Categories
Antivaccine nonsense Medicine Quackery

Quackery and antivax are inseparable

A recent study reaffirms the high degree of correlation among physicians between antivax views and an embrace of quackery. This is an old finding that needs to be documented periodically and shows why the acceptance of non-science-based treatments by physicians endangers vaccination efforts.

I have long argued that the most effective medicine is science-based medicine, ongoing efforts of alternative and “integrative” medicine advocates to promote placebo medicine notwithstanding. Unfortunately, a depressing number of physicians do not share this philosophy, resulting in the rise of a specialty known as “integrative medicine” and “subspecialties” of quackery like “integrative oncology.” We have also long bemoaned one of the consequences of this increasing acceptance, namely the infiltration of quackery into medical schools and academic medical centers, a phenomenon for which Dr. R. W. Donnell coined the termquackademic medicine” nearly 16 years ago. Although its proponents like to bill “integrative medicine” as being the “best of both worlds,” combining the benefits of science- and evidence-based medicine with the supposed benefits of medicine not based in science and evidence, in reality and practice, integrative medicine involves “integrating” quackery like homeopathy, acupuncture, naturopathy, reiki and “energy medicine,” and more with medicine. As friend of the blog Mark Crislip has long put it:

So integrative medicine is taking rank pseudo-scientific nonsense and combining it with real medicine. That is why I say, when you integrate cow pie with apple pie, the cow pie is not made better, the apple pie is made worse.

recent study (hat tip: Edzard Ernst) examining attitudes of physicians in Europe who embrace alternative medicine modalities “integrated” into medicine in “integrative medicine” has yet again reinforced just how correct Dr. Crislip was when he first wrote these immortal words. It also describes just how common both the embrace of various forms of quackery and antivax are among physicians in the countries studied. It is a cross-sectional study by a team of researchers from Germany, France, Finland, and Portugal. including a co-author with whom regular readers of this blog might be familiar: Stephan Lewandowsky, who co-authored an excellent lay primer on conspiracy theories, examining attitudes among physicians who have vaccination responsibilities in the four countries from which the authors hale. The results are depressing but instructive.

Unscientific medicine is associated with unscientific views towards vaccination, prologue

In the introduction, the authors lay out the rationale for the study:

Prior studies among the general population and nurses suggest that complementary and alternative medicine (CAM) is positively related to vaccine hesitancy.9–14 CAM is defined by the World Health Organization as “a broad set of health care practices that are not part of that country’s own traditional or conventional medicine and are not fully integrated into the dominant health care system”15—in Western societies: homeopathy, acupuncture, energy and crystal healing, reflexology, magnet therapy, or anthroposophic medicine.16–18 Due to its potential effect on willingness to recommend and receive vaccines, the analysis of the relationship between vaccine hesitancy and CAM endorsement among physicians is particularly relevant due to their direct contact with the general public and vulnerable populations, as well as to their key role in patients’ vaccine-related decision-making processes.19,20.

I can’t help but note here that the authors seem to be using an outdated term: CAM, which was often used in years past to describe adding alternative medicine and non-science-based medicine to science- and evidence-based medicine. However, alternative medicine advocates didn’t like the term CAM because it placed alternative medicine as “complementary,” meaning something secondary added to medicine, the “cherry on top,” if you will. In other words, it was an implicit admission in the name that the “alternative medicine” was ineffective (or at least far less effective) compared to the actual medicine. That’s why around 15 years ago CAM was “rebranded” as “integrative medicine” and the even vaguer and more general term “integrative health” arose. They imply the “integration” of “equals,” or the true “best of both worlds” in the alternative medicine belief system. Integrative medicine practitioners still (usually) don’t use the quackery alone, but rather with evidence-based medicine, but now they approach the modalities as co-equals even though they most definitely are not.

Whatever term is being used—CAM, integrative medicine, integrative health, or any of the other euphemisms for integrating quackery with medicine—the authors sought to examine the correlation between CAM beliefs and vaccine hesitancy (or antivaccine) beliefs, noting:

Despite studies reflecting physicians’ general dissatisfaction with the state of knowledge and research about CAM,21,22 a literature review of 21 survey-based studies in Canada and the U.S. found that a substantial number of HCPs express positive attitudes toward CAM and recommend, or would consider recommending, CAM to their patients—e.g., between 6% and 80% used CAM in their clinical practice, with these results varying depending on the definition of CAM and sampling methods used in the study.23 In fact, one systematic review suggested that HCPs are equally, or even more likely, than the general population to use CAM.24 Another systematic review, this time of surveys with British physicians, found that the mean prevalence of personal use of CAM among physicians was 20.6%, with an average referral rate to CAM of 39%, even though only 10.3% of these physicians had received specific training in CAM.25 Other studies conducted in European countries show a similar scenario. For example, in the study by Berretta et al.26 55% of the sample of Italian physicians recommended CAM to their patients, whereas in the German sample analyzed in the study by Linde et al.27 23% of family physicians, 6% of internists, and 31% of orthopedist personally used four or more forms of CAM frequently, and 68% reported using homeopathy to treat patients.

This summary of existing evidence with respect to physicians and CAM is truly disheartening to be reminded of, but not at all surprising to those of us who have been paying attention to the increasing infiltration of unscientific medicine into medicine under the rubric of CAM or “integrative medicine.” Seriously, if you are a physician and use homeopathy—or, as I like to call it, “The One Quackery To Rule Them All”—you need to go back to medical school to learn basic biochemistry and pharmacology. In fact, you need to go back to college and take a basic physics class. Of course, it’s not entirely surprising that homeopathy is so popular among German physicians given that the man who invented it nearly 230 years ago, Samuel Hahnemann, was German. Unfortunately, as a result, homeopathy continues to be viewed very favorably in Germany.

