As regular readers will know, I don’t allow abusive comments or personal rants on the site. Primarily, this is because such nonsense contributes nothing productive, and I am under no obligation to provide angry or crazy people with a forum for their vitriol. Such comments lower the tone of debate and shift the focus away from salient issues and towards personalities, which dumbs down any discussion. Some mainstream science publications have actually blocked all comments on their sites because vacuous attacks come to dominate and crowd out any thoughtful discussion or debate. People are welcome to disagree with me, and I daily allow comments that do so. But as I try to be substantive and civil in my criticism of others, focusing on their ideas and claims, not their personalities, so I hold commenters here to a similarly adult standard of behavior.

That said, I think it is instructive to periodically look at the sort of bile spewed at me by people who have no real evidence or intelligent argument to offer but just want to express their anger at my challenging some of their beliefs. These are the people who drive society away from science and reason, who make compromise and cooperation so difficult in politics that we end up with a dysfunctional government, and who threaten the functioning of a society in which civil disagreement is possible and productive. These folks also illustrate how distant many of the alternative ideologies they espouse are from science and how much more like fundamentalist religion they really are. And, finally, sometimes they are simply funny. Enjoy!

Short and Sweet?
There is one word for you the author of this article….”””IDIOT””””

Skeptvet is a dumb fuck

You’re an idiot.

Are you living under a rock dude?

Homeopathy has healed my dog AND myself. Take your Big Pharma and shove it.

Go take your drugs and destroy your kidneys and liver. And kill all our animals that way as you promote drugs and surgery and toxic immunization a. You are a total moron.

Skepvet, you are an absolute fool. The fact that you would happily prescribe…makes you a complete moron…An education beyond University of Phoenix should be your next life goal.

[This one was creative enough to invent an email to represent me abusing myself!] From: skeptvet@dispostaba.fuck

I am truly a motherfucker… I Have cancer and dying. Im trily sorry I trust in protandim now

Tinfoil Hat Wearers
How much are Hills, Purina and the pharmaceutical companies like Merck slipping you on the side? Clearly, you are attempting to manipulate an uneducated, easily led, public with your claptrap disguised as science.

Your site tag says, “A Vet Takes a Science-Based Look at Veterinary Medicine”. It should more accurately say, “A Vet Takes a Pharmaceutically Skewed Prospective of Veterinary Medicine.” That would be more accurate. You’re sole reason to exist is to try to hold back the tide that threatens your alternative medicine buddies in big pharma.

And for every “expert” that has “scientific” proof that ACTION A is best, there will always be another “expert” that has “scientific” proof that ACTION B is best. Look closely at who pays which “expert” for the proof and you’ll have the answer as to why which ACTION is best. It’s all about the bottom line, folks. Now that the pet industry is a multi-billion dollar a year industry, unfortunately it appears the vets and “pet-care” companies are using our pets in the same way the human medical establishment has done…cause confusion and watch the big bucks roll in!

You are a skeptic because it could put you out of business.

The FDA is a sub contractor for Monsanto. Come to think, so is this website!

Huh, sounds a lot like what you say you aren’t – a pet food company lackey. The strong reason in favor of healthy, appropriate, homemade diets is the health of our pets…the strong reason against is two-fold – money and sickness – both of which I am sure you have no problems with. Sick animals are good for business.

What a HORRID article! If everyone in this world was healthy and living without chronic disease, then how would the pharmaceutical companies make money?

Who is paying you to write all this crap? The AMA? Jeez.

Another example of Government out of control serving Big Pharma both in an alliance and both disserving the unknowing blinded public while they RAKE IN $BILLIONS IN PROFITS. It’s the Government and its Agencies like the FDA THAT CANNOT BE TRUSTED! Do we need any more evidence for this? No, it is clear. SkeptVet clearly takes THEIR side.

You are a typical vet who just wants to stand behind the prescriptions that pay for your lifestyle.

I know one thing for sure……Vets scoff because it is about the $$$$…..they focus on keeping us coming back for the prescription food, meds and their $$$’s…….I do not trust doctors for humans let alone for my precious little ones. They are ALL about the money

To all you ignorant people bought off by Big Pharma . It is getting old by now you all not getting it. America is a fat, diseased very sick nation. The irony of thinking we are this Great nation when we are the international laughing stock. Europe has a seperate factory for making send out food to America because the Ingredients we allow are not allowed in their country due to most are toxic. Even the little cashier at World Market know’s this… If people were well and did not need prescription medicine their would be no money to be made in this billion dollar Big Pharma Industry. They want us sick!

