Talk:Vaccine hesitancy/Archive 2

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Deletion Debate

This article is mostly poorly formed ad hominem attacks. I propose it be deleted. Zbrock 17:52, 11 October 2006 (UTC)

While it is rather poor quality and think it's all bull, doing that will not help Nil Einne 12:36, 13 October 2006 (UTC)

While I agree that quite a bit of it is rubbish, there are some factual concerns hiding away. In any case, there is a significant controversy over widespread mandatory vaccination policies, and the controversy should be addressed. I do suggest a total overhaul, however! Kitarra 07:29, 3 February 2007 (UTC)

Maybe it should be merged with Anti-vaccinationist (or visa versa) since one page is essentially pro and the other anti. Cilstr 17:00, 6 April 2007 (UTC)

Problems

Actually, at least one autoimmune disease (MS disease) is a known adverse effect of Engerix hepB vaccine, mentioned in the approval informatio, see e.g. http://us.gsk.com/products/assets/us_engerixb.pdf - also, vaccines are mentioned as a possible cause on more than one page on autoimmune disases. Jkpjkp 14:11, 13 October 2006 (UTC)

"Rare instances of exacerbation of multiple sclerosis have been reported". That's not at all the same thing as saying that MS is caused by the vaccine (and as the document says, it's not restricted to that vaccine). --ajn (talk) 15:05, 13 October 2006 (UTC)

Are we reading the same document? A quote from the above approval information URL directly from the vaccine manufacturer's site: "Postmarketing Reports: Additional adverse experiences have been reported with the commercial use of ENGERIX-B. Those listed below are to serve as alerting information to physicians. ... Nervous System: Migraine; syncope; paresis; neuropathy including hypoesthesia, paresthesia, Guillain-Barré syndrome and Bell’s palsy, transverse myelitis; optic neuritis; multiple sclerosis; seizures." Jkpjkp 15:12, 13 October 2006 (UTC)

Second here to the previous comment of "Are we reading ...". If the offending statement is "Many severe autoimmune diseases are known or suspected to be caused by vaccines" then it would appear the statement could at least be reworked to read "Many severe autoimmune diseases suspected to be caused by vaccines", which would be entirely consistent with customary cautions associated with drug delivery where side-effects were reported or detected during studies or clinical events but insufficient data exists to say outright that causality is present. Detection of causality is not required to issue an alert to prescribing physicians, simply credible detection during test. Provided with the warnings, physicians and patients are expected to exercise intelligent judgment under uncertainty, i.e.: Nexium may control acid reflux but many patients report that when taking it they get heartburn. We don't have to establish causality to write the patient reports into the alert. That way, if a patient reports the response to the prescribing doctor, the doctor knows this isn't in isolation but there have been other reports and can re-assess and determine alternatives. Requiring statistical evidence of causality prior to expressing any concerns about the affects of a drug is a practice of denying critical information to patients who have a right to the information and a right to decline treatment based on their own assessment. —The preceding unsigned comment was added by 143.182.124.3 (talk • contribs).

I see what you're saying, and I agree that it's definitely worth a (sourced!) mention in the article. Perhaps the statement could read, "Many severe autoimmune diseases are suspected to be caused or exacerbated by specific vaccines." As the original reads, all vaccines are suspect, and the only sources proffered are for ENGERIX-B. However, even that isn't ideal as it doesn't address any of the concerns besides autoimmune diseases. It would be nice, for neutrality's sake, to have a well-written and properly sourced entry on the con side of the debate. Kitarra 07:25, 3 February 2007 (UTC)

Several studies have found no link between Hep B vaccination and MS (PMID 10683009, PMID 11172163, PMID 12707063 for example, in Lancet and New England Journal of Medicine). At least one study did find an increased risk (PMID 15365133). The authors of the positive study, from the Harvard School of Public Health, wrote a 2006 editorial entitled "Hepatitis B vaccination and multiple sclerosis: the jury is still out" (PMID 16245367), in which they examined the methodology of all of these studies and found some degree of flaw with each. Their conclusion was that there's not enough evidence to establish a causative link between Hep B vaccine and MS, but also not enough evidence to completely disprove such a link. And of course, "further study is needed" as always. This shouldn't be too hard to write into the article, yes? MastCell 18:51, 5 March 2007 (UTC)

To expand on the above: the cited source (Hep B product insert) clearly states that no causal relationship between Hep B vaccine and MS is known. The article makes sweeping statements which are just not backed up by the citation, and I'll tag them as such. I agree with the anon IP that people should have all the information available to make their own health decisions, which is why it's important not to claim there's a "known" relationship when there isn't. As for the other neurologic conditions, sources will be needed for those as well - Guillain-Barre should be pretty easy to find, the others maybe not so much. MastCell 19:16, 5 March 2007 (UTC)

Journal of American Physicians and Surgeons

I'm sorry, but the political agenda of JPandS is relevant (as one of their major political issues is anti-vaccinationism). The journal has a clearly stated political agenda, and the piece in question was, in fact, authored by someone with a legal rather than scientific or medical background. Setting it up as if it "rebuts" the Cochrane Library report is a clear violation of WP:NPOV#Undue weight. As it claims to be a medical journal, the fact that it's not indexed in MEDLINE is relevant. MastCell ^Talk 03:07, 19 March 2007 (UTC)

Please don't keep reverting without discussing these issues on the talk page. MastCell ^Talk 16:08, 19 March 2007 (UTC)

Supporters and critics

What on earth is that long list of vaccine supporters and critics doing on the page? Shouldn't they be at least on their own list pages, like List of vaccine supporters and another for critics? They take up an immense amount of space on the page, for nothing much I can see. It's got to violate a couple WP:NOTs, like indiscriminate information, mere collection of internal links, directory, etc. --WLU 20:51, 14 April 2007 (UTC)

I removed the lists for supporters and critics - I can't see any value to the page. It just asks people to add their names to it as if it were a petition, and you could see this by the number of redlinks in each list. WLU 13:11, 15 July 2007 (UTC)

Yes, also raises BLP issues as it's essentially unsourced. I agree with removing it. MastCell ^Talk 14:44, 15 July 2007 (UTC)

Merge?

Should the article Anti-vaccinationist be merged into this one? The two articles cover a lot of the same ground, and I do not see a reason why there should not be a single cohesive article on this subject, as opposed to two disorganised ones. -Severa (!!!) 20:06, 28 May 2007 (UTC)

I think that makes a lot of sense. Anti-vaccinationist is a logical section here in vaccine controversy, in my opinion. Heathhunnicutt 05:56, 7 June 2007 (UTC)

Anti-vaccinationists are a group of people against vaccines. They oppose them because of a controversy. Merging the two articles would be like merging Libertarianism with the Libertarian Party. Sincerely, Sutjo. Sutjo-18005 (talk) 22:24, 28 November 2007 (UTC)

No they don't. Not because of. They seek to produce the appearance of controversy because they oppose vaccination. And they claim not to be a group, around this article and in other places. Midgley (talk) 23:07, 21 March 2008 (UTC)

Concerns about the lead

I have two concerns about recent edits to the lead. First, mentioning (in the first paragraph, no less) a U.S. bill proposing to investigate a vaccine/autism link is a bit odd. This is not only recentist and U.S.-centric, but the bill has not even been voted on, so far as I can tell, and its prospects for becoming law are unknown. Mention it, sure, but in the lead?

Secondly, the final paragraph on the vaccine compensation fund has some of the same issues of U.S.-centrism, and it seems like a non-sequitur in its current position in the lead paragraph. Undoubtedly, the fund needs to be mentioned in this article, but again, I don't think it's necessarily lead material, especially since the fund itself does not seem particularly "controversial", and the paragraph doesn't make clear how it relates to the "vaccine controversy". MastCell ^Talk 03:44, 23 July 2007 (UTC)

The lead was POV without those additions, MC, and basically read as though written by a pro-vaccination campaigner. We have to describe the dispute, not engage in it. Therefore, we must do two things in the lead: make clear (1) that the vaccination/autism issue remains unresolved, and (2) that no one denies that vaccination does harm people. The way the lead was written, the reader would be left with the impression that there was no truth whatsoever in the claims that vaccines can cause damage, whereas no one is saying they don't. What is at issue is which ones do, and to what extent they do.

The fund relates directly to both issues, because first it shows that govts do acknowledge that vaccination can cause serious damage to some children, and secondly because families are currently battling to have autism included in the list of diseases that might be compensated for, and the govt is resisting that. SlimVirgin ^{(talk)(contribs)} 04:09, 23 July 2007 (UTC)

I admit that the lead was POV. I was frustrated by how awful these two articles are. They didn't even mention the alleged autism link in the lead. Yes, a certain number of people will become ill and some will die from compulsory vaccines, and this raises interesting ethical questions, and I agree that the fund is a good illustration of it. However, the bill is an absurd WP:WEIGHT problem. Carolyn Maloney proposed a similar bill last year, which went nowhere. She and Dave Weldon also proposed removing vaccination safety from CDC oversight and creating a new government agency for immunizations. That Carolyn Maloney proposed this bill simply means that Carolyn Maloney (and cynically, plaintiffs attorneys) take the link seriously. Cool Hand Luke 05:07, 23 July 2007 (UTC)

We do need to take care to respect WP:WEIGHT here, as well as try to avoid lede-bloating. Not every issue and every argument needs to be made in the lede. As MastCell has suggested, including an unpassed bill as the fourth sentence may be giving undue weight to an isolated factoid. (As well, the way in which the information is presented – "...require the National Institutes of Health to conduct an epidemiological study to determine whether there is a link [between vaccines and autism]" – leaves out any mention of studies which already exist on this topic, as well as prior U.S. government work (by the IOM and others).)

We also need to be careful to avoid presenting the issue as entirely black-and-white. I know of no responsible scientist or physician who would deny that any vaccination program carries with it a small (but nonzero) incidence of adverse effects, yet the lede implies that only vaccine critics/skeptics acknowledge safety concerns or adverse events. Among vaccine critics, there are those who believe (correctly or not) that there are specific problems with specific vaccines while still generally supporting most vaccination programs; there are also those who believe that all vaccination is a sham, that vaccines are the work of the Devil or the military-industrial complex, and that the germ theory of disease was cooked up by Freemasons. Some among the former can be engaged reasonably, the latter are wingnut conspiracy theorists who can (or at least should) be ignored by policy makers and the public. This problem is also mirrored to an extent in the article as a whole, which is divided sharply into pro- and anti- vaccination sections—any nuance or subtlety of position is lost, and we're left giving the impression that this is some sort of epic battle between two diametrically opposed sides.

Finally, the third paragraph about the U.S. compensation program is material that belongs in the article body, not in the lede. It's too specific and too U.S.-centric for an introduction. TenOfAllTrades(talk) 05:15, 23 July 2007 (UTC)

Whether it's U.S.-centric is irrelevant. What matters is whether it's informative, appropriate, and well-sourced. SlimVirgin ^{(talk)(contribs)} 05:17, 23 July 2007 (UTC)

Well, per WP:LEAD, it should be all of those things, plus "...the emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources." I don't see a preponderance of reliable, published sources on the vaccine controversy mentioning this proposed legislation, though perhaps I'm missing something. MastCell ^Talk 05:31, 23 July 2007 (UTC)

(edit conflict) I don't deny the lead was suboptimal before. I do think, though, that if we are to accurately characterize the dispute (again, without engaging in it), we should not pretend that the pro- and anti-vaccination camps are equally represented among experts in the field. We should also put the uncertainty re: autism and the harms of vaccination in much sharper perspective than the current intro does. Certainly the vaccine-autism link is an ongoing public concern which should be covered in depth here. But when a large number of scientific and medical organizations weigh in, stating that the currently available evidence does not support a link, then WP:WEIGHT demands we at least mention that. As to the vaccine injury fund, as you say, no one disputes that serious vaccine injuries do occur. The other side of the coin, though, is that such injuries are both exceedingly rare and orders of magnitude less common and severe than deaths and complications from the diseases prevented by vaccination. The "vaccine controversy" described in this article has very little to do with the known, rare complications of vaccination (which the fund addresses), and a lot to do with unproven harms such as autism, "immune overload", etc. In order to accurately characterize that debate, we need to draw a sharper focus. MastCell ^Talk 05:27, 23 July 2007 (UTC)

I don't dispute that the material about the U.S. compensation program is informative, nor that it's well-sourced, nor even that it's a valuable and appropriate bit of information for this article. However, I disagree that it belongs in the lede. It's too much space used for too-specific and too-detailed a piece of information. The reader is left to wonder what that factoid is trying to convey, floating all by itself there in the introduction. Are we trying to say that vaccines are dangerous? That vaccines are safe, in that only about 75 people per year have filed claims? That policymakers are anti-vaccine and want to publicize adverse events? That policymakers are pro-vaccine, and want to comfort the public by saying in the unlikely event of an adverse reaction their children will be taken care of? Does the trust fund have anything to do with the vaccine controversy at all, or is it just a way for the government to streamline a process that would otherwise involve costly and complicated lawsuits between injured parties, health agencies, state and federal governments, the CDC, and drug companies?

Do you see where I'm coming from here? TenOfAllTrades(talk) 05:30, 23 July 2007 (UTC)

Moving the MMR controversy to it's own page

The MMR controversy takes up a disproportionate part of the article. It's longer than all of the separate Thiomersal controversy article. The MMR controversy is somewhat complicated with all the media aspects etc and thus essential information would be dropped if it were significantly trimmed down. I think it would be reasonable to move the MMR controversy to a separate article. --Jkpjkp 06:49, 28 August 2007 (UTC)

This one makes sense to me. It has been proposed before, though, no? Have you looked into the history to see why it didn't happen earlier? If not, please do so. Eubulides 00:30, 29 August 2007 (UTC)

Rename article to "Vaccine controversies" (proposal withdrawn --Jkpjkp 10:58, 30 August 2007 (UTC))

It would seem reasonable to rename the article to "Vaccine controversies" as there are many separate controversies - thiomersal, MMR/autism, vaccination and religion, the debates over the role which vaccines had in the decline of different diseases, the debate over how common adverse effects are, the debate whether vaccines cause diabetes, the debate whether vaccines cause other autoimmune disease etc. --Jkpjkp 13:50, 28 August 2007 (UTC)

Sounds reasonable. Andrew73 17:35, 28 August 2007 (UTC)

I disagree. All other things being equal, it's (1) better to use a singular title than a plural one, and (2) better to stick with the name that has been long been used, rather than change it. Any major political, religious, or medical controversy is actually a collection of smaller controversies, and this one is no different. There is not a compelling reason to change the name, so let's leave the name alone. Eubulides 00:28, 29 August 2007 (UTC)

Point (3) - I think there were more than a hundred links to "Vaccine controversy" and last I checked, there was no automatic way to fix them, and I tend to agree with your point (1) and I guess your point (2) makes sense as well. I withdraw the proposal; I think we can work with the article named as it's now, and the controversies in separate sections (or separate articles where warranted). --Jkpjkp 00:37, 29 August 2007 (UTC)

Article is now breathtakingly biased

This article has been substantially rewritten by a single editor, and is now breathtakingly biased. Section title after section title present arguments against vaccination, without even a token effort to present the mainstream view. Wikipedia is not supposed to be a soapbox for minority opinion; it is supposed to prevent a fair summary of the consensus view. Eubulides 06:46, 30 August 2007 (UTC)

Actually, the article has not been rewritten, but the issues have been rearranged so the subject is handled in a more analytic way. The aim of the article is to describe the controversies, and section titles refer to the issues of controversy. I agree that the article needs to have more referenced content for the viewpoint defending use of vaccines in each controversy. The solution to this is simple - editors need to add that kind of content. --Jkpjkp 10:16, 30 August 2007 (UTC)

Not to mention the severity of the cleanup issues; familiarity with WP:MOS would help. Is there a better version that can be reverted to ? SandyGeorgia (Talk) 13:19, 30 August 2007 (UTC)

Yes the version of 2007-08-18T00:07:58 UTC is a better version that can be reverted to. This is the version just before Jkpjkp started a large series of edits that introduced massive bias. The old version is superior to the current version in overall quality, and far superior in neutrality of point of view. (I'm not claiming the old version is great; just that the current version is quite bad.) There are a few improvements made in the new version; they can be folded into the old one as needed. This would be the simplest way to restore quality. Eubulides 13:51, 30 August 2007 (UTC)

Apart from the MMR controversy section, the version of 2007-08-18T00:07:58 UTC has severe problems and fundamental bias - rather than telling what each side of the controversy is saying, it reads like an attempt to try and list people's concerns (in a very biased way, like "anti-vaccinationist assertions") about vaccines and refute them. That is not what the article is supposed to be about; it's supposed to neutrally describe the vaccine controversies. --Jkpjkp 14:02, 30 August 2007 (UTC)

Yes, as I said, the old version of 2007-08-18T00:07:58 UTC had problems. But it is far superior to the current one in terms of avoiding bias. Here's just one example. The old version's lead gives four sentences to skeptics of vaccination, and two sentences to mainstream opinion. This is biased against the mainstream, which was bad enough, as Wikipedia guideline is to align with the mainstream (see WP:FRINGE). However, the two sentences were longer and were placed at the end, so it wasn't too bad. In contrast, the current version's lead gives four sentences to skeptics, and zero sentences to the mainstream. This is breathtakingly biased against the mainstream opinion. This is just one example of recently-introduced bias; there are many, many others. Eubulides 14:22, 30 August 2007 (UTC)

The simplest way to fix the problems is to revert to the old version and start bringing in the few recent improvements incrementally. I don't like doing things this way (I have never done it in the past) but the current situation is extraordinary in my experience. The recently-introduced massive bias has also affected MMR vaccine controversy; most likely it has affected other subpages too (I haven't checked). Eubulides 14:22, 30 August 2007 (UTC)

I reverted. Honestly, when I encounter an article in such bad shape, I wonder if it's not time for a Request for Comment on the editor introducing so much deterioration. It's hard to know where to start, but cleaning up the basic violations in WP:MSH, WP:MOS and WP:CITE/ES would make the article at least more readable. It's truly hard to know where to start, so a return to an earlier version is in order. SandyGeorgia (Talk) 14:26, 30 August 2007 (UTC)

Replying to the comment in #Quality issues about whether the theory that MMR vaccine causes autism is a "fringe theory". It's not as fringe a theory as (say) the theory that autism is caused by diabolical possession. But it is more of a fringe theory than (say) the theory that autism is largely caused by exposure to pesticides. All these theories are most likely incorrect, based on the scientific evidence that we have now. The MMR vaccine theory was briefly plausible but has been investigated and discarded. This is not a question of my opinion: it's a question of what the reliable sources say. Eubulides 03:14, 31 August 2007 (UTC)

The bias issues seem to have been cleaned up by reverting and subsequent editing, so I removed the POV tag. Also, the OR and weasel tags seem to be obsolete, so I removed them as well. The article still neads cleanup big-time, though. Eubulides (talk) 19:37, 22 November 2007 (UTC)

When I wrote the first draft, the intention was an article about anti-vaccinationists. One of the anti-vaccinationist tactics is to disguise themselves as mere critics of some aspect or aspects of some vaccinations. Midgley (talk) 12:47, 7 December 2007 (UTC)

Check out http://www.mercurynews.com/business/ci_7910416 195.38.117.220 (talk) 07:35, 9 January 2008 (UTC)

Quality issues

The article is marked for cleanup since June 2006, which was one thing which prompted me to start rearranging the article and making other edits. As can be seen on the page edit log, opinion has been expressed that the edits have made the article quality lower than higher. Could we be more specific, and discuss what the quality issues are? NPOV and weasel words are two which are tagged separately, but how about other issues. For example, the long list of external reference seems like quite a big portion of this article - while it gives references to the article subject, is it disproportionate? How about organization / subtitling? I think it still needs some work - maybe some grouping of the controversies, as there are quite many subtitles now at the same level. Also, the "Common arguments" for and against vaccinations seem redundant and repetitive after the Overview - how about ditching them and writing a Summary at the end instead? Maybe that would also alleviate the NPOV concern, since the summary could repeat the claims of each public health organization and government that their policy is the right one. --Jkpjkp 10:57, 30 August 2007 (UTC)

The most important quality issue is the amazingly strong bias that has been introduced in the recent edits, discussed in #Article is now breathtakingly biased above. There are several other problems with the recent edits, but they are secondary. I am aware that other Wikipedia editors favor the fringe theory that vaccines cause autism, but that does not make the theory mainstream. Eubulides 14:03, 30 August 2007 (UTC)

Well, it's obvious from writing (fringe theory that vaccines cause autism) that you think there is no chance that vaccines cause autism. However, the article is not meant to reflect your opinions, or be a refutation of peoples thoughts or theories you think are "fringe". There are a lot of controversies with vaccines - and sure, you can probably find some in which the suspection of the risk can be called "fringe". However, for example the question of whether there's enough evidence about the safety of MMR is not some kind of "fringe" question - the Cochrane Collaboration, reports that there were no studies good enough to fulfill their inclusion criteria. Thus, it appears there not that much hard evidence to support the safety. In any case, the article should be about _reporting_ the issue and viewpoints, not about _refuting_ the concerns as you seem to think it should be doing. See WP:NPOV - no viewpoint should be asserted as 'the truth'. --Jkpjkp 15:32, 30 August 2007 (UTC)

I address the question of bias in #Article is now breathtakingly biased above. Eubulides 03:14, 31 August 2007 (UTC)

The external links are a mess; I would favor getting rid of all of them now, and adding back one at a time as they are shown to add encyclopedic value per WP:EL. I think the quality issues were mainly in the layout, which has always been highly unsatisfactory; rather than juxtaposing "claims of the mainstream" with "claims of anti-vaccinationists", we should probably address these in a more synthesized fashion to avoid re-engaging in the debate. "Summaries" are a bit dangerous since they generally run the risk of improper synthesis.

I think a good first step would be to identify a number of solid, reliable sources on the vaccine controversy which we can draw from to create a better article. There are such sources; the controversy has been covered fairly responsibly by elements of the mainstream media, for example. We should remove the unsourced or poorly sourced stuff and add it back as we find supporting sources. Right now we have a bunch of unsourced arguments that editors (many of whom are no longer active here) wanted to advance, and we're trying to find sources to back up those arguments. That's back-asswards. MastCell ^Talk 15:30, 30 August 2007 (UTC)

Well, in principle that sounds reasonable. However, if it means in practice that the viewpoints published in publications of organizations like American Physicians and Surgeons will be removed because someone considers the organization "political", it seems like suppresion of relevant information. --Jkpjkp 16:03, 30 August 2007 (UTC)

The Association of American Physicians and Surgeons does have a primarily political rather than scientific agenda, as noted by the New York Times and other reliable sources. From a scientific standpoint, the use of any journal not indexed on MEDLINE is highly questionable; MEDLINE is how scientists learn about others' work, read about it, and cite it in their own work. A non-MEDLINE-indexed publication is essentially outside the sphere of mainstream scientific discourse and should be treated as such. What I particularly objected to, in this context, is that the JPandS studies were juxtaposed to "rebut" the Cochrane Library findings, which is a clear violation of WP:WEIGHT. The Cochrane Library is one of the most respected and conservative evidence-evaluation bodies in medicine (as you've alluded to); claiming that their careful analysis is somehow balanced by an article in JPandS is a clear violation of WP:WEIGHT. MastCell ^Talk 16:09, 30 August 2007 (UTC)

Yes, I understood what you meant by your edit comment. A couple of comments - first, the vaccine issue is political, and very political in USA, which (unlike most countries in the world) has compulsory vaccinations. Excluding reference from someone on the basis that the publisher of the journal is primarily something else than "medical" (in whose opinion?), doesn't seem to be warranted. Should we exclude all studies funded by vaccine manufacturers, on the basis that the manufacturers are commercial in nature? Should we exclude all studies with publishers who are commercial? Second, the JPANDS article reference in no way is presented to "rebut" anything, it's just one in a list of studies. The article editors shouldn't aim to rebut or refute the criticism presented, they should report it. WP:NPOV (Oh, and by the way, it appears JPANDS was already characterized in the article, so the relevant background of the journal/organization was clear) --Jkpjkp 16:46, 30 August 2007 (UTC)

It's fine to include political commentary, but the politics of the issue should not be presented as if they're the science of the issue. The JPandS paragraph I removed was clearly designed to "rebut" Cochrane; I agree that it's inappropriate. Simply put, we should not present work from a non-MEDLINE-indexed "house magazine of a far-right group" as if it's the equal, in scientific terms, of more respected work. I'm fine with quoting JPandS as an example of a particular brand of anti-vaccinationism (motivated primarily by libertarianism and anti-govermentalism rather than religion etc), just not as a high-quality source of scientific information. MastCell ^Talk 18:17, 30 August 2007 (UTC)

Should there be included a section on the goals of individuals and groups opposed to vaccination? Obviously, the section on compulsory vaccination is self-contained. But, if someone is opposed to vaccination, are they against everyone receiving a vaccine? Are they against all vaccines or just some? What if an individual wants a vaccine? Should they be prevented from receiving one? Or is someone opposed to vaccination just simply not willing to get on themselves. These seem like obvious questions that just aren't answered. Justin Custer 08:31, 12 November 2007 (UTC)

Sounds like a bit much for a whole section. I added a note to Vaccine controversy #Religion noting that religious objections are to all vaccinations, even when they are not compulsory; hope that clarifies thins enough. Objections based on individual liberty are obviously to compulsory only, as you mention. Objections based on ineffectiveness, safety, etc., apply to all vaccinations; surely this is obvious too. Eubulides 08:54, 12 November 2007 (UTC)

Unsourced statements and adding back references

I had added references to many of the unsourced statements - all of those were wiped out by User:SandyGeorgia who did a massive wipe of the recent edits after very little discussion but with lots of shouting and handwaving by User:SandyGeorgia. Now I'm wondering whether there's a point in re-adding the references, or will they have the same fate again. Any guesses? --Jkpjkp 21:03, 30 August 2007 (UTC)

Good citations would be welcome. Please see Wikipedia:WikiProject Medicine/Reliable sources for advice about what sort of sources to use, and Wikipedia:Manual of Style (medicine-related articles) #Citing medical sources for more advice about good citations. Briefly, the best sources are systematic reviews in reputable medical journals, and widely recognized standard textbooks written by experts in a field. The source you relied on heavily, namely Halvorsen's new book (ISBN 9781903933923) doesn't qualify as one of these high-quality sources. Eubulides 23:14, 3 September 2007 (UTC)

Some of the controversies surrounding vaccines are not controversies inside the medical research community, and in those cases it's not rational to demands sources from the medical research literature. For example, when a sentence in the article provides an example of a criticism of vaccines presented by a medical doctor like Dr Halvorsen, it's not rational to demand that the article provides a medical journal reference for what Halvorsen said. Or, if the article describes a parents' organization's position on the thiomersal controversy, it's not rational to demand that a medican journal be provided to present what the parents' organization said. --Jkpjkp 19:04, 4 September 2007 (UTC)

If all it takes to make something a reliable source is to prepend "Joe Shmoe said" to a controversial claim, then there will be no end to the sort of junk one could put into the lead. If that is all it takes, we could no doubt source a claim that vaccines are an invention of the Devil. However, I don't think that would be a fair summary of the state of vaccine controversies. If a criticism of vaccines is on religious grounds, then a reliable source would be a generally recognized religious body like the Vatican. If the criticism is on scientific grounds, then the usual scientific rules apply. The Halvorsen book is unrefereed, it is put out by a political publisher, and it was written by a doctor whose main expertise, as far as I know, is general practice and acupuncture. Surely stronger sources exist on the skeptical side. The Cochrane Library is much better, for instance. Again, please see WP:MEDRS and WP:MEDMOS for details about what constitutes a reliable source in the medical area. Eubulides 19:47, 4 September 2007 (UTC)

The title of the article is not "Medical community's view on vaccines", but "Vaccine controversy" - the aim of the article is not to describe just what is the medical community's view. The aim is to describe vaccine controversies, not to resolve the controversies one way or another, and not to describe just the "mainstream medical view" (or major medical views) on vaccines but to describe controversies and other views on vaccines. Halvorsen's book does a good job of presenting recent concerns voiced by parents, researchers like the ones having written the Cochrane report, and thus is a perfectly reasonable reference to use in describing some of the controversies. --Jkpjkp 20:08, 4 September 2007 (UTC)

I did not say Halvorsen should not be cited, just that more-reliable sources are preferable. I agree with you that the article should describe the controversy fairly using the usual Wikipedia rules. However, Halvorsen's book does not summarize the controversy fairly, nor does it meet the high standards that Wikipedia strives for in sources, particularly in sources for medical articles; so citations to it must be taken with a grain of salt. Surely there are better sources for the skeptical side. Eubulides 20:39, 4 September 2007 (UTC)

Reference to entry 23 does not seem to be valid

The following entry in the text:

* Secondary and long-term effects on the immune system from introducing immunogens and immunologic adjuvants directly into the body are not fully understood. Some autoimmune diseases, like acute disseminated encephalomyelitis, Guillain-Barré syndrome, transverse myelitis and multiple sclerosis, are known, suspected, hypothesized, or claimed to be connected to vaccines.[23]

Refers to reference 23:

1. ^ GlaxoSmithKline. Prescribing Information—Energix-B® [Hepatitis B Vaccine (Recombinant)]. Retrieved on 2007-07-25.

