The magazine What Doctor’s Don’t Tell You (WDDTY), who have apparently threatened Simon Singh with legal action, are at the centre of a row over the content of their magazine and its appearance on the shelves of several major retailers. Blogger JQH gave his views on the magazine’s content here and Andy Lewis of the Quackometer blog asked the question should WHSmith stock the magazine. (Josephine Jones has now gathered a list of blogs covering the complaints and legal threat here.) I decided to take a look at the WDDTY article on the HPV vaccine. I was not impressed.
Warning: some of the quotes in this blog post may contain misinformation. Please carefully evaluate what you read.
On page 29, the article by Lynne McTaggart claims that the vaccine is “a dubious, untested, ineffective and highly dangerous solution” to the problem of cervical cancer.
A CDC page describes a number of randomized, double-blind, placebo-controlled studies of Gardasil. It seems to me that to describe the vaccine, without any qualifiers, as “untested” is misleading.You can find further studies of Gardasil on Pubmed, including systematic reviews. Like this one, for example. The article later claims, in large text, that “Gardasil was never tested in young teenaged women”. This is number 10 in a list of 14 ‘facts’. Here is the full text of a paper that looked at HPV vaccination in young people. They didn’t use the same outcomes as the previous trials referred to but they did test the immunogenicity and safety of the vaccine in over 500 girls aged 10-15. It’s worth noting that none of the serious adverse events suffered by participants was linked to the vaccine. Gardasil may not have been tested in the manner that McTaggart would like it to have been, but it most certainly is not “untested”.
The CDC’s section on efficacy describes the vaccine as having “a high efficacy for prevention of vaccine HPV type HPV 6-, 11-, 16-, and 18-related persistent infection, vaccine type-related CIN, CIN 2/3, and external genital lesions (genital warts, VIN and VaIN)” in participants receiving three doses of the vaccine who had no protocol violations and had not previously been infected with HPV. It seems that Gardasil does in fact do what it is claimed to do – prevent HPV infection and the abnormal growth of squamous cells on the surface of the cervix. In this, it is effective.
McTaggart uses VAERS data to support her suggestion that the vaccine is dangerous. Sorry, “highly dangerous”. Here’s what the VAERS website says about interpreting data:
When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.
McTaggart also refers to deaths in India. As Andy Lewis points out, these deaths included a drowning, a snake bite and the effects of malaria. Using deaths that are clearly unrelated to the vaccine in order to spread fear about Gardasil is, well, an interesting way to make your case.
I think the kindest way to interpret McTaggart’s use of VAERS data and the deaths in India involves assuming that she was unaware of both the nature of the information in the VAERS database and the fact that many of the deaths reported following administration of the vaccine have actually been clearly and unambiguously unrelated to the vaccine. I know of no deaths that have been attributed to the vaccine after investigation.
If people’s decisions on healthcare are being influenced by magazines such as WDDTY, then these magazines have a duty to be very, very careful not to inadvertently mislead anybody on topics such as HPV vaccination. I think they need to be rather more careful than they currently are.
I’ve just typed around 600 words arguing against a fragment of a sentence. There is so much wrong with the HPV article and the magazine as a whole that to address it all would take an age. Here are just a few further (brief) comments on some of the problems with WDDTY.
In the HPV article, there is a boxout on page 30 that is headed “first invent the problem”. Lynne McTaggart might not think that cervical cancer is the most serious or the most common problem women face, but it’s certainly not been invented by the vaccine manufacturers. Hundreds of women die each year in the UK from cervical cancer. In the US, there are thousands of deaths.
On page 35, McTaggart points out that HPV expert Dr Diane Harper has distanced herself from Merck’s marketing tactics. She fails to mention Harper’s views on the vaccine itself. Fortunately, Ben Goldacre did, in 2009. “I fully support the HPV vaccines,” she says. “I believe that in general they are safe in most women. I told the Express all of this.”
