Wednesday, January 25, 2012

Dr. Paul Offit, vaccine guru, speaks at Yale

Source: sarahmillerbooks,

On Friday January 13, I attended the Beaumont Medical Club seminar in the Yale Medical Historical Library. That night the guest speaker was Dr. Paul Offit, a pediatrician, professor of pediatrics at University of Pennsylvania, and the director of the Vaccine Education Center at the Children’s Hospital of Pennsylvania. He is also the co-inventor of a vaccine to prevent rotavirus infection (the leading cause of diarrhea in young children), and a public proponent of vaccination.

Dr. Offit started his presentation with a brief history of vaccines: from Jenner, to Pasteur, Salk and Sabin, and finally Maurice Hilleman. Interestingly, Hilleman is not a name many people recognize, but Offit considers Maurice Hilleman to be the modern father of vaccines. In sheer number, Hilleman has contributed more to the field of vaccinology than any other single scientist. He developed a staggering nine different vaccines—including ones for measles, mumps, hepatitis A, and chickenpox, among others—and is the subject of one of Offit’s books: Vaccinated: One Man’s Quest to Defeat the World’s Deadliest Diseases.

Dr. Offit then discussed the current CDC-recommended vaccination schedule, highlighting not just the number of shots kids receive these days (26 doses within two years of life), but emphasizing some of the debilitating and crippling infectious diseases that are now preventable because of vaccines. Also worth mentioning, Dr. Offit laments, is the fact we now live in a society in which young parents have never encountered many of these preventable diseases and, therefore, don’t fully understand the risks associated with delaying or denying their children’s vaccinations.

Following this introduction, Dr. Offit moved quickly into the public perception of vaccines and how we’ve arrived at the forefront of medical controversy. The most interesting detail that I took away from this history was that there was actually very little opposition to vaccination in the earlier part of the 20th century. This was despite good cause for alarm, including a large-scale polio outbreak in 1955 from the Salk polio vaccine made in Cutter Laboratories (the subject of another Offit book, The Cutter Incident: How America's First Polio Vaccine Led to the Growing Vaccine Crisis). It wasn’t until the founding of the National Vaccine Information Center (NVIC) in 1982 that the anti-vaccine movement really began. Despite its name, the NVIC provides little material on vaccine efficacy and vaccine-preventable diseases. Instead, the group focuses on providing information on vaccine safety and vaccine-associated side effects and injuries. In addition to the birth of the NVIC, Dr. Offit believes that the documentary DPT: Vaccine Roulette, which was written, directed, and hosted by the actress Lea Thompson in 1982, was also partially responsible for the start of vaccine dissention. This program claimed that the diphtheria, pertussis, tetanus (DPT) trivalent vaccine caused brain damage. It featured harrowing stories of children suffering from brain damage and seizures after receiving their DPT vaccine. Offit believes this was one of the most powerful programs to ever air on national television and that it paved the way for all of the future vaccine-injury scare tactics by the anti-vaccine movement.

Following the founding of the NVIC and the airing of the DPT documentary, there was an immense rise in the number of lawsuits by individual families against vaccine manufacturers. This resulted in skyrocketing prices of liability insurance and vaccine production costs for pharmaceutical companies, leading to reduced vaccine production and ultimately vaccine shortages. Dr. Offit notes that by 1985 only one DPT vaccine manufacturer remained in the U.S. and the drastic reduction in the number of vaccine manufacturers necessitated government intervention. In 1986, Congress passed the National Childhood Vaccine Injury Act, which created a federal Vaccine Injury Compensation Program (VICP) in order to reduce the financial liability of vaccine makers. Of course this hasn’t tempered the enthusiasm of anti-vaccination advocates, but at least the pharmaceutical companies could continue to produce enough vaccine.

Then in 1998, British doctor and scientist Andrew Wakefield published a paper in the journal The Lancet in which he proposed that the measles, mumps, rubella (MMR) vaccine caused autism. He reached this hypothesis by claiming that measles virus could be found in the intestines of intestinal bowel disease (IBD) patients. IBD is quite prevalent in autism patients; therefore, he proposed that the measles part of the MMR vaccine causes autism. However, this paper was not a scientific study as much as it was a small case series of eight autistic children. This claim has been discredited by more than 14 independent scientific studies, yet the allegation remains as vigorous today as it was back then. Dr. Offit spoke quickly about the contributions of Wakefield to the anti-vaccine movement. It almost seemed as if his dislike for Wakefield was enough to keep him from persisting on the topic, but it should be noted that The Lancet paper was retracted in 2004 and the British General Medical Council revoked Wakefield’s medical license, citing numerous ethical violations and fraud.