Another sellout medical doctor…Medical doctors and mainstream people are so arrogant. They think they know everything, when behind closed doors, the people who fund these foods and treatments are actively trying to harm them.

Keep being oblivious, so people like me have to live in a perpetual hell, where I can’t even know what is in my food or water. Because of people like you, they have total control… as long as you keep supporting the corporations aspirations, nothing will EVER change.

Maybe you should go through your records and see how many of those dogs you vaccinate develop an illness within 12 weeks of the vaccine.  I think you’d find it more eduational than blindly working for the pharmaceutical industry who are constantly being sued for lying about test results on their products.  Why would they lie if their products have been properly tested and proved to be safe?  I don’t suppose it’s occurred to you that they’re not in the business of healing.  They’re in the business of making as much money as they can… Most vets who switch to a holistic practice earn far less money than you do, so what possible reason could they have for changing?  Has it occurred to you that they have actually bothered to pay attention and have realised that they are hurting our animals with unnecessary medications? That their consciences have stepped in and prevented them from continuing to cause chronic disease in our pets?  Obviously not. Our animals need healers working with us owners, not drug sales people.

Who’s paying you!!?? Talk about biased. I’d like to know the serious side effect of taking cats claw… I always read opposing info when researching but this is so slanted its crazy. So I figure you are either a vet or you are paid/paid off by them. Let’s all feed science diet, shall we!… Seriously, who pays you!!??

If you don’t get a payment from the drug company, it’s not worth recommending.

Big devious lie of an article!!! Probably working for the misinformation industries!!!!!!

Typical hate spewing from the medical field, these studies are only argued against because it affects the medical industries bottom line and making them lose money (and to keep their monopoly of the healthcare market).

After reading this blog and these testimonials, I think the skeptics here are for the most part, on someones payroll. Science has been Hijacked long ago, and the truth is being continually sacrificed on the alter of Corporate profits. I dont know what they are paying you to slander this company, too much if you ask me,

The drug industry ARE the quacks. Its a protection racket. This skepvet is a living testament to that. Ignore them and do what works not what their rigged trials tell you should work.

Someone is paying you to discredit vitamins, glandulars and minerals as beneficial remedies. You probably are a stupid medic. Breast feeding at age 80 off the pharmaceutical TIT. Die quickly so u can be reborn and do something to help someone.go pop a pill. You are an idiot.

Another sellout medical doctor…. These people probably promote heavy metal-laden vaccines; liver destroying drugs and toxic foods that contain genetically modified organisms. Go ahead, be ignorant and take the medical industries junk. They will be happy to benefit off of your illnesses. Big pharma and agribusiness work hand-in-hand… Medical doctors and mainstream people are so arrogant. They think they know everything, when behind closed doors, the people who fund these foods and treatments are actively trying to harm them.

Why do you attack natural products? The conspiracy is for all the chemicals with the phony white papers. I have seen many a healthy person and or pet die from chemical meds and would have survived had they been given a real natural product that actually works.

Unemployed Psychotherapists
I understand your need to feel as if you are flying the EBVMA flag in your posts and blog in general. To be quite honest, it comes across as if you were not able to obtain a real medical position so you chose to rant on “evidence based veterinarian medicine.”… .” If you don’t understand the origin from which we were created you might not see the total picture doc. God actually gave our bodies their own defense mechanism from many diseases, enhanced by utilizing another thing God created that assist this healing process, there called nutrients.

Maybe if you spent more time actually observing the animals and building your practice instead of blogging this nonsense you could find the success and attention you so obviously crave.

This blog is such non-sense and sounds like it has been written by an angry veterinarian with an unsuccessful practice.

You sir, are a disgrace to your profession. Your ego and agenda have overcome your common sense.

Taking pot shots at Nutriscan and scoffing at people who have found flea meds to be dangerous to their pets might make you feel superior but from here you look like an a__.

This treatment is now being used by vets who are not arrogant and close-minded such as you are, with much success. You know–you aren’t always right just because you got a degree in Veterinary Science.

There’s a lot that isn’t thoroughly taught in either vet or (human) medical school. I’ve noticed that the medical professionals who know the least are the ones who are the most arrogant!