The authors of the current study also reiterate something that I’ve long pointed out here at RI, namely how among the general public acceptance of the alternative medicine treatments commonly used in CAM correlates with negative views towards vaccines:

The link between CAM endorsement and negative attitudes toward vaccines has been documented in previous research among the general public. A systematic review, which categorized arguments against vaccines retrieved from peer-reviewed articles and debunking texts published by international fact checking agencies, identified a category of arguments largely based on alternative health beliefs related to CAM.28 This category was the third most common in the scientific and fact-checking literature. Furthermore, anti-vaccination arguments related to CAM were also among the most endorsed arguments by individuals from the British general population in a study by Holford et al.29 These results suggest that CAM beliefs play an important role in individuals’ justification of their hesitant attitudes toward vaccines for both adults and children.30 Bryden et al.,31 Soveri et al.,12Lewandowsky et al.,11 and Hornsey et al.10 analyzed samples from the Australian, Finnish, American, and Spanish general populations and found that positive attitudes toward CAM were related to negative attitudes toward vaccines. In a recent large-scale study in 18 European countries, parental consultation with homeopaths was associated with higher vaccine hesitancy than consultation with pediatricians or nurses.32 Moreover, in a systematic review, Wardle et al.33 found that CAM use tended to be positively associated with lower childhood immunization – see the work by Bleser et al.34 and Frawley et al.35 for more recent results from the U.S. and Australia.

I was most interested in reference 28 cited above because it is a recent paper about the taxonomy of antivax arguments mapped to eleven common alternative medicine beliefs and attitudes. Unfortunately, my library does not carry the journal, so I’m still waiting for the article through interlibrary loan and can’t comment about it other than by the abstract. However, I will be curious to see how closely the findings resemble things that I’ve been saying all along—also, whether I need to alter my beliefs on this based on new evidence or can just use this article going forward as evidence supporting those beliefs.

In any event, it is not even controversial that belief in unscientific medicine of the sort “integrated” into medicine by “integrative medicine” is associated with vaccine hesitancy and even outright antivax beliefs among the general public. But what about physicians? That’s what the study cited by Prof. Ernst set out to try to quantify by testing two hypotheses, H1 and H2:

H1:

CAM endorsement among medical practitioners with vaccination responsibilities will predict negative vaccination attitudes and behaviors.

Following the well-established theory of planned behavior, according to which behaviors are influenced by previous attitudes in a process of sense-making,Citation36 we also hypothesized that negative attitudes toward vaccines associated with CAM endorsement would constitute a motivational context in which physicians’ willingness to recommend and receive vaccinations is reduced:

H2:

Attitudes toward vaccines will mediate the relationship between CAM endorsement and vaccine-related behaviors.

Let’s dig in.

Unscientific medicine is associated with unscientific views towards vaccination, the study

One thing about this study that interested me is when the survey was done to assess the attitudes of physicians towards CAM and vaccines: between 03/31/2022 and 04/24/2022 via Schlesinger Group Germany; between 04/06/2022 and 05/06/2022 through invitations sent to the mailing list of the Portuguese Society of Pediatricians and the Portuguese Association of General Practice and Family Medicine; between 03/18/2022 and 04/27/2022 in France through invitations sent to the mailing list of National Association of General Practitioners; and in Finland, GPs between 04/25/2022 and 05/16/2022. This was a period of time after the initial wave of hope and enthusiasm about COVID-19 vaccines and right about when antivax sentiments toward the mRNA vaccines had risen markedly and attitudes linking antivax views with ideological and political orientations had hardened.

Instruments assessing attitudes towards CAM and towards vaccines were used on a sample of 2,875 physicians, of which 88 were excluded due to missing values on one or more variables of interest, resulting in a final sample of 2,787 participants. The instrument measuring attitudes towards CAM was a five-item scale measuring CAM rejection developed by Lewandowsky et al.,  with 2 items taken from Hyland et al. The authors listed sample items, which included: “complementary medicine builds up the body’s own defenses, so leading to a permanent cure” and “complementary medicine is superior to conventional medicine in treating chronic ailments such as allergies, headaches, and back pains.”

For vaccine attitudes, the authors used the international version of the Professionals Vaccine Confidence and Behaviors Questionnaire (I-Pro-VC-Be), which is composed of 33 items to measure psychosocial determinants of HCPs’ attitudes toward vaccines, which are grouped into six constructs, described thusly:

  • Confidence in Vaccines, composed of items reflecting perceived risks of vaccines (i.e., how safe HCPs perceive certain vaccines to be), complacency (i.e., the perception of lack of usefulness of vaccines), perceived benefit-risk balance of vaccines (i.e., the degree to which HCPs perceive that the benefits of vaccines outweigh their potential risks), and perceived collective responsibility (i.e., the extent to which HCPs recommend vaccines to contribute to community immunity). Sample items: “vaccines against human papillomaviruses are safe” and “the benefits of the vaccine against measles outweigh its potential risks.”
  • Trust in Authorities (i.e., trust in institutions and health authorities to provide reliable vaccine information and to define the vaccination strategy). Sample items: “I trust the information provided by the [relevant national institution] about the risks and benefits of vaccines” and “I trust the [relevant national institution] to establish the vaccination strategy.”
  • Perceived Constraints (i.e., perceived practical constraints, such as cost of or access to vaccines). Sample items: “the cost of some vaccines is a problem for some patients and can keep me from prescribing them” and “the lack of availability of certain vaccines in my country is sometimes a problem that can keep me from prescribing them to my patients.”
  • Proactive Efficacy, composed of items reflecting commitment to vaccination (i.e., the extent to which HCPs are proactive in motivating their patients to accept vaccinations) and self-efficacy (i.e., how prepared HCPs feel in terms of knowledge and skills to address vaccination with patients). Sample items: “I am committed to developing the skills needed to communicate better with my patients about vaccination” and “I feel comfortable discussing vaccines with my patients who are highly hesitant about vaccination.”
  • Reluctant Trust (i.e., the “leap of faith” to trust vaccines and policies even if HCPs have doubts). Sample items: “I may sometimes recommend vaccines from the official schedule even if I feel I am not sufficiently informed” and “I may sometimes recommend the vaccines on the official schedule even in cases where I have doubts about their safety.”
  • Openness to patients. These items express positive attitudes toward hesitant patients, such as viewing their concerns regarding vaccination as legitimate, letting patients to delay the immunization of children, and a neutral approach to informing patients about the benefits of vaccines. Sample items: “patients who are hesitant about the benefits and risks of vaccines have legitimate questions” and “I am open to patients delaying immunization of their children.”

