tag:theconversation.com,2011:/global/topics/andrew-wakefield-2029/articlesAndrew Wakefield – The Conversation2021-08-25T12:27:47Ztag:theconversation.com,2011:article/1664012021-08-25T12:27:47Z2021-08-25T12:27:47ZUnverified reports of vaccine side effects in VAERS aren’t the smoking guns portrayed by right-wing media outlets – they can offer insight into vaccine hesitancy<figure><img src="https://images.theconversation.com/files/417267/original/file-20210820-19-1ul7s7t.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Studying trends in public adverse event reporting could help researchers address vaccine hesitancy and misinformation.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/symbol-of-the-manipulation-of-information-on-royalty-free-illustration/1287191706">Pict Rider/iStock via Getty Images Plus</a></span></figcaption></figure><p>Chances are you may not be not familiar with <a href="https://vaers.hhs.gov/about.html">the Vaccine Adverse Event Reporting System, or VAERS</a>. Co-managed by the U.S. Centers for Disease Control and Prevention and the Food and Drug Administration, VAERS was established in 1990 to detect possible safety problems with vaccines.</p>
<p>Unfortunately, the anti-vaccine movement has used this once-obscure database to spread <a href="https://www.vice.com/en/article/qjpmp7/anti-vaxxers-misuse-federal-data-to-falsely-claim-covid-vaccines-are-dangerous">misinformation about the COVID-19 vaccine</a>.</p>
<p>VAERS is ripe for exploitation because it relies on unverified self-reports of side effects. Anyone who received a vaccine can submit a report. And because this information is publicly available, misinterpretations of its data has been used to <a href="https://www.npr.org/sections/health-shots/2021/06/14/1004757554/anti-vaccine-activists-use-a-federal-database-to-spread-fear-about-covid-vaccine">amplify COVID-19 misinformation</a> through <a href="https://www.npr.org/sections/health-shots/2021/06/14/1004757554/anti-vaccine-activists-use-a-federal-database-to-spread-fear-about-covid-vaccine">dubious social media channels</a> and mass media, including one of the <a href="https://www.factcheck.org/2021/05/scicheck-tucker-carlson-misrepresents-vaccine-safety-reporting-data/">most popular shows on cable news</a>.</p>
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<p>We are <a href="https://scholar.google.com/citations?user=v6UjvxIAAAAJ&hl=en">political scientists</a> <a href="https://scholar.google.ca/citations?user=05S4uMoAAAAJ&hl=en">who study</a> the social, political and psychological underpinnings of vaccine hesitancy in the U.S. In our <a href="https://doi.org/10.1371/journal.pone.0256395">recently published research</a>, we argue that VAERS, despite its limitations, can teach us about more than just vaccine side effects – it can also offer powerful new insights into the origins of vaccine hesitancy in the U.S.</p>
<h2>What the side effects database was designed to do</h2>
<p>Medical experts at the Department of Health and Human Services are <a href="https://apnews.com/article/fact-checking-afs:Content:9957832237">well aware of</a> <a href="https://vaers.hhs.gov/data/dataguide.html">VAERS’ limitations</a>. Rather than taking each individual report at face value, regulators remove clearly fraudulent reports. Demonstrating this, anesthesiologist and autism advocate James Laidler once used the system to report that a vaccine <a href="https://www.beckershospitalreview.com/data-analytics/some-self-reported-cdc-data-fueling-the-anti-vaccination-movement.html">turned him into the “Incredible Hulk,”</a> which was only removed <a href="https://web.archive.org/web/20130419004549/http://neurodiversity.com/weblog/article/14/chelation-autism">after he agreed to have the data deleted</a>.</p>
<p>Regulators also look for <a href="https://www.bloomberg.com/news/features/2021-04-28/is-covid-vaccine-safe-doubt-around-shots-threatens-to-extend-the-pandemic">reporting patterns</a> that can be corroborated by additional evidence. For example, reports of Guillain-Barré syndrome should be <a href="https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html">more common in people over 50</a> than in younger adults. This can <a href="https://theconversation.com/new-covid-19-vaccine-warnings-dont-mean-its-unsafe-they-mean-the-system-to-report-side-effects-is-working-164455">help researchers</a> identify potential adverse events that were not detected in clinical trials.</p>
<p>Because VAERS claims are self-reported, they tell us something about what ordinary people, as opposed to doctors and medical researchers, think about vaccine safety. In other words, people who feel that a vaccine is responsible for a side effect they might be experiencing can log that concern with the federal government, whether or not those claims would stand scrutiny in rigorous clinical testing.</p>
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<a href="https://images.theconversation.com/files/417462/original/file-20210823-17-1mp2j8y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Red breaking news banner behind two vials of COVID-19 vaccine." src="https://images.theconversation.com/files/417462/original/file-20210823-17-1mp2j8y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/417462/original/file-20210823-17-1mp2j8y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/417462/original/file-20210823-17-1mp2j8y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/417462/original/file-20210823-17-1mp2j8y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/417462/original/file-20210823-17-1mp2j8y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/417462/original/file-20210823-17-1mp2j8y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/417462/original/file-20210823-17-1mp2j8y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Media stories on vaccine side effects can influence public sentiments toward vaccination.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/covid-19-vaccine-in-the-tv-studio-royalty-free-image/1288842567">MikeMareen/iStock via Getty Images Plus</a></span>
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<p>Consequently, VAERS reports might not only document people’s negative experiences with vaccination, but also their attitudes toward vaccination. People may be more likely to report side effects, for example, in response to media stories about vaccine safety concerns. If reports to VAERS increase following these stories, then the reporting system may be functioning similarly to a public opinion poll. It could reflect, in part, public attentiveness to and concern about potential side effects. To see if this is the case, we examined a well-known case of vaccine misinformation: the since-retracted paper that claimed a link between the Measles, Mumps, and Rubella (MMR) vaccine to childhood autism.</p>
<h2>Is a fraudulent study responsible for MMR vaccine skepticism?</h2>
<p>In 1998, former physician Andrew Wakefield and his colleagues published a <a href="https://dx.doi.org/10.1503%2Fcmaj.109-3179">since-retracted</a> paper claiming that the MMR vaccine could cause autism in children. Although the study was rife with unreported conflicting interests and data manipulation, it nevertheless garnered <a href="https://doi.org/10.1542/peds.2007-1760">significant media attention</a> in the late 1990s. <a href="https://time.com/5175704/andrew-wakefield-vaccine-autism/">Some journalists</a> and <a href="https://doi.org/10.1016/j.vaccine.2010.02.052">researchers</a> have since argued that the paper played a major role in inspiring <a href="https://doi.org/10.1016/S1473-3099(20)30522-3">MMR vaccine hesitancy</a>.</p>
<p>While this is plausible, there hasn’t been evidence to support the argument. <a href="https://doi.org/10.1371/journal.pone.0256395">Virtually no opinion polling about MMR</a> existed prior to the publication of Wakefield’s paper. Consequently, researchers have not been able to directly observe whether or not the study influenced how Americans think about the MMR vaccine.</p>
<p>VAERS data, however, could offer some clues. In our study, we examined whether the number of VAERS reports following publication of Wakefield’s paper was significantly greater than expected based on typical report numbers prior to its publication. We found that the number of adverse event reports for MMR <a href="https://doi.org/10.1371/journal.pone.0256395">increased by about 70 reports per month</a> following publication of the paper. This is significantly greater than what we would expect by chance based on previous reporting frequencies. Notably, we did not find a similar effect for other childhood vaccines in the same time period. This further underscores the power this since-debunked study has had in shaping public opinion about the MMR vaccine.</p>
<p>Importantly, we also found that adverse event reporting rates <a href="https://doi.org/10.1371/journal.pone.0256395">rose in tandem with negative media coverage</a> of the MMR vaccine. Following the publication of Wakefield’s paper, television and print news published significantly more stories about MMR than before the paper was published. These results suggest that Wakefield’s article influenced how much more attentive Americans were about the MMR vaccine.</p>
<h2>VAERS: A double-edged sword</h2>
<p>In recent months, interest in the side effects reporting system has been growing exponentially. Google search engine trends suggest that more <a href="https://trends.google.com/trends/explore?geo=US&q=VAERS">Americans have been looking up VAERS</a> than ever before. The trend began shortly after <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-key-action-fight-against-covid-19-issuing-emergency-use-authorization-first-covid-19">emergency use authorization of the first COVID-19 vaccines</a> in the U.S. and has continued to increase until a peak in early August.</p>
