I Speak of Dreams

COVID-19 Vaccinations: "Allergic reaction" or A Vagal Response?

Let's talk about a common response to immunization: the vagal response. It's more than just fainting.

Causes

The vagal response involves your central nervous system, peripheral nervous system, and cardiovascular system. When the reflex is triggered it causes an abrupt drop in blood pressure and a sudden reduction in heart rate.

The blood vessels in your legs may widen, causing blood to pool in your legs. This can further drop your blood pressure.

All of these changes can result in less blood flowing to your brain and trigger sensations that make you feel as if you might faint. At its worst, the reflex can result in an actual brief loss of consciousness, a condition known as vasovagal syncope.

It is important to know that experiencing episodes in which you have symptoms caused by a vagal response does not necessarily mean that there is something wrong with you. It is thought that the reflex is universal.

Source: What Triggers the Vagal Response? https://www.verywellhealth.com/vasovagal-reflex-1945072

A note from a pediatrician friend, who was vaccinated a couple of days ago.

I got my first COVID19 vaccine and had a vagal light reaction to it (~10 min after I felt hot, nauseated, dizzy... Lasted 45 min). I'm fine. I wouldn't count it as a reaction.

There are also reports of Globus sensation (the feeling of having a lump in the throat when in fact there is nothing there. The sensation can come and go. It does not interfere with eating and drinking. The exact cause of globus sensation is uncertain. And headaches, racing heart, and similar. These may be anxiety symptoms.

But as I said, the symptoms quickly resolved. Even my arm pain was gone by 48 hours.

My concern is that lay people are going to claim that the vagal response to the COVID19 vaccine is an anaphylactic or allergic response, likewise the anxiety symptoms."

This was originally posted in the Facebook group,  Vaccine Talk: A Forum for Both Pro and Anti Vaxxers, and commenters had some excellent suggestions for managing vagal responses.

Commenter A: [My cardiologist] also taught me a cool trick......when I feel an onset (sounds like I'm underwater, black spots, warmth on back of my neck), cross my legs and squeeze hard for as long as I can. Then release. This restriction/release rushes the blood back up the body.

It works for me.

Commenter B:This is called the applied tension technique. Ever since I started doing this, I haven’t fainted once when doing blood draws! Tighten your leg and abdominal muscles. Prevents the blood from pooling in your legs

Commenter C:I get a vasovagal response when I think about things that make my body respond as if I'm in shock. To fight it, you have to contact your muscles all over your body rapidly like a football player running in place while squeezing your fists, etc.

This is a function called skeletal muscle milking that pumps your interstitial fluid. It has saved me from passing out many times. Also helps on long flights with little room for movement and it prevents your feet from swelling up from being idle.

Commenter D:Totally me when I get injections or when they draw blood. I almost fainted when I got my tattoo. I never thought there were so many people with this issue. We should start a club.

Feel free to share this with friends who are concerned about reports of "adverse reactions" to the Pfizer and Moderna vaccines

Are The Vaccines Given To Children on Medicaid Substandard or “Dirty”?

U.S. children whose health insurance is provided through Medicaid receive free vaccines, purchased by the Centers for Disease Control from vaccine manufacturers and distributed by the Vaccines For Children (VFC) program. They are identical in every way to vaccines purchased by medical practices for private-pay patients.  See here for the price list indicating that all vaccines purchased and distributed by VFC are brand-name vaccines. 

Yet, there's a myth that just won't die -- that there are two or more tiers of vaccines, from the "dirty" vaccines for the poor to the super-duper vaccines given to the elite. Here are some sample claims.

Text reads:

What is so worrisome and what I've stated for years is that the poor are getting a cheaper quality vaccine. It is the reason why doctors in affluent areas like Beverly Hills are telling their patients that their formulas are cleaner and safer.

Here are a few more, from various social media venues.

Text reads:

I’ve heard this from more than one source and now just heard it again so I thought I’d ask in here. Is it true you can get “clean” vaccines with less fillers, additives, etc.? As far as I know I thought you only could ask for thimerosal free flu vaccines but are there others you can specifically ask for that is “cleaner”, less fillers and additives and they can order for you? I keep hearing this is what the elite and rich do, celebrities, royalty, etc., for their children, they special order cleaner vaccines than the general public gets and they have the money to do it. The last person who mentioned this said they know this is true because they demanded a clean vaccine for their child (sounds like it might have been tetanus because there was an injury and it’s my understanding they don’t do vaccines anymore for their child and have a medical exemption) and it took four hours but they were able to get it for them. I don’t know if that was because of so many allergies and other things going on or what exactly. This might have been a special case because I believe the child has some severe allergies. But if people wanted to, can they special order vaccines without all the fillers and additives and just pay extra for?

 

Text reads in part

Do you believe people in the public eye aren't being vaccinated with real vaccines?

Another example from social media, referenced in the Reuters article above:

Text reads:

My son's pediatrician was like we gave your son the wrong vaccinations so you owe us $700 and I'm like What??? He was like we gave him the insured vaccinations and not the free vaccination.. Soo I'm like what's the difference??? He didn't respond...Now I'm wondering wtf are they giving the poor kids with Medicaid and famous??? It that why it's more black kids with ADHD??? #mindwondering #momagainstvaccines

Myth asserted and debunked:

"Those who get medicaid... Please research the vaccines you get with state insurance. They are 5x more dangerous. For your loved ones, please do this research. I cannot stress it enough."

Source: https://lizditz.typepad.com/i_speak_of_dreams/2016/03/anti-vaccine-myth-294056.html

The Myth of Substandard Vaccines

This myth originates from the Vaccines for Children (VFC) program, which purchases more than half of of the pediatric vaccines produced in the US.  Vaccines acquired through the VFC program cannot be interchanged with vaccines acquired through other supply chains (more the reasons for this, on this below). 

I suppose to people who are conspiracy-minded,  because the VFC vaccines are segregated, that must mean they are inferior.  This rumor became so prevalent, in June 2020 Reuters Fact Check had to issue a rebuttal. 

"Viral posts on Facebook suggest that children from families on Medicaid or without insurance receive different vaccines than children whose families have private insurance. This claim is false….

The claim that children whose families receive Medicaid or do not have insurance receive different vaccines than those covered by private insurance is false. A CDC spokesperson told Reuters via email that while “providers have to keep the vaccines separate for auditing and accountability purposes,” there is “not a different vaccine for the VFC program.” The spokesperson added that VFC “purchases half of all vaccines given to people under age 18 in the country, and they purchase the same vaccines from the same manufacturers as everyone else.”

Facts about the Vaccines for Children Program

While the vaccines distributed through the VFC program are identical to private-pay vaccines, the management is somewhat different. The management and inventory of VFC is very highly regulated, and medical practices that are VFC providers must follow strict guidelines on vaccine storage, accounting, and reporting.

The ordering and distribution of private-pay vaccines are handled differently than VFC vaccines.

Private-pay vaccines are typically ordered and managed by an individual in the medical practice, and are ordered either directly from the manufacturer or through a supply firm. They can reorder vaccines when they feel like it. The practice owns the vaccines.

Clinics or medical practices that are participants in the VFC program order VFC vaccines are ordered through state departments of health (and a few city and territory departments of health (called "awardees"). Each awardee has their own inventory/tracking/storage regulations of the program (although there's a lot of overlap). VFC can only reorder vaccines when the practice has documented that the previous supply has been used. The practice does not own the vaccines; they're the property of the VFC program, and cannot be interchanged with private-pay vaccines.

https://www.cdc.gov/vaccines/imz-managers/awardee-imz-websites.html

Some large practices participating in the VFC program have separate refrigerator/freezer units for VFC vaccines; others use one refrigerator/freezer for both sources, but keep them labeled and stored separately.

History of the Vaccines for Children Program

In 1989 – 1991, a measles epidemic in the United States resulted in tens of thousands of cases of measles and hundreds of deaths. Upon investigation, CDC found that more than half of the children who had measles had not been immunized, even though many of them had seen a health care provider.

In partial response to that epidemic, Congress passed the Omnibus Budget Reconciliation Act (OBRA) on August 10, 1993, creating the Vaccines for Children (VFC) Program. VFC became operational October 1, 1994. Known as section 1928 of the Social Security Act, the Vaccines for Children program is an entitlement program (a right granted by law) for eligible children, age 18 and younger.

https://www.cdc.gov/vaccines/programs/vfc/about/index.html

Eligibility:

Q: Which children are eligible?

A: Children through 18 years of age who meet at least one of the following criteria are eligible to receive VFC vaccine:

• Medicaid eligible: A child who is eligible for the Medicaid program. (For the purposes of the VFC program, the terms “Medicaid-eligible” and “Medicaid-enrolled” are equivalent and refer to children who have health insurance covered by a state Medicaid program)
• Uninsured: A child who has no health insurance coverage
• American Indian or Alaska Native: As defined by the Indian Health Care Improvement Act (25 U.S.C. 1603)
• Underinsured

https://www.cdc.gov/vaccines/programs/vfc/parents/qa-detailed.html

So the next time the myth comes up, either here or in the rest of your life, feel free to pass along this article.

Other Sources

• How Anti-Vaccine Myths Start and Spread: VFC edition -- "Private Stock Vaccines" Available to Elites; Junky Vaccines Given to the Hoi Polloi -- I Speak of Dreams
• Medicaid Vaccines -- Vaxopeia
• Anti-Vaccine Points Refuted A Thousand Times -- Vaxopedia

Had Your Flu Shot This Winter????--List of Concerning "Ingredients" -- Or Are They In Flu Shots At All?

This alarming image has been circulating in emails and in Facebook Groups. Let's take a look

I will start with the left column, continue with the center column, and finish with the right column.

1. Chicken Protein -- It turns out that "chicken protein" is different than "chicken egg protein". You can be allergic to chicken egg protein, and be able to consume chicken meat, or be exposed to chicken feathers, and have no allergic response. 

   https://www.jacionline.org/article/S0091-6749(97)70154-4/pdf

   Chicken meat proteins are not in any vaccine. Also see item #6

   https://www.vaccinesafety.edu/components-Excipients.

   Is this substance used in flu vaccine manufacture? No. Score: 0/36.

2. human albumin -- it is used as a diluent and stabilizer in two vaccines, MMRII and MMRV. Not in flu vaccines. Furthermore, albumin purified from human blood is being replaced by recombinant (synthetic) human albumin products.

   "Human serum albumin (HSA) is widely used in clinical and cell culture applications. Conventional production of HSA from human blood is limited by the availability of blood donation and the high risk of viral transmission from donors."

   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223471/

   https://www.vaccinesafety.edu/components-Excipients.htm

   Is this substance used in flu vaccine manufacture? No. Score: 0/36.

