Statin Deniers and Anti-Vaxxers. How political rhetoric is infecting medicine

By Jerome Burne

Last month I read an opinion piece in the Guardian by an experienced and, I’d always assumed, thoughtful journalist, warning about public enemy number one. Worse than Trump, worse than the person who had just cut funding for the Paralympics, it was the ‘anti-vaxxers’, people opposed to vaccination; especially the MMR.

Wow! Really?  I know deciding to refuse or delay a vaccination is now routinely described as mad and bad, but this seemed particularly excessive. It was also noticeable for another reason. This sort of rhetoric is becoming increasingly common in other areas where medical orthodoxy is being challenged.

It featured recently in a series of aggressive newspaper attacks on statin critics – labelled ‘statin deniers’  - as well as reports of research claiming that following a low-carbohydrate/ketogenic diet could take four years off your life, starve your microbiome and even give you an unpleasant condition dubbed ‘keto crotch’.

All are signs that what might be called a medical counter-revolution is well underway. It is an angry response to recent well-informed attacks on some conventional treatments such as the low-fat diet, the policy of prescribing statins to lower everyone’s cholesterol and the promotion of a low-carbohydrate (ketogenic) diet and lifestyle change as alternatives.

Vaccine hesitancy threat to global health

One of the longest running and most bitter of these battles is over the benefits and risks of some vaccinations, notably the MMR. The critics, many of them parents uncertain about what is best for their children, have lost the battle in the public sphere. Questioning vaccination is no longer even a debatable issue. The WHO has declared: ‘vaccine hesitancy’ to be one of the 10 biggest global threats to health.

Next month the Guardian is hosting a seminar aimed at discovering:

‘Who are the anti-vaxxers and why are they fuelling the epidemic?

What are the root causes of the issue?

In a world resistant to facts, can physicians and public health officials debunk the mythological link between the MMR vaccine and autism?’

There to provide answers are an academic whose work links ‘populism’ to ‘vaccine hesitancy’, the head of the Vaccine Confidence Project and a senior medic.

The notion that this is an issue for debate is long gone. Those questioning vaccination have now become a threat to human life. The piece by the Guardian columnist ends on this apocalyptic note: ‘While we fret about rising sea levels …. the threat posed by Russia …a lunatic in the White House…. it’s going to be the anti-vaxxers who end up killing all of us.’

Saying this is exaggerated will be dismissed by campaigners as like questioning global warming at a Greenpeace conference. But it is alarming that those doubting vaccination are not just dismissed as failing to understand the science but are now being totally depersonalised.  How can any rational person believe in a myth that is a threat to world health?

UK measles deaths running at 1 to 2 a year for 20 years

What we do know is that concerns about a link between MMR and autism raised in 1998 by Andrew Wakefield lead to a drop in the percentage of children being vaccinated. Then it was 92% in the UK, subsequently, it dropped to below 80%. But what was the effect of this? The official Gov.UK website has a page entitled: ‘Measles notifications and deaths in England and Wales: 1940 to 2016.’, which puts it in context.

This shows that while hundreds of thousands of cases and hundreds of deaths were recorded in the 1940’s and 50’s, by 1989 yearly deaths had dropped to single figures and never rose any higher.

In 1945, for instance, there were nearly 450,000 cases and 729 deaths. By 1971 however, cases were down to 135,000 with 28 deaths. The MMR jab was not introduced until1988 when the rates were 86,000 and 16. It had a dramatic and consistent effect; afterwards, the death rate was never higher than 4 and rarely more than one. A couple of the deaths involved people with immune disorders or who were on immune-suppressing drugs, others had serious infections.

In 1998 when Wakefield’s paper came out there were around 3.700 cases and 3 deaths, but the number of cases continued dropping until 2009 when they went up to 5000 and see-sawed till 2013, after which they dropped again and by 2016 were just over 1600. What is striking though, is that whether the number of cases was 6,000 or 1600, the number of deaths was either 1 or 0. There was only a tenuous link between the number of cases and the number of deaths.