I’m a pet parent, not a vet, and whoever wrote this article seems very upset and angry… Do everyone a favor and get over yourself.

Yesterday, I wrote about some environmental chemicals that may play a role in causing disease. While this sort of environmental risk factor is a real and recognized phenomenon supported by good science, it can easily be cited to lend support to a bit of popular pseudoscience that may appear quite similar but which is actually something quite different: detoxification. Detoxification is one of the classic bogus pseudoscientific concepts of alternative medicine, and since I brought up the subject of environmental toxins, I thought it worthwhile to illustrate today some of the differences between the legitimate field of environmental toxicology and the quackery that is detoxification.

The notion of detox suggests that our bodies accumulate harmful substances, either from environmental toxins or the waste products of our own normal metabolism, and that these need to be removed or neutralized by some therapeutic process in order to prevent or cure disease. The details about what is toxic, how we come by it, and what we should do to detox vary widely according to the many and mutually inconsistent theories of different alternative practitioners.

At the heart of this notion is the emotion of disgust, and inherent reaction we have evolved to encourage avoidance of potential sources of harm, particularly infectious disease. Though there is controversy about the details, it is commonly argued that this innate emotional reaction has been generalized to cultural and moral domains, and this has led to the social constructs of contamination and purification. Detox schemes are portrayed as healthcare, but they are really a set of purification rituals intended to ward off harm magically like some religious practices.

The problem with this and many other alternative medicine ideas that are more religion than science or medicine is that evidence for or against specific proposed toxins or therapies becomes irrelevant. It’s not that there is no such thing as a toxin, since there are many well-characterized by science. And it’s not that we can’t remove or neutralize some toxins with medical treatment, because in some cases we can. The issue is that the specific claims about detoxification are often made up completely or extrapolated wildly and irrationally from small pieces of actual scientific knowledge, and they become self-sustaining components of a belief system rather than hypotheses that can be confirmed or disproved.

A typical example of this kind of pseudoscience, which mixes distorted but real science with complete nonsense, comes from the ever-reliable source of pseudoscience, Dr. Karen Becker at Mercola.com. Dr. Becker produces a steady stream of advice for pet owners. It ranges from the perfectly reasonable to the unproven but plausible all the way to the completely ridiculous, often all jumbled together. The key is that real evidence is almost never needed or heeded, and her claims are based predominantly on opinion, hers or that of the other alternative practitioners she interviews.

The  Big Scare

Her detoxifications creed begins with The Big Scare, that classic snake-oil sales technique in which the CAM advocate tries to convince an audience that they and their pets are swimming in a toxic soup constantly threatening ruin to our fragile health and well-being. Without this fear, we might not realize that our apparently perfectly healthy pets were actually in terrible danger and that we need to act now to save them! We might be at risk of coming to believe that not all bad things that happen can be avoided if we just do the right things and that those who become ill have only their own poor lifestyle choices and inaction to blame.

It’s actually mind-boggling to think about all the different ways our pets are exposed to toxins in today’s world…. If you’re wondering if your own pet is carrying a toxin load, sadly there’s no doubt he is. The truth is that virtually every pet has measurable amounts of chemicals in their body, because they walk through chemicals, they sleep on them, they breathe them in, and they eat and drink them. And unfortunately, veterinarians prescribe and inject them on a regular basis as well.

Dr. Becker lists a host of the usual bogeymen of alternative medicine, from medicines that actually protect your pet’s health and prevent disease, like antibiotics and parasite preventatives, to poisonous commercial dog food that carry cancer in every bite, to the invisible threat of—gasp!— electromagnetic fields! Some of the specific things mentioned do have potential harmful effects, depending on dose, exposure route, species, lifestage, and many, many other variables. After all, anything, including such necessities of life as oxygen and water, can be harmful under the right circumstances.  Others, such as fluoride in drinking water and electromagnetic fields have been thoroughly investigated and not found to be dangerous. But again, we are dealing with a faith-based, not evidence-based belief system here.

Pretend Science

After The Big Scare, Dr. Becker moves on to explaining precisely how these toxins harm your pet. Well, not precisely, more like generally. Well actually, it’s more like using some vague science-y words that imply stuff without actually meaning anything.

When your pet’s body accumulates too many toxins, it stores them for future elimination. For many pets, that future opportunity never arrives and the toxic load begins to impede the body’s ability to function. Ultimately, toxic overload can interfere with the immune system to the point where cellular abnormalities like tumors and cysts develop. Other serious diseases may also show up as cells degrade and organ function is impaired.

