Science and the things we find on the Internet

Dr. Stephen Miles did a masterful job of clinically explaining the HPV vaccination and the virus that can lead to cervical cancer in women. He appeared today on MPR’s Midday program.

But caller after caller took issue with what he had to say, rarely citing clinical evidence, and it was clear that whatever science-bassed education Miles was trying to provide, it wasn’t working.

That seems to be the dilemma in a debate that, like climate change, is too polluted by politics to have an enlightening discussion.

Part of the problem? The Internet, according to some experts. Several decades after it came into our lives, there are still far too many people who think if it’s on the Internet, it’s got to be true.

The other part of the problem? Well, when’s the last time you had a belief and you changed it? It’s not something that happens often in public discourse of important issues.

“I recently had a mother who had cervical cancer who refused the HPV vaccine for her child,” Dr. Mary Anne Jackson an infectious disease expert at Children’s Mercy Hospital & Clinics in Kansas City, Missouri, told Reuters. “I asked her where she got her information and she said, ‘the Internet, and innuendo.”‘

Indeed, one of the callers to today’s Midday cited an Internet website that opposes the vaccine as the source of her information, citing claims of 98 deaths from the vaccine Gardisil.

“I’ve looked at the same website” Miles responded. “The website includes zero medical records. It does not include links to the medical records… its entire board does not include anyone, as far as I can see, with any medical training or experience. Testimonials are important in marketing products and getting products to be not marketed. But that is not a substitute for science.”

Science, of late, has a hard time getting much respect.

“What is especially disturbing is you’ve got organizations like the American Academy of Pediatrics, the Advisory Committee on Immunization Practices, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists — every learned medical organization in the country and indeed around the world — in favor of immunization,” Jackson said.

She said 85 percent of her patients readily accept the vaccine, 12 percent are hesitant, and 3 percent “flat out refuse.” She said she’s not worried about the daughters in the 3 percent.

“It’s not going to impact the flat-out refusers. I worry it is going to impact this group of vaccine-hesitant families,” she said.

  • Duke Powell

    I’m with Dr Miles on this issue, but only because I looked into it a few years ago and determined that vaccines are generally safe. During my study of the matter, I found that a great many people came down on the other side. Despite what you have read recently, those who worry about vaccinations cross the political divide.

    Folks have good reason to mistrust science. One only has to look around to see how “science” has been used by those with political agendas to press their issues.

    A good example is the subject of this post. Once upon a time, cervical cancer was a disease for elderly women. “What changed that?” would be the inconvient question that Dr Miles should have been asked.

    The answer largely lies in the “safe sex” craze of the last 25 years where condoms were sold as a preventive measure for sexually transmitted diseases.

    While “science” clearly shows that the only safe sex is between two monogamous, disease-free partners, certain groups came up with an “alternative” that simply was used to justify and continue practices that are inherently dangerous.

    Where have the public health professionals been on this issue?

  • lucy

    The humble, insightful and non-masterful Dr. Mercola’s view point on the HPV vaccine and cervical cancer.

    Mercola has other articles on the HPV vaccine in addition to the one above.

  • Bob Collins

    Two things i’m noticing on the blog recently need to be corrected:

    1) Please don’t post long URLs and expect people to cut and paste them into the browser. Form the html, the guide of which is listed just above the box where you fill in your name.

    2) Use your REAL e-mail addresses (which are not made public). No fake ones.

    If you find your comments disappearing, either #1 or #2 is probably the reason.

    Please and thank you.

  • B Joe

    Lucy,

    Does Dr. Mercola provide any links to details about the deaths he attributes to Gardasil?

    People die every day. Some of these people will die within a week or two of receiving a vaccine. However, this doesn’t mean the vaccine killed them.

    I’ve seen multiple people on the internet cite gardasil related deaths as evidence that the vaccine is dangerous, but I have yet to see anyone provide even the barest of objective evidence that any deaths have even occurred. Things like “I know someone who died” isn’t convincing evidence, especially when the person making the claim is some anonymous internet user.

    I’m agnostic on the vaccine. I honestly haven’t looked into it enough to have an opinion. However, I wouldn’t trust Mr. Mercola any more than I’d trust a PHRMA rep.