3. fetal cow serum. -- yes, it's used in vaccine production, for non-viral organisms. "Fetal bovine serum is the most widely used growth supplement added to eukaryotes in vitro cell cultures. It has been in use since the 1960s and, for over fifty years, has outperformed both synthetic and natural growth supplements." To the best of my knowledge, it's not used in flu vaccine manufacture.

   https://www.vaccinesafety.edu/components-Excipients.htm

   Is this substance used in flu vaccine manufacture? No. Score: 0/36.

4. cow muscle tissue. -- may be an ingredient in various growth mediums in some vaccines. Mueller's medium (see item # ) originally used essentially consommé made from beef heart. Growth mediums are purified out of the end product. 

   Is this substance used in flu vaccine manufacture? No. Score: 0/36.

5. cow serum albumin. More properly called Albumin, Bovine Serum, or bovine serum albumin. It's a stabilizing agent in the Japanese encephalitis vaccine, Pentacel, Quadracel, and a rabies vaccine. Amounts in the common pediatric vaccines Pentacel and Quadracel are on the order of <50 nanograms

   https://www.vaccinesafety.edu/components-Excipients.htm

   https://www.fda.gov/vaccines-blood-biologics/questions-about-vaccines/bovine-derived-materials-used-vaccine-manufacturing-questions-and-answers

   Is this substance used in flu vaccine manufacture? No. Score: 0/36.
   
   

6. Chicken egg protein. no intact protein cells from chicken eggs are found in vaccines produced using chicken eggs as the growth medium. There may be trace (<10 ng) amounts of chicken DNA in such vaccines. Also see item #1. 

   https://www.vaccinesafety.edu/components-Excipients.htm

   Is this substance used in flu vaccine manufacture? Yes, in all brands except Flucelvax and Flublok. Score: 1/36.
   
   

7. Monkey Kidney Cells this is a references to Vero (African monkey kidney epithelial cells) .Various lines of Vero cells have been used for human vaccine production for nearly 40 years, and were the only World Health Organization approved continuous cell line substrates for some time." Some sources list "live attenuated flu vaccine" as one of the vaccines that used Vero cells, but the current Package Insert for FluMist does not mention Vero cells.

   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514150/

   https://www.fda.gov/media/83072/download

   Is this substance used in flu vaccine manufacture? No. Score: 1/36
   
   

8. Porcine (pig) Gelatin -- hydrolyzed porcine gelatin is used as a stabilizer in the FluMist Quad and Zostavax (the first anti-shingles vaccine). Gelatin, species source not specified, is used as a stabilizer in the vaccines against Yellow Fever, MMRII, and MMRV.

   https://www.vaccinesafety.edu/components-Excipients.htm

   Muslim and Jewish religious authorities have agreed that porcine gelatin in injectable form is acceptable.

   https://www.vumc.org/health-wellness/news-resource-articles/immunizations-and-religk

   Is this substance used in flu vaccine manufacture? Yes, in the brand FluMist. Score: 2/36.
   
   

9. Porcine (pig) Arginine Arginine is an amino acid, C6H14N4O2, obtained from the hydrolysis of plant and animal proteins. Argenine (without species origin) is listed as an excipient in FluMist, 2.42 mg/dose arginine as a stabilizer.  Since I'm feeling generous, I'll count the argenine and ignore the requirement for it to be porcine. 

   https://www.fda.gov/media/83072/download

   Is this substance used in flu vaccine manufacture?  Yes, in the brand FluMist. Score: 3/36.  

10. calf serum and protein. This is a bit confusing. How would this be different than item #5, ,"cow serum albumin"?  "Calf serum and protein" isn't listed for any vaccine, but some variations are. "Fetal bovine serum albumin" is listed as a stabilizer in the vaccines Rotateq and Varivax. "Calf Serum Albumin" is listed as a stabilizer in Zostavax, Kinrix, and Pediarix. "Calf serum protein albumin" is listed as a stabilizer in the vaccine IPOL

    Bovine products of any kind do not appear to be used in the manufacture of any flu vaccine

    Is this substance used in flu vaccine manufacture? No. Score: 3/36.
    
    

11. Embryonic Guinea Pig Cells -- The Oka/Merck strain of varicella vaccine virus, used in the Varivax vaccine approved in the US, was passaged through embryonic guinea pig cell cultures before a final passage through WI-38 human diploid cell cultures. I believe that is the only way embryonic guinea pig cells have any relationship to any US-approved vaccines.

    https://www.fda.gov/media/76000/download

    Is this substance used in flu vaccine manufacture? No. Score: 3/36.

12. DNA from Pig Circoviruses (PCV) In 2010, porcine circovirus DNA (PVC1 and PVC2 were found in both approved rotavirus vaccines, Rotarix and Rotateq. Neither PCV1 nor PCV2 is known to infect or cause disease in humans.

    https://www.cidrap.umn.edu/news-perspective/2010/05/second-rotavirus-vaccine-found-contain-porcine-circovirus#:~:text=The%20FDA%20said%20neither%20has,both%20have%20strong%20safety%20records.
    
    Is this substance used in flu vaccine manufacture? No. Score: 3/36.

13. insect cell bacterial, and viral protein. This is word salad, but since I've read all the flu vaccine Package Inserts, I'm thinking it's a garbled reference to Section 11 for FluBlok. A quote from the PI:

    contains purified HA proteins produced in a continuous insect cell line (expresSF+®) that is derived from Sf9 cells of the fall armyworm, Spodoptera frugiperda (which is related to moths, caterpillars and butterflies), and grown in serum-free medium composed of chemically-defined lipids, vitamins, amino acids, and mineral salts. Each of the four HAs is expressed in this cell line using a baculovirus vector (Autographa californica nuclear polyhedrosis virus), extracted from the cells with Triton X-100 and further purified by column chromatography. The purified HAs are then blended and filled into single-dose syringes.

    https://www.fda.gov/media/123144/download

    Since I'm feeling generous, I'll say it is such a reference. Is this substance used in flu vaccine manufacture?  Yes, in the brand FluBlock. Score: 4/36.  
    
    

14. Canine (dog) Kidney Cell Protein and DNA --The MDCK cell line was derived from a kidney of an apparently normal adult female cocker spaniel, September, 1958, by S.H. Madin and N.B. Darby. Since then, variations on the MDCK cell lines have been produced to facilitate flu vaccine production. While "embryonated chicken eggs" were the first influenza viral growth medium, they are not necessarily the best, especially since some influenza virus strains do not grow well in eggs.
    
    Flucelvax contains  <10 ng per dose of residual MDCK cells or fragments.

    https://www.atcc.org/products/all/CCL-34.aspx#:~:text=The%20MDCK%20cell%20line%20was,Madin%20and%20N.B.%20Darby.&text=The%20cells%20are%20positive%20for%20keratin%20by%20immunoperoxidase%20staining.,-Cellular%20Products&text=Comments-,This%20line%20is%20hyperdiploid%20and%20there,bi%2Dmodal%20chromosome%20number%20distribution.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514150/

    https://link.springer.com/chapter/10.1007/1-4020-3103-3_163

    Is this substance used in flu vaccine manufacture? Yes, in the brand Flucelvax Score: 5/36.
    
    https://www.fda.gov/media/123144/download
    

15. Human Embryonic (aborted baby) Lung Culture -- this is WI-38 and MR-5. Human diploid cells are not used in flu vaccine manufacture.

    Aborted Human Diploid Cell Cultures (WI-38 & MR-5) Why repeat this inaccurate information, except to arouse disgust? 

    https://www.historyofvaccines.org/content/articles/human-cell-strains-vaccine-development
    
    Is this substance used in flu vaccine manufacture? No. Score: 5/36.

16. Dextrose --is a sugar. "Dextrose is a type of simple sugar made from corn. It is similar to fructose and chemically identical to glucose, which is blood sugar.

    Simple sugars, including dextrose, fructose, and glucose, appear in foods such as table sugar, honey, and bread."

    https://www.medicalnewstoday.com/articles/322243#overview

    It is only in the adenovirus vaccine, which is not available to the public.
    
    Is this substance used in flu vaccine manufacture? No. Score: 5/36.

17. Chloride -- "The chloride ion  is the anion (negatively charged ion) Cl−. It is formed when the element chlorine (a halogen) gains an electron ".  Cloride does not exist as a single substance, because it 's an anion. There are chloride containing compounds in vaccines, such as sodium chloride (table salt) and potassium chloride (which is consumed as a table salt substitute). These chloride salts are used as buffering agents and growth medium nutrients.

    Is this substance used in flu vaccine manufacture? No. Score: 5/36

18. Gelatin -- see the porcine gelatin discussion in item #8. Again being generous, allow the double count. 
    Is this substance used in flu vaccine manufacture? Yes, in the brand FluMist. Score: 6/36.

19. Casein is a family of related phosphoproteins found in mammalian milk, and is widely used in food production.

    The CDC's Vaccine Excipient Table lists casein as an ingredient only in the cholera vaccine.

    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    The "Table of Excipients" published by the Institute for Vaccine Safety at Johns Hopkins lists "bovine casein" as an medium nutrient in a number of vaccines, but no flu vaccines

    https://www.vaccinesafety.edu/components-Excipients.htm

    Is this substance used in flu vaccine manufacture? No. Score: 6/36.

20. Glucose is a simple sugar with the molecular formula C6H12O6. Glucose is the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is naturally occurring, and is found in fruits and other parts of plants in its free state. In animals, glucose is released from the breakdown of glycogen in a process known as glycogenolysis. Glucose, as intravenous sugar solution, is on the World Health Organization's List of Essential Medicines

    The CDC's Vaccine Excipient Table and the IVS Table of Excipeients lists glucose as an ingredient only in one rotavirus vaccine, Rotarix.

    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    Is this substance used in flu vaccine manufacture? No. Score: 6/36.

21.  Fructose, or fruit sugar, is a simple ketonic monosaccharide found in many plants, where it is often bonded to glucose to form the disaccharide sucrose. It is one of the three dietary monosaccharides, along with glucose and galactose, that are absorbed directly into blood during digestion.

    The CDC's Vaccine Excipient Table lists casein as an ingredient only in the cholera vaccine.

    The "Table of Excipients" published by the Institute for Vaccine Safety at Johns Hopkins does not list fuctose in any vaccine.

    Is this substance used in flu vaccine manufacture? No. Score: 6/36.

22. Detergent -- there is no excipient called "detergent" in any vaccine

    https://www.vaccinesafety.edu/components-Excipients.htm
    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    Is this substance used in flu vaccine manufacture? No. Score: 6/36.

23. Yeast protein. Some vaccines (such as the Hepatitis B vaccine) are produced using modified yeast cultures; there may be residual amounts of proteins in those vaccines.Yeast cultures are not used in flu vaccine production.

    Is this substance used in flu vaccine manufacture? No. Score: 6/36.

