Listicles. I hate Listicles. I don't do them. Yet, as much as I hate them, I can't deny that in this brave new world of click bait, listicles bring the clicks, which is why so many blogs and websites post them. Indeed, there's a website, Thrillist, that is dedicated to pretty much nothing but listicles. Not surprisingly, quacks and cranks love listicles as well, because they can go viral, getting passed around through the fevered swamp of antivaccine and quack Facebook pages and Twitter feeds like measles through a Waldorf School.

So it was that I came across yet another one of these annoying listicles, and something in me said: Enough! I need to respond, just for the educational value and because it perturbed me. Such is the benefit of having your own blog. I'm referring to this annoying listicle from Kate Tietje, a.k.a. Modern Alternative Mama, entitled 12 Mainstream Vaccine Lies You Probably Believe. Not surprisingly, the list consists of misinformation and straw men about vaccines, all backed up by references to a rogue's gallery of well-known antivaccine pseudoscientists, all served up with a heapin' helpin' of victimhood, as evidenced by her pre-emptive attempt to inoculate herself against deconstructions of her misinformation and lies by painting all skeptics who question her as nasty, abusive people:

I know — uh-oh, I said the v word. It’s probably the most controversial topic out there right now, and it can lead to seriously vicious attacks. So before we even get started, I ask you, please remember that whatever ‘side’ you’re on, there are real people on the other side of the screen. It is possible to discuss this topic without getting nasty. And I’m not going to publish comments that swear, insult others, or are unnecessary and don’t further the discussion. If you wouldn’t say it to someone’s face, don’t say it here. Differing opinions are welcome; nastiness is not.

Well, I would be happy to say to Tietje's face anything I write here. Stupidity, pseudoscience, and just plain idiocy need to be called out. Also, I'm not writing to change her mind. Her past history shows that that's a fool's errand. I write to counter her misinformation among those whose minds might still be changed. In any case, claiming victimhood and painting herself as badly abused by those oh-so-very-mean pro-vaccine activists is classic Modern Alternative Mama. It's what she does. She also likes to pull what I like to call the "Help! Help! I'm being repressed!" gambit, confusing legitimate criticism of what she says with criticism of her personally and an attempt to shut her down. It's a common tactic of antivaccinationists, who seem to think that freedom of speech means freedom from criticism. It does not.

So, on to the list! Fallacy number one:

1. If you’re vaccinated, you can’t catch the diseases Sorry, but no. No matter what, vaccines are not 100% effective. Some people will fail to develop any “protection” at all. Some will find that protection wanes after only a short time. In fact, the pertussis vaccine (DTaP and Tdap) are among the least effective vaccines, with any protection fading in a matter of months (this study explains waning protection). There’s also no evidence (and can be no evidence) that the disease would be milder if you were vaccinated first. One study showed that a single dose of DTaP was only 55% effective — and only at preventing hospitalization, not the infection itself. And even then, only very temporarily. The bottom line is, you actually can catch the disease, even if you’ve been vaccinated.

Of course, if there's one place where this fallacy exists, it's among antivaccinationists. Either that, or they disingenuously use this claim whenever it is pointed out how low vaccination rates endanger herd immunity. How many times have you heard an antivaccine activist retort to someone criticizing them something along the lines of, "Why are you worried about my child? If your child is vaccinated, my child is no danger to yours"? I've lost count over the years.

It's also not as though those of us who counter antivaccine pseudoscience don't discuss these issues, either. I've written posts about the problem with the low efficacy of last year's flu vaccine and about waning immunity from pertussis vaccination. In fact, it's because vaccines aren't perfect and do not provide 100% protection that herd immunity becomes important. Think of it this way. Wearing a seatbelt decreases your risk of dying in an auto accident by "only" 45% and of serious injury by "only" 50%? Does that mean seatbelts aren't worth wearing? Of course not! Antivaccinationists like Tietje tend to be prone to black and white thinking. To them, vaccines are 100% safe and 100% effective, or they're dangerous crap. The real world doesn't work that way.

Fallacy number 2:

2. If you’re vaccinated, you can’t spread diseases Again, no. If vaccines work as advertised, then you may come across an illness and not catch it — that’s kind of the whole point. However, you can still become a carrier of that illness, and you can still pass it on to others. An article by Suzanne Humphries, M.D., explains that you’re actually more likely to be a carrier if you’re vaccinated. And, a study shows that DTaP is not preventing transmission and infection. That’s the real reason why we’re seeing outbreaks of disease right now — that, and vaccine failure (see point 1).