Side effects of an accumulating toxin load cover a wide range of diseases, from skin conditions to organ failure. There can be behavior problems associated with toxicosis, endocrine disease, autoimmune disease, and even cancer.

So basically, your pets is constantly besieged by all sorts of toxins that are everywhere and in everything, and they can cause almost any disease if not eliminated. And while she admits that your pet has its own systems for dealing with toxins (since it would be hardly to explain how any suggests that they can’t be relied on. This, again, is a necessary step in selling you something which you can do to defeat this terrible threat and which will work better than the natural systems evolved over millennia which have kept us all alive so far.

A Magic List
Everyone likes lists. Just put “10 Steps to…” in front of almost any advice, and it will be more fun to read and more persuasive. The only trouble here is that most of these steps are either too vague to be meaningful, unproven hypotheses, or total nonsense.

1. Improve Your Pet’s Diet

What Dr. Becker means by “improve” is really “change to what is recommended by my favorite nutrition mythology.” Avoiding commercial food, which is full of those pesky toxins, and switching to home-cooked, grain-free, ideally raw diets despite the complete lack of evidence to support the claim that any of these changes actually improves health or reduces disease risk. I’ve addressed a number of these myths and claims before, and they are far more about ideology than science.

2. Provide Clean Drinking Water

Presumably, you are unaware that the drinking water we get from the tap here in the U.S., which has eliminated numerous infectious diseases that have plagued humanity for millennia and continue to trouble the developing world, is actually a toxic brew that will poison your pet. Fluoride, in particular, is mentioned as a risk despite the overwhelming evidence that it is safe and effective at dramatically educing dental disease. No evidence needed here, just pure belief!

3. Beware the Air!

Apparently, the very air you breathe in your home is full of perils as well. Avoiding smoking is a sound and well-established way to reduce disease risk. Other than that, the notion that every cleaning product that doesn’t call itself “green” on the label is a poison for your pet and that you can somehow find a magic combination of products and purifiers to ward of sinister unseen toxins in normal household air is just another arrow in the quiver of The Big Scare.

4. Make Your Pet Exercise

The benefits of exercise for humans are well-established, and it is likely that our pets could stand a good deal more physical activity than many of them get. There isn’t actually much research for dogs to tell us how much of what kind of activity is ideal, and the notion that our cats should workout more is pretty far-fetched. Still, among the very real benefits of exercise is not “helping the body’s detoxification efforts.” Suggesting that without more exercise your pet will not urinate, defecate, circulate blood to the liver and kidneys, or breathe sufficiently to perform ordinary removal of waste products is just nonsense.

5. Avoid Pollutants and Chemicals

A perfectly sound bit of advice, except for the problem that everything is made of “chemicals,” and Dr. Becker’s notion of what is a “pollutant” is pretty vague. Sure, washing off your dog’s feet when they come in the house is fine, but there’s no reason to imagine it will dramatically affect their health or ward off any terrible illness.

6. Say No to Drugs!

Dr. Becker recommends avoiding “unnecessary” “drugs,” by which she usually means vaccines and medicines. I too recommend avoiding unnecessary medical treatment, but I suspect we have different definitions of what this is. I have written extensively about the issues involved in deciding what to vaccinate for and how often, and it is a far more complex subject than simply “avoid yearly vaccinations” as Dr. Becker recommends. And while antibiotics and steroids are probably overused, they are also important and beneficial medicines, and it is dishonest to sow fear of them without being clear and evidence-based in presenting both the risks and benefits and without defining “unnecessary” in any way. Making people afraid of medicine doesn’t make their pets healthier. Similarly, there are risks as well as benefits to parasite prevention, as well as to eschewing such prevention, but the “safe, natural alternatives” Dr. Becker mentions are not proven substitutes.

