Déjà vu all over again: Another Internet survey on vaccinations [Respectful Insolence]

November 24, 2015 Orac

It is an article of faith among the antivaccine movement that vaccines are degrading the health of our children, such that vaccines cause autism, asthma, diabetes, and a number of other chronic diseases. You won’t have to look far on most antivaccine websites to find claims that today’s children are the sickest in history and insinuations, if not outright statements, that vaccines are at least part ofthe cause. If you’ve been following the antivaccine movement as long as I have (more than a decade) or even if you’ve only been following it one tenth as long, you are probably aware that one of the most common arguments trotted out by antivaccine activists is that there has never been a true study of vaccinated versus unvaccinated study, or “vaxed vs. unvaxed” for short. Early on, when I was writing about antivaccine activists, I would see calls for an actual randomized clinical trial of “vaxed vs. unvaxed.” Indeed, three years ago, no less a crank luminary than Vox Day himself blamed vaccines for sudden infant death syndrome, and castigated the lack of such a randomized trial, producing rich fodder for an epic (and much-deserved) ranty takedown by yours truly.

Of course, the concept of clinical equipoise renders such a randomized clinical trial of vaxed vs. unvaxed hopelessly unethical right from the get-go. Basically, in clinical trials clinical equipoise demands that there be state of genuine scientific uncertainty in the medical community over which of the drugs or treatments being tested is more efficacious and safer or whether a drug being tested with placebo is better or worse than doing nothing. Without that genuine scientific uncertainty over which option being tested in a clinical trial is better (or at least less harmful), the trial cannot be ethical because investigators would then be knowingly assigning one group of subjects to a treatment known to be inferior, or at least strongly suspected to be inferior. One reason (among many) why a prospective randomized, clinical trial that intentionally leaves one group unvaccinated to determine whether vaccines cause autism (or whatever condition or disease the investigator suspects to be associated with vaccines) would be completely unethical is that it egregiously violates the principle of clinical equipoise. The unvaccinated group would be left unprotected against potentially life-threatening vaccine-preventable diseases, and that is completely unacceptable from an ethical perspective. Consequently, when it comes to studies of this type, we have had to rely on less rigorous trial designs to ask the question of whether vaccines cause various problems. While each individual trial of such types is less powerful and convincing than randomized clinical trials, the accumulated weight of such evidence can (and is) often enough. In the case of vaccines, it’s more than enough.

Some antivaccine activists have realized that there’s no way a randomized clinical “vaxed vs. unvaxed” trial will ever be done. Many do not truly accept or believe that such a trial would be unethical, but they grudgingly accept that virtually every other physician does; so they try to find evidence of vaccine harm in other ways. For example, way back in the day, J.B. Handley and Generation Rescue did what was in essence a vaxed vs. unvaxed phone survey. Let’s just say that it didn’t show what J.B. Handley thought it showed, and, even if it had, its methodology was so poor that it was a meaningless study anyway. A few years later, a German homeopath named Andreas Bachmair conducted a hilariously incompetent survey that purported to find that vaccinated children are unhealthier than unvaccinated children. It didn’t.

Yes, I’ve seen several epically incompetent attempts at “vaxed vs. unvaxed” surveys by antivaccine activists over the years. Yesterday, I might just have seen the most incompetent one of all, courtesy of Rashid Buttar (yes, that Rashid Buttar). who is promoting this survey:

VANVCD.org

The splash page of the website features a large photo of a girl being vaccinated, her mother holding her hand for support, emblazoned with the question, “Do vaccinations help or hurt my child?” Whenever you see a question like that on a website, a good rule of thumb is that you’re probably on an antivaccine website, but let’s take a look at how the survey is described:

One of the most controversial issues in society today is the issue of vaccinations. Evoking intense feelings, both sides of the debate are very passionate. Studies have shown evidence to support both sides of the debate. Each alleges the other side skewed the data or altered the results to show desired outcome. So what is the truth? Maybe YOU can help us in less than 2 minutes to find the truth for the benefit of all children on the planet!

Nope. Vaccinations are not “one of the most controversial issues in society today.” Not even close. To the small cadre of dedicated antivaccine activists who fervently believe that vaccines are toxic and deadly, the equivalent of injecting toxic waste into children, maybe they’re “controversial.” To the scientific community, not so much. The overwhelming scientific consensus is that vaccines are both effective and safe, a consensus built upon considerable evidence.

Of course, it’s incredibly silly to think that an uncontrolled Internet survey can reveal much about the state of health of vaccinated and unvaccinated children, but that doesn’t stop whoever made up this site:

The following survey is a simple 11 question survey that will take you only 1 minute to complete (2 minutes if you read all the quotes, which we hope you do). Your information will be added to the data being collected and once submitted, you will be able to immediately see the results on a global scale, or just by your country if that is what you choose to view. Even better, you will be able to filter the data for specific criteria and see the results in real time.
Please remember, this is a world community project and we are dedicated to empowering the world, so that all of us can benefit from the truth and our future generations are provided with the maximum level of protection. Our promise to you is the following:

  1. You will never have to pay a single penny at this site. This site is 100% FREE…no secret agendas!
  2. You will never have to worry about your information being sold to anyone. Everything is strictly confidential!
  3. You can be assured that the data you see at the end will be completely unbiased, with the sole agenda of discovering the truth!