Let's just say this. Quoting Suzanne Humphries to back up your argument is akin to quoting Mike Adams or Joe Mercola or citing Whale.to or NaturalNews.com. She is antivaccine to the core, and has been known to refer to vaccines as "disease matter," just like Bill Maher. a primate study that questioned whether the pertussis vaccine prevents transmission, which might or might not be applicable to humans, and (2) an article by Suzanne Humphries that cites evidence that, although it prevents disease from the bacteria, the pertussis vaccine might produce a suboptimal immune response that allows colonization of vaccinated, so that they can pass the disease. Whether true or not, this is not a rationale for not vaccinating. It's a rationale for developing a better pertussis vaccine. Of course, a lot of the shortcomings of the current pertussis vaccine came about because concerns about neurological injury from the whole cell pertussis vaccine in the 1980s (which subsequently turned out to be unfounded) led to the development of the acellular pertussis vaccine, which has fewer antigens but is also arguably less effective. It's not as though they aren't recognized and discussed.

Fallacy #3:

3. Titres mean that you’re immune to the disease

Of course, low titres don't mean you're not immune to the disease either. It's not as though immunologists don't know this. On the other hand, the article Tietje cited doesn't actually say that titers are meaningless, either. It's a lot more complicated and nuanced than that. In fact, it even includes a table showing what antibody titers are correlated with protection after various vaccinations.

Fallacy #4:

4. Safe treatments for these diseases don’t exist. No. While our medical knowledge 50 or 60 years ago was clearly more limited, we have made great advances now. We’re now able to treat many illnesses with simple, non-invasive means. Vitamin A supplementation is used to prevent complications of measles. Mullein is an herb that’s excellent at treating pertussis (along with vitamin C) and other illnesses. We know so much more now. And alternative medicine often has an answer! Plus, if you’re concerned about polio, read up on that.

This is, of course, utter nonsense. There are not "safe and natural" treatments for serious diseases, as much as naturopaths and useful idiots like Tietje argue otherwise. As for polio, in her article linked to, Tietje basically argues that polio isn't dangerous and even going so far as to dismiss all those pictures of iron lungs thusly:

As for those iron lungs, they’re outdated medical technology, pure and simple. Doctors today have much more sophisticated machines that they use when someone is struggling to breathe. So, even if the absolute worst did happen — no, we would not see a recurrence of iron lung machines.

Yes, she really said that. To her, just because we now have positive pressure ventilators and long-term tracheostomies for people who can't breathe on their own, it's damned deceptive to be showing iron lungs because we don't use them anymore. Sorry, Kate old bean, but that's history, and, quite frankly, while being hooked up to a modern ventilator via a tracheostomy is better than being stuck in an iron lung, it's still plenty bad.

The rest of her article cites nonsense like the claim that lead arsenate pesticides and DDT are the actual reason polio epidemics started occurring more frequently in the 1930s through 1950s. It's dangerously ignorant misinformation I've deconstructed at length before.

Fallacy #5:

5. The formaldehyde, aluminum, etc. in the vaccines is similar to amounts found in food, etc. and is not a concern Wrong! Well — technically, the amounts are similar, or the amounts in foods are even greater. But, ingested aluminum (etc.) is not the same as injected! One study shows that aluminum adjuvants in vaccines are correlated strongly with the development of autism. This study links autoimmune disorders to aluminum adjuvants in vaccines (and cautions against the ever-increasing vaccine schedule). This study suggests that the relationship between aluminum adjuvants in vaccines and autism is probably causal (ie. vaccines cause autism).

Once again, as I've discussed so many times before, the tiny amount of formaldehyde in vaccines is not a threat, as much as antivaccinationists claim it to be so. As for the other "studies," they aren't really studies but review articles by the latest tag-team of antivaccine scientists spewing misinformation, Lucija Tomljenovic and Christopher Shaw. If you want to get an idea of just how bad this not-so-dynamic duo's arguments are, check out my discussion of one of their studies. Let's just put it this way, Tomljenovic and Shaw are fast on their way to becoming the Mark and David Geier of the 2010s.

Fallacy #6:

6. The antigens in vaccines are low and children run across more in daily life Yes — but. The antigens in vaccines have been reduced because older versions of vaccines were causing significant reactions. Vaccines bypass the normal immune system defenses — the mucus membranes (stomach, nose, throat) and are injected, which is why large amounts of antigens caused a serious reaction. It’s worth noting that the antigens children run across in daily life do not bypass those initial immune defenses. They replaced the higher levels of antigens with the adjuvants to stimulate a reaction without so many antigens. But as we saw in the point above, those are quite dangerous.