The referenced article does not validate any of the above claims. It could be that there is no citation, or that the incorrect citation is being used. If anyone knows and could correct, that would be good... —Preceding unsigned comment added by 210.84.25.115 (talk) 16:09, 10 September 2007 (UTC)

Thanks for catching that. I replaced that reference with a request for an on-point source. Eubulides 16:55, 10 September 2007 (UTC)

I like the phrase "known, suspected, hypothesized, or claimed." Many of those are, in fact, "hypothesized or claimed", but it makes it sound like they might just be "known" to be connected to vaccines. We should probably be more specific. A better source, I agree, would be the place to start. MastCell ^Talk 17:40, 10 September 2007 (UTC)

Vaccination and liberty

About Vaccination and Liberty -- does anyone actually argue that vaccination is an infringement of some sort of right, besides conspiracy theorists? Do we allow baseless conspiracy theories to be repeated as legitimate on wikipedia? Can I delete this section?

Certainly the section could be improved, but the subject is not a conspiracy theory: there have been two U.S. Supreme Court cases on it. I added a couple of references to help clarify things a bit. Eubulides (talk) 05:14, 18 November 2007 (UTC)

Vaccination and schizophrenia

Removing for citation and interpretation according to medical sources, see WP:MEDMOS and WP:MEDRS:

• Recent studies have linked prenatal exposure to maternal antibodies for influenza as a risk factor in the development of schizophrenia in children. The vaccine for the flu causes the same antibody production, potentially elevating the risk of schizophrenia in children in the womb. Results are preliminary and scientist still recommend that pregnant woman receive the flu shot, since having the flu during pregnancy is hazardous both to the fetus and the mother. Shankar, Vedantam (November 27, 2007). "A Theory That Raises Questions Schizophrenia Risk May Start in Womb". Washington Post. p. HE01. Retrieved 2007-11-29. {{cite news}}: Check date values in: |date= (help)

SandyGeorgia (Talk) 23:32, 29 November 2007 (UTC)

Possible sources (I don't have full access):

• PMID 17610387
• PMID 17962542
• PMID 17913903
• PMID 12514227 Free full text. SandyGeorgia (Talk) 23:45, 29 November 2007 (UTC)

Brown et al. 2004 is an influential study, though the concern about prenatal infections and neurological disorders goes way back. Penner & Brown 2007 (PMID 17610387) looks like a great source, but it's not in my library. Brown's 2006 summary (PMID 16469941) is the best reviewish thing I could find (it's not really a review, but it does summarize his recent work well, it's free, and Brown is 1st-class). I added a section along these lines but am not particularly happy with it (especially the article organization; what a mess!). Perhaps someone can improve it? Eubulides (talk) 00:53, 30 November 2007 (UTC)

I nominate MastCell :-) If no one else gets to it, I'll give it a try, but it's over my head. SandyGeorgia (Talk) 01:05, 30 November 2007 (UTC)

If drafted, I will not run... if nominated, I will not accept... :) I will try to get to this, though it will take some reading and time is a bit tight at the moment. Here's my first impression - there is a hypothesis that pre-natal viral infections may be a risk factor for schizophrenia or other mental illness, and this hypothesis is supported by at least some good evidence. However, we're talking not about viruses but about vaccines here. It's a major jump to say that vaccine-induced immunity will have the same (proposed) harmful effects as viral infection. Is there a reliable source directly linking vaccine-induced immune activation with schizophrenia? My first glance indicates that the sources above all discuss actual infection, not vaccination. Well, one source does discuss IL-6 as a mediator in rats, but I would think that IL-6 levels after vaccination are dramatically lower than after an actual influenza infection. MastCell ^Talk 05:17, 30 November 2007 (UTC)

Eubulides had added a nice short blurb, but someone else deleted it. Greek to me :-) Shermanesque statements ... hmmm !!! I was thinking more in terms of how to reorganize the entire page. I've been tackling some of the less medically-oriented parts of the autism garden, but this one is hard for me. SandyGeorgia (Talk) 05:19, 30 November 2007 (UTC)

Ah. Yes, I would really like for Wikipedia to have a good, solid, balanced, readable article on this topic, because it's fairly relevant. The organization of the article is suboptimal, but it's so entrenched that it will be hard to reorganize. Let me think about it... Ideally, I'd like to move away from a point-counterpoint style to a more flowing narrative (this is what I tried to do on AIDS reappraisal), but it will be tricky. MastCell ^Talk 05:40, 30 November 2007 (UTC)

I agree on getting rid of point-counterpoint, but it's nontrivial to do so. User:Jkpjkp tried to reorganize the article that way in August (you can see the results here) but inserted so much bias into the article that the whole thing had to be reverted. Organization-wise I thought it was better than point-counterpoint (you might want to take a look) but it still needed work. Eubulides (talk) 06:38, 30 November 2007 (UTC)

MastCell did you read the article from the Washington Post (linked above), where Brown who is one of the researchers in this filed is quoted? Its not the infection its self that is the problem but the immunological response the mother has to the infection and since the flu shot produced the same response. The incidence of mental illness from pre-natal infections is low, and the question now seems to be were the incidence is the same for a flu infection verses immunization. What percent of pregnant women will get the flu, and is it advisable for all pregnant woman to be immunized. If there is good chance of contracting the flu- one is better off being immunized. The sources from medpub are older papers that do not really propose a mechanism that harms the fetus, Brown makes the case that we can pin the problem on maternal antigens (antibodies) effecting the fetus during its early development. Hopefully a full pledged study will be published soon- but there was no indication of this in the Washington Post piece. The story went out yesterday over the wire servecs and I came across it in our local paper first. Hardyplants (talk) 05:48, 30 November 2007 (UTC)

No, to be honest I started reading from the PubMed ID's and didn't read the Washington Post piece until you mentioned it again just now. It sounds like Patterson is the leading exponent of the hypothesis that flu shots might also be a risk factor. As you say, there does not appear to be any experimental evidence to support the idea, though Patterson hopes to see such research in the future per the article. Perhaps we can work this in as pure speculation (albeit speculation by a researcher in the field), but without supporting scientific data it's hard to gauge its notability (especially as the Washington Post piece just came out, so it's hard to guess how much traction this will pick up in the popular press). Thanks for re-directing me to the Post article - I'd skipped over it. MastCell ^Talk 06:05, 30 November 2007 (UTC)

I read the articles and they don't even slightly support the supposition that vaccinations cause anything but, let's hold our breath here, an immune response. I'm shocked. Just shocked! Anyways, everything I'm reading is that there is no evidence. The danger of these PMID articles is that they are only abstracts (unless you have access to the whole article, which some of us have). Most of the abstracts are written with very broad language. Some of them (not here) might say something like, "further study is required", meaning they haven't found crap, but sure go ahead and try. Anyways, this Schizophrenia and immunization theory is exactly the definition of fringe theory. I'm with MastCell. Speculation, at best. OrangeMarlin ^{Talk• Contributions} 06:13, 30 November 2007 (UTC)

I should clarify that speculation by an expert in the field, published by major newspapers, may be worthy of inclusion here. I'm on the fence about that. I'm just not sure whether we should put it in now, making clear the level of uncertainty involved, or wait to see how much popular traction the idea gets. If it leads to pregnant women declining flu shots en masse, then regardless of the level of medical evidence it will be notable enough for inclusion on Wikipedia. MastCell ^Talk 06:32, 30 November 2007 (UTC)

That seems prudent, my main concern is that people will draw the wrong conclusion from the news paper story and forgo vaccinations, this is a unique situation and its still safer not to get the flu while pregnant. I believe Orangmarlin is being to hasty in dismissing the issue though. A good number of leading researches seems to think it is plausible and the animal study illustrated in the story was very interesting. A formal paper would be more interesting to read thought. Hardyplants (talk) 06:48, 30 November 2007 (UTC)

I know of no reliable source directly linking vaccine-induced maternal immune activation with the child's schizophrenia, or with any other neurological disorder in the child for that matter. That's not to say there's no link. It's an active research area. Let's put it this way: I know of no reliable review where the authors say one way or another whether such a link is plausible. Eubulides (talk) 06:38, 30 November 2007 (UTC)

Prenatal infection

User:Hardyplants reverted the new section on the grounds that it "was a misunderstanding of the issue, Its the mothers imulogical response that is harmful to the baby, not the virus its self." I'm afraid this is based on a misreading of the new section. The new section does not say that the virus harms the baby. It says there is evidence that exposure to infection helps cause schizophrenia. This closely mimicks the cited source (Brown 2006), which says "Accumulating evidence suggests that prenatal exposure to infection contributes to the etiology of schizophrenia." I see nothing incorrect about the new section, as far as it went; it was deliberately vague about exactly how an infection might cause schizophrenia. But I sense that Hardyplants also wants the article to contain something about a possible link from flu vaccine via maternal immune response and schizophrenia. Here the scientific case is much more speculative, but I made a further change to try to address that point. Eubulides (talk) 06:38, 30 November 2007 (UTC)

User:Orangemarlin then reverted the further change, on the grounds that "Neither reference supported this silly piece of original research." I don't see how Orangemarlin could have come to that conclusion. The new section is not original research. Here are all the sentences in the new section, along with quotes from the cited sources that directly support these sentences.

• "There is evidence that prenatal exposure to infection helps cause schizophrenia." This is directly supported by the first reference (Brown 2006, PMID 16469941) which says, "Accumulating evidence suggests that prenatal exposure to infection contributes to the etiology of schizophrenia."
• "Associations have been found between schizophrenia and rubella, influenza, and toxoplasmosis." This is directly supported by Brown 2006's "Prenatal infections that have been associated with schizophrenia include rubella, influenza, and toxoplasmosis."
• "For example, one study found a seven-fold increased risk of schizophrenia when mothers were exposed to influenza in the first trimester of gestation." This is directly supported by Brown 2006's "first trimester exposure to influenza conferred a 7-fold increased risk".
• "This may have important public health implications, since there are several strategies for preventing influenza and other infections, including vaccination, antibiotics, and simple hygienic measures." This is directly supported by Brown 2006's "This may have important public health implications, given that there are many available preventive strategies for influenza and other infections, including vaccination, antibiotics, and simple hygienic measures."
• "When weighing the benefits of protecting the woman and fetus from influenza against the potential risk of vaccine-induced antibodies that could conceivably contribute to schizophrenia, influenza vaccination for women of reproductive age still makes sense, but it is not known whether vaccination during pregnancy helps or harms." This is directly supported from the following quote from Arehart-Treichel 2007: "'Vaccination against influenza for women who are of reproductive age and sexually active makes sense. It isn't clear yet whether influenza vaccination during pregnancy could be helpful or harmful,' Brown added. 'One needs to weigh the benefit of protecting the woman and fetus from influenza against the potential risk of a vaccine-induced antibody elevation that could conceivably predispose to schizophrenia.'"

I suppose one could argue that the new section relies too heavily on Brown, but Brown is one of the most important researchers in this area, and I don't detect any sign of him being on the fringe. So, unless I hear good arguments otherwise, I'm inclined to put this material back in, in one form or another. Eubulides (talk) 06:38, 30 November 2007 (UTC)

Perhaps OrangeMarlin hasn't encountered your editing before or hasn't separated your editing from those he usually reverts. It's certainly ... interesting ... to see your edits being associated with "fringe theories". The danger of these PMID articles is that they are only abstracts (unless you have access to the whole article, which some of us have). Most of the abstracts are written with very broad language. OrangeMarlin, Eubulides reads the research, and not just single studies; he seeks out reviews. He is not in the habit of 1) basing his edits on PubMed abstracts or 2) basing his edits on the popular press. Please discuss, and try not to use words like "original research"[1] in your edit summaries about serious Wiki editors who have authored multiple featured articles. SandyGeorgia (Talk) 13:42, 30 November 2007 (UTC)

Again, this is an active research area, but it does appear that prenatal immune events do affect the adult nervous system and can contribute to schizophrenia. Plausible mechanisms have been proposed. See, for example, Romero et al. 2006 (PMID 17180123), Lencz et al. 2007 (PMID 17522711), Waddington et al. 2007 (PMID 17720028), Edwards 2007 (PMID 17688466). However, we don't know which (if any) model is correct. Most likely none of them are; the actual mechanism, whatever it is, is likely to be complex. We lack epidemiological data that would indicate either cause for concern or cause for unconcern about flu vaccination in pregnant women helping to cause schizophrenia in children. All that being said, the CDC recommends that pregnant women get flu shots, and we should definitely mention that. Eubulides 18:59, 30 November 2007 (UTC)

Yes, I agree completely with your summary of the matter. MastCell ^Talk 19:14, 30 November 2007 (UTC)

OK, thanks, I added stuff about the CDC's recommendations and re-added the section. A few points. First, this time I put it under "Arguments against widespread vaccination" since that seems a bit more logical place for it in the current (poor) organization. Second, the CDC's 2007 recommendations (which are not yet in Pubmed; that's too bad, as they've been out since July) have a lot more on pregnant women and flu vaccines than the 2006 recommendations did. This topic is clearly of some concern to the CDC, and rightly so. Eubulides 20:05, 30 November 2007 (UTC)

I'm on my way to leave a note for OrangeMarlin. SandyGeorgia (Talk) 20:35, 30 November 2007 (UTC)

Thanks. Orangemarlin's comment in the change log was "Read the citations. One citation is a great reason to get vaccinated, since rubella exposure might lead to lowered IQ." For the record, I had read the citations. (:-) Obviously rubella exposure is bad news for the fetus; nobody is disputing that. But the section in question is primarily about flu vaccine, not rubella, because that's where most of the professional and public concern is. In writing the section I attempted to give plenty of space to the mainstream position that flu shots are recommended for pregnant women, without giving undue weight to the theory that there might conceivably be a schizophrenia-related problem. No doubt the section could be improved, but I think that the article will be stronger if it addresses this topic. Eubulides 20:55, 30 November 2007 (UTC)

OK, you just can't invent what I say or mean. I read the article, and it clearly makes no mention of your claim. "Conceivably" is a weak word. I can conceive of lots of stuff in medicine, but that doesn't mean it actually happens. And I disagree that added this topic strengthens the article. Why do we encourage crap science on Wikipedia? The very last thing we want is someone who types "Vaccine" into google, and finds this article, making an insanely bad decision on vaccination. I run a medical products company (and am a physician with a strong science and medical research background), and I hate urban myths. I'm not opposed to inclusion, but it's got be one sentence, and it's got to be iterate that it is speculative. I can see some shyster with the 1-800-SUETHEM, putting an ad on late night TV with this kind of stuff. It's bad news. OrangeMarlin ^{Talk• Contributions} 21:48, 30 November 2007 (UTC)

Which article does "I read the article, and it clearly makes no mention of your claim." refer to? And which claim? Currently "conceivably" is used in Vaccine controversy in the phrase "the potential risk of vaccine-induced antibodies that could conceivably contribute to schizophrenia". Is that the claim you are referring to? But this phrase is taken nearly directly from the cited source (Arehart-Treichel 2007), which quotes Brown as saying "One needs to weigh the benefit of protecting the woman and fetus from influenza against the potential risk of a vaccine-induced antibody elevation that could conceivably predispose to schizophrenia." Eubulides 04:05, 1 December 2007 (UTC)

I disagree with the "one sentence" limit; that's too strict, and it would eviscerate the purpose of this article, which is to describe vaccine controversies. Other sections (e.g., Vaccine controversy #MMR vaccine) do not conform to the "one sentence" limit. But even if there was such a limit, the "conceivably" phrase quoted above is part of the only sentence that casts doubt on the safety of flu vaccines, so the new section is already conforming to the "one sentence" limit. Eubulides 04:05, 1 December 2007 (UTC)

In my experience with accurately citing medical articles, the best defense is a good offense. Putting out accurate info now will forestall problems later. The information is already in the mainstream media; why should we ignore it rather than address it reliably? SandyGeorgia (Talk) 22:01, 30 November 2007 (UTC)

Valid point Sandy, but I would hate crossing the line from being accurate to encouraging it. My problem remains that just because someone is whining about it publicly doesn't make it real. MastCell pointed me to Duesberg hypothesis which is one guy pushing a bad theory. Anyways, can we write it in a way that states that it is far from causal? OrangeMarlin ^{Talk• Contributions} 22:06, 30 November 2007 (UTC)

Eubulides is usually able to accomodate discussion and dig up sources that help; I'm confident he can work out the text in a way that everyone can end up happy; the reason I pulled the text out of the article to begin with is I was counting on him to investigate thoroughly as he usually does :-) I'm trying to figure out if I got the football analogy backwards, since I'm really a Lowell/Beckett person. SandyGeorgia (Talk) 22:10, 30 November 2007 (UTC)

Problems

[[:Image:August Hirt.jpg|thumb|150px|right|August Hirt dissecting a corpse.]] There are several aspects not adequately covered. Not all vaccine critics are hysterical pseudo-scientists. For example:

• Some critics are opposed to just one vaccine or another (e.g., Chicken Pox, which does not directly kill infected children, although it may end in death due to complications such as Staph infection or end in death due to a suppressed imune system.) This vaccine may be dangerous to children who are not vaccinated because it may delay the onset of chicken pox infections until a later age, when it may cause sterility and other problems. I personally hold the view that Chicken Pox vaccine causes more harm than good, unless or until it is shown as a safe and effective prevention of shingles. (Currently, there are rumors that this is likely the case, but no FDA submitted studies that I know about).

• Some critics are opposed to mandatory vaccination (e.g., against diseases that are sexually transmitted) on civil rights grounds.

• Some critics are opposed to mandatory vaccination on religious grounds (E.g., Amish, mennonites, Jehovah witness).

• Some critics are opposed to certain vaccines on fruit of the poisonious tree grounds, e.g., because they were developed using aborted fetuses. This would be akin to Asian medical school students refusing to benefit from NAZI dissections of unwilling Asian and other subjects.

• Macro benefit versus micro benefit: as the percentage of a society that is vaccinated increases, the marginal risk of getting vaccinated is essentially constant while the marginal benefit of getting vacinated decreases. That is, at the micro-level, the risk/reward ratio increases as vaccination rates approach +90%. In this case, it may be rational at the micro level to not get vaccinated, while at the same time it is rational at the macro level to suppress the affect on the risk/reward ratio, in that it may lead to lower vaccination rates. (Hence, the need for propaganda on the part of government organizations).

• The uncompensated paperwork involved in reporting adverse reactions leads to under reporting.

• And, of course, the nuts who think vaccines are a communist plot to pollute their precious bodily fluids.

That's all for now. CM (talk) 21:58, 21 January 2008 (UTC)

Many of these points are already covered by the article. Some of the topics are so large that they have subarticles (e.g., Vaccination and religion); in such cases the usual Wikipedia policy is to have a short section in this article, and refer to the subarticle for the bulk of the discussion. Specific suggestions for improvement are welcome, of course. Eubulides (talk) 02:24, 22 January 2008 (UTC)

Yes, this seems to be censoring (via marginalization) information.[2] CM (talk) 18:15, 22 January 2008 (UTC)

The practice of using subarticles to handle large topics is widespread on Wikipedia and is hardly "marginalization". Vaccine controversy gives more space to anti-vaccination arguments than to pro-vaccination. Adding lots more detail about relatively minor arguments against vaccination (such as disputes over paperwork or filing fees) is out of place here; if included its sheer volume would make for a POV that is out of place in Wikipedia. That sort of detail belongs in the subarticles. When there is a subarticle, only its top-level big ideas belong here. Eubulides (talk) 20:06, 22 January 2008 (UTC)

Column inches is one measure. The placement of the column inches is another. This article might be better organized in a pro/con section by section, instead of pro (multiple sections) con (multiple sections) remedies (one of the smallest and latest sections). CM (talk) 20:24, 22 January 2008 (UTC)

I tend to agree with you on the organization issue. It'd be a lot of work, though. It's been tried during the past year, but that effort failed; please see #Vaccination and schizophrenia above and search for "point-counterpoint". Eubulides (talk) 20:38, 22 January 2008 (UTC)

Well, good. Maybe we can collaborate later. CM (talk) 20:59, 22 January 2008 (UTC)

Injured persons are usually referred to as victims in tort

A recent change was made on the grounds that "Victims is a bit POV.". The word victims was replaced with "claimants," which seems a bit double-speakish to me.
See also:

• Threats and Responses: Leagal Risks; For Victims of Vaccine, Winning Case Will Be Hard By Robert Pear/The New York Times.
• "It was revealed Monday that another victim, a 24-year-old man, whose identity was kept secret at the family's request, died on Jan. 2." This was a victim of the disease, not a vaccine. Sorry. ^{Brazil suspends exports of yellow fever vaccine to satisfy domestic demand Xinhua}

Injured persons are usually referred to as victims in tort. CM (talk) 23:45, 21 January 2008 (UTC)

The cited source says neither "victims" nor "claimants". It says "people". I made this change to have the article match the source more closely here. Eubulides (talk) 02:18, 22 January 2008 (UTC)

The source above use the term "victim". CM (talk) 18:14, 22 January 2008 (UTC)

Victims is a pejorative term. I would submit that these families ought to be thankful that their children aren't dying of any number of diseases. Just because ONE source uses that term, doesn't mean a thing. In a strictly legal sense, it is a claimant. They've won nothing (and I submit they deserve nothing, but who cares), so they are nothing more than claimants. But people is fine too, although reads kind of weird. OrangeMarlin ^{Talk• Contributions} 18:18, 22 January 2008 (UTC)

Victims is a legal term for those who are injured--although, until they are successful, they are probably claimants or plaintiffs.

Stating that "I would submit that these families ought to be thankful that their children aren't dying of any number of diseases" is extremely provocative and insensitive, considering many of the victims are probably dead, killed by lethal vaccine: A payout of $1.18E9/1500 victims is over $750,000/victim--an average payout that does not indicate mere temporary discomfort due to high fevers and rashes. CM (talk) 18:37, 22 January 2008 (UTC)

Yup, it is provocative and insensitive and highly POV, so I don't write it in the article. But I'll say it here. These people ought to thank me, manufacturers, their physicians, the researchers, everyone that their kids are alive. They should shut their mouths, and quit trying to suck money out of the pharmaceutical companies. OrangeMarlin ^{Talk• Contributions} 20:47, 22 January 2008 (UTC)

The MDs, manufacturers, and researchers want the glory (thanks) but not the financial responsibility, preferring "no fault". I am thankful for pool chlorination, personally. CM (talk) 21:06, 22 January 2008 (UTC)

There should be no fault. Tort law makes it difficult for vaccine manufacturers to get product to the market. Furthermore, it adds significant cost. The system should be if the pharmaceutical company takes the risk to bring it to market, it must comply with the laws of the local jurisdiction (in the US, that would be the FDA). If they lie, take them to prison, as what happened with CR Bard when they tried to cover up the fact that radiopaque tips of their angioplasty catheters broke off in the coronary artery. Like I said, if they don't want the vaccine, don't take it. They'll die or become seriously ill, it doesn't matter to me--perfect Darwinian selection. OrangeMarlin ^{Talk• Contributions} 21:31, 22 January 2008 (UTC)

The odd thing is that the Vaccine Injury program is being presented as if it were proof that vaccines are harmful or deadly. In fact, the opposite is true. The program exists because universal vaccination is undisputably a societal good. We've replaced thousands of cases of disease or disability due to disease with a handful of cases due to vaccination. Still, many ethical readings (including my own) suggest that we as a society owe compensation to individuals injured by vaccination, regardless of the unanswerable issue of whether they would have gotten sick if they hadn't been vaccinated, and regardless of the undeniable fact that vaccination saves countless lives. The Vaccine Injury program is a recognition that vaccination is of huge benefit to society as a whole, though associated with harm in a handful of cases which we as a socity are obliged to try to mitigate. MastCell ^Talk 19:25, 22 January 2008 (UTC)

Vaccines are in fact deadly in some cases. The diseases they prevent are not always deadly. See chicken pox, for example. Chicken pox does not kill children. A very small number of children do die when they have chicken pox, or due to pre-existing conditions exacerbated by chicken pox, but as far as I know, no child with an intact immune system has died from chicken pox. The Chicken pox vaccine's value is mostly economic—enabling parents to work instead of tending to polka dotted children. Meanwhile, the medical profession which is silent on the over prescription of chicken pox vaccine is vocal when it comes to the use of anti-biotics to treat ear and sinus infections in children warehoused in daycares. The issues are far more complicated than Vaccine always good, vaccine skeptics always nutty. Also, I don't think anybody denies that it is a societal good. However, think about the differential effect on the risk/reward ratio as the percentage of the "herd" that is vaccinated increases, and you may see that in some cases it is rational for an individual to quietly decline vaccination. (See my comments in a previous section on this topic). CM (talk) 20:27, 22 January 2008 (UTC)

Actually, chickenpox is not merely a cosmetic or economic issue. Varicella is the leading cause of vaccine-preventable death in the U.S. Prior to the introduction of the vaccine, about 40 children died of varicella annually, and most were immunocompetent and did not have pre-existing risk factors for severe disease (PMID 9603627). The varicella vaccine does save lives and not just get parents back to work (PMID 15689583). Adults have it worse: the rate of varicella pneumonia among healthy adults with primary infection is about 1 in 400 (PMID 3763290), and this complication carries an overall mortality rate of 6-19% (PMID 12765439). "Chickenpox does not kill children" is incorrect, as is "no child with an intact immune system has died from chickenpox". I'm not sure where you're going with the antibiotics thing, but perhaps we're already off-topic enough. MastCell ^Talk 20:39, 22 January 2008 (UTC)

Thanks MastCell. I'm not sure reliable sources are going to help. BTW, YOU talked me into coming to this article. Grrrrrrrrrr. Back to drinking. OrangeMarlin ^{Talk• Contributions} 20:48, 22 January 2008 (UTC)

edit conflict: "40 children died annually." Is that in the United States? Annually? By way of comparison, about 260 children under the age of 5 die each year in the United States by drowning.[3] 1.3 million children are aborted yearly.[4] That is 148 children per hour.