  • lucy

    Dr.Mercola commented from his article, “HPV Vaccine Blamed for Teen’s Paralysis” from his website:

    “Once you educate yourself and know the facts about Gardasil, the truth about HPV, and the statistics of cervical cancer, it will become quite clear just how outrageously useless — and dangerous — this vaccine really is.

    The FDA, in not-so-rare form, insists there’s no medical reason to be worried about the side effects of Gardasil. “We’re monitoring the safety of the HPV vaccine very carefully, and the only adverse event that causes some concern is fainting after the vaccine,” says Robert Ball, director of the FDA’s office of biostatistics and division of epidemiology.

    He continues to say, “Higher rates of Guillain-Barré have been associated with the swine flu vaccine and possibly with the meningitis vaccine Menactra, but it is no more common in those who get Gardasil than in those who don’t.”

    Alright. Let’s say you agree with the idea that the cases of Guillain-Barre syndrome are pure coincidence, despite the fact that they occur within days or weeks of vaccination.

    But what about the deaths?

    Infant deaths following Merck’s rotavirus are routinely disguised under the label SIDS (sudden infant death syndrome). So what do we have when healthy teenagers drop dead for no reason? SAD — Sudden Adolescent Death? Will that be the next big thing? Will there be SAD campaigns, with physicians educating the public about proper sleeping positions until you’re well into your 20’s?

    Let’s get real.”

    So yah, B Joe, Let’s get real.

    My interpretation of Dr. Mercola’s comment would be,

    ” Sister Shannon bakes a cake for sister Alison’s birthday, and an hour later she discovers someone has thrust their hands into the lovely frosting job she so painstakenly paved to make perfect. She discovers sister Elizabeth with frosting around her mouth and sister Susan with frosting on her fingertips. Although sister Shanon did not catch them in the act she could infer they are the guilty party of cake snatching.”

    And really, if you fear cervical cancer then quit having sex with so many strangers, I mean different men.

    And I beg of you Bob, why do you need our email address if it is not shown? Are you going to chat-it-up via email with your patrons of the News Cut? Are we being added to your electronic Christmas E-card list? Gosh, if we are I am flattered.

  • Bob Collins

    //And I beg of you Bob, why do you need our email address if it is not shown?

    Sent the answer to you via email.

  • Bob Collins

    Question back to the original: How do you know that anything of what you cut and pasted from the Internet is true? What is the process by which you vett that information.

  • B Joe

    Lucy

    You didn’t answer my question. And neither does the good doctor. I just want some objective evidence that these deaths have occurred. I have an open mind on this. You seem to have made up your mind without even attempting to verify the doctor’s claims. Why is this doctor more trustworthy than the ones who endorse vaccines?

    Your cake example doesn’t make sense. A more appropriate one would be if Sister Shannon discovers Sister Elizabeth and Sister Susan endowed with frosting a few weeks after she baked and decorated the cake, since that is apparently the difference in time between the administration of the vaccine and death for the as-yet-unsubstantiated deaths from gardasil.

    And sexual proclivities have nothing to do with this discussion about whether or not anyone has actually died as a direct result of taking this vaccine. Please don’t change the subject.

  • Bob Collins

    Lucy, I left that comment up there but that’s the last one you’re going to be allowed to post.

    You provided a fake email address.

    One of the reasons I look at email addresses is to be sure that the commenter isn’t directing traffic to a web site in which he/she has a financial interest while pretending to comment as a mere observer, basically a way to keep spammers out of News Cut.

    And another reason is sometimes I have to send private email to commenters.

    It also keeps trolls out. NewsCut is for intelligent and honest discussion and the quality of it depends on everyone being who they say they are, and requires them to be here for intelligent and honest discussion and not for whatever thrill trolling provides them.

    The terms of use is pretty clear here:

    You are responsible for all of your submissions.

    You may not post any messages misrepresenting yourself as someone else, or by using a false e-mail address. In MPR and APM forums and content contributions, you must post under your own username, and are responsible for all posts from your account.

    In order to be “responsible” for your comments, you have to be a real person and we have to be able to contact you.

  • Jim Hartmann

    Peer reviewed science is available on the internet. I look at the references, and build a trust after a while on some sources that consistently provide reliable information with back up evidence.

    All medical treatments can have side-effects including death. I’m sure I couldn’t get a tooth filing (or even a hair cut) if I required my dentist (or barber) to sign a statement that they won’t injure me.

