Commenting Policy

So I was reading a great article about crank Facebook groups this week and tremendously enjoying it.

Until I came to the wretched scum that floated to the top of the bowl in the comments.

So far I have been lucky with the quality of comments my blog has received, and even people who have disagreed have been by and large polite, considerate and accurate in their critiques. From looking at the comments on this article (plus the sort of ridiculously pseudoscientific bilge that generally shows up in sceptic blogs) I can foretell that the same may one day hit me.

So this is my policy. You can post any comment you like on this blog and I will not delete it. I won’t silence you, promise. I won’t edit anything you have to say, and you can make as many comments as you like.

But for every single anti-vaccine/anti-evidence based medicine/pseudoscientific comment I receive, I will donate $2 to Oxfam, MSF or the Red Cross for their vaccination programs in humanitarian crisis areas. I will do it in your name. And I am happy to pay as many times as I have to in your name so as many people as possible receive vaccines.

I guess this will mean you need to evaluate the sincerity with which you hold your beliefs: are you so convinced that vaccines are bad that you are willing for children abroad to received vaccines, just because you had to share your dumbass, uninformed opinions about vaccines/chemtrails/paleo/oil pulling etc? Or do you only care about your kid, or rich white middle class kids like your own, and the rest of the world can suffer autism/vaccine injury because you are living the DILLIGAF lifestyle? I guess this will give you a great opportunity to evaluate your personal ethics, hey?

But surely an influx of spam means you might be forced to pay hundreds, if not thousands of dollars for what is ultimately an act of spite?, you might say.

To that I respond: my spite has no limit. I am a wealthy, child-free professional who has as much discretionary money to do with as I please. I am actually pretty good with paying money to charity: those kids in Syria need a polio vaccine more than I need my weekly cafe breakfast. And what I don’t get to pay this fortnight I can pay next. And next. And next. 

I write a post that makes people angry? No problem – one fewer massage, or a quiet night in, or a month of packed lunches. I get linked by an anti-science FB group? No probs: I can go without new shoes or clothing.  

Your choice. Because, ultimately, isn’t it all about your right to choose?

19 thoughts on “Commenting Policy

  1. The gold standard of Evidence based medicine are blinded Randomised Controlled Trials compared to a non-active placebo.

    But how many of the immunisations on our current schedule have actually been tested for safety against a non-active placebo?

    How many of them have a large enough sample size to attempt characterize the risk of rare reactions, such as increased incidence of autoimmune conditions (say, between 1/1000 to 1/10,000)? If you use a beta of 0.05 (95% confidence that there is not a type II error) and existing incidence, with additional incidence of 1/5000 or 1/10000, the required sample size blows out to hundreds of thousands, to millions (depending on incidence). For any study that you read, try to calculate the confidence level for ruling out a type II error at 1/5000 or 1/10000 and you might be very surprised (disappointed!).

    A 20-30% confidence level is laughable.

    Which means that the true risks of immunisations are mostly unknown and our knowledge does not meet the gold standard of evidence based medicine.

    We therefore fall back to surveillance programs, but those programs have poor quality data – both due to events that are not reported due to medical practitioners who are unwilling to report a vaccine reaction, or false positives due to lack of investigation.

    The efficacy of immunisations is well established and we need high rates of immunisation to maintain herd immunity. But there are risks (however rare) and the best way to deal with this is not to pretend that they don’t exist, since we lack high quality evidence to rule out those risks. It is unjust to have a compulsory vaccination scheme and not compensate the victims, however rare. Sadly Australia does not have a no-fault compensation scheme.

    Why do I care? Because I am on the other side of the story. I had one of those rare reactions – Guillain Barre syndrome when I was 15. I lost the ability to walk just a few weeks after the oral polio, diphtheria and tetanus immunisations (and had symptoms such as difficulty swallowing within a few days of it). I regained the ability, but suffer from severe pain, fatigue and concentration issues that have prevented me from holding down a job or having a romantic relationship over 15 years later. Please do not pretend that cases like mine don’t exist. You can email me if you want to verify my story.

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    • This gish gallop is worth at least $3, but I’ll respond pretty much by saying a) sure, fine, set up a compensation scheme for the astronomically low number of people who get genuine and severe adverse events, even though courts overseas including the much-lauded Italian verdict have overturned these decisions on appeal; and b) no real medicine is going to be risk free, but the risk is still lower than the numbers claimed by anti-vax proponents.

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      • Some empathy would have been nice. You are the lucky one who gets to take your health for granted I guess. I am however very glad that you see the light on the need for a compensations scheme though, I expect you to mention that need in any future articles on this subject.

        How can you claim that the risk is lower when you haven’t examined the evidence primary evidence and examined the level of confidence of the statistics yourself? I challenge you to learn the statistics and examine the data for yourself.

