Here we are, into a new week, and the Disneyland measles outbreak continues to grow, the total number of cases now having topped 100 and the disease attributed to someone visiting Disneyland now having reached my state. More than ever, given the high proportion of victims who weren't vaccinated, antivaccinationists are feeling the heat. Rober, "Dr. Bob" Sears, MD might have been the most petulant one trying to downplay the seriousness of measles and then letting out a whole bunch of antivaccine dog whistles to his patients to let them know that, despite his assertion that the measles vaccine works, he's still one of them.

Now others are getting in on the act. Maybe they're envious at how much attention Dr. Bob has been getting (although the attention he's been "enjoying" has been almost universally negative, given that supporters of science-based medicine recognize it for the disingenuous BS that it is and antivaccinationists can't be too pleased by some of Dr. Bob's positive assertions with respect to vaccines even as they recognize his antivaccine dog whistles about "freedom to choose" and how antivaccinationists shouldn't be "ostracized").

Enter Katie Tietje, known by her nom de blog as Modern Alternative Mama, and a deliciously schadenfreude-inducing whine entitled Enough is Enough with Blaming “Anti-Vaxxers.”

No. No it's not.

But let's listen for a moment to what Teitje has to say. After starting out with a boisterious, "All right, I've had it!" and complaining about articles in the mainstream media "dripping with hate and anger towards families that don't vaccinate," she lashes out thusly:

There is bullying, nastiness, insanity from every corner. We’re at the peak now. And it’s affecting people in their everyday lives. More and more are having to read tirades in their Facebook newsfeeds about how stupid “anti-vaxxers” are, or endure personal berating over their family’s choices. Some are encouraging people to find out which children in their child’s classroom aren’t vaccinated so they can ostracize them. Some are refusing to allow unvaccinated children into church nurseries, playgroups, and more. Perfectly healthy children, who happen to not have been vaccinated. I’ve even been told that some of my readers have been messaged by trolls and harassed, simply for participating in some of the threads on my Facebook page! That’s just going too far.

"Messaged by trolls" on Facebook? Oh, the horror! Ever hear of the "block" function? It works quite well—better of Facebook than, for instance, on Twitter, and if you report a troll on Facebook you're more likely to get him or her banned from Facebook, either temporarily or permanently. "Endure personal berating"? Those horrific bullies! What's next, the comfy chair? Here's the thing: The "personal choices" of Tietje and her fellow antivaccinationists not only endanger others but do indeed contribute to outbreaks like the still growing one linked to Disneyland that we continue to follow with alarm. If I ran a church nursery, a playgroup, or any other function where large numbers of children congregate, for whatever reason, I'd start banning unvaccinated children too. In fact, it'd be my general policy because it's the responsible policy. Personally, I see this as a good thing that this measles outbreak is getting the attention of organizations that didn't previously require childhood vaccinations are starting to wake up. Similarly, if I were a parent of young children I would not let Tietje's kids play with mine. Yes, they might be "perfectly healthy"—now. However, by not being vaccinated they are at a much higher risk for contracting the measles. More importantly, they could contract it and seem to be completely asymptomatic but infectious. (That's the reason for quarantines, by the way, and even though measles is one of the most infectious diseases there is, people can't seem to get that.)

o, my dear Ms. Tietje, I'm oh-so-sorry that your "personal choices" have consequences. You seem to think that they should not, which is an unrealistic, childish standard that we apply to virtually no other choice that impacts others. By her "logic," someone making the "personal choice" to drink alcohol and then drive shouldn't be ostracized. But wait, she would say. Those people are a danger to everyone on the road. And so they are. It's an immediate danger of crashing into other cars and causing death and injury. The choice to leave your child unvaccinated poses a much less obvious danger, but it's a danger nonetheless. Moreover, it helps degrade the herd immunity that keeps infectious diseases outbreaks from spreading.

All of this leads to a call to arms from Tietje:

Families who believe in vaccine choice, it’s time to stand up. I know it’s hard, with all the hate. But if we sit silently and let them rage and fight, they’ll strip our rights. Yes, it’s easier to be quiet and hope people don’t know who we are, so that we don’t have to deal with the brunt of the anger directly. If we are silent, they win. And they cannot win. They are wrong. They are wrong to bully people into their way of thinking. They are wrong to try to force their will on others. And they won’t do it, if I have anything to say about it.

You know, when I read something like this, I often find it hard to tell how much of this "hate" is real and how much is simply people like Tietje not liking criticism for her "personal choice" and having a hard time accepting responsibility for their choices. From my perspective, I've yet to see an article or story in the mainstream media that I'd characterize as "hateful." I've seen op-eds criticizing antivaccinationists for facilitating outbreaks by contributing to pockets of low vaccine uptake that degrade herd immunity to the point where outbreaks are possible in those pockets. I've seen antivaccinationists characterized as misguided and wrong (which is true). However, I haven't seen anything that I'd characterize as "hate" or "bullying."

Of course, Tietje is not likely to succeed in getting too many more parents to speak up and identify themselves as non-vaccinators. As we all know (and as Dr. Bob himself teaches antivaccinationists), being a non-vaccinator involves "hiding in the herd" and relying on herd immunity to protect one's child. That doesn't work if others know, both because more might try to hide in the herd and other parents might understandably react the way that Tietje is complaining about right now! If you "out" yourself as a non-vaccinating parent, you can't easily hide in the herd any more—at least not as easily and certainly not in the middle of an outbreak, when awareness of the measles is at, as Tietje might put it, a "fever pitch."