So what did the investigators find when they looked at these variables and assessed the participants vaccine-related behaviors, including:

  • Vaccine recommendations to patients. Sample question: “Please imagine you are treating an adult who has not had the COVID-19 vaccine and has no contraindications. How likely is it that you would recommend the vaccine to the patient?”
  • Self-vaccination against influenza and COVID-19 during the previous three years.
  • General vaccination behavior. Sample question: “How often do you check that your patients have received the vaccines recommended for them (whether from records or asking)?”

Regarding the first hypothesis (positive attitudes and behaviors with respect to CAM will predict vaccine behavior and negative attitudes towards vaccines), the investigators used a linear mixed effects model and found that the results “support our hypothesis that CAM endorsement among medical practitioners with vaccination responsibilities predicts negative vaccination attitudes and behaviors.” The second hypothesis (that attitudes toward vaccines will mediate the relationship between CAM endorsement and vaccine-related behaviors) was also supported:

The results indicate that Confidence in Vaccines constitutes a significant mediator and that its mediational role is particularly strong for the relationship between CAM Endorsement and Vaccine Recommendation, accounting for 84% of the association (R2 = 0.27). Furthermore, Confidence in Vaccines accounts for 56% of the association between CAM Endorsement and Self-Vaccination (R2 = 0.16). These mediations were robust across countries, albeit the indirect effects were particularly strong in Germany (see Supplementary Material), and support our hypothesis that attitudes toward vaccines mediate the relationship between CAM Endorsement and vaccine-related behaviors.

The finding that most interested me, however, was the finding of latent profiles among physicians with respect to their attitudes towards CAM and vaccines. In brief, latent profile analysis is an analytical approach that focuses on identifying latent subpopulations within a population based on a certain set of variables, assigning people with varying degrees of probabilities into categories that have different configural profiles of personal and/or environmental attributes. In this case, the latent profile analysis sought to characterize the physicians in the sample into categories based on “the number of participants expressing higher-than-average CAM Endorsement and lower-than-average Confidence in Vaccines, Vaccine Recommendation, and Self-Vaccination.”

The authors identified three latent profiles in their subjects:

CAM and antivax

My first reaction was that I suppose I should be happy that 81% of the physicians surveyed fell into the CAM-negative, vaccine-positive profile. However, that means that the other 19% fell into CAM-positive, vaccine-negative profiles, the majority of whom also exhibited low levels of self-vaccination; in other words, they practice what they preach.

Unsurprisingly, the percentage of physicians who fell into the CAM-positive/vaccine-negative profiles varied between countries:

  • 24% in Germany
  • 18% in France
  • 10% in Finland
  • 6% in Portugal

Apparently, if you want science-based recommendations with respect to alternative medicine and vaccines in Europe, your best bet is a Portuguese doctor and your worse bet is a German doctor. In fairness, these profiles are defined by averages, as in below average confidence in vaccines and above average confidence in CAM. There is variability. Even so, these percentages of CAM-positive/vaccine-negative physicians are alarming high, even in Portugal.

This study has a number of strengths, not the least of which is that it is a large sample. However, the authors concede that it is unclear how representative their samples are of the physicians in each country and therefore how generalizable their findings are. In addition, the mediation analyses are correlations and can’t by themselves prove causation, although I would point out that we have a lot of other evidence from other sources and studies that suggest probable causation. Finally, the study was not particularly granular. CAM was treated as a single category, even though the popularity of different CAM modalities no doubt differed between countries.

Unscientific medicine is associated with unscientific views towards vaccination, what now?

I’ve long pointed out the strong association between belief in quackery and antivaccine views and how often quacks are at least highly vaccine-averse if not outright antivaccine. The authors lay out some potential reasons for their findings in their Discussion, and I can’t help but agree with much of their reasoning:

Ernst47 proposed several potential causes for the observed relationship between vaccine hesitancy and CAM.9–12,14,48 Since CAM use occurs more frequently at the poles of the disease spectrum (i.e., in cases of minor or life-threatening illness), CAM use has been identified as a marker of both misperception of risk and frustration with regular healthcare (e.g., negative prognosis or lack of remission of symptoms).49 Accordingly, CAM-related health conceptions could be motivating HCPs to be more reluctant to recommend and receive vaccinations both for illnesses that are perceived as minor and in cases of severe clinical pictures. There are also reasons related to the potential alignment between CAM and the ideology or worldview of the HCP, such as their distrust in “Big Pharma” or a general disregard for scientific knowledge.50 Along the same lines, Attwell et al.51found in semi-structured interviews with vaccine hesitant Australian parents that the main reasons for their preference for CAM included a greater affinity between CAM, their do-it-yourself approach to health care, and their sympathy for natural and harm-free products in contrast to medications marketed by pharmaceutical companies, which were perceived as ineffective, “toxic” and “adulterating.”52

All of these are topics that have been extensively discussed here on RI, in particular the affinity of CAM for the “natural” and the seeming belief that vaccines are “unnatural” or even something that “contaminates” the “purity” of one’s “natural” body. (It’s the reason why I frequently use clips like the clips below of Gen. Ripper ranting about the dangers of fluoridation of water and how “they” wanted to fluoridate much more—”ice cream, Mandrake, children’s ice cream!”—from the six decade old classic movie, Dr. Stangelove, or: How I Stopped Worrying and Learned to Love the Bomb.