        Also, side note, the risk profile varies quite a lot between different infections since some infections are much more prevalent in Australia than others.

        In terms of a rational argument for the individual in developing countries is quite different to that in Australia, since herd immunity is not yet achieved and incidence rates are magnitudes of order higher. As such, there is a higher risk of getting the illness than the risks of the immunisation. Sadly the same argument does not hold true for many (not necessarily all – the Pertussis immunisation is a good idea if you live in Byron Bay) immunisations in Australia. Polio is an excellent example of where the risk (for the individual) is much greater than the risk of the infection since there is no incidence of Polio.

        Data on infectious disease in Australia is here:
        http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-annlrpt-nndssar.htm
        RCTs, and other data can of course be found doing a literature review in Pubmed, Google Scholar etc.

        If you are serious about claiming it is a rational evidence-based choice, then you’d compare the incidence of the infection (and rates of serious complications) vs potential risks per immunisation dose and therefore actually have an idea of what level of risk profile needs to be demonstrated for each immunisation dose.

        With regards to RCTs, it is ethical to test some immunisations where the incidence has dropped to zero – Polio for example. The reason why we don’t see it is because of the statistics, specifically it would require a very large and very expensive study (or meta analysis of groups of studies) to have any confidence (If you were serious about statistics and evidence, you would do the math as I mentioned above, it is your choice to step up to test your assumptions). What is the incentive to do a very large and very expensive study that would only decrease peoples willingness to vaccinate?

        Again, I strongly urge you to do a literature review and examine the statistics for yourself (including the calculating yourself the confidence levels for ruling out type 2 errors). I am lucky in that I come from a family of scientists who help me out with this sort of stuff.

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      • **Some empathy would have been nice. You are the lucky one who gets to take your health for granted I guess. **

        This may come as a shock, but I do actually have a finite amount of empathy, not one skerrick of which I have to provide to every internet commenter that comes my way. I do, however, have the health of my relatives who are immunocompromised on account of cancer treatments to consider and who require the herd immunity of others around them, ensured with a compulsory vaccine scheme, so I reserve my empathy for them.

        **I am however very glad that you see the light on the need for a compensations scheme though, I expect you to mention that need in any future articles on this subject.**

        And I expect that if you request that I alter my content for your feelings that you will pay the hosting fees for my blog. $19.99 a month, take it or leave it.

        **How can you claim that the risk is lower when you haven’t examined the evidence primary evidence and examined the level of confidence of the statistics yourself? I challenge you to learn the statistics and examine the data for yourself.**

        Um, no. That is the whole reason I have my blog: because cowboy dickheads with an unrealistic estimation of their own scientific and mathematical skillsets expect that their ability to interpret data challenges the mainstay of actual trained, skilled researchers and doctors, the vast majority of whom find that vaccines are overwhelmingly safe and that the benefits strikingly outweigh the risks. I am fine with leaving data analysis to people who are trained in it – just like I am fine with a doctor diagnosing me and not some halfwit hippie moron with strong feelings about gluten.

        **Also, side note, the risk profile varies quite a lot between different infections since some infections are much more prevalent in Australia than others. **

        Wow. I learned something new.

        **In terms of a rational argument for the individual in developing countries is quite different to that in Australia, since herd immunity is not yet achieved and incidence rates are magnitudes of order higher. As such, there is a higher risk of getting the illness than the risks of the immunisation. Sadly the same argument does not hold true for many (not necessarily all – the Pertussis immunisation is a good idea if you live in Byron Bay) immunisations in Australia. Polio is an excellent example of where the risk (for the individual) is much greater than the risk of the infection since there is no incidence of Polio.**

        Yes – because we eradicated it in Australia to the extent that we now have zero cases and therefore any risk from the vaccine is statistically going to be greater than the risk of getting the disease. No kidding. That’s thanks to vaccines.

        **Data on infectious disease in Australia is here:
        http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-annlrpt-nndssar.htm
        RCTs, and other data can of course be found doing a literature review in Pubmed, Google Scholar etc.**

        Thanks for helping me learn how to search for stuff on the net.

        **If you are serious about claiming it is a rational evidence-based choice, then you’d compare the incidence of the infection (and rates of serious complications) vs potential risks per immunisation dose and therefore actually have an idea of what level of risk profile needs to be demonstrated for each immunisation dose.**

        And the risk of infection for things like whooping cough is still high, both due to a slightly less effective vaccine and people who don’t keep up with their boosters. The answer isn’t to get rid of vaccines – it is to ensure a higher rate of coverage while concomitantly developing a better vaccine. And developing better products is basically the reason we have evidence-based medicine, which isn’t going to stop working at it.