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<p>This search behavior is likely a result of increased media attention to VAERS, particularly by right-leaning news outlets. According to the data from media research platform <a href="https://mediacloud.org/about">Media Cloud Explorer</a>, there have been 459 stories in mainstream national news outlets, such as CNN or the USA Today, mentioning VAERS since December 2020. In right-wing media outlets such as Fox News, The Daily Caller and Breitbart, however, coverage soared to 3,254 stories – over seven times more than mainstream news media.</p>
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<p>Consequently, VAERS data could be seen as something of a double-edged sword. On one hand, it has been <a href="https://doi.org/10.1126/science.abj6981">weaponized by the anti-vaccine movement</a> and <a href="https://doi.org/10.1017/S0008423920000396">political actors on the right</a> to sow doubt and distrust about COVID-19 vaccinations. On the other hand, this data could also tell public health researchers something useful about how American vaccine skepticism might ebb and flow in response to events like the brief <a href="https://www.fda.gov/news-events/press-announcements/fda-and-cdc-lift-recommended-pause-johnson-johnson-janssen-covid-19-vaccine-use-following-thorough">pause in Johnson & Johnson COVID-19 vaccine administration</a>, or fluctuations in the tone of media coverage about COVID-19 vaccines.</p>
<p>VAERS data may even offer an important advantage over public opinion polls which, with the exception of <a href="https://morningconsult.com/covid19-vaccine-dashboard/">weekly vaccine uptake polls</a>, have typically been administered much less frequently. Our research cautions that media attention to discredited vaccine-related claims may undermine public confidence in vaccination.</p>
<p>[<em>Understand new developments in science, health and technology, each week.</em> <a href="https://theconversation.com/us/newsletters/science-editors-picks-71/?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=science-understand">Subscribe to The Conversation’s science newsletter</a>.]</p>
<h2>How to avoid another wave of misinformation</h2>
<p>To ensure that VAERS is used properly, journalists and scientific researchers can team up to guide the public on how to interpret new findings. Journalists should, in our view, contextualize their coverage within a broader body of scientific evidence. Scientific researchers can aid in this by helping journalists <a href="https://doi.org/10.1371/journal.pone.0248328">accurately portray studies on vaccine side effects</a>, clearly outlining their methodologies and results in accessible language.</p>
<p>By <a href="https://www.aaas.org/resources/communication-toolkit">working together</a>, researchers and journalists can take constructive action to address vaccine hesitancy before it has a chance to germinate.</p><img src="https://counter.theconversation.com/content/166401/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Anti-vaccine activists are using the side effect reporting system to spread fear and misinformation about the COVID-19 vaccines. But the database could also be used as a gauge for public concerns.Matt Motta, Assistant Professor of Political Science, Oklahoma State UniversityDominik Stecuła, Assistant Professor of Political Science, Colorado State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1242442019-10-08T09:59:29Z2019-10-08T09:59:29ZHow one NHS anaesthetist is fighting international medical research fraud<figure><img src="https://images.theconversation.com/files/295491/original/file-20191003-52816-1xz4g8g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/580066207?src=d1rtejMWJygp48hbv5Ub8A-3-10&size=medium_jpg">nhungboon/Shutterstock</a></span></figcaption></figure><p>John Carlisle is a consultant anaesthetist at Torbay Hospital on England’s south coast. Unless you’ve been one of his patients, you’ve probably never heard of him. But he’s a researcher too, and he’s <a href="https://www.nature.com/articles/d41586-019-02241-z">developed statistical methods</a> to help spot signs of fraud in medical research.</p>
<p>There’s a public image of medical researchers as being trustworthy people, working hard to make us all healthier. Scientists and doctors come right at the top of an <a href="https://thinks.ipsos-mori.com/trust-in-professionals-and-the-global-trustworthiness-monitor/">international survey</a> on the trustworthiness of professions. I’d say that image is deserved. But there are cases of very questionable research practice, or even downright fraud. </p>
<p>People usually remember the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831678/">discredited paper</a> published in The Lancet in 1998, linking the MMR vaccine to autism. Because of the major problems with that research, its lead author, Andrew Wakefield, was <a href="https://www.bmj.com/content/340/bmj.c2803">struck off</a> the medical register.</p>
<p>The Wakefield case is unusual, though. Most cases of research fraud are harder to spot and aren’t so widely publicised.</p>
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Read more:
<a href="https://theconversation.com/autism-and-vaccines-more-than-half-of-people-in-britain-france-italy-still-think-there-may-be-a-link-101930">Autism and vaccines: more than half of people in Britain, France, Italy still think there may be a link</a>
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<h2>Raft of retractions</h2>
<p>Carlisle and other anaesthetists got suspicious, more than a decade ago, about studies by a Japanese researcher, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914207/">Yoshitaka Fujii</a>. He published results from a series of <a href="https://www.ctu.mrc.ac.uk/patients-public/about-clinical-trials/what-is-a-randomised-clinical-trial/">randomised, controlled clinical trials</a> (RCTs) investigating medicines to prevent nausea and vomiting in patients after surgery. Carlisle, and others, thought the data was too tidy to be true. He <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2012.07128.x">showed</a> that it was extremely unlikely that some of the patterns in Fujii’s data had occurred by chance. Because of this and further investigation, Fujii lost his university job. </p>
<p>No less than 183 of his papers were retracted, that is, effectively “unpublished” by the journals concerned. That’s <a href="https://retractionwatch.com/the-retraction-watch-leaderboard/">far more retractions</a> than any other individual has had.</p>
<p>Since then, Carlisle has developed his methods further. In 2017, he produced <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/anae.13938">an analysis</a> of over 5,000 clinical trials. Most were published in journals in his own field, anaesthetics, but he also included two top-ranking American medical journals, the Journal of the American Medical Association (JAMA) and the New England Journal of Medicine (NEJM). He found suspect data in about 90 papers. </p>
<p>In some cases, there were innocent explanations. But there were several retractions. For instance, a <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1200303">major Spanish trial</a>, investigating whether a Mediterranean diet could help prevent heart diseases and strokes, had to be retracted. The random allocation of people to different diets had, in some cases, been done wrongly. A <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1800389">revised trial report</a>, omitting the wrongly randomised participants, appeared later.</p>
<h2>Adopted by medical journals</h2>
<p>Carlisle’s methods are now routinely used by at least two medical journals to screen reports of RCTs that are submitted for publication. They are Anaesthesia, in Carlisle’s own specialty, and the prestigious NEJM. Others may well follow. </p>
<p>Carlisle’s method does not definitely say whether a trial report is fraudulent. It’s a screening method that suggests that some trial reports need to be examined more thoroughly to check whether anything untoward is going on. There could, sometimes, be innocent explanations for the unusual patterns of data that the method detects.</p>
<p><a href="https://royalpapworth.nhs.uk/consultant-profiles/dr-andrew-klein">Andrew Klein</a>, the Cambridge-based anaesthetist who is editor-in-chief of the journal Anaesthesia, told me via email that the journal receives about 500 submissions of reports on RCTs each year. These are all checked using Carlisle’s method, and more than one in every 40 is detected as being potentially fraudulent. Not all of these will be fraudulent, but the journal asks to see the original patient data, checks it, and takes appropriate further action if necessary.</p>
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Read more:
<a href="https://theconversation.com/retraction-of-scientific-papers-for-fraud-or-bias-is-just-the-tip-of-the-iceberg-43083">Retraction of scientific papers for fraud or bias is just the tip of the iceberg</a>
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<p>Carlisle’s method builds on particular features of how randomised clinical trials are run. A simple RCT might compare how good two different drugs, A and B, are at curing a certain disease. Patients with the disease are divided into two groups. One group gets drug A, the other drug B. Then they are all followed up to see who is cured. </p>
<p>The key feature is that the division into groups is made at random. This is to ensure that the two groups of patients are similar, on average, in all respects. Then, if patients on drug A do better, one can be confident that this is because they took drug A rather than B, and not because of some other difference. </p>