The Gov.uk website suggests a serious disconnect between the inflammatory language of the Guardian and the numbers involved, certainly in the UK. And there are other reasons why concern about vaccines need not involve the rise of populism. They include compensation payments for vaccine damage and evidence that the research done by the vaccine manufacturers may not be very reliable.

Compensation for vaccine injury runs into millions

Hundreds of millions of pounds a year are paid out by the American government compensation scheme for vaccination injuries. Part way through 2017, the Health Resources and Services Administration had paid out over 142 million dollars for cases settled so far that year.  So side effects are not negligible.

Lack of transparency about trial results became a major issue for vaccine manufacturer Merck which made Tamiflu, the anti-viral drug prescribed to block the actions of the flu virus.

It took members of the Cochrane Collaboration – a respected, loose association of scientists who assessed the effectiveness of treatments – five years to get access to the raw data collected during clinical trials of Tamiflu. 

During that time the NHS stockpiled £500 million pounds-worth of doses to treat a possible epidemic. So, when it became clear that the effectiveness of Tamiflu was very limited, a House of Commons committee investigated and produced a report in January 2014.  

It concluded that:

‘**There is a lack of consensus over how well Tamiflu works, in particular whether it reduces complications and mortality.

**Discussions over this issue among professionals have been

hampered because important information about clinical trials is routinely and legally withheld from doctors and researchers by manufacturers.

**This longstanding regulatory and cultural failure impacts on all of medicine, and undermines the ability of clinicians, researchers and patients to make informed decisions about which treatment is best.’

Is it inconceivable that the manufacturer would do anything similar when testing its vaccines?

HPV vaccine studies failed to properly assess side effects

Then last year a dissident group of Cochrane researchers mounted a detailed attack in ‘BMJ Evidence-Based Medicine’ on a formal Cochrane report on the HPV vaccine to protect against cervical cancer. The headline read:

‘The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias.’ 

The critique pointed out that many relevant trials were missing, those that were selected were more likely to favour the vaccine, and that side-effects weren’t properly assessed. The Cochrane review missed nearly half of the eligible trials. The main points were:

  • No included trial in the Cochrane review used a placebo comparator.
  • The included HPV vaccine trials used composite surrogate outcomes for cervical cancer.
  • The Cochrane review incompletely assessed serious and systemic adverse events.
  • The Cochrane review did not assess HPV vaccine-related safety signals.
  • The review ignored industry trial funding and other conflicts of interest.

Now, none of this proves all vaccines are to be avoided, in fact, many are clearly valuable, but it does suggest that a degree of scepticism about vaccine effectiveness and safety is not irrational. Fiddling the evidence is recognised as a serious problem for clinicians in general when deciding about drug use– see below.

How to take down statin critics

What is also worrying is that the inflammatory language now routinely directed at ‘vaccine deniers’ is being increasingly used to describe those criticising other official treatments. What might be called a medical counter-reformation, is underway. It involves ignoring the details of past criticism and wrapping it up in phrases such as ‘statin denier’ or ‘anti-vaxxer’. When labels are combined with support from ‘experts’, journalists and commentators don’t even have to look inside; just print the message.

An example also comes from the Guardian, which seems uncharacteristically ready to ignore the distorting effects of billions of dollars when it comes to the pharmaceutical industry. Last year, in October, the paper carried an ambitious 3-in-1 attempt to wrap up, not just detailed criticisms of the low-fat diet but also of the related hypothesis that cholesterol is the major cause of heart disease and of the massively well-funded campaign to put the whole country on cholesterol-lowering statin drugs. The headline captured the intention perfectly: Cholesterol Deniers

It was a technically skilful example of the medical counter-reformation playbook. First, keep it personal – identify, belittle and denigrate the critics. Then quote several experts emphasising their credentials and thirdly work the dismissive phrases into the copy. But as an account of an important scientific debate, it had the objectivity of a Boris Johnson on the EU.

By the second paragraph, the critics are identified as ‘a small group of dissident scientists, whose work usually first appears in minor medical journals.’  No need to take them seriously, especially as the first paragraph has already established that the views of these dissidents ‘contradict decades of medical advice’.

