Tuesday, January 17, 2006

An email from Ron Law!

I think Evidentally, my comments have managed to strike a nerve and I've recieved an email from someone 'claiming' to be Ron Law. I'm not sure if it's the real Ron Law however, because normally he seems to use a different email address (not a gmail one) but none the less, I am prompted to make a response. If it isn't the real Ron Law then I would encourage him to contact me (my email is aegeri AT hotmail DOT com) so I can make a clarification.

The email is (in its entirety):
Your ignorance shows... the MeNZB vaccine does not have a herd effect... I don't mind ignoramuses sledging my comment as all will be revealed in time... it exposes critics underbellies...

You say, "This is not an unreasonable or unexpected thing to have occured for two primary reasons. As the rates of vaccination go up, the only people that can potentially be infected with the organism coincidentally end up being those who are vaccinated. No vaccine can be 100% effective and instead the reliance of how a vaccine works is by herd immunity, where a virulent organism 'burns' itself out of susceptible hosts until it no longer encounters anyone it can infect."

By the way, I have never been anti-vaccination... I've never bagged other vaccines... the fact that MeNZb is a vaccine is immaterial... what is material is the scientific sleight of hand.

Take a look at the following graph... this was the vaccine that was going to "stop the epidemic."

The information parents and the public are being provided with regarding meningococcal disease and the MeNZB(tm) vaccine is seriously deficient. The Ministry of Health has developed policy and process with the transparency of a black box.

Have you analysed the gp letter you refer to? You should... at least before you write your best seller and do your PhD. You might develop some critical analysis skills.

Ron Law
Risk & Policy Analysis
Quite strongly worded but it's all air without any substance from Mr. Law. Firstly, he comments that MeNZB does not protect individuals through 'herd immunity', but rather than actually rebut my comment he simply quotes what I write and then adds no actual rebuttal. As I've mentioned in the past, vaccines function through an effect called herd immunity. As diseases tend to spread between individuals who are immune naive, they start to 'select' for members of the population that survive over those that are susceptible. Inevitably, over the course of the organisms spread it slowly grinds itself out of hosts that have never seen the organism before. Eventually, it can only spread between individuals who have seen the organism and it runs into a brick wall, unable to spread any further. This is 'herd immunity' and is the principal that is being used for all vaccinations. A rate of 80%+ immunity to an organism is still sufficient to confer this immunity and offer protection. This does not mean the organism can't 'break-through' the immunity however, but generally once enough individuals are vaccinated the spread will peter out.

Ron Law then moves on to claiming that he is not 'anti-vaccination'. Unfortunately, when you use the same arguments and the same kinds of misrepresentations, that does firmly stick you in the 'anti-vaccination' camp. He then tries to claim that there is some sinister 'sleight of hand' going on from the scientific community, which he evidentally didn't care to support in his email. Perhaps this is the same sleight of hand as him misrepresenting why MeNZB hasn't had a phase III clinical trial? Why doesn't Mr. Law protest against each new flu shot that doesn't go through such a trial either?

Ron Law then presented a graph taken from data collated from data released for the ministry of health for the Counties Manakau region here. Although I'm certain he's trying to make another variation on the 'THE DISEASE WAS ALREADY IN DECLINE, INEFFECTIVE!!!!!!" argument I've heard so often before, I think it's a good time to compare the non-vaccinated years with those that have been vaccinated from 2002 to 2005 to see how the argument stacks up.

Firstly, this data is taken from the site referenced above so you can follow what I am doing for yourselves. Bear in mind that not all of the cases reported are going to be from the epidemic strain, as meningococcal disease can be caused by several strains and by several viruses.

In 2002:

The very preliminary total number of notified cases for the year 2002 is 550 with 17 deaths. At the same time in 2001, 649 cases and 26 deaths had occurred.
In 2003:
The tentative total number of notified cases for the 2003 year is 549 with 13 deaths. At the same time in 2002, 555 cases and 18 deaths had occurred.
In 2004:
The current total number of notified cases for 2004 so far is 346 with eight deaths. Not all of the cases reported in 2004 so far are due to the same strain that the vaccine is designed to protect against. The average number of cases per year for the last five years over the same time period is 546.

The total number of cases of meningococcal disease for the calendar year 2003 was 541 (a rate of 14.5 per 100 000) including 13 deaths (a case fatality rate of 2.4%). In 2003, 71.5% of laboratory confirmed cases were caused by the strain that the vaccine is designed to protect against.
in 2005:
The provisional total number of notified cases for 2005 is 229 with 14 deaths. Not all of the cases reported in 2005 are due to the same strain that the vaccine is designed to protect against. The average number of cases per year for the last five years over the same time period is 463.

The total number of cases of meningococcal disease for the calendar year 2004 was 342 (a rate of 9.2 per 100 000) including eight deaths (a case fatality rate of 2.3%). In 2004, 73.0% of laboratory confirmed cases were caused by the strain that the vaccine is designed to protect against.
So we see from this data a more complete picture than attempting to take one isolated region and demean the whole campaign on it with an obvious strawman. From the vaccines introduction in 2004, we see a marked drop in the number of cases from 550 in 2002/2003 to 346 from merely introducing the vaccine. This is even more impressive when it is considered that the vaccine was initially introduced to Counties Manakau and Auckland on the 19th of July 2004, not over the whole country. As we move from 2004 to 2005 the vaccine still hasn't been introduced to the whole country yet (The Christchurch area is next IIRC) and has *still* had a remarkable drop in cases over a mere two years. Ron Law would like people to believe that has nothing to do with the vaccine and that this is just following the organisms normal 'decline'. Sorry Ron, myself and the public you're trying to mislead are not going to buy that without much more convincing evidence.

After this, Ron Law then goes on to make some interesting new claims such as the Ministry of Health lacking 'transparency'. This is a rather curious claim, because Mr. Law has the same access to the same figures and data that everyone else does. In fact, this vaccine has been the most closely monitored vaccination trial in history, as it has been followed up immensely aggressively by health monitors and by the ministry of health itself. If this is apparently being non-transparent then I would have to wonder what exactly he thinks is being transparent. Also, it's a great understatement to claim that the information about Meningococcal disease has been poor, because numerous advertising and education campaigns have been aimed at aiding parents and caregivers to spot the early signs. Unfortunately, that's not sufficient to prevent an epidemic and now the authorities have appropriately and responsibly acted by introducing a vaccine. There is only one group here being irresponsible and it's not the ministry or scientific community.

Finally, Ron Law tries to take a shot at my critical reading ability. Unfortunately, I should suggest that he reads my previous rebuttal to his points (linked above). Only an extremely biased and skewed reading of the Ministries letter to GPs would be required to claim the MeNZB campaign has failed. Of course, that Mr. Law makes another baseless assertion without bothering to actually respond to any of my points only underscores the lack of solid arguments he has.

Edit: Also to add, going back to the first point that Ron Law made in his email, if time does prove that I am wrong I will be one of the first to admit that. Can the public of New Zealand expect the same from Mr. Law, especially those who believed what he was saying?