This is an old antivaccine trope, and a truly ignorant one. (Aren't they all?) For instance, nasal flu vaccines, which are the form of the flu vaccine that many children receive, don't bypass the normal immune system in the mucus membranes. The live attenuated virus vaccine is squirted right onto the mucus membranes of the nasal passages! As for the rest, does Tietje think that kids never cut themselves or never have breaks in their nasal or oral mucosa? Of course they do. The tetanus vaccine, for instance, would be unnecessary if kids didn't cut themselves on dirty objects so often. That's how tetanus is introduced. As for the rest, this is nothing more than the claim that anything not viewed as "natural" must be inferior.

Fallacy #7:

7. Vaccine reactions are incredibly rare/almost never happen Unfortunately, this might be the biggest lie of all. Thousands of children have been injured and even killed by vaccines. I personally know dozens of mothers who have vaccine-injured children, and some who, themselves, were injured. It’s not nearly as rare as we’re led to believe. We do not have solid data, however, because vaccine advocates dismiss almost all reactions as “coincidence.” When a child gets a round of shots and develops a high fever hours later, the mother is usually told that “s/he must have been exposed to something a few days ago; some children will just get sick after shots but the shots do not cause it.” This is a lie.

Wrong again. The reason such reactions are attributed to "coincidence" is not because of a reflexive dismissal of claims of vaccine injury. It's because the question has been looked at in numerous studies and there is no increased incidence of the the reactions attributed to vaccines after vaccination above the baseline. For instance, there's no evidence that children manifest the first symptoms of autism within close proximity of vaccination any more than any other population of children who didn't receive vaccines in that time would develop those symptoms in the same time period.

8. Vaccine companies are liable if reactions do occur This may surprise you, but no. They are not. In 1986, Congress signed an act that removed vaccine manufacturers’ liability for any vaccine injuries. There were so many lawsuits that the companies threatened to stop making vaccines. So, Congress gave them legal immunity. If you are injured by a vaccine, first you must report it. Then, there is a special court system set up. Most cases are dismissed — the vast majority. The few that make it through the entire (long, expensive) process will get a payout from the government. There is a tax on every vaccine dose to pay for this system.

Not quite. All the law says is that claims for vaccine injuries have to go through the Vaccine Court first. If the Vaccine Court rejects the claim the parents can pursue their claim through federal courts, although admittedly post-Bruesewitz, state court claims have been virtually eliminated for product defect suits. Also, as I've explained time and time again, the Vaccine Court is actually set up to make it easier to make claims. For instance, win or lose, complainants will be reimbursed for their legal expenses, which is utterly unlike any other court. Of course, the reason we needed a special court in the first place was that in the 1980s there was a real possibility that vaccine manufacturers would stop making vaccines due to the number of lawsuits being brought against them.

9. The dose of the vaccine varies depending on age, weight, etc. Again — no. Vaccines are typically one dose. Occasionally there are two dose options, for certain shots (like high-dose vs. regular flu shot), but generally there is one. That means that the same amount of antigens, aluminum, etc. are going into a 10-lb. baby and a 200-lb. man. Babies and young children, whose bodies do not metabolize drugs like adults’ bodies do, are treated exactly the same when it comes to vaccination.

More nonsense. Vaccines are designed to be safe for children. It's also not true that vaccines aren't adjusted based on weight. For instance, there are specific adult and pediatric versions of these vaccines: hepatitis A, hepatitis B, and tetanus, diphtheria, and pertussis vaccines.

In the cases of hepatitis A and hepatitis B vaccines, adults receive greater quantities of the components that afford protection in order to produce a protective response. However, in the case of the latter vaccines, the quantities of components of the diphtheria and pertussis vaccines used in adults are less than those found in pediatric doses because adults are more likely to experience side effects from these vaccines. As the CHOP vaccine website points out, in the case of hepatitis A and hepatitis B vaccines, adults receive greater quantities of the components that produce protection. In contrast, in the case of the other vaccines, the quantities of components of the diphtheria and pertussis vaccines used in adults are less than those found in pediatric doses because adults are more likely to experience side effects from these vaccines. This whole argument is nothing more than an appeal to one's "special flower" who must have completely individualized dosing. It's a fallacy. Doses of vaccines are not arbitrary. They are determined in the usual series of clinical trials that lead to FDA approval.

Fallacy #10:

10. Vaccine mandates are rational policy. Not even a little bit. With the mounting evidence of potential harm from vaccines, the wisest course of action would be to develop new methods to screen children for anything that would increase their risk of harm (auto-immunity in the family, certain genetic mutations, etc.). Also, to delay vaccination, to spread them out, to carefully document any reactions to particular vaccines in each child, to do an individual risk-benefit analysis and decide which one(s) are worth getting for a particular child and which ones are not. It would be wise to practice individualized medicine, as well as to give fewer vaccines overall — reserving the practice for the truly important ones.