24. Sucrose is common sugar. It is a disaccharide, a molecule composed of two monosaccharides: glucose and fructose. Sucrose is produced naturally in plants, from which table sugar is refined. It has the molecular formula C12H22O11.

    Sucrose is used in a number of vaccines, including some flu vaccines, as a stabilizer. The amounts are typically <10 mcg/dose for injectable flu vaccines and 13.68 mg/dose for the nasal vaccine.  
    
    Is this substance used in flu vaccine manufacture? Yes, in the brands Afluria and Flumist. Score: 7/36.

25. salts and sugars. I'm am afraid I find this just a silly listing, as we have discussed the sugars above, and will discuss the salts below. Without more specificity, I am going to score this zero.

    Is this substance used in flu vaccine manufacture? No. Score: 7/36.

26. Sodium phosphate is a generic term for a variety of salts of sodium (Na+) and phosphate (PO43−). Phosphate also forms families or condensed anions including di-, tri-, tetra-, and polyphosphates. Most of these salts are known in both anhydrous (water-free) and hydrated forms. Sodium phosphates have many applications in food and for water treatment. For example, sodium phosphates are often used as emulsifiers (as in processed cheese), thickening agents, and leavening agents for baked goods. They are also used to control pH of processed foods.

    Sodium phosphate is listed as an ingredient in many vaccines, including some flu vaccines.

    Is this substance used in flu vaccine manufacture? Yes, in the brands Afluria and Flumist. Score: 8/36.
    
    

27. Mercury (thimerosal) -- Thimerosal is not mercury, and mercury is not thimerosal. The chemical formula for thimerosal is C9H9HgNaO2S It is only used in multi-dose vials. Typically around 25.4 mcg (or millions of a gram) per dose. Thimerosal is a safe and effective anti-microbial. Most flu vaccines now come in single-dose vials, so do not need or contain thimerosal. 

    https://www.cdc.gov/vaccinesafety/concerns/thimerosal/timeline.html

    Is this substance used in flu vaccine manufacture? Yes, for multi-dose vials only Score: 9/36.
    

28. Ethanol-- antifreeze.  This is just completely wrong.  First, ethanol is also called alcohol, ethyl alcohol and grain alcohol. It is not used in vaccines. A compound, d 2-phenoxy-ethanol, is used in some vaccines as a stabilizer, but not flu vaccines. Second, ethanol is not antifreeze. Antifreeze is typically a mixture of distilled water with a base product - ethylene or propylene glycol. Finally, there has never been anti-freeze in any vaccine, no matter how many times it's been so claimed. Polyethylene glycol (a chemical used in antifreeze and personal care products like skin creams and toothpaste) was formerly used to deactivate the virus in some flu vaccines, but is no longer used.

    https://www.vaccinesafety.edu/components-Excipients.htm
    
    https://www.monarchchemicals.co.uk/Information/News-Events/700-/The-difference-between-Propylene-Glycol-and-Ethylene-Glycol-in-antifreezehttps://www.supremecourt.gov/opinions/URLs_Cited/OT2010/09-152/Am.Academy.PDF
    https://vaxopedia.org/2018/03/28/which-vaccines-contain-antifreeze/ 

    Is this substance used in flu vaccine manufacture? No. Score: 9/36.

29. Polysorbate 20 &80. First, some chemistry: The term surfactant comes from the word surface active agent. They are molecules that have distinct regions: one region rejects water or liquid (nonpolar) and one region that is attracted to water or liquid (polar) regions. Surfactants thus, so to speak, serve to "weld" liquid and gaseous mixtures, and cause the decrease in surface or interfacial tensions. Surfactants are particularly useful in mixing oil and water.

    https://www.biolinscientific.com/blog/what-are-surfactants-and-how-do-they-work

    Polysorbate 20 is used in Flublok, an adult vaccine.

    The amounts of polysorbate 20 used in the vaccines is ≤27.5 mcg

    Polysorbate 80 is reported to be in FluAd, a flu vaccine for those over 65; in Fluarix; in Flucelvax (the highest amount; ≤1500 mcg) and in Flulaval ( ≤887 mcg)

    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    https://www.vaccinesafety.edu/components-Excipients.htm

    PS20 and PS80 are the most commonly used surfactants in biotherapeutic formulations and are also added to foods and cosmetic products as emulsifying agents. The Dailymed database refers to PS20 and PS80 as excipients in 2475 and 6326 drugs, respectively, with oral, parenteral, ophthalmic, and topical routes of administration. The FDA has granted PS80 the status of generally recognized as safe (GRAS), and both PSs are listed in its Inactive Ingredients Database. Per the WHO, the accepted oral daily intake of PSs by adults is 25 mg/kg, compared with 10 mg/kg as suggested by the Scientific Committee on Food.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7022221/
    
    Taking the above-mentioned limits, let us propose a hypothetical average 6 month old girl baby, weighing 7.3 kg, who received Flulaval. She would be exposed to (887 mcg/7.3 kg) or 121.5 mcg/kilo, far less than the accepted intake dose.

    Is this substance used in flu vaccine manufacture? Yes, for  some but not all  brands Score: 10/36.
    

30. Aluminum Dye-- aluminum lake dye is part of the outer coating of the adenovirus type 7 tablet. "Adenovirus vaccine is only available for United States military personnel. There is currently no adenovirus vaccine available to the general public."
    
    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    Is this substance used in flu vaccine manufacture? No. Score: 10/36

31. Formaldehyde is used in many vaccines, including flu vaccines, to inactivate the viruses. The human body makes formaldehyde as a part of protein synthesis, and the small amounts in vaccines do not change the amount of formaldehyde circulating in the blood. Fluzone Quadrivalent has the most, at ≤100 mcg/dose. 

    https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-ingredients/formaldehyde

    Is this substance used in flu vaccine manufacture? Yes, in the brands Fluad, Fluarix, Flulaval, Fluzone High-dose, Fluzone. Score: 11/36

32. Aluminum, the element, is not used in vaccines. Various aluminum salts and compounds are used as adjuvants. For example, the pneumococcal vaccine Prevnar13 has 0.125 mcg of aluminum phosphate as an adjuvant. So 1/8 of a millionth of a gram of aluminum phosphate. No aluminum salts are used in flu vaccine manufacture. 

    https://fullfact.org/online/vaccine-ingredients/

    Is this substance used in flu vaccine manufacture? No. Score: 11/36

33. Acetone --Part of the outer coating of the adenovirus vaccine. "Adenovirus vaccine is only available for United States military personnel. There is currently no adenovirus vaccine available to the general public."
    
    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    Is this substance used in flu vaccine manufacture? No.  Score: 11/36

34. Alcohol.  This is another meaningless, fearmongering entry, like #25, "salts and sugars", and #38, "E. coli".  In chemical terms, "Alcohol, any of a class of organic compounds characterized by one or more hydroxyl (―OH) groups attached to a carbon atom of an alkyl group (hydrocarbon chain)....Alcohols are among the most common organic compounds. They are used as sweeteners and in making perfumes, are valuable intermediates in the synthesis of other compounds, and are among the most abundantly produced organic chemicals in industry."
    
    https://www.britannica.com/science/alcohol
    
    Is this substance used in flu vaccine manufacture? No.  Score: 11/36

35. Barium -- was a microingredient in one flu vaccine for those over 65, Fluad, although the 2020 package insert doesn't mention it.

    https://www.vaccinesafety.edu/components-Excipients.htm
    https://www.fda.gov/media/94583/download

    Is this substance used in flu vaccine manufacture? Not currently. Score: 11/36

36. E. Coli -- this is just a scare tactic, because what the general public knows about E. coli is that it is a dangerous infectious organism, not the truth, which is it has many, many strains, some of which are used in vaccine and medication production.

    https://en.wikipedia.org/wiki/List_of_strains_of_Escherichia_coli 
    
    Is this substance used in flu vaccine manufacture? No. Score: 11/36
    
    

So this list got an accuracy score of 30.6%.  Generally speaking, anything below 59% is considered an F grade.  Well done, meme maker, you failed!

The influenza vaccines approved for use in the US, 2020-2021 season

If you would like to share this article as a PDF or attachment, feel free to download this: Download Debunking %22Had Your Flu Shot this Winter?%22 meme

Flu Shot Ingredients Includes Some of These -- Or Do They?

Have you seen this meme being passed around?

I decided to go through each of the named ingredients,  and see if they are in any vaccine, let alone the flu vaccine. I'm also going to keep score: how many of the 24 items are actually in flu vaccines?

Reminder: You may know this, but:

• A paper clip weighs about 1 gram.
• Most vaccines are 0.5 milliliters (ml) or approximately 10 drops of water
• mg = milligram, 1/1,000 of a gram
• mcg = microgram, 1/1,000,000 of a gram
• ng = nanogram, 1/1,000,000,000 of a gram

Substances listed, starting from top left

1. Mercury (thimerosal) -- Thimerosal is not mercury, and mercury is not thimerosal. The chemical formula for thimerosal is C9H9HgNaO2S It is only used in multi-dose vials. Typically around 25.4 mcg (or millions of a gram) per dose. Thimerosal is a safe and effective anti-microbial. Most flu vaccines now come in single-dose vials, so do not need or contain thimerosal. 

   https://www.cdc.gov/vaccinesafety/concerns/thimerosal/timeline.html

   Is this substance used in flu vaccine manufacture? Yes, for multi-dose vials only Score: 1/26

2. Formaldehyde is used in many vaccines, including flu vaccines, to inactivate the viruses. The human body makes formaldehyde as a part of protein synthesis, and the small amounts in vaccines do not change the amount of formaldehyde circulating in the blood. Fluzone Quadrivalent has the most, at ≤100 mcg/dose. 

   https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-ingredients/formaldehyde

   Is this substance used in flu vaccine manufacture? Yes, in the brands Fluad, Fluarix, Flulaval, Fluzone High-dose, Fluzone. Score: 2/26

3. Ethanol-- is also called alcohol, ethyl alcohol and grain alcohol. It is not used in vaccines. A compound, d 2-phenoxy-ethanol, is used in some vaccines as a stabilizer, but not flu vaccines.

   https://www.vaccinesafety.edu/components-Excipients.htm

   Is this substance used in flu vaccine manufacture? No. Score: 2/26

4. Human Embryonic (aborted baby) Lung Culture -- this is WI-38 and MR-5. Human diploid cells are not used in flu vaccine manufacture.