I am skeptical that "most were immunocompetent and did not have pre-existing risk factors for severe disease." Did they die from Chicken pox or staph infection? With the vaccine, the number of adults who die from chickenpox will go up in the future (my speculation but seems logical enough). CM (talk) 20:52, 22 January 2008 (UTC)

It depends on how much one values a child's life. If children's lives are not worth much, then Cagey Millipede is correct that the biggest economic benefit of childhood chickenpox vaccination is letting parents work; see the economic analysis in Preblud 1986 (PMID 3093966). However, if the children's lives are considered to be valuable, then those calculations are, shall we say, incomplete. Preblud reports two deaths per 100,000 varicella cases among otherwise-healthy persons; the rate rises to 7.2 deaths per 100,000 for babies (under age 1), and 30.9 deaths per 100,000 for adults (above age 19). Speculation and comparison to abortions etc. is out of place in this article: we need reliable sources and we need to stick to the topic. Eubulides (talk) 21:04, 22 January 2008 (UTC)

Yes, sorry, somehow I was led off track. My main point was that it was not POV to call a person injured by a vaccine a victim. It is nuetral. So, I guess this concludes the matter. CM (talk) 21:09, 22 January 2008 (UTC)

Also, thanks for this refernce, as it seems to be in agreement with a lot of what I was arguing. I am impressed that you shared the source. CM (talk) 21:13, 22 January 2008 (UTC)

Except for the fact that a child who develops Chickenpox is at greater risk for Herpes zoster, which can be debilitating and extracts a high cost to society. Once again, cutting off the argument without discussing all consequences lessens the value of the vaccine. OrangeMarlin ^{Talk• Contributions} 21:26, 22 January 2008 (UTC)

I think we agree. Previously (in the previous section) I wrote: "I personally hold the view that Chicken Pox vaccine causes more harm than good, unless or until it is shown as a safe and effective prevention of shingles." Should we take this to a Talk page? CM (talk) 21:47, 22 January 2008 (UTC)

Sorry for my contribution to dragging this thread off-topic. As to its original issue, I like Eubulides' edit ("people" vs. "victims" or "claimants"). MastCell ^Talk 06:01, 23 January 2008 (UTC)

A summary of the controversy is not a lie

This change removed the following text:

Two recent major vaccine controversies occurred in the U.S. and the UK, concerning hypotheses linking vaccines to autism spectrum disorders: the vaccine preservative thiomersal controversy, and the MMR vaccine controversy. These controversies are independent, as the MMR vaccine has never contained thiomersal.

with the comment "Per WP:WEIGHT. Let's keep the lies out". I don't see any "lies" in the quoted text; on the contrary, the quotation contributes the useful information that the two vaccine controversies are independent. Furthermore, the controversies are indeed major ones: if you visit Google News right now, both the MMR and the thiomersal controversies have seen dozens of articles in the past month, far more than any other autism-related story. This article is about vaccine controversies; it is not neutral to summarize the controversy merely with a statement "There is no evidence that any childhood vaccine contributes to autism.", as the above change does.

The newly added claim is also incorrect in its own right. There is some evidence that childhood vaccines contribute to autism. The problem is that the evidence is not scientific. Furthermore, the citations given in support of the claim do not, in fact, support it. The first citation (Baird et al. 2008, PMID 18252754) merely gives strong evidence that Wakefield's MMR hypothesis is wrong. The second citation (Fitzpatrick 2007, PMID 17688775) is also about MMR. Neither citation suffices to prove that there is no evidence that any childhood vaccine contributes to autism; they are both talking only about MMR.

For now I have attempted to work around the problem by removing the "Autism" section header entirely, but I think this has removed useful information (such as the independence of the controversies mentioned above). Eubulides (talk) 08:46, 10 February 2008 (UTC)

In an article about the controversy, I'd expect to see definitional summaries of the controversy, so I can't agree with the removal of that text. SandyGeorgia (Talk) 22:37, 10 February 2008 (UTC)

I'm sorry, but if we put in every little nutjob insinuation with every medical article, we're going to have a HUGE project going. They are lies, they have been disproven in current literature. It's like the Dinosaur article keeping information in that T. rex was carried on Noah's Ark. I don't think we should keep crap science in these articles. But Eubulides, do whatever you want. I'll revert if it continues to promote out and out lies. OrangeMarlin ^{Talk• Contributions} 19:22, 11 February 2008 (UTC)

I think so long as the mainstream view is properly presented as such, we're OK. It's acceptable to note that there is a controversy, just as it's acceptable to note that there is a controversy surrounding intelligent design and evolution. That doesn't mean ID is right, just that there is a controversy. Science comes down quite heavily on one side of these controversies, and we need to make that clear, but that doesn't mean there's no controversy. I'm all for excluding tiny-minority or "nutjob" views from the encyclopedia, but the idea that vaccines are harmful is, unfortunately, not a tiny-minority view in the general populace, though it is such in the scientific community. I don't think Eubulides has an agenda here beyond making the article better - certainly I've been impressed with his work on other vaccine/autism-related topics - so I think we should be able to find common ground. MastCell ^Talk 19:29, 11 February 2008 (UTC)

But there isn't one reliable source that states that autism has anything to do with vaccines. The controversy is manufactured. The way the section read was that essentially vaccines caused autism. If it were written "some dumb-ass lawyers tried to mind-fuck the American populace with bullshit research that was refuted by about 1000 articles published in peer-reviewed articles," ok, I'd be fine with that. We can probably edit my commentary down a few notches, but my point is why given the autism POV-pushers any latitude at all? It has to be definitive, in that we're giving undue weight to a LIE, so let's give proper weight to the vast bulk of research that states vaccines and autism are unrelated. Let's call it a lie, a manufacturing of evidence. To claim otherwise is just plain wrong. And by the way, don't know anything about Eubulides, but he appears to be an POV pusher of Autism and vaccines. Just calling it how I see it. OrangeMarlin ^{Talk• Contributions} 19:40, 11 February 2008 (UTC)

That certainly hasn't been my experience; he's done excellent work cleaning up a walled garden of autism POV forks created by one of our worst offenders on the subject, for example. While most of the medical sources alleging a link are questionable (Wakefield and Geier's work, Medical Hypotheses articles, etc), the issue has achieved enough prominence that medical science (in the form of the IOM and others) have taken the time to address is quite extensively. And as you point out, the battle has moved from the scientific to the legal arenas, where the standards and operating assumptions are quite different. All of this is evidence that a controversy exists. If the section is written to suggest that vaccines cause autism, I will be the first to object, as there is a scientific consensus that there is no convincing evidence of such a link. If the article simply says that there have been recent controversies regarding the vaccines and an alleged link to autism, then I think that's a verifiable statement of a notable fact. So long as it goes on to provide context, I don't have a problem with it. I also agree that it's important to point out that MMR and thiomersal are two separate issues, as this is not intuitively obvious. The controversies surrounding specific pieces of evidence produced by specific researchers are probably addressed at Andrew Wakefield, Mark Geier, etc.

I should add that my personal views are probably closely akin to yours, particularly with regard to the shift to the legal arena. Drug companies can be justifiably accused of a lot of things, but vaccine development is one of the undeniable societal benefits that they provide, and it's very unfortunate that the already-meager resources allocated to vaccine development will likely be eliminated by this legal action at a time when we've got problems. At the same time, this controversy is not really "manufactured" in the sense that the tobacco industry manufactures controversy about secondhand smoke. It arose organically, in concert with other issues (increasing number of recommended childhood vaccines, increases in autism diagnoses, declining prevalance of vaccine-preventable disease) though it has certainly been exploited by a variety of groups. MastCell ^Talk 20:00, 11 February 2008 (UTC)

OrangeMarlin, I've worked with Eubulides on many articles, and that is not at all my experience with or impression of Eubulides. SandyGeorgia (Talk) 20:03, 11 February 2008 (UTC)

My experience with Wikipedia is that I give good faith, I get screwed by sockpuppets, POV-warriors, etc. He doesn't appear to be an NPOV editor. I call it how I see it, even though you two are two of the probably 20 editors I actually trust, so I'll be nice. But let's just say I need some convincing. OrangeMarlin ^{Talk• Contributions} 20:26, 11 February 2008 (UTC)

By the way, see this. SandyGeorgia (Talk) 23:58, 11 February 2008 (UTC)

I don't need to apply AGF wrt Eubulides: I've edited in conjunction with him for almost a year, and the proof is in his work. He is also strictly professional and has a calming influence on difficult talk pages. My experience with AGF is different than yours. I've learned (through trial by fire) that if I edit civilly and with good faith, I will prevail against injustice in front of ArbCom; those who don't, are likely to be sanctioned by ArbCom in addition to finding themselves in constant imbroglio. I'm proud to be in the company of editors of Eubuldes' caliber on numerous article talk pages, where AGF, civility and patience have consistently produced improvement in Wiki articles. SandyGeorgia (Talk) 20:47, 11 February 2008 (UTC)

Oh well. OrangeMarlin ^{Talk• Contributions} 22:27, 11 February 2008 (UTC)

I second Sandy's assessment. I've yet to come across an editor more committed than Eubulides to using (a) the very best sources and (b) basing the text on them, no more no less. An article on "Vaccine controversy" must cover significant controversies, whether they have any scientific foundation or not. An encyclopaedia must document the world as it is, warts and all, not as we'd like it to be. I see no lies or harm in the text that was removed. Colin°^Talk 22:38, 11 February 2008 (UTC)

And I don't? I'm like the most anal retentive editor for references. I dug up the one that basically said the autism story was big fat lie. I'm fairly committed to this project, but Eubulides gets to work on the easy articles. I work on the crap articles. I used to be in the Navy, and because I'm an MD, I got to wear nice pretty uniforms, unless I was in scrubs. But I knew that there were men and women getting their fingernails dirty, getting killed, and standing on the line. I'm standing on the line, and I don't get the luxury of AGF, NPA, etc. Whether Eubulides is a great editor or not, matters not to me. There is a weight issue by pushing a POV that includes a completely discredited statement. OrangeMarlin ^{Talk• Contributions} 23:01, 11 February 2008 (UTC)

They aren't easy articles, Orange; they're subject to canvassing and POV and off-Wiki attacks on our good names just as ID et al are. You might not realize that both Eubulides and I were the targets of off-Wiki attacks on the largest autism forum, earning us scrutiny and watchers,[5] and where I was also falsely accused of being a drup rep, and it was claimed that I have TS and OCD (false). Because of that, I spent my holiday in front of ArbCom, and it was hellish. I prevailed because there is and never will be any evidence against me of any violation of Wiki's etiquette and civility policies. If we give POV pushers the upper hand by failing to AGF, they win in front of ArbCom. Contrast my case to another recent case of a now-departed editor. SandyGeorgia (Talk) 23:06, 11 February 2008 (UTC)

(outdenting) SandyGeorgia gets 1000 times the grief that I do, despite being a much better editor. (Or perhaps that's because editor quality is correlated with grief-getting?) Changing the subject slightly, I recently discovered that many chiropractors oppose vaccination and added a note to this effect to Vaccine controversy without (ahem) controversy so far, but when I made a similar addition to Chiropractic it was almost immediately reverted with the comment "We need to discuss this on Talk first." The discussion there has not been conclusive yet; I hope that something will go in, but given the mess and controversy surrounding that article I'm not sure it's worth the effort to try to clean up the stables there. Eubulides (talk) 06:10, 12 February 2008 (UTC)

Eubulides, hopefully it is worth the effort. Please come on over to chiropractic. There are a number of issues at the moment that need you. Mccready (talk) 11:15, 12 February 2008 (UTC)

OrangeMarlin, don't piss-off your allies. Calling Eubulides a "POV pusher of Autism and vaccines" or saying he just works "on the easy articles" doesn't help and the only reason it isn't offensive is that it is so laughably untrue. Perhaps Eubulides doesn't wear a pro-mainstream POV on his sleeve quite as prominently as you, but that is because we are all supposed to be discussing the article, not the people, and trying to write what our sources say, not what we want to say. The controversy may well be based on a 100% false hypothesis, but it still exists and has been on the front page of many newspapers for years. Trying to suppress that is a book burning attitude that won't help the battle to produce a NPOV article. Colin°^Talk 11:08, 12 February 2008 (UTC)

Chiropractic and the vaccine controversy

Hi all, I just stopped in after Eubulides stopped in at the chiropractic article making some perfectly valid points concerning chiropractic and an anti-vaccination stance. There is a colorful history associated with this that was probably at the heart of the medicine/chiropractic turf wars from the 1920s to the 1950s. Yes, it was heated and hard fought as medicine worked very hard and basically succeeded in getting enough people vaccinated. The efforts of chiropractors to stop the process may well have been the impetus that caused chiropractic to lose face with the public health machine that was reacting to the very frightening polio outbreaks. In 1963, BJ Palmer died and chiropractic began a different path; increasing education standards and so much more. My point here is that the statement about chiropractic in the first section concerning the controversy is a little over the top:

• Traditional chiropractic opposes vaccination on the grounds that all diseases are traceable to causes in the spine, and therefore cannot be affected by vaccines; Daniel D. Palmer, the founder of chiropractic, likened vaccines to "filthy animal poisons", and they remain controversial within chiropractic. The American Chiropractic Association and the International Chiropractic Association support exemptions to compulsory vaccination laws. The Canadian Chiropractic Association supports vaccination, but even in Canada, surveys have found that over a quarter of chiropractors oppose vaccination and advise patients against vaccinating themselves or their children.

While it probably won't make too much of a difference, I think we have to go further in describing 1) what "Traditional" chiropractic is (a small but very vocal group).. 2)clarify why the ACA and ICA statements currently support exemptions. The way we have it written makes it sound like they are against vaccinations, but really they are pro freedom of choice. I think it is important to give exactly the weight that chiropractors do play in this debate. In other words, if we state that ALL chiropractors are against vaccination that empowers the anti-vaccinationists too much because we are talking about 70,000 chiropractors out there preaching "no vaccines", which I am sure we all agree would be quite a force to reckon with. But, if we say that NO chiropractors are against vaccination, that would be wrong, too. If it is okay with everyone, I can try to reflect this in the article. I would consider this to be a good neutral source [6]. I would also need that survey that is mentioned in the paragraph above. -- Dēmatt (chat) 01:48, 13 February 2008 (UTC)

The source looks good - Pediatrics is definitely a solid journal. Interesting article, by the way. MastCell ^Talk 04:41, 13 February 2008 (UTC)

I agree, I think it gives a thorough evaluation and is my understanding from all the history research I've done on chiropractic. If only we could get it all in one paragraph! -- Dēmatt (chat) 05:03, 13 February 2008 (UTC)

Thanks for the suggestions and for the pointer to Campbell et al. 2000 (PMID 10742364). I made this change to capture the suggestions as best I could. Further comments are welcome. Eubulides (talk) 06:33, 13 February 2008 (UTC)

No problem, I would also suggest that having the chiropractic section under 'Effectiveness" seems out of place. Maybe a new section called "The culprits" :-) or something less POV I suppose, you know what I mean. ---- Dēmatt (chat) 19:49, 13 February 2008 (UTC)

Thanks. We've been meaning to reorganize the page, and I'll try to remember this suggestion for when that actually happens. In the meantime, the core of the chiropractic philosophic objection seems to be that vaccines are ineffective, so why take the risk? In that case, Effectiveness seems a bit more apropros than Safety. Eubulides (talk) 20:18, 13 February 2008 (UTC)

My understanding of the topic is that philosophic objection doesn't come from a lack of effectiveness, but rather it is inserting a pathogen to boost immunity as opposed to strengthening the host from within. Straight DCs would suggest that spinal manipulation can boost immunity and there is very limited but interesting research that suggest neuro-immunological improvements in asymptomatic subjects (Injeyan et al. 2006) following manipulation. I would agree with Dematt suggestion that a separate section dealing with this might be more appropriate, but will defer to you as you're more familiar with this article. EBDCM (talk) 20:25, 13 February 2008 (UTC)

But we have a 1995 survey saying about a third of U.S. chiropractors believe that there is no scientific proof that immunization prevents disease. This very much sounds like an argument against effectiveness. There is undoubtedly a safety argument too, but the effectiveness argument seems to be the core: if vaccines don't work, why take the risk of using them? Eubulides (talk) 20:49, 13 February 2008 (UTC)

Wow, that was 13 years ago. And that is 1/3? So 2/3 did think there was proof back then. I'm willing to believe that these new guys graduating since the advent of HMOs and integrated healthcare are less likely to feel that they don't, but I also realize we have to go with the V and RS. EBDCM, didn't the CCA just recently make the statement concerning vaccinations? Basically, there are an aweful lot of people that respect their chiropractors and I don't think we should give those that read this an erroneous reason to not get vaccinated. We need to be careful to get it right. -- Dēmatt (chat) 20:59, 13 February 2008 (UTC)

The 1/3 is just one example from the survey. Here's another: more than half of those surveyed thought that the risks of pertussis vaccination outweigh its benefits. And more recent surveys (in Canada) show a similar pattern. For example, a 2000 survey in Canada (cited in Busse et al. 2005) found that about 30% were anti-vaccination, about 40% were pro-vaccination, with the remaining 30% unsure. The CCA statement is motion 2139/93, which I guess means it's dated 1993. The ACA statement (which opposes mandatory vaccination) is dated 1998. As Campbell et al. 2000 make clear, the ACA officially recognized that vaccination was cost-effective and clinically practical in 1993, but withdrew this recognition in 1998. So the official statements of chiropractors turned more against vaccination in 1998. I see no evidence from reliable sources that chiropractors have become more pro-vaccination in the past decade; this is not to say that no movement has occurred, just that we know of no reliable evidence that it has. Eubulides (talk) 21:12, 13 February 2008 (UTC)

Pertussis is interesting, since in 1995 there was still a significant residual scare over the whole-cell pertussis vaccine (e.g. PMID 9652634) - I'd be curious to know if this view has persisted in the chiro community since the advent of acellular pertussis vaccine, but without a good source we could only speculate. In terms of actual content, I think we're on the right track by citing position statements of major chiropractic organizations and surveys of opinion on the ground, though I agree we should carefully contextualize when these surveys were done. MastCell ^Talk 21:24, 13 February 2008 (UTC)

I did find another survey, but this was published in a conference and not a refereed journal so I don't think it's worth citing in the article. It was done in 2005 and surveyed chiropractors in Kansas. Some results:

• "Immunizations are effective in the prevention of disease." strongly agree 12.0%, agree 30.7%, neutral 12.1%, disagree 19.3%, strongly disagree 19.9%.
• "Encouraged patients to be immunized." yes 16.3%, no 54.2%, under certain circumstances 29.5%

So it sounds like, as recently as 2005, anti-vaccination sentiment continued to be strong but not dominant. The source: Holman S, Nyberg SM (2006). "Attitudes and beliefes toward routine vaccination: a survey of Kansas Chiropractors" (PDF). Proceedings: 2nd Annual Symposium on Graduate Research and Scholarly Projects. Wichita State University. Retrieved 2008-02-13. {{cite conference}}: Unknown parameter |booktitle= ignored (|book-title= suggested) (help) Eubulides (talk) 22:43, 13 February 2008 (UTC)

So far so good. Of course there are likely differences in those numbers depending on which vaccine they are thinking about, i.e. polio, flu, cervical cancer, etc. I would expect opposition to the flu vaccine to be much higher, yet childhood vaccines lower, except perhaps the chicken pox vaccine. Basically, though I think you are close. I still think that it is in the wrong column. It needs to be in a section of 'Who are the anti-vaccinationists' and include all the holistic groups, and whoever else you find. I am sure that each antivaccinationist group uses the same arguments, of which 'effectiveness' is only one. -- Dēmatt (chat) 02:59, 14 February 2008 (UTC)

I too think it's in the wrong section. Would the "History of anti-vaccinationism" section be a better place? Dematt's suggestion of a new section describing "Who" are opposed might be another good possibility. I see that there is no specific mention (by name) of the many anti-vax websites, some with impressive "national" titles. That's probably a good idea as they are major suppliers of extremely deceptive information that causes death, especially of children. -- Fyslee / talk 06:45, 14 February 2008 (UTC)

I dunno, the history section talks about ancient history (19th century); it's a bit of a stretch to put into it current opposition by a substantial minority of chiropractors. I still think the whole article needs reorganization . In defense of putting it under Effectiveness, most of the citations and discussion (including the new Kansas survey) are related to effectiveness. Eubulides (talk) 07:23, 14 February 2008 (UTC)

Good point. Maybe a separate section, as suggested by Dematt, might be the best solution. To the best of my knowledge, chiropractic represents the largest organized anti-vax group from any single profession, with centralized resistance being maintained until rather recent times, and still maintained by the International Chiropractic Association and World Chiropractic Alliance. There are various anti-vax groups composed of all types of people, but organized resistance in chiropractic is an old phenomenon with a substantial number of chiros still maintaining such views. Both DD Palmer and BJ Palmer were vehemently opposed to vaccinations, surgery, and higher educational standards, so it can take time for such resistance to subside. -- Fyslee / talk 15:25, 14 February 2008 (UTC)

In all fairness to chiropractors, one of the best pro-vaccination information websites that deals with the controversies is run by a chiropractor, Lon Morgan. Even if it might not be deemed a RS, it contains excellent information and can be used as a metaresource:

• Issues in immunization

I think the Kansas survey could be included and attributed as results from Kansas. It is a professional piece of work, and since such surveys are uncommon, we need to cite those we have. -- Fyslee / talk 06:45, 14 February 2008 (UTC)

OK, you talked me into it; I added it. Eubulides (talk) 07:23, 14 February 2008 (UTC)

Just an observation, but is chiropractic the only CAM profession which is ambivalent towards vaccination? What about naturopaths, homeopaths, acupuncturists or other providers? If so I would like to see some kind of mention of this to provide better overall context. EBDCM (talk) 23:26, 14 February 2008 (UTC)

I just now checked for that, and there are others. Here's a citation but I haven't had time to read it. Ernst E (2001). "Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination". Vaccine. 20 (Suppl 1): S89–93. doi:10.1016/S0264-410X(01)00290-0. PMID 11587822.

There are definitely others, most notably among naturopaths. Many mixer chiropractors practice with a naturopathic mindset, sharing many of the methods and philosophies found in naturopathy. -- Fyslee / talk 03:41, 15 February 2008 (UTC)

That's an interesting citation from Edzard Ernst you have found there! He is quite discerning when he writes "...many people (are led to) believe..." The part in parentheses is very correct, and he knows it. Many think that CAM is just a collection of various practices and philosophies, little realizing that it encompasses a mindset characterized by intense competition with the established medical system, and one of the tools used is to discredit the medical system by spreading false information, conspiracy theories, exaggerations of faults and mistakes, and generally failing to assume good faith. There is little genuine attempt to establish a cooperative relationship. Hence Ernst's formulation "are led to". It would be nice if we could get access to the full text. -- Fyslee / talk 03:51, 15 February 2008 (UTC)

Just as an observation, my impression in the UK is that homeopathy is far more widely practiced than chiropracty here and more influence on vaccination issues (what do I know, [7] states it is the the 3rd most popular CAM in UK). Whilst the small medical-qualified homeopath group does support vaccination (precisely because they feel it proves the Homeopathic principle of a little of what causes a disease acts to prevent it), the main non-medical Homeopathy organisations are anti-vaccination.[8]

In 2002 "More chiropractors than homeopaths displayed a positive attitude towards the MMR vaccination"[9]. See also 2003 response of "Society of Homeopaths does not advise against vaccination" http://www.bmj.com/cgi/content/full/326/7381/164 David Ruben ^Talk 21:50, 15 February 2008 (UTC)

I have a few problems with the current passage on chiropractic on vaccine

Chiropractic originally strongly opposed vaccination on the grounds that diseases are traceable to causes in the spine, and therefore cannot be affected by vaccines; Daniel D. Palmer, the founder of chiropractic, wrote, "It is the very height of absurdity to strive to 'protect' any person from smallpox or any other malady by inoculating them with a filthy animal poison."[24] Vaccination remains controversial within chiropractic. The ambivalence towards vaccination is seen by the opposing views of chiropractors and their associations. The American Chiropractic Association and the International Chiropractic Association support exemptions to compulsory vaccination laws on the grounds that vaccines have risk; a 1995 survey of U.S. chiropractors found that about a third believed there was no scientific proof that immunization prevents disease,[25] and a 2005 survey of Kansas chiropractors found them nearly evenly split over whether vaccines are effective.[26] In contrast, the Canadian Chiropractic Association supports vaccination; however, surveys in Canada in 2000 and 2002 found that only 40% of chiropractors supported vaccination, and that over a quarter opposed it and advised patients against vaccinating themselves or their children.[24]

1) the palmer quote appears gratuitous, out of context and as mccready would say is 'puff' 2) an apparent cherry picking of the evidence and finding surveys that does not represent the profession as a whole (i.e. Kansas DCs) 3) The inclusion of precise statistics as opposed to generalizable trends. Stats can easily be manipulated to a POV, trends, not so much. I would like to see the specifics here condensed into more generalizable statements. 4) this is in the wrong section; chiropractic opposition does not necessarily stem from lack of effectiveness, but differences in philosophy as to what is the right approach towards prevention of illness 5) lack of inclusion of other CAM professions who share a similar viewpoint re: vaccination.EBDCM (talk) 00:26, 18 February 2008 (UTC)

To address the points one by one:

• The Palmer quote was originally just "filthy animal poison"; this was criticized for being out of context so more context was added and it's now a longer quote. Apparently this is not the context that was desired, so what exactly is meant by the criticism that the Palmer quote is "out of context"?
• I don't see why the Palmer quote is "gratuitous". It provides motivation for chiropractic's early strong opposition to vaccination. We can't expect the casual reader to be familiar with this motivation.
• I was originally opposed to putting the Kansas data in on the grounds that it wasn't published in a refereed journal, but Fyslee liked it on the grounds that it is a reliable source. Fyslee talked me into it so I put it in. I disagree that the Kansas data is "cherry-picking"; it's the most recent survey we have and its results are not hugely different from other surveys. However, it does appear to be two editors to one right now, so for now I removed it. We can revisit this issue if Fyslee chimes in again.
• While it's true that statistics can be manipulated, these statistics (except for the Kansas data) are taken from reliable reviews, not from primary sources. When reliable reviews are reporting numbers, I don't see why the Wikipedia article should settle for vaguer statements.
• As mentioned above the article could use reorganization, but that's a big project; for now many chiropractors do argue against the effectiveness of vaccines (unlike most other skeptics, who focus on safety) so this is the most plausible location for the material now.
• Mentioning other CAM professions would be welcome, obviously supported by a reliable source. I suggest the Ernst 2001 source mentioned above.