Yes, I’ve argued that both CAM and antivax ideology amount to, in essence, a purity cult requiring ritual purification, a.k.a. in CAM parlance, “detoxification.”

As I also like to say, the end of the second clip also partially explains why antivaxxers think that women should not have sex with vaccinated men, namely because their “purity of essence” will be contaminated or corrupted, because the male’s “corrupted essence” will be passed on through sex.

Also, there are many beliefs within CAM that are incompatible with science, but more specifically with the science behind vaccination, as the authors further note:

Besides these implicit reasons, some CAM traditions are theoretically incompatible with vaccination and portrayed as a valid, or even superior, alternative to scientific knowledge.51 A quantitative study found that pro-CAM and anti-vaccination attitudes both reflect beliefs contrary to basic scientific knowledge, such as “an imbalance between energy currents lies behind many illnesses” and “an illness should be treated with a medicine that has properties similar to those of the illness.”31,53 An example of these CAM-related beliefs that contradict the theoretical basis of vaccinations is “homeopathic immunization” through so-called “nosodes” – orally administered extreme dilutions of infectious agents.54 Similarly, Rudolf Steiner and Ryke Geerd Hamer, promoters of anthroposophic medicine and German new medicine, respectively, have sown doubts about vaccinations based on their conceptions of the etiology and treatment of diseases.55 Consequently, strong science denial and vaccine hesitancy can be found within these communities,56,57 and outbreaks of vaccine-preventable diseases, such as measles and whooping cough, have been reported in educational centers linked to anthroposophy.58

This correlation resulting in the phenomenon of CAM being linked to outbreaks of vaccine-preventable disease is something that we’ve discussed for a long time, a discussion that has continued since COVID-19 arrived in 2020. But why are there such differences between nations in the percentage of CAM-positive/vaccine-negative physicians? The authors note several potential reasons. Germany, for instance, has recognized natural health practitioners (heilpraktiker) since the late 1930s, something we’ve discussed before and something that Prof. Ernst has often mentioned. It is also common for German physicians to provide CAM – around 60% in some surveys, cited by the authors. The authors also note that CAMis embedded in the French healthcare system; indeed, recall right before the pandemic how French physicians speaking out against homeopaths and their quackery and formed fake médecine to combat homeopathic quackery were threatened with the suspension of their medical licenses. All is not bad in France, though, as the country recently stopped reimbursing its citizens for homeopathic treatments in 2021. In contrast, CAM is not integrated into the Finnish or Portuguese healthcare system, supporting my longstanding contention here that government regulation and incentives matter—a lot.

There are many examples of physicians for whom the linkage between alternative medicine and antivax beliefs is clear, something I’ve started calling a seamless simultaneous embrace of quackery and antivax views. For instance, the “early COVID-19 treatment” doctors (such as America’s Frontline Doctors and the Frontline COVID-19 Critical Care Alliance) started out promoting “early treatment” protocols for COVID-19 that often involved repurposed drugs plus a panoply of supplements, basically a CAM approach to treating COVID-19. Now, they are fully antivaccine. In the other direction are doctors like Dr. Peter McCullough, who started out being against COVID-19 mitigations, moved on to become anti-COVID-19 vaccine to the point of embracing the conspiracy theory that the vaccines were causing young people—even athletes!—to “die suddenly,” and then became fully antivaccine, who now hawks supplements containing nattokinase and bromelain to treat “spike protein” toxicity due to COVID-19 or, more commonly, the bogus claim that COVID-19 vaccine poison you with spike protein. Then there’s Tess Lawrie, who went from supporting ivermectin to COVID-19 antivaccine beliefs to an outright embrace of homeopathy. The list goes on.

The bottom line to me, though, is that the integration of quackery into medicine through the specialty of “integrative medicine” or “integrative health” has a malign influence on more than just the science of medicine. It represents a direct threat to public health not only through its undermining of the scientific basis of medicine, but how that undermined science results in increasing distrust of vaccines by physicians that will inevitably contribute to increasing distrust of vaccines and public health among their patients. Unfortunately, the alignment of believers in CAM and antivaccine beliefs with powerful right wing ideological interests has made the likelihood of increasing acceptance and tolerance of quackery in medicine more, not less, likely.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

71 replies on “Quackery and antivax are inseparable”

So curious how “quackery” never seems to apply to big pharma therapeutics that don’t actually work. I wonder why that is.

We won’t get an informative answer from this one.
But for us, the reason is that real pharmaceutical drugs have to show both safety and some efficacy in trials to get licensed. That by definition makes them Not Quackery.

We can learn about more subtle or less frequent problems once they are in widespread use. And that may lead to their being delicensed (which never happens with quackery).

And sometimes the evidence of efficacy is pretty marginal (like in the Alzheimer’s drugs). And in those cases, we’ve seen Orac point that out.

Of course these drugs do get hawked on TV and in magazines and elsewhere. And that can be perceived as a bit quackish.

Of course these drugs do get hawked on TV and in magazines and elsewhere.

That’s just greed and one of the downsides of free markets–not Pharma per se.

And there might be patients organisations that might put some pressure to get these medicines on the market. And there are instances where patient organistations get some financial support from companies that produce medicines.

like what specifically?

if actual medicine is shown to be ineffective (if it ever reaches the market) it would quickly be withdrawn. Unlike actual quackery that keeps getting used for years and decades despite being shown to be ineffective.

No matter how hard you try to paint them as the same, they are not the same.

@ Orac,

Cherry picking homeopathy is akin to one rotten apple spoils the whole barrel.

Aroma and massage therapy are CONFIDENTLY cherry picked from integrative medicine to improve vaccinated patient well-being.

I get this one a lot from “friends”. I end up granting them that aromatherapy MAY reduce stress for some which MAY be considered an effect. Of course this is usually followed by something like “science doesn’t know everything”.