   Aborted Human Diploid Cell Cultures (WI-38 & MR-5) Why repeat this inaccurate information, except to arouse disgust? 

   https://www.historyofvaccines.org/content/articles/human-cell-strains-vaccine-development
   
   Is this substance used in flu vaccine manufacture? No. Score: 2/26

5. Aluminum, the element, is not used in vaccines. Various aluminum salts and compounds are used as adjuvants. For example, the pneumococcal vaccine Prevnar13 has 0.125 mcg of aluminum phosphate as an adjuvant. So 1/8 of a millionth of a gram of aluminum phosphate.

   https://fullfact.org/online/vaccine-ingredients/

   Is this substance used in flu vaccine manufacture? No. Score: 2/26
   

6. Monkey Kidney Cells this is a references to Vero (African monkey kidney epithelial cells) .Various lines of Vero cells have been used for human vaccine production for nearly 40 years, and were the only World Health Organization approved continuous cell line substrates for some time."

   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514150/

   Is this substance used in flu vaccine manufacture? No. Score: 2/26
   

7. Fetal Cow Serum -- yes, it's used in vaccine production, for non-viral organisms. "Fetal bovine serum is the most widely used growth supplement added to eukaryotes in vitro cell cultures. It has been in use since the 1960s and, for over fifty years, has outperformed both synthetic and natural growth supplements." To the best of my knowledge, it's not used in flu vaccine manufacture.
   
   Is this substance used in flu vaccine manufacture? No. Score: 2/26

8. DNA from Pig Circoviruses (PCV) In 2010, porcine circovirus DNA (PVC1 and PVC2 were found in both approved rotavirus vaccines, Rotarix and Rotateq. Neither PCV1 nor PCV2 is known to infect or cause disease in humans.

   https://www.cidrap.umn.edu/news-perspective/2010/05/second-rotavirus-vaccine-found-contain-porcine-circovirus#:~:text=The%20FDA%20said%20neither%20has,both%20have%20strong%20safety%20records.
   
   Is this substance used in flu vaccine manufacture? No. Score: 2/26

9. Embrionic (Sic) Guinea Pig Cells -- The Oka/Merck strain of varicella vaccine virus, used in the Varivax vaccine approved in the US, was passaged through embryonic guinea pig cell cultures before a final passage through WI-38 human diploid cell cultures. I believe that is the only way embryonic guinea pig cells have any relationship to any US-approved vaccines.

   https://www.fda.gov/media/76000/download

   Is this substance used in flu vaccine manufacture? No. Score: 2/26

10. Human Albumin -- it is used as a diluent and stabilizer in two vaccines, MMRII and MMRV. Not in flu vaccines. Furthermore, albumin purified from human blood is being replaced by recombinant (synthetic) human albumin products.

    "Human serum albumin (HSA) is widely used in clinical and cell culture applications. Conventional production of HSA from human blood is limited by the availability of blood donation and the high risk of viral transmission from donors."

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223471/
    
    Is this substance used in flu vaccine manufacture? No. Score: 2/26

11. Porcine (pig) Gelatin -- hydrolyzed porcine gelatin is used as a stabilizer in the FluMist Quad and Zostavax (the first anti-shingles vaccine). Gelatin, species source not specified, is used as a stabilizer in the vaccines against Yellow Fever, MMRII, and MMRV.

    https://www.vaccinesafety.edu/components-Excipients.htm

    Muslim and Jewish religious authorities have agreed that porcine gelatin in injectable form is acceptable.

    https://www.vumc.org/health-wellness/news-resource-articles/immunizations-and-religk

    Is this substance used in flu vaccine manufacture? Yes, in the brand FluMist. Score: 3/26

12. Canine (dog) Kidney Cell Protein and DNA --The MDCK cell line was derived from a kidney of an apparently normal adult female cocker spaniel, September, 1958, by S.H. Madin and N.B. Darby. Since then, variations on the MDCK cell lines have been produced to facilitate flu vaccine production. While "embryonated chicken eggs" were the first influenza viral growth medium, they are not necessarily the best, especially since some influenza virus strains do not grow well in eggs.
    
    Flucelvax contains  <10 ng per dose of residual MDCK cells or fragments. 

    https://www.atcc.org/products/all/CCL-34.aspx#:~:text=The%20MDCK%20cell%20line%20was,Madin%20and%20N.B.%20Darby.&text=The%20cells%20are%20positive%20for%20keratin%20by%20immunoperoxidase%20staining.,-Cellular%20Products&text=Comments-,This%20line%20is%20hyperdiploid%20and%20there,bi%2Dmodal%20chromosome%20number%20distribution.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514150/

    https://link.springer.com/chapter/10.1007/1-4020-3103-3_163

    Is this substance used in flu vaccine manufacture? Yes, in the brand Flucelvax Score: 4/26
    

13. Mueller's Media (containing cow extracts) (sic) -- it's Mueller's medium. Mueller's medium is a culture medium, used to grow tetanus and diphtheria, among other organisms. It was developed by Fiskek, Mueller, and Miller in the 1940s.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC357228/pdf/jbacter00552-0091.pd. MUSCLE EXTRACTIVES IN THE PRODUCTION OF TETANUS TOXIN 1953
    
    The original Mueller’s medium "recipe" used a broth made of beef hearts as a protein and micronutrient source. The beef heart infusion has since been standardized and is a common laboratory product. https://www.sigmaaldrich.com/content/dam/sigma-aldrich/docs/Sigma-Aldrich/Datasheet/1/05121dat.pdf

    It's used in the manufacture of a few vaccines, those that prevent pertussis, diphtheria, and tetanus, but not any flu vaccines. 
    
    Is this substance used in flu vaccine manufacture? No. Score: 4/26

14. Detergent -- there is no excipient called "detergent" in any vaccine

    https://www.vaccinesafety.edu/components-Excipients.htm
    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    Is this substance used in flu vaccine manufacture? No. Score: 4/26

15. Chloride -- "The chloride ion  is the anion (negatively charged ion) Cl−. It is formed when the element chlorine (a halogen) gains an electron ".  Cloride does not exist as a single substance, because it 's an anion. There are chloride containing compounds in vaccines, such as sodium chloride (table salt) and potassium chloride (which is consumed as a table salt substitute). These chloride salts are used as buffering agents and growth medium nutrients.
    
    Is this substance used in flu vaccine manufacture? No. Score: 4/26

16. Anti-freeze -- no. This has been debunked for a long time. Polyethylene glycol (a chemical used in antifreeze and personal care products like skin creams and toothpaste) was formerly used to deactivate the virus in some flu vaccines, but is no longer used. 
    https://www.supremecourt.gov/opinions/URLs_Cited/OT2010/09-152/Am.Academy.PDF
    https://vaxopedia.org/2018/03/28/which-vaccines-contain-antifreeze/
    

    Is this substance used in flu vaccine manufacture? No. Score: 4/26

17. Aluminum Dye-- aluminum lake dye is part of the outer coating of the adenovirus type 7 tablet. "Adenovirus vaccine is only available for United States military personnel. There is currently no adenovirus vaccine available to the general public."
    
    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    Is this substance used in flu vaccine manufacture? No. Score: 4/26
    

18. E. Coli -- this is just a scare tactic, because what the general public knows about E. coli is that it is a dangerous infectious organism, not the truth, which is it has many, many strains, some of which are used in vaccine and medication production.

    https://en.wikipedia.org/wiki/List_of_strains_of_Escherichia_coli 
    
    Is this substance used in flu vaccine manufacture? No. Score: 4/26

19. Human serum albumin (HSA)—one of the most demanded therapeutic proteins with immense biotechnological applications—is a large multidomain protein containing 17 disulfide bonds. The current source of HSA is human blood plasma which is a limited and unsafe source. Thus, there exists an indispensable need to promote non-animal derived recombinant HSA (rHSA) production. Escherichia coli is one of the most convenient hosts which had contributed to the production of more than 30% of the FDA approved recombinant pharmaceuticals. It grows rapidly and reaches high cell density using inexpensive and simple substrates."

    https://microbialcellfactories.biomedcentral.com/articles/10.1186/s12934-017-0784-8
    
    Human serum albumin is used in the MMRII vaccine and the rabies vaccine.
    
    https://www.vaccinesafety.edu/components-Excipients.htm
    
    Is this substance used in flu vaccine manufacture? No. Score: 4/26

20. Acetone --Part of the outer coating of the adenovirus vaccine. "Adenovirus vaccine is only available for United States military personnel. There is currently no adenovirus vaccine available to the general public."
    
    https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

    Is this substance used in flu vaccine manufacture? No.  Score: 4/26

21. Barium -- was a microingredient in one flu vaccine for those over 65, Fluad, although the 2020 package insert doesn't mention it.

    https://www.vaccinesafety.edu/components-Excipients.htm
    https://www.fda.gov/media/94583/download

    Is this substance used in flu vaccine manufacture? Not currently. Score: 4/26
    

22. Cow Muscle Tissue -- may be an ingredient in various growth mediums in some vaccines. Mueller's medium originally used essentially consummé made from beef heart. Growth mediums are purified out of the end product.
    
    Is this substance used in flu vaccine manufacture? No. Score: 4/26

23. Chicken Protein -- no intact protein cells from chicken eggs are found in vaccines produced using chicken eggs as the growth medium. There may be trace (<10 ng) amounts of chicken DNA in such vaccines.
    
    https://www.vaccinesafety.edu/components-Excipients.htm
    
    Is this substance used in flu vaccine manufacture? Yes, in all fluvaccine brands except Flublok and Flucelvax Score: 5/26

24. Porcine (pig) Argine (sic) Argine is not a word. The person who wrote this list was possibly referring to arginine, an amino acid, C6H14N4O2, obtained from the hydrolysis of plant and animal proteins. It is an excipient in FluMist, 2.42 mg/dose arginine as a stabilizer.
    
    https://www.fda.gov/media/83072/download

    Is this substance used in flu vaccine manufacture? No, for the word argine. Score: 5/26
    

25. Dextrose --is a sugar. "Dextrose is a type of simple sugar made from corn. It is similar to fructose and chemically identical to glucose, which is blood sugar.

    Simple sugars, including dextrose, fructose, and glucose, appear in foods such as table sugar, honey, and bread."

    https://www.medicalnewstoday.com/articles/322243#overview

    It is only in the adenovirus vaccine, which is not available to the public.
    
    Is this substance used in flu vaccine manufacture? No. Score: 5/26

26. Gelatin -- see the porcine gelatin discussion, above.
    Is this substance used in flu vaccine manufacture? Yes, in the brand FluMist. Score: 6/26

So this list got an accuracy score of 23%.  Generally speaking, anything below 59% is considered an F grade.  Well done, meme maker, you failed!

Additional sources:

https://www.orau.gov/cdcynergy/web/im/Content/activeinformation/resources/IM_additives.pdf

https://pediatrics.aappublications.org/content/pediatrics/112/6/1394.full.pdf

What's In the US Flu Vaccine for 2020-2021? Hint: It's Not A "Low Strain of Covid"

I want to start off by stating the obvious. There is not yet a single vaccine approved for preventing COVID-19. There may not be any COVID-19 vaccines in commercial production yet, and it takes months to produce even an approved vaccine. 