Eubulides (talk) 01:59, 18 February 2008 (UTC)

(undent) I made a bold edit that encompasses the discussion above, mostly that the chiropractors that do oppose vaccination, do so for more reasons than effectiveness. I think it woul dbe fair to add naturopaths and homeopaths to this same section to give the reader an overall picture of who the anti-vacc people are. Feel free to revert, I'm just trying to help get it organized. -- Dēmatt (chat) 19:36, 18 February 2008 (UTC)

Thanks, I made these further changes to create a new section to talk about the alternative-medicine opposition to vaccination, and move the chiropractic material into it, along with the new material. Eubulides (talk) 21:57, 18 February 2008 (UTC)

Good move. This first sentence:

• Many forms of alternative medicine are based on philosophies opposed to mainstream medicine, and have substantial proportions of practitioners opposed to vaccination.

'substantial proportions' sounds like more than half which feels misleading. Maybe something like 'vocal minorities', although that might be considered POV, but you know what I meand.

'opposed to mainstream medicine' probably should just be 'contrary to interventions such as vaccination'. The result would be something like:

• Many forms of alternative medicine are based on philosophies contrary to interventions such as vaccination and voice their opposition.

Also, with the formulation that you have written, I think it is appropriate to narrow the chiropractic anti group to straights, so I'll go ahead and put that in the article. I think the percentages are probably similar and that group deserves the credit/blame while others do not, such as reform and most mixers.

-- Dēmatt (chat) 00:40, 19 February 2008 (UTC)

Thanks, I made [ this change] which substitutes the even-simpler "Many forms of alternative medicine are based on philosophies that oppose vaccination and have practitioners who voice their opposition." Eubulides (talk) 00:51, 19 February 2008 (UTC)

That's perfect! I made a few other simple changes that did alter some meaning, so take a look. We apparently were editing at the same time, so I'll back off and let you take a look. -- Dēmatt (chat) 01:23, 19 February 2008 (UTC)

Thanks. I made a few more changes. The inserted "straight" is plausible but is not supported by the cited source, so I removed it. The scholarly-works stuff was a bit long and weaker than necessary, so I abbreviated and strengthened it. Eubulides (talk) 04:47, 19 February 2008 (UTC)

The Ernst source did narrow the field of chiropractors to 'sections of chiropractors' and homeopaths to 'lay homeopaths'. I still think we would be more accurate to leave it at 'straight chiropractors' and even link it to that section of chiropractic so that we do not unintentionally fault/credit the reform group. These are real differences within chiropractic. -- Dēmatt (chat) 04:58, 19 February 2008 (UTC)

If I had to guess, I'd guess that most of the straights, some of the mixers, and few of the reforms are antivaccination. But we shouldn't guess. The general Wikipedia rule is that it's better to say nothing than to say something that's not supported by a reliable source. Eubulides (talk) 05:29, 19 February 2008 (UTC)

That's a cop out, Eubulides. Your outright speculating (first NO reformers would be anti-vaccination, they're evidence-based and the evidence favours vaccinnation and immunization) and clearly Ernst knows which faction it is (as you do). I support Dematts edit for many reasons and you're mainly playing a technicality here; there are many, many edits on wikipedia without reliable source far, far worse than this case. This IMO, this type of edit is petty and goes against the spirit of editing here at Wikipedia. EBDCM (talk) 06:15, 19 February 2008 (UTC)

That's not really a helpful comment, for several reasons. Eubulides isn't "playing" anything here. Characterizing his editing as "petty" and against the spirit of Wikipedia is presumptious and misguided, as he's done excellent work bringing a number of thorny articles into compliance with policy and is quite scrupulous about sourcing. The fact that other articles are poorly sourced is not a good reason to drop the bar on this article; it's an argument to improve those others. Let's talk about the edit without imputing motivations and strategies to the editor, particularly as your charges here are groundless. MastCell ^Talk 06:50, 19 February 2008 (UTC)

Of course I was speculating. That was my point. It is OK to speculate in talk pages. However, unsourced speculation should not appear in the article itself. Admittedly Wikipedia is not perfect and much unsourced material appears in it, but the WP:V#Wikipedia policy is quite clear: all material must be attributed to a reliable, published source. This is true regardless of the editor. Eubulides (talk) 07:00, 19 February 2008 (UTC)

I think your mostly right as well, though I do agree that there would be no reform chiropractors, but that, too would be speculation. I think we may have it as close as we can get it until we have a source that can reliably tell us differently as far as chiropractors go. If I see anything that helps, I'll drop it by. Thanks for working with me. -- Dēmatt (chat) 15:40, 19 February 2008 (UTC)

[undent] This is a fair compromise, sections of chiropractors. I apologize for my non-constructive post; I was a bit cranky and apparently needed some food (have noticed a strong correlation between those 2). Anyways, MastCell is right but I'm glad this was sorted out in the proper way. EBDCM (talk) 16:24, 19 February 2008 (UTC)

Graph

Shouldn't there be a graph that shows the decline of diseases before the vaccine's introduction to get an to put the decline of diseases in context? This is the basis for some of the controversy, and it should be addressed. —Preceding unsigned comment added by 96.236.9.224 (talk) 20:56, 15 February 2008 (UTC)

That would be nice, but graphs from reliable sources don't appear by magic; someone has to create them and contribute them to Wikipedia. Do you have one in mind? Eubulides (talk) 21:45, 15 February 2008 (UTC)

individual vs. group good

In many cases, the "best" for each individual would be for everyone else to be vaccinated, since indeed there might be some risk from the vaccine. This situation presents a basic tension between the individual and society. The existence of the dilemma is not very controversial, and deserves to be clearly laid out in the article.

The same applies also to quarantines etc. -69.87.203.171 (talk) 14:35, 3 March 2008 (UTC)

I agree; that tension is a central issue in many disputes or discussions related to vaccination. The challenge is to cover it in a manner supported by reliable sources, rather than by arguing the positions ourselves. MastCell ^Talk 18:53, 3 March 2008 (UTC)

I gave it a shot, with this brief change here, and this longer change in Vaccination policy. Eubulides (talk) —Preceding comment was added at 22:39, 3 March 2008 (UTC)

Reliable secondary source about the autism link

This a a credible reference that can be integrated in the article: [10] MaxPont (talk) 18:20, 9 March 2008 (UTC)

That story is summarized in a subarticle, Thiomersal controversy #Court cases, and in more detail in a sub-subarticle, Vaccine court #Proceedings. It's not clear it's worth bringing up at the higher-level of abstraction here. Eubulides (talk) 18:54, 9 March 2008 (UTC)

More RS: [11] [12] MaxPont (talk) 14:33, 22 March 2008 (UTC)

Again, the subarticles are a better place for this single court case. The first source is not reliable. It claims that the government conceded that mercury causes autism, which isn't true for two reasons: first, the government did not concede that autism was caused; second, the government did not concede that mercury caused the symptoms in question. The second source is more reliable, although it's duplicative of the NPR and AP sources already cited in the subarticles. Eubulides (talk) 00:25, 23 March 2008 (UTC)

Problem #2

The "Events following reductions in vaccination" section seems to be way to welcoming to cherry-picking, and there are no corresponding sections on the "against" side of things. The section should either report opposite findings, demonstrate that the pattern is absolute, or not be given such a prominent part of the article.Not even Mr. Lister's Koromon survived intact. 04:20, 23 April 2008 (UTC)

• Are there any examples where vaccination rates dropped significantly, followed by a significant decrease in infection rates? If so, these would be worth citing: the material is in the Vaccine controversy#Arguments for section, and under the article's current organization these counterexamples (if they can be found) should appear under Vaccine controversy#Arguments against.
• Demonstrating that the pattern is absolute would require proving a negative, no? That sounds like it's asking for a bit much; I doubt whether anybody could do that.
• It might be reasonable to turn this section into a sub-page, if it's too long, and just briefly summarizing it here.

Eubulides (talk) 05:09, 23 April 2008 (UTC)

If I remember correctly, at Leicester got rid of the vaccine and managed to eliminate disease through the oft-repeated "just need better sanitation", and according to "Dr. Beddow Bayly", Australia had almost no smallpox deaths despite not using vaccinations. While vaccination is almost certainly a good thing, there have been examples provided by the opposition where vaccinations were gotten rid of and occurrences of sickness decreased.Not even Mr. Lister's Koromon survived intact. 02:47, 24 April 2008 (UTC)

Sources would be helpful. MastCell ^Talk 04:28, 24 April 2008 (UTC)

Specifically, sources showing a causal link between cessation of vaccination and decreased incidence. Coincidental examples would also be interesting, but should be cited in terms of 'epidemiology research is messy' or of historical impact. - Eldereft ~(s)talk~ 07:18, 24 April 2008 (UTC)

....it seems to be exactly the same format as the cases "for" - merely that incidences dropped when vaccinations were supported/eliminated. I don't actually have ample sources on the subject - I'm just commenting that there seems to be a blatant imbalance, and that from personal experience, parallel instances have been put forward.Not even Mr. Lister's Koromon survived intact. 20:34, 24 April 2008 (UTC)

You're not giving us much to work with. You're saying that the section is cherry-picked, but not providing any sources which have been overlooked. The examples of disease outbreaks following a decline in vaccination are sourced to good-quality peer-reviewed medical literature and mainstream media (BBC). It's all well and good to complain about an "imbalance", but I'm not aware of any literature suggesting that disease rates go down after vaccination is stopped, and you've not provided any, which leaves us unable to verify or address your complaint. MastCell ^Talk 21:08, 24 April 2008 (UTC)

The section is, by nature, cherry-picked. There are no examples where increasing vaccinations either had negligible or adverse effects, and it provides only a few examples that support it's case, without only implication through these, instead of solid proof, that the claim is correct, and that the pattern is absolute. That is the main problem, and it either needs to be solved, or the section needs to be given less prominence (something that can be done even without sources). This is more of a basic problem, rather than a details one.

As for details, I don't actually have access to most of the relevant data, as I previously explained. However, you have the Leicester info in the article itself (just set very small, and hard to find, in the "history of anti-vaccination" section), so I don't understand how you're having trouble understanding my counter-examples - you already have them! The problem is that, instead of being set as a counterpart to the respective pro-vaccine info, the Leicester case has been minimalized on this page. (Oddly enough, you have a section with nothing to do with anti-vaccination right after this paragraph, doing more to extoll vaccination).Not even Mr. Lister's Koromon survived intact. 04:18, 25 April 2008 (UTC)

The Leicester case is an interesting one. I'd suggest looking at PMID 1357411 (Lancet 1992 Oct 24;340(8826):1019-21) - many libraries (certainly all medical libraries) will carry it, and it's a useful summary. The Leicester case dates to the late 1800's, and suffice to say it's not quite as simple as you make it out to be. The town largely declined mandatory vaccination - but instead relied on strict quarantine of affected individuals, the effects of which were far more harmful than those of vaccination. Additionally, the town actually did vaccinate all contacts and caregivers of infected persons. Finally, as the Lancet makes clear, the town did benefit heavily from high vaccination rates in surrounding communities. At best, the Leicester case demonstrates that a policy of strict quarantine and targeted vaccination, in the setting of a high background rate of vaccination in the surrounding community, can effectively control smallpox. As the idea of mandatory quarantine of the ill is generally considered more distasteful than the idea of mandatory vaccination, I see little applicability of the Leicester case to the modern debate over vaccination, though it remains an interesting historical event. MastCell ^Talk 18:43, 25 April 2008 (UTC)

(undent) Yes, we can only cite a subset of all available research and opinion, but we can do our best to make sure that these references reflect the full body of data and the scientific consensus. For instance, the CDC seems pretty certain that decreasing vaccination rates would have adverse public health consequences. - Eldereft ~(s)talk~ 07:32, 25 April 2008 (UTC)

Recent changes re Boenhoeffer&Heinenger and White

This change contained some good points, but some problems:

• In Vaccine controversy#Arguments for, it replaced "benefits of saving children from tragic outcomes of common diseases" with "benefits of the immunization". But the cited source (Bonhoeffer & Heininger 2007, PMID 17471032), says "Immunization safety concerns have existed since the day of the first available vaccine. Since the introduction of Jenner's cowpox vaccine, however, the benefits of saving children from tragic outcomes of common diseases outweighed the risks of perceived adverse events following immunization (AEFIs)." This is the Arguments for section, and personal disagreement with an argument is not sufficient reason for toning it down, particularly when the argument is made by leading experts in a peer-reviewed journal. Whoops! it was the Arguments against section. My mistake. I revised it to omit the "tragic effects" phrase.
• The citation to White 1896 was removed without explanation. But that citation supports the claims made. The article says "Early Christian opponents argued that if God had decreed that someone should die of smallpox, it would be a sin to thwart God's will via vaccination." White 1896 writes of the Rev. Edward Massey, who in 1772 opposed smallpox inoculation with the argument "that diseases are sent by Providence for the punishment of sin; and that the proposed attempt to prevent them is 'a diabolical operation'." The article says "The first arguments against vaccination were theological." and White 1896 writes "Early in the last century Boyer presented inoculation as a preventive of smallpox in France, and thoughtful physicians in England, inspired by Lady Montagu and Maitland, followed his example. Ultra-conservatives in medicine took fright at once on both sides of the Channel, and theology was soon finding profound reasons against the new practice." If there is some concern that the wording strays too far from the source let's see it, but in the meantime it seems to be a mistake to remove that citation, or to change the wording to say "The first arguments against compulsory vaccination claimed that they were violations of individual freedom." (the vaccination in question was not compulsory).

I made this change to accomplish the fixes suggested above. Eubulides (talk) 05:43, 23 April 2008 (UTC)

I did explain why the White 1896 citation was removed - as it is written, it is blatantly biased. It provides no basis for it's claims, on its own, and is blatantly written as an attack piece. Furthermore, as explained before, I rewrote the final paragraph because it seems to claim that modern objections are based on religion, which is opposite the claim of the reference.Not even Mr. Lister's Koromon survived intact. 20:41, 24 April 2008 (UTC)

The result of that change removed the citation to White 1896 from Vaccine controversy#Religion without otherwise changing the text. But the text itself is NPOV, regardless of whether White 1896 is biased. The change also removed the sentence "The first arguments against vaccination were theological." (citing White 1896); I don't see how that can be interpreted as claiming that modern objections are based on religion, but to avoid any ambiguity I rewrote it to give an example from 1772, and (while I was at it) gave a new citation (Noble 2005, PMID 17142878) that says basically the same thing that White 1896 does about this particular topic. Let's keep White though, since it is freely readable whereas Noble is not. Eubulides (talk) 23:55, 24 April 2008 (UTC)

To explain, for the third time' - the paragraph as a whole lends that interpretation when it puts "religious reasons" as the original objections, and then later claims that modern objections are much the same. This is patently false, as the source for the final line instead quotes that, while they have similar objections to the originals, these originals are concerns over individual freedoms, not religion. I've explained this every single time I changed that section.

A text cannot be NPOV if it is derived from a POV work. I removed the ref, because it was inappropriate, but left the text so that you could find a more appropriate source - as previously explained.

"While I don't doubt that religious objections were given, this is not an appropriate source to use."

See?Not even Mr. Lister's Koromon survived intact. 04:04, 25 April 2008 (UTC)

• Some modern objections are religious, and some are not. The text in question does not claim that all modern objections are religious. I'm afraid I still don't see the problem.
• The final line is comparing modern objections to 19th-century objections, not to the earlier 18th-century objections (which were more religious). Admittedly this is confusing and the wording should be cleared up.
• This edit removed the claim that the first arguments against vaccination were religious, and replaced it with a claim that the first arguments against compulsory vaccination were based on individual freedom. However, those are two different claims. The article can make both claims; neither trumps the other.
• In reviewing the Vaccine controversy #History I see that part of the problem is that paragraphs are in somewhat random order chronologically, which adds to the confusion.
• NPOV texts can cite POV work. NPOV sources are preferable, of course, but in this particular case the source is freely readable and is accurate about the points being sourced. If a better freely-readable source is available then by all means we can use that instead.
• I made this change to address the above issues.

Eubulides (talk) 06:07, 25 April 2008 (UTC)

1. The referenced text specifically claims that modern objections are still based on "individual freedoms".
2. "Arguments made against the safety and effectiveness of vaccines in the 21st century are similar to those of the early anti-vaccinationists." - I see nothing in there limiting it to 19th-century objections, and when I first edited the section, it said nothing about the concern over individual freedoms - which is the main thrust of the ref for that sentence. I explained EACH TIME that this is why I reworded the section.
3. I never removed the claim that early arguments were religious - if you actually looked, instead of reverting each time, it was in fact the very next sentence:

"Some anti-vaccinationists also based their stance against vaccination with reference to their religious beliefs."

No. The source being used has nothing to back it up, and is blatantly an attack piece. What you are arguing is analagous to suggesting a Hamas or Al-Jazeera site for information about Israel - while certain points in it may, in fact, turn out to be true, the source itself is blatantly unreliable, and cannot be used. I will not demand that the text itself be removed, but surely such a "scientifically-supported" view can find better sources, neh?

Your edit seems to solve most of the problems - I will add in a slight clarification to the final sentence, but I trust it should be acceptable.Not even Mr. Lister's Koromon survived intact. 08:25, 25 April 2008 (UTC)

• Suggestions for better sources are welcome. In the meantime this is what we have. It is not like present-day Israel, where there are lots of sources. There aren't that many freely-readable sources on 18th-century anti-vaccinationists.
• Thanks, that last change was an improvement, but it still has a couple of problems. First, it causes the last sentence to imply that modern criticisms are based on individual liberties but 19th-century criticisms were not. Second, there are several other criticisms common to 19th and 21st century criticims (e.g., unholy alliance for profit) and it is not clear from the source which criticisms are typical. Perhaps it's better to simplify things by omitting the criticisms; I did that. Eubulides (talk) 08:55, 25 April 2008 (UTC)

I think, at the least, the criticisms specifically mentioned in the source should be presented.Not even Mr. Lister's Koromon survived intact. 14:46, 25 April 2008 (UTC)

This change is misleading. The source does not justify mentioning a focus on individual freedom. It mentions several concerns, of which individual freedom is only one (it mentions "focus" on that one only with respect to an 1867 law). The source does not say that 21st century critics are focusing on individual freedom, or on any particular one of these concerns. In reviewing the article, it's easier to just wikilink to those concerns rather than highlight one or a few of them here; also, I noticed some concerns were missing, including coverups, profit motive, and temporariness. So I made this change to try to address the issues. Eubulides (talk) 17:19, 25 April 2008 (UTC)

Time article: "How Safe Are Vaccines?"

I have added a comment from a new Time article. The article probably contains other good information that can be used in this and other related articles. -- Fyslee / talk 03:08, 27 May 2008 (UTC)

One of the bits of info there (the $10 billion figure) the article already mentions, supported by the original source for that figure (Zhou et al.). The TIME piece is merely citing Zhou et al., and there's little point in citing the middleman when you can cite the actual source for that figure. The other bits of info are relevant and I put them into the life-saving section (though this section is no longer strictly about saving lives, alas). Eubulides (talk) 06:16, 27 May 2008 (UTC)

Vaccine makers motivations section

The section on vaccine makers motives and actions seems a bit weak and one-sided. (Just presents the "criticism" without other perspectives.) I added a little bit of balancing (noting some of the financial motives among critics - specifically e.g. Wakefiled and co.)

It might also be worth including that vaccines are not necessarily highly profitable. (As compared to say Viagra (high demand), or Supplements (in the US, vaccines have to be proven safe and effective, supplements don't, which means considerable savings in development and manufacture)). A few years ago when there was a shortage of Influenza vaccine in the USA, this got some coverage in the popular press. (Manufacture of that vaccine is hard to automate, many vaccine buyers are poor or public agencies, etc.) I haven't added it to the article because I don't have a good citation. Anybody have a good citation on this?

The article on vaccines has some material related to this under Vaccine#Economics of development. But it also lacks citation. Zodon (talk) 03:45, 15 June 2008 (UTC)

I agree it would be worth mentioning the lack-of-profit argument as part of the controversy, and that we need to find a source for this. Eubulides (talk) 05:20, 15 June 2008 (UTC)

Here is one in testimony from an FDA center director, which should be WP:RS for this sort of statement. Feel free to drop it in if someone else has the time before I get to it.

Importantly, the market returns for producing this and many other vaccines are usually minimal, while the financial and other risks involved are great.<ref name='market_return'>{{cite news | first=Jesse L. | last=Goodman | coauthors= | title=Statement of Jesse L. Goodman, M.D., M.P.H. Director, Center for Biologics, Evaluation and Research Before the Committee on Energy and Commerce United States House of Representatives | date=2005-05-04 | publisher= | url =http://www.fda.gov/ola/2005/influenza0504.html | work = | pages = | accessdate = 2008-06-15 | language = }}</ref> - Eldereft (cont.) 19:38, 15 June 2008 (UTC)

I took a stab at putting it in here, also added it to vaccines#Economics of development. Thanks. Zodon (talk) 00:30, 16 June 2008 (UTC)

Vaccines weakening the immune system

The section titled Auto-immune disorders might be improved by adding a couple of items for perspective.

• Some researchers have hypothesized that recent increases in autoimmune disease might be due to decreased exposure to antigens/parasites. (Askarisk for asthma, etc.) I don't know how well supported that idea is, and whether it has been linked to vaccines, but if it has, it might be a nice counterpoint to the idea of "weakening" the immune system.
• Even though there are more vaccines on current schedules, many of the vaccines are much more refined with much less antigenic material. So recipients of current vaccines may not be getting more antigenic material than their parents/grandparents - it is just spread out in more individual doses. (This was a comment one of the presenters made in a training on HPV vaccine.)

I don't have references off hand on either of these - but thought worth adding if we can come up with sources. Thanks. Zodon (talk) 04:08, 15 June 2008 (UTC)

The first point doesn't seem that relevant to vaccines; perhaps I'm missing something. Eubulides (talk) 05:20, 15 June 2008 (UTC)

The 2nd point is more relevant; I'll look for a source. Eubulides (talk) 05:20, 15 June 2008 (UTC)

I found it; it's a source we already cite, Offit 2008. I made this change to add the 2nd point. Eubulides (talk) 05:29, 15 June 2008 (UTC)

Neat - thanks. Zodon (talk) 06:52, 15 June 2008 (UTC)

Refactored to cover topics one by one

I installed this change to reorder the article so that it discussions each topic one by one, rather than having one big section for the pro-vaccine side, and another big section for the anti-vaccine side. This sort of refactoring is long overdue. This article should be about the controversies; it shouldn't be a debate where one side gets the 1st half of the article and the other side gets the 2nd half. This sort of refactoring was done in August but that version was reverted as it introduced a massive POV problem. The refactoring I just did consisted entirely of moving text around, plus rewording section headers and moving some linking text into the lead (replacing inferior text that was already there). Eubulides (talk) 05:20, 15 June 2008 (UTC)

Nice - I also thought something of the sort was needed. Zodon (talk) 06:45, 15 June 2008 (UTC)

Source talks only about financial risks of production

This edit changed "the financial risks for producers are great" to "the financial risks for developers and producers are great". But the cited source nowhere says that the financial risks are great for developers; only for producers. The source says:

"…the influenza vaccine market is very fragile because the increasing demand has been coupled with a decline in the number of U.S-based and U.S.-licensed manufacturers. Importantly, the market returns for producing this and many other vaccines are usually minimal, while the financial and other risks involved are great. Further, vaccine manufacturing requires careful and comprehensive controls, a complex and sometimes unpredictable manufacturing process and highly specialized facilities that can be expensive to maintain and update."

This is talking about production and manufacturing. It is not talking about development. I worked around the problem by removing "developers and" from the article. Eubulides (talk) 19:52, 16 June 2008 (UTC)

Another way to handle it, if you feel that there is question of the verifiability of the riskyness of vaccine development would be to put a citation needed tag on that part of the item. Zodon (talk) 09:12, 17 June 2008 (UTC)

It's not just verifiability; it's a mild skepticism of the claim. It could be, for example, that vaccine development is often done by nonprofits and thus the financial risks are not great, at least, not in the usual commercial sense. Let's omit the claim until we get a reliable source on the subject. Eubulides (talk) 20:23, 17 June 2008 (UTC)

Or to put that another way - the risks are so great that the commercial entities are reluctant to undertake them. (For instance, they don't seem to be similarly content to leave the hunt for the next Viagra to nonprofits.) Research and development of new products (in most fields) is generally regarded as riskier than manufacturing an existing product. (e.g. all the "me too" drugs, etc.) The claim existed on the vaccine page (again without citation), when we find citation can put it back here as well. Zodon (talk) 17:53, 20 June 2008 (UTC)

There is little charitable or government support for research into the next Viagra. But there is considerable nonprofit support for vaccine development, e.g., the Doris Duke Charitable Foundation and the Bill and Melinda Gates Foundation. It could be that the risks are great for commercial entities precisely because there's so much charitable effort in that area; or it could be that a common pattern here is to have nonprofits develop the vaccines and commercial entities produce them. Either way, it would be misleading simply to say that the financial risks are great for development, implying that no work will be done in such a risky area, when such an implication would be inaccurate. Again, what I'm writing here is unsourced speculation, but it is plausible speculation, and we need a high-quality, reliable source in this area before putting claims about vaccine development profitability and risk into the article. Eubulides (talk) 18:25, 20 June 2008 (UTC)

Hepatitis B vaccination and the risk of multiple sclerosis

Sears R (2007). The Vaccine Book: Making the Right Decision for Your Child. Little, Brown. ISBN 0316017507. This book provides very useful information about vaccines. Hepatitis B for example. Hepatitis B vaccination and the risk of multiple sclerosis.He writes that one of the companies who produce the vaccine warns that people should be informed about multiple sclerosis risk before they decide to use the vaccine. --Coyote3 (talk) 15:29, 22 June 2008 (UTC)

NPOV tag

This change by an IP address added an NPOV tag without any commentary here or specific suggestions for improvement. I'm inclined to remove the tag, unless someone can make specific suggestions. Eubulides (talk) 22:10, 17 August 2008 (UTC)

It seems like a large omission that the article doesn't link to any antivax resources or websites. (Ethan Mitchell, forgot to sign in.) —Preceding unsigned comment added by 68.142.47.166 (talk) 13:35, 19 August 2008 (UTC)

Wikipedia is not a collection of links, and it does list several anti-vaccination resources (see Further readings). Zodon (talk) 19:05, 19 August 2008 (UTC)

I also posted a NPOV tag which was removed. I was told that I was not following customary procedure by not posting here. While I do apologize for not knowing the customs, it would be preferred if I was asked for specification before it was removed. Here are my reasonings: 1) The second paragraph in the introduction should not be in an introduction at all for it clearly starts the whole article in a pro-vaccination perspective. It is also repeated later on in the article. 2) The first paragraph in the beginning of the supports for the article (beginning with "Mass vaccination helped...") is all stated as fact, while the following paragraph which is used to denote the opposing view repeatedly reads, "Some vaccine critics claim..." and other similar pieces. The "some" denotes a small minority the idea that these are the claims of critics as opposed to the claimed facts in the preceding paragraph gives them a lesser strength in argument. One reading these two paragraphs can obviously see the bias of the author. 3) The sections entitled "Population Health" and "Cost-effectiveness" have no opposing argument at all. These sections and several other bits in this article should more likely be placed in an entirely different article denoting only the positives of vaccination. The same can be said for "Events following reductions in vaccinations". While I am pro-vaccination, this part could also be followed up, for instance, with examples of people who were supposedly vaccinated, but then contracted the disease instead. 4) It is in the "Safety" section where the biased paragraph is repeated but with added insults to the opposing side by stating it has "inadequate methodology" and "typically a poorly controlled or uncontrolled case series". The paragraph goes on to use other derogatory words such as "premature" and "alleged adverse effects". While this section is cited it not only leads to a site where one must entire their Credit Card number in order to view, but it leads to an article that is heavily biased toward the argument of pro-vaccination. 5) The next section entitled "Vaccine Overload" makes a statement in the first paragraph which reads "Although no scientific evidence supports this idea,...". I'm sure looking into any of the work of Robert Mendelsohn, M.D. a leading proponent of the anti-vaccination movement (I found this through one Google search and supports for its accuracy) could prove this incorrect. Fontevrault (talk) 06:32, 1 September 2009 (UTC)

Please see #Removed tag below. Eubulides (talk) 07:25, 1 September 2009 (UTC)

In order to place the NPOV tag, the article really needs to violate WP:NPOV. Rather than slapping a tag on the article, can you propose the changes to the article's text that you wish to modify it to? Also, don't place it here but put it right at the bottom on this talkpage. Thanks --Shot info (talk) 07:22, 1 September 2009 (UTC)

Thanks everyone. I'll do that now too. This is like trying to get something done in a bureaucracy. Do I have to take the yellow form to one office and the blue one to another once it has a red and a green stamp from three different offices? (Just joking. I'll catch on, I'm sure.) Fontevrault (talk) 18:33, 1 September 2009 (UTC)

Removed tag

A recent edit [13] added a regional bias tag, with the edit summary suggesting NPOV concerns. It is customary to make specific suggestions on the talk page when tagging an article, especially for NPOV concerns. Since no specific concerns have been raised, I have removed the tag. Yobol (talk) 21:13, 28 August 2009 (UTC)

A followup was made in #NPOV tag above; but I am responding here to that followup, so that things are in more-chronological order.

