The opposite of stumped: 9 unanswerable anti-vax questions answered

9 Questions That Stump Every Pro-Vaccine Advocate and Their Claims found its way onto the Facebook page for the Winnipeg Skeptics when a member’s friend posted it, along with the qualification “if you can give me a good, scientifically-backed answer to each of these questions, I will vaccinate my children.”

Oh, if it only were all so easy! The article claims:

I have never encountered one pro-vaccine advocate, whether medically or scientifically qualified, who could answer even 1 let alone all 9 of these questions.

Well, here’s one non-immunologist, non-virologist, unqualified physiology & medical student who had zero problem with finding scientific answers to any of their questions. Let’s dive right in, shall we?

1. Could you please provide one double-blind, placebo-controlled study that can prove the safety and effectiveness of vaccines?

Yes, although you can’t find any modern studies of old vaccines, because it’s unethical to deviate from the standard of care. However, there are tons of modern (i.e. internet searchable) literature on the subject. Honestly, go to Google Scholar and search “double blind placebo vaccine” I’ll start you off:
Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial

2. Could you please provide scientific evidence on ANY study which can confirm the long-term safety and effectiveness of vaccines?

Yes. Seriously, it took me 30 seconds to find this. Google Scholar is your friend.

3. Could you please provide scientific evidence which can prove that disease reduction in any part of the world, at any point in history was attributable to inoculation of populations?

4. Could you please explain how the safety and mechanism of vaccines in the human body are scientifically proven if their pharmacokinetics (the study of bodily absorption, distribution, metabolism and excretion of ingredients) are never examined or analyzed in any vaccine study?

You can’t study the pharmacokinetics of something which is not physically acting on the body—rather, vaccines are designed to be acted upon. I can’t answer this; not because of a conspiracy, but because this is an unanswerable question. It’s like asking, “Why haven’t they studied the mating habits of tennis shoes?”

5. Could you please provide scientific justification as to how injecting a human being with a confirmed neurotoxin is beneficial to human health and prevents disease?

Neurotoxins are a matter of dosage, just like radiation, and all interventions are a risk-benefit ratio. You accept the risk of getting a chest x-ray if you might have pneumonia because the dose is very low, and you won’t have it done repeatedly. Also, for something to be a neurotoxin and have effects on the brain, it must be able to pass the blood-brain barrier. This is very, very difficult and chemists spend their entire lives trying to design something that will get across. Just because something can be toxic doesn’t mean it is, just because something has risk doesn’t mean it’s not worth doing, and just because something has theoretical potential to do harm doesn’t mean that it will do harm.

‎6. Can you provide a risk/benefit profile on how the benefits of injecting a known neurotoxin exceeds its risks to human health for the intended goal of preventing disease?

See the above study on measles vaccines saving hundreds of thousands of lives. Any risk of “injecting a known neurotoxin” (Which one? At what dose? Neurotoxic to who? Correlation or causative?) is unequivocally lower than the very real and potentially lethal risk of an outbreak in an unvaccinated community or one with a low uptake.

7. Could you please provide scientific justification on how bypassing the respiratory tract (or mucous membrane) is advantageous and how directly injecting viruses into the bloodstream enhances immune functioning and prevents future infections?

Different parts of your body have different types of antibodies associated with them. In the mucous membranes of your body, like the GI tract and the respiratory tract, white blood cells at the membrane produce IgA antibodies on exposure to a pathogen. In the blood stream, you have direct access to the memory cells which produce IgGs: the more robust antibodies that provide lifetime immunity against a particular pathogen. Those memory cells will stay in your lymph nodes, ready to produce an onslaught of deadly (to the pathogen) IgGs whenever the body recognizes it again. IgAs are incapable of this, and many respiratory pathogens are defeated after exposure by the body’s initial defences, before an specific set of antibodies can ever be manufactured.

8. Could you please provide scientific justification on how a vaccine would prevent viruses from mutating?

Viruses mutate as they replicate, but fortunately, by definition, viruses require the machinery of living organisms to do so. To do this, viruses must enter the cells and hijack their function to produce more viruses. If the body is prepared to identify the pathogen, it can respond immediately to the pathogen in a matter of hours instead of days. Given that viruses can replicate at phenomenal rates, the faster the body responds, the less replication will happen, the less likely a beneficial (to the virus) mutation will occur. Furthermore, even if a mutation does happen, if individuals around the infected patient are all immunized, the mutation will not be carried on. The nice thing about adaptive (post-exposure) immunity is that it identifies a bunch of different parts of the pathogen as foreign, so even if little bits of it change, one antibody might be useless but all of the others will still work!

9. Could you please provide scientific justification as to how a vaccination can target a virus in an infected individual who does not have the exact viral configuration or strain the vaccine was developed for?

Although I sort of just addressed this, it’s a matter of phylogeny. If you look at human beings (obviously far more complicated than viruses, but work with me) almost all of our diversity and mutation is contained in a fraction of a fraction of a percentage of our DNA. This is because we all come from a common ancestor and we have been building off of that base DNA ever since, so we have more in common than not. Viruses work the same way. Each type of virus has certain defining characteristics, defining proteins that make it work. For retroviruses, this is something like reverse transcriptase, which allows the HIV to copy itself into our DNA and hide. So, if the vaccine causes you to develop an antibody against a particular protein, say one on the surface of a influenza virus, it’s going to make antibodies against little chunks of it, and the odds of a related virus having mutated all of those little chunks beyond the wiggle-room there is in these sorts of processes is pretty low.

Think of pathogens like fugitives and antibodies like really zoomed in “wanted” photos that the body has put up in the Post Office. The fugitive tries to hide by dying their hair, so maybe that photo of their hair is useless. And maybe they’ve changed their shirt, so throw out that photo too. But that hand is still a hand, and that mouth looks like the right mouth even though it’s got a moustache now. The fugitive is spotted—the white blood cells are primed to look for that mouth and that hand—and the pathogen is “arrested”.

That’s not to say that an imperfect match is going to lead to the best result. If you can put all those little snapshots together and get the whole thing, you’re even better off, just like a perfect match is going to trigger a wide variety of antibodies to be produced and the response will be more robust, but immunization with a closely related virus is going to provide some protection.

So no, Random Internet Website that hasn’t even bothered to try and learn about the immune system (I cannot reiterate enough that I am not an immunology expert and all of this information is freely available via appropriate internet search): none of these are stumpable questions. If someone is confused by your questions, it’s because they don’t make sense or because they are so unbelievably broad as to be useless.

Asking questions is good, and should be encouraged! You should know these things before you vaccinate your kids! However, critical thinking can teach you to ask better questions. For example: What sort of evidence is there for the 25 year safety and efficacy of the Canadian childhood MMR vaccine in a healthy Canadian population? This a specific, quantifiable, discrete question to which discrete answers can be obtained. These are the sort of questions that scientists ask—and the ones that drive the clinical trials you’re asking for.

Cross posted from the Winnipeg Skeptics blog.
Photo credit to JoeBenjamin on flickr.

20 Responses to “The opposite of stumped: 9 unanswerable anti-vax questions answered”

  1. Iain says:

    Ooh! Not fair using Google Scholar! OK, if you can give me a good, scientifically-backed answer to these questions *using only web sites liked by Jenny McCarthy*, then I’ll vaccinate my children….

  2. Mike says:

    Another answer to question 3:

    http://arstechnica.com/science/news/2012/01/india-triumphs-over-polio-with-no-new-cases-in-a-year.ars

    Summary: India, which used to lead the world in polio, now has gone a year without any new cases.

  3. Great stuff, but your statement, “You can’t study the pharmacokinetics of something which is not physically acting on the body—rather, vaccines are designed to be acted upon” doesn’t make sense to me. Vaccines certainly do act on the body — they get immune cells to come and respond to them.

    Also, re question 7, most vaccines are injected intramuscularly, not “straight into the bloodstream”.

    • Thanks, I’ll try and make #7 more clear that it has better access, not direct.

      That’s a good point re: pharmacokinetics but I’ve done a little more reading and we’re both wrong – it’s the study of how the body acts on the drug (vaccine) and not the other way around. I’ll need to update that question to reflect that, but it still seems to be a term used for drugs and not vaccines, although the same information is obtained in early clinical trials (Phases I & II).

      • Bryan says:

        Just to add to this (I’m an immunologist, FWIW).

        We can and do measure aspects of pharmokinetics for vaccine ingredients. It is – perhaps – correct to say the term doesn’t apply to vaccines as the term is formally defined, however the properties measured in pharmokinetic studies (half-life, effective dose, decomposition products, metabolism, etc) certainty do apply to vaccines.

        The pharmacological properties of various vaccine ingredients (i.e. half-life, toxicity, biological interactions if any, etc) are generally well known – thimerisol, alum, and the various other preservatives, buffers and adjuvants that allow a vaccine to work all have been extensively studied and are well understood. The “pharmokinetic properties” of the active portion of the vaccines (be it a recombinant protein, killed pathogen, attenuated pathogen, or something more exotic) are established during the pre-clinical and Phase I/Phase II trials.

        Bryan

  4. Sympathizer says:

    Nice writeup!

    As for the “known neurotoxin”, I’m pretty sure they mean the mercury.
    Mercury is used as a stabilizer (read: preservative) in many vaccines. You might want to compare the dose of mercury you get from a vaccination to the dose of mercury you get from seafood.

    • Bryan says:

      There is no mercury in vaccines, nor has there ever been. There is (or was, its not in many vaccines anymore) thimerisol, an organo-mercuric compound used as a preservative. Organo-mercuric compounds do not behave, nor have the same toxicities, as mercury – just like other salts and organic compounds do not have the characteristics of their constituent atoms (if they did, table salt would be amoung the most lethal compounds out there – being comprised of highly toxic chlorine and sodium; a metal that bursts into flame when in contact with water).

      The half-life and toxicity of thimerisol and its decomosition product ethylmercury, are well established. They bear no resemblance to the half life and toxicity of either metallic mercury, oxidized mercury (the most common form encountered) or methylmercury (a common industrial contaminant).

      Bryan

  5. Chris says:

    Good answers. You can also include the Dr. Crislip’s unique view:
    http://www.sciencebasedmedicine.org/index.php/nine-questions-nine-answers/

    He also has a Quackcast of the post, where the tone of his voice adds to the effect.

  6. Theo Bromine says:

    One pro-vaccine argument that antivaxers never seem to consider: If vaccination does not work, how would they explain the eradication of smallpox, a disease that is not even on the vaccine schedule any more (not to mention the fact that smallpox is responsible for the convoluted etymology of the word “vaccination”).

    • Chris says:

      Actually, some do have an answer for that. One of John Scudamore’s (whale.to guy) claims is that is now called monkeypox. Oh, and polio is some kind of meningitis.

  7. Composer99 says:

    Great news from India, Mike!

    ==========
    Another aspect of the whole “neurotoxin” shtick: anti-vaccinationists usually refer to mercury when they refer to “neurotoxins” in vaccines.

    However, such mercury as can be found in vaccines (a) is at trace levels far too low to act as a neurotoxin in any colloquial sense of the term and (b) in vaccines is found in a form (ethylmercury) which is easily and speedily cleared from the human body, further reducing any potential toxicity – as compared to methylmercury, which is what you get eating tuna.

  8. Gillian says:

    Is it necessary to vaccinate everyone, or could children who shows signs of weakened immunity be exempted from the typical vaccine schedule? (By weakened immunity I mean everything from being born prematurely, to lesser autoimmune problems like asthma, allergies, excema, to major autoimmune problems, to autism. Could these children just be protected by the majority of the population being vaccinated? (Wondering about this since reading Gut and Psychology Syndrome)

    • Kim Hebert says:

      Vaccination is generally not recommended for children with weakened immune systems (e.g., those fighting cancer, etc). That is part of why herd immunity is so important. If they are too weak to safely get a vaccine, they are almost certainly too weak to withstand infection. The more healthy children go unvaccinated, the more immune-weakened children are at risk of life-threatening infections.

      Autistic kids don’t necessarily have weaker immune systems than other kids. Also the only relevant allergies are to the ingredients in the vaccine. Premature birth babies don’t necessarily have additional health problems either, so prematurity isn’t itself a reason not to vaccinate. Eczema, as long as the affected area isn’t somehow preventing injection, wouldn’t prevent vaccination either. Not vaccinating kids because of perceived contraindications may put sick kids at higher risk. It is better to consult a doctor for advice for each specific child rather than avoiding vaccination.

      Fore more info, see this link from the CDC: http://www.cdc.gov/vaccines/recs/vac-admin/contraindications-misconceptions.htm and this PDF: http://www.cdc.gov/vaccines/recs/vac-admin/downloads/contraindications-guide-508.pdf

    • Just another note, allergies/eczema/asthma are also part of a trifecta called “atopy” which is actually a problem with inappropriately reactive immunoglobulin E (IgE) to specific triggers. The part of the immune system that is activated by vaccines is the production of IgGs, which are produced by a completely different cell type. Unless the person has a sensitivity to something in the vaccines (usually egg products if it’s a vaccine that contains adjuvant) there’s no reason not to vaccinate someone simply because they’re atopic. There is one hypothesis that atopy is associated with a stronger, not a weaker immune system.
      In any case, atopy is incredibly common (I have it, as does my fiancé and neither of us are immune compromised, for example, and some areas in Canada report rates as high as 66%) and we would not be able to attain herd immunity if we excluded people only on that basis.

      • Chris says:

        Someone once told me I had to boost my immune system. I laughed and said my immune system usually tries to kill me every spring by over protecting me from evil pollen! I feel it starting with the alder trees now. I am even allergic to nickel (I cannot wear my wedding set due to nickel being used to harden the gold).

        Immune systems are finicky, and there is a problem with them being too “strong.” It has nothing to do with vaccines.

    • Oh, and this might be worth reading about GAPS.

      • Dana Gower says:

        This is a serious question I hope you might answer, not an anti-vaccine rant. There are a number of similar stories from late 2008 and early 2009. Did anything ever come of this?

        http://www.sciencedaily.com/releases/2009/04/090401145312.htm

        Einstein researchers contend that scientific evidence directly points to the locus coeruleus–noradrenergic (LC-NA) system as being involved in autism. “The LC-NA system is the only brain system involved both in producing fever and controlling behavior,” says co-author Dominick P. Purpura, M.D., dean emeritus and distinguished professor of neuroscience at Einstein.

      • Hi Dana, just last month there was a series of very exciting findings that demonstrated that children with autism show structural brain abnormalities as early as 6 months. Although it needs to be replicated in a larger data set, it may be that structural changes in autism precede and cause behavioural changes. Of course, the standard caveat applies: it’s almost certainly more complicated than either this paper or the one you linked hypothesizes.

        http://www.sciencedaily.com/releases/2012/02/120217101048.htm

  9. Epinephrine says:

    The question about bypassing the mucous membranes is actually a good question, though the bit about “bloodstream” is inaccurate. We don’t inject vaccines into the bloodstream. Typically, vaccines are administered intramuscularly or subcutaneously, though there are exceptions. There are oral vaccines, intranasal vaccines, intradermal vaccines, etc.

    So, the first answer is that we don’t always bypass the mucous membranes. We have oral vaccines against polio (not used here, but used in endemic areas), rotavirus, and cholera, to name a few, and these are illnesses passed via the fecal-oral route. Recently an intranasal influenza vaccine was marketed. Mucosal immunity is different, activating different antibodies, and it can be difficult to boost the immunogenicity of the antigens as we don’t have good adjuvants for mucosal vaccines.

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  • Richelle McCullough

    Richelle is a second-year medical student living in Calgary, but hails originally from Winnipeg. An outspoken advocate for lifestyle interventions within the scope of science-based medicine, Richelle’s favourite topic is to debunk complementary and alternative medicine. She is frequently trolled by geocentrists at her personal blog, Subspecies, and despite the distance, remains active with the Winnipeg Skeptics.