Today, the “face” of the anti-vaccine movement has shifted to celebrities and public officials, including actress Jenny McCarthy and GOP candidate Michelle Bachmann. “I don’t know about you,” Offit said, in probably the funniest quip of the night, “but I always get my medical advice from Michelle Bachmann.” The audience chuckled, but Dr. Offit seemed wary of dwelling too long on this point. He did mention that the narration of personal stories about the suffering of children pulls at everyone’s heartstrings. “You’d have to be non-human to not feel bad for those kids on the DPT: Vaccine Roulette special,” Offit said. Because of outbreaks from vaccine-preventable diseases such as polio and measles, we now have the personal stories and emotional anecdotes in support of vaccination. It’s a sad truth that we have to use the suffering of children to make this point, but the anti-vaccine movement has been manipulating people with scare tactics for years.

During the Q & A someone asked, “What can we do when we’re not asked to give our side?” and cited the absence of a vaccine expert or scientist during Jenny McCarthy’s appearance on the Oprah Winfrey show. Interestingly, Dr. Offit nodded his head knowingly, and said, “Oh, I was invited to go on that show.” He chose not to go, he said, because “Oprah’s show is meant to entertain, and in any good story there are three roles to play: there’s a hero, a victim, and a villain. Well, Jenny is the hero, her son is the victim, and that only left one role for me.” Offit suggests that we all use emotional and personal stories like the anti-vaccine activists and get out there and share our knowledge. Another great point that I took away from the lecture was that there is no venue too small to stand up for science—and we shouldn’t let misinformation go unchallenged.

The microphone was then handed to someone behind me who started shouting quickly and energetically before I even had a chance to turn around.  I didn’t catch his name at the time, but I found out later it was Jake Crosby, a young man with Asperger's Syndrome and a contributor to the Age of Autism website, which is not so much an autism awareness website as it is a venue for anti-vaccine propaganda. However, all that Mr. Crosby was allowed to say into the microphone was his name and affiliation, followed by the beginning of a question regarding Andrew Wakefield, before Dr. Offit shouted out, “Let me just stop you right there!” Dr. Offit proceeded to tell the audience that Jake was following him around the country and disrupting his seminars and that he had obviously “made it” since he now has a stalker. I agreed with Mr. Crosby’s assertion that he should be allowed to ask a question and personally thought that Dr. Offit disrupted his own seminar more than simply answering the question would have caused. Regardless, Jake Crosby got up and left under his own will. Although I appreciate Mr. Crosby's enthusiasm for increasing autism awareness, sensationalizing his interactions with Dr. Offit on his Age of Autism blog does little to further his cause.

The microphone made its way to a woman during the Q & A, whose question was more of a tirade and by the end of her rant I wasn’t quite sure where she had started or where she was going. She seemed not to be against vaccination per se, but was very concerned about autism and she appeared to be asking Dr. Offit whether he would debate Andrew Wakefield in a public forum. Dr. Offit asked for her name, replying “Ohhh, you’re Mary Holland!” after her response. Mary Holland is an attorney and co-editor of the book Vaccine Epidemic: How Corporate Greed, Biased Science, and Coercive Government Threaten Our Human Rights, Our Health, and Our Children. The book highlights the necessity for informed consent for all medical interventions, including vaccination, which I believe is a reasonable topic for discussion. However, this book is also a cover for anti-vaccine philosophy and includes chapters on and written by Andrew Wakefield and the debunked link between MMR and autism as well as a variety of other conspiracy theories. Getting back to the Q & A, Dr. Offit was very frustrated with Mary Holland’s request for debate because all the scientific evidence discredits any link between vaccines and autism. “What is there to debate about? The scientific data is the truth,” Offit replied. Mary Holland is an attorney, so she can probably debate just about anything, and she continued to push the notion that vaccines can and have caused autism, citing rulings by the federal vaccine injury compensation program (VICP) as proof of causality. What’s lost in this reasoning is the fact that the VICP is a no-fault program, meaning that the biological cause (in this case, a vaccine) of a side effect or disease does not need to be scientifically validated to provide compensation. Unfortunately, Mary Holland’s audience (outside of this particular venue) probably doesn’t realize this is an empty argument.

As for the future of vaccination, Dr. Offit was surprisingly optimistic. He thinks that despite the accessibility of misinformation, we’ve turned a corner in getting the truth out there. Besides from mandating vaccination, a program he has pioneered for all employees in his own hospital, we can only provide parents with correct, scientifically valid information. He hopes, and I do as well, that enough parents make the choice to vaccinate their kids so that herd immunity can protect us all.

-Heather D. Marshall, Ph.D.
Postdoctoral fellow
Immunobiology Department, Yale University

For more information:

Wednesday, January 18, 2012

Research Works Act in Name Only

The Research Works Act (H.R.3699.IH) does not actually make research work. It allows publishers to charge exorbitant fees to view research payed for by the public that is submitted and edited for free by scientists.    