But what about all the people who find aromatherapy scents disgusting? I’m not even talking about everyone who is allergic to the scents (common) but even just the people who find “relaxing” scents aggravating, nauseating or upsetting?

Smelling something that makes me gag could hardly be described as “improving my well-being”.

You are right. I can’t stand some kinds of incence, my neightbours sometimes tend to burn, especially on summer days. I prefer the smell of their cooking.

“So curious how “quackery” never seems to apply to big pharma therapeutics that don’t actually work. I wonder why that is”

Technically it does, after all, homeopathic remedies aren’t made in a hedge-witch’s boudoir are they?

Sure, let’s apply the term “quackery” to Big Pharma products.

Take for instance the global homeopathic drug market, which exceeded $6 billion in 2020 and is projected to reach nearly $20 billion by 2030.

That’s a pretty big chunk of quackery revenue flowing into large corporations like Boiron.

Quackery is everywhere.

Besides some examples pointed out by Orac, the flu vaccine is also quackery.

Flu vaccine neither prevents the flu nor does it prevent severe outcomes. It is a completely useless treatment. Recently, effectiveness of the flu vaccine in seniors was -2%, statistically indistinguishable from zero (I have links).

That said, flu vaccine is promoted by the medical industry and doctors are required to be flu vaccinated by their employers.

This does not help these doctors be healthier, however it makes sure that “doctors believe in vaccines”, because those who do not believe in flu vaccines get fired and are no longer doctors.

All this perpetuates the cult behavior, because requiring doctors to take useless products, to make sure that all doctors believe in useless products, cannot be described other than cult behavior.

I am very sorry for doctors taking mandated flu vaccines, I hope their salaries make it worth it.

Flu vaccine neither prevents the flu nor does it prevent severe outcomes. It is a completely useless treatment.

Interesting then that my Medical Insurer, which has specialists called actuaries to look at the matter, disagree with you. It not only pays for my flu shots, but gives me points for getting it.

Recently, effectiveness of the flu vaccine in seniors was -2%, statistically indistinguishable from zero (I have links).

Yet you didn’t provide them. Which is getting to be a habit with you.

(Igor) Recently, effectiveness of the flu vaccine in seniors was -2%, statistically indistinguishable from zero (I have links).

(Julian) Yet you didn’t provide them. Which is getting to be a habit with you.

Sorry, made a mistake, effectiveness of flu vaccine at preventing severe outcomes in seniors is -3%, not -2% as I mentioned (statistically indistinguishable from zero). I am becoming forgetful!

The source is this CDC presentation, page 24, Vaccine effectiveness against laboratory confirmed influenza A/H3N2 in inpatient setting, 2022.

https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2022-10-19-20/04-influenza-chung-olson-lewis-508.pdf

It says right that that adjusted VE against hospitalization in seniors is -3%.

For people over the age of 18, the VE against hospitalization is +11%, also statistically indistinguishable from zero.

You picked this one (senior inpatients):
≥65 years 90/156 58 343/551 62 17 (-19 to 42) -3 (-54 to 31)
Not this one (senior outpatients):
≥65 years 17/23 74 332/412 81 32 (-79 to 74) NR3 NR3
(That is, 32%)
You notice the error margin. Actually, VE is not known

When mandatory flu vaccination was first instituted at my hospital, there were a very few protesting physicians*, but the vast majority recognized the need to protect vulnerable patients, especially the immunosuppressed and elderly, as well as themselves.

“I have links”

We knew that your subscription to the Epoch Times would come in handy.

*correlation with AAPS membership was probably strong.

I suspect that “I have links” without the links is for a reason. One possible reason, as you suggest, is that the link is to an unreliable source. But ti could also be links to a junk study, a study that does not actually show what is claimed, and so forth.

A few messages above, I posted a link (and pointed to the page) to the CDC document from 2022. Information from the CDC itself, not some conspiracy website.

Igor, your dishonesty of statistical use is showing once again. If a CI contains zero that is indicative of no statistical effect — period. It makes no sense to select either endpoint and say “see, this is bad” or “see, this is good”. The endpoints are no more likely to be correct than any other value in the interval — it isn’t like looking at the tails of a normal distribution.

Another comment: those intervals are huge, indicating a very large standard error in the underlying point estimate. Just as you never make a decision based on a p-value alone, you should never examine an interval without looking at issues around it.

And you do not understand error margins. Next exercise for you: find a study with more participants and a reasonable error margin,

“…could also be links to a junk study, a study that does not actually show what is claimed, and so forth.”

Crank sources like the Epoch Times are well-known for publishing stories about junk studies or wildly misrepresenting more credible research. Natural News is famous for the latter, expecting that its gullible readers won’t bother wading through the actual papers.

Looking at your link, that’s quite a bit of both cherry picking and misreading.

The confidence intervals are huge. The results are not very good. And focusing on that one number (ignoring other numbers that show substantially higher effectiveness) out of one powerpoint presentation (not a published study) while ignoring other data (several studies linked here: https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm) is cherry picking.

You are absolutely correct!

The confidence intervals are huge, effectiveness is indistinguishable from zero, despite this being a very large nationwide study.

This means that flu vaccine does not work, and therefore it is medical quackery, just like homeopathy etc.

Forcing doctors to submit to medical quackery perpetuates it.

I am very sorry for the doctors involved…

Error margins were huge, and so results are ambigous, not zero. Huge natiowide study had few hundred seniors.
You will notice thay numbers you do not cite, with more participants did show non zero efficiency
As I said would you trust a measurement that told your length is 175+-150 cm

This means that flu vaccine does not work,

Not necessarily igor. It means that one set of data did not detect an effect. There are many possible reasons. Just as we don’t do a single hypothesis test and make an overarching conclusion, we don’t look at the results of one interval and do so [I would ask if you realize that hypothesis tests and CIs are mirror images of each other, but your history of using and citing statistics indicates you don’t. ]

The N for that specific number was 343+90=433 vaccinated people, 551+156=707 total. So not exactly “very large”. Remember that you zeroed in on one sub-result (and ignored the fact that these are preliminary results, too).