        **With regards to RCTs, it is ethical to test some immunisations where the incidence has dropped to zero – Polio for example. The reason why we don’t see it is because of the statistics, specifically it would require a very large and very expensive study (or meta analysis of groups of studies) to have any confidence (If you were serious about statistics and evidence, you would do the math as I mentioned above, it is your choice to step up to test your assumptions). What is the incentive to do a very large and very expensive study that would only decrease peoples willingness to vaccinate? **

        Yes – why waste finite funds on things that are only done to assuage the unmerited high self-esteems of the anti-vaxxers when we actually have pressing health concerns in Australia that need and deserve our money now, including (but not limited to) emergency bed shortages in regional hospitals, glaucoma/diabetes in remote Indigenous communities, and a rapidly ageing population and a concurrent rise in degenerative diseases which are costly to provide care for? Why waste money testing the efficacy and safety of a vaccine when it has already been proven safe for the vast majority of people and where observational data is perfectly sufficient for monitoring for adverse effects? We don’t ban safety measures like vaccines, drugs, seat belts or other mechanical safety devices simply because there are side-effects or failures for a tiny minority of people. More to the point, we already have a crisis of over-testing in the Australian medical system that I am sure wouldn’t be helped by scrutinising tens of thousands of people for vague, amorphous and self-limiting conditions they are not likely to get. (Believe it or not, doctors are reasonably averse to prescribing medication when the risks and cost outweighs the benefits – if, after the recent PBS and medicare reviews of covered drugs, the medical community still argues for universal vaccine coverage, then I am going to bet that people more informed than you and I have made the case for it.)

        **Again, I strongly urge you to do a literature review and examine the statistics for yourself (including the calculating yourself the confidence levels for ruling out type 2 errors). I am lucky in that I come from a family of scientists who help me out with this sort of stuff**

        I am not doing a literature review because I am not trained in statistics at all. The end. I have the same mathematical and statistical skills of any other wellness blogger – hence why I have become a wellness blogger. There are people who spend their careers developing an innate skill and interest in statistical analysis and immunology who get paid to do it, and I am fine to trust their judgement and the policy decisions that are influenced by their judgement. I am sure they want an innumerate idiot like you or me intruding on their work, telling them that they’re doing their job, as much as I would want a non-teacher invading my classroom and telling me how to teach. Just because you come from a family of scientists doesn’t make you a scientist anymore than having a surgeon for a father makes me a doctor.

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  2. **I am not doing a literature review because I am not trained in statistics at all. The end.**

    I had hoped, based on what you had first written, that you were different and would me making arguments based on primary evidence.

    Not merely regurgitating the opinions of others who have themselves not done examined the evidence directly. Sadly I was mistaken.

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    • I just have a question: what aspect of your upbringing left you, as an untrained and unqualified adult, so adamantly convinced that you are better equipped to uncover the truth that people with years and decades of experience, formal qualifications and professional obligations such as CPD, registration and professional oversight couldn’t find?

      Are you that arrogant that you think that what you have to offer – which is copy-pasted rubbish from other websites which has been debunked ad nauseum on the internet already so DON’T EVEN MAKE THAT REGURGITATED OPINION ARGUMENT – is that much more trustworthy, relevant and accurate than the work of people who have the appropriate skillset and training?

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      • I am sorry if I have led you to feel angry. I cannot help but suspect that we would have had a much more constructive (and sympathetic) converstation, had this discussion been in person, rather than with the distance on the internet.

        To answer your question, I rely on the following:

        I studied science and mathematics at university and plan on completing my PhD (eventually… Chronic illness is very frustrating…).
        Spending personal time to read the primary literature when I have been too unwell to attend university. (my focus is on medical science, since I wish to understand my illness)
        First hand experience to know that vaccine reactions are real and can cause life long disability, however rare

        Liked by 1 person

      • However, working under the presumption that you are here in good faith (and not just to post gotcha walls of text and accuse me of being a big meanie mean who means), this is what I say:

        If you, in your life’s study, produce quality, reproducible and verified evidence that your claims are right and this can be verified by peer review and is accepted by the mainstream medical community and becomes scientific consensus, I will change my position 100%. I will hang a banner saying “Andrew is right and I am wrong” (and so you know, I totally paid ten bucks to Oxfam last night due to a pisstaking commenter so I do double-down on my word no matter how ridiculous or short-sighted it is).

        But I am not going to change my views and distrust qualified people who are held to extremely high scrutiny just because one dude on the internet who I don’t know shares his n+1. That line of uncritical thinking is why we have people abandoning evidence-based cancer treatment, or giving their kids bleach enemas on the presumption it will cure autism, or pulling out their teeth to avoid amalgam toxicity. For the record it is not like I haven’t met people who have experienced anaphylaxis after Gardasil. I have, and still advocate that vaccines be copulsory and near universal for all people who are not legitimately medically contraindicated.