7. Brush & Bathe Your Pet

Sure, why not? But ignore this bit of nonsense: “Your cat or dog eliminates toxins through his skin, and regularly brushing or combing will remove loose fur and debris and help his skin breathe.” Oh, and don’t forget not to use shampoos that contain “toxins.” Make sure they are “natural.” *sigh*

8. Support Your Pet’s Liver and Kidneys

Here’s where the poor logic behind the detoxification scam shows itself especially clearly. We are warned that “chemicals” and all kinds of substances in our food, water, and air are bad for us and should be avoided, despite the lack of evidence in most cases that this is true. We are warned of the dangers of medicines are parasite preventatives without any discussion of the benefits and with no consideration given to the abundant evidence showing that these generally do much more good than harm. And then, after all this fear mongering without good evidence, we are told to protect our pets by giving them a bunch of untested and unproven chemicals! I have collected an enormous volume of evidence showing that the chemicals(!) in herbs and supplements and even needed compounds like vitamins and minerals can cause serious harm. Without proper testing, these cannot simply be assumed to be safe and effective. Giving such substances without this evidence and warning people away from substances for which good evidence of safety is available is bizarre and misleading. Only the fundamentally faith-based nature of the detox myth could explain such inconsistent and illogical recommendations.

9. Support Your Pet’s Immune System

Boosting the immune system is one of the other classic bits of alternative dogma and nonsense nicely dealt with already elsewhere. It suffers from many of the same problems with faith above evidence and illogic as the detox scam.

Dr. Becker lists a number of specific “detoxing” agents, and not surprisingly several of them have come up here before, including Chinese Herbal Medicine, turmeric, resveratrol, and others. None of these have good clinical trial evidence to show that they “detoxify” anything, and while there are some suggestive tidbits of research that some might have some legitimate medical uses, there are not clinical trials showing any to be safe and effective at preventing serious disease in apparently healthy animals. Their use is based entirely on anecdote or entirely unproven theories about health, not real evidence.

Finally, Dr. Becker recommends regular detoxing with these unproven chemicals if your pet has any exposure to supposed toxins, which of course is unavoidable since these malignant substances are everywhere, except apparently in the chemicals she recommends giving to detox your pet.

Bottom Line
The whole notion of detoxification is a non-scientific concept that is part of an ideology which has more in common with religion than science-based medicine. The theories are unproven or outright false, and the specific claims made about toxins and detox treatments are made without real evidence. The strategy is no different in its essence than warding off bad luck or evil spirits, and it serves more to assuage the anxiety of humans than protect the health of pets. Here are some useful resources on the subject for further reading:

The Detox Scam: How to spot it, and avoid it

You can’t “detox” your body: It’s a myth. So how do you get healthy?

Detoxification Schemes and Scams

The Detox Delusion

Detoxification Therapies

Introduction
As I have been quite involved in the struggle to reform our vaccination exemption laws here in California, I’ve been spending a lot of time reading about childhood vaccination lately. While this is only tangentially related to my usual veterinary focus, I thought I would share an interesting document I found.

Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee, DHSS. Draft Report

The purpose of this report was to evaluate the degree of confidence parents in the U.S. have in the recommended vaccination protocols, how this is assessed, and what we might be able to do to increase confidence and improve vaccination rates. There weren’t a lot of surprises in the report, but it’s a concise summary of the situation.

The Good News
One persistent problem with media coverage of most issues, including vaccination, is that it is easy for small numbers of vocal, passionate people to be disproportionally represented and to thereby create an inaccurate impression of how widespread their views are. In the case of vaccine confidence, the vast majority of parents trust and follow the recommendations of the medical community, and this level of adherence has been stable for many years. 80-90% of parents have their children fully vaccinated, which is far more of a consensus than on just about any other hot-button political issue. The emphasis on the exceptions, and the desire to improve vaccine compliance is not a reflection of a widespread resistance to vaccination but a function of the need to have very high rates, generally well over 90%, in order to reap the benefits of herd immunity and protect those who cannot have vaccines for medical reasons or for whom vaccination is not 100% protective.

It is important to remind ourselves that vaccinating your children is not only a good idea for their health and the health of others, it is also a normative social behavior. While people should, ideally, make rational and evidence-based decisions independent of the beliefs of others, the reality is that people are influenced strongly by what they perceive to be the beliefs of other members of their community. If parents mistakenly believe that vaccine-refusal is mainstream, they may take it more seriously despite the misguided and mistaken foundations of anti-vaccine attitudes. However, if people understand that vaccination is not, in fact, controversial but accepted by the overwhelming majority of American parents, they may be more comfortable rejecting the scare tactics and specious arguments of vaccine opponents.

This study also found that there is a high degree of confidence in reliable sources of information about vaccines, especially healthcare providers. Most parents trust their pediatrician’s advice, and many who have reservations about vaccines but ultimately decide to follow the guidelines do so because of information and counseling given by their children’s doctor.