Note the comments from the scientists about your misinterpretation, and note that you ignored the point about cherry picking within the powerpoint and compared to other data.

At best, this suggests lack of understanding. At worst, it is dishonesty.

Dangerous Bacon,

Please explain to me, in simple words, how can a vaccine with no effectiveness, taken by doctors, “protect vulnerable patients, especially the immunosuppressed and elderly”.

Like, how is it supposed work?

Read my question again.

how can a vaccine with no effectiveness, taken by doctors, “protect vulnerable patients, especially the immunosuppressed and elderly”

How can a doctor taking the vaccine, protect patients, when the vaccine does not even prevent influenza?

And also, “25% effectiveness in a good year when there was a good match between circulating influenza viruses and selected vaccine strains.”, per the study you cited, sounds like a joke to me.

Medical quackery, sadly, reaches deeply into the medical field.

I completely agree with Orac that high-dolution homeopathy is quackery – but so is the flu vaccine, and many other things

@ Dangerous Bacon

My favorite Kosher pork. Great article, thanks for finding it.

To Igor:
This study has 44 456 participants. So tell difference between this study and your link

Vaccines advantageously dampen the immune response?

A study showed that among individuals recently infected with SARS-CoV-2, those who were fully vaccinated had lower concentrations of almost all cytokines and chemokines than those who were unvaccinated in the short-term and long-term after symptomatic SARS-CoV-2 infection.

https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(23)00171-4/fulltext

MJD says,

In continuation, a history of allergies has a beneficial dampening-effect on the immune response during acute infection.

https://ijsra.net/sites/default/files/IJSRA-2021-0196.pdf

@Igor Chudov You should answer my question: Do you understand error margins ? Smallstudy withhuge error mrgins o not prove.
Doctors could of course spread flu to their patients, Vccins o not prevent ransmission is and old trope.Perhaps you have some data ? With reasonable error marrgin.

Dochniak Do you know infection causes cytokines ? It is natural that you more them afr infection.
Causing allergic reactions is positively dangerous. Do not do it. You could be sued for it

Aarno Syvänen writes,

“Causing allergic reactions is positively dangerous. Do not do it. You could be sued for it”

MJD says,

The ultimate goal is to use the power of IgE-effector cell complexes to safely and effectively inhibit metastases (stage IV cancer.) The risk of complications from allergies often do not outweigh the life-threatening situation of a solid tumor(s) growing out of control and metastasizing.

I’m thankful that Aarno Syvänen acknowledges the “positively dangerous” affect of allergies. In the spirit of cancer immunotherapy, we continue to evaluate the allergy cascade as a tool to increase the five (5) year survival rate of patients with terminal stage-IV cancer.

@ Orac,

We’ve come full circle, avoiding allergies during early childhood development (i.e., allergy-induced regressive autism) to inducing allergies to inhibit metastatic cancer. MJD teaches that aspects of “Integrative Medicine” may be helpful to enhance well-being during cancer immunotherapy.

If you have a link, post it ? Why this this is such a problem to you ?
I remember this one. You picked lowest number, and lowest patnof error margin.
This is not how to evaluate data.

In light of the above and recent comments on other posts, it might be relevant to discuss credible or reliable sources. ( e.g. SCRIBBR; CRAAP test )

If you write a report, essay or dissertation on RW phenomena, you usually need to provide sources AND not all sources are created equal.
Wikipedia does not allow many sources that anti-vaxxers/ alt med folk would readily accept. Why is that?
Much of what I survey is weak : often anything goes. Asserting something ( vaccines kill) or speculating based on opinion or what people say does not make the grade. Contrarians may use research that is not peer reviewed or from reasonable journals.

Alties/ anti-vaxxers usually find a way to scare readers away from standard sources by saying that experts are paid off or out of date. OF COURSE they do! Reliable sources negate them with RW evidence. In addition, good sources reinforce each other. Scoffers may say that all of them are hypnotised or reading from the same script but it is because they reference evidence of the same phenomena over and over.

Scoffers may say that experts have been wrong before but, while no source is 100% perfect, some are much better than others. In the old days, people read newspapers and watched television news but with growth of the internet/ social media, anyone can be a reporter, opinion writer, expert or trend caster but it doesn’t mean that they write anything of value.

Because most people DON’T study medicine/ bio/ psych in great detail, those topics are prime targets for poseurs who pretend expertise.

To compare this to general news: repetition solidifies a story much as repetition consolidates memory. During the fog of war, many reports trickle in but careful study shows that eventually a sameness becomes apparent about a particular event.
If you doubt a particular source, read others. There are international news reports available in the original or translation. I read/watch MSNBC, BBC. CBC as well as Le Monde, RAI and NHK English.

Someone’s Substack or X is not the same.

“Scoffers may say that experts have been wrong before”

…but their preferred pseudo-experts are never wrong, and have Twitter polls to prove it.

Yes, because if it’s proven they are wrong, like with Ivermectin, the proof is rigged, because Big Pharma………………..

Here we are, deep inside the mind of igor:

“Hmm. Which is more reasonable: that all of the studies supporting the use of vaccines are correct, or that my suspicions that everyone involved in them has been tainted by some worldwide group led by Bill Gates and the Club of Rome are correct?

I’m a smart guy so I’ll go with the notion that all medical people have been tainted (unless they agree with me) and my views are the correct ones. Besides, that pays the bills on substack.”