Once again, this is utter nonsense, as is usual for Tietje. There is not "mounting evidence of potential harm from vaccines." Vaccines are incredibly safe. The rest of this is nothing more than pseudo-educated technobabble that makes it sound as though Tietje knows what she's talking about when she clearly does not. The bit about "individualized" medicine is nothing more than latching on to the latest buzzwords, like "personalized medicine" or, as it's now more commonly called, "precision medicine." Here's the problem that is easily demonstrated by simply repeatedly asking point blank of people who spew this nonsense: What, precisely, are your criteria for determining which diseases should be vaccinated against? Which vaccines do you consider safe and effective and therefore recommend? Why? How, specifically, would you determine which children are more at risk for vaccine-related adverse events? What tests would you use. Inevitably, antivaccinationists will dodge the questions, respond vaguely, or unleash a bunch of quackery about tests that purport to predict vaccine reactions.

Fallacy #11:

11. The diseases we vaccinate for are incredibly dangerous Thankfully, no. Most of these diseases were normal childhood illnesses and were a very uncomfortable week or two, but were not dangerous for healthy children. Read more about measles, a risk-benefit analysis, and pertussis. It’s not to say that there aren’t a small number of children who were seriously ill or died in the past, but medical knowledge has advanced quite a bit since that time, and we still haven’t answered the question which is truly safer for our children long-term, the vaccines or the illnesses. That’s important.

This is just so wrong it's not even wrong. Hepatitis B, for instance, is incredibly dangerous. For measles, as I discussed in the wake of the Disneyland measles outbreak, actually hospitalizes a significant proportion of children who get it, while one in a thousand can develop encephalitis. When tens or hundreds of thousands of children get measles, the number of children who develop encephalitis or die becomes significant. Measles is not benign, and benefits of the measles vaccine actually go beyond preventing measles because measles suppresses the immune system and children die of other diseases at a higher rate in the two years after having the measles. When weighing the risks and benefits, there's no doubt: Vaccination is far safer than the diseases.

Finally, fallacy #12:

12. There is a clear scientific consensus on vaccines, and doctors recommend them because they fully believe in them. As we can tell from all the information above — which is not shared in the mainstream, but which many doctors and researchers believe and share through alternative means — there is not.

Um, no. This is nothing more than a technique beloved of cranks everywhere: Cherry pick poorly done science from a crank fringe and then use it to claim that there is a scientific "controversy" about a scientific consensus. Creationists do it. Anthropogenic global climate change denialists do it. Cancer quacks do it.

And antivaccinationists do it. A lot.

Indeed, there's a whole cottage industry of people doing bad science designed to demonize vaccines, including a cast of characters we've met many times before and whose descents into the depths of pseudoscience I've documented over the last decade, names like Mark and David Geier, Andrew Wakefield, the aforementioned Lucija Tomljenovic and Christopher Shaw, and, unfortunately, many others. This "science" is then cited by antivaccine advocates as "evidence" that there's an actual scientific controversy. There isn't.

Hilariously, Tietje finishes with a challenge:

I have no interest in getting into a fight with anyone over issues that can’t be informed by science. And by the way, for those who will argue with this post, if you are going to state that the science I relied on is wrong, you need to be prepared with your own peer-reviewed information. Newspaper articles do not count. Saying it exists and not sharing it does not count. Saying that your science is right and my science is wrong will be ignored (and not published). Acknowledge it’s a complex issue and we’ll discuss it rationally.

Such an utter lack of self-awareness due to the worst case of Dunning-Kruger effect that I've seen in a long time amuses me.

I didn't have time or space to refute each reference that Tietje listed point by point, as that's beyond the scope of a single blog post. However, I can do that. I have done that sort of thing many times in the past, as I linked to past discussions of the bad science of the antivaccine movement. If I thought Tietje were serious, I'd even drop the snark for such a discussion. However, I know how such a discussion would go. I'd point out the flaws in a study in detail, and she'd reject my criticisms. I'd cite many studies showing the safety and efficacy of vaccines, and she'd reject them as being hopelessly tainted by big pharma. I'd point out where her understanding of the basic science of vaccines is wrong, and she'd interpret that as trying to suppress her freedom of speech or "attacking" her. It wouldn't matter how polite and civil I was. That's how it would go.

So I created a counter-listicle instead.