<p>In publishing the trial results, the researchers must report on “baseline” comparisons between the two groups before they start the treatments. Carlisle’s method uses measures of discrepancies between the groups called <a href="https://towardsdatascience.com/p-values-explained-by-data-scientist-f40a746cfc8">p-values</a>, and he then combines all the baseline p-values in a trial into a single measure. </p>
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<figcaption><span class="caption">P-values explained.</span></figcaption>
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<p>His method will unearth trials where the two groups appear to be too similar to be true, or too different to be true. Both of these indicate that, possibly, the data has been invented or interfered with.</p>
<p>Carlisle’s method does make some statistical assumptions that aren’t always appropriate. But it’s a fairly simple approach that suggests some trials deserve more scrutiny. It’s a valuable part of the efforts to stop fraud in medical research. The question of why a small number of researchers should commit these frauds is complicated. I don’t believe all fraud will ever be eliminated from clinical research, but that’s no reason not to be vigilant.</p><img src="https://counter.theconversation.com/content/124244/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kevin McConway does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>John Carlisle’s method for spotting potentially fraudulent figures has already been adopted by two top medical journals.Kevin McConway, Emeritus Professor of Applied Statistics, The Open UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1019302018-08-22T09:24:06Z2018-08-22T09:24:06ZAutism and vaccines: more than half of people in Britain, France, Italy still think there may be a link<figure><img src="https://images.theconversation.com/files/232915/original/file-20180821-149475-w76ptw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>One of the most frustrating misperceptions in our many <a href="http://bit.ly/perils-perception">studies on what people commonly get wrong</a> is the enduring myth that vaccines pose a risk to healthy children. It’s particularly maddening because it has direct and long-lasting consequences.</p>
<p><a href="https://www.bbc.co.uk/news/uk-england-essex-45223818">Public Health England</a> recently warned young people to look out for symptoms of measles before attending a music festival in Essex. This was in response to <a href="https://www.essexlive.news/news/health/public-health-england-issue-urgent-1902679">12 cases being identified in the county</a> since July, way up on usual numbers. The rise reflects a broader trend. Measles cases in Europe increased fourfold in 2017, affecting more than 20,000 people and causing 35 deaths.</p>
<p>In the UK, the rise in cases is often among young adults, who <a href="https://www.telegraph.co.uk/news/2018/07/02/national-measles-warning-five-fold-rise-cases-england/">were less likely to be immunised as children</a> during a period of vaccine concern sparked by Andrew Wakefield’s now completely discredited claims that the MMR vaccine caused leaks in the gut that went through the bloodstream to the brain.</p>
<p>But new doubts keep being layered on, with points about freedom of choice from <a href="http://time.com/5165670/vaccine-skepticism-northern-league-five-stars/">Italian political parties</a> muddying the waters, and more than <a href="https://www.independent.co.uk/news/world/americas/trump-vaccines-autism-links-anti-vaxxer-us-president-false-vaccine-a8331836.html">20 tweets from the US president, Donald Trump</a>, suggesting a link. This is despite many reviews that fail to find any link, including a 2014 meta-analysis of records from over <a href="http://vk.ovg.ox.ac.uk/no-link-MMR-and-autism">1.25m children</a>.</p>
<p>Have these unfounded fears stuck with the public around the world? Our first ever multi-country study, in 38 nations, on vaccine misperceptions suggests they have. Around one in every five people believe that “some vaccines cause autism in healthy children”, and 38% are unsure whether it is true or not.</p>
<p>The proportions positively believing it is true ranged from an incredible 44% in India, down to 8% in Spain.</p>
<p>But there are majorities in many countries who think it’s true or are unsure: in France it’s 65%, in Britain it’s 55%, in Italy it’s 52%. And even in countries where it’s not quite a majority who think it’s true or are unsure, it’s often only just below: in Sweden it’s 49% and in the US and Germany it’s 48%.</p>
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<img alt="" src="https://images.theconversation.com/files/232919/original/file-20180821-149496-7858tu.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/232919/original/file-20180821-149496-7858tu.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/232919/original/file-20180821-149496-7858tu.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/232919/original/file-20180821-149496-7858tu.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/232919/original/file-20180821-149496-7858tu.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/232919/original/file-20180821-149496-7858tu.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/232919/original/file-20180821-149496-7858tu.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Do vaccines cause autism in healthy children?</span>
<span class="attribution"><span class="source">Ipsos MORI</span></span>
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</figure>
<h2>Why do we fear vaccines?</h2>
<p>So why do three in five people across these countries feel unsure or believe that there actually is a link between some vaccines and autism in healthy children, despite the claims being so widely discredited? It is partly because it has many of the ingredients that drive conspiracy theories.</p>
<p>First, it’s a highly emotive issue – there is little more emotional than the health of our children. We treat information differently when we are in highly emotional states, being more sensitised and less considered or rational.</p>
<p>Second, it involves medical complexity and requires an understanding of risk, which we really struggle with. In particular, we need to understand the <a href="https://www.regulation.org.uk/library/2017-Spiegelhalter-Risk_and_Uncertainty_Communication.pdf">distinction</a> between hazard, which is the potential for harm, and risk, which is the probability of that adverse outcome actually happening. For example, there is an incredibly small but real chance that a vaccine could aggravate an underlying mitochondrial disorder, which has been linked to regressive autism in a miniscule fraction of children. There are US court rulings that we could legitimately take as evidence of this being a hazard, but they are vanishingly rare, and the risk is therefore effectively non-existent. But that is a difficult point to communicate.</p>
<p>In addition, the communications we do see on vaccines are often actively unhelpful, with sections of the media keeping these stories alive. This does not just mean television shows or articles that give space to those who make the case for the vaccine–autism link without providing space for counter claims.</p>
<p>Then there is also a more subtle effect from “balanced” reporting. This is where a media item says that while a credible source disagrees with a position, some others still believe it. There is increasing evidence that this apparent balance actually serves to polarise, because we have <a href="https://www.dartmouth.edu/%7Enyhan/nature-origins-misperceptions.pdf">directionally motivated reasoning</a>, where we pick what we want from the evidence. Cass Sunstein, in studies on reactions to contradictory information on climate change, has called this “<a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2821919">asymmetrical updating</a>”, where people take the information that fits with their views, and ignore the counter evidence. </p>
<p>The narrative across all these sources is also important. Stories stick with us, and there are a lot of individual case study claims in the vaccine–autism link. Jenny McCarthy, the model, actress and television presenter, is the highest profile “autism mom” and <a href="http://archives.cnn.com/TRANSCRIPTS/0804/02/lkl.01.html">regularly explains</a> how she’s told by “thousands” of other parents how, following vaccination, “I came home, he had a fever, he stopped speaking, and then he became autistic”. Elevating these stories to be on a par with representative evidence, McCarthy says, without a hint of irony that “parents’ anecdotal information is science-based information”.</p>
<p>In these environments, the story takes over from reality. Paul Offit, a vaccine scientist, refuses to appear with McCarthy in media interviews, as <a href="http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1000114">he explains</a>: “Every story has a hero, victim, and villain. McCarthy is the hero, her child is the victim – and that leaves one role for you.”</p>
<p>The contrast with early days of vaccines couldn’t be greater. When Jonas Salk announced the results of his polio vaccine tests there were 16 television cameras filming the dry, academic presentation, relaying the outcome to 54,000 physicians across the country – judges even suspended trials so people could celebrate the results. It was as if <a href="https://www.bmj.com/content/332/7543/733">a war had ended</a>, said one observer.</p>