The whole carefully researched critique of the low-fat diet is then dismissed as ‘more than bad science’ according to ‘leading scientists and medical authorities’. One of them was ‘Prof Louis Levy, head of nutrition science at Public Health England’ who declared that: ‘Encouraging people to eat more saturated fat is dangerous and irresponsible.’ And lined up behind Prof Levy is World Health Organisation, the British Heart Foundation and Heart UK, which agree that ‘LDL cholesterol… is implicated in heart disease.’

When one of these dissidents – Dr Aseem Malhotra –is introduced, it is in a way designed to downgrade his expertise. He is a ‘telegenic young cardiologist in private practice’ whose book, The Poppi Diet ‘has the distinction of being named by the British Dietetic Association as one of the five worst “celeb” diet books in Britain.’

Doubts about statins? You’re as blinkered as a religious fundamentalist

All this without any details of why the dissidents reject the claims that fat and cholesterol are dangerous. A similarly cavalier approach, based on the use of dismissive phrases, is wheeled out against the detailed criticisms of the widespread prescription of statins. An example of ‘flat-earthism’, declares one senior researcher. Another describes cholesterol sceptics as: ‘a bit like religious fundamentalists’.

When the Mail-on-Sunday repeated this exercise in March, it used identical techniques but ramped up the attack level. Three researchers who had burrowed into the complex data supposedly supporting statin use and found it unconvincing had their mug shots lined up across the page under a large headline: ‘Statin Deniers’.

Behind these examples of what has been called ‘eminence-based medicine’ is the assumption that standard treatments are all backed up by a well-functioning system of evidence-based medicine. If that is right, then dismissing small groups of dissidents who publish their research in minor medical journals, is obviously reasonable. But if not then they may well be valuable canaries warning that all is not well in the official coal mine.

It certainly isn’t if research by the University of Oxford’s Centre for Evidence-Based Medicine is to be believed. It published a manifesto in the BMJ in 2017 which began by describing it as a: ‘response to systematic bias, wastage, error and fraud in research underpinning patient care.’ ([behind a paywall]

(The BMJ, not a minor medical journal, has an impressive record of publishing research on the poor evidence for the dangers of saturated fat, detailed critiques of statin benefits and investigations into faulty evidence for vaccine safety.)

The manifesto’s summary of current problems includes:

  • Results from half of all trials are never published, and positive trials are twice as likely to be published as negative ones.
  • The cost of clinical drug trials rose fivefold in one decade and is hindering the development of new medicines
  • 85% of research spending currently goes to waste
  • In a study of systematic reviews, 86% of 92 Cochrane reviews did not include data from the main harm outcome
  • From 2009 to 2014 the drug industry received fines totalling $13bn (£10bn; €12bn) for criminal behaviour and civil infringements—few systematic changes have occurred to prevent such problems occurring again
  • “Despite repeated calls to prohibit or limit conflicts of interests among authors and sponsors of clinical guidelines, the problem persists”

Such a list of serious and known problems with the workings and failings of current medical research, make appeals to medical authority considerably less impressive. Engaging with the bright, thoughtful and caring critics would be far more beneficial for patients.

Jerome Burne

Jerome Burne

Jerome Burne is the editor of HealthInsightUK. He is an award-winning journalist who has been specialising in medicine and health for the last 10 years and now works mainly for the Daily Mail. His most recent book “10 Secrets of Healthy Ageing” was written with nutritionist Patrick Holford. He blogs at “Body of Evidence” – jeromeburne.com. 2015: Finalist for 'Blogger of the Year' award from Medical Journalists' Association.

15 Comments

  • An excellent article. The ever more extreme position taken against anyone who asks questions about vaccines is sinister and probably counter productive. If they have such a strong case, why do trials or reviews show such obvious bias, not to say malpractice?

    The argument could be settled by proper trials, independently monitored, of unvaccinated children with vaccinated. Instead we have trials where the unvaccinated are given the aluminium in what should be a placebo, which disguises its effect in vaccines. ‘Rigged’ is the only suitable word.

    There are stories of unvaccinated populations (the Amish in America, for example) experiencing barely any auto-immune diseases. In a system concerned with health and not profit, we would be properly investigating such comparisons. The failure to do so leads many to conclude that the pharmaceutical industry fears the results.