        I am not a researcher – by and large what I challenge is so widely known and basic that anyone with a weak Year 10 science education can see it is stupid. And that’s why I started my blog – because most of this stuff is so obviously wrong, or the consensus is so overwhelming, and people are buying into it out of low literacy or fear. The answer isn’t for me to tell them stuff that I don’t have scientific training in – it’s to address how pseudoscientific advocates and conmen use the semiotics, cultural mores and language of science in a means that does use my qualifications as an English and literacy teacher and debating coach.

        There are plenty of people on the net who do have this training and who are able to address the issue on an immunological and epidemiological front. They do a great job, but that is not what I am here for.

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  3. Thank you for your more reasonable reply.

    I don’t expect you to take me on my word, I expect you examine the evidence yoursef in sufficient depth.

    Understand that that the risk profile of immunisations is not nearly as well characterised as you (or I) first guessed. The problem is that the risk for the individual in society differs from the risk to society – it becomes a conflict of interest between individuals vs health promotion. This is why none of the studies say that immunisations are ‘safe’, they say at most that the immunisations ‘have a good risk profile’, which basically means that the risk of reactions is rare and the true rate is unknown due to lack of statistical power.

    My best advice is that if you want to differentiate this blog from all the others me-too blogs who just quote experts, then the key is to actually read, quote and cite directly the underlying. You claim you aren’t an expert, but so what? I don’t see that as a good excuse not to engage the underlying literature in detail. You can learn by engaging with the literature just like everyone else who studies science.

    The truth is, that the one thing I learned while studying science is that we shouldn’t take any of it for granted. A parable about science is that only two sections of a scientific report are true – the method and the results. This is why we need to pay attention to just the method and results and understand what a report proves and what it cannot prove.

    The limitations of peer review and the strange phenomena where by there is an absurdly high (statistically) number of positive scientific results from underpowered studies is why we need to question such. I am glad that scientists are starting to take post-publication peer review seriously once again, with pubmed comments, new journal models like PeerJ and popular iconoclasts like Ioannidis http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124

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    • I don’t think you get that a significant part of the reason I find you so tedious is that you keep telling me what to do.

      Believe it or not, I have got limited skills mathematically, and I have further limitations on my time on account of my work and the rest of my life. There are plenty of other people who are able to interpret the data and present it. That is not my job. That is not why I started blogging or what my focus is on now.

      Believe it or not, I do not write to entertain you specifically. I have absolutely no obligation to do anything to or for you other than not post blatant untruths or misleading information. Telling me that I should focus on doing one thing – which I have not needed to do to participate in the dialogue, and for which I have had no blowback from the numerous people in the scientific community who have read and liked and reshared my work – is rude and presumptuous, and while you aren’t paying my hosting fees or helping me significantly in any meaningful way, it isn’t appreciated. I write the content that I want to write in the style I want to write with, and people are happy to read it thus far.

      The cultural and sociological implications for pseudoscience interest me and surprisingly I actually don’t require a huge amount of my own knowledge to get by on the basis of this area of specialty. I operate under the same principle that leads me to hire a mechanic to fix my own car, or a solicitor to deal with my conveyancing: the principle that entails western society being run with people trading their own areas of interest and expertise for others so we don’t kill ourselves figuratively and literally.

      Liked by 1 person

      • If you want to write a me-too blog that adds nothing substantive to the discussion, then that is indeed your prerogative.

        Have a nice life! (sincerely!)

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      • Siq burn, bro.

        Hint: you can get a wordpress account for free. Please, by all means, enjoy cultivating a blog which meets your very requirements for tone and content.

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  4. If Andrew ever writes, let alone publishes, anything worth taking seriously, in a reputable scientific and peer-reviewed journal, and when his anti-vaccine perspective is shared by the overwhelming majority of medical scientists, then and only then can he say that he himself has added anything substantive to the discussion

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  5. And now I feel the need to add some gratuitous poe statements so that some fortunate people in developing countries can be the recipients of life-saving vaccines. Here goes: people should pay attention to anti-vaccine celebrities like Jenny Macarthy and that Deuce Bigolo actor because outside of a script, I’m sure they have something valuable to say about things they’re not qualified to talk about, it’s just that anything of value that they may have to say won’t be about vaccinations. People should educate themselves about immunisations and when they have 1) gained their medical science PhD, they should 2) publish frequently in reputable peer-reviewed medical science journals and 3) set up a lab successfully funded by research grants to further research into more medical advancements and 4) repeat steps 2 & 3 until you have reached professorial and/or Nobel prize winning levels

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