That's an example of "prebunking": "research that shows it can be more effective to give people information about how to identify conspiracy theories or misinformation before they are exposed to it. This is a fantastic idea, and I love the fact that this is being done in coordination with research to show if it is effective."

In this COVID-19 epidemic, we have learned that people can be infected at second, or third, or fourth hand. The same is true for anti-vaccine myths.Somebody doesn't have to read or here the original wild claim to believe it and repeat it.

This is a story about how a wild, completely unfactual story posted on Facebook started affecting what decisions people are making about getting the flu vaccine for themselves and their children.

Influenza is a virus, but like many infectious viruses, it's not just one strain. It's a particularly protean (or promiscuous) virus, swapping around bits with abandon (this video,Three types of flu, from Khan Academy Medicine is from 2013, but still accurate and very informative. The lecturer is Rishi Desai, MD, MPH.  He also has one on how flu strains are named.)

So who decides which strains are included in each year's annual flu vaccine? Does somebody at CDC just sit down and guess? No. Back in 2018, Serese Marotta, Chief Operating Officer of Families Fighting Flu, wroe a great explainer on the complex, international process for identifying which strains to recommend for alternating "seasons" -- Northern Hemisphere, including the US, and the Southern Hemisphere. Marotta's explainer was posted at Vaccinate Your Family's blog, Shot of Prevention.

The very short version

• Throughout the year, dozens of flu monitoring centers around the world track and analyze virus samples. These are sent to the Collaborating Centers for Reference and Research on Influenza, which are part of the World Health Organization (W.H.O).
• In February of each year, W.H.O. issues recommendations for the strains to be included in Northern Hemisphere vaccines, and in September to recommend flu strains for the Southern Hemisphere.
• With respect to the US, an Food and Drug Administration's  Vaccines and Related Biological Products Advisory Committee (VRBPAC)  (a panel of experts) meets shortly after the W.H.O. recommendations are published, and makes the recommendations for the strains to included in that year's vaccine. This year the meeting was March 4, 2020. 
• Once the selected strains are announced, all the manufacturers start growing them, either in egg or cell cultures. Growing enough virus for the nation takes months.
• The next regulatory step is the approval of the Advisory Committee on Immunization Practices (a volunteer panel of experts). ACIP does most of its work in subcommittees, called Work Groups, that meet virtually as needed. The Influenza Work Group is a permanent Work Group. The final report is typically issued in August.

People sometimes wonder why the annual flu vaccines can be approved so rapidly. Don't they change every year? The best analogy I have is cookies made with candy chips (you know, chocolate chips, butterscotch chips, peppermint chips...). You might have your favorite recipe for the dough (one brand of flu vaccine), which is a little different than your neighbor's (another brand), and so on. The dough recipes don't change, but you can slot in whatever kind of chip you want: milk chocolate, dark chocolate, butterscotch.... all that changes, year to year, in flu vaccines (after the initial approval) is three or four strains of flu.

Here are the various strains that Vaccines and Related Biological Products Advisory Committee recommended in March and the Advisory Committee on Immunization practices approved in August:

Image Source: https://www.fda.gov/vaccines-blood-biologics/lot-release/influenza-vaccine-2020-2021-season. Click to enlarge.

So what's different about this year? Well, since March (or January, if you are interested in epidemiology and emerging pandemic threats) it's been SARS Cov-2 (the virus) and COVID-19 (the disease) all the time. And the deep, deep desire for a vaccine, and and equally deep amount of anxiety about the safety and efficacy of the vaccine

Rumors and disinformation about  COVID-19, and the many vaccines in development,  have been swirling for months. This is not a surprise.  People have lost beloveds to this disease, people have suffered economically, people with school-age children have had their lives upended, the US  Federal government's  response has been catastrophically bad -- in short, people are anxious.  People are being flooded with information (good, bad, ambigous) that they lack the intellectual furniture to evaluate.

Even in a normal year, there's always a lot of flu vaccine hesitancy and refusal (why is a story for another time). This isn't a normal year, so I wasn't surpised to see this from a pediatrician I follow on social media

Image Source: https://twitter.com/greenhousemd/status/1316793539158835202

I got curious about this particular bit of misinformation, so I went looking.  On September 18, 2020, Reuters published Fact-check: The flu vaccine is not an untested COVID-19 vaccine

A post shared over 6,600 times on Facebook claims the children’s influenza vaccine is actually an untested COVID-19 vaccine. This is false.

Oops. Reuters failed Lakoff's "truth sandwich" approach

1. Start with the truth. The first frame gets the advantage.
2. Indicate the lie. Avoid amplifying the specific language if possible.
3. Return to the truth. Always repeat truths more than lies.

Sources: https://twitter.com/georgelakoff/status/1068891959882846208?lang=en and https://soundcloud.com/user-253479697/14-truth-sandwich-time

How Reuters might have more effectively have framed this story:

1. The only antigens present in this year's flu vaccines are influenza antigens for four different named strains of flu. Flu vaccine production starts in the spring. The CDC may encourage flu vaccine uptake, but has no power to compel physicians to administer them.
2. In a dramatic post on Facebook, a woman claimed that there were no flu antigens in this year's vaccine, just a "low strain of COVID", which the CDC is compelling doctors to give.
3. There are no COVID vaccines available outside of clinical trials.

Reuters helpfully linked to the woman's Facebook post, so here is her dramatic (and totally imaginary) recounting of her recent conversation with her child's pediantrician.

Text version

COVID PARENT WARNING ALERT

I had to take my son to the doctor for a ear ache this morning ... when we were done this was my conversation with the Pediatrician, NO JOKE!

Doctor : would you like the kids to get the flu shot

Me: (I was curious) what strain of the flu is it

Doctor: Covid but a very low strain of it

Me: No thanks.

Doctor: they are really pushing us to push parents to get the flu shots for kids.

Me: I’m not a fan of what’s going on in the world and I’m not giving my children a untested Covid flu shot.

Doctor: I am sure if you and I sat and talked we would have similar beliefs on what’s going on.

Me: then why are you pushing a vaccine that’s not tested or Barely tested

Doctor: Because they tell us to.

Me: who tells you?

Doctor: CDC

Wake 👏UP👏and 👏for all the is Holy DO 👏NOT 👏GIVE 👏your 👏children 👏a 👏Covid 👏vaccine!!

Anybody who has been following the antivaccine movement will recognize the overall shape of this urban legend.

• Woke Mom visits the doctor
• Woke Mom discovers a terrible hidden truth about some vaccine
• Woke Mom's doctor confides in Woke Mom that physicians are bribed or forced into concealing THE TRUTH
• Woke Mom tells all her friends
• Woke Mom gets all kinds of accolades and social capital for her discovery, and her "bravery" in spreading the truth

These elements get shuffled and reassorted, but the overall arc is the same

(By the way, there's another anti-vaccine urban myth shape, the "everybody claps")

• Woke mom visits the doctor
• Woke mom spreads "truth bomb"
• doctor "wakes up"
• doctor ceases to vaccinate
• everybody claps

Here are a few examples of the genre

and

It became such a common trope in antivaccine circles there were even playing cards

But, why would somebody tell such a lie? And why did this woman's obviously false story get traction?

It probably has to do with her backstory, and the way that the Qanon narrative has taken hold among young suburban mothers.

Here is her backstory, from her Facebook page

Good morning Facebook! The Smart Sex Podcast I recorded with Leslie Newby Gustafson will be released this Friday! I talk about abuse as a child, how I was lured into being trafficked, and how I was rescued and where I’m at now! I hope you all will tune in. I of course will post on here once it’s released!

Intro to Podcast:

Madyson is a former porn star who's choice led to her freedom being taken away. She was trafficked for almost a decade. Madyson has bravely spoken out about her time in the porn industry and how it altered her life, her choices and how she gained her voice and took her freedom back. Madyson was owned by Derek Hays from LA Direct models but not anymore.

Here's her website

And here's her book, My Father's Daughter. Several reviews suggest that the details recounted are completely fabricated, and that the woman has a history of fabricating wild tales for attention or for money. If true, that would explain why she fabricated the vaccine story as well.

But she seems to have a large and enthusiast following, especially for her stories of being trafficked as a minor. This is part of a "moral panic" that gripped the US in the summer of 2020

In "HOW QANON CONSPIRACY THEORIES SPREAD IN MY COLORADO HOMETOWN, During the pandemic, some of the people I grew up with got sucked into QAnon and the Q-adjacent “Save the Children” movement.

During the pandemic, some of the people I grew up with in Colorado had gotten sucked into QAnon, the sprawling and baseless pro-Trump conspiracy theory that is deemed a domestic terror threat by the FBI. I remembered them as perfectly reasonable people: some liberal, some conservative, but all frozen in my memory as intellectually curious. Now, online and from a distance, I was watching them change. Young, white suburban women, in particular, were falling for a Q-adjacent movement, “Save the Children,” which raises false fears about child sex trafficking through fabricated stories, pastel infographics, and hashtag campaigns.

In How #SaveTheChildren is pulling American moms into QAnon The hashtag, its links to conspiracy theories, and its implications for the election, explained.

Another article, with more details

.....But all share the same message: Child sex trafficking is out of control in the US and around the world, and no one is paying attention. And they end with the hashtag #SaveTheChildren.

The hashtag, which started to gain popularity this summer, seems hard to argue with. Ending human trafficking and protecting children, after all, are uncontroversial goals, barely even political.

But in reality, many say, QAnon adherents are trying, via the hashtag, to use the real issue of trafficking to spread their ideology — which includes the bizarre, untrue claim that liberals like Hillary Clinton, Barack Obama, and Chrissy Teigen are all part of a vast pedophile ring. While such outlandish theories may not be palatable for many, more general fears about child sex trafficking are easier to get behind. And so social media posts about saving the children have, for some, become a way “to launder QAnon into the mainstream,” as Whitney Phillips, a professor of communication and rhetorical studies and co-author of the book You Are Here: A Field Guide for Navigating Polarized Speech, Conspiracy Theories, and Our Polluted Media Landscape, put it to Vox.

So now you know the origin of this completely unplausible story, and how and why it spread.

Vince Iannelli writes Vaxopedia, a huge collection of facts about vaccines, and debunkings of persistent vaccine myths. Here's his article debunking "the flu vaccine is really "Covid but a very low strain of it" myth.

I hope this post gives pediatricians, family medicine physicians, and other flu vaccine providers the ammunition they need to turn flu vaccine refusers into flu vaccine accepters. If any of them reading this wants a handbook, may I suggest Gretchen LaSalle's "Let's Talk Vaccines: A Clinician's Guide to Vaccine Hesitancy and Saving Lives.

