Call for vaccine opt-out penalty

[Varied A]

Originally Posted by Muffin2

the scare about autism and MMR where to do with the combined vaccine. the separate ones don't seem to carry this risk.

What a bizarre comment to make, given that (I presume) you don't believe that the triple vaccine carries any risk either?

[469er]

Originally Posted by Muffin2

the scare about autism and MMR where to do with the combined vaccine. the separate ones don't seem to carry this risk.

But I thought you said that there was no risk? That it was all a "ridiculous paper" that "panicked parents"? What are you saying now?? And why would you reconsider your position about the triple vaccine in response to what I said? I have no particular position on the triple vaccine as opposed to the single ones, nor did I at any point mention autism.

If you read the research, you will find that the original investigation into what Wakefield called autistic enterocolitis involved children who had had the triple vaccine, the single vaccine and also wild measles. But you know all this, I'm sure. Otherwise your vehemently held opinions on it would all just be kneejerk judgements based on stuff you've heard other people saying and seen on the telly, right? Which is exactly the sort of stupidity you denounce parents refusing vacinations for.

I'm very confused now. And I think you are too.

[Muffin2]

i'm not confused. i'm very clear on my thoughts thank you very much. and i am clear on the report, otherwise i wouldn't have mentioned it.

i'm sorry but i thought it was common knowledge that the study (wrongly) suggested the combined vaccine carried a high risk of autism. and so parents naturally went for the separate vaccines, carrying the lower risk (according to the report)

so therefore, my point was if the vaccines where to become compulsory, parents may perhaps be more comfortable with the idea of separate vaccines instead of the combined one. regardless of the fact the report has had all support withdrawn.

if you don't understand now i'm sorry, i've tried to explain in a multitude of different ways.

[Varied A]

Originally Posted by Muffin2

i'm not confused. i'm very clear on my thoughts thank you very much. and i am clear on the report, otherwise i wouldn't have mentioned it.

i'm sorry but i thought it was common knowledge that the study (wrongly) suggested the combined vaccine carried a high risk of autism. and so parents naturally went for the separate vaccines, carrying the lower risk (according to the report)

so therefore, my point was if the vaccines where to become compulsory, parents may perhaps be more comfortable with the idea of separate vaccines instead of the combined one. regardless of the fact the report has had all support withdrawn.

if you don't understand now i'm sorry, i've tried to explain in a multitude of different ways.

Have you actually read the article? I do wonder, by the way you talk of it it does sound very much as though you're vaguely aware of some media hype but not of the actual paper. It's available at ScienceDirect - The Lancet : Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children (if you have Athens!)

If you read the article carefully, you'll see that the abdominal complaints as well as various psychological disturbances (not just Autism) were linked by the authors not only to MMR, but to single measles vaccines, single rubella vaccines and to actual measles infection.

I don't claim to know much about this area of medicine other than what I've seen in the media, or in secondary medical sources, which is why I don't make that many claims about it. I think you should adopt a similar approach.

Or, perhaps, if you have read the paper, you'd be kind enough to give us a line by line critique explaining exactly why it is you believe it to be flawed? I would be genuinely interested, as whilst I do know of some of the ethically dodgy things which went on during sample selection (which, funnily enough, aren't mentioned in the paper), I've never heard a clear and unbiased account of why the actual research (or its interpretation) is flawed. As such an expert, I'm sure you could enlighten me!

[Muffin2]

get lost.

i'm not about to write a full critical appraisal of the paper. as a student nurse i imagine you've never had to do this because you are obviously unaware of the process and how long it takes to critically appraise a paper. if you want an idea, i had to do one as a piece of coursework, we were given 6 weeks and it was worth 40% of the overall module mark.

if your that bothered do it yourself. i'm sure your critical appraisal will be just as unbiased. if you want any info on how to do one PM me.

if you can't accept my opinion that i think vaccination should be compulsory then fine, we'll agree to disagree.

[469er]

Originally Posted by Muffin2

i'm not confused. i'm very clear on my thoughts thank you very much. and i am clear on the report, otherwise i wouldn't have mentioned it.

i'm sorry but i thought it was common knowledge that the study (wrongly) suggested the combined vaccine carried a high risk of autism. and so parents naturally went for the separate vaccines, carrying the lower risk (according to the report)

so therefore, my point was if the vaccines where to become compulsory, parents may perhaps be more comfortable with the idea of separate vaccines instead of the combined one. regardless of the fact the report has had all support withdrawn.

if you don't understand now i'm sorry, i've tried to explain in a multitude of different ways.

How is any of this a response to what I said?? You asked me to give you some more detail about why my children haven't had all their vaccinations so that you could understand where I was coming from, but your response seems to consist entirely of banging on about Wakefield and MMR, which is emphatically not where I am coming from.

My objection to making vaccination compulsory is that there are situations (and I believe my children's is one), where the current evidence base would not support excluding a child from the programme, but where careful research by an interested party (which, realistically, is more likely to be a parent than a doctor, as regards any particular child) tends to suggest that avoiding a vaccination may be prudent following a risk/benefit analysis which takes into consideration the seriousness of the disease being vaccinated against.