    The attempts to close the debate simply feeds suspicions. If they can’t win the argument, abuse those asking awkward questions.

  • Great article.

    I hope it gets widely read.

    I’ll be sharing.

  • Back in 2015 the Academy of Nutrition and Dietetics had a moment of clarity when it submitted this recommendation to the government authorities charged with issuing dietary advice to the American public.

    “In the spirit of the 2015 DGAC’s commendable revision of previous DGAC recommendations to limit dietary cholesterol, the Academy suggests that HHS and USDA support a similar revision deemphasizing saturated fat as a nutrient of concern. While the body of research linking saturated fat intake to the modulation of LDL and other circulating lipoprotein concentrations is significant, this evidence is essentially irrelevant to the question of the relationship between diet and risk for cardiovascular disease. The 2010 Institute of Medicine (IOM) report on the use of biomarkers as surrogates for disease outcomes examined LDL and HDL as case studies and concluded ‘unequivocally’ (emphasis mine) that they were not suitable for use as surrogates for the impact of diet on heart disease.” https://health.gov/dietaryguidelines/dga2015/comments/uploads/CID27125_Academy_Comments_re_DGAC_Scientific_Report.pdf

  • The black and white thinking that labels anyone not agreeing with the establishment view in a variety of issues (generally involving products which make a lot of money for corporations) is depressing.
    The Guardian article on “statin deniers” you mention was full of false arguments, before you even get to the point of thinking about whether statins are a good idea for a lot of people or not – eg the article mentioned that a group of Oxford statin researchers have not been paid personally for their work on statins, for which their department is funded by the pharmaceutical industry. The implication in the Heart Breakers article seemed to be that therefore, the funding will not have affected their findings. However, there’s a large body of research which has found that the source of funding, even partial funding, does in fact affect the conclusions, even when researchers are not paid directly by the funder.

    Can I mention though, that in this article you have missed out the fact that measles vaccine was introduced in 1968 in the UK, over 20 years before MMR, so it is hardly surprising that measles infections had gone down further by the 80s. This is not to invalidate other points you have made, but it’s important to include all the facts.

    • Editorial

      Yes the full extent of Merck’s contributions to the CTT project was not revealed until 2014 when Sir Rory was demanding retraction of two articles in the BMJ about side-effects when it emerged as a kind of afterthought in an email. Given that previously the strong impression had been given that all supporters were neutral, non-commercial organisations such as MRC and BHF, the figure of over 250 million came as a bit of a shock.

      According to the v interesting Gov.UK data on measles cases/death, they did come down afer 1968 but cases in individual years could vary by hundreds or thousands both before and after, although decline in deaths was more consistent, dropping into the 20′s from 1968.

  • Well written, factually sound and insightful article. Thank you.

    I have been tracking the media frenzy over measles and the war on Anti-Vaxxers on social media. I wrote this blog.

    https://nippled.blogspot.com/2019/02/anti-vaxxers-and-dangerous-scourge-of.html

  • Great article. I have written an article about the Guardian’s David Robert Grimes and his dodgy grasp of epidemiology, here:

    http://objectiveskeptic.blogspot.com/

    • Editorial

      Yes Grimes is obviously seeking to inherit Ben Goldacre’s rather tattered crown, not so shiny since his involvement with statin study that concluded no real problem with side-effects based on studies for which the raw material is not available. Making such material available was at the heart of his Bad Pharma book.
      Pleased to see you referenced Travis Christofferson’s rebuttal of Grimes on keto diet in HIUK.
      Articles impressively detailed so only skimmed so far but looks v useful. I like to think that his kind of scepticism is fading as many younger clinicians increasingly see the need to look at the body from a terrain or ecological perspective – how do we get this ecosystem functioning well again? The answer is rarely one or a large number of drugs.

  • T2Diabetes and other metabolic (read ‘Lifestyle’) diseases will never get the same passion and media attention, – there’s no lucrative vaccine for them !
    - Prove me wrong…

  • “the Cochrane Collaboration – a respected, loose association of scientists”

    Maybe in the old days, certainly not anymore. Their reviews of CBT and exercise for what they call “CFS” are awful and actively harming patients. [1] They admitted the 2014 review of exercise therapies is rubbish but refuse to follow through.