• "The second paragraph in the introduction should not be in an introduction at all for it clearly starts the whole article in a pro-vaccination perspective" This comment seems to reflect a misunderstanding of the WP:NPOV policy. That policy does not specify equal time for all sides. It specifies that various viewpoints should be given weight similar to that accorded by reliable sources. Vaccination controversy should follow this policy in emphasizing the mainstream view of the controversy, e.g., how mainstream historians, scientists, and medical sources view it.
• "It is also repeated later on in the article." That is what leads are supposed to do: they are supposed to summarize the body of the article. If the lead did not repeat what the article later says, something would be wrong; but here it does repeat the article body, which means it's doing what it's supposed to. See WP:LEAD.
• "The first paragraph in the beginning of the supports for the article (beginning with "Mass vaccination helped...") is all stated as fact," Perhaps the wording could be improved, and specific suggestions are welcome; however, the wording should not state or imply that there is a reasonable doubt among reliable sources that mass vaccination helped eradicate smallpox, because there is no such doubt.
• "while the following paragraph which is used to denote the opposing view repeatedly reads, "Some vaccine critics claim..."" That is because not all vaccine critics make that claim. In fact, only a small minority of vaccine critics make such a claim. Again, perhaps better wording could be suggested, but the point should be made that only a few of the critics claim that vaccination has never worked.
• "The sections entitled "Population Health" and "Cost-effectiveness" have no opposing argument at all." If an opposing argument is available and is reported by reliable sources, by all means let's include it. Again, specific suggestions for wording improvements would be welcome.
• "These sections and several other bits in this article should more likely be placed in an entirely different article" No, that sort of thing would contradict Wikipedia guidelines; please see WP:POVFORK.
• "Examples of people who were supposedly vaccinated, but then contracted the disease instead." That topic is mentioned in the Safety section, (polio vaccine causing paralysis), but I agree that further coverage would be warranted. Again, specific wording proposals would be welcome.
• "It is in the "Safety" section where the biased paragraph is repeated but with added insults to the opposing side by stating it has "inadequate methodology" and "typically a poorly controlled or uncontrolled case series". The paragraph goes on to use other derogatory words such as "premature" and "alleged adverse effects"." Again, repeating the lead is what articles are supposed to do; see WP:LEAD. The "inadequate methodology ... case series" wording is well supported by the reliable source (Bonhoeffer & Heininger 2007, PMID 17471032), and we know of no reliable sources disputing the point, but if some are available then let's please cite them and alter the text.
• "While this section is cited it not only leads to a site where one must entire their Credit Card number in order to view" That is, alas, all too common in medicine and science: scholarly sources are not freely readable. All other things being equal, we prefer freely-readable sources; but the most important goal is to cite the best and most-reliable sources regardless of whether they require a fee or subscription (please see WP:MEDRS#Choosing sources for details).
• "but it leads to an article that is heavily biased toward the argument of pro-vaccination." Again, please see the first bullet in my response. There is nothing wrong with citing mainstream sources roughly in proportion to how often a view is supported by reliable sources.
• "The next section entitled "Vaccine Overload" makes a statement in the first paragraph which reads "Although no scientific evidence supports this idea,...". I'm sure looking into any of the work of Robert Mendelsohn, M.D. a leading proponent of the anti-vaccination movement (I found this through one Google search and supports for its accuracy) could prove this incorrect." Robert S. Mendelsohn has been dead for twenty years and his opinions, even if they were correct for the time, are not that relevant for an encyclopedic treatment of today's understanding of vaccine overload. His views might be appropriate for the history section, though. Again, a specific proposal for wording changes (with citations) would be helpful.

Eubulides (talk) 07:25, 1 September 2009 (UTC)

This article has reached a fairly stable and appropriate balance of "pro-" and "anti-" vaccination views. The changes as suggested above would be a violation of WP:NPOV, in particular WP:Undue. To show that there is too much "pro-" POV, one would have to demonstrate that this article is biased relative to the mainstream scientific literature, which has been cited in the article. This would best be shown by suggesting a change, providing the appropriate high-quality reliable source that shows how the article can be improved. Yobol (talk) 18:00, 1 September 2009 (UTC)

Changes not supported by sources

A recent edit introduced some changes that made the article worse:

1. It removed the citation to Gerber & Offit 2009 (PMID 19128068), even though that is an important source for that section in that it provides the overall outline for flaws in claims for vaccine overload. The phrase "The idea is flawed for multiple reasons." is well-supported by the source. Since the precise wording seems to be the issue here, I will try changing it to "The idea has several flaws" which is clearer anyway.
2. It introduced the claim "Many researchers have pointed out that" but as far as I know, none of the cited sources say anything about many researchers pointing things out.
3. It introduced a word "actually" that is certainly unnecessary and arguably introduces POV.
4. It introduced a claim "Vaccines are also considerably safer than before." that is contrary to what the cited source says. The cited source (Gerber & Offit) says that vaccines have always been a minute contribution to the load on the immune system, which means that the reduction in the number of immunological components does not make vaccines "considerably safer than before".
5. It removed the point "because of changes in vaccine formulation"; I don't see why this was removed.
6. It changed "the fourteen vaccines now given to young U.S. children" to "Fourteen of the standard vaccines administered to U.S. children today", losing the information (present in the source) that these are all the vaccines given. (The deletion of "young" is an improvement, though, since the source doesn't say "young".)
7. It changed "contain less than 10% of the number of immunologic components of the seven vaccines given in 1980" to "contain less than 10% of the amount of immunologic material found in just seven of the vaccines used in 1980." But this paraphrase is incorrect: the cited source clearly says "components", not "amount of material", so it is referring to types, not to volume or to weight. Furthermore, the paraphrase loses the information, present in the original, about it being the seven vaccines.

I have removed the parts of the change that had the problems noted above. I suggest discussing here what further changes to make. Eubulides (talk) 07:48, 5 October 2009 (UTC)

1. The citation was removed simply because it was unnecessary. The phrase "The idea is flawed for multiple reasons." is conjecture. The preceding paragraph states that some parents fear that multiple vaccinations may weaken the immune system. There is nothing specific there to label "flawed" (whereas stating a reason being factor XYZ, for instance, might be).
2. "For example" just sounds silly to me in this context. At any rate, I don't think multiple sources are necessary here. The general consensus among the medical community is that they are safe, so the attribution is fine.
3. Used here, the word "actually" simply qualifies the researcher's assertion. Not POV in the strictess sense.
4. From a statistical point of view, the statement 100% valid. Less is more safe. Nor does that contradict the source, either.
5. You're right about that. Leaving that in works fine, too.
6. I don't see a loss of information there. They both convey essentially the same point.
7. Right. Well that is an important difference.

Sebastian Garth (talk) 08:32, 5 October 2009 (UTC)

1. The phrase "The idea is flawed for multiple reasons" is not conjecture: it is directly supported by a reliable source. There is no disagreement among reliable sources on this point.
2. The phrase "for example" makes it clear that the paragraph is giving just some of the flaws, not all of them. The phrase could be reworded, but there shouldn't be an implication that the list is exhaustive.
   • "At any rate, I don't think multiple sources are necessary here. The general consensus among the medical community is that they are safe, so the attribution is fine." Sorry, I don't get the connection between this comment and the "for example" comment.

     Hmmm, following up my own remark: were you suggesting that we remove the citations to Murphy 1996 (PMID 8801433) and to Sloyer et al. 1974 (PMID 4151506)? If so, then that makes sense and I agree: those citations are ancient anyway and are therefore of lower quality. Eubulides (talk) 08:54, 5 October 2009 (UTC)

3. If the researcher doesn't say "actually", then we shouldn't qualify the researcher's assertion with "actually". The qualifier "actually" implies that the qualified statement is surprising or counterintuitive, an implication that I don't see in the original. At any rate the "actually" isn't needed in the article.
4. The claim was "Vaccines are also considerably safer than before." (my italics). That claim is contradicted by the source, which states that the vaccine load is small compared to the natural load. Even if the word considerably were removed, the claim would not be supported by the source. The source does not make or support the claim that a tiny reduction in immunological burden is safer. It might actually be safer to have a tiny increase. (Nobody knows.)
5. OK, thanks.
6. The original makes the point that 14 total vaccines are given now, compared to 7 total earlier. The revised version makes it sound like more than 14 are given now, and more than 7 were given earlier. This is a loss of information and the revised version incorrectly implies a different number than was in the source.

Eubulides (talk) 08:46, 5 October 2009 (UTC)

NPOV problems

I removed the 2nd paragraph from the lede, as it implied that all anti-vaccination concerns are unfounded.

• Many vaccines have been recalled or discontinued because they were toxic or ineffective. The rotavirus and lyme disease vaccines are two recent examples. The Vaccine Controversy

Let's present both sides of the controversy, without telling the reader which side we are on. Better, yet, as contributors lets not take any side but merely give the pros and cons of each position. --Uncle Ed (talk) 13:42, 21 October 2009 (UTC)

WHAT??? You want a Wikipedia article to present all the information from all credible sources? That would allow people to make up their own minds. We can't have that. FX (talk) 15:40, 21 October 2009 (UTC)

I restored the paragraph and added an intro sentence (supported by the cited source) saying that vaccines may cause side effects and that public confidence in safety is needed for a successful program. While we're on the subject of NPOV problems, that edit also removed a recently-introduced and unsourced claim that vaccines can cause middle ear infections (!); removed a "Studies have shown" that is unnecessary and not in the cited source; and removed unnecessary verbiage in the lead sentence that distinguished between vaccination and general and a specific vaccination. That distinction is not necessary in the very first sentence, and was POV in making the suggestion a la Jenny McCarthy that it's OK to oppose (say) the measles mumps and rubella vaccines so long as you say that you don't oppose all vaccines. Eubulides (talk) 18:48, 21 October 2009 (UTC)

Legal counsel

The first paragraph of the Financial Motives section contains text whose reference doesn't seem to support it. I'm removing the following: "Legal counsel and expert witnesses employed in anti-vaccine cases may be motivated by profit" as it is not supported by the reference. Also, in context, it seems to be anti-vaccine, while the reference itself speaks about unreliable anti-vaccine witnesses. —Preceding unsigned comment added by RhoOphuichi (talk • contribs) 21:09, 21 October 2009 (UTC)

The cited source, Fitzpatrick 2007, says "Of the £15million in legal aid funding spent on the MMR litigation, around £8million went to the solicitors, £1.7million to barristers, £4.3million was shared among expert witnesses; the children, of course, were left with nothing." I agree that this doesn't directly support the "motivated by profit" part of the comment, but it does support a claim about that particular litigation. I reworded the claim to say "in one UK case alleging a vaccine–autism link, legal counsel and expert witnesses received about £14 million of legal aid funding, and the children received nothing." Eubulides (talk) 20:45, 22 October 2009 (UTC)

Concerning NPOV wording

Eubulides, you seem to have a problem grasping the concept of a neutral point of view. From the second pillar of Wikipedia: "When we discuss an opinion, we attribute the opinion to someone and discuss the fact that they have this opinion". This is the point that you are missing. By saying "This assumption is flawed" you attribute the statement to noone (except for Wikipedia itself, implicitly). I don't care if it reads "It has been stated that the idea is flawed" or "Researchers have indicated that the assumption is ludicrous", honestly. Just pick something, anything, neutral and put it there. Besides that, the *first* sentence of the referenced article states "An extensive new review summarizes the many studies refuting the claim of a link between vaccines and autism", and so the wording I chose *is*, in fact, an appropriate paraphrase of the referenced material. Sebastian Garth (talk) 19:19, 21 October 2009 (UTC)

• The previous comment is about this this recent edit to Vaccine controversy #Vaccine overload:

"This assumption has several flaws. Studies have shown, however, that this assumption is fundamentally flawed." (citing Gerber & Offit 2009, PMID 19128068)

The old version was directly supported by the cited source, which says "The notion that children might be receiving too many vaccines too soon and that these vaccines either overwhelm an immature immune system or generate a pathologic, autism‐inducing autoimmune response is flawed for several reasons:" (and then the source gave several reasons). It is an OK paraphprase to replace the source's "notion" with "assumption" (or with "idea", as the longstanding stable version did before today), but it is not OK to paraphrase it with a "Studies have shown".

• "By saying "This assumption is flawed" you attribute the statement to noone (except for Wikipedia itself, implicitly)." It is not necessary to insert in-text attribution such as "Studies have shown" for claims that are not controversial among reliable sources. For example, there is no need to say, in Common cold, something like "Studies have shown that the the common cold is caused by viruses." It suffices to say "Common colds are caused by viruses" (and provide a footnoted citation). Inserting the text "Studies have shown" would be misleading, as it would connote to the naive reader that there is some doubt over whether the common cold is caused by viruses. The situation here is similar: the claim in question is not controversial among reliable sources, and inserting in-text attribution here is not only unnecessary, it's misleading.
• 'the *first* sentence of the referenced article states "An extensive new review summarizes the many studies refuting the claim of a link between vaccines and autism"' No, that quote is not from the cited source; it is from a lay summary. And the quote is not about vaccine overload; it is about vaccines and autism in general. It cannot be used to support the claim quoted above, which is a claim specifically about vaccine overload.
• To summarize: the new version is not supported by the cited source, whereas the old version was supported. The change should be reverted.

Eubulides (talk) 20:15, 21 October 2009 (UTC)

1) If you wish to use a statement to that effect, then simply attribute it to the source(s).

2) My sole contention is that the statement is formulated as a first-person opinion.

3) Fair enough.

4) Again, I openly encourage you to use the words of your choosing *as long as they meet Wikipedia guidelines*. My edit was neither destructive nor misleading and should remain in place unless you or someone else can come up with an equivalently neutral statement. Sebastian Garth (talk) 20:54, 21 October 2009 (UTC)

I agree with Eubulides' assessment of the Gerber and Offit paper. "Vaccine overload" is not a subject of controversy within the medical community, so qualification with "studies have shown" is not necessary. The original sentence was concise and adequately supported by the citation. Yobol (talk) 22:50, 21 October 2009 (UTC)

The qualification is necessary, though. Besides being more consistent with Wikipedia guidelines, this isn't merely some "flat-earth"-type of claim being refuted. Whether or not enough research into the matter has been done is debatable. The studies that have been conducted are statistical in nature, and few, if any, have addressed the matter on a molecular level. The matter is not yet settled, and a neutral presentation is still warranted. Sebastian Garth (talk) 00:38, 22 October 2009 (UTC)

No, the qualification is not necessary. There are 6 cited papers regarding the issue in this article under the references section. There is to my knowledge, no controversy on this issue in the medical community. Qualifying an un-controversial statement to give the appearance of a controversy would go against WP:NPOV. Unless you can provide citation that this issue is controversial in the medical community, I don't see that your objections have merit, and would support removal of the NPOV tag. Yobol (talk) 01:38, 22 October 2009 (UTC)

Nonsense. None of the edits I have made cast any "appearance of controversy" whatsoever - I don't see how they could have even been construed as such, honestly. On the contrary, they have only reinforced the original statement, while preserving neutrality. Also, keep in mind that I'm not the first person to object to the original wording, either, if that helps put things into perspective for you. So I don't think it's unreasonable to ask for a compromise here. Sebastian Garth (talk) 02:57, 22 October 2009 (UTC)

I don't know how else to say it, but un-controversial facts should be stated as such. Adding un-needed qualifying phrases is not only poor prose, but can lead the reader to make un-warranted conclusions (such as the fact is controversial when it is not). Yobol (talk) 03:10, 22 October 2009 (UTC)

I agree, but I don't think that is the case here, viz. "Studies have shown that the assumption is fundamentally flawed", in fact, both supports and reinforces the general consensus without sounding biased. Contrast with "The idea has several flaws", which frankly comes off as "The idea is flat out false". That, in my opinion, is a classic example of both poor prose *and* bad taste. Sebastian Garth (talk) 03:39, 22 October 2009 (UTC)

The source makes that direct statement, and Yobol has pointed out that the body of the article has more sources supporting it. There is no need to attribute the sentence to some unnamed studies when we are citing a review that holds a fact that is not controversial in the field. The ref tag is already good enough for attribution. --Enric Naval (talk) 17:33, 22 October 2009 (UTC)

I'm sorry, but that still doesn't make it a neutral statement. Originating from the source that phraseology is perfectly fine, but in the context of encyclopedic content, it creates a strong sense of POV, which is inappropriate. Citing every single word is not a requirement for a Wikipedia article (as long as it is verifiable), and so the edit that I have proposed neither introduces superfulous words nor obscures the original intent of the message. When given the choice of a strictly neutral statement versus one that is sufficiently not so, the former is clearly preferable over the latter. Sebastian Garth (talk) 18:23, 22 October 2009 (UTC)

The current statement is neutral. There is no controversy in the medical community about this, and you have yet to present any evidence that there is. Continuing to insist on a wording that artificially qualifies a straight-forward statement that is supported by the WP:RS is a violation of NPOV. Yobol (talk) 18:45, 22 October 2009 (UTC)

Please see #Attribute it to the sources below. Eubulides (talk) 20:45, 22 October 2009 (UTC)

Attribute it to the sources

• "If you wish to use a statement to that effect, then simply attribute it to the source(s)." The current text does provide attribution, using a footnote. That's all that's needed here.
• "My sole contention is that the statement is formulated as a first-person opinion." There is no first-person pronoun in the statement. It is no more a first-person opinion than millions of other statements in Wikipedia that are simply cited using footnotes, the ordinary way of citation.
• "as long as they meet Wikipedia guidelines" The current and proposed wording both meet Wikipedia guidelines as far as neutrality goes. The problem is that the proposed wording does not meet Wikipedia guidelines as far as proper sourcing goes, because it's not supported by the cited source.
• Even if the "Studies have shown" phrase were directly supported by the cited source (which it's not), it would be classic bad wording. You don't see Autism (a featured article) saying "Studies have shown that autism has a strong genetic basis"; it says merely "Autism has a strong genetic basis", citing the review which makes this conclusion based on a large number of studies. Studies should be mentioned in article text only in areas where the studies themselves are part of the topic, e.g., because the research is controversial or unsettled and where there is genuine disagreement among reliable sources. For example, in Autism:

• "Some studies have reported diagnoses of autism in children due to a loss of language or social skills, as opposed to a failure to make progress, typically from 15 to 30 months of age. The validity of this distinction remains controversial; it is possible that regressive autism is a specific subtype, or that there is a continuum of behaviors between autism with and without regression."
• "Studies of interventions have methodological problems that prevent definitive conclusions about efficacy."
• "Although some children with autism also have gastrointestinal (GI) symptoms, there is a lack of published rigorous data to support the theory that autistic children have more or different GI symptoms than usual; studies report conflicting results, and the relationship between GI problems and ASD is unclear."

In this part of Vaccine controversy, there is no controversy among reliable sources, so there would be no need to mention the studies directly even if the cited source directly supported the claim about the studies.

Eubulides (talk) 20:45, 22 October 2009 (UTC)

Influenza vaccine effectiveness

A recent addition to the Effectiveness section added information regarding the effectiveness of the influenza vaccine. It would seem this material would be more appropriate in the Influenza vaccine article (and a quick glance shows that most of the cited articles are already represented in the Effectiveness of vaccines subsection in that article). I would think this article should focus on general effectiveness issues with vaccinations, with the specific issues relegated to each specific vaccine page, otherwise it would get too large with the effectiveness of each vaccine being added here.Yobol (talk) 01:58, 22 October 2009 (UTC)

I agree, and moved the material to Talk:Influenza vaccine #Material from Vaccine controversy. Eubulides (talk) 20:45, 22 October 2009 (UTC)

Nobody cares what you think

If you want to express your opinion, your views, your conclusions about this, or any matter, start a Blog and go do it.

Wikipedia is not your soapbox, it is not for your original ideas or research, and it isn't about your point of view. On that there is no controversy. On articles about controversial matters, (or any article) attempting to push a point of view and censor sources, is against Wikipedia. Stop doing it.

Thank you in advance.FX (talk) 16:56, 22 October 2009 (UTC)

Scientifically unsupported

A recent edit to the Vaccine overload section changed this:

"The idea is flawed, for several reasons."

to this:

"Experts in the field consider the vaccine overload theory to be scientifically unsupported. There are several lines of reasoning used to support this finding."

This change isn't directly supported by the cited source, Gerber & Offit 2009 (PMID 19128068), for two reasons:

• The source doesn't say that the vaccine overload theory is scientifically unsupported (i.e., there is no scientific evidence for it); it says that the theory is "flawed" (i.e., the theory has important problems), a stronger claim. The article shouldn't water down that claim.
• The source doesn't say that "experts in the field say" the idea is flawed; it says merely that the idea is flawed. There is no controversy about this among reliable sources, so there is no need to qualify this statement with phrases like "experts in the field say", just as there is no need to qualify the statement "Drinking colloidal silver can turn your skin blue" with the phrase "Experts in the field say".

This wording has been extensively discussed (see #Concerning NPOV wording and #RFC: NPOV wording above, for example) and is currently awaiting mediation in search of a compromise. Before changing the wording in the article, I suggest looking at these previous discussions (and the mediation, once it gets going), and proposing new wordings on the talk page. For now, I moved the edit's wording to the start of this thread. Eubulides (talk) 21:48, 27 October 2009 (UTC)

Statement has nothing to do with inline source

Controversies in this area revolve around the question of whether the risks of adverse events following immunization outweigh the benefits of preventing adverse effects of common diseases.

The cited source says nothing about that. FX (talk) 04:05, 28 October 2008 (UTC)

Sure it does. For example, the first paragraph of its introduction (p. 237) says:

Immunization safety is a real concern because all vaccines may cause side effects. Both healthcare workers and patients need reminding that immunization is an induced, controlled stimulus to the immune system, so some adverse reactions can be expected. Most reactions, however, are transient and mild. Immunization safety concerns have existed since the day of the first available vaccine. Since the introduction of Jenner’s cowpox vaccine, however, the benefits of saving children from tragic outcomes of common diseases outweighed the risks of perceived adverse events following immunization (AEFIs).

Now that you mention it, though, we should put the word "perceived" before "risks" in that sentence, to match the cited source more closely. I'll do that. Eubulides (talk) 05:01, 28 October 2008 (UTC)

Immunization safety concerns have existed since the day of the first available vaccine. Since the introduction of Jenner’s cowpox vaccine, however, the benefits of saving children from tragic outcomes of common diseases outweighed the risks of perceived adverse events following immunization (AEFIs).

I don't think you can see it. The source says three pertinent things.

1: Safety concerns have always existed.

2: Since the first vaccine the benefits have outweighed the risks.

3: The risk is of "perceived adverse effects".

What the wiki article said: "Controversies in this area revolve around the question of whether the risks of adverse events following immunization outweigh the benefits of preventing adverse effects of common diseases."

So you are taking the article, which states three clear facts, and then saying "Controversies in this area revolve around the question", which is not what the source said. The source clearly states "the benefits have outweighed the risks". The source clearly states there is no question. FX (talk) 05:38, 28 October 2008 (UTC)

No, that is just one example quote from the cited source. Here is another (p. 244):

The withdrawal of Rotashield in the USA had a global effect and remains an issue of controversy in view of the global burden of rotavirus disease: since the date of withdrawal several million children’s lives could have been saved, if the vaccine was still available, particularly in developing countries where mortality is high."

The point is that there is indeed real controversy over benefits versus perceived risks, even if the mainstream opinion is that benefits outweigh the perceived risks. Eubulides (talk) 06:16, 28 October 2008 (UTC)

Of course there is a controversy. And as an encyclopedia, wikipedia ought make record of the cultural fact that certain groups feel certain ways about certain needles (and certain fluid transfusions, and certain methods of terminating pregnancy) but, as an enclcopedia wikipedia is also responsible to make a record of the medical fact that certain needles put in certain bodies tend to cause certain wooden boxes to not fill up so quickly. If the article is to be a legitimate encyclopedic entry on a medical topic, then the view purported ought to be a credible (expert) one, meaning articles like this one are fated to look one sided because the expert community is as near a concensus as a scientific community can reasonably be expected to be (I would bet some people level the same bias complaints against wikipedia's evolution article too). The statisical effectiveness of vaccination is a fact, out there in the world to measure; reporting it from the mouths of experts is the very core of objectiveity. —Preceding unsigned comment added by 69.168.144.140 (talk) 05:24, 30 October 2009 (UTC)

Propaganda

This whole article reads like pro-vaccer screed! I thought wikipedia was supposed to be an objective, encyclopedia resource. Glossing over the bad science used by pro-vaccers to back up big pharma and the research-industrial complex isn't really doing much to support ACTUAL science.