I'm not particularly interested in whether anyone thinks my decision is clinically sound (not least because I have deliberately not included enough detail for anyone to make that assessment). But surely the point of debate here is whether or not such an example successfully highlights the flaws in a compulsory vaccination scheme.

If you can't be bothered to respond to what's actually been said ... well, why respond at all?

[469er]

Originally Posted by Varied A

I would be genuinely interested, as whilst I do know of some of the ethically dodgy things which went on during sample selection (which, funnily enough, aren't mentioned in the paper), I've never heard a clear and unbiased account of why the actual research (or its interpretation) is flawed. As such an expert, I'm sure you could enlighten me!

One of the interesting things, IMO, about critiques of the original research is that they tend to consider the alleged link between the measles virus and ASDs/GI disorders in a very unidirectional way. What I mean by that is that discussion focuses very much on whether an abnormal response to the measles virus could cause autism (to use blunt terms). What there is very little discussion of - or at least I have never been able to find any - is whether an existing (e.g. genetic) predisposition to autism could cause an abnormal response to the measles virus. The phenomenon of abnormal, heightened, immune response in autistic children is well documented, and yet there seems to have been no orchestrated attempt to investigate whether the autism Wakefield was observing in post-vaccination children was causal of an abnormal immune response which then triggered the autoimmune GI problems, rather than consequential to the vaccination (or contact with wild measles).

I guess the media storm that ensued, and the wild-eyed response of the DH, have probably firmly squashed the likelihood that anyone is going to risk their career by taking this research any further for a good long while, which, IMO, is a far sorrier consequence of the whole affair than the tongue-biting frustration poor GPs are having to labour under.

[Muffin2]

i was responding to what varied A said.

i see i'm going to have to make myself very clear as to who i'm reponding to.

right here i'm responding to what you said, the quote thing won't work so its below.

"But surely the point of debate here is whether or not such an example successfully highlights the flaws in a compulsory vaccination scheme"

which is exactly why i said, although compulsory vaccination is a good idea and i don't think its going to happen unless there was something in place for children such as yours, which, if its as bigger concern are your GP and immunologists think, i would imagine opt outs would be there.

i really hope this is undertsandable, cos i'm getting a bit tired of repeating myself.

[469er]

Originally Posted by Muffin2

i was responding to what varied A said.

No you weren't.

I explained my stance and asked you: "Does that change your position at all?" And you said:

Originally Posted by Muffin2

hmmmm i respect your right to choose whats best for your kids. i don't know if it changes my position, maybe on MMR (at least the combined one). i suppose if the separate vaccines where offered then people may be more accepting. as regards to tetanus and meningitis, there doesn't seen to be much of a reaction around them. it would be interesting to know which vaccines the report is on about.

Which was pretty much irrelevant to the issues I had raised and the question I had asked.

i really hope this is undertsandable, cos i'm getting a bit tired of repeating myself.

I think we're all getting tired of it. Your opinion is only too clear. What's not clear is why all you keep doing is coming back to restate it, despite all the new and interesting questions people keep raising.

Face it, Steph, you shot out of the gates with a snap judgement, and despite lots of thoughtful posts by people who actually appear to have a genuine interest in this topic, can't bring yourself to admit you may not quite have thought things through from anybody else's viewpoint but your own, and perhaps have a little reading to do besides.

[Varied A]

Originally Posted by Muffin2

get lost.

i'm not about to write a full critical appraisal of the paper. as a student nurse i imagine you've never had to do this because you are obviously unaware of the process and how long it takes to critically appraise a paper. if you want an idea, i had to do one as a piece of coursework, we were given 6 weeks and it was worth 40% of the overall module mark.

if your that bothered do it yourself. i'm sure your critical appraisal will be just as unbiased. if you want any info on how to do one PM me.

if you can't accept my opinion that i think vaccination should be compulsory then fine, we'll agree to disagree.

Hahaha. Very good. "Awww, the student nurse doesn't understand the real world that we doctors live in"

Actually, in order to get my degree, I had to do a 12000 word dissertation (which was mostly a systematic lit review), another 4000 word lit review, and pass 2 exams on research methodology and statistics (amongst lots of other things). I've also had 2 (unrelated) lit reviews published (in medical journals), and am currently running a research project. So I do know a thing or two about critiquing research.

What I don't know is much about this topic, which is why I'm not really in a position to objectively review this paper myself. Even if you can't give us a full critique of the paper, perhaps you could tell us maybe 3 or 4 of the most serious points which you'd like to challenge? That's not exactly hard, for someone who obviously knows so much about it, is it?

It strikes me that you've been caught out prophetising on something about which you know little. That's fine, just admit it, I'm sure nobody will care. It does amuse me though that instead of doing that, you're digging your heels in, being arrogant, and making yourself look ridiculous. I imagine that it will amuse your patients (and your consultants!) a little less when you get into clinical years or are qualified. God help us all!