just concluding? In any event, I, too would be concerned if my fully vaccinated child was exposed to whooping cough, as the fully vaccinated are usually the most susceptible. I’m sure that Snopes.com, Wikipedia, or another blog would completely refute any credible primary source on that, so I won’t bother.
    I do disagree with you, and the OHA, on the merits of the HPV vaccine, but if Wikipedia tells you it’s legitimate, it must be. If I thought you were genuinely interested, I’d encourage you to read up on the studies that discuss how the HPV vaccine will likely increase the rates of cervical cancer, and do nothing to discourage it. The HPV vaccine didn’t work out so well in India for the Gates Foundation, but that’s likely a bunch of frivolous nonsense.
    The science is murky unless it supports your ideas, right? Thank goodness it is 100% settled that vaccines have nothing to do with autism!
    Despite what your beliefs are, it is incredibly crass to suggest to the parent/grandparent of a vaccine injured child that not only do you think they are wrong, but if they were ever right, the injury of their child is a “small price to pay.”

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