    “What are the root causes of the [vaccine] issue?”

    Perhaps it has something to do with the fact that our dear leaders lie to us all the time about nearly everything. The scientific knowledge base is now so polluted with poor methodology, muddled thinking, and outright fraud that it is nearly impossible to separate the wheat from the chaff. We are told to just eat all of it, even the dirt and bugs. Sorry, but I don’t find dirt to be very nutritious.

    Establishment hacks like the Guardian tell us we are “anti-science” and expect us to ignore all the data and accept appeal to authority in the same breath. Whenever a powerful institution says “Trust Us” prepare to get a knife in the back, ’cause it’s already out of the sheath.

    [1] http://www.virology.ws/2019/03/12/trial-by-error-cochranes-report-on-courtneys-complaint/

    • You are aware the Cochrane Collaboration has been hijacked, co-opted right? Co-founder Peter C. Gotzsche has been pushed out for exposing big pharma’s fraud. Why isn’t anyone mentioning that here?

      Gates Foundation Buys Cochrane Integrity for $1.15 Million …
      healthimpactnews.com/2018/gates-foundation-buys…
      This may be the last straw in dissolving the illusion of scientific integrity in reviews published by the Cochrane Collaboration group. With a $1.15 million “donation” – chicken feed for the Bill and Melinda Gates Foundation – they have purchased the Cochrane seal of “science-based reviews”. I don’t know what you’re being told about B.Gates in UK, but here in America, we’re very familiar with Bill Gates and are fully aware of his genocidal programs & agendas.

      • Editorial

        It’s true that I didn’t mention Gotzsche by name but then I didn’t mention the names of those trashed in the “statin denier” story nor the authors of the two highly biased Guardian pieces i quoted from. My thinking was that we had had enough of personalities.
        I have great respect for Gotzsche having written several stories about his campaigns (mammograms and antipsychotic medication) and in this post I mentioned two of his crucial studies in connections with vaccines – the dismantling of the Tamiflu claims and subsequently his breaking with the Cochrane position on the HPV vaccine, which prompted his outrageous dismissal.
        The reference to Cochrane as “respected” etc was true at the time of the unearthing of the Tamiflu data. That has of course changed now. This is a complicated story with a lot of players, my intention was to set out data that I felt warranted concern in relation to the MMR or illustrated how debates over research evidence was moving closer to political name calling than scientific exchange.

  • “the Cochrane Collaboration – a respected, loose association of scientists” ‘Peter Gøtzsche, MD is among the bravest, most ethical and scientifically motivated doctors in the history of medicine and psychiatry. As a result, he is now under attack by the organization he helped found, the Cochrane Collaboration, whose purpose in better days was to raise published medical research to a higher ethical and scientific standard.’ Is it any wonder? Peters exposing big pharma fraud, psychiatric fraud and pharmaceutical fraud. https://breggin.com/alert-60-peter-gotzsche-md-honored-while-enduring-an-unscrupulous-attack/

    ‘Peter Gøtzsche, MD, the remarkable Danish physician and researcher who has written the stunning book, Deadly Psychiatry and Organized Denial. Our theme is How Psychiatry Uses Force Against Its Patients and Its Critics’. and in English for us American’s: Deadly Medicines and Organised Crime: How big pharma corrupted heatlthcare’ – Your article seemed a smear job on the Cochrane Colloration when we all know it’s been hijacked. But you didn’t mention that fact.

    Gates Foundation Buys Cochrane Integrity for $1.15 Million …
    healthimpactnews.com/2018/gates-foundation-buys…
    This may be the last straw in dissolving the illusion of scientific integrity in reviews published by the Cochrane Collaboration group. With a $1.15 million “donation” – chicken feed for the Bill and Melinda Gates Foundation – they have purchased the Cochrane seal of “science-based reviews”.

    • Editorial

      Not clear how the blog could be considered a smear on Cochrane. It refered to its impressive success over Tamiflu and a dissenting study over HPV. There was, inevitablity a lot more to be said and thanks for filing in those details.

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