<p>In some ways, vaccines are a victim of their own success, because we are much more likely to notice phantom scares than world-changing but incremental improvements. We need to fight these frighteningly widespread vaccine misperceptions to avoid a much more attention-grabbing reverse.</p><img src="https://counter.theconversation.com/content/101930/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The Perils of Perception – Why We’re Wrong About Nearly Everything is published by Atlantic Books on September 6, 2018.</span></em></p>Cases of measles are on the rise as a cohort of unvaccinated children grows up.Bobby Duffy, Visiting Senior Research Fellow, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/809092017-07-13T12:44:37Z2017-07-13T12:44:37ZWhat’s behind the sudden rise in measles deaths in Europe?<figure><img src="https://images.theconversation.com/files/178055/original/file-20170713-11517-1eclmdc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Measles virus.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/674006347?src=O5OBhMyw5gRtIxHGbj0yUw-1-9&size=medium_jpg">Kateryna Kon/Shutterstock</a></span></figcaption></figure><p>Deaths from measles <a href="http://www.euro.who.int/en/media-centre/sections/press-releases/2017/measles-continues-to-spread-and-take-lives-in-europe">have risen</a> to new heights in Europe in the past year. The rapid spread of the measles virus has led to more than 3,300 cases and 35 deaths in Romania, Italy, Germany and Portugal. The most recent death was that of a six-year-old boy in Italy who died on June 22. </p>
<p>Nearly all of the recorded deaths have been in unvaccinated individuals, despite there being a safe and effective vaccine against measles, routinely used in the UK since 1968 and, as <a href="http://www.nhs.uk/conditions/vaccinations/pages/mmr-vaccine.aspx">part of a triple measles, mumps and rubella (MMR) vaccine</a>, since 1988. </p>
<p>Successful implementation of the MMR vaccine was interrupted in the early 2000s following publications by Andrew Wakefield linking it to autism. These claims have since <a href="https://www.cdc.gov/vaccinesafety/vaccines/mmr/mmr-studies.html">proven unfounded</a> in large epidemiological studies – but, for a period between 1998 and 2004, <a href="http://www.pbs.org/wgbh/nova/body/autism-vaccine-myth.html">MMR coverage fell dramatically</a> enabling measles epidemic outbreaks such as <a href="http://www.wales.nhs.uk/sitesplus/888/news/29688">the one in Swansea, UK</a> in 2012-13 (1,219 people infected), and the 2015 <a href="http://www.bbc.co.uk/news/blogs-echochambers-30942928">Disneyland outbreak</a> in California (147 people infected).</p>
<p>The recent European outbreaks have been recorded in <a href="http://www.euro.who.int/en/media-centre/sections/press-releases/2017/measles-outbreaks-across-europe-threaten-progress-towards-elimination">areas with low vaccination rates</a>, linked to highly vocal anti-vaccination groups and their supporters (for example the <a href="https://www.theguardian.com/world/2017/mar/23/italys-five-star-movement-blamed-for-surge-in-measles-cases">Five Star Movement, a populist Italian party</a>). This has been compounded by continuing problems in the supply of vaccines and access to vaccination services. </p>
<p>Ten years ago, immunisation rates in Romania were <a href="http://data.worldbank.org/indicator/SH.IMM.MEAS?locations=RO">as high as 97%</a>. Several events prompted a downward trend. Around 2013 a former TV presenter and media celebrity fronted <a href="https://www.romania-insider.com/romania-sees-measles-outbreak-due-anti-vaccination-campaign/">an anti-vaccination campaign</a> in Romania, supported by an ultra-conservative religious pro-life movement. A shortage of <a href="https://www.worldcrunch.com/culture-society/in-romania-where-infant-mortality-meets-anti-vaccination-movement">vaccine supplies</a> made the problem worse, as did difficulties in vaccination services reaching <a href="http://edition.cnn.com/2017/07/11/health/measles-outbreak-europe-bn/index.html">more rural parts of the country</a> and minority groups, such as <a href="http://sofiaglobe.com/2017/03/17/bulgarian-health-ministry-reacts-to-measles-outbreak-in-romania/">Romanian Roma</a>. Within three years the immunisation rates dropped from 92% <a href="https://medicalxpress.com/news/2017-03-measles-outbreak-romania-children.html">to below 80%</a>. </p>
<p>Even if a country has high vaccination rates, there can be pockets of low vaccination. Portugal has very high vaccination rates (98% in 2015) but still experienced an outbreak in which <a href="https://ecdc.europa.eu/en/news-events/epidemiological-update-measles-monitoring-european-outbreaks-7-july-2017">nearly half of the cases were healthcare workers</a>. And Germany has high national rates but <a href="https://www.thelocal.de/20170113/german-children-insufficiently-vaccinated-against-measles">large regional variation</a>.</p>
<p>Migration can also bring new cases to countries with high immunisation coverage: Slovakia experienced an “imported case” of measles in 2015 in a <a href="https://ecdc.europa.eu/en/news-events/epidemiological-update-measles-monitoring-european-outbreaks-7-july-2017">25-year-old, unvaccinated Italian student</a>. Vaccination coverage in Hungary has been over 95% for a few decades, yet in 2017 there were <a href="http://www.balkaninsight.com/en/article/hungary-fears-romanian-measles-epidemic-might-have-crossed-the-border-03-10-2017">54 cases of measles in the regions bordering Romania</a>. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/178054/original/file-20170713-12241-1ru0qjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/178054/original/file-20170713-12241-1ru0qjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=826&fit=crop&dpr=1 600w, https://images.theconversation.com/files/178054/original/file-20170713-12241-1ru0qjp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=826&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/178054/original/file-20170713-12241-1ru0qjp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=826&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/178054/original/file-20170713-12241-1ru0qjp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1038&fit=crop&dpr=1 754w, https://images.theconversation.com/files/178054/original/file-20170713-12241-1ru0qjp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1038&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/178054/original/file-20170713-12241-1ru0qjp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1038&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Combination vaccine against measles, mumps and rubella.</span>
<span class="attribution"><a class="source" href="http://www.epa.eu/health-photos/preventative-medicine-health-treatment-medicines-photos/measles-vaccine-photos-51813639">Bernd von Jurtczenka/EPA</a></span>
</figcaption>
</figure>
<h2>Not a benign disease</h2>
<p>Far from being a benign childhood illness, measles is highly infectious and dangerous. It <a href="https://www.theguardian.com/society/ng-interactive/2015/feb/05/-sp-watch-how-measles-outbreak-spreads-when-kids-get-vaccinated">spreads rapidly</a> in unvaccinated populations, through direct contact but also through the air by coughs and sneezes. Just visiting a room where an infected person has been within a couple of hours, such as a GP’s surgery, can be sufficient for a susceptible person to catch the disease. It can cause a number of complications (such as ear infections, pneumonia, meningitis, gastroenteritis or brain damage from encephalitis). Measles can also cause a rare but devastating condition called <a href="http://vk.ovg.ox.ac.uk/stories#sarah-walton">SSPE</a> which leads to a progressive destruction of the central nervous system.</p>
<h2>Is the UK protected?</h2>
<p>Measles vaccination coverage of at least 95% of the population has been <a href="http://www.euro.who.int/en/media-centre/sections/press-releases/2017/measles-outbreaks-across-europe-threaten-progress-towards-elimination">recommended by the WHO</a>. This significantly reduces the chances of the virus spreading, and creates a protective barrier known as <a href="http://vk.ovg.ox.ac.uk/herd-immunity">herd protection or immunity</a>. </p>
<p>Certainly there are many reasons for the causes of outbreaks in Europe, so what could this mean specifically for the UK? Should we be concerned? The UK is keeping up rates of MMR immunisation at the moment, achieving the <a href="http://www.who.int/mediacentre/factsheets/fs378/en/">WHO target</a> of 95% in 2016 for the first dose of MMR, and maintaining rates of over 90% for two of the recommended three doses.</p>
<p>But it would not take much to send this off course. Immunisation rates only need to drop slightly below 95% for measles to start circulating more widely in the population, leading to serious illness and deaths. As this has already been happening across Europe, governments of <a href="https://www.reuters.com/article/us-germany-health-measles-idUSKBN18M0PW">Germany</a>, <a href="http://www.independent.co.uk/news/world/europe/france-vaccination-mandatory-2018-next-year-children-health-measles-dying-anti-vaxxers-edouard-a7824246.html">France</a> and <a href="http://www.bbc.co.uk/news/world-europe-39983799">Italy</a> are bringing in urgent measures in order to prevent further cases.</p>
<h2>Distant memory</h2>
<p>Most people are too young to remember a time when deaths from measles were commonplace. The author Roald Dahl painfully recalled how his seven-year-old daughter died of measles encephalitis. Olivia died in 1962, six years before a measles vaccine was available in the UK. Two decades years later, he wrote <a href="http://vk.ovg.ox.ac.uk/blogs/ojohn/how-dangerous-measles">a moving account of her death</a>. Unfortunately, his pleas to vaccinate are still echoed by parents who have experienced the heartbreak of losing their child from the same <a href="http://www.mirror.co.uk/lifestyle/family/distraught-mums-powerful-vaccination-message-9610620">vaccine-preventable complication</a>. </p>