It’s that last statement that reveals a well of scientific ignorance so deep that I fear it might hit magma made of burning stupid. “Unbiased”? Seriously? By its very nature this survey will be biased. It’s an Internet survey! At the very least, only people with access to the Internet, either by smartphone or computer, can take this survey, which introduces a huge bias right there. Worse, there’s no effort whatsoever to make sure the sample is representative of the general population. In fact, given that I’ve seen links to this survey being passed around by antivaccine practitioners and activists like Rashid Buttar, it’s a virtual guarantee that this survey massively overrepresents parents who believe that vaccines cause autism and other health issues, which means it also massively overrepresents children with autism or chronic health problems. It even has a “Tell A Friend” page that tries to encourage people taking the survey to “spread the word” to at least five friends and to “help us discover the truth once and for all!”

No, there’s no way this survey can be anything near representative of anything.

This is even more so given the sorts of questions it asks. For instance, the very first question is: “Has your child received any vaccinations since being born?” The possible choices in the dropdown menu include:

  • No vaccinations
  • 1-5
  • 6-10
  • 11-15
  • 16-20
  • 21-30
  • 30+

The very nature of this question buys into the “too many too soon” antivaccine trope, along with the way antivaccine activists try to make the number of vaccines sound really huge by counting combination vaccines not as one vaccine but as the number of vaccines included in them; e.g., MMR counts as not one but three vaccines.

Next up is this question: “Where would you place your child on their developmental milestones?” Possible answers include:

  • They were way ahead of their peer group
  • They were with their peer group
  • They were behind their peer group

No medical verification needed, this is just a survey asking parents.

More questions follow, such as:

  • Does your child have any type of chronic illness or neurological deficits?
  • Is your child currently taking any prescription medication for any condition (do NOT include nutritional supplements, even if prescribed by a doctor)?
  • Has your child EVER taken any medication for any medical condition, now or in the past, for more than 10 days continuously?
  • Does the mother have any medical condition(s)?

At this point, you have to enter an e-mail address, your child’s first initial and last name (HIPAA, anyone?) before you can access the remaining questions. These remaining questions are quite revealing (click to embiggen):
 
q7-8
 
q9-10
 
q11
 
Gee, what do you think most parents who take this test will answer to these questions?

Not surprisingly, the “results” thus far (such as they are) show—surprise! surprise!—that the vaccinated children have more health problems. You can explore the “results” for yourself if you are so inclined, but I’ll just show a representative example, namely who does and does not have chronic illnesses or neurologic results based on vaxed/unvaxed status.

For instance, here is the graph for vaccinated children (click to embiggen):
 
Vaccinated
 
And here is the graph for unvaccinated children (click to embiggen):
 
Unvaccinated
 
Obviously, this is completely unscientific and entirely expected given the nature of the survey and where it’s being advertised, namely in antivaccine mailing lists and on antivaccine websites. No physician or scientist will take this seriously, nor should they. In fact, no one with even a modicum of knowledge about epidemiology, surveys, or medical study design will take this the least bit seriously. Unfortunately, the vast majority of people do not fall into either category and might therefore think this survey tells us something when it really doesn’t, other than to demonstrate how a highly biased sample can predetermine the results of a survey. I would, however, look at this survey as a bit of an intelligence contest. If someone takes it and its results the least bit seriously, that person is just too stupid or ignorant to be worth dealing with.

Another thing about this “study” bothered me. Unlike the case with, for example, Generation Rescue’s or Andreas Bachmair’s surveys, nowhere on the website is there any indication of who is offering the study. So I did a quick WHOIS search on vanvcd.org and found that this domain is registered to someone named Jason Yensid of the Progressive Health Consortium, LLC in Lake Tahoe, NV. The URL progressivehealthconsortium.com goes to a SiteWorx account setup page. The domain was registered on June 22, 2015. Oddly enough, there are other domains registered to Yensid and the Progressive Health Consortium, such as kennelvomwiese.net, which is a dog kennel site. The office address, 297 Kingsbury Grade Suite 100 Lake Tahoe NV 89449, which houses Kingsbury Executive Suites, a service that offers full and part-time office suites, which suggests—shall we say?—newness and a lack of permanence. Calling the phone number at the address went straight to voicemail.

It was at this point that I got tired of trying to figure out who Jason Yensid is, about the same time I realized that “Yensid” is “Disney” spelled backwards and did a massive facepalm, first because of the obviousness of it all and second for my not having noticed this sooner. My speculation is that this Progressive Health Consortium, whatever it is, is planning to launch some business or product designed to cater to the antivaccine fringe, and this survey is a marketing tool. Whoever is offering this survey and whatever it’s for, from a scientific standpoint it’s a perfect microcosm of how antivaccine activists work: If you don’t have the data you want, create it!

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