Or are you just going to keep pretending that the reality ISN'T that the overwhelming majority of vaccinated children get autism or ADHD????? 136.159.117.2 (talk) 20:39, 28 October 2009 (UTC)

The article relies on mainstream medical and scientific opinion, regardless of whether it's supported by big pharma. No reliable source supports the claim that "the overwhelming majority of vaccinated children get autism or ADHD"; nor does it support other claims of a significant connection between vaccines and autism, or between vaccines and ADHD. Wikipedia is supposed to rely on reliable sources for medical information. Eubulides (talk) 22:54, 28 October 2009 (UTC)

Besides what Eubulides has already pointed out, it really isn't constructive (nor civil) to make conspiratorial accusations. If you have a contribution that can cite a reliable source that substantiates a correlation between vaccines and autism/ADHD, then submit it. Otherwise, such additions to the article are not appropriate, as they would obviously contradict Wikipedia's undue weight policy. Cheers. Sebastian Garth (talk) 15:17, 29 October 2009 (UTC)

The article was originally called "Antivaccinationisism". Several of the antivaccinationists insisted that they do not exist, and as is occurring above added excess verbiage to obscure clear meaning, changed the title, and then as usual wrote about another topic. Has anyone else seen November's edition of Wired? Midgley (talk) 18:01, 30 October 2009 (UTC)

Vaccine overload has always been pure bollux. Try to prove it as a hypothesis, it is not up to people who understnad the immune ssytem to demonstrate with each new antigen that it has not crossed some magic threshold of overload. Midgley (talk) 18:04, 30 October 2009 (UTC)

Well, although I obviously agree that VO cannot be categorically ruled out, on principle, the scientific method can nonetheless be used to assess the possible risks associated with a given combination of substances in order to reach a conclusion about the general case. Even so, it's practically impossible to predict the response in every possible situation, so there is always the chance that some unforseen (even deadly) reaction could arise. Of course, when that does occur it then becomes a factor in the overall statistic, and thus represents at least some additional percentage of risk. Sebastian Garth (talk) 19:03, 30 October 2009 (UTC)

Vaccine overload lead sentence

I see that many people are editing the lead sentence to the Vaccine overload sentence. The current tagging is inappropriate, and appears to reflect more editors' personal disagreements with reliable sources, rather than any real issues among the sources themselves. Rather than join the edit war, I am going to suggest a new draft here, which is based more closely on what the cited source says.

Vaccine overload is the notion that giving many vaccines at once may overwhelm or weaken a child's immune system, causing long-term damage to health.<!-- ref name=Hilton --> Although no scientific evidence supports this idea, it has caused many parents to delay or avoid immunizing their children.<ref name=Hilton>

The Hilton reference is the same as what's currently in the article, namely this one:

• Hilton S, Petticrew M, Hunt K (2006). "'Combined vaccines are like a sudden onslaught to the body's immune system': parental concerns about vaccine 'overload' and 'immune-vulnerability'". Vaccine. 24 (20): 4321–7. doi:10.1016/j.vaccine.2006.03.003. PMID 16581162.{{cite journal}}: CS1 maint: multiple names: authors list (link)</ref>

It uses the word "notion" when it first mentions overload. Eubulides (talk) 20:24, 30 October 2009 (UTC)

Hilton (2006) also refer to "immune-overload" as a "concept", which is why I changed it. I have no particular preference between concept/notion/assertion as wording. Yobol (talk) 20:30, 30 October 2009 (UTC)

If the source uses both "notion" and "concept", I also have no preference between the two words. "Assertion" seems a bit out of place, but I guess it'd be OK too. Eubulides (talk) 20:49, 30 October 2009 (UTC)

Attribution

Is the recently introduced attribution necessary and in accordance with WP:ASF. QuackGuru (talk) 20:26, 30 October 2009 (UTC)

No, per the multiple threads above. Not only does the attribution have the problems as noted above, but why does this fact require this level of attribution (we're giving the journal and university they work at too?) while others don't? Would support revert to previous version.Yobol (talk) 20:34, 30 October 2009 (UTC)

The edit both agrees with and is most relevant to the guidelines of WP:ASF. The attribution is indeed appropriate for all matters of debate.Sebastian Garth (talk) 20:49, 30 October 2009 (UTC)

The edit is not appropriate when there is no disagreement among reliable resources. Eubulides (talk) 21:11, 30 October 2009 (UTC)

I disagree with this recent edit, which made the following insertion:

"Writing in 2009 in the journal Clinical Infectious Diseases, Jeffrey Gerber and Paul Offit of the Children's Hospital of Philadelphia reviewed the scientific literature dealing with this hypothesis. They stated that the idea is flawed, for several reasons."

The edit summaries said "attribute" and "closer to what a review does", but this is not the sort of language that one would normally find in a review, when summarizing material that is not controversial among reliable sources. Reviews normally do not mention journal names in main text, nor do they spell out author names (unless they do so for all citations, Harvard-style, which is not the style here), nor do they give author affiliations. Furthermore, the discussion in this section is not supported merely by Gerber and Offit 2009 (PMID 19128068); it is supported by several other reliable sources that say pretty much the same thing (e.g., Schneeeweiss et al. 2008, PMID 19471677, and Gregson & Edelman 2003, PMID 14753385), and attributing it only to Gerber and Offit in the text gives the misleading impression to the reader that the opinion is held only by some reliable sources and not others. I suggest that the change be reverted and that we discuss better wording (if needed) here. Eubulides (talk) 20:35, 30 October 2009 (UTC)

Also, for other editors who may be reading this thread: the topic of attribution has been discussed recently in several other threads above, which you may want to read in order to avoid repeating the same points; please see #RFC: NPOV wording, #Concerning NPOV wording and #Changes not supported by sources. Eubulides (talk) 20:41, 30 October 2009 (UTC)

Since there are many sources that say the same thing, list them all and attribute them all. This is a bit cumbersome, but is often the best way of solving intractable problems. Eg, - Writing in journal A, X and Y of This University said "this idea is junk". Similarly, writing in journal B, P and Q of That University stated "the idea is laughable". This view was also expressed by M and N of Random University in a 2009 review published in journal C, stating that "I can't believe anybody seriously said this". - Continue until you have added all the recent reliable sources that discuss the question. Tim Vickers (talk) 20:47, 30 October 2009 (UTC)

To see an example of such "list and attribute" writing read A4M#Credential_dispute. Clunky, but unarguable. Tim Vickers (talk) 20:50, 30 October 2009 (UTC)

If every time a controversial article had to resort to this level of attribution due to one editor's personal preferences or biases, all our controversial articles would be so clunky as to be unreadable. Some of these articles have over 100 separate citations; can you imagine what these articles would look like? Yobol (talk) 20:57, 30 October 2009 (UTC)

Well, you could omit the institutional affiliations, but these are useful when you are attributing the opposite view, to make absolutely clear to the reader what level of expertise the proponents of an idea have. See A4M#Divergent_views_on_anti-aging_products for an example of this. Tim Vickers (talk) 21:03, 30 October 2009 (UTC)

Per WP:ASF if there is no "serious dispute" we should assert facts as facts. Since there is no "serious dispute" in the scientific community about vaccine overload, we should not load the article with superfluous material. If the reader wants to find out who is cited and where they work, they can look at the citation themselves. Yobol (talk) 21:07, 30 October 2009 (UTC)

Yobol is right. A Simon-says style may be necessary in A4M#Credential_dispute (which is about assertions of fraud by unscrupulous practitioners), due to Wikipedia's policy about biographical info about living persons. It may also be helpful in A4M#Divergent views on anti-aging products, as that is a narrow article about a particular controversial organization. However, the style is harmful in any discussion of facts that are not disputed by reliable sources. Imagine if Evolution had to use this style for discussing routine facts about evolution, merely because creationist editors didn't believe them. The section in Vaccine controversy is supposed to be a high-level summary of various topics about vaccine controversies: it is not the place to go into detailed blow-by-blow description in the main text of exactly where source X said Y, and what source X's affiliations are. Doing that for the Vaccine controversy sections would balloon this section of the article to ten times its size, raising serious WP:WEIGHT issues, not to mention making the section far less useful as an encyclopedia entry. Again, I ask that the edit be reverted and that we discuss here what the section would look like, rather than inserting potentially-controversial changes without discussion. Eubulides (talk) 21:11, 30 October 2009 (UTC)

True, if there is a detailed sub-article on vaccine overload then you just need to summarise this article. Can't see one under that title though. I'll revert myself since consensus seems to be against this. Tim Vickers (talk) 21:56, 30 October 2009 (UTC)

Sentence about the effect of "full vaccination"

Today I reverted another users edit that changed the wording in the "Effectiveness" section from

Fully vaccinating all U.S. children born in a given year from birth to adolescence saves an estimated 33,000 lives [...]

to

One source states that fully vaccinating [...]

which has been reintroduced now, but I (obviously) don't think it should stay that way. First of all, it's really hard to tell how many sources there are because the article we use as source is speaking about CDC officials, but what is more important is that to me the wording sounds like it's meant to question the validity of the estimation (in which case it would be more appropriate to find another source with a trustworthy estimation). However, I'm not a native speaker so I might be wrong about how the average reader would understand this sentence. What do uninvolved editors (ideally native speakers) think of the wording? --Six words (talk) 14:31, 1 November 2009 (UTC)

That's a good revert. There's no need to be modest about your English-language skills — the change had exactly the (inappropriate) effect that you read. TenOfAllTrades(talk) 14:52, 1 November 2009 (UTC)

User's edits need watching

Resolved

The edits of banned Blowme c===3 and their newer account Panicfanatic001 need to be examined for fragments that might not have been deleted. Apparently the ban was because of the original username, but the disruptive nature of the individual's edits should still draw attention. If the edits aren't NPOV, they should be reverted or modified. -- Brangifer (talk) 16:02, 1 November 2009 (UTC)

As of now the cumulative changes look clean. - 2/0 (cont.) 07:34, 2 November 2009 (UTC)

Good. -- Brangifer (talk) 15:01, 2 November 2009 (UTC)

Strong evidence for link between mercury in vaccines and autism

Recently strong evidence for a direct link between mercury in vaccines and autism has become what must be described as more than just relatively abundant. Interviews with scores of doctors, researchers, investigators, organizations and publicly led and supported research groups are propping up globally as well as clear evidence from the so called "danish studies", faults or flaws in the interpretation of those studies, evidence from the respected Oxford NPO, The Cochrane Collaboration, an institute for evidence based medicine and research. Recently revealed sources of the pharmaceutical industry's own meetings, reports and minutes from their meetings all indicate or rather effectively prove the strong correlation between mercury use in vaccines and autism and hundreds of other severe long term adverse side effect that have impaired people or led to serious disability or been seriously detrimental to their health in any number of ways. The obvious flaws in the interpretation of the Danish studies that allegedly proved that autism rose even after thimerosal was removed was based on the fact that the danish health institute started up a program for registering autism and autists after the correlation was noted, effectively leading many more to come forward to gain the help that the authorities offered and be registered. This is even to this day still erroneously reported on this wikipedia page and shows how a lack of understanding of what research and public debate and reporting actual controversies are about on the part of wiki admins. It is such a blatant disregard for actual controversy and public knowledge that it borders on intent to mislead the public. Its as repugnant as it is intellectually dishonest. Wiki admins have become notorious in their lack of following links, reading public documents and summarily posting one sides of current controversies effectively portraying themas if they were actually already settled and that one party was irrefutably confirmed by the public community as a whole. I find it disturbing, but at the rate and speed with which information floats and have started to circulate only the last 12 months they will be thoroughly discredited within the year. —Preceding unsigned comment added by Nunamiut (talk • contribs) 01:21, 5 November 2009 (UTC)

Wikipedia is not a soapbox. Eubulides (talk) 04:57, 5 November 2009 (UTC)

Agreed. Putting a hat on this nonsense. In the whole world of alternative medicine pharmanoia, I know of no other branch that is more dishonest and dangerous, especially to children and the weak, than the antivaccination quacks. -- Brangifer (talk) 05:29, 5 November 2009 (UTC)

|}

Field or profession

/* Alternative medicine */ field --> profession. The source used the word "profession". I should probably seek consensus before making arbitrary alterations of this nature for this controversial topic. QuackGuru (talk) 06:23, 8 November 2009 (UTC)

I'd laugh if I didn't think you were trying to be contentious. Moving along, wording revised as requested. Sebastian Garth (talk) 07:03, 8 November 2009 (UTC)

Toronto Star

This edit made the following change in the Vaccine overload section:

"It has The Toronto Star reported that it had has been proposed as a cause for autism without attrributing the suggestion to any particualr soruce, or offering any suggested evidence or cause."

with the edit summary " I read the reference, it is not a soruce for teh suggestion, it merely asserts that it has been made. I say again, who, as a reliable soruce, actually came up with this stupid".

The vaccine-overload theory has not been proposed by any reliable source. But that does not mean that the theory has not been proposed as a cause for autism; it clearly has (by Andrew Wakefield, and by others). Today the vaccine overload theory is perhaps the most common reason why parents in Europe and North America don't follow vaccination recommendations. There is no need for the article to cite a "reliable source" that has proposed a popular-but-unsupported theory: this article is about vaccine controversies, regardless of whether the controversies have scientific support on both sides.

There is no dispute among reliable sources that the vaccine-overload-causes-autism theory is popular. Inserting text like "The Toronto Star reported" makes it sound like only the Toronto Star is reporting the theory's popularity, and that it is seriously disputed whether the theory is popular. No such dispute exists. Furthermore, the edit introduced the text "without attrributing the suggestion to any particualr soruce, or offering any suggested evidence or cause" which is clearly editorializing.

I attempted to improve the situation by replacing the text in question with "Many parents of autistic children firmly believe that vaccine overload causes autism", a statement that is more-directly supported by the cited source. Eubulides (talk) 07:50, 4 November 2009 (UTC)

So we are agreed that without a reliable source, this meme is now part of the encyclopaedia? Should this not be in the article on mass hysteria, rather than immunisation? Midgley (talk) 21:44, 18 November 2009 (UTC)

This is an article on vaccine controversy, not about vaccines themselves. We do have reliable sources that a controversy exists. If you'd like to see more sources (along with a long discussion of them), please see Wikipedia talk:Requests for mediation/Vaccine controversy: that talk page discusses Gerber & Offit 2009 (PMID 19128068), Gregson & Edelman 2003 (PMID 14753385), Hilton et al. 2006 (PMID 16581162), Bonhoeffer & Heininger 2007 (PMID 17471032), Schneeweiss et al. 2008 (PMID 19471677), Tickner et al. 2006 (PMID 16890330), Leask et al. 2008 (PMID 18578819), Heininger 2006 (PMID 16784799), and Bedford & Lansley 2007 (PMID 17920170). There is quite a bit of support for the notion that this is a controversial issue among the lay public, even if there's no controversy in the scientific and medical community. Eubulides (talk) 00:11, 19 November 2009 (UTC)

Basis for anti-vaccination attitude

• This proposal is for Alternative medicine after the sentence: These include anthroposophy, some elements of the chiropractic community, non-medically trained homoeopaths, and naturopaths.[10]
• Proposed sentence: "The reasons for this negative vaccination view are complicated and rest, at least in part in the early philosophies which shape the foundation of these professions."<ref name=Ernst/>
• Ernst E (2001). "Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination". Vaccine. 20 (Suppl 1): S89–93. doi:10.1016/S0264-410X(01)00290-0. PMID 11587822.
• Requesting review of proposal. QuackGuru (talk) 04:54, 8 November 2009 (UTC)

That would be a good addition, I think. The only problem with the reference though is that it only links to the abstract. Do you have a link to the complete article? Sebastian Garth (talk) 06:30, 8 November 2009 (UTC)

I do not have a link to the full text. You can e-mail Ernst in the UK and they might have a copy of the full text. QuackGuru (talk) 06:37, 8 November 2009 (UTC)

It is available through libraries, as is much genuine science. Midgley (talk) 21:46, 18 November 2009 (UTC)

RFC: NPOV wording

The original statement in dispute (from the section on Vaccine Overload):

"The idea has several flaws."

Does this wording reflect neutrality or bias? My contention is that the cannotations of this statement lean strongly towards the latter. In the interest of preserving NPOV standards, I would prefer something along these lines:

"Evidence has shown that this assumption is fundamentally flawed."

All comments/recommendations are welcome. Thank You. Sebastian Garth (talk) 18:57, 22 October 2009 (UTC)

For reference, it appears that this RfC stems from the dispute in the section above, #Concerning NPOV wording. TenOfAllTrades(talk) 19:39, 22 October 2009 (UTC)

• The proposed rewording is inaccurate, as it does not reflect what the cited source says. The cited source does not say that the assumption is "fundamentally" flawed, nor does it say that "evidence has shown" that this evidence is fundamentally flawed. Here's what it actually says:

"The notion that children might be receiving too many vaccines too soon and that these vaccines either overwhelm an immature immune system or generate a pathologic, autism‐inducing autoimmune response is flawed for several reasons:" and then it goes on to give four reasons.

Whatever POV problem is in the current wording cannot be fixed by replacing the wording with statements that are not directly supported by the cited source. This is not to say that the wording couldn't be improved. For example, we could change it to:

"The idea is flawed, for several reasons."

(This would link well with the following text in the article.) Would that be an acceptable compromise? I boldly added that, but please feel free to revert it if you don't like this proposal. Eubulides (talk) 20:45, 22 October 2009 (UTC)

Well, first of all, I think it's important to keep in mind that citing a source does not require the associated text to be a verbatim transfer of words. I'm not talking about artistic license, either; there is a certain level of inference allowed, by convention. I do agree, however, that the process should not be permitted unconstrained, and in that respect overall conformity with the source is preferable. That said, the real issue here is the quality of the words chosen to represent the referenced source. Are we to adopt a derogatory, condescending tone, or one that sounds most reasonable, civil, and unbiased? My view is that the former tends to isolate readers and thus undermine the whole intent of writing an article in the first place - to educate people about the facts. Like a physician faced with a doubting parent, we should approach the matter with tact, and choose words that don't incite. Anyway, you're suggestion was a little better, but it still seems to fall just short of a perfect solution. What about this:

"Several flaws have been found in this assumption."

Much less edgy, and yet it's essentially identical to the original statement. Would that work? Sebastian Garth (talk) 23:49, 22 October 2009 (UTC)

Some sort of rewording would be fine, but that particular wording is problematic, since the "have been found" suggests a false chronology. The "have been found" theory suggests that the vaccine-overload theory was proposed and seriously considered and that (after some search) flaws were eventually discovered in it. But that's not what happened. What happened is that the idea was popularized on TV by Andrew Wakefield without any scientific support whatsoever (please see MMR vaccine controversy for details), and that the idea has serious flaws that were and are obvious to anyone with even a modicum of expertise in the area. This is why the cited source uses the wording it does. Although it's fine to use different words, the rewording should not water down the essence of what the cited source says. Can you think of alternate wording that doesn't suggest the incorrect interpretation or water things down, while still addressing the problems that you see with what's in the article now? Eubulides (talk) 01:19, 23 October 2009 (UTC)

But, in fact, it has been seriously considered (indeed, if not then we should all have something to worry about). Suppose that the side-effects of substance X are well constrained and predictable. Likewise for the substances Y and Z. Yet, is it unreasonable to ask if a combination thereof could cause unforseen side-effects? Of course not. It follows then that the question exists for *any* possible combination of substances; the issue must be assessed on a case-by-case basis. Thus, in this situation, to say that it "has been found" that the assumption was incorrect is a reasonable chronological characterization. Sebastian Garth (talk) 03:18, 23 October 2009 (UTC)

Sorry, but the previous comment is not something that we can base article wording on. Article wording must be based on what's actually in a reliable source. My comment was an attempt to explain the wording used by source, nothing more. We can't depart from what the source says based purely on our own conjecture. Eubulides (talk) 04:06, 23 October 2009 (UTC)

I was simply illustrating (by logical deduction, by the way, not conjecture) that the phrase "has been found" does not necessarily imply a "false chronology", in this context. And to be honest, in light of the extreme sensitivity of the subject that we are dealing with here, it surprises me that such a weak example of "false chronology" would even be so tenaciously pursued, at the expense of creating quality content that is both tactful *and* accurate. Care to address that point? Sebastian Garth (talk) 04:32, 23 October 2009 (UTC)

If the scientific consensus is that the idea is flawed, and our own sources say the idea "is flawed", why should we say anything else except that it "is flawed"? Yobol (talk) 04:46, 23 October 2009 (UTC)

Perhaps the phrase "has been found" could logically be interpreted in some other way, but the false-chronology interpretation that I gave is a natural one and is one that a reader is likely to take. The article shouldn't use wording that can so easily be misinterpreted. Accuracy is, of course, an important goal here, and the article's current wording more accurately reflects the source than the proposed wording. Tact is a far less important goal; Wikipedia is not censored. Eubulides (talk) 05:17, 23 October 2009 (UTC)

To quote the referenced policy: "(offensive wording) should be used if and only if their omission would cause the article to be less informative, relevant, or accurate, and no equally suitable alternatives are available—however, when a cited quotation contains words that may be offensive, it should not be censored". This is clearly not the case (and if you argue that this is the citation of a quote then it should be structured as such). The wording *should* be accurate and faithful to the source, but should not be done in a tasteless manner, for the sole reason that it is "closer to what was said". So far I have recommended attributing the statement to the source, generalizing it, framing it tactfully, presenting it neutrally, etc. I think it's fair to say that I have been diplomatic and reasonable. Anyone else care to join in on the process? Sebastian Garth (talk) 06:58, 23 October 2009 (UTC)

"Offensive" refers to four-letter words, racially derogatory terms, and that sort of thing. Saying that an idea "is flawed" is not offensive. The wordings that you've suggested have all departed from the source, or are likely to give readers mistaken impressions. I have also suggested several different wordings, all more faithful to the source. I am open to further suggestions, so long as they remain faithful to the source. Eubulides (talk) 07:08, 23 October 2009 (UTC)

Fair enough. Here is my list of candidates:

"Several studies have been conducted on the subject<reference>, and the assumption has proven to be flawed.<reference>" (the two statements correlate and cite their respective sources)

"The idea has been challenged and deemed flawed.<reference>"

"On the basis of findings from numerous studies<reference>, the assumption is flawed.<reference>" (the two statements correlate and cite their respective sources)

"Studies prove, however, that the assumption is fundamentally flawed.<reference><reference>" (the two statements merged and cited jointly)

"Studies do not support this claim<reference>, however, and the idea is considered flawed.<reference>" (the two statements correlate and cite their respective sources)

"Research has shown that the assumption is flawed.<reference>"

Sebastian Garth (talk) 08:05, 23 October 2009 (UTC)

You know, that last wording doesn't sound bad.... --Enric Naval (talk) 14:53, 23 October 2009 (UTC)

I remain unconvinced that what is written is 'tasteless' or 'offensive'. I therefore see no reason to change a clear, concise, neutral and well supported statement such as it currently exists.Yobol (talk) 15:40, 23 October 2009 (UTC)

I agree with Yobol. Furthermore, statements like "Studies have shown" are pompous: they make it sound like we're trying to intimidate the reader by waving a bunch of papers in the air. One often sees "studies have shown" wording in advocacy websites, but this article is not supposed to be advocating, and we shouldn't be inserting wording that makes it sounds like it's advocating. This is on top of my earlier comments that the cited source doesn't say "studies have shown" or anything like it (this is a more important point than the pomposity point). Please suggest a wording that does not involve "Research has shown", "Studies have shown", or similar wording. Eubulides (talk) 21:25, 23 October 2009 (UTC)

Alright then, how about one of these:

"Evidence shows that this assumption is flawed.<reference>"

"These claims however are not supported by evidence, and in fact have proven to be flawed.<reference>"

"Research has revealed that the idea is flawed, for several reasons.<reference>"

The last one looks especially promising, I think, due to the fact that it essentially conveys the exact meaning of the original without sounding unobjective. Sebastian Garth (talk) 22:59, 23 October 2009 (UTC)

But "research has revealed" is even more pompous and/or POV than "studies have shown", no? It's the sort of breathless wording that one might see in a press release, but hardly ever in a neutral source. "Evidence shows that" is better, but it still suffers from the "studies have shown" problem. The phrase "has proven to be" is also problematic, as it suggests some sort of proof has been applied (it hasn't been), and the "has proven" has the same problem with implying the wrong chronology that was mentioned earlier. Finally, the phrase "These claims however are not supported by evidence" would unnecessarily repeat the phrase "Although no scientific evidence supports this idea" in the previous sentence. But perhaps we can solve that by coalescing the two. How about if we replace the current wording:

"Although no scientific evidence supports this idea, it has caused many parents to delay or avoid immunizing their children. ¶ The idea is flawed, for several reasons."

with this:

"The idea has caused many parents to delay or avoid immunizing their children. ¶ No scientific evidence supports the idea, and it is flawed for several reasons."

Eubulides (talk) 23:39, 23 October 2009 (UTC)

Much better, but the ending is somewhat disjoint. The word "is" could be replaced or expanded by something more descriptive. I really think "has proven" would be a good choice since it asserts that the doubts have been methodically addressed and ruled out as significant. As far as the suggestive (eg. false chronological) implications, they really seem extremely minor, in my opinion. Anyway, perhaps it could be restructured just a bit, such as in:

"The suggestion has caused many parents to delay or avoid immunizing their children. Yet no scientific evidence supports this claim, and several flaws in the idea have been exposed."