    Having looked at the excellent record for Gardasil I will encourage my teens to get this vaccination as I have for all of the other recommended vaccinations. I would get it for myself if there was evidence that there was a benefit for someone my age.

    A highly respected medical blog is that of surgeon/scientist

    Orac, here writing about the vaccine controversy.

  • gjkennedy

    It takes critical thinking to understand cause and effect. Critical thinking requires information, time, and skill.

    The internet has increased our access to information. It is up to individuals to develop the skills and invest the time to understand the information they receive. If we don’t, all we have are opinions and rumor.

    I actually think it’s great that everyone has greater access to science and the information that comes from it. Knowing that facts/results will be scrutinized and challenged should encourage even better science.

  • Heather

    Bob, thank you for the effort you put into building community and real conversation in this forum.

  • lucy

    “Bob, thank you for the effort you put into building community and real conversation in this forum.

    Posted by Heather | September 16, 2011 10:59 AM ”

    agreed.

  • B Joe

    Lucy,

    Your cake example tries to confuse the time frame along which events are occurring. In your cake example, evidence linking cake tampering to the cake tamperers is nearly immediate. Whereas with possible adverse effects from vaccination, all the anecdotal evidence seems to rely on young women falling ill weeks after they received the shot. It’s not an apt comparison, especially when you can’t even be sure that there weren’t other possible causes of death.

    I think that it’s pretty obvious you didn’t read any of the links from the link you gave me about the deaths. The largest number of deaths described in the 7 or so that I looked at was 7, and that was in the context of 10 million shots given. That’s a probability of death less than 0.0000007. Further, many of these press releases are poorly sourced and written in suggestive and misleading ways. If you are the critical thinker you purport to be, I would hope you’d take a long look at Dr. Mercola and give him just as much skepticism as you give those doctors speaking from a more establishment oriented perspective. He’s got an angle too. I suspect it involves selling you things.

    And while your HPV facts are facty, they aren’t relevant to this discussion.

  • B Joe

    Lucy,

    My eyes are open. I’m just not about to replace blind trust in the medical establishment with blind trust in people who disagree with the medical establishment. Frankly, it’s difficult to put a lot of trust in Mercola because a) he’s selling stuff, b) he doesn’t cite his sources very consistently and c) he phrases things in obfuscatory ways with the seeming intent to scare people.

    The current problems with pharmaceutical-doctor-FDA conflicts of interest deserve to be discussed, but not by people who seem more concerned with scaring people with half-truths.

    Again, you provided no evidence linking actual deaths (as described by you and other people, as in I heard of a person who got the vaccine and died two weeks later) to the vaccine. The only evidence you provided seemed to indicate that the vaccine was exceedingly safe, with a mortality rate of 0.0000007.

    Your cake example is flawed. If it wasn’t, you wouldn’t need to distort the scale of time for it to make sense.

    I don’t care about your personal philosophy on vaccination. I was just hoping you could provide evidence to back up your claims and so far you haven’t.

  • B Joe

    Lucy,

    I understand the analogy completely. It’s a bad analogy.

    To anyone else who happens to stumble upon this conversation: It makes perfect sense to question the role that money plays in the interaction between medical science and the pharmaceutical industry. It also makes perfect sense to question the FDA’s role, given that it is currently tasked with regulating companies that it also relies on for funding.

    However, it is important that in the process of formulating your perspective and deciding who to trust, you don’t reflexively trust everyone who happens to express an opinion counter to the mainstream medical community.

    The Dr. cited by Lucy is a salesman. He sells alternative medical products. Of course he’s going to be anti-establishment. He also tends towards not citing many of his claims or interpreting facts in ways which seem more alarmist than is warranted by reality.

    Don’t be like Lucy, who can’t seem to conjure up any actual evidence to support her assertions and instead resorts to distracting allusions to promiscuity and overly simplistic analogies about cake tampering.

  • B Joe

    Why did 4 of Lucy’s posts get deleted?

  • Bob Collins

    Waiting for her to validate the email address she provides with posts. I don’t think she checks her email, though, b/c it’s been 5 days.

  • Liz

    This singling out, smells unlawful and unconstitutional.

  • Bob Collins

    The Terms of Service are very clear. They apply to everyone equally. Everyone is free to test it via comments here if you’d like.

    Trolling is banned and the easiest way to find out if that’s enforced is to be one. I don’t see how that’s compatible with our penchant for intelligence and insight.