Edited to add, October 25, 2020

Here are a few representative samples of Madyson Marquette's tweets

Vaccine Hesitant, Vaccine Fearful, Vaccine Refuser, Ex-Vaxxer, Vaccine Abolutionist, Anti-Vaccine: Coming to Terms

This conversation with Johan Bester, director of bioethics for UNLV’s School of Medicine, got me to thinking about me policing the terms I use.

Is there a chance that those vehemently opposed to vaccinations will strengthen their resolve?

I would expect that there are some parents who would double down on their vaccine refusal, and become more entrenched in their opposition to childhood vaccines during the pandemic. The world, unfortunately, has become more polarized in recent years. As the psychologist Jonathan Haidt pointed out, people often make up their minds about controversial issues based on the tribe they belong to, and come up with justifications for their choices afterwards. The same principle is at work for many who refuse vaccines: their identity is tied up with the refusal of vaccines; being opposed to vaccines is part of who they are.

They simply don't trust information from experts, people who provide evidence in favor of vaccines. There is research that shows that some people who have very strong anti-vaccine views become even more opposed to vaccines when you provide them with evidence and facts about vaccine safety. When you present information related to vaccine science to people who have their identity wrapped up in opposition to vaccines, they experience it as a personal attack rather than a discussion on what should be done for a child.

Overall, the key is building trusting relationships. People will hear what you say if they trust you. Relationship and goodwill comes before education and communication of the scientific facts; you can’t have one without the other.

This is one reason I have such an antipathy to the moniker "anti-vaxxer.” It is not helpful to lump all vaccine-hesitant people together under a term that has taken on derogatory overtones. It polarizes the issue further, rather than seeking to build the trust and goodwill needed for people to hear what you have to say.

The reality is pretty subtle and shaded, while online conversations tend to be more polarized, I think.

Personally I've been trying to reserve the terms, "anti-vaccine", "anti-vax", and AV for those who profit or benefit from raising fear, uncertainty, and doubt (FUD) about vaccines, and who lie repeatedly about the safety and efficacy of vaccines: the likes of Barbara Loe Fisher, Robert F. Kennedy jr., Larry Cook, Joe Mercola, Del Bigtree, Jack Wolfson, Suzanne Humphries, Sherri Tenpenny, Jacqueline "Deep Roots at Home", Bob Sears, Lawrence Palevsky,

Parents (and others) who parrot their words, without really understanding what they are saying, should be called something else.

Liz's Big COVID19 Testing Adventure! Follow Along.

On Monday, May 18th, 2020 I saw an announcement from San Mateo County and Project Baseline (PB) that free COVID19 testing was opening up in my county. So of course, being a good citizen-scientist, I signed up. Plus, I wanted testing.  Plus, I eventually wanted access to antibody testing. Yes, I had to give PB some personal medical information, but nothing that probably isn't already publicly available.  I mean, my height and weight are on my driver's license. Here are the states where Project Baseline testing is available:

Free COVID-19 testing is open in select states:
CA, CT, DE, ID, MA, MD, MI, NH, NJ, NY, OH, PA and VA, and we are continuing to expand.

The first available convenient appointment was Wednesday, May 20th, at 11 pam in Daily City, which is about a 30 minute drive from my house. I arrived at the testing location (buildings that belong to Jefferson Union High School District) to an almost-empty parking lot. The first stop was a sheriff's officer, who asked me (through my rolled-up window) if I had an appointment. I indicated I did, so he waved me, still in my car, to the next stop, which was a gloved, gowned, and masked man who asked me to put my driver's license up to the window, so he could sort me into the correct line.

And this is where I discovered something, or had something brought to mind: I have a danged hard time understanding people when they are wearing masks and talking to me through my closed car window.  (To-do list: referral to audiologist please).

At the next station, two other masked, gowned, and gloved women looked at my driver's license through the car window, retrieved an already-labeled plastic envelope, and tucked it under the car's windshield wiper, and directed me to the correct line for a pair of tents (I wasn't allowed to take pictures or video.)  Then there was a little bit (less than 5 minutes) delay.   I think they had just opened up, and were working out the logistics of where to put directional and stop signs for optimal processing of cars.  Well, people in cars. So, some rearrangement of signage.

Finally, it was my turn.  I pulled up to see a woman in mask, face shield, and one of those disposable yellow gowns. She smiled, gestured theatrically (a nice touch) to a DON'T IDLE--TURN OFF YOUR CAR sign, and turned to the table to don a fresh pair of gloves. She retrieved the plastic envelope from the car windshield and put it on the table. Turning back to me with a vial and a swab, she then told me her first name, that she was a nurse, and that this test would be a self-administered swab. 

I already had a plastic bag open on my lap (in case it was a nasopharyngeal swab, and I gagged and vomited), so I was relieved.

I could hear her clearly through the closed window, so the engine noise might have been part of the problem. I think she asked me if I still wanted to continue with the testing -- I said yes, of course.  Then she described how to do the test.  I was to "take the swab, stick it up my nose until I hit resistance, twirl it around 10 times, and then repeat (10 twirls) on the other side."  I asked, "both nostrils?" and she said yes.  She also said the swab makes some people cough or sneeze; it I did to turn my head into my car.  Then she asked me to crack the window, and poked the vial in so I could grab it, and had me grab the swab from the sterile packaging.   It looked kind of like this.

A teeny little stalk and a fuzzy head, MUCH smaller than a Q-tip.  I did as instructed.  Scraping around the inside of my nose made my eyes water, but not profusely, and there was a residual unpleasant sensation that persisted for about 15 minutes.

Anyway, swab twirling on both sides accomplished, I opened the vial, dropped the swab in, fuzzy end first, and secured the top. I cracked my window again, handed the vial to the nurse, who placed it in the plastic specimen envelope. We wished each other good day, and I was on my way.

From turning off my engine to restarting was less than 10 minutes (I should have started my stopwatch....) and may have been less than 5 minutes. 

By the time I got back to my house, I'd had an email from Project Baseline:

So, by Tuesday May 26th  at the latest, I'll know if I am currently infected with SARS-COV-2, or not.  I predict not.  Check back in a couple of days, I'll update on the next step. 

Update #1:evidently there's some confusion about the test offered. Here's a visual

:

About Those Urgent Care Doctors in Bakersfield: They're Wrong. Here's Why.

Important update 90 minutes after this first posted at : a strongly condemning press release from both the American College of Emergency Physicians (ACEP) and the American Academy of Emergency Medicine (AAEM). This is a big deal; such professional guilds/bodies don't do this

About those two doctors in Bakersfield, California, Dan Erickson and Artin Massihi. They released a video Wednesday April 22, 2020, claiming that their data from "early testing" showed that it was time to start reopening California, and that "sheltering in place" could weaken the immune system. (I'm not linking to the video; it's easy to find on YouTube.).

The very short critique

1. They are not epidemiolpgists or infectious disease experts. I believe only Massihi is board certified. They lack the specialized training to analyze their test results (see discussion below).
2. They own a chain of urgent care centers (Accelerated Urgent Care) that are reported to be struggling financially because of the shut down.
3. They don't identify which of the current tests they used. Some of the tests are more reliable than others, and all tests have significant error ranges.
4. Erickson and Massihi did not test a random sample of the population, but tested sick people who presented to their clinics. This renders their analysis invalid.
5. The calculations they used were highly inaccurate. "Erickson compared Norway to Sweden and did the math wrong. Norway has 37 deaths per million so far and Sweden has 253 per million so far. Sweden also has the steepest curve and is 7th in the world in deaths per.million of their population and rising the fastest in percentage"
6. There is no evidence "sheltering in place" weakens the immune system.There are hundreds of millions of organisms to challenge the immune system, even in the cleanest house

Local infectious disease expert Navin Amin,critiqued their analysis on April 23.

On April 25,  Jennifer Kasten, MD, a pathologist with degrees in infectious disease epidemiology, mathematical modeling of epidemics, and fieldwork in epidemic control, published an in-depth critique of Drs. Erickson and Massihion on Facebook

If Dr. Kasten's analysis is too long for you to read, here is my summary:

They made two epidemiology/immunology claims:

1. That based on their testing, 6.5% of the entire Central Valley is positive.
2. Prolonged social distancing damages the immune system, and we are all becoming weaker for staying at home.

Both of their claims are false.

Also on April 25, on Twitter Professor of Public Policy and Sociology Richard M. Carpiano remarked

Got #COVID19 findings? Report them as scientists do? Nah! Go for press hype, public view, evid. be damned!

• hold press conference at urgent care clinic you own
• wear scrubs (looks expert-y)
• get news to lead w/your creds bf your epid. 101 weak finding

Feel free to copy and paste the above as needed. Now I'm going to get (as was my wont) a lot more detailed critiques. A record, if you will, of reactions. It's long, and detailed, and may not be of interest to you, but there should be a record.

Carl T. Bergstrom started a twitter thread the morning of April 26. His twitter bio reads:

Prof. Biol. @UW. Information flow in biology, society, & science. I love crows and ravens. he/him Book *Calling Bullshit* coming Aug 4th.

I am doing this as a text file, rather than something like Thread Reader App, because... well, I lost a lot of valuable content when Storify shuttered. You can read the originals in the Twitter link above.

Dr. Bergstom's Tweet Thread

Unfortunately the misleading claims of those two doctors in Bakersfield keep making the rounds, so I want to very briefly address the problem with what they are saying.

I won't get into their possible motives, past political activity, etc.

What they did was simple: they looked at the fraction of patients who tested positive for #COVID19 at the clinics they own. They found 340 out of 5213 tests were postive, about 6.6%

Then they assume the same fraction of the whole population are infected.

From there, they scale up to the state level and claim 12% incidence statewide. The news story says it is using the same calculation, but it can't be—how did they get from 6.6% to 12%? Perhaps they estimating infected *ever* versus infected *currently*. It's not clear.

Using that 12% infected figure, and a known 1400 deaths in California, they assume 1400 out of 4.7 million have died. That gives them an infection fatality rate of 0.03%. That is, they think that if 10,000 are infected, 3 will die on average. .

The problem with this approach is that during a pandemic, the people who come into an urgent care clinic are not a random sample of the population.

A large fraction of them are coming in precisely because they suspect that they have the disease.

This generates sampling bias.

Estimating that fraction infected from patients at an urgent care facility is a bit like estimating the average height of Americans from the players on an NBA court.

It's not a random sample, and it gives a highly biased estimate.

Moreover the estimate does not pass even a basic plausibility check.

In New York City, 12,067 people are known to have died from the virus, out of a population of 8.4 million.

This is a rate of 0.14% of all people. Not just infected people. All people.

That gives us a lower bound on the death rate in New York. Not an estimate, a lower bound.

The death rate for infected people is obviously higher than 0.14%, because not everyone in New York has been infected.

