The Vancouver Sun from Vancouver, British Columbia, Canada • 41

SATURDAY, MAY 23 1 2009 BREAk'NG NEWS VVNOHATRSl N.COM WEEKEND REVIEW C5 i QUOTABLE "As well consult a butcheron the value of vegetarianism as a doctor on the worth of vaccination." George Bernard Shaw "I can't tell you that we know that the MMR vaccine causes autism. But the Department of Health can tell you with 1 00 per cent certainty that it they believe that, and that concerns me greatly." Andrew Wakefield 1 i Science is clearly not on their side, but vaccination foes are unswayed Their movement is motivated by beliefs, values and conspiracy theories We chose the status quo. Now we can decide on the negative T- -V--' -J i. i I 7 lit i ii VACei.VA.TION, 'A mighty and horrible monster, with the horns of a bull, the hind hoofs of a horse, the jaws of a krakin, the teeth and claws of a tyger, the tail of a cow, all the evils of Pandora's box in his belly, plague, pestilence, leprosy, purple blotches, foetid ulcers, and filthy running sores covering his body, and an atmosphere of accumulated disease, pain and death around him, has made his appearance in the world, and devours mankind From vide Vaccinae Vindicia, London, 1807. GORDON GIBSON We are a democracy.

What that means is that on a few great questions we will have our collective way, wise or stupid as it may be. Which brings us first to the recent B.C. referendum on electoral reform and then the Conservative personal attack on Michael Ignatieff. In British Columbia (as earlier in On tario) the voters have massively rejected a change in the voting system. The insider machinations were curious.

The opposition to the change (using public money) was led by two New Democ rats. Neither they, nor their party, nor the supporting labour unions seem to have recognized that so-called progres sive ideas would have had much more influence in the future under the new system, because it would typically have produced coalition governments that would have to listen to all sides. Instead the New Democrats hung out tor the status quo, winner-take-all elec toral system. In a conservative province like B.C. this delivers the socialists a majority elected dictatorship only once a generation, at most.

Bad trade. Oh well, there we are. As a democrat ic reformer for 30 years, now that we have come to the losing crunch, I ac knowledge that one can't fight the bal lot box. Comes now a new opportunity, and a big one, for the public to get it right or wrong. There is a thing called the "Harper government, which is how the PMO in its official press releases de scribes the government of Canada.

This outfit has through its party advertising now launched an intensely personal attack on Liberal leader Michael Ignati- eff. The character assassination details don't matter much in fact, but may sell in a political sense. Ignatieff is attacked for being out of the country for 30- some years, a "cosmopolitan" and so on words carefully crafted to appeal to the bigoted and the ignorant. The Con servatives are very good at this. Similar tactics destroyed Ignatieff predeces sor, Stephane Dion.

Of course, Dion was a far easier target. He was a compromise candidate tor the Liberals without much real sup port; there wasn't much substance there and no royal jelly at all. There is a lot more to Ignatieff, world-class, and it sullies Stephen Harper to play this game. But then, winning is everything, isn it? Sullied or not. So the public, fxlish or wise, will de cide whether they buy these attack ads or not.

Jean Chretien, a past master at this sort of thing himself, used to say (when in a defensive posture) that "He who throws dirt, loses ground." Maybe. But you only get a positive election of the Obama type now and again. Mostly, as in the B.C. referendum and count less ordinary elections, negative wins. If I were Ignatieff I would take the gloves off right now, before this goes further.

Try for an election, fast. Canadians don't want another elec tion, but my bet is that if put to the test thov will like dutv politics less. Hie issue? Continued denial of equal treatment for unemployed Canadians right across the country is a place where the Harper government has now cho sen to draw a line in the sand. They sav a British Columbian or On- tarian out of work is not nearly as meritorious for benefits as a Nova Scotian or Quehecer, despite having paid the same 1.1 premiums. II the Harper gov ernment keeps up tins game, let get on with the fight that will decide whether we want dirty politics fir civili ty.

Of course, vou never know what the public will do. We are a soft, fearful and conservative people compared to our ancestors of just a couple of genera- tii tiii ago. Mayoo we win again go with the nega tive ami the status quo. Foolish or wise? lime to check it out. Milmiisxiimi titc ()r pulilii v.int omri -mum out "CP A K'j'- iJ There are two assumptions about the anti-vax movement -first, that it is new and growing, and second, that it will be persuaded by the evidence.

There is reason to believe both of these assumptions are false. public health experts, who therefore suggest that we must counter the apparent growth of the anti-vaccination-ist movement with the dissemination of the scientific evidence. The trouble with this approach is that it's based on two assumptions about the anti-vax movement first, that it is new and growing, and second, that it will be persuaded by the evidence. There is reason to believe both of these assumptions are false. Anti-vax sentiments have, in fact, been around since Edward Jenncr first demonstrated the effectiveness of the smallpox vaccine in the late 18th century.

One outspoken critic was 19th cen-tury British physician Charles Creighton, who characterized vaccination as introducing poison into the body, and accused Jenncr of being motivated by financial concerns. Anotherhigh-profile critic, renowned British bacteriologist Edgar Crook-shank, went further, arguing that the smallM)x vaccine was not only ineffective, but the cause of a serious disease called "vaccinia." Such arguments, and the enactment of British laws mandating vaccination, led to the development of many anti-vaccinationist groups, which published hundreds of newsletters and pamphlets and actively lobbied the British Parliament. The anti-vax movement Is certainly not new, then, and was at least hs powerful 150 years ago as it is today, though there were many more scientifically eminent members of the movement in the 19th century. But what's really fascinating is the arguments made today are not appreciably different from those advanced by Creighton, Crook-shank and other critics in the 1800s. In a recent paper, Julie-Anne Iask and Simon Chapman of the University of Sydney assessed anti-vax arguments In the 1990s, and noticed several domi more than Till words to: Minoplnlnnm pngi dren's Hospital of Philadelphia provides a brief review of the vaccine-autism theory in a recent issue of the journal, Clinical Infectious Diseases.