Vaccination has been the most successful preventative healthcare intervention in history, and the high rates of vaccine acceptance in the U.S. have allowed more than one generation to grow up ignorant of the dangers of many infectious diseases that routinely injured and killed children for millennia before the development of vaccines. Even though the number of people who have firsthand experiences with these diseases is few and dwindling in the developed world, most parents still understand the importance of vaccinating their children to prevent the resurgence of these infections.

The Bad News
Despite the overall high and stable levels of acceptance of science-based vaccination guidelines, confidence in vaccination varies dramatically by region. The problem today is not widespread rejection of vaccines but high levels of rejection in localized communities. These communities have proven to be sources of outbreaks of otherwise well-controlled infectious diseases. Regional and demographic factors which are partially but not completely understood have led to such pockets of vaccine rejection in which vaccination rates are low enough to undermine herd immunity and facilitate outbreaks. I know because, sadly, my own child goes to school in such a pocket, with vaccination rates well below the average for the state and the other schools in the district.

As mentioned earlier, the formation of such pockets of mistrust in vaccines are facilitated by the impression they create that suspicion of vaccination is common and mainstream. Even in my community, 84% of children are fully vaccinated, yet the remaining 16% of families are able to sustain misguided beliefs about vaccines within a supportive echo chamber that helps insulate them from the information and arguments that the rest of the community offers in support of vaccination.

Though the report does not address this, I have the subjective impression that there is a strong correlation between vaccine refusal and more general pseudoscientific attitudes and beliefs. Most of the individuals arguing against the scientific consensus on vaccines in my community, for example, also proclaim homeopathy and other alternative therapies to be safer and more effective alternatives. And the organized voice for chiropractors in California, the California Chiropractic Association, has come out in opposition to reforming the state’s vaccine exemption laws and recently gave a hero’s welcome to disgraced physician Andrew Wakefield, who launched the modern anti-vaccine movement:

The California Chiropractic Association is actively lobbying against California Senate Bill 277, which would end the state’s “personal belief” exemption against ten types of vaccinations now required to begin school. [Mason M. Chiropractors lobby against bill ending belief exemptions for vaccines. Los Angeles Times, March 5, 2015] CCA’s Web site advises members to say that they are “NOT anti-vaccine we are pro-inform consent and choice.”

Life Chiropractic College West sponsored a talk by Andrew Wakefield, who lost his British medical license for unprofessional conduct related to vaccine scaremongering. The San Francisco Chronicle has reported that he received standing ovations after he advised hundred of students that SB 277 was a step toward mandatory vaccination that could have dire consequences. The paper also noted that the school’s president was considering hiring buses and canceling classes so students could attend a Senate hearing. consent and choice.”

The importance of legislation like SB277, the initiative to eliminate non-medical exemptions to school vaccination requirements in California, is also emphasized in the report. Such exemptions, particularly those that require only a “philosophical” objection and are easy to get, have increased significantly, and they are directly associated with the growth of local clusters of vaccine refusal, and the subsequent outbreak of vaccine-preventable disease. Such exemptions serve no legitimate purpose because they essentially eliminate vaccination requirements altogether and undermine the public health value of immunization. The legal and scientific legitimacy of such mandates has been settled for over a century, and recent efforts to undermine them by extending vaccine exemptions is supported only by misinformation and fear.

Conclusions & Recommendations
The report concludes that while overall confidence in vaccination and trust in doctors and public health officials is high, there are communities in which misinformation and misguided distrust have taken root, and this represents a real threat to public health. The committee made a number of recommendations for monitoring and improving confidence in vaccination:

• Objective and standardized measures of vaccine confidence should be developed and ongoing surveillance of these should be conducted by public health agencies
• Doctors, public health officials, and parents who support vaccination should continue to communicate the benefits of vaccination and reinforce that it is a social norm accepted by the vast majority of Americans. These communication efforts should be supported with evidence-based materials and training.
• Vaccine exemptions for non-medical reasons should only be available if parents are adequately informed about the safety and efficacy of vaccination and the risks of not vaccinating.