And yet that 0.14% lower bound is nearly *five times as high* as the 0.03% that the Bakerfield duo are claiming. They've used absurd methodology to arrive at an implausible number.

If the pandemic were not so severely politicized, this would be a non-issue from the start.

. . /fin



 . 


This is a much longer, detailed critique, with timestamps

From a physician, reposted by his friend Michael Falk MD on Monday, April 27

OK, since this video by Drs. Erickson and Massihi has been making the rounds on facebook, I feel like I need to respond. Now first of all, I actually agree with the basic premise that this is not as dangerous as we first thought and we should probably move to open. However they make many false and misleading claims so I feel like I need to respond.

This video is I believe making the rounds because it sounds internally logical and has many facts that are either deliberately or inadvertantly misinterpreted and about 95% of the things they are saying are true and then there's the 5% that's the gotcha.

So let's go through it point by point.

1. at around the 3 minute mark, he says that we should quarantine the people that are sick and not the people that are well. ABSOLUTELY CORRECT. However in order to quarantine the sick and not the well, you need to know who is sick and who is well. That's the problem with Covid-19 is that unlike measles or most other infectious diseases, people can spread the disease when they are asymptomatic so how do you know who needs to be quarantined and who doesn't? Ideally, you do what South Korea did and have lots of testing available and you test everyone and then you trace all their contacts and test them and now you know who has the virus and who doesn't and you quarantine those who have the virus and let the others go about their business. We did not have testing and we still do not have enough testing to test everyone. so what do you do when you don't know who has the virus? yeah, you quarantine everyone.

2. around the 4 minute mark, they say that they had 340 out of 5213 tests positive (6.5%). Then they talk about how 12% of the tests in california were positive and 39% of the tests in new york were positive. Then they say that Ca has 39 million people and 12% of them being positive means 4.5 million people have covid-19. THIS IS THE SINGLE GREATEST PROBLEM WITH THIS VIDEO.

Either they are being purposely misleading or they completely forgot statistics 101. They are confusing testing within a high pretest probability cohort with a random sample of the population that can be extrapolated to the general population. Let me explain. Until now, the way covid testing worked was that there were so few tests that we only tested people that we were pretty sure had the disease. And even if we were pretty sure they had the disease, if they had mild symptoms, we didn't test them. Therefore the tested samples will have a much higher rate of positivity than the general population.

This kind of thought process would be like I run an emergency room and tonight 10% of the people have a stroke. Then I extrapolate that to mean that 10% of the world is having a stroke tonight. That's obviously ludicrous. The sample of people coming to the ER is not representative of the entire population.

There are currently random testing studies being done to look at prevalence in the general population and I've discussed them and they think the prevalence is about 2-3 percent. These are early studies and still should not be used to extrapolate nationwide and have problems dealing with bayesian probability and testing specificity but are FAR FAR better than using testing data in a hospital setting to the population. That's just plain wrong.

He keeps saying he's following the science and using data. The problem is that he doesn't understand data and is misinterpreting it and is NOT following the science.

3. Around 13 minutes, they discuss Norway and Sweden. Sweden has 1,765 deaths. Norway has 182 deaths. He claims this is statistically insignificant. I have no idea what statistical test he used and I'm pretty sure he has no idea either because he didn't do one. The correct test to do would be a chi squared test with Yates correction. That gives a P value of <0.0001. That's about as statistically significant as it gets! In fact, you don't even need to do a statistical test on it. Sweden has 10 times the deaths as Norway. No one looks at a ten fold increase and says "BAH, that's nothing!"

4. Around 16 minutes he talks about the downsides of the shutdown. These are valid points there are DEFINITELY downsides.

5. Around 18 he starts talking about the immune system. He talks about how the immune system needs to be exposed to pathogens to develop. ABSOLUTELY TRUE. But then he takes immunological development in a child to adults in quarantine. NOT TRUE. Unless you live inside a bubble, your home and your yard have TRILLIONS of pathogens. No amount of lysol and handwashing is going to remove pathogens that you breathe in and touch all the time. Your own mouth has billions of microbes. Your skin is teeming with microbes. Fungal spores and viruses in the air. Your immune system will 100% not be weaker by being at home. Your immune system might get weaker if you stay home, don't exercise and eat candy all day but the fact of being home in an of it self will not harm your immune system.

6. Around 26 minutes he says academics and reality are two different things. This appeals to some people but in this case, they need to go back to academics to learn basic statistics.

7. Around 27 minutes he talks about all the fomites you bring from costco to your house and totally contradicts his own point from 18 minutes (#5)

8. Around 28 he talks about the logical inconsistency for being able to go to costco but not to work or church. Because you're going to be interacting with people at either place. YES, ABSOLUTELY TRUE. Ideally, people should go nowhere. But we do need to eat and there's no other mechanism available to get food so they are letting what they consider "essential" continue. Now what's considered essential is up for debate since they've said liquor stores are essential which I personally disagree with but there is a logic in that.

9. Around 30, he claims doctors are being pressured to add covid to the diagnosis. That is definitely not happening at Loma Linda University or any other institution that I've spoken to.

10. Around the same time he talks about how covid doesn't kill people, their preexisting condition kills them. well we know for a fact that young healthy people have died. not often and definitely having poor health before makes you more likely to succumb.

11. Around 33. they said widespread testing is needed to open the economy. YUP. THAT'S WHAT EVERYONE IS SAYING.

12. Around 34, he says that covid and flu kill people. Completely contradicting himself from 3 minutes ago.

13. Around 37 he talks about quarantining the sick. YES, but no one knows who is infected or not right now and THAT is the biggest problem.

14. Around 41 minutes, they said that no one does in house testing. Actually every major hospital does in house testing. Loma Linda, USC, UCLA, Stanford, U of Washington, etc.

15. Around 45 minutes he talks about staying home if you have symptoms. Yes, but maybe he's not aware that people are infectious and shedding virus when they have no symptoms and a significant proportion NEVER get symptoms but are still spreading the virus. That's what makes covid-19 harder to get a handle on. If people didn't shed virus until AFTER they had symptoms it would be very easy. Just tell everyone to stay home once they get symptoms. problem solved. Unfortunately, this one transmits before symptoms are evident.

16. Around 47 they claim the virus will mutate and become less and less virulent. There is absolutely zero basis for that claim. None WHATSOEVER. It's possible that it will mutate and become less virulent but then that virus will be out-competed by the parental strain that is more virulent. It's also possible that it will mutate and become MORE virulent. There is no basis for which to say that a virus will mutate and become less virulent.

17. Around 48 minutes, they make a claim saying that academics haven't seen a patient in 20 years. That's not how academic medicine works. I see patients every day. And I see the patients that are too complex for the doctors in the community to deal with.

18. Around 50 minutes, they claim that wearing masks and gloves reduces your bacterial flora. You get your bacterial flora from the food you eat, the clothes you wear, the air you breathe. Wearing masks and gloves have minimal impact on that especially since most people take those things off once they get home.

They also claim that they spoke to Kern County public health commissioner who agrees with them. That's not true either.

Source: https://www.theblaze.com/news/doctor-dan-erickson-coronavirus-reopen

(Updated April 28, 2020, at 5:21 pm  to add this anonymous account.  I can't reveal specifics, but it is from a medical person in the Central Valley. )

I am publishing this at 6:48 pm, April 27, 2020. I will add content as I find it, and will specifically state when content is added. I may also make sources more visible (making visible the URLs hidden in links). All errors are my own. In the future, updates will be noted at the bottom of the post

Articles and other media critical of Drs. Erickson and Messihi's messages

April 27, 2020: The announcemnt

The American College of Emergency Physicians (ACEP) and the American Academy of Emergency Medicine (AAEM) jointly and emphatically condemn the recent opinions released by Dr. Daniel Erickson and Dr. Artin Messihi. These reckless and untested musings do not speak for medical societies and are inconsistent with current science and epidemiology regarding COVID-19. As owners of local urgent care clinics, it appears these two individuals are releasing biased, non-peer reviewed data to advance their personal financial interests without regard for the public’s health.

COVID-19 misinformation is widespread and dangerous. Members of ACEP and AAEM are first-hand witnesses to the human toll that COVID-19 is taking on our communities. ACEP and AAEM strongly advise against using any statements of Drs. Erickson and Messihi as a basis for policy and decision making.

April 26, 2020 I posted a shorter version of this post to my wall on Facebook. It was shared a LOT which was heartening.

April 27, 2020 Barbara Feder Ostrov at Cal Matters: Cue the debunking: Two Bakersfield doctors go viral with dubious COVID test conclusions

But already the Bakersfield doctors — who tout their support of President Donald Trump and refuse to wear masks in public — had become heroes on social platforms and conservative media outlets, with some commenters calling them “brave.” Others who support continuing to shelter-in-place described the doctors as self-promoters whose chain of urgent care centers would benefit from reopening. Non-COVID medical visits have plummeted during the pandemic, endangering the practices of many doctors.

“As struggling business owners, their economic frustration is understandable. But it can’t be mistaken for science. People trust doctors,” Michigan emergency room doctor Rob Davidson wrote on Twitter. “When they tell Fox viewers to ignore recommendations from real experts, many will believe them…The impact of rejecting science-proven recommendations in exchange for these erroneous ideas would overwhelm health systems and cost lives. While re-opening the economy might be good for their Urgent Care Centers (sic), it would kill medical personnel on the actual front lines.”

April 27, 2020 Ari Allyn-Feuer at The Prepared Dr. Erickson’s viral “COVID-19 Briefing” video is dangerously wrong

The video, which is better browsed in transcript form, is a catalog of errors that range from the blatantly wrong to the subtly misleading. But the central and most inexcusable flaw of the entire video is this. Erickson confuses test positivity rates (i.e., the percentage of positive PCR tests among a group of people who were actually able to get tested for COVID-19) with community attack rates  (i.e., the percentage of people in a whole population who have had COVID-19).

April 28, 2020: From David Gorski MD at Respectful Insolence: Dr. Dan Erickson and Artin Massihi: Promoting dangerously bogus pseudo-epidemiology about COVID-19

There’s a pandemic of more than just COVID-19 right now. There’s also a pandemic of pseudoscience, misinformation, disinformation, and just plain bad science. There’s also a pandemic of armchair epidemiologists confidently spouting off about infection rates and case fatality rates, people who self-assuredly say, “I’m not an epidemiologist or infectious disease expert, but…” and then proceed to make opine about the incidence, prevalence, and treatment as though they were experts. 