In 1998, a paper published by British gas-troenterologist Andrew Wakefield in the The Lancet appeared to provide some empirical support for the theory. Wakefield examined a small number of autistic children who had recently received the MMR vaccine and found they were suffering from gastrointestinal symptoms supposedly caused by the vaccine. Wakefield then hypothesized that the gastrointestinal damage permitted the entrance of certain proteins into the bloodstream that would ultimately make their way to the brain, and could thereby cause autism. There are all sorts of problems with this study among other things, it lacked a control group, thereby precluding findings related to causation but things really went south when it was revealed that Wakefield had received financial support from parents who were suing vaccine manufacturers. After that, Wakefield's co-authors and 77ic Lancet distanced themselves from the study, and this year, The Times newspaper in IaMidon suggested that Wakefield might have altered data in the study.

With Wakefield's theory in shambles, proponents of the vaccine-autism link took a different tack, arguing that thinierosal, an cthylniercury-contain-ing anti-bacterial preservative present in sonic vaccines, might be responsible for causing autism. Although that theory was biologically implausible for a number of reasons, epidemiological studies were conducted, but could find no evidence of a link between thimerosal-containing vaccines and autism. Indeed, after thinierosal was removed from vaccines, autism diagnoses continued unabated. I'inallv, vaccine-HUtism theorists proposed that the administration of multiple vaccines could overload children's Immune systems and make them susceptible to autism. Studies again failed to find evidence for this children are typically infected with a variety of viruses that affect their Immune systems more than vaccines which Khould have put the vaccine-autism theory to rest.

Unfit didn't. And the fact that It didn't led to great consternation among many uml numlxT ulong with sulinihsion of no nant themes vaccines are ineffective and dangerous as they cause disease, the vaccination movement is the product of big pharma allied with physicians and government officials and motivated by financial interests, and the real way to avoid disease is through hygiene, sanitation and natural living. People in the 19th century could, perhaps, be forgiven for not appreciating the efficacy of the smallpox vaccine, though they should have noticed that smallpox outbreaks inevitably occurred in areas where vaccination rates were low, just as measles outbreaks occur today in regions with low vax rates. And today, with the abundance of scientific evidence available, there really is no excuse for doubting the efficacy and safety of vaccines. But many in the anti-vax movement suggest that much scientific evidence has been suppressed, thanks to the "unholy alliance" between big pharma, scientists and physicians and government officials.

I lence, the movement is motivated not so much bv a lack of knowledge of the research, but by suspicion of those who conduct and disseminate it. Further, the movement's focus on "natural" living suggests not merely suspicion of the people who conduct and disseminate scientific research, but of medical science itself. Many in the alternative health movement reject the very foundations of what they refer to as "allopathic medicine, osiecially its etunhasis on introducing "poisons" Into the body. The anti-vax movement is therefore motivated by values, by specific philosophies about how to live. Riven this, it'sltighly unlikely that dissemination of the research will change anv an-ti-vaxer's opinion.

This has in factlwn confirmed empirically, as studies have shown that anti-vaxers are actually more likely to oppose vaccination after being informed of the risks and benefits. Consequently, it simply might not be possible to convince everyone of the benefits of vaccination. But any attempt to do so should recognize the deeply and sincerely held worldviews of those who op)se vaccination, rather than treating them as empty vessels just waiting to be filled with ihe latest evidence. pmiknight vaiKOUYtfsunxom anuri.ium (no alMt hineni-), Writer who? II M. Tres rvliNW: suimi'Hllp(i( PETER Mcknight VANCOUVER SUN To people under 30, one of the most devastating diseases in human history is a purely historical matter.

That's because the last natural case of smallpox infection occurred in Somalia in 1977, and the last laboratory-acquired case in 1978. We have vaccinations to thank for the eradication of this disease that once killed one in 10 children in Europe and one in seven in Russia. Vaccinations are also responsible for the near eradication of polio, and for dramatically reducing the incidence of many other deadly diseases. Despite this conspicuous succccs success far beyond that of any other medical intervention vaccination remains a controversial matter, with celebrities touting "natural" means of avoiding disease, and "anti-vaccina-tionist" websites repeating heart-wrenching stories of children allegedly devastated by vaccines. Indeed, when it conies to promoting the importance of vaccination, it seems we're one step forward and two steps back.

Just as a U.S. "vaccine court" was re-cently rejecting a claim that the nieasles-munips-rubella (MMR) vaccine was responsible for the plaintiffs children's autism, Oprah Winfrey announced that she had signed a development deal with model-actress Jenny McCarthy, who claims that she used natural methods to "recover" her son from autism caused by the MMR vaccine. Hie Winfrey-McCarthy deal will provide a shot in the arm to the vaccine-autism theory, despite the fad that the theory has been repeatedly shot down by science. (liven the rise in autism diagnoses over the past few decades, many people in the 1990s suspected that vaccines might Ix? responsible even though it's not clear if there really are more cases of autism, or if the rise in diagnoses Is a result of a change in diagnostic criteria and Increased awareness of the disorder. In any case, Paul Offit of the Chil COMMENTARY In hide III be n.imc nitlilied liliin two week.

Address: 1 he um ouve Mm, Niile 2n) l.ram ille N.iih omer,.