Personally, I don’t believe this final recommendation goes far enough. Given the evidence that accurate information rarely changes entrenched anti-vaccine beliefs, I think the degree to which education requirements will reduce vaccine exemptions is too small to be effective. Such exemptions should not be allowed without sound medical justification. People may have the right to choose not to vaccinate their children, even if the choice is based on inaccurate beliefs and fears, however they do not have the right to then endanger others by sending their children to schools and daycare centers with other people’s children

I’m stepping outside of my usual territory as a veterinarian to raise a human healthcare issue– vaccination exemptions. In my state of California, it is very easy for misinformed parents with unfounded concerns about the safety and efficacy of vaccinations to choose not to vaccinate their children and yet send those children to school where they can pose a health risk to others. In the wake of the recent measles outbreak centered at Disneyland, the California state legislature is considering legislation to eliminate the “personal belief” exemption from vaccination requirements for schoolchildren. As a parent and a scientist, I support this legislation and am advocating for it in my community. I have put together some information and links on the subject for others in the state who wish to contact their legislators and urge passage of this bill.

I have started a petition to the CA State Senate and State Assembly which I encourage supports of SB277 to sign:

Here is my letter to the parents in my own child’s school:

Parents,

The CA State Assembly is currently considering SB277, a bill that originated in the state senate and is intended to reduce the risk of vaccine-preventable disease in California by preventing children from attending schools, daycare centers, or other such institutions if they are not appropriately vaccinated. The legislation allows exemptions for medical reasons but not on the basis of the personal beliefs of parents. As this issue significantly affects all of us as parents of school-aged children, I urge members of the community to inform themselves about this legislation and to make their views known to their representatives.

I have collected some useful links below with additional information about the legislation and with reliable sources of information concerning the relevant vaccines. While parents have the right to refuse vaccination for their children, even when this decision is based on misinformation or fear, they do not have the right to endanger other children or vulnerable individuals through this choice. Opponents of this legislation include extreme anti-vaccine activists who have likened the measure to the Nazi Holocaust and have threatened violence against legislators who support it. Though misguided and misinformed, these views could intimidate politicians into not taking action on this important issue, so it is important that they hear from more moderate citizens with all points of view.

Thank you,

SB 277
http://www.vaccinatecalifornia.org/sb277_faqs

How to Contact Your Representatives
http://findyourrep.legislature.ca.gov/

Reliable Information About Vaccines
http://www.vaccines.gov/
http://www.cdc.gov/vaccines/vac-gen/howvpd.htm
http://vec.chop.edu/service/vaccine-education-center/home.html
http://www.vaccine.org/

Parents Supporting Appropriate Vaccination
http://www.voicesforvaccines.org/
http://shotofprevention.com/
http://valueofvaccination.org/

Herd Immunity
http://www.cdc.gov/vaccines/parents/vaccine-decision/prevent-diseases.html
http://www.vaccines.gov/basics/protection/
http://www.who.int/bulletin/volumes/86/2/07-040089/en/
http://eziz.org/assets/docs/IMM-1056.pdf
http://cid.oxfordjournals.org/content/52/7/911.full

Here are some statistics on the risks associated with previously common childhood illnesses and the effects of vaccination on these. I think it is clear that we SHOULD prevent these diseases:

http://www.cdc.gov/measles/about/complications.html
http://www.cdc.gov/mumps/about/complications.html
http://www.cdc.gov/pertussis/about/complications.html
http://www.cdc.gov/chickenpox/about/complications.html
http://www.ncbi.nlm.nih.gov/pubmed/18000199
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a4.htm

Vaccines and Autism

1. A recent study of over 95,000 children looked at those at highest risk for ASD, siblings of those with the syndrome, found no link to vaccination, confirming yet again the results of other studies involving millions of children:

http://jama.jamanetwork.com/article.aspx?articleid=2275444

“Conclusions and Relevance  In this large sample of privately insured children with older siblings, receipt of the MMR vaccine was not associated with increased risk of ASD, regardless of whether older siblings had ASD. These findings indicate no harmful association between MMR vaccine receipt and ASD even among children already at higher risk for ASD.”

2. The American Academy of Pediatrics has clearly stated that the extensive research shows no connection between MMR or specific ingredients in vaccines, including thimerosol, and ASD. The AAP has listed many of the original studies here so parents can investigate them for themselves:

https://www2.aap.org/immunization/families/faq/vaccinestudies.pdf

3. The Centers for Disease Control has also stated directly that “studies have shown that there is no link between receiving vaccines and developing ASD.” Here is the CDC page addressing the issue, again with links to relevant evidence:

http://www.cdc.gov/vaccinesafety/concerns/autism/

4. Autism Speaks, a parent and child advocacy group for families affected by ASD has also officially accepted the evidence that vaccines are not linked to the disorder and provides summary of some of the most compelling studies:

https://www.autismspeaks.org/science/science-news/new-meta-analysis-confirms-no-association-between-vaccines-and-autism

“Over the last two decades, extensive research has asked whether there is any link between childhood vaccinations and autism.  The results of this research are clear: Vaccines do not cause autism.  We urge that all children be fully vaccinated.”