@ Igor Chudov

The stats you give are the lower part of a 95% confidential interval. The closer one gets to the lower or upper part of a confidential interval, the lower the probability. Just look at a normal curve. So, not impossible that the lower number is correct; but probability very very low. Also, flu vaccine protection much much better for H1N1. H3N2 not as good; but still better than nothing. The risk from the flu vaccine is so minuscule that even reducing my risk by 10% of being hospitalized still worth a few hours of a sore arm. Check out CDC webpage: Vaccine Effectiveness: How Well Do Flu Vaccines Work? https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
Gives a list with links to a number of studies, not just one.

You have NEVER indicated you understand even a minimum of how immune system works. If infected, first line of defense, innate immune system, sometimes can stop infection cold or, at least, slow down and, at same time, alert the adaptive immune system, B-cells that lead to antibodies and T-cells. Takes about 14 days for adaptive immune system to rev up, but by that time we have suffered, possibly even hospitalized. Then memory immune cells also created that can protect us against same infection again. All that a vaccine does is set in motion the memory immune cells, exactly same; but without us suffering infection.

Orac, myself, and numerous others have torn to shreds your many comments; but you are either too stupid to understand, mentally disturbed, and/or just plain “intellectually” dishonest. I put “intellectually” in quote because I doubt your intellectual abilities.

Yes, exactly, a large CDC study found that flu vaccine does NOT work and its effectiveness is indistinguishable from zero, with the center point BELOW zero.

Yet they still push it. How is this NOT quackery?

Large study with few hundred participants and huge error margin. As I said find a study with more participant ans smaller error margin
You picked one number among many, too.

No, -3% is the MIDDLE of the confidence interval

So what? Igor, when a CI indicates no statistical significance no single number in that interval matters, whether in the center or at near either end.

Good lord that was a stupid comment.

Hmmm — error when I first tried posting this.

No, -3% is the MIDDLE of the confidence interval

It doesn’t matter Igor — no single value of a confidence interval is more or less likely than any other, whether the interval is one that indicates significance or one that does not indicate significance. Maybe you should apply your critical reading (snort, guffaw) to a text on introductory statistics.

re sources…

Don’t people study this in secondary school? Which sources are valuable, which aren’t and how to tell the difference.
University writing courses focus upon research skills and how to develop and present ideas. I sometimes wonder who is reading anti-vaxxers/ alt med writers because their audience willingly accepts fanciful and unlikely assertions without evidence.
Thousands were killed by the vaccine babies were murdered evil actors manufactured a virus it was a plandemic

Those I survey (mis-re)present themselves as educators and informers- even as a news service- HOWEVER their material runs counter to realistic sources so they need to discredit those sources and steer followers away from them. One grand old woo-meister especially despises Wikipedia- having written scores of exposes of it- and Orac himself. They discourage media reports and – often- universities, which are vastly inferior to their revelations. Governmental sources and medical research fall far short. They present “Brighteon University” or a “classroom on the air” in their cargo cult cosplay. NN, prn.live

Substack is an especially virulent variant of alt med/ anti-vax because writers post long winded recitatives that savage SBM and reasonable writers/ news reports in displays of opportunistic contrarianism: they doubt most everything that is current and often side with reprehensible characters that are authoritarians or like minded frauds. They can make money without selling supplements or writing books but must keep up the supply to satisfy readers.

There’s more but I’m tired.

Don’t people study this in secondary school? Which sources are valuable, which aren’t and how to tell the difference.

Nope — they study critical reading instead.

@ Idw56old:

Heh!

With several Substackers ( and alt med/ anti-vax proselytisers), I get the distinct impression that they would function as revelators, I use that term to suggest a religious aspect, faith in the unseen, that they possess a secret knowledge of hidden truth beyond the illusions and deceits of everyday life that produces mundane reporters, experts and scientists, whilst they tear the veil, revealing the ultimate nature of reality.

They ask readers to reject the bulk of what is written/ discovered about phenomena and to substitute their own speculation/ belief into the workings of biology, commerce or international politics, being masters of all they survey.
Seers, prophets or Saviours/ Moshiachs, call them what you will, they will not be shy about it: they assert that they were right long ago and NO ONE listened to them just like the Prophet in his own town but now, doom is upon us – their time has arrived.

Most of those I survey invoke religious themes and endtimes scenarios.

I remember learning about how to identify reliable sources back in 6th grade, but that was when the internet was new, so I assume things have changed a bit in how that’s taught in the interum.

“Don’t people study this in secondary school?”

My experience from a teaching career spanning four decades: just because you teach it doesn’t mean they learn it. To put a finer point on it, just because they learn how, doesn’t mean they apply it consistently.

When a student looks to reliable sources for use in a paper assignment, that’s a kind of superficial intellectual exercise. That’s quite different than the search for some emotionally confirming revelation — I take your usage to be quite apt, though I think it’s a secular phenomenon following a religious pattern and function. By definition, revelation is NOT going to be found from the usual legitimated sources.

I would guess people turn to very different sorts of sources for uncovering ‘the truth about vaccines!’ say, vs. something like finding a good value on a new set of automobile tires.

I have a new theory about some of these quacks using their license to make money before inevitable board action based on a recent example but will have to post more later when I don’t have an ER full of COVID

You’ll have to forgive Igor for appearing more unbalanced than usual; he’s probably still miffed about not being given recognition for one of his lame-brained Covid conspiracy theories.

One of his Substacks attacks a factcheck which debunked the claim that Covid vaccines cause “VAIDS”, in particular an article which appeared on the U.K. conspiracy-promoting fake news website “The Exposé”, founded by a British welder. It’s one of a series of articles on this imaginary syndrome, with others being written by such distinguished Exposé journalists as “A Concerned Reader” (you can’t make this stuff up) or vaguely attributed to staff. “VAIDS” nonsense has gotten some attention partly because it sucked in the Brazilian President (Bolsonaro), but has been thoroughly exposed (sorry) as crap by various informed sources and fact-checking organizations. Which brings us back to poor Igor, frustrated because a fact-check article in Tech ARP stomped all over one of The Exposé’s “VAIDS” articles written by none other than Igor – but Tech ARP didn’t “credit” him (The article is by-lined as By The Exposé, so any confusion is understandable). Bottom line: Igor seems to care far more about not getting publicity (and a possible boost in his Substack subscriber base) from being published on a horribly unreliable crank website than about the gross errors and misinterpretations in his article. The published study used as the jumping-off point for Igor’s rant, doesn’t mention “VAIDS” or anything about real-world susceptibility to infections, cites other evidence contrary to its in vitro findings and mentions the possibility that Covid vaccines actually improve immune responses to non-Covid pathogens (Ignorant Igor ignores all this and more).

