To get the shot, or not

Anyone with young children in their extended family has probably come up against the childhood vaccination question, and the debate about causes of autism. And we are all, parents or not, hearing the cases for and against the H1Ni vaccines (and flu vaccines in general).


Flying back this week from New York, and a visit with my grandson who is recovering from flu (assumed by health professionals involve to be H1N1 though no tests were made), I read Amy Wallace's article in Wired. Her strongly worded defense of the science behind childhood vaccinations for mumps, measles, rubella, pertussis, etc. was already known to me from a Twitter storm involving various sides in the debate.


The next day I read an article in The Atlantic that called into doubt the efficacy of flu vaccines, for both seasonal flu and H1N1. The article focused on a few serious scientists who are questioning widely accepted claims for vaccines, at the risk of the approbation of other health professionals.


So, who are we supposed to trust? And, most importantly, what are we supposed to do if we want to improve our odds in a world that seems to threaten our fragile health on so many levels? 


Looking at the questions raised by the Wired articles, it seems important to me that the anti-childhood-vaccination proponents often get lost in personal attacks on one or another of the scientists arguing in favor of vaccinations. Such ad hominem attacks are often used by people who may be so convinced of their position that they can overlook the facts in favor of finding a villain to blame. In this case there may indeed be a certifiable villain in the mix: big pharma.


It's a bit like OJ. The LA cops from the time of Bill Parker had so thoroughly lost the trust of black Angelenos that there was no way a jury of peers was going to believe anybody representing LA, let alone a nut case like Mark Fuhrman, who were out to get a black man, any black man. By the same kind of reasoning, because vaccines come from big pharma, who are one of the least credible institutions in the US, there's no way I would believe anything they claim.


Except. Sometimes the bad guys are not the story. For one thing, big pharma doesn't really make much from vaccines. Only a few hundred million bucks a year. What they're focused on is the big payoffs, the one-or-two-a-day-for-the-rest-of-your-life drugs like Lipitor or Cialis. The others, like childhood vaccines, are just chump change.


The most incendiary charge against the childhood vaccines is the issue of autism. And this could easily be a case of post hoc ergo propter hoc, the term for a classical logical fallacy: just because thing A happens and then thing B happens does not prove A causes B. Autism has become our syndrome de jour, a diagnosis that seems to be growing more common. Like many, I think it may be just a case of different diagnostics applied to a wide range of human behaviors, especially a range of behaviors that is understood to be a continuum anyway.


But the post hoc argument also calls into question most statistical analyses, which only point to correlation, not causation. It was Benjamin Disraeli (and later Mark Twain) who said "there are three kinds of lies: lies, damned lies, and statistics." Statistics can certainly be slanted, but a close examination should be able to discover the bias. And that is the case with flu vaccines.


The argument for getting an annual flu vaccination, it seems, may be based on a conflation of   proximity (like post hoc) and causation. The statistical evidence says that people who get vaccinated are half as likely to die. However, a closer look also says that people who get vaccinated are more likely, for a number of socio-economic reasons, to be healthier in the first place. Where statistics indicate a correlation, scientific testing should support or question it. However the case for the efficacy of flu vaccines has never been actually tested, with controls and placebos and the whole scientific method.


I believe our challenge is to see the world as it really is, not just as conventional wisdom tells us the world should be. Which also means that we should not be overly trusting of "experts." Add to that the deep distrust (or misunderstanding) of science and the scientific method that seems to be a part of our culture, and we are naturally set up to distrust those who claim any kind of truth that doesn't align with our beliefs.


My point is that our beliefs must be continuously tested -- and the scientific method is the best model for a way to discern the world as it really is by rigorous examination. It is highly unlikely that any truth is THE truth. But a single isolated truth can be more significant than a passionate belief. 


It's all about the testing, and the willing suspension of belief.