Thursday 1 October 2009

A rational debate.

As you probably already know, Natalie Morton dropped dead within hours of being given the new HPV vaccine.

A vaccine to protect against cervical cancer was unlikely to have caused the death of the schoolgirl Natalie Morton, health officials said last night.

Preliminary results from a post-mortem examination suggest that the 14-year-old had a "serious underlying medical condition".

Understandably, the event was a bit worrying for many parents. Which has, predictably, prompted hundreds of self-congratulatory rationalists to start insulting those parents.

Gary links approvingly (for some reason) to Malcolm Coles's object lesson in how not to see the wood for the trees:

Let's be clear. The only reason parents are worried, boycotting the vaccine, and demanding suspensions of the vaccination program is because the media whipped up a storm with no evidence whatsoever.

Look, it doesn't do anyone any favours to misrepresent your opponents in a political debate. It just lowers the level of discourse across the board.

Some people are worried about the side effects of the vaccine — which is natural and normal when a girl drops dead shortly after taking it. It's all very well to say that the authorities have looked into it and discovered that she was actually killed by an unrelated underlying medical condition, but people in the UK don't need particularly impressive memories to remember being assured by respected scientists that thalidomide was safe and that BSE couldn't transfer to humans and that any mother with more than one child dead from SIDS was a murderer. That's not to say that if the authorities are wrong once they're wrong every time, but that the self-important clueless whining of scientists that "We are scientists and we do science and so everyone should trust us and anyone who disagrees with us is being irrational" is ignorant and tiresome. Government scientists have a good long history of being wrong in order to promote their pet projects, being wrong in order to support government policy, and just plain being wrong.

Furthermore, I'm sure a lot of people are asking themselves the entirely reasonable and rational questions "Would this unrelated underlying medical condition have caused the girl to drop dead that day anyway, or might she have survived for years with it, maybe got it diagnosed eventually, had it treated successfully? Did the vaccine exacerbate matters?" and "Does my daughter have this medical condition?" In fact, I notice Malcolm Coles is himself asking these questions:

If it's shown that the vaccine did trigger an underlying health issue, then public health officials and parents (like me) will be in the position of having to balance risks.

Yet he insists that it is grossly irresponsible for newspapers to publish the story that causes people to ask these reasonable questions.

Before this health scare, a lot of people made what I think is also an entirely reasonable point. We have discovered that promiscuity can be seriously bad for women's health, to the extent of killing them. We could therefore strongly advise girls not to be promiscuous. But this idea is such anathema to the libertine Baby-boomers running our country that to do so is regarded as impossible. So we'll provide a vaccine instead. It's not the vaccine that's the problem per se; it's the reasoning behind the declared importance of the vaccination program. And it's easy to see this by noticing that there was a period during which scientists and the Government were aware of the risk from the cancer but had yet to develop a vaccine, and during that period there was not a widespread program of discouraging promiscuity. They clearly don't view the vaccine as merely the better or the more effective option; they view it as the only option. Heaven forbid that parents or teachers might be encouraged to tell their daughters that sleeping around at the age of fourteen isn't a great idea.

As for this popular assertion that it's stupid to suggest that giving someone a vaccine against a fatal STD might encourage them to be more promiscuous — so stupid that only the Christian Right would believe such a thing — I observe that the advent of AIDS had a huge effect on the behaviour of gay men, and it seems highly unlikely that the invention of an HIV vaccine wouldn't have roughly the opposite effect.

And, of course, there are some crazy stupid fanatical anti-vaccine people.

But here's the thing. A lot of the people rationally and sanely worried by this news have the same contempt for the crazy anti-vaccine crowd as the rest of us. To lump them all in together is insulting, and insulting people neither reassures or persuades them. Coles even links to a good example — surely one of the few sane things ever to have appeared in The Guardian's Comment Is Free — and says "I have to ask, however, what the hell this is." It's sane, calm, reasonable common sense, Malcolm. Try not to let it give you histrionics.

Coles is under the false impression that it's the job of newspapers to print what they're damn well told and not to publish anything without rock-solid evidence. Sorry, but no. Every instance in history of journalists uncovering a true story that contradicts the official story has involved publishing stuff that they have been reliably and authoritatively told is false. The price for their being allowed to do that when they're right is that they also be allowed to do that when they're wrong. The alternative is that they do neither.

And that's not even what they've done here. What they've done is to accurately report on the true fact that a girl dropped dead after being given the vaccine, and to reasonably ask whether the two events be related. The relevant authorities and scientists have also asked that same question, which is how they've been able to answer it. Coles has yet to explain why it is that reporting the story is scaremongering but putting the entire batch of vaccine into quarantine isn't.

And then there's the kind of obvious point that there is middle ground between having the vaccine right now and never having the vaccine at all ever: my guess is that a lot of parents decided to withdraw consent for their daughters to be vaccinated while this matter was investigated and will allow their daughters to be vaccinated once they're sure it's safe. This is sensible, reasonable behaviour. It's what I'd do. The vaccination program is aimed at twelve- and thirteen-year-olds, and it is to prevent a disease caused by promiscuity. Exactly how urgent does Malcolm Coles think it is?

Don't hesitate — don't contribute to encouraging others hesitating. Not having this vaccine puts your daughter's life at risk.

Got that? Just hesitating will kill your daughter. And this is from a man complaining about others scaremongering. Will waiting a few weeks or months really be the lethal disaster he claims?

For the record, I support the vaccination program. I agree that it's bad that our rulers will push a national mass vaccination program but would never consider promoting abstinence or fidelity in order to achieve the same health results, but that, for me, is a side issue: I still support all safe vaccination programs, and have written before that this is one of those areas that Libertarians tend to get wrong. No, it's not a matter of personal choice about whether to be immunised, because vaccination works not be immunising individuals but by immunising populations. We should be aiming to drive every disease to extinction, no matter how each disease happens to be transmitted.

But the fact that I support the vaccination program doesn't mean that everyone who opposes it is a moron. And calling them morons and misrepresenting their entirely rational views simply makes you look like a condescending bully.

Oh, and anyone who supports the NHS is a Communist who wants to kill you.

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