<p>As <a href="http://www.independent.co.uk/news/health/doctor-blames-andrew-wakefield-son-catching-measles-vaccine-mmr-autism-anti-vaxxers-measles-a7813001.html">British GP Eleanor Draeger</a> told her colleagues at the recent British Medical Association annual meeting: measles is a disease that should by now be consigned to history.</p><img src="https://counter.theconversation.com/content/80909/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anita Milicic receives funding from the Medical Research Councill UK and the Wellcome Trust. </span></em></p><p class="fine-print"><em><span>Sarah Loving receives funding from the NIHR Oxford Biomedical Research Centre. </span></em></p><p class="fine-print"><em><span>Samantha Vanderslott does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>In the past year, 3,300 cases of measles were reported in Europe. Most of them were entirely preventable.Anita Milicic, Senior Post-doctoral Scientist, University of OxfordSamantha Vanderslott, Postdoctoral Researcher, University of OxfordSarah Loving, Vaccine Knowledge Project ManagerLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/805952017-07-10T14:19:28Z2017-07-10T14:19:28ZIn era of fake news, honest documentary makers have never mattered more<p>Facts are under threat. I write this after Donald Trump <a href="https://twitter.com/realdonaldtrump/status/881503147168071680">tweeted</a> an old clip of himself wrestling a CNN avatar to the ground, declaring them “FNN: Fraud News Network”. Over at Info Wars, meanwhile, a guest on the Alex Jones show <a href="https://www.washingtonpost.com/news/speaking-of-science/wp/2017/07/01/no-alex-jones-nasa-is-not-hiding-kidnapped-children-on-mars-nasa-says/?utm_term=.a26a6f39521c">declared the</a> existence of a child slave ring on Mars. </p>
<p>Inflammatory clickbait, conspiracy theories and populists dismissing the mainstream media and scientific reports are challenging the ways in which people make sense of the world. I am interested in how documentary film making has been affected, and how it can respond. This was the subject of <a href="https://www.edfilmfest.org.uk/2017/docsalon-documentary-age-fake-news">a session</a> of industry professionals that I chaired at the <a href="https://www.edfilmfest.org.uk">Edinburgh International Film Festival</a>. </p>
<p>The panel saw the internet and social media as both cause and potential cure for these problems. They amplify the speed and reach of misinformation. And because people are used to giving such material only glancing attention, it forestalls their critical engagement. </p>
<p>Long-form documentary encourages a more contemplative commitment for viewers, yet it faces challenges from an industry eager to adapt to the online space. Sonja Henrici of the <a href="https://www.scottishdocinstitute.com">Scottish Documentary Institute</a> described <a href="https://medium.com/@AnnaEHiggs/dis-content-creative-direction-in-the-audience-age-447ebfaf6b2a">a shift</a> in emphasis from storytelling to content marketing, where the widest possible distribution is the priority. </p>
<p>This means that soundbite clips of documentaries that are well liked and shared on social media have become coveted by funders and broadcasters. These videos have their appeal, but it’s not clear if social media activity translates into deeper engagement. It also risks replicating the conditions that facilitated the rise of fake news in the first place. </p>
<p>Still, it is impossible to dismiss the value of technology for documentaries. Platforms from Netflix to YouTube have increased our access to other voices. As one audience member noted, when Indian broadcasters refused to support documentaries made by and about Dalit, those at the bottom of the caste system, YouTube offered a means of watching and exchanging such <a href="https://www.dalitsolidarity.org/donate/91-documentaries-about-dalits.html">material</a>.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/BZ_doYiDOTc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<h2>The gatekeepers</h2>
<p>One <a href="https://www.theguardian.com/society/2013/apr/25/mmr-scare-analysis">marked example</a> of fake news as documentary is arguably the 2016 film <a href="http://vaxxedthemovie.com">Vaxxed</a>. Directed by former gastroenterologist Andrew Wakefield, it reasserts his <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/">discredited 1998 claims</a> of links between the MMR vaccine and autism. </p>
<p>Vaxxed was scheduled for both the <a href="https://www.nytimes.com/2016/04/02/nyregion/anti-vaccine-film-pulled-from-tribeca-film-festival-draws-crowd-at-showing.html?_r=0">Tribeca Film Festival</a> in New York and a <a href="http://uk.businessinsider.com/vaxxed-anti-vaxx-documentary-screening-uk-2017-1">Curzon cinema</a> in central London, but both cancelled following negative publicity. On the other hand, the film is available <a href="https://www.amazon.co.uk/Vaxxed-Cover-Up-Catastrophe-Del-Bigtree/dp/B01NA0ESU7">on Amazon</a>, in an example of the reluctance of internet platforms to make value judgements about their content. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/177332/original/file-20170707-29852-hldfoy.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/177332/original/file-20170707-29852-hldfoy.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/177332/original/file-20170707-29852-hldfoy.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/177332/original/file-20170707-29852-hldfoy.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/177332/original/file-20170707-29852-hldfoy.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/177332/original/file-20170707-29852-hldfoy.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=422&fit=crop&dpr=1 754w, https://images.theconversation.com/files/177332/original/file-20170707-29852-hldfoy.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=422&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/177332/original/file-20170707-29852-hldfoy.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=422&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Not coming to a cinema near you.</span>
</figcaption>
</figure>
<p>This case highlights the role of exhibitors, funders and distributors as gatekeepers who decide access to a documentary that could potentially cause harm. Despite my own agreement with the cancellations, this touches on broader questions about what it means to use “truth” and “harm” in deciding what should be publicly available. After all, yesterday’s accepted knowledge can be considered oppressive or dangerous today. </p>
<p>Science is grounded in social biases – <a href="https://io9.gizmodo.com/the-9-most-influential-works-of-scientific-racism-rank-1575543279">race science and eugenics</a> may be the best example; women’s <a href="https://www.theguardian.com/lifeandstyle/2015/apr/30/fda-clinical-trials-gender-gap-epa-nih-institute-of-medicine-cardiovascular-disease">long exclusion</a> from medical research is another. Documentaries that counter official stories – in history or science – are therefore crucial. <a href="https://sheffdocfest.com/articles/440-luke-w-moody-appointed-as-director-of-film-programming">Luke Moody</a>, film programming director of the <a href="https://sheffdocfest.com">Sheffield Doc/Fest</a>, stressed to the Edinburgh audience the need for a range of voices at a film festival, including opinion-based work. </p>
<h2>History of misdirection</h2>
<p>The panel also pointed out that fake news and post-truth is nothing new. Documentary makers have been blurring the boundaries of fiction and nonfiction ever since Louis Lumière instructed his workers to exit his factory as if they had finished a day’s work for his famous 1895 short. Experimenting to achieve maximum effect, Lumière made <a href="https://www.youtube.com/watch?v=J1EdyZtkGXo">three versions</a> of the film. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/J1EdyZtkGXo?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>Richard Warden, a documentary producer and film lead for the Mental Health Foundation UK, made a similar point about the 1855 Crimean War photo “<a href="http://www.radiolab.org/story/308563-truth-cannonballs/">The Valley of the Shadow of Death</a>”. Taken by the pioneering British photographer Roger Fenton, cannonballs were placed in shot for dramatic emphasis. </p>
<p><a href="http://www.imdb.com/name/nm1250210/">Flora Gregory</a>, a documentary consultant and former commissioning editor for Witness, Al-Jazeera English’s documentary strand, said the conflict between a free press and authoritarian leaders is also age-old. It may seem like a novelty in the West with the arrival of Trump and other populists, but that’s not the case. </p>
<p>When Oxford Dictionaries <a href="https://en.oxforddictionaries.com/word-of-the-year/word-of-the-year-2016">made post-truth</a> its word of 2016, it was not because it was new but because usage had increased in relation to the Brexit referendum and the US presidential election. </p>
<p>Indeed, US comedian Stephen Colbert <a href="http://uk.businessinsider.com/the-colbert-report-truthiness-clip-2014-12">introduced “truthiness”</a> in 2005 to mean preferring concepts or facts one wishes or believes to be true to those that are true. He was applying this to the Iraq war, which is a reminder that fakery can have very real effects. </p>
<p>While discussing the range of perspectives offered through documentary, the panel also noted that national broadcasters can influence the truths audiences witness. <a href="http://www.larmfilm.dk/en/feras-fayyad/">Firas Fayyad</a>, director of the award-winning <a href="https://www.theguardian.com/film/2017/jan/24/last-men-in-aleppo-review-sundance-film-festival-white-helmets-syria">Last Men in Aleppo</a>, recounted how an earlier short observational film about children in Syria was shaped by two broadcasters’ differing priorities. </p>