The fruits of academic endeavor should be available freely for the enrichment of all. Right now, a large portion of academic research gets paid for by the federal government through programs like the National Science Foundation (NSF). In fields that don't have pharmaceutical or commercial applications like my own (paleontology), almost all funding can come from the government. However, when this research is published in peer reviewed journals, the publishing companies are allowed to copyright the data and demand exorbitant subscription fees for other researchers just to read the articles. The journals get free content and free editing by academics yet they charge through the nose for their publications. The result is that researchers from poorer countries or institutions and interested members of the public cannot afford to view actual scientific studies. Rich institutions like Yale can afford subscription fees, but much of their budget comes from grant overhead on these same federal grants. Effectively, the government pays for the research and the editing, and then has to pay again just to read what it already wrote. Publishers do add value to scientific papers by archiving, advertising, and distributing them. But the whole point of publishing your findings is so that others can read and critique your results and learn from your conclusions. Denying people from reading your work, especially if it was publicly funded, is antithetical to the aims of science. This is a small bill but it could greatly limit our access to the latest scientific and medical research. If the taxpayer paid for it, she should own it. Free data is not just good science, it's good economics too.

-Matt Davis
2nd year Geology and Geophysics graduate student

Other links:

New York Times editorial against the bill by UC Berkeley Associate Professor Michael Eisen

Michael Eisen's blog post about the bill featuring good arguments on both sides of the issue

The Copyright Alliance's statement in support of the bill

The Association of American Publishers statement in support of the bill

This post represents the views of an individual author, and does not necessarily reflect the views of Yale Science Diplomats.

Thursday, January 12, 2012

Science in the News: Location Scouting

An important part of the planning for Science in the News 2012 is finding a great location. Last year we had the privilege of hosting the series of talks at the Leitner Family Observatory and Planetarium. We were very happy to start our series there and get the support of the students and employees of the Observatory, however the location is a bit hard to find (for good reason, of course; you want to be at the top of a hill to see stars).

This year we decided to explore other location options. We had heard that the New Haven Free Public Library (NHFPL) Ives Memorial Library (main) branch had just renovated their Program Room, so we decided to check them out.

The NHFPL building was built between 1908-1911 and is really gorgeous. It was designed in a Colonial Revival style made of brick and marble. Large white columns greet you as you walk up the steps on the outside that lead into a lovely entrance of the spacious three story library.1,2


NHFPL really is a city landmark, situated right across the New Haven Green on Elm St. and Temple St.  Aside from being beautiful and centrally located in downtown New Haven, it is right across the street from a Yale parking lot that has free parking on weekdays after 4pm.

We were really excited about connecting with the NHFPL, since it already is a great resource for our community. However, we didn’t want to miss out on seeing the space it in person first. On a cold December evening, six of us took a field trip downtown and met up with Kathie Hurley, the library’s Public Information Officer, who gave us a tour of their facilities.  I took some quick pictures with my phone, so I apologize if they’re a little bit blurry.

The entrance to the room we would be using is very clearly marked. :)

As you can see below, the room is very large. It can definitely fit our audience comfortably. The chairs weren’t set up on the day of the tour, but you can see a stack of them on the right. (We visited on the day of their holiday party, so some festive decorations were up to greet us).

Not shown is a white screen that comes down in front of the back window. You can see a standard podium that will be perfect to hide our laptops well—although I hope our speakers won’t do the same! There is also a lot of adjustable lighting on the ceiling. They really did a beautiful job with the renovation (although I had seen this room before).

This next photo is not just a great candid shot of Madam President, Elizabeth, but shows a neatly hidden cupboard (on the right) where all the fancy projector electronics are hidden. There’s also a glass window to the kitchen.

I must admit I am quite excited that the kitchen area is so close to the action. So you can take a sneak peak at where we will be preparing all the yummy snacks and drinks for our audience.

If you can’t tell, Kathie was very excited to meet us. She’s a local and loves when Yale students interact with the community. We are obviously very excited to do this, and love the support from her!

Overall, I have to say I’m very happy with the space and more importantly, the support that we got from Kathie about having the Science in the News series at the library. I think this will be a great partnership, that will hopefully last many years!

New Haven Free Public Library
133 Elm St.
There is a convenient side entrance that leads more directly into the Program Room on Temple Street. We will try to have signs directing our audience there.

Science in the News will have six talks this semester, on the last Tuesday of every month from January through June, at 6pm.

-Griselda Zuccarino-Catania
6th year Immunobiology PhD candidate
Science in the News Co-Director

Monday, January 9, 2012

STEM or HELP? Which Would You Have Chosen as a Sophomore?

