measles deaths and antivax misinformation

Today the death toll from measles in Samoa rose to 32. All but four of the dead were less than 5 years old. Absolutely terrible, heartbreaking, news.

That statistic alone should be enough to give the lie to the common claim by antivaccination activists plague enthusiasts that “measles is a benign childhood disease”. Clearly it is not. (And never has been.)

However, that hasn’t stopped them making a range of incorrect claims about vaccines (I’ve given a few further down), or from indulging in asking questions in a way that’s calculated to sow fear and uncertainty (often described as Just Asking Questions, aka JAQing off, because typically they aren’t really interested in the answers).

I want to address one of those “questions” here, because it demonstrates a lack of understanding of how studies are designed (& also a fairly poor grasp of research ethics), and because it’s commonly used to imply that vaccines have not been tested properly and should therefore not be used:

All new vaccines are tested against a saline placebo during clinical trials. This is to find out whether they perform better than, well, salt water in terms of generating a useful immune response. Despite repeated claims to the contrary, these trials exist (here’s one, as an example); they are regularly performed and well-documented.

However, when a new version of a vaccine is being trialled – one that differs only in the antigens it includes (antigens are what generate that immune response) – then best practice requires that it’s not tested against placebo.

This is for two reasons.  Firstly, because the question is now not “does it perform better than placebo?”, but “does it perform better than the earlier form of this vaccine?” (There’d be no point in using it, if it was better than placebo but worse than the original.)

And secondly, because it would be highly unethical to expose children & adults to the known risks of a disease by using a saline placebo when we already had a vaccine known to be protective – no ethics committee would ever approve it.

And it would also be almost impossible to recruit participants: no parent supporting vaccination would be willing to take the chance that their child would be in the saline arm of the trial (in a double-blind trial neither participants nor researchers know who’s getting which treatment), and similarly I doubt a parent opposed to vaccination would want their child in the vaccine arm.

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As I said at the start, that sad, dreadful death rate has not stopped plague enthusiasts suggesting – on pretty much every news outlet’s posts about this epidemic – that the children were malnourished (effectively blaming the parents):

or that the vaccine spreads the disease:

– which is an outright lie: there is no evidence that this has ever happened for the measles vaccine. And yes, scientists have looked for it. In fact, simple logic shows that claim is wrong – because if it were correct then countries with high vaccination rates would also have constant high levels of measles infections. The situation in Samoa, sadly, shows us that the reverse is true.

or that the Samoan government’s decision to make vaccination mandatory is somehow equivalent to the evil done in Europe under the Nazis (see recent posts by this reprehensible ill-educated young woman).

They appear to have no sense of shame – perhaps they should start to develop one.

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