<p>Broadcasters are beholden to perceived national preferences, Flora Gregory added. In the UK, they often prioritise presenter-led documentaries. Observational films on difficult subjects without voiceover or interviews can struggle to get picked up. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/177330/original/file-20170707-3020-vciojr.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/177330/original/file-20170707-3020-vciojr.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/177330/original/file-20170707-3020-vciojr.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/177330/original/file-20170707-3020-vciojr.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/177330/original/file-20170707-3020-vciojr.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/177330/original/file-20170707-3020-vciojr.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/177330/original/file-20170707-3020-vciojr.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Left to right: Leshu Torchin, Firas Fayyad, Richard Warden, Flora Gregory, Sonja Henrici, Luke Moody.</span>
<span class="attribution"><span class="source">EIFF</span></span>
</figcaption>
</figure>
<p>In short, the historic challenges in making documentaries risk being exacerbated by online echo chambers and those in public life seeking to exploit them. It redoubles film makers’ duty to trade in honest portrayals and encourage deep reflection. Meanwhile, I hope broadcasters and exhibitors do not shy away from challenging subjects and experimentation in response to fake news. </p>
<p>I don’t see any general deterioration in the commitment from documentary makers to telling these complicated stories. <a href="https://www.netflix.com/gb/title/80000770">Making a Murderer</a>, and Last Men in Aleppo are two examples.</p>
<p>Yet in these testing times for facts, the future can definitely not be taken for granted. The overwhelming message from Edinburgh was that responsible documentary making has never been more important.</p><img src="https://counter.theconversation.com/content/80595/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Leshu Torchin does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Documentaries are vital vehicles for explaining the world.Leshu Torchin, Senior Lecturer in Film Studies, University of St AndrewsLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/741592017-03-07T05:15:01Z2017-03-07T05:15:01ZIs there a test your child can take before getting vaccinated, as Pauline Hanson said?<p><em>During an exchange with journalist Barrie Cassidy on the ABC television program <a href="http://www.abc.net.au/insiders/content/2016/s4630647.htm">Insiders</a>, One Nation leader Pauline Hanson suggested there are tests available to see if children will have an adverse reaction to vaccinations.</em></p>
<blockquote>
<p>HANSON: Barrie, some of these - parents are saying - vaccinations have an effect on some children. Go and have your tests first. You can have a test on your child first…</p>
<p>CASSIDY: Take advice from the doctor.</p>
<p>HANSON: Have a test and see if you don’t have a reaction to it first. Then you can have the vaccination.</p>
</blockquote>
<p><em>It’s not clear what kind of test Hanson was referring to. (The Conversation contacted her office to ask, but didn’t hear back before deadline.) The Conversation asked three experts for more information.</em></p>
<hr>
<p>Immunisation programs <a href="https://www.science.org.au/learning/general-audience/science-booklets/science-immunisation">prevent millions of deaths</a> worldwide each year. Vaccine safety monitoring – what experts call vaccine <a href="http://vaccinepvtoolkit.org/">pharmacovigilance</a> – as well as many other <a href="http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/F466A36DFA42DD93CA257F0F000216D7/$File/How-are-vaccines-shown-to-be-safe.pdf">checks and balances</a> before and after <a href="http://www.ncirs.edu.au/vaccine-safety/">vaccines registration</a>, ensure that vaccines have a minimal risk of causing harm. </p>
<p>Almost all vaccine side effects are mild and short lived. Common reactions such as low grade fever or pain at the injection occur in about one in every 10 children and go away within a day or two. Such reactions are evidence of our immune response to vaccines and a small trade-off for protection against serious diseases. </p>
<p>In most cases, we can’t predict which person will be the one in a million to have a potentially more serious reaction after a vaccine. </p>
<p>There is no blood test to see if vaccines shouldn’t be given. In fact, the best “test” for a deciding if a vaccine is appropriate is taking a good old medical history. </p>
<h2>Pre-vaccination screening</h2>
<p>Pre-vaccination screening involves the nurse or doctor asking the patient a series of questions. It is done to ensure any conditions for which vaccines should or shouldn’t be given are noted. </p>
<p>For example, <a href="https://theconversation.com/vaccines-to-expect-when-youre-expecting-and-why-50587">pregnant women</a> should not receive <a href="http://vaccine-safety-training.org/live-attenuated-vaccines.html">live attenuated</a> vaccines (meaning vaccines derived from disease-causing pathogens that have been weakened in the lab) such as measles-mumps-rubella vaccine. That’s because there is a potential risk of rubella virus infection in the fetus.</p>
<p>However, they <em>should</em> have the inactivated pertussis (whooping cough) and influenza (‘flu) vaccines to protect both themselves and their newborns against these diseases. </p>
<p>People who have a compromised immune system, due to a medical condition or treatment, should not be given live vaccines. This includes elderly people who need their medical history checked carefully prior to administration of the live attenuated Zoster or “<a href="https://theconversation.com/explainer-how-do-you-get-shingles-and-who-should-be-vaccinated-against-it-64436">shingles</a>” vaccine. </p>
<p>Vaccines should be used in the correct way: nurses and doctors who administer them have to have proper training. There is also extensive guidance for healthcare workers, who must update their knowledge each year. </p>
<p>Our centre – the National Centre for Immunisation Research and Surveillance <a href="http://www.ncirs.edu.au">(NCIRS)</a> – works with the <a href="http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/atagi">Australian Technical Advisory Group on Immunisation</a> and others who support the <a href="http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Home">National Immunisation Program</a> to update the <a href="http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home">Australian Immunisation Handbook</a> regularly to support this. </p>
<h2>Managing risk</h2>
<p>Parents take risks all the time because of the benefits of their action. We put babies in car seats, we let them play in playgrounds, and we vaccinate them. Vaccines are hugely beneficial but they are like any medicine: there are some rare but well-documented risks. </p>
<p>One is anaphylaxis, a life-threatening allergic reaction that occurs within minutes in about one in 1 million people. This risk is why patients are observed for 15 minutes after immunisation – if an anaphylactic reaction does occur, adrenaline is available to fully treat it. </p>
<p>If a patient has experienced anaphylaxis soon after a vaccine, expert opinion from a <a href="http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home%7Ehandbook10part3%7Ehandbook10-3-3#3-3-1">specialist immunisation service</a> should be sought. There are also <a href="http://www.ncirs.edu.au/vaccine-safety/clinical/">clinics</a> in most major cities. </p>
<p>Specific clinical assessment can help to differentiate if the cause was a vaccine ingredient or something coincidental – such as the peanut butter sandwich or aspirin taken shortly after the vaccine.</p>
<h2>Causation versus correlation</h2>
<p>Some problems previously blamed on vaccines have been found to be caused by other things.</p>
<p>For example, research into the human genome has helped disprove a link between vaccines and at least one serious condition. <a href="https://theconversation.com/explainer-what-is-dravet-syndrome-and-how-can-it-be-managed-50077">Dravet syndrome</a> is a severe incurable form of epilepsy due to a genetic change that affects nerve cells. </p>
<p>The condition was previously associated with vaccines because the seizures appear in the first months of life in previously healthy babies and are often triggered (but not caused) by fever. </p>
<p>If a vaccine caused the fever, it <em>appeared</em> that vaccination caused the syndrome. It didn’t.</p>
<p>Unfortunately, other conditions that become apparent in children in the first 12-24 months of life, such as autism spectrum disorder, have also wrongly been blamed on vaccines. In the case of <a href="https://theconversation.com/au/topics/autism-533">autism</a>, dozens of high quality studies and reviews over more than 15 years have shown <a href="https://theconversation.com/mondays-medical-myth-the-mmr-vaccine-causes-autism-3739">absolutely no link to vaccines</a>. </p>
<p><a href="http://www.wehi.edu.au/research/research-fields/personalised-medicine">Personalised medicine is beginning to help understand disease</a> at the individual patient level, such as by customising treatment based on the genetic make-up of a person’s cancer. Gazing into the future, we may eventually learn more about what can predict both reactions as well as good responses to vaccines.</p>