Not necessarily those words exactly, of course, but maybe something along those lines? Sebastian Garth (talk) 00:40, 24 October 2009 (UTC)

That ending is not disjoint when it's placed in context. What looks like the "ending" here is actually the topic sentence of a paragraph, and the paragraph's next sentence starts with "For example," which builds directly on the last words of the "ending". I'm afraid the words "yet" and "have been exposed" imply a chronology that isn't supported by the source and (as I've mentioned above) is not what actually happened. Eubulides (talk) 02:46, 24 October 2009 (UTC)

Perhaps then you could make a reasonable suggestion that does not imply a false chronology? Sebastian Garth (talk) 03:19, 24 October 2009 (UTC)

I did above, in the proposed wording "The idea has caused many parents to delay or avoid immunizing their children. ¶ No scientific evidence supports the idea, and it is flawed for several reasons." (The "¶" means "begin paragraph".) Your next comment objected on the basis of the ending being somewhat disjoint; I responded that it's not disjoint in context. In rereading your comment I now see that you objected to the "is" and wanted something something "more descriptive". The cited source says that "The notion ... is flawed"; an alternative wording that would be fine is "has flaws", or if we want something a bit fancier, perhaps "has defects", or "is faulty", or something like that. However, saying something like "flaws have been exposed" goes too far beyond what the source says; we can't squeeze descriptive wording out of a source that lacks the description. Eubulides (talk) 03:50, 24 October 2009 (UTC)

By 'disjoint' I simply meant that the flow was rather awkward. Besides that, it still lacks objectivity. Your contention seems to be that any sort of restructuring/rewording of the content would either create a false chronological relationship or deviate from the intended message of the cited source. In that case, perhaps a direct quote would be more appropriate. Sebastian Garth (talk) 05:40, 24 October 2009 (UTC)

That's not my contention, and I've proposed several alternate wordings. The flow is not awkward in context. The current wording does not lack objectivity. There is no need for a direct quote here; the science is not controversial among reliable sources, and putting a direct quote from a particular source here (as opposed to all the other places in the article) will give an undeserved air of controversy to the point. Eubulides (talk) 05:44, 24 October 2009 (UTC)

The very fact that the section addresses a desputable claim (given that the supposition in and of itself is not frivolous) suggests that a controversy exists, so yes to state flatly that it is false would be, by definition, unobjective. It seems reasonable to me then that to "find", "conclude", "show", "prove", "demonstrate", "reveal", "expose", or "determine" that the hypothesis is flawed would be a fair and accurate characterization of the situation. Moreover, the article itself covers a controversial topic, and as such special precautions should be taken so as not to sound one-sided about the matter. Sebastian Garth (talk) 07:34, 24 October 2009 (UTC)

Again, there is no dispute within the scientific community about this topic, and you have provided no references to support the position that there is. Your arguments are unconvincing. By the logic above, our article on AIDS should not state that HIV causes AIDS directly without phrases like "studies show" due to a "controversy" surrounding that subject - a position that would make providing concise encyclopedic content impossible. Yobol (talk) 12:58, 24 October 2009 (UTC)

It may be true that there isn't any current dispute, but as the question itself is in fact one of drug interaction, it cannot be ruled out categorically (whereas the example you have given can be). Therefore the assertion that there is no reasonable basis, that it cannot be a matter of consideration, or that no debate could ever exist, is indeed flawed, for several reasons. Sebastian Garth (talk) 15:35, 24 October 2009 (UTC)

No one, as far as I can tell, has said anything about "no reasonable basis", "cannot be a matter of consideration", or "no debate could ever exist." I simply want the article to reflect what is stated by the WP:RS (i.e. that the idea "is flawed"). Yobol (talk) 18:06, 24 October 2009 (UTC)

Specifically, it has been said that certain wording may lend undue weight to a subject that is not debatable (eg. controversial), which suggests that the disputed claim is in fact a fringe theory. Considering the pharmacokinetic implications of the question, though, this cannot be so. I too want to represent the source accurately, and also recognize the importance of the statement in the context of the article, but simply feel that a more appropriate choice of words is in order, all things considered. Sebastian Garth (talk) 19:39, 24 October 2009 (UTC)

The current wording is fine. Since you cannot or will not produce any WP:RS that shows any dispute or controversy within the scientific community, I personally consider the matter closed until such evidence is produced and would encourage the NPOV tag be removed. Cheers. Yobol (talk) 19:52, 24 October 2009 (UTC)

I'm sorry, but reliable sourcing simply relates to the support of a position, which isn't even the case here. Furthermore, you have neither addressed the key arguments that I have put forward nor shown a significant effort to assume good faith in my objections. I have made repeated attempts to resolve the issue by striving to accomodate everyone's expectations as nearly as possible, at all times willing to make concessions and accept a reasonable compromise, as have I recommended several viable alternatives that would have ensured that the original statement would be largely unaffected. I only ask that everyone make a sincere effort to work towards the goal of real consensus. Can we all agree to that? Sebastian Garth (talk) 21:04, 24 October 2009 (UTC)

Your arguments for a reason why there needs to be a change are wholely unconvincing. Since you have not convinced me that there needs to be a change at all, providing alternatives, all of which are changes, is moot. As to your accusation I have not followed WP:AGF, you should read part of that same guideline you cite. Just because someone doesn't agree with your arguments doesn't mean they didn't consider them in good faith. Cheers. Yobol (talk) 21:46, 24 October 2009 (UTC)

• The key distinction is that the cited article argues that vaccine overload is a flawed concept prima facie, on its face, as opposed to based being upon retrospective studies. I believe that this is the point Yobol and others have argued in favor of retaining the present wording. In contrast to other claims addressed in the article, which reference studies making the rebutting claim on their own, with respect to vaccine overload the article references studies which in a piecemeal way support the authors' overarching reasoning. This is an important distinction that should be communicated to the reader. While the proposed wording changes give precisely the wrong impression, the present wording does not explicitly make the distinction either, and in fact leaves it unclear whether the source is making the argument prima facie or based on statistical studies. Thus I would propose the following wording for the opening line and following paragraph in order to maintain the present intended meaning while making it explicitly clear.

"Based on several facts regarding the immune system, vaccinations, and autism, this notion is prima facie flawed."

I'll note that I have already made significant edits to the rest of the section following this statement, which I think both improve it an would help to explain the statement made in this wording so as to make it particularly factual, neutral, and clear.Locke9k (talk) 19:30, 19 November 2009 (UTC)

Science is based on evidence

Science is based on evidence and to assert that "the evidence indicates that ..."<:ref> is quite appropriate specifically in an encyclopedic article. In contrast, an absolute statement that "the idea is flawed ..."<:ref> in an encyclopedic article that tries to illuminate a controversy strains objectivity as a position is taken (based on a limited reference base). Such a dogmatic stance does not help the article.Ekem (talk) 03:09, 29 October 2009 (UTC)

There is no disagreement or controversy within the scientific community on this point regarding "vaccine overload". We do not say "evidence indicates that AIDS is caued by HIV", we say "AIDS is caused by HIV" as a definitive statement, despite "controversy" in the lay community. Since our sources say it definitively, it would violate our policies to water it down unless you can find other reliable sources that shows some controversy within the scientific community. Yobol (talk) 03:20, 29 October 2009 (UTC)

Keep it simple - writing The Evidence has shown ...$_EVIDENCE is repetitive and a mite pompous. The first proposed wording by Eubulides here is I think the best way to go, though honestly the current wording is well-supported and does not feel particularly clunky or out of place. - 2/0 (cont.) 04:33, 29 October 2009 (UTC)

Just to be the devil's advocate: The reference supporting the clause of concern is primarily discussing if in children multiple vaccinations could lead to autism, not if many vaccinations lead to any type of damage (short term-long term). Further, there may be some concern that one of the two authors is closely linked to the vaccine industry. It is not clear to me if in the wp-article the term "idea" relates just to autism (in children) or to any sequelae; - in case of the latter the reference just does not cover it. Further, while vaccine doses have been reduced over time, neither the wp-article nor the reference adresse the role of vaccine adjuvants and any potential (alone or cumulative) side-effects (-vaccine adjuvants are used to augment the reduced vaccine dose to obtain the desired antibody response). I suggest, therefore, not to take such a dogmatic stance at this time.Ekem (talk) 00:49, 30 October 2009 (UTC)

The sentence in question deals specifically with the concept of "vaccine overload", not autism and vaccines in general, and the cited source says, "The notion that children might be receiving too many vaccines too soon and that these vaccines either overwhelm an immature immune system or generate a pathologic, autism‐inducing autoimmune response is flawed for several reasons". The current sentences in the article, as you can see, matches the source closely and therefore should be the preferred version. Likewise, whether or not an author is "linked" to any industry does not automatically disqualify a paper from being valid; as has been said multiple times before, no one has brought forth any sources showing significant controversy about "vaccine overload" in the scientific community. To introduce it here when none exists either in the source cited nor in the scientific community would violate WP:NPOV. You are more than welcome, however, to present any WP:RS that shows a controversy in the scientific community with regards to "vaccine overload" and the conclusions reached by the cited source. Yobol (talk) 01:36, 30 October 2009 (UTC)

Yet, the statement on question defies logic. Every new combination of vaccines requires new studies to be performed. The ACIP, for example, issues recommendations of approval for a particular combination based on these studies. It's a perpetual process. If anything, the entry should read "Based on currently approved vaccine schedules, the idea is flawed". Moreover, of the four 'flaws' found by the researcher, #1 is mostly generalized conjecture ("although the infant immune system is relatively naive, it is immediately capable of generating a vast array of protective responses", and "vaccines represent a minute fraction of what a child’s immune system routinely navigates"), and the rest merely make references to statistics. None of them actually succeed in pointing out any flaws whatsoever (given that a 'proof' is necessarily required to reveal a 'flaw'). My opinion is that it's a weak reference that could really be replaced with something better. But until then, it should at least agree with common sense. Sebastian Garth (talk) 02:51, 30 October 2009 (UTC)

"Common sense" is not a Wikipedia guideline. What you or I may consider "common sense" is irrelevant to what the reliable sources say, as different people have different views on what "common sense" is. If you have concerns about the arguments presented in the source, it is incumbent upon you to find reliable sources that state these concerns, at which point they go into the article. Until you find a reference that supports your suppositions, it is my opinion that we take the expert opinions in the field as documented by the sources in the articles over any one Wikipedia editor, per our guidelines. Yobol (talk) 03:32, 30 October 2009 (UTC)

Just because none of his peers actually decides "Hey, Gerber's point is a bit of an over-generalization. I'd better write an article to clarify that statement", doesn't mean that it shouldn't be subject to scrutiny here. The fact is, it doesn't agree with reason, and as such should either be admitted with qualification or else rejected altogether. In the context of the statements of his peers: "Currently available vaccines are safe in immunocompetent individuals and there is no evidence to deviate from current immunization schedules" (Bonhoeffer, Heininger), and "At present, the safety of a new vaccine must be demonstrated in large-scale clinical trials before the product is licensed. After licensing, the safety of new vaccines is constantly monitored, and the results of monitoring are published" (Schneeweiss, Pfleiderer, Keller-Stanislawski). These statements directly contradict Gerber's assertion that the possibility of vaccine overload is a once-and-for-all settled issue. Sebastian Garth (talk) 04:13, 30 October 2009 (UTC)

Supplanting your opinion for those of the reliable resources is against our guidelines. We do not substitute our own judgment for those of the sources if they are well supported by the scientific community and the medical literature.

You also quoted the improper sections from the cited articles, as you quote from sections not directly related to "vaccine overload".

• From Bonhoeffer: "...there is insufficient evidence supporting the concern that vaccines would weaken or otherwise harm the immune system. Immunogenicity of combination vaccines generally is not inferior to separate administration. Some studies even observed a cross-protective effect against infectious diseases not targeted by a given vaccine and hypothesized that the simultaneous presentation of multiple antigens might unspecifically stimulate the immune system resulting in increased ‘immunological fitness’ rather than compromising it." (bold mine) In other words, there is evidence that multiple vaccinations increases immune response, which certain suggests that "vaccine overload" is flawd. (As an aside, I note that Bonhoeffer is not cited in the vaccine overload section, and that at the least, it should be cited to show the consensus on this issue).
• From Schneeweis: "A question frequently raised by vaccination skeptics is whether a child’s immune system might not be overburdened, particularly by combined vaccines comprising up to 25 different antigens. In humans, however, the T-cell receptors responsible for the recognition of microbial antigens are present in quantities on the order of 1018 even in childhood. On today’s knowledge of the immune system, the antigens in combined vaccines occupy only a minute fraction of the available receptors." Again, this supports Offit and Gerber as they show no biological basis to suspect the immune system can be "overloaded".

As you can see, these sources support Offit and Gerber. Why would you cite from these two articles portions which are not directly addressing the issue of "vaccine overload" and ignore the sections that do address it? Yobol (talk) 04:42, 30 October 2009 (UTC)

I was merely correlating the temporal aspects in order to corroborate the contention that the statement in question defied the obvious pharmacokinetic implications. Vaccine overload is ultimately a question of drug interaction, and as we have yet to see any evidence to suggest that the study of the latter will ever exhaustively document every possible combination of substances, in every concievable ratio, there is no doubt that the same must be true of the former. Claiming that the two are unrelated or can somehow be decoupled would be fanciful, at best. Sebastian Garth (talk) 06:09, 30 October 2009 (UTC)

Please provide sources for the above assertions:

• that "vaccine overload" is a "question of drug interaction", as opposed to a question of antigen "overload" as our sources (and frankly the name) suggests
• that the only way to evaluate "vaccine overload" is to "exhaustively document every possible combination of substance, in every concievable ratio"

I have yet to see anything in the literature to suggest this, and would be interested to see from which reliable sources you are getting this information. In the future, I would suggest you actually quote the articles that directly relate to the topic at hand, rather than another topic, as what you did above is very misleading, which I'm sure you do not want to do again. Yobol (talk) 06:24, 30 October 2009 (UTC)

So to suggest that vaccines are subject to the principles of drug (eg: molecular/biological) interaction is simply conjecture? Perhaps you can cite a reliable source to support such a conclusion? Sebastian Garth (talk) 06:55, 30 October 2009 (UTC)

No, I am asking you to support your claim that "vaccine overload" is related to "drug interactions" as you claimed. Please provide a source for this claim, as well as the other claim I noted above. Yobol (talk) 07:25, 30 October 2009 (UTC)

The two are related by virtue: Vaccines contain molecular agents and organic materials which interact with organisms; Incidentally, this is precisely the subject of study in the field of drug interaction research. Sebastian Garth (talk) 07:45, 30 October 2009 (UTC)

Sorry, but the previous comment is not based a reliable source on the topic of vaccine overload. We can't modify the article to dispute reliable sources (and we have several) merely by appealing to general principles and our own reasoning. Eubulides (talk) 15:56, 30 October 2009 (UTC)

I admit that my jaw dropped when I saw the argument that those quotes "directly contradict Gerber's assertion that the possibility of vaccine overload is a once-and-for-all settled issue". First, those quotes don't even mention vaccine overload. Second, they don't contradict anything that Gerber & Offit say about vaccine overload. Third, Gerber & Offit did not say that vaccine overload is a once-and-for-all settled issue. (By the way, thanks for adding Bonhoeffer & Heininger 2007 (PMID 17471032) as a citation to the vaccine overload section, as it's quite relevant.) Eubulides (talk) 05:57, 30 October 2009 (UTC)

The very implication of "the idea of vaccine overload is flawed" is that it is indisputably, in all cases, and at all times, a false assumption. In fact, the reference is really saying that "the idea that the currently approved vaccine schedule can lead to overload is not supported by evidence". Because once a new vaccine or a combination thereof are introduced into the equation, the original quote is invalidated (at least until newer studies prove otherwise). Sebastian Garth (talk) 06:23, 30 October 2009 (UTC)

Sorry, but that paraphrase of Gerber & Offit is quite wrong. They're saying that the very notion of vaccine overload is suspect, due to our understanding of how the immune system works. Their conclusion is not based merely on negative results from safety studies, and it won't become false after the next vaccine is released. And it's not an argument that only Gerber & Offit make: all our reliable sources on this subject agree. Eubulides (talk) 06:42, 30 October 2009 (UTC)

To suggest that an untested combination of substances poses no risks whatsoever would be beyond optimistic - it would be completely unrealistic, actually. The immune system isn't exempt from the laws of chemistry. Sebastian Garth (talk) 07:29, 30 October 2009 (UTC)

Nobody has made that suggestion, and the article does not make that suggestion. Again, a comment that merely appeals to "the laws of chemistry" is not based a reliable source on the topic of vaccine overload, whereas the article's existing text is directly based on several reliable sources. The article cannot dispute what reliable sources say merely based on our own intuition. Eubulides (talk) 15:56, 30 October 2009 (UTC)

• Gerber & Offit 2009 (PMID 19128068) does not limit its discussion of the vaccine overload theory to children, or to autism. It is clearly a reliable source, written by acknowledged experts in the field, and we can't attempt to undermine its conclusions merely because we believe them to be mistaken.
• Attacking the conclusions of a reliable source based on one author's ties to industry shouldn't form the basis of the article without reliable sources.
• Several reliable sources agree that the vaccine-overload theory is implausible and/or is not supported by scientific evidence. These include not only Gerber & Offit 2009, but also Gregson & Edelman 2003 (PMID 14753385) and Bonhoeffer & Heininger 2007 (PMID 17471032), which are already cited in the article. I looked for other recent reliable sources in this area, and found just one, Schneeweiss et al. 2008 (PMID 19471677), which I just now added. This is a good new source because it also covers theories such as SIDS which the article did not mention. I added a new section for these other theories. A plus of this source is that it's freely readable.
• As far as we know, no reliable sources talk about the role of adjuvants in the vaccine overload theory, and without reliable sources to discuss a topic we cannot say anything about it.
• In the Wikipedia article, the phrase "the idea" clearly refers to the definition in the topic sentence of that section, which is adverse effects among children. The cited source talks about the more general claim of adverse effects among any individuals, of which children are an important special case; it would be OK revise the text to make it clear that the flaws in the idea are not limited to vaccination in children.

Eubulides (talk) 03:18, 30 October 2009 (UTC)

Financial Motives

A recent edit here introduced inappropriately worded content to the Financial Motives section. Could we see some better suggestions that would follow a more encyclopedic format? Also, apologies to Eubulides for the complete revert, as opposed to a re-edit - there just seemed to be too many problems with the submitted version. Sebastian Garth (talk) 01:17, 25 November 2009 (UTC)

This is my suggestion, presented without citations, for clarity:

• "Some have criticised the vaccine industry of misrepresenting the safety or effectiveness of vaccines, or influencing health policy decisions for mere financial gain. This is in spite of the fact that vaccine makers spend billions of dollars anually on safety research and conduct numerous studies to monitor the long-term effects of their products. Others have pointed out that many profit by promoting the controversiality of vaccines, such as lawyers, expert witnesses providing testimony for exorbant fees, and practitioners of alternative medicine offering expensive supplements and various procedures which are unproven to treat the diseases that are prevented by vaccines."
• "In the late 20th century, vaccines were a product with low profit margins, and as a result, the number of companies involved in vaccine manufacture have declined. In addition to low profits and liability risks, manufacturers have complained about low prices paid for vaccines by the CDC and other U.S. government agencies."

Sebastian Garth (talk) 02:00, 25 November 2009 (UTC)

Here's the wording you reverted:

"Many groups benefit from the continuing controversy over vaccines and autism: lawyers could earn millions of dollars, expert witnesses are paid to testify and to speak at conferences, journalists can write attention-getting articles, and practitioners of alternative medicine can sell medications such as expensive supplements and procedures such as chelation therapy and hyperbaric oxygen therapy."

• What's unencyclopedic about this text? This issue is not controversial among reliable sources.

It really has nothing to do with being controversial with reliable sources, actually. I would object just as much to the inclusion of a statement such as "vaccine makers could stand to earn billions", or similar. The comment about journalists doesn't sound right, either. It just doesn't read encyclopedically - I don't know how else to put it. Also, it really isn't necessary to list specific, dubious, treatments being offered by certain AMP's. A summary that the treatments are not accepted practices is sufficient, I think. Sebastian Garth (talk) 03:04, 25 November 2009 (UTC)

• Another editor restored the text, and also restored the primary-source material that I had replaced with the text. The resulting paragraph has a POV problem, in that it spends too much time discussing financial motivations of critics, and too little time discussing financial motivations of proponents. This is partly why my edit removed the primary-source material discussing motivations of individual vaccine critics; the other reason is that the article should prefer secondary sources such as Kerr 2009 to primary sources (as per WP:PSTS).

I agree. The replaced text definitely had some issues. Sebastian Garth (talk) 03:04, 25 November 2009 (UTC)

• The wording you propose is not directly supported by the cited sources. We do have a source (Wolfe & Sharp 2002, PMID 12193361) that directly supports a claim of the form "Some have criticised the vaccine industry ...", because that source is about vaccine critics and what they say. However, we do not have any source that directly supports a claim of the form "Others have pointed out that many profit by promoting the controversiality of vaccine ...", so we can't use the "Others have pointed out" part of that claim.

Concerning your first point, I don't think a citation is needed in stating that some have raised the issue, but if you really want one, I'm sure it could be found. To your second point, I thought that was taken care of by the Kerr reference. But either way, I suppose it could simply drop the first part, eg: "Others have pointed out that", as it's superfulous, though I still think it reads better, personally. Sebastian Garth (talk) 03:04, 25 November 2009 (UTC)

• More generally, the wording you propose attempts to shoehorn this controversy into a "Proponents say X and critics say Y" form. That form is entirely appropriate when X and Y are controversial, but it's inappropriate and even misleading when there is no controversy about X and Y. Instead, the article should simply state uncontroversial facts (such as vaccine makers having the profit motive, and lawyers also being motivated by profit), and should use the "A says X" format only when X is controversial.

Okay, I hope I addressed that above by the recommendation of dropping the lead-in. Let me know, if not. Sebastian Garth (talk) 03:04, 25 November 2009 (UTC)

Eubulides (talk) 02:17, 25 November 2009 (UTC)

Okay, well can you comment on the current draft I have submitted? I'm still reviewing your comments thus far, and will try to address your points shortly. Sebastian Garth (talk) 02:45, 25 November 2009 (UTC)

Also, can we drop the last paragraph? There really isn't any need to mention actual profit figures, right? It just seems like an unnecessary digression. Sebastian Garth (talk) 06:02, 25 November 2009 (UTC)

There are some serious problems with the new version installed:

• "Some have accused ..." This violates Wikipedia:Avoid weasel words. The sentence should say who is accusing. "Critics of vaccines" is a good replacement for "Some".

Good point, okay.Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The new version removes the claim by critics that vaccine makers cover up information. This is a serious accusation that is well supported by the cited source; it should stay in.

Right, that makes sense.Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The new version contains argumentation that is an editorial interpolation, not directly supported by the cited sources. The sentence "In spite of this, vaccine makers spend billions of dollars annually on safety research and conduct numerous studies to monitor the long-term effects of their products, while goverment and consumer protection agencies review the practices of these companies to ensure that the best interests of the public are being maintained." is mostly propaganda, and is not directly related to the topic of this section, namely financial motives by both sides. The "In spite of this" is particularly bad (in spite of what?), but the entire sentence should go unless we have a source that directly connects this point to the profit motive of vaccine makers.

Yes, I was aware that it had some problems. I was really just trying to temper the allegations with the fact that the industry's attitude toward their products is far from careless, and also that institutions exist to help prevent such problems from arising. I think those are important points, and their inclusion would really improve the section. I'll see if I can come up with something more coherent. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The new version contains the phrase "exorbitant fees" that is not at all supported by the cited source.

Done. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The new version removed the point that lawyers stand to earn significant attorneys' fees: this is an important point that should not be removed, and is well supported by the cited source.

Done. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• Likewise, the point that expert witnesses are also paid to speak at conferences seems relevant; why was this removed?

Done. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The rewording removed the point that alt-med practitioners offer various medications, not just supplements.

Done. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The claim "which are unproven to treat the diseases that are prevented by vaccines" is not supported by the cited source, and it isn't even relevant. The treatments in question are not claimed, even by those promoting the treatments, to treat the diseases that are prevented by vaccines. Please restore the original text that was well supported by the source, "can sell medications such as expensive supplements and procedures such as chelation therapy and hyperbaric oxygen therapy".

Concerning the first issue: That is a good point, actually. Done. As far as the references to specific treatments, how is that relevant? Does it really matter if they recommend aromatherapy, or salt baths, or whatever it may be? What is the rationale there? Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

There's no need to list the hundreds of treatments, of course, but it is useful to give one or two examples of medications, and one or two examples of procedures, so that readers (who can't be assumed to be familiar with these treatments) can get an intuition for how alternative medicine practitioners make their money and are thus financially motivated. Eubulides (talk) 20:27, 25 November 2009 (UTC)

I see, so it establishes a bit of context. Fair enough. Sebastian Garth (talk) 21:14, 25 November 2009 (UTC)

• The new version contains the phrase "as a result" that is not supported by the cited sources.

Yes, definitely WP:OR. Done. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The new version changed "manufacturers complained" to "manufacturers have complained". This change is not supported by the cited source: the cited source talks about complaints well in the past, not complaints continuing to the present.

Done. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The new version replaced "In the early 21st century" with "More recently". This is a step backwards, as per [[Wikipedia:Avoid weasel words. Please restore the more-precise phrasing.

Okay. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The new version replaced "the vaccine market greatly improved" with "profits have improved". The cited source doesn't say that profits have improved. Please restore the wording that is supported by the source.

Done. Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

• The new version removed the point that there is a small number of highly-priced blockbuster vaccines now. This is an important point with regard to financial motives, and should not be removed. Also, the new version removed the point that Prevnar was the pathbreaker here; why remove that?

How does that relate to finacial motives? Some people will steal for 10 dollars. It's a question of ethics, not "how much profit is at stake". Sebastian Garth (talk) 10:11, 25 November 2009 (UTC)

The important point is that the vaccine makers' financial motivations are not evenly spread out among vaccines: they have a few blockbuster vaccines which make a lot of money, and they have many more humdrum vaccines which are not major revenue sources. Financial motivations and ethics in boom-or-bust environments such as vaccines or Hollywood filmmaking or oil wildcatting are qualitatively different from financial motivations in more-steady businesses like primary care or TV news broadcasts or salt mines. This boom-or-bust phenomenon is fairly recent in vaccines (it wasn't true ten years ago) and we can't assume that typical readers will know it. Eubulides (talk) 20:27, 25 November 2009 (UTC)

I see what you mean. I guess that is a more realistic assessment of the dynamics that could come into play there. Sebastian Garth (talk) 21:14, 25 November 2009 (UTC)

Eubulides (talk) 07:56, 25 November 2009 (UTC)

NPOV Violations

This article utterly *wreaks* of non-NPOV. Remember: Wikipedia is not to be used to espouse any particular ideology or opinion. This is an Encyclopedia, after all. State the facts from both sides and leave it at that. Is that really too difficult to understand? Sebastian Garth (talk) 03:46, 5 October 2009 (UTC)

Which bits in particular do you object to? Rather than say "the whole article" pick out one (for a start) and then offer your alternative edits. Then the merits of your proposed edit can be discussed and if it mets with the consensus of editors, it can go in. Shot info (talk) 03:54, 5 October 2009 (UTC)

You probably mean "reeks" rather than "wreaks". It would be dishonest and non-neutral to pretend that there are two equally valid "sides" with competing facts. You know, "some people say the Earth is round(ish), while others counter that it is flat" doesn't exactly have that encyclopedic ring to it. MastCell ^Talk 04:55, 5 October 2009 (UTC)

The problem is essentially that (1) the vast majority of the article is spent discussing the benefits of vaccination, and (2) the tone used to address the other side of the argument borders on ridicule. To be fair to both sides, the best solution would simply be to split the article into two parts, each describing the respective positions. Superfulous, opinionated wording, such as "the idea is flawed for multiple reasons", et al, should be removed or rephrased for neutrality, as well. With that approach, at least, the existing text could basically remain as-is in it's own section, and we'd have a more balanced treatment of the issue, overall.Sebastian Garth (talk) 05:20, 5 October 2009 (UTC)

Which bits in particular do you object to? Shot info (talk) 05:38, 5 October 2009 (UTC)

• I did see a specific objection to the wording "the idea is flawed for multiple reasons". This wording attempts to summarize the section in the cited source (Gerber & Offitt 2009, PMID 19128068) that begins "The notion that children might be receiving too many vaccines too soon and that these vaccines either overwhelm an immature immune system or generate a pathologic, autism‐inducing autoimmune response is flawed for several reasons." Specific suggestions for improving this wording would be helpful.
• Moving the "pro" material into one section, and the "con" into another, would cause more troubles than it would cure; please see Wikipedia:Neutral point of view #Article structure.