5. For those not into reading research studies, PBS has put together a clear and comprehensible presentation on the vaccine/ASD question and the general issue of childhood vaccinations which is fact-based and informative:

http://www.pbs.org/wgbh/nova/body/autism-vaccine-myth.html
http://www.pbs.org/wgbh/nova/body/vaccines-calling-shots.html

Toxins in Vaccines

In addition to having accurate information about the ingredients in vaccines, it is important to have accurate information about the health effects, if any, of those ingredients. No substance is absolutely safe (it is possible, after all, to die from too much oxygen or water despite the fact that both are necessary for life). Likewise, many substances can be safe or even beneficial at some level or in one form even when they are harmful at a higher level or in a different form.

As an example, people are often familiar with the use of formaldehyde in embalming and with the fact that, under the right circumstances, it can increase the risk of cancer and cause other adverse effects. So it is natural to be surprised to see it listed as an ingredient in vaccines. What people often do not know is:

1. Formaldehyde is produced naturally in the body and is essential in the production and metabolism of certain amino acids needed to make proteins.

2. The amount of formaldehyde in vaccine sis far, far less than what is normally present in our bodies and naturally produced in many foods. The highest possible exposure to this chemical in normal vaccination practice is less than 1% of the amount already present in the body naturally, and the extra is typically metabolized completely within 30 minutes after vaccination.

3. The formaldehyde present in vaccines makes them safer by reducing the risk of vaccines becoming contaminated with viruses and causing infections or other illness.

Here are some further sources of information about formaldehyde and other vaccine ingredients people may have concerns about:

http://www.fda.gov/BiologicsBloodVaccines/ScienceResearch/ucm349473.htm
http://www.harpocratesspeaks.com/2012/04/demystifying-vaccine-ingredients.html
http://www.cdc.gov/vaccines/vac-gen/additives.htm
http://www2.aap.org/immunization/families/faq/vaccineingredients.pdf
http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/ucm187810.htm

So when considering vaccine ingredients when making decisions about vaccination, it is necessary to find detailed and accurate information about them to determine whether or not we should be concerned about individual compounds.

My letter to my representative: 

I write to urge you to vote for SB277, which will make our state’s schools safer.  

I appreciate the critical importance to public health of vaccination both as a veterinarian and as the parent of a student in the California public schools. While our generation has been fortunate enough not to see the epidemics of polio, measles, and other vaccine-preventable disease our parents can still remember, many of these disease can and will return to harm our own children if we are not vigilant. Parents certainly have the right to decline vaccination for their children, even if their decision may be based on misinformation and fear. However, they do not have the right to endanger my daughter or others by sending their children to public schools unvaccinated.

The measles outbreak and the pertussis epidemic are stark reminders of how fragile we are as a community.  SB277 will protect our children and communities by raising the vaccination rates.  SB277 is the best way to ensure that the weakest among us – the young, the ill, the old, and those for whom vaccines don’t work – are safe from vaccine-preventable disease. 

We are relying on you to help protect our communities.  This legislation is the right thing to do.  Please vote for it.

A great science advocacy group from the UK called Sense About Science offers annual prize to recognize individuals who are publically promoting the importance and use of science and evidence. Here is how they describe the award:

2015 John Maddox Prize

The John Maddox Prize rewards an individual who has promoted sound science and evidence on a matter of public interest. Its emphasis is on those who have faced difficulty or hostility in doing so. Nominations of active researchers who have yet to receive recognition for their public-interest work are particularly welcomed.

The prize is open to nominations for any kind of public activity, including all forms of writing, speaking and public engagement, in any of the following areas:

Addressing misleading information about scientific or medical issues.

Bringing sound evidence to bear in a public or policy debate.

Helping people to make sense of a complex scientific issue.

Nominations can be made here. There are MANY great individuals out there working in this area, so pick your favorite and nominate them (even if it’s not a certain awesome veterinary blogger!) 😉