<p>However, right now, the benefits of immunisation for children, adults and communities in eliminating or controlling some of the worst infectious diseases worldwide are clear.</p><img src="https://counter.theconversation.com/content/74159/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kristine Macartney receives funding from the National Centre for Immunisation Research and Surveillance (NCIRS) and grant funding from the National Health and Medical Research Council (NHMRC).</span></em></p><p class="fine-print"><em><span>Julie Leask receives funding from the Australian Government Department of Health, National Centre for Immunisation Research and Surveillance and the National Health and Medical Research Council. </span></em></p><p class="fine-print"><em><span>Nicholas Wood has received funding from the NHMRC to investigate vaccine related research questions. He has also an investigator on a NHMRC partnership grant. He has previously received pharmaceutical industry support for investigator initiated clinical trials.</span></em></p>Speaking on the ABC program Insiders, One Nation leader Pauline Hanson suggested there are tests available to see if children will have an adverse reaction to vaccinations. We asked three experts.Kristine Macartney, Associate Professor, Discipline of Paediatrics and Child Health, University of SydneyJulie Leask, Associate Professor, University of SydneyNicholas Wood, Associate Professor, Senior Lecturer Paediatrics & Child Health, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/191492013-10-16T03:34:46Z2013-10-16T03:34:46ZMeasles outbreaks show the illness is down, but not yet out<figure><img src="https://images.theconversation.com/files/33109/original/nrstsxzd-1381892964.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Despite the availability of a safe, effective vaccine, measles outbreaks continue to occur throughout the world.</span> <span class="attribution"><span class="source">CDC/Wikimedia Commons</span></span></figcaption></figure><p>New South Wales has become the latest Australian state to issue an alert about a <a href="http://www.health.qld.gov.au/communicablediseases/measles.asp">measles outbreak</a>, joining Victoria and Queensland.</p>
<p>Queensland’s chief health officer has even <a href="http://www.couriermail.com.au/news/queensland/vaccination-noshows-prompt-toplevel-measles-outbreak-warning">written directly to parents</a> to encourage them to make sure their children’s vaccinations are <a href="http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/nips-ctn">up-to-date</a>. </p>
<p>The move is in response to an ongoing <a href="https://theconversation.com/measles-outbreak-calls-for-vaccination-vigilance-10042">outbreak of measles</a> in the state, with 21 cases so far this year. There have also been 24 cases reported in <a href="http://www.health.nsw.gov.au/infectious/pages/measles.aspx">New South Wales</a> and 25 in Victoria in the same time.</p>
<p>Despite the availability of a <a href="https://theconversation.com/muddied-waters-setting-the-record-straight-about-mmr-vaccinations-and-autism-3391">safe, effective vaccine,</a> <a href="https://theconversation.com/a-persistent-spot-of-bother-why-vaccinations-havent-stopped-measles-943">measles outbreaks</a> continue to occur throughout the world and the country - even though local transmission in Australia has been <a href="http://www.who.int/bulletin/volumes/87/1/07-046375.pdf">largely eliminated</a>.</p>
<h2>The virus</h2>
<p>Measles is one of the most transmissible, infectious diseases. The likelihood of an unimmunised person who comes in contact with an infectious case of measles being infected is <a href="http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf">around 90%</a>. </p>
<p>This rate of infection requires very high levels of vaccination to maintain <a href="https://theconversation.com/braving-the-jab-for-community-immunity-330">herd immunity</a>. Herd immunity is conferred when the majority of people have been vaccinated so the disease is stopped from spreading across the community.</p>
<p>Measles is <a href="http://www.ncirs.edu.au/immunisation/education/mmr-decision/index.php">very infectious</a> because it’s transmitted by tiny droplets that can remain in the air for a prolonged period, even after the ill person has left the room. </p>
<p>Places where ill people congregate, such as the waiting rooms of hospital emergency departments or medical clinics, are prime spots for the disease to spread. Indeed, “waiting room measles” has been described <a href="http://www.ncbi.nlm.nih.gov/pubmed/23908937">in Australia</a> and <a href="http://dx.doi.org/10.1016/S0022-3476(05)80725-5">overseas</a>. </p>
<p>This is the reason health authorities recommend you call your doctor or the hospital before going to see them if you are unwell with measles symptoms.</p>
<p>People also shed the virus for several days before the appearance of the typical rash, increasing the risk of silent transmission.</p>
<h2>The vaccine</h2>
<p>Of course, no vaccine (or any other medical intervention) is perfect, but as far as vaccines go, the one for measles-mumps-rubella is pretty good. </p>
<p>Around 95% of people who receive a single dose of MMR will <a href="http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm">develop immunity</a> to measles and most who don’t will do so with the second dose. Sometimes immunity wanes, but, overall, fewer than one in 20 people who have been vaccinated will remain susceptible to the disease.</p>
<p>In Australia, vaccination is <a href="http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/handbook10-4-9">recommended</a> for anyone born after 1966, who has definitely not received two doses of a measles vaccine. People born before that year are highly likely to have had measles and have natural immunity.</p>
<p>As part of the state’s outbreak response, the vaccine is currently being supplied for free in Queensland (although doctors may still charge fees for administering it). </p>
<p>People who aren’t sure whether they have been vaccinated should err on the side of caution and get a booster; the side-effects are minor, and there’s no harm in having an additional dose.</p>
<h2>Safety profile</h2>
<p>The measles vaccine is <a href="https://theconversation.com/mondays-medical-myth-the-mmr-vaccine-causes-autism-3739">safe</a>.</p>
<p>Fever is relatively common side effect, particularly after the first dose. And, on rare occasions, the vaccine can cause a rash similar to measles, but it’s mild and transient. </p>
<p>Extremely rare cases of inflammation of the brain have also been reported. But the measles virus itself causes encephalitis (swelling of the brain) in one in 1,000 cases. One in ten of these people will die and many others will be disabled because of brain damage. </p>
<p>Around one in 100,000 children who recover from measles will go on to develop a <a href="http://en.wikipedia.org/wiki/Subacute_sclerosing_panencephalitis">degenerative brain disease</a> that is almost invariably fatal. </p>
<p>Concerns over safety of the MMR are almost entirely based on a <a href="http://www.sciencedirect.com/science/article/pii/S0140673697110960">1998 paper</a> by <a href="http://en.wikipedia.org/wiki/Andrew_Wakefield">Andrew Wakefield</a>. The paper was <a href="http://www.sciencedirect.com/science/article/pii/S0140673697110960">eventually retracted</a> and Wakefield was struck off the medical register for research fraud and unethical treatment of the children he researched. </p>
<p>But the damage was done and panicked parents refused to have their children vaccinated. These children are now as old as 15, and one of the key age groups for transmitting infections. </p>
<p>Anti-vaccination lobby groups continue to quote the Wakefield paper, despite the fact that he has been discredited and the paper being retracted,</p>
<h2>Source of cases</h2>
<p>Outbreaks of measles in Australia always begin with imported cases, that is, from someone getting infected while travelling abroad. These people cause secondary cases when they come in contact with an unvaccinated local upon their return. </p>
<p>The WA Department of Health recently <a href="http://www.theage.com.au/travel/travel-news/measles-warning-for-tourists-to-bali-20131012-2vf1j.html">issued a warning</a> to travellers to Bali for this very reason. There isn’t anything special about Bali and measles, it’s just a common destination for Australian travellers and so a <a href="http://au.ibtimes.com/articles/448168/20130320/study-released-australasian-society-infectious-diseases-asid.htm#.UltkuKwgJpw">frequent source of infections</a>. </p>
<p>Travellers to Bali, or any other overseas destination should include the MMR shot in their pre-travel vaccinations.</p>
<p>Measles is a very efficient infection; it was the <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5443a3.htm">fifth-leading</a> cause of childhood death worldwide in 2000 (estimated at more than 750,000 deaths). </p>
<p>But vaccination has made the disease so rare in Australia that many young (and some not-so-young) doctors have never seen a case. If the current outbreaks continue, we may see the first Australian measles death in years, which would be a completely preventable tragedy.</p><img src="https://counter.theconversation.com/content/19149/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This article represents the personal opinions of the author, and not those of his employer.</span></em></p>New South Wales has become the latest Australian state to issue an alert about a measles outbreak, joining Victoria and Queensland. Queensland’s chief health officer has even written directly to parents…Trent Yarwood, Infectious Diseases Physician, Associate Lecturer, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/46782011-12-13T03:56:06Z2011-12-13T03:56:06ZMeryl Dorey at Woodford Folk Festival: a hazard to your child’s health?<figure><img src="https://images.theconversation.com/files/6357/original/n388ncvx-1323747712.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">AVN spokesperson Meryl Dorey's message contradicts the position of several Woodford Folk Festival sponsors.</span> <span class="attribution"><span class="source">AAP</span></span></figcaption></figure><p>This year’s bill of speakers at the <a href="http://woodfordfolkfestival.woodfordia.com/">Woodford Folk Festival</a> features anti-vaccine lobbyist Meryl Dorey, spokesperson for the Northern New South Wales-based Australian Vaccination Network (AVN), and purveyor of vaccine misinformation. </p>