April 29, 2020 From FallacyMan at Logic of Science blog: Shoddy statistics and false claims: Dr. Erickson dangerously misled the public on coronavirus</p>

Their entire argument rests on the notion that the mortality rate from COVID is actually very low, even less than 0.1% (roughly the typical mortality rate from the flu). Actual studies have found that the mortality rate varies from 3.6% (Baud et al. 2020) to 1.4% (Wu et al. 2020). I have yet to see an estimate based on confirmed cases that was anywhere near the number these emergency doctors came up with (see Note 3). So how did they get such a low number? Easy: they’re bad at statistics.

Articles and other media supporting or amplifying Drs. Erickson and Messihi's messages

April 24, 2020: Brit Hume, a Fox News commentator with 1,190,000 followers, tweeted out a link to the physicians' press conference. Mr. Hume's link was re-tweeted more than a thousand times. 

April 27, 2020: Drs Erickson and Messihi appear on Ingraham Angle

April 27, 2020: Tucker Carlson: New Evidence Means The Coronavirus Far Less Deadly Than We Were Told,, calls Dan Erickson "a researcher"

April 28, 2020: Charles Creitz at FoxNews: "California urgent care doctor questions stay-at-home orders: 'You can get to herd immunity without a vaccine'"

News Coverage

April 29, 2020 Anna-Maja CNN Wire Service, Dubious coronavirus claims by California doctors condemned by health experts
April 29, 2020 Stacey Shepard, Bakersfield dot com,   Local doctors spark widespread debate over virus's death rate, when to reopen

Measles in Samoa: What You Need to Know

First, the Samoan Islands are an archipelago.  

Second, the Samoan Island archipelago include two different political entities, Samoa, a sovereign nation, with historical ties to New Zealand;   and American Samoa, which is a US territory (but it controls its own immigration and border matters). 

Third, earlier this year, Samoa, the sovereign nation, had a terrible immunization tragedy, in which two children were killed by improperly-prepared measles vaccination. 

Fourth, Samoa,  the sovereign nation, has had historically low immunization rates, including the Measles, Mumps, Rubella vaccine (MMR)

Fifth, the current terrible measles outbreak is occurring in Samoa, the sovereign nation. There have been over 700 cases in this nation of 197,000. If the same rate happened in the US, it would be about 1,171,000 cases. There have been 8 suspected deaths: a case fatality rate of 1.1%

Samoa’s Director General of Health Leausa Take Naseri says the crisis is partly his ministry’s fault with coverage rates being at a low 41 per cent and it’s taken a crisis to change that.

He says his staff are working around the clock to keep the epidemic from worsening but it’s far from over.

And a New Zealand infectious disease expert blames her country's lack of action

Dr Helen Petousis-Harris said given New Zealand's responsibility for the 1918 flu epidemic reaching Samoa and wiping out 22 per cent of the population, this country should have done more to protect Samoa from the outbreak.

"I feel deeply ashamed and incredibly angry that this has happened because it was absolutely predictable," Petousis-Harris said.

"It was inevitable that we would export this to Samoa. The situation in Samoa is well known that they have very low levels of immunity there."

Measles is the most contagious disease known to man and in an unimmunised population the infection spreads rapidly, she said.

"A single case can infect on average a further 12 to 18 others. So it virtually explodes. And the only way to prevent that is to have at least 95 per cent of your population immune to stop it from spreading."

The immunologist said successive New Zealand governments had failed their closest neighbour.

"I think ultimately we need to look to our leaders. [Not] the current leadership, or the one before... We've known about these problems for 20 years, so where are you going to place [sic] the buck?

"We've had 20 years to do something about this. This is something we could have done a lot better on."

The head of public health in Samoa, Dr Robert Thomsen, said Samoa had asked New Zealand for medical supplies and also for nurses who were competent to vaccinate, had experience caring for children and who could volunteer their time.

Joyetter Feagaimaali'i, writing in the Samoa Observer, reported

American Samoa has had two suspected measles cases imported from Samoa, but is acting to curb further importation.

But Samoans planning to travel to the territory should carry their immunisation records, as those who are unable to produce them will be turned back.

American Samoa Director of Health, Motusa Tuileama Nua, told the Samoa Observer in an interview that the reports of a border closure are not true, but Samoan citizens entering the territory now have to show their immunization records. 

Update 11/15/2019: Samoa declares state of emergency over measles epidemic as child deaths mount

There have been nine suspected deaths from the disease - most of them children - with more than 700 cases reported.

All isolation wards are full and the main hospital is at capacity. Many children are in critical condition.

The state of emergency will include a ban on any mass gatherings and an urgency will be given to vaccinating 100,000 people.

Is Theresa Deisher a Reliable Expert on Vaccine Ingredients?

This is mostly a guest post, as the majority of the research and writing was done by a medical student, V. Abey. I have added some historical material. 

On October 31, 2019, the anti-vaccine propagandist Del Bigtree invited Theresa Deisher on his show, to promote her unscientific views on fetal cell fragments in some vaccines.

There's a Deisher backstory, which I (Liz) will review briefly. I first became aware of Dr. Deisher through a 2009 post at Respectful Insolence, Thermonuclear stupid about vaccines from someone other than Jenny McCarthy, deconstructing her 2009 white paper, Is Aborted Fetal DNA in Vaccines Linked to Autism? Orac concluded his deconstruction with:

[Deisher’s] strategy panders to the anti-vaccine movement and super-religious conservatives at the same time. Indeed, I grudgingly have to admit that it’s brilliant, from an anti-vaccine PR perspective–except for the fact that the anti-vaccine movement doesn’t really care if “fetal parts” are removed from vaccines because it’s the vaccines they oppose. Still, it may make Dr. Deisher some money. What more could she ask for?

In 2013, Matt Carey at LeftBrain/RightBrain wrote about a petition Dr. Deisher had made to have access to Vaccine Safety Datalink files, to look for a connection between receipt of the varicella vaccine and autism.  The request was denied, in part because Deisher's peers "have found her proposed study to be critically deficient".

In 2014, Deisher published a study, Impact of environmental factors on the prevalence of autistic disorder after 1979. It was (to put it mildly) not well-received. I (Liz) did a summary post of the criticisms at Critical Evaluations of "Impacts of Environmental Factors on the Prevalence of Autistic Disorder after 1979", Deisher et al. 2014   (It was from Genevieve H., writing at Rational Catholic, that I learned that Deisher's son was ill with Burkitt's lymphoma.) Sadly, he died on July 3,  2013. Deisher filed a National Vaccine Injury Compensation Program (NVICP) petition on his behalf; it was denied in April, 2019.

In spring, 2015, Deisher published two papers in the journal Issues In Law and Medicine,

1. Sociological Environmental Causes are Insufficient to Explain Autism Changepoints of Incidence, and
2. Epidemiologic and Molecular Relationship Between Vaccine Manufacture and Autism Spectrum Disorder Prevalence.

In a 2015 blog post, More horrible antivaccine “science” from Theresa Deisher, Orac addressed the dire shortcomings of the "Epidemiologic and Molecular Relationship Between Vaccine Manufacture and Autism Spectrum Disorder Prevalence" paper.

Earlier in  2019, Washington State legislators were considering HB 1638, which  removed personal and philosophical options  to exempt children from the MMR (measles, mumps, and rubella) vaccine required for school and child care entry.  (The bill passed in May. )  The bill  retains medical and religious exemptions and leaves intact personal belief exemptions for all other required immunizations.

On April 8, 2019. Dr. Deisher published an “Open Letter to Legislators Regarding Fetal Cell DNA in Vaccines”.   The open letter  didn't name the legislators -- but as we can see from the above, it's clearly to Washington State legislators, and Dr. Deisher lives in Washington State.

The "Open Letter" was republished by Brian Shillavy's anti-vaccine, anti-science organization, Vaccine Impact, which is part of his publishing stable, Health Impact.

Claim:Theresa A. Deisher, PhD in molecular and cellular physiology from Stanford, is an expert in stem cell research.

Theresa Deisher may have a PhD from Stanford but her claims don’t reflect an expertise in stem cell research - or biology in general. Her mantra is this: that ‘fetal parts’ used in the making of vaccines somehow infiltrate the brain and recombine with neuronal DNA to cause autism. Interestingly, the only ‘evidence’ of such a phenomenon is found in her own studies, statements and open letters.

Health Feedback is a worldwide network of scientists sorting fact from fiction in health and medical media coverage. Shortly after Deisher's Vaccine Impact article was published, three reputable scientists in the Health Feedback network gave the article a close reading, and and deconstructed them, one by one. One of the reviewers concluded:

The claims are so biologically and immunologically wrong that the entire letter is just a condensed list of fake claims and fear mongering that can be dangerous when read by someone that does not understand biology.

In summary, her claim that homologous recombination of fetal DNA in vaccines leads to mutagenesis and autoimmune disease is proven wrong by basic biology. For this to occur, the vaccine DNA has to integrate into cell surface protein genes and express foreign or altered proteins on the cell; for a reaction as prolific as the one she describes, it would have to occur on a massive scale. This is implausible; it’s the reason why gene therapy isn’t exactly a walk in the park.

Deisher, a molecular biologist, would be more than aware of this. Yet, what I (V.) find most distasteful is her data manipulation.  Let's use the infamous paper Epidemiologic and Molecular Relationship Between Vaccine Manufacture and Autism Spectrum Disorder Prevalence for examples.

Point one:  she begins by claiming a “worldwide autism epidemic” - an ableist and untrue claim. She also combined data from three random countries, Norway, Sweden and the UK - a recipe for the ecological fallacy (where inferences about the nature of individuals are deduced from inference for the group to which those individuals belong.)

.Point two: Deisher cultured cells at a Cot1 DNA concentration of 500-750 ng of DNA per 107 cells; she found uptake in some cell lines. It is a subtle deception because, by her own admission, the most DNA was found in Havrix: “276 ng single-stranded and 36 ng double-stranded DNA per vial”. It is certainly interesting that her culture more than doubled the DNA concentration found in vaccines.

Point three: Her graphs use cheap and deceptive tactics to imply significance; for example, Figure 1 has the autism prevalence axis ranging from 0 to 0.6%, whilst the MMR coverage axis ranges from 86 to 95%. Matt Carey of Left Brain/Right Brain normalised the MMR coverage axis to 0 to 100% (as it should be) and the scary curve flattened. Her findings are not remotely analogous to the true scope of DNA in vaccines.

Source: https://soundchoice.s3.amazonaws.com/soundchoice/wp-content/uploads/Deisher-article-2-FINAL1.pdf

Source: https://respectfulinsolence.com/2015/08/24/more-horrible-antivaccine-science-from-theresa-deisher/

Deisher is a conservative Catholic. After she lost her son to Burkitt’s lymphoma, she added childhood cancers to her list of vaccine consequences. I am more than empathetic of her circumstances and I understand how they may have turned a great scientist into a fearful one. But I struggle to find sympathy for Deisher’s deceitful tactics, to demonise a foundation of vaccine development that her own Church finds acceptable.