The offending factcheck with link to the original study:

http://techarp.com/facts/covid-vaccines-vaids-children/

Thank you for mentioning the Tech ARP fact check by Adrian Wong. It was the first fact-check of my article (even though they referred to The Expose UK), and sadly not a very good one.

A much better fact check was written by Lead Stories and is located here:

https://leadstories.com/hoax-alert/2023/09/fact-check-government-report-did-not-find-millions-of-children-vaccinated-for-covid19-developed-vaids.html

Its author, Madison Dapcevich, did a much more thorough job. She also referred to a repost of my post in a fake news website ThePeoplesVoice.

Note: all fact checks always pick the worst source to debunk, for several reasons, the main one being the “inoculation theory”, an unethical approach to closing minds with “inoculation with weakened form of misinformation”. So they try not to refer to sites with well-written and deeply researched material and instead highlight fake news websites.

No matter, going back to Madison Dapcevich, she did a much better job debunking my post than Mr Wong. She contacted the study authors, etc. The authors denied that their study finds VAIDS in children and pointed out that they did a similarly designed BCG vaccine study, also finding “similar changes”.

Except the changes were NOT similar and the BCG to Covid vaccine comparison is very damning for the COVID vaccine, further buttressing my VAIDS conclusion. But I understand why the authors would want to not associate with my interpretation of their findings.

It is funny how Covid vaccine reporting works: I am not a doctor nor a biologist; the Expose guy is a weldor; The TechARP guy Wong is a computer writer; Madison Dapcevich is a former Alaska fishing boat deckhand and has a degree in environmental studies. All of us are busy being visible, discussing and debunking complicated biological issues. It is so ridiculous!

further buttressing my VAIDS conclusion

Igor, you devotion to conspiracies, even after the issues the supposedly address have been shown to be completely bogus, just continues to sink your “reputation” to Marianas trench level lows.

You are right about one thing: you are neither a doctor nor a biologist: you’re simply the grown up version of the 5-year old who tells the most outrageous lies every time he opens his mouth — or in your case, begin typing.

So, you admit misrepresenting a research study and being ludicrously unqualified to discuss “complicated biological issues”.

Good to know.

While preening in the knowledge that someone finally took the trouble to factcheck one of your obscure antivax articles, you should realize that you’re way down the list of cranks in that regard (for instance, Steve Kirsch is into double figures). Keep plugging away though and you might move up the ranks, with a chance of making the Disinformation 500. 😉

“All of us are busy being visible, discussing and debunking complicated biological issues. It is so ridiculous!”

Some self awareness?

It’s as if power cycling a computer to solve a problem makes your opinions on default gateway configuration worth something.

And I’m a goddamned pornographer, not a doctor. Does that mean you’ll listen to what I have to say about vaccines?

Alright, listen when I say this then:

There are many very nice people on this blog who have been answering the questions you’ve been asking, providing the links you’ve been curious about and doing their best to explain complicated medical concepts in a way that even i can understand. When you ask for numbers they give you the ones that are available. When you ask why something might or might not be so they explain it and give receipts.

Yet every time, in discussion thread after discussion thread, you ask the same questions and seem to get frustrated when told that you’ve already been given the answers. You wonder about the same things without showing any greater understanding despite the information that’s been provided to you. When you are shown to be wrong, that the numbers you are using are either cherry picked or outright made up you shrug and insist that the real numbers that back up what you are saying must be out there, or that there are different studies by different people that still prove you right.

Did it ever once occur to you that the whole world other than you the statistically minuscule number of people who agree with you aren’t all in on a world wide conspiracy, involving every government and health agency on the planet and that instead you might be wrong?

I don’t mean paying lip service by saying ‘Oh, yeah, I could be wrong’, I mean seriously examining your views and considering the enormity of the conspiracy necessary to make them true, then stepping back and weighing if something that big could be real.

Is every doctor, every world leader in every country (even countries that are actively at war with each other), every member of the pharmaceutical industry right down to the janitors, interns and Sally the secretary with a terminally ill daughter who’s in danger of losing her job because of the amount of time she needs to take off to care for her, willing to sacrifice themselves and everyone they know, and every one they don’t know, in fact the whole world, just to keep the conspiracy going and keep down those who know the truth?

@Silex, you see I did listen to you! You made some interesting points.

Regarding “the whole world”. The whole world, with the exception of the United States, phased out Covid vaccines for [healthy] people under 65.

The United States is an outlier, recommending untested Covid shots to infants 6 months old.

So if, as it seems, “the whole world” is something whose opinion you like to follow, you need to ask why does the United States recommend Covid shots to infants as of October 2023.

@Igor:

Regarding “the whole world”. The whole world, with the exception of the United States, phased out Covid vaccines for [healthy] people under 65.

WHO covid vaccine recommendations dated August 2023:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines/advice

Medium priority group includes:
Healthy younger adults – adults without comorbidities under the age of 50 to 60 years (age thresholds depend on countries)…
For this group, WHO recommends the primary series and first booster dose.

Please note: The “W” in WHO stands for “World”.

Want to respond to Orac? Here's your chance. Leave a reply! Just make sure that you've read the Comment Policy (link located in the main menu in the upper right hand corner of the page) first if you're new here!

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: