Introduction: Liking & Similarity, a Form of the ‘Sceptic’ Gambit, and Spin
This is my first post about Richard Halvorsen’s book. There may be further posts if I can maintain my enthusiasm for writing about Dr Halvorsen’s view of vaccination as I continue to read about it.
On the first page of his introduction, Halvorsen begins by providing some background. Apparently (in 1983 when his son was born), he felt uneasy about the whooping cough vaccine due to adverse publicity.
Breath Spa for Kids has a summary of the pertussis scare from Paul Offit here: link. In brief: the British media reported on a study that alleged a link between pertussis vaccine and permanent brain damage; vaccine coverage dropped; children died from pertussis; “subsequent studies of hundreds of thousands of children showed that the risk of permanent brain damage was the same in children who had not received the vaccine as in those who had” – which I think bears comparison with the more recent MMR scare. There is also an account of the pertussis scare on Brian Deer’s website: here.
Halvorsen then refers to his bewilderment at being asked to write about MMR in 2000. He comments that he “started to write the article with an open mind.” In painting himself as an open-minded, concerned parent who felt uneasy about the pertussis vaccine and as someone who was surprised by concerns about the MMR vaccine in 2000 (two years after Wakefield’s infamous press conference), Halvorsen appears to both identify himself with those most likely to be alarmed by the MMR scare and portray himself as being initially unconcerned by the MMR vaccine.
Sceptics may be familiar with the latter gambit in other forms (for example: ‘I have always been the biggest sceptic around when it comes to detox body wraps – but this one really works!‘). It matters not whether a person is sincere and has a genuine change-of-heart, what matters is the reason for the change of position.
If somebody alters their opinion because the best available evidence shows that their previous stance was most likely the wrong one to take, then that is perfectly reasonable (in fact, some would applaud the intellectual honesty of such a move). If however, a different stance is taken on the basis of a misinterpretation of the evidence, on the basis of flawed evidence, or on the basis of too narrow a view of the evidence then the change-of-heart has been made mistakenly. In any case, whether another person has changed their opinion should have no bearing on whether we change ours – although I suspect it might.
As for the seeming identification with his audience of open-minded, concerned parents: while this is something that will likely cause an audience to become more receptive to an author’s view, it should not. Whether a person is like us, or we find them likeable, has no bearing on whether their message is one we should put our trust in. As Robert Cialdini writes in Influence - Science and Practice (pp 150-151):
We like people who are similar to us (Byrne, 1971). This fact seems to hold true whether the similarity is in the area of opinions, personality traits, background, or lifestyle. Consequently, those who want us to like them so that we will comply with them can accomplish that purpose by appearing similar to us in a wide variety of ways.
I make no assumptions about whether Halvorsen genuinely identifies with open-minded concerned parents. The effect, however, is the same whether a person actually identifies with, or intends to appear to identify with others. It is an effect we should be wary of, as it can lead us to make poor judgements.
Halvorsen claims on page 11 of his book that we are being fed “spin and half-truths” – having read several of his articles in the mainstream press, I shook my head ruefully on reading this claim. Then I went back over the introduction to see whether Halvorsen has managed to avoid feeding us “spin and half-truths” in the first five pages of his book.
On page 7, Halvorsen tells us of the evidence linking MMR to autism that he “felt there might be something in it.” He goes on to claim that the government’s defence of MMR was “based on virtually no evidence at all” and tells us that one unnamed vaccine expert referred to the government’s evidence as ‘crap’. He then portrays the situation as being one in which there is “limited evidence suggesting the vaccine was a problem, but hardly any to demonstrate its safety”, which struck me as a remarkable statement. It seems to imply that while there is little evidence of “harm”, there is even less evidence of “no harm”.
As far as I can tell, Halvorsen’s book was first published in 2007. The updated edition I am currently reading was published in 2009. The following PDF lists studies that suggested a connection between MMR vaccine and development of autism, and studies that refute a connection: http://www.immunize.org/catg.d/p4026.pdf. There are twenty-five studies in the latter category and only three in the former. Of those three studies, one was retracted by ten of the thirteen authors in 2004, there are links to further reading on limitations of two of the studies (including the retracted paper) and there is a note below the third citation to the effect that “The validity of this finding has been called into question when it could not be reproduced by other researchers.”
That an edition of a book published in 2009 still carries the representation of the evidence for and against MMR being a cause of autism described above is astonishing. I believe that Halvorsen’s characterisation of the evidence could be fairly described as having at least a foot in the “spin” category.
Are there any other examples in the introduction that might also qualify? I believe so. Mercury is said to be “a highly toxic poison” (this in the context of the use of mercury in vaccines). Halvorsen makes no mention of dose. Almost anything can be toxic in sufficient quantity – even things that we consider to be good for us, such as water or vitamins (vitamin A toxicity is probably the best known example of hypervitaminosis). Without stating what level of mercury is “highly toxic” and what level of mercury is contained in vaccines, it is meaningless to describe mercury as highly toxic in the context of mercury in vaccines.
Something else Halvorsen fails to mention is the form of mercury. If you will permit me to digress, I would like to point out that while for trivalent chromium the acute oral toxicity ranges between 1500 and 3300 µg/kg, with hexavalent chromium the acute oral toxicity range is between 50 and 150 µg/kg (“The hexavalent chromium compounds appear to be 10-100 times more toxic than the trivalent chromium compounds when both are administered by the oral route.” Link).
The safety limits for mercury are based on methyl mercury. The form of mercury found in vaccines (as one of the ingredients in thimerosal) is ethyl mercury. In 2002, Pichichero et al wrote this paper. From the abstract:
The blood half-life of intramuscular ethyl mercury from thimerosal in vaccines in infants is substantially shorter than that of oral methyl mercury in adults. Increased mercury levels were detected in stools after vaccination, suggesting that the gastrointestinal tract is involved in ethyl mercury elimination. Because of the differing pharmacokinetics of ethyl and methyl mercury, exposure guidelines based on oral methyl mercury in adults may not be accurate for risk assessments in children who receive thimerosal-containing vaccines.
Halvorsen goes on to claim that we are told that the fact that mercury-free vaccines have replaced mercury-containing vaccines is “entirely coincidental”, while this article in the New England Journal of Medicine relates that the removal of thimerosal came about because “the CDC and AAP decided to exercise the precautionary principle” – a statement that is at odds with Halvorsen’s view of what we are being told. There appear to be further examples of spin throughout the book. I was mildly amused to note that in the chapter on autism and vaccination 40% is described as “nearly half”. Of course, 40% is exactly two-fifths, and is closer to one-third than it is to one-half – but “nearly half” sounds better. It reminds me somewhat of the “journalists’ dozens”:
“dozens is tabloid shorthand for ‘a number considerably less than 100 which nevertheless needs to sound big for our purposes’” [This definition is courtesy of the ridiculously-named jonnyhead.]
I have previously written blog posts about Richard Halvorsen here and here on The Lay Scientist website (the former is regarding an article on vaccination written by Halvorsen and published in the Daily Mail, the latter is regarding an appearance on the Today programme on Radio 4). I also have a category on this blog for posts about Halvorsen here – including a post I wrote about a Halvorsen article in The Times (on swine flu vaccination) and one I wrote recently about a terrible article (on HPV vaccination) in the Sunday Express that relied heavily on Halvorsen.