Next up, Tietje tries to demonstrate that it isn't the unvaccinated who are to blame:

In the Disneyland situation: There are around 70 confirmed cases currently

5 of them were fully vaccinated

37 were not vaccinated

There are no records available for at least 30 cases (so we don’t know their vaccination status)

We don’t know the vaccination status of “patient zero” (the first person to have measles in this outbreak) We can’t make the leap, from what we do know, that this was “caused by unvaccinated people.” We simply can’t. That is just an easy scapegoat. If fits their agenda — to stir up hate and anger towards people who make alternative vaccination decisions, in order to try to strip exemptions and peoples’ rights. (No, nobody has the right to force medical care of any sort on anyone else. Period.)

Yes, Tietje's post was written a few days ago, when the total was 70. It's 100 now. Funny, however, that her own figures largely demolish her own argument. As even Dr. Bob himself recognizes, in many outbreaks more vaccinated children than unvaccinated children fall victim to the disease because vaccines are not 100% effective and there are a lot more vaccinated than unvaccinated children. However, when you correct for that difference and calculate the risk of catching a disease in an outbreak, the unvaccinated are always at much, much, higher risk. Indeed, in a measles outbreak in the Netherlands in 2000, it was estimated that unvaccinated children were over 200-fold more likely to catch the measles than vaccinated children, although it's usually more like a 20-fold differential—still substantial. By Tietje's own estimate, at least half of the measles cases to that point were unvaccinated, which points to an enormously increased risk of contracting the measles among the unvaccinated.

Of course, the next tactic Tietje moves on to is the same one that Dr. Bob used, essentially a variant of what I like to call argumentum ad Brady Bunchium, namely the claim that measles just isn't so bad. For those who don't remember, argumentum ad Brady Bunchium is a term I coined four years ago based on how frequently antivaccinationists appeal to an old episode of the Brady Bunch in which all the kids contract the measles and the family treats it as just a normal part of growing up. In fact, the kids are portrayed as not very sick and happily playing Monopoly, glad not to have to go to school for a week. It's a mischaracterization of measles, which is not a benign disease.

Tietje then rattles off a bunch of figures about the measles vaccine and measles, harping on how the last measles death was in 2005 and there have been only 15 measles deaths since 1992. Yes, and we'd like to keep it that way; actually we'd like that number to be zero, because zero is achievable, but people like Tietje are, through their ignorance, fear mongering, and belief in "personal choice" above all, sure are doing their best to make that impossible. No, they don't believe they're doing that, but that is the end result of their actions.

Finally, Tietje concludes with a call to action. The first is a request for people to sign a highly misguided Change.org petition entitled Stop allowing the violation of our children's human rights through mandatory and forced vaccinations with or without parental consent. Of course, in this country no one is "forcing" vaccinations. Parents can refuse vaccination. They simply pay a price of not being able to get their kids into public schools, although in most states nonvaccinating parents don't even pay that price because of easily obtained religious and personal belief exemptions.

One other thing by Tietje stands out:

Third, speak up. If people are being rude, call them out. Be respectful, but say something. “We all make different medical decisions for our children. The evidence is not clear cut. Being rude isn’t going to change anyone’s mind, and I’m asking you to stop talking to others like this.” I suggest deleting and banning anyone who can’t remain civil. If you’re ready, share some information on your personal Facebook profile, or talk to friends in person. Remain calm and let everyone know how hurtful and harmful this sort of negative attitude is.

To which I would respond: Those supporting science-based medicine should also speak up. Remain civil. Tell parents like Tietje (politely) that the evidence actually is clear cut. Vaccines are very safe, and measles is not. As for "hurtful or harmful negative attitudes," realize that concern trolling is a powerful weapon. As a pro-science advocate, to a person like Tietje you can never, ever be sufficiently civil. You will always be accused of being incivil, mean, nasty, and unfair by antivaccinationists, no matter how polite and civil you are. The reason is that antivaccinationists hate the message; so the messenger can never be civil enough. Also, accusing someone of "incivility" is a powerful means of shutting them up, particularly in face-to-face social situations, as opposed to online debates. Nobody likes being portrayed as a meanie, and most will usually back off.

Finally, Tietje calls for censorship by taking advantage of Facebook's automated banning policies:

Fourth, report hate pages. There are a number of different ones on Facebook. “Anti-Vax Wall of Shame.” “Things Anti-Vaxxers Say.” “Banned by Modern Alternative Mama.” There are many others. Report them for hate speech. Their entire purpose is to take screenshots from groups where they troll and mock the people — some of you may recognize your own comments being mocked on those pages!

Sorry, but mocking stupid things said by antivaccinationists does not equal hate speech. It just doesn't. Tietje seems to think, as many antivaccinationists do, that freedom of speech should equal freedom from consequences due to that speech. It's a profoundly immature attitude that says, "I can say anything I want, and you can't criticize me because freedom of speech." Sorry, but it just doesn't work that way.

Sadly, Tietje is not the only one spouting nonsense like this, but I am out of time and energy, other than to note that The Onion nailed the attitude of Tietje and her ilk perfectly in a post entitled I Don’t Vaccinate My Child Because It’s My Right To Decide What Eliminated Diseases Come Roaring Back.

But, then, I suppose Tietje would consider The Onion too mean.