<p>The festival is one of Australia’s largest and most popular festivals with approximately 130,000 people attending every year. Held over six days and six nights, the programme includes bands, street performers and speakers covering a range of styles and topics. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/6358/original/k246mmjm-1323748001.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/6358/original/k246mmjm-1323748001.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=954&fit=crop&dpr=1 600w, https://images.theconversation.com/files/6358/original/k246mmjm-1323748001.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=954&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/6358/original/k246mmjm-1323748001.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=954&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/6358/original/k246mmjm-1323748001.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1199&fit=crop&dpr=1 754w, https://images.theconversation.com/files/6358/original/k246mmjm-1323748001.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1199&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/6358/original/k246mmjm-1323748001.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1199&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Meryl Dorey.</span>
<span class="attribution"><span class="source">luckylosing.com</span></span>
</figcaption>
</figure>
<p>The AVN is a self-declared vaccine safety watchdog and list among its goals, to “empower people everywhere to make informed health choices for their families and themselves”. Yet, if you know any of the history of AVN, you might be sceptical about this claim. </p>
<h2>Dubious dealings</h2>
<p>In 2009, a <a href="http://www.hccc.nsw.gov.au/Publications/Media-Releases/PUBLIC-WARNING-/default.aspx">public warning was issued about AVN’s website</a>, following a 12-month investigation by the <a href="http://www.hccc.nsw.gov.au/">NSW Health Care Complaints Commission</a>. Despite assertions from the AVN that it is “pro-choice”, the commission concluded that its website “provides information that is solely anti-vaccination, … is incorrect and misleading.” </p>
<p>The Commission also found evidence that the AVN cherry-picks reliable and peer-reviewed research, quoting selectively and often contradicting the conclusions or findings of the studies themselves. </p>
<p>In response to this accusation, Meryl Dorey asserted that her assessment of scientific data was better than that of the authors – “We actually read the studies and frequently, the summary and conclusion does not agree with the raw data itself.”</p>
<p>She went on to suggest that this was due to some kind of conspiracy – “that disconnect can be explained by the financial links between the study’s researchers and the companies whose products are being studied” and therefore her interpretation was “not selective reporting - it is accurate reporting.”</p>
<p>This is curious considering Dorey has no scientific or medical qualifications, and in response to a query on the topic, declared, “I am not a doctor, but I have a brain.” </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/K3hO7nFrgoU?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<h2>Harassment</h2>
<p>Although she claims to have studied vaccination for over 20 years, Dorey gets some things fundamentally wrong. Australia has been in the <a href="https://theconversation.com/clear-and-present-danger-how-best-to-fight-the-latest-whooping-cough-outbreak-3134">grip of a whooping cough epidemic</a> for several years now, and since 2008, seven babies have lost their lives. But discussing whooping cough on national television in 2009, Dorey said, “You didn’t die from it 30 years ago and you’re not going to die from it now.”</p>
<p>The AVN also repeatedly misrepresent statistics for whooping cough to make it appear that the current epidemic is solely a result of vaccine failure. This was the subject of a complaint <a href="http://www.abc.net.au/contact/upheld/s2739849.htm">upheld</a> by the Australian Broadcasting Corporation (ABC) in 2009. </p>
<p>What’s more, the <a href="http://www.abc.net.au/lateline/content/2010/s2951651.htm">AVN has been accused of harassing the parents of a baby who died</a> from whooping cough and going so far as calling a director of public health at the North Coast Area Health Service demanding to know the details of the child’s death. Dr Corben described how “Ms Dorey called me on 12 March seeking details of your daughter’s illness and death. Ms Dorey contended that I had misled the public in attributing your daughter’s death to pertussis (whooping cough).”</p>
<h2>Flogging a dead horse</h2>
<p>According to the Woodford Festival program details Dorey will be sitting in a panel and giving a lecture about autism, where she will “explain more about the causes of this epidemic so you can help prevent your children from being affected”. </p>
<p>It seems likely Dorey will assert a role for vaccines in autism, despite the fact that this link has been <a href="http://www.medicine.ox.ac.uk/bandolier/booth/Vaccines/MMRDen.html">well and truly debunked</a> both in the <a href="http://www.iom.edu/Reports/2011/Adverse-Effects-of-Vaccines-Evidence-and-Causality.aspx">lab</a> and the <a href="http://www.skeptics.com.au/latest/announcements/special-court-rules-that-vaccines-are-not-linked-to-autism/">courts</a> and the paper that sparked the debate has been <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673697110960/fulltext">struck from the scientific record.</a></p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/6355/original/smy2r8p5-1323746813.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/6355/original/smy2r8p5-1323746813.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=766&fit=crop&dpr=1 600w, https://images.theconversation.com/files/6355/original/smy2r8p5-1323746813.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=766&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/6355/original/smy2r8p5-1323746813.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=766&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/6355/original/smy2r8p5-1323746813.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=962&fit=crop&dpr=1 754w, https://images.theconversation.com/files/6355/original/smy2r8p5-1323746813.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=962&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/6355/original/smy2r8p5-1323746813.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=962&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Disgraced researcher Andrew Wakefield.</span>
<span class="attribution"><span class="source">AAP</span></span>
</figcaption>
</figure>
<p>The lead author of that paper, Andrew Wakefield, claimed there was a link between the MMR vaccine and a gastrointestinal disorder in autistic children, warning parents against using the triple jab. But what he neglected to mention was that he was being <a href="http://briandeer.com/mmr/st-dec-2006.htm">paid</a> more than $A676,658 by lawyers building a case for vaccine damage, and he had a <a href="http://briandeer.com/wakefield/vaccine-patent.htm">patent</a> for a single measles vaccine, all of which stood to make him an nice swag of cash. </p>
<p>In 2010, Wakefield was <a href="http://www.guardian.co.uk/society/2010/may/24/mmr-doctor-andrew-wakefield-struck-off">struck from the medical register</a> for unethical and dishonest behaviour and “for showing callous disregard for children’s suffering” and in 2011 he was accused of elaborate fraud by the <a href="http://www.bmj.com/content/342/bmj.c7452">British Medical Journal</a>. Despite these serious ethical breaches, Dorey <a href="http://www.northernstar.com.au/story/2011/01/08/dorey-backs-fraud-medico-andrew-wakefield/">continues to support him</a>. </p>
<h2>Highly inappropriate</h2>
<p>But you won’t find any of this information on the website of the Woodford Folk Festival even though several people have already written to the organisers to express their concern about the omission. Indeed, it appears that the AVN’s message contradicts that of <a href="http://woodfordfolkfestival.woodfordia.com/index.php?id=112">several festival sponsors</a> including the Queensland Government and the Moreton Bay Council. The latter actually provides <a href="http://www.moretonbay.qld.gov.au/living.aspx?id=738">several free immunisation clinics</a>. </p>
<p>The trouble with the AVN is that it’s not completely transparent about its agenda. The AVN insists it is pro-choice, but offers information which is anything but balanced. In some cases, it’s misleading, and in others, outright incorrect. </p>
<p>At a time when vaccine preventable diseases are on the <a href="http://www.goldcoast.com.au/article/2011/03/21/300795_gold-coast-news.html">rise</a>, it’s irresponsible and dangerous of the Woodford Folk Festival to be supporting such misinformation. The AVN poses a threat to public health and the public has a right to be know about its agenda, so – like the AVN says – they can make informed health choices. </p><img src="https://counter.theconversation.com/content/4678/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rachael Dunlop receives funding from the Heart Research Institute and The Institute for Ethnomedicine, Wyoming. She has previously received funding from the NHMRC.</span></em></p>This year’s bill of speakers at the Woodford Folk Festival features anti-vaccine lobbyist Meryl Dorey, spokesperson for the Northern New South Wales-based Australian Vaccination Network (AVN), and purveyor…Rachael Dunlop, Post-doctoral fellow, University of Technology SydneyLicensed as Creative Commons – attribution, no derivatives.