Eubulides (talk) 06:13, 5 October 2009 (UTC)

I was referring to the article "in general", actually. Both sides of the issue simply need to be presented without bias. I think everyone can agree with that. Just how to go about doing that is debatable. I would say that if it is possible to merge both arguments into the article as a whole, that would be best. On the other hand, it would certainly be easier to separate the content into two sections, and would probably help prevent unproductive edit wars, as well. Either way, though, as long as NPOV is maintained neither camp will have much to complain about.Sebastian Garth (talk) 06:41, 5 October 2009 (UTC)

Note the edit in the Vaccine Overload section. I think the original import of the paragraph was preserved, though.Sebastian Garth (talk) 07:27, 5 October 2009 (UTC)

What I feel about this article is that it is missing the point of "Vaccine Controversy". I think that the focus should be on stating what arguments have been used against vaccinations. Of course these arguments can be refuted but I feel that sections such as "Population health", "Cost-effectiveness", "Events following reductions in vaccination" etc. would be better suited to the vaccination article and don't really tell us much about vaccine controversy. Mhairiiscool (talk) 01:39, 29 November 2009 (UTC)

It would hardly be fair to cover a controversy by focusing only on one side's arguments, no? Eubulides (talk) 02:00, 29 November 2009 (UTC)

I don't think this is exactly one side vs. another - the whole debate is defined by the anti vaccination movement, without it this page wouldn't exist. We don't have a Surgery Controversy page because there is no notable "anti-surgery" movement (as far as I am aware of...). There is scientific facts about vaccines and there is "Vaccine Controvery". Not that scientific facts about vaccines aren't relevant to the Vaccine Controversy page (quite on the contrary) but I think the page should mainly be a factual report on what arguments have been used against vaccines rather than a debate about vaccines. There can still be counterarguments and refutations! I just don't think they should be the focus.
For example, I imagine the effectiveness section to go something like: "Bla has said that Vaccines are ineffective. They say bla bla and bla. They cite bla bla bla. However bla evidence bla vaccines do otherwise.
I dunno, this is just what my interpretation of "Vaccine controversy", I think it would be a more useful page and easier to keep NPOV. If that makes any sense... —Preceding unsigned comment added by Mhairiiscool (talk • contribs) 04:56, 29 November 2009 (UTC)

It's certainly not true that "the whole debate is defined by the anti vaccination movement". If that were true, then there wouldn't be a controversy, and nobody would be using vaccines. The debate is framed both by the pro-vaccination and by the anti-vaccination sides. Some scientific facts about vaccines argue against vaccines' use, for example. It would not be neutral if this page merely listed anti-vaccination arguments, one by one, and then refuted them: first, that would give only one side of the framing issue (the anti-vaccination side), and second, the refutations would give the pro-vaccinationists the last word. Both practices would be non-neutral. Eubulides (talk) 06:53, 29 November 2009 (UTC)

No serious dispute

Please see WP:ASF. Attribution is a policy violation. QuackGuru (talk) 18:43, 28 November 2009 (UTC)

No, even if stating opinions of general consensus, WP:ASF requires attribution. Sebastian Garth (talk) 21:18, 28 November 2009 (UTC)

No, ASF does not require attribution when no serious dispute exists. QuackGuru (talk) 23:37, 28 November 2009 (UTC)

No serious dispute has been presented. Attribution is against ASF. Please provided evidence of a serious dispute. QuackGuru (talk) 23:46, 28 November 2009 (UTC)

WP:ASF does not require in-text attribution for information where there is no serious dispute. Requiring in-text attribution for widespread consensus of reliable sources on the grounds that it is "opinion" would allow a contrarian reader to insist on in-text attribution for material about which there is no serious dispute, using the argument that the material is an "opinion". This would mean, in the end, that all material in Wikipedia would require in-text attribution, even if only one Wikipedia editor insisted on it, which is not the intent of WP:ASF or of WP:CONSENSUS. Eubulides (talk) 00:34, 29 November 2009 (UTC)

A few ideas about neutrality

When there is a dispute over something "out there in the real world", we must not pretend that the dispute doesn't exist. Also, if we (as writers) cannot agree on what percentage of the general public (or some special group such as research scientists, or school principals, or pediatricians, or drug company representatives) favors the various sides, then we should not guess or assume.

It is a fact that some people (myself most definitely included!) are cheerfully and confidently in favor of vaccination in general, but there are others who oppose the concept or who worry about the side effects or other ramifications of certain particular vaccinations.

A neutral article would not bother to say which group is right about which aspect, but would only try to identify the positions, the adherents and (if available) their reasoning. --Uncle Ed (talk) 02:30, 29 November 2009 (UTC)

The Wikipedia policy on neutrality does not preclude summarizing the scientific consensus on an issue. The vaccine controversy is (in large part) over what the scientific consensus should be; this article cannot cover the controversy without stating the consensus. Eubulides (talk) 06:53, 29 November 2009 (UTC)

Proposed replacement for the sentence about "flawed"

In Wikipedia talk:Requests for mediation/Vaccine controversy #Changes to the wording of the article it's proposed that in the Vaccine overload section we change "The idea is flawed, for several reasons." to "The vaccine-overload notion is not only unsupported by the evidence, it is contradicted by the evidence." Comments? Eubulides (talk) 00:34, 29 November 2009 (UTC)

I suggest we keep the original wording and also include the above wording. QuackGuru (talk) 00:49, 29 November 2009 (UTC)

Sorry, but that's not a compromise in any sense that would be understood by the participants of Wikipedia talk:Requests for mediation/Vaccine controversy. The objection was to the wording "The idea is flawed". From the viewpoint of the side objecting to that wording, simply adding more wording to reinforce the point makes it worse than if the wording hadn't been changed at all. Eubulides (talk) 01:05, 29 November 2009 (UTC)

It is a compromise because it is now clear the idea is flawed without violating ASF. Just stating it is flawed was not enough without reading the reference. Now it is clear it is flawed with the additional context. A reader can understand the text more clearly now. QuackGuru (talk) 01:15, 29 November 2009 (UTC)

How is the statement "the idea is flawed..." a reasonable overview of the literature? Please explain. Sunray (talk) 05:19, 29 November 2009 (UTC)

It was not a reasonable summary. With the additional context I recently added, it is now a resonable summary because it makes it clear to the reader the evidence according to the reliable sources. QuackGuru (talk) 18:37, 29 November 2009 (UTC)

The proposed text only captures some of the problems with the vaccine overload hypothesis. Yes it has no evidence so is "unsupported". Yes, experience with vaccines and with exposure to pathogens both "contradict" the notion. But this doesn't capture just how way off the mark the hypothesis is. It has some ironic comedy value like "The notion that Colin is a world class athlete is not only unsupported by the evidence, it is contradicted by the evidence." There is no serious dispute over the language used by experts: that vaccine overload a is "myth", a "misperception" or "flawed." These are strong words.

The mediation request centred on the idea that there was some serious dispute therefore the flaws of the vaccine overload hypothesis could not be stated as fact. The mediation proposer failed to convince the two other parties and appears to have dropped that argument. We now have the current situation that a very weak but "it is a fact: this is wrong" lead sentence is proposed along with recent text that contains a full paragraph of the flaws. Given that the flaws can be listed in ones face it is rather hard to claim that it does not have flaws, of that the idea it has flaws is only an opinion. Mediation utterly failed to show that the existing statement should be changed to being just an opinion, therefore the idea that the text must be changed is wrong. I strongly oppose the idea that hard truths should be watered down just to appease any editor who disagrees with them and is determined enough.

The current text where someone has inserted the "The vaccine-overload notion ... evidence" sentence between the lead sentence and the first flaw should be reverted. It breaks the flow and isn't required.

The paragraph lead text should include one of the words "myth", "misperception" and "flawed". Each of these are equivalent to the extent they show the hypothesis is conceptually wrong (rather than just proven wrong). Since "is flawed" fits nicely with the rest of the paragraph, I see no need to change it. Colin°^Talk 09:44, 29 November 2009 (UTC)

The problem is that it is an opinion, thus original research. As stated in WP:ASF:

"When we discuss an opinion, we attribute the opinion to someone and discuss the fact that they have this opinion. For instance, rather than asserting that "The Beatles were the greatest band ever", locate a source such as Rolling Stone magazine and say: "Rolling Stone said that the Beatles were the greatest band ever", and include a reference to the issue in which that statement was made."

So we could quote from a researcher who states this. Or we could take the approach suggested by Eubulides at the beginning of this section. Sunray (talk) 17:53, 29 November 2009 (UTC)

By value or opinion,[1] on the other hand, we mean "a matter which is subject to dispute." No dispute has been presented. So we assert an opinion as fact on Wikipedia. Adding attribution is a policy violation. The problem is that editors ignore that we can assert any opinion when no dispute has been presented. QuackGuru (talk) 18:33, 29 November 2009 (UTC)

Sunray, I really had hoped that someone offering mediation services would have a better grasp of policy. If you can't see the difference between a subjective opinion like whether the Beatles were the greatest band ever, and an objective fact universally held by all the worlds experts in vaccines and immunology, then please stand aside. This debate should never have been accepted for mediation. No reliable source or serious dispute has been found against the statement that the hypothesis is flawed. The flaws can and have been enumerated in the article and are based on evidence and our scientific understanding of immunology. That it is "contradicted by the evidence" (one the the facts you appear to be happy to accept and state as fact rather than opinion) is one of the flaws. Colin°^Talk 19:08, 29 November 2009 (UTC)

According to this comment it is required to include attribution even when there is scientific consensus among reliable references. This is a waste of time when editors can't agree on the intent of Wikipedia's ASF. QuackGuru (talk) 19:23, 29 November 2009 (UTC)

That statement you quote is clearly wrong. There is scientific consensus that 2+2=4. What matters is the degree to which that consensus is opinion-based (rather than evidence-based, for example) and the degree to which there is any serious dispute. Education, not mediation is what is needed here. Colin°^Talk 19:58, 29 November 2009 (UTC)

Please avoid making personal remarks. The problem is this: We cannot state that the concept is "flawed" because that is not a universal conclusion of the literature. We can quote from a researcher who says it is flawed or we can reword the sentence. Those are the only choices I can see. What is your preference? Sunray (talk) 19:54, 29 November 2009 (UTC)

The concept is flawed according to the source. Attribution is a violation of ASF when you refuse to present a serious dispute. Please read Wikipedia policy again. The real problem is that a few editors don't understand policy. See WP:IDHT. QuackGuru (talk) 21:06, 29 November 2009 (UTC)

Yes, we all agree that one or two sources do say that the concept is flawed. Others say it is a "misconception," "a myth," "rubbish," etc. Still other sources say that research findings do not support the concept (with no statement that it is flawed). The problem that we are wrestling with is that the view that it is flawed is not universal. Thus, if we use it, we need to put it in quotes and attribute it or we need to change the wording. Sunray (talk) 21:48, 29 November 2009 (UTC)

That a concept is "universally" accepted as truth is not a requirement of WP:ASF. The idea that it is a "misconception" or a "myth" is not just "one or two sources" is it? "Flawed" is quite tame compared to "Myth", which is the World Health Organisation's term. The World Health Organisation, not Clive from Swindon. Sunray, do you or do you not accept that being "contradicted by the evidence" is a fundamental flaw in a hypothesis? Colin°^Talk 22:15, 29 November 2009 (UTC)

It seems to me that you are missing my point. I personally agree that the concept is flawed, that is not the issue. If we were writing an academic paper, it would be easy to survey the literature and give the opinion that the concept is flawed. However, this is not an academic publication. We are not a primary (or even a secondary) source. Thus we cannot venture an opinion on the literature. We are limited to quoting an opinion. Sunray (talk) 00:41, 30 November 2009 (UTC)

I'm afraid the previous comment is missing the point others have made, which is that there's universal consensus among reliable sources that the vaccine-overload notion is flawed, or a misperception, or a myth, or whatever term one likes to use to say (politely) that the theory is misguided. We do not have sources disagreeing with each other, with one saying "It's flawed!" and another saying "No, it's not flawed! It's a myth!". Instead, we have universal agreement, with sources differing only in unimportant differences in terminology, saying that the notion is (let's try another synonym) mistaken. A case like this clearly does not require in-text attribution. Eubulides (talk) 03:03, 30 November 2009 (UTC)

Primary/secondary/tertiary is not relevant here. I think the point you are looking for is that we are not written by a named authority who can voice his own assured opinion as fact if he fells confident enough about it. Therefore, we must quote or attribute opinions to others. The issue here is whether the vaccine overload hypothesis is flawed/mistaken/a-myth/contradicted-by-the-evidence is an opinion or a fact. You still haven't answered my question: "do you or do you not accept that being "contradicted by the evidence" is a fundamental flaw in a hypothesis" Colin°^Talk 08:19, 30 November 2009 (UTC)

Perhaps those who consider "is flawed" to be an opinion are mistakenly thinking that such language is subjective. This is not similar to "is rubbish" or "is a stupid idea". It is an objective statement that the hypothesis has serious weaknesses. It doesn't even go as far as saying the idea has no merit whatsoever. Compared to the utterly condemning "is a myth" or "is a misperception", it is mild. Colin°^Talk 08:43, 30 November 2009 (UTC)

But the reality is that there is a very real controversy over the issue. Various studies have raised doubts about multiple vaccinitions, parents have filed suits claiming injuries sustained, and health providers have dissented on the issue. These are not the minority views of fringe groups. As editors of Wikipedia, we have a responsibility to our readers to represent these things objectively. We should be very careful not to allow information to be filtered through the colored lens of our own personal bias. Doing so severely degrades the quality of the content of this site, and is a disservice to the community. Sebastian Garth (talk) 15:58, 30 November 2009 (UTC)

Your personal opinion does not represent a serious dispute. Next... QuackGuru (talk) 16:21, 30 November 2009 (UTC)

There are very real controversies on all sorts of things we state as facts. Consider the age of the earth or the cause of AIDS or why the the three World Trade Center buildings fell down. There's an entire AIDS denialism movement which sucked in an entire country (South Africa) to the extent that hundreds of thousands of lives were needlessly lost. In comparison to those controversies, the relatively few opponents to vaccination that desperately cling onto this busted myth are a drop in the ocean. Yet we confidently state the age of the earth ("The planet formed 4.54 billion years ago") or the origin of AIDS ("caused by the human immunodeficiency virus") or why those buildings feel down ("collapsed due to structural failure") in our articles. As we should. We, along with editors who write articles on military history or Jane Austen, cite expert authors and follow expert consensus. If experts agree that something is so, we say it is so. Colin°^Talk 17:33, 30 November 2009 (UTC)

Well, first of all, this isn't an issue of vaccinationists versus anti-vaccinationists. It's whether or not the immune system can respond or react undesirably to multiple vaccines. The evidence is clearly not conclusive, and so it would be unfair to act as if it were. In that respect, comparisons with issues such as the ones that you mention are not completely meaningful. On a side note, my personal feelings towards vaccinations are generally positive. No less than three of my ancestors championed their use, and in times when superstition and witchcraft were rampant in the medical field, no less. I appreciate the hard work that has been done to promote such a beneficial cause. But I also recognize the need for honest reflection, to consider the implications of the way in which the task has been carried out, and what, if any, mistakes have been made in the process. Experts in the field have also asked such questions, and their conclusions have been mixed. We should respect that and give the proper weight of both sides. Sebastian Garth (talk) 18:36, 30 November 2009 (UTC)

If the evidence (the idea is flawed) is clearly not conclusive then provide a reference that supports this view. QuackGuru (talk) 19:30, 30 November 2009 (UTC)

Agree. Please provide a reliable source for your opinion that the "evidence is clearly not conclusive". Please provide a reliable source that claims the issues involved in the vaccine overload concept have produced "mixed" conclusions. Both the CDC and WHO think the evidence is so conclusive they call it a myth and a misconception. Colin°^Talk 20:10, 30 November 2009 (UTC)

Sebastian, let's suppose you are right and the evidence is not conclusive. Perhaps vaccine overload is a concern. What we as Wikipedians must do is wait for the experts to realise this, accept it and to put it into print in a reliable source. Currently, the big brains at the CDC, the WHO, the BMJ, the NHS, etc, etc all remain to be convinced. I wouldn't hold your breath. Colin°^Talk 20:27, 30 November 2009 (UTC)

Evidently I have missed something. It has been suggested that the statement that "the concept is flawed" is a valid summary of the research findings, rather than an opinion. Would someone please walk me through that? How is it not an opinion? Sunray (talk) 21:38, 30 November 2009 (UTC)

This point has been discussed both here and in Wikipedia talk:Requests for mediation/Vaccine controversy, at quite some length. There seems little point to rehashing the argument yet again. Eubulides (talk) 21:58, 30 November 2009 (UTC)

Yes it has, but I've not yet seen the answer to my question: How is it not an opinion? Sunray (talk) 01:58, 1 December 2009 (UTC)

Because there is no serious dispute about it among reliable sources. It is not an opinion according to WP:ASF's definition, any more than "[AIDS] is caused by the human immunodeficiency virus" is an opinion when it appears in AIDS. (In this comment I am attempting to briefly summarize one answer to your question that has appeared in the discussion, even if you may happen to disagree with this answer.) Eubulides (talk) 02:18, 1 December 2009 (UTC)

How is it not an opinion? It does not matter when it is an opinion. We assert an opinion as fact when there is no serious dispute. QuackGuru (talk) 02:56, 1 December 2009 (UTC)

Apparently the matter is disputed (hence the name of the article "Vaccine controversy") and while the literature is compelling that there is no evidence for the vaccine overload concept, it is not unanimous. Some sources say it is "flawed" (or "a misconception"), others say it is a "myth," still others treat it with more seriousness, but state that there is "no evidence to support it." I'm not convinced that rolling all that into the statement that "it is flawed" represents a universal view, even of scientists or the medical establishment. Furthermore, to attempt to bludgeon people out of their fears about vaccines won't work. That is why this remains a health policy concern. Sunray (talk) 06:23, 1 December 2009 (UTC)

The matter is certainly disputed among unreliable sources, but that is not a serious dispute in the sense of WP:ASF. The existence of the dispute is why the topic is suitable for Vaccine controversy; the lack of serious support among reliable sources for one side of the dispute is why there's no need for in-text attribution. Similarly, there is a controversy among unreliable sources about the cause of AIDS, and this is covered (for example) in HIV/AIDS in South Africa, an article that flatly says that HIV "is the virus that causes AIDS" while discussing popular notions to the contrary in South Africa. Since there is widespread consensus among reliable sources that HIV causes AIDS, that's all that needs to be said in that article; in-text attribution is not required. The case is similar here. No reliable source disagrees with the claim that the notion of vaccine overload is flawed/misconception/myth/etc., and no reliable source disagrees with the claim that the notion is unsupported. We see no dispute among reliable sources where one side says "Vaccine overload is a myth!" and another side says "No, it's not a myth! It's unsupported!" There is no requirement that every reliable source must say that the vaccine overload notion is both unsupported and that it's flawed/misconception/myth/etc.; all that's required is that reliable sources on the topic that it's a myth/flawed/whatever have a widespread consensus on that topic (which they do), and that reliable sources on the topic of whether the notion is unsupported have a widespread consensus on that topic (which they do). Eubulides (talk) 06:39, 1 December 2009 (UTC)

Thank you for your discussion of this matter. It seems that we are not making progress. You and others believe that the statement "it is flawed" is supported by the literature. I, on the other hand, see it as an opinion on the subject. However, I see no point in continuing further. Sunray (talk) 08:08, 1 December 2009 (UTC)

Flawed edit

This edit:

"Vaccine overload is the flawed<ref name=Gerber/> notion that giving many vaccines at once may overwhelm or weaken a child's immune system and lead to adverse effects."

is POV and a serious mistake. The first sentence of the Vaccine overload section should simply define the notion without throwing rocks at it, just as the first sentence of Flat Earth simply defines the notion of the flat earth without throwing rocks at it. The interpolation of a citation there, simply to justify the word "flawed", is obviously POV. The repetition of the word "flawed" in the first sentence, and later in the topic sentence of the next paragraph (the paragraph that actually talks about the flaws and where "flawed" is appropriate) is more POV. Please do not repeatedly insert the word "flawed" in the definition of the notion, a location where the word is out of place. This occurrence of the word "flawed" (and the spurious citation to Gerber) should be removed. Eubulides (talk) 04:54, 2 December 2009 (UTC)

Agree it should be changed back. The description and definition of the notion/idea should be done in a totally non-judgemental way. And then the language used to point out the flaws (and indeed state that there are flaws) should be careful, measured and not go beyond the expert consensus. The recent painful mediation gave no consensus to make the language stronger or to start repeating "flawed, flawed" all over the section. Colin°^Talk 08:55, 2 December 2009 (UTC)

You say that the language should not go beyond expert consensus. However, numerous reliable sources demonstrate that the notion is indeed considered flawed and incorrect within expert consensus, both prima facie and upon further investigation. What then is your justification for presenting the material from the beginning in any way other than as it is described in these sources?

As a side note, I'll mention that I had no role in the mediation you mentioned and was not even aware it had occurred. It was not my intent to act against consensus in any way; I merely re-added the word because I thought that the corrected reference addressed the point raised by the editor who reverted it. If there has been a broad discussion on this section and a consensus has formed, I'm perfectly willing to let it sit for a while without the first 'flawed' so that people have time to cool down and think it over more objectively before attempting to change or re-test that consensus. That being said, I'd still appreciate a response to my earlier point along with a removal of the word if that is done.Locke9k (talk) 16:05, 2 December 2009 (UTC)

I'm not at all saying that "it is flawed" goes beyond expert consensus and have argued for it to be kept... but in its place. Eubulides and I feel that to be fair the description of the VO notion should be without judgement. Being flawed is not its defining characteristic. Let's stick to the definition first and then note its merits or flaws. Colin°^Talk 19:13, 2 December 2009 (UTC)

Our sources typically define the notion first, without using a word like "flawed", and then go on to explain its flaws later. For example, Gerber & Offit 2009 (PMID 19128068) start off by saying "The most prominent theory suggests that the simultaneous administration of multiple vaccines overwhelms or weakens the immune system and creates an interaction with the nervous system that triggers autism in a susceptible host." This is a neutral summary, which does not support or criticize the theory; and this is the standard way that scholarly sources discuss ideas even when the the sources go on to say that the ideas are completely mistaken. Our article should use a scholarly style, not an advocacy style. Eubulides (talk) 19:30, 2 December 2009 (UTC)

In accordance with this discussion, I have removed the word "flawed" that I earlier added to the first sentence of the section. Some good points have been made by several other editors in favor of doing so, and I'm happy to let it sit this way for a while and see how it is coming across. I think overall the section is in a much better state than it was a few weeks ago. Locke9k (talk) 20:00, 2 December 2009 (UTC)

minor contradiction

Smallpox outbreaks were contained by the latter half of the 19th century, a development widely attributed to vaccination of a large portion of the population.[79] Vaccination rates fell after this decline in smallpox cases, and the disease again became epidemic in the 1870s (see smallpox).

Are not the 1870's part of the latter half of 19th century?

24.36.78.185 (talk) 21:04, 31 October 2009 (UTC)

Smallpox was contained in the latter half of the 19th century, then vaccination rates fell around 1870, upon which a resurgence in smallpox cases was witnessed. I see no contradictions here. Mkemper331 (talk) 16:15, 17 November 2009 (UTC)

Sorry, I think I just misread it. Carry on. 24.36.78.185 (talk) 10:41, 4 March 2010 (UTC)

Prenatal Infection section

I've been following this article for awhile and thought I'd chime in on this section, which I think could use some work. Here's how I read the section as written: 1) Studies have shown that prenatal infections can cause schizophrenia. 2) This has public health implications, as vaccinating could prevent some prenatal infections and thus might help prevent some cases of schizophrenia. 3) Vaccine-induced antibodies could also potentially cause schizophrenia. 4) We must balance the benefits of #2 against the risks of #3. 5) Many mainstream organizations recommend pregnant women get influenza vaccinations, yet few do.

My main concern is with #3 -- the idea that vaccine-induced antibodies could cause schizophrenia, because I don't think it's well supported. The source is a quote from a researcher in a newspaper called the Psychiatric Times (the newspaper of the American Psychiatric Association). But when you read that researcher's study, there's no mention of vaccine-induced antibodies causing schizophrenia, or for that matter any mention of vaccination at all. I can't find any scientific literature supporting the idea that vaccine-induced antibodies can cause schizophrenia; there is some literature supporting #2 above. So basically the only source I can find supporting #3 is a quote (from an MD) in a newspaper, which isn't supported by any further evidence that I can find. Thus, I think it should be removed.

If that's the case, then the section could either be re-written to focus on the concerns of vaccinating pregnant women, or since there's already another article on that topic, we could delete the section entirely. Please let me know your thoughts.Trabeculae (talk) 19:44, 18 December 2009 (UTC)

I agree that the Psychiatric News source was weak, so I did some legwork and edited the article to cite a much better source, Skowronski & De Serres 2009 (PMID 19515466). What other Wikipedia article were you thinking of? Perhaps it should also be updated with this new source in mind? Eubulides (talk) 21:25, 18 December 2009 (UTC)

Immunization during pregnancy, I expect. It currently has only two references, though they look solid. - 2/0 (cont.) 09:51, 19 December 2009 (UTC)

OK, that's a stronger source for the section. Yet in the animal models, the mice were actually infected with influenza -- they weren't vaccinated. Are there animal models that looked at vaccinated subjects rather than infected ones? I worry we're drawing connections that haven't been made in the literature yet. The new source you added says "implications of these hypotheses for or against routine influenza immunization in early pregnancy have yet to be explored" -- so if they haven't even been explored, should we be including them on Wikipedia?

Regardless, we could expand this section to talk more broadly about the controversy of vaccination during pregnancy. It could link to the other article I was mentioning, Immunization during pregnancy, though that article could use some more sources. This seems like an important section to cover thoroughly beyond just the schizophrenia link.Trabeculae (talk) 05:07, 20 December 2009 (UTC)

I don't know offhand the answer to your question about mouse models. Sorry, I don't know what implications are being referred to in the previous comment; unless I'm missing something, the text that's in the article is pretty closely tied to what's in that source. I agree that the section should talk more generally about controversy of vaccination in general during pregnancy, not just flu shots. Eubulides (talk) 06:43, 20 December 2009 (UTC)

Ongoing vaccine debate at "Bill Maher" article talk page

Interested editors should check out the RfC & contribute to the discussion at the Bill Maher talk page (here).
Valerius Tygart (talk) 20:51, 24 December 2009 (UTC)

Please open spanish language page

We are going to have same problems that USA and Canada in some years. It is time to prepare to translate that anti-vaccionists are wrong. Thank you. —Preceding unsigned comment added by 194.179.55.198 (talk) 12:24, 23 August 2010 (UTC)