In early December, Yale Student Science Diplomat's Outreach Coordinator, Keerthi Shetty, escorted fellow grad students Liz Turner, Patrick McMillen, and me to James Hillhouse High School in New Haven. We were preparing to give a Science in the News talk on GMOs to about 30 sophomore students. Before any students had arrived in the classroom, anatomy teacher Ms. Mara Dunleavy informed us that these sophomores are poised on the brink of having to choose between STEM (science, technology, engineering, and math) and HELP (humanities, education, law, and public service). She winked at us, encouraging us to push them towards STEM.

Keerthi, Patrick, Liz and I exchanged concerned glances. We were all thinking the same thing: as 15 or 16-year-old high school students, would we have chosen STEM? Back in my sophomore year, English, History, and German were clearly my better subjects, edging out Chemistry and Algebra not only in test scores, but in preference. I mean, who'd want to calculate molarities when you could instead read a novel The fact that these kids have to choose, and choose so early, is not unique to Hillhouse High, or even uncommon. Many high schools around the world use this technique to better prepare students for college and to put them in classes that they'd prefer, ostensibly to keep them interested in what they're learning. But what if their interests change? What if I had chosen HELP back then in high school but then changed my mind later? Would I have stayed away from science altogether, believing it to be not for me, that I was too far behind to catch up?

These thoughts were buzzing in our minds when, seemingly all of the sudden, the classroom filled up with rambunctious students sizing us up, sizing up Science, not as a method but as a life choice.

Our talks went really well (Liz being completely ill and in no shape to give a talk notwithstanding). And the students asked really great questions. We got a few old GMO standards like, "If you put a gene in a plant to make it grow bigger, why won't it make us grow bigger when we eat it?" (the answer being that plant growth hormones are very different from animal ones, and people don't even actually use plant hormone genes in making GMOs anyway). But we also got questions that we hadn't heard before, ones we were talking about in the car on the way back to Yale, like, "What happens if a bee flies into a soy or wheat flower and then flies over to a weed?"

Soy and wheat are usually self-fertilizing plants, and their small flowers aren't very attractive to bees. This is fortunate if you don't want your introduced gene to move into nearby weeds, the plants related to soy or wheat at the edges of your fields. Most of the time, this doesn't happen: the gene stays in the crop because the pollen doesn't even move outside of its own flower. But as we pointed out in our presentation, self-fertilization of crops doesn't ever 100% prevent gene flow. Sure, the gene a human puts into a plant is no more likely to get into a weed than any other gene, but that doesn't mean it's impossible. A bee could absolutely stop at a soy or wheat flower by mistake and then land on a weed flower and fertilize it with the GM pollen. Is it likely that a bee would do that? No. Is it likely that the crop and the compatible weed would be flowering at the same time? Probably not. Is it even likely that the weed's seed with the new gene would survive? Well maybe. But the point is that it's possible.  This student had come up with a perfectly reasonable explanation for GM gene flow. Kudos to her scientific thinking! But will she choose STEM? And if she doesn't, does that rule out a career in science for her for ever?

-Elizabeth Winograd-Cort
6th year MCDB PhD candidate
President of Yale Student Science Diplomats

Friday, January 6, 2012

Health Secretary Sebelius's dangerous precedent

                                             Images source: Wikipedia

In December of 2011, the Food and Drug Administration (FDA) issued a report that found Plan B One Step, a “morning after” pill, was safe for all females of childbearing age and met the standards for over-the-counter drugs. Therefore, they decided this pill should be available to women of any age over-the-counter; previously, girls under 17 years old needed a prescription. However, the head of the Department of Health and Human Services (DHHS), Secretary Kathleen Sebelius, overruled the FDA’s decision on December 7, 2011. The implications of her decision go far beyond young women having restricted access to a safe and effective drug.

I would like to put aside political and social leanings and highlight that Secretary Sebelius has set a very dangerous precedent. Although the head of DHHS technically has the right to overrule the FDA, this has never been done before. The FDA is a fairly autonomous body for good reason--they can make extremely important decisions regarding what products are safe and useful without political orientation becoming a factor. Now, Secretary Sebelius has opened the door for future DHHS leaders to ignore the facts and influence important food and drug policy based on political climate and preferences rather than scientific evidence.

Regardless of whether Sebelius’s decision was driven by political factors, it was destructive. The FDA is a large organization designed to assess the scientific integrity of clinical trials and make decisions about what drugs are safe and effective for us. Now she, as an individual, has discredited and debilitated the FDA’s efforts, and paved the road for others (who may not be as informed or well-intentioned) to do the same.

One of the main reasons I joined Yale Science Diplomats was to actively mend this sort of disconnect between science and policy… needless to say I’m extremely disappointed by Secretary Sebelius’s decision.

Related links:

-Becky van den Honert
1st year Psychology graduate student

This post represents the views of an individual author, and does not necessarily reflect the views of Yale Science Diplomats.