I’ve only looked at the HPV article, but I think it would be a mistake to assume that the rest of the magazine is any better. JQH points out that the research on vitamin D that is discussed is not as clear-cut as WDDTY would have you believe. He also points out that there is a recommendation in one article to take Ginkgo Biloba, but no mention is made of potential side-effects of this remedy.
Update, 10 October 2012
Hilariously, free speech advocate Lynne McTaggart of WDDTY has removed the comment facility on her blog. I am now unable to comment on her new posts, and all my previous comments have disappeared (as have everyone else’s). The post I had commented on is here. In it, McTaggart complains that Simon Singh wanted to ban WDDTY (as far as I am aware he has never said he wanted to ban it and he would not be in a position to ban it) and asks “Why are you attempting to silence any discussion of alternatives…” She also wrote “We launched What Doctors Don’t Tell You to open this debate, to examine what else to do, to find out what else is out there with any chance of success” and “So my challenge to Singh and every troll and indeed anyone from Big Pharma is this: when you can debate the issues like grown-ups and not schoolyard bully boys, and look for genuine solutions that aren’t simply about lining the drug industry’s pockets, then I’m happy to do so. ”
I would suggest that Lynne’s words in this post do not match her subsequent actions.
Sceptical Letter Writer has republished his questions to Lynne here
Here is the first comment I left about the HPV article:
As you say you are happy to “debate the issues like grown-ups”, perhaps you would like to discuss your article on HPV vaccination?
You use VAERS data to support your suggestion that the vaccine is dangerous. The VAERS website says that “it is important to note that for any reported event, no cause-and-effect relationship has been established” and “VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.”
Do you accept that in using VAERS data, you are including adverse events that are coincidental and not caused by vaccination?
You also refer to deaths in India. These deaths included a drowning, a snake bite and the effects of malaria. Do you think it is reasonable to use the deaths in India to cast doubt on the vaccine’s safety?
Here is the second comment I left regarding that article:
On page 35 of your magazine article, you point out that HPV expert Dr Diane Harper has distanced herself from Merck’s marketing tactics. You fail to mention Harper’s views on the vaccine itself. Dr Harper has said she fully supports the HPV vaccines and that she believes that in general they are safe in most women.
I would have thought that in an article on the efficacy and safety of HPV vaccination, Dr Harper’s views on the vaccine would be more relevant than her views on Merck’s marketing. Do you agree?
Lynne McTaggart made no attempt to answer either comment. She is still free to do so if she wishes, here on this blog.
Just for completeness, here is the other comment I left (in reply to someone who wanted the reference for Lynne’s claim that BMA research showed only 13% of treatments were effective).
I’m afraid I’ve been unable to track down this research.
I did manage to find this though: http://www.veterinarywatch.com/CTiM.htm
“…published results show an average of 37.02% of interventions are supported by RCT (median = 38%). They show an average of 76% of interventions are supported by some form of compelling evidence (median = 78%).”
A figure for how much of CAM is evidence-based can be found here: http://www.hindawi.com/journals/ecam/2011/676490/ “The resulting figure was 7.4%.”
McTaggart has a new post up here. She approvingly quotes Ben Goldacre, and the comment preceding the quote is this:
Ben Goldacre, once so critical and disbelieving of WDDTY’s stance on conventional medicine, now writes in the introduction of his book Bad Pharma:
WDDTY and Lynne McTaggart go in for tedious, simplistic conspiracy theories (for example, about ‘what doctors don’t tell you’ about non-drug ‘cures’ for various ailments) and the rubbishing of vaccines – on the basis of dubious data and deaths that are clearly unconnected to the vaccines they complain about. Which is probably why Lynne didn’t quote this next bit, also from the intro to Bad Pharma:
This isn’t a simple story of cartoonish evil, and there will be no conspiracy theories. Drug companies are not witholding the secret to curing cancer, nor are they killing us all with vaccines.
(I happen to know this because I’m currently reading the book – available from all good bookshops. See the introduction for yourself here. If you, or Lynne McTaggart, want to know what’s actually wrong with Big Pharma, then reading this book might be a good place to start.)