As hard as it is to believe, I've actually "known" pediatrician to the antivaccine stars (such as Jenny McCarthy), "Dr. Jay" Gordon, for nearly nine years now. It began back in 2005 when I first noticed him writing blogs full of antivaccine nonsense at the then-new group blog, The Huffington Post, where I noted antivaccine rhetoric running rampant, complete with amazing examples of what I like to call the "pharma shill" gambit. Since then, he's periodically come to my attention, be it for nonsense equating vaccine manufacturers to tobacco companies, falling headlong for the bogus "toxins" gambit (specifically formaldehyde) so beloved of antivaccinationists, writing ill-informed legal opinions, or penning the foreword to a Jenny McCarthy antivaccine book. It's not just me. Dr. Gordon has demonstrated that his understanding of science is poor and that he is, if not outright antivaccine, definitely sympathetic to antivaccine viewpoints. He even earned the "honor" of being featured on Penn & Teller's Bullshit! episode about the antivaccine movement.

All of which is why it saddens but doesn't surprise me to learn of a letter he sent to his patients recently about the ongoing measles outbreak in southern California:

Greetings! Our office has received a large number of phone calls and emails about measles. There are 21 reported cases in Orange County. I’m not aware of the number of cases in our immediate area. In July, 2014, we celebrate the 30th year at 901 Montana and we have never had a child in our office contract measles. As many of you know, I use the MMR vaccine more sparingly than most pediatricians so I’m a bit surprised that the number is zero, but it is. The media, as they often do, are covering this story quite heavily and the headlines make it appear that there is imminent great danger. In fact, the last fatality from measles in the USA was eleven years ago in 2003. Headlines speak of “ten times more measles in 2014.” The newspaper articles often don’t mention that California had very few cases of measles in the past five years so the 35 cases reported among 38,000,000 Californians is not a frighteningly large numerical jump. There have been about 80 cases of measles in the United States this year. All of these cases began with importation by travelers and then spread to close contacts. Measles is unlikely to be spread by a brief encounter or sharing a BART train. If you would like the MMR vaccine, please feel free to get it. My personal reservations have nothing to do with Dr. Wakefield’s “Lancet” article and are not supported by published medical research. These reservations are supported by observation and anecdotal evidence only. The CDC defines outbreak as two cases spread from the same source. The measles outbreak of 2014 does not pose a risk to your healthy child. Best, Jay Jay Gordon, MD, FAAP

I suppose I can say one good thing about Dr. Jay. He actually admitted that his "personal reservations" about the MMR vaccine are not based in science. Of course, that's nothing that I haven't known for nine years. As we've seen time and time again, Dr. Jay values his "observation" and "anecdotal evidence" above and beyond actual science. No matter how many times he is shown studies that fail to find a link between the MMR vaccine (or any vaccine, for that matter) and autism or various other conditions, he refuses to accept it and retreats to his "observation" and "anecdotal evidence," asserting, in essence although he doesn't put it that way, that his "30 years of clinical experience" trump epidemiology and all the evidence that have failed to find a link between vaccines and autism.

the thing that most immediately struck me about Dr. Jay's letter is just how similar it is to the whiny rants published by Dr. Bob Sears on Facebook recently. In the first one, "Dr. Bob" basically ranted at the parents of his patients for getting all worked up (unnecessarily, in his mind, apparently) about the very same measles outbreak that "inspired" Dr. Jay to write his note to his parents. In the second Facebook rant, he used a very similar technique to that of Dr. Jay to downplay the severity of the outbreak by fallaciously using the entire population of California as the denominator for the incidence of measles.

Dr. Jay is wrong about the CDC definition of "outbreak," as well, as he could find out just by searching the CDC website. The CDC defines an outbreak thusly in its EXCITE educational tool:

An outbreak or an epidemic exists when there are more cases of a particular disease than expected in a given area, or among a specific group of people, over a particular period of time. An aggregation of cases in a given area over a particular period, regardless of whether the number of cases is more than expected, is a cluster. In an outbreak or epidemic, we usually presume that the cases are related to one another or that they have a common cause. Many epidemiologists use the terms "outbreak" and "epidemic" interchangeably; however, some restrict the use of "epidemic" to situations involving large numbers of people over a wide geographic area. The public is more likely to think that "epidemic" implies a crisis situation.

More can be found here.

I don't know where Dr. Jay got that definition, but it's just plain wrong. As for the downplaying of the outbreak by the relatively small number of cases thus far. Particularly disingenuous is the way he points out that there hasn't been a death from measles in 2003. One notes that there will certainly be more if the number of measles cases continues to increase. As I pointed out last time, as many as 3 in 1,000 who contract measles can die of the disease; 1 in 1,000 can develop measles encephalitis; and 1 in 20 develop pneumonia. Yet Dr. Jay has the utter gall to reassure his patients that the measles outbreak of 2014 "does not pose a risk to your healthy child."

Measles is highly contagious, and pockets of unvaccinated or undervaccinated children provide the perfect reservoir for measles to exist and proliferate—children like Dr. Jay's and Dr. Bob's patients. What Dr. Jay and Dr. Bob either forget or neglect to mention is that the very reason that the number of measles cases isn't that large (yet) is because of the mass vaccination program and the very MMR vaccine that Dr. Bob eschews too long, his alternative vaccine schedule leaving children unprotected too long, and that Dr. Jay has "reservations" about based in no science.

Lest you think I'm being too harsh on Dr. Jay, let me remind you of a comment he made a few years ago:

I gave a half dozen vaccines today. I gave some reluctantly but respected parents’ wishes to vaccinate.

It's most telling to me that Dr. Gordon said that he "reluctantly" vaccinates apparently only when parents badger him to give CDC-recommended vaccines to their children and then, not because he thinks it's the standard of care, the right thing to do, but rather because he “respected parents’ wishes to vaccinate.” Why was he “reluctant” to give these children appropriate vaccines? What is there to be reluctant about? It's because he has...reservations, reservations that he openly proclaims not to be supported by science.

I'll say one thing: It is indeed amazing that he hasn't (yet) had a case of measles in his practice given his "selective" (i.e., "non") vaccinating policy. It's also nothing to be proud of, nor is it evidence that parents in Dr. Jay's practice area don't need to be worried about the measles outbreak that is currently occurring. In fact, they should be worried, more worried than average, given that many of Dr. Jay's patients are either unvaccinated or undervaccinated and thus inadequately protected (or even unprotected) against an incredibly contagious disease.

After nearly nine years, I've tried. I really have tried. You, my readers, have tried. Dr. Jay occasionally appears in the comments, and you and I have tried to lead him to an understanding of why he's so wrong about vaccines, autism, and outbreaks of vaccine-preventable diseases. Sadly, we have failed. Yet optimism springs eternal. Why, I don't know anymore.

You know, it just occurred to me that this is April Fools' Day. I only wish this were an April Fools' Day post.