Quoth the dingbat:
After a long day out yesterday, I returned to find an alert from a friend. They directed me to your blog and, it seems, the source of the 'innumerate dingbat' call.
Well, Greg, I'm not actually sure whether I originated the comment. I just liked it very much. It's so... apt.
I see you've had a go at my maths and concluded "Yes, Greg, you're an Innumerate Dingbat. You're just going to have to learn to live with it."
Well, live with it I will, Jason. After all, you seem intent on sticking with the name, and you're free to do so. I did however detect a hint of hostility in your analysis,
No shit, sherlock.
so in my response I'll be trying to 'spread the love' so to speak, which is something I think is really needed in this debate.
No, Greg. What's needed in this "debate" is a shred of intelligence, something which the antivax side is sadly lacking. Still, I'll let you continue.
The first thing I need to draw your attention to is that none of the issues you raise actually have anything to do with numeracy. Not one of them. Did you realise that? You're actually having a poke at my comprehension, not my maths. So the 'innumerate' part doesn't fit (neither does the comprehension, but we'll get to that). I just wanted to point that out.
Actually, Greg, it's very much to do with numeracy. You see, one very important foundational aspect of mathematics is knowing where to put your numerators and denominators. Another is having a decent grasp on set theory - that is how given sets of data intersect and relate - and then how to apply the mechanics of calculation to those data. And in using the figures to inform your interpretation, rather than the other way round. Also, at the start of your response, you say "I see you've had a go at my maths", seemingly admitting that I'm right? But let's not split hairs, shall we?
It doesn't mean I think you're 'illiterate' though. Perhaps you initially thought of "not-so-good-at-comprehension dingbat", but found it not rolling off the tongue as nicely. Mind you, you claimed it was all about maths... "Greg is no smarter than Meryl Dorey when it comes to numbers... The maths here are not hard at all. They're barely high-school level...". It's just that NONE of your issues were about maths, Jason.
Sigh. See above. Also, what was that about comprehension, Greg?
There are many more problems with your piece so I suggest you get a drink. Next problem (and this is worse) is that my ONLY comment on the data was actually approved by the custodians of the data. If you think I didn't comprehend it properly then you're obviously taking issue with them. Did you realise this when you wrote your piece? Read the page again and ask yourself, where did he say that this data showed us ANYTHING about the vaccine being good or bad?
Clearly you didn't read my blog. I am not only commenting on your failure. I am commenting, also, on your dear friend Meryl Dorey's failure. If you notice the very large screenshot at the top of my blog post, you might realise that Meryl is the one explicitly stating that the vaccine is ineffective, a view which you presumably support, given that you're a regular commenter on Meryl's various fora and you haven't rebutted Meryl's interpretation once. Or were you waiting? Or didn't you notice?
Nowhere. So again, this doesn't mean I think you don't know how to read, but I wonder whether you should be commenting on someone else's comprehension. You've clearly inferred something that was not there.
Inferring something that's not there. Hmmm. Why does that sound familiar?
Now, you're possibly wondering why I didn't draw any conclusions from the data. After all, I published it. Why do that and not infer anything? Anyone familiar with my writings will know the answer to this. I don't regard notifications as valid indicators of disease incidence. Chapter 4 of my latest book goes into some detail as to my reasons for this, but you can get a small taste of them here: https://groups.google.com/group/vaccination-respectful-debate/msg/e2463b...
Thanks and all Greg, but I'm certainly not going to buy your book, though I'll read it if you send me a copy, and I consider the "respectful debate" group to be a laughable echo chamber masquerading as a forum, useful only for comedy purposes. But feel free to persist in your delusion. As for your not drawing conclusions from the data, well, your little percentages comment certainly appears to be putting forward a conclusion. I'll remind you of the wording:
Of the remaining 7082 cases whose vaccine status was known, and who were eligible to have received the vaccine, 5296 (75%) were fully vaccinated for their age. A further 986 (14%) were partly vaccinated. Only 800 (11%) were un-vaccinated.
Your wording shows that you're certainly trying to downplay the unvaccinated figure ("only 11%") and trying to emphasise the vaccinated figures. It's subtle, I'll give you that, but it certainly rallied the troops, didn't it, Greg? Even though it actually shows higher-than-expected incidence in the unvaccinated.
Why did I publish it? To generate discussion. It is of immense public interest. Reported cases of whooping cough have increased roughly 80-fold in the past 20 years, and during this time vaccination against it has also INCREASED. Ironically, this has led to damnation of unvaccinated children in the media. They are being blamed for the situation. So I acquired the data and threw it out there for discussion. And I'm indebted to you for taking it up.
Sadly, what you've done is thrown raw data to the hounds, who will do little more with it than scrabble through it to find ways of justifying their preconceptions. As we see with your dear friend Meryl, declaring, and I quote "the vaccine was completely ineffective in preventing whooping cough". This is in fact completely untrue. You're dog-whistling with data, Greg, and I think you know it - which could be why you kept your conclusions - aside from your dodgily compiled percentages - to a minimum.
If I were going to be drawn into making any meaningful comment on the data it would have to be that I'm astonished that a system which is biased toward reporting whooping cough in unvaccinated children
, actually shows up so many in the vaccinated.
Could it be because, in fact, the bias you claim exists isn't actually there? SAY IT AIN'T SO, GREG, AN ANTIVAXER'S PRECONCEPTION WRONG?
The system predisposes doctors to suspecting whooping cough in children who are unvaccinated, and not suspecting it so much in the vaccinated. How much of an influence this is we don't know, but it will inevitably skew the data to some extent.
There is of course an alternative hypothesis featuring bias, and it's one I find compelling because, well, it has some circumstantial evidence to suggest investigation is warranted. It goes like this: We know, from the public declarations of many AVN members, not the least of which is Dorey herself, that many unvaccinated kids seem to exist outside the conventional health system. Dorey, for instance, claims she treated her own kids' whooping cough with homeopathy, and has intimated on several occasionas that she uses a chiropractor as primary care physician, and won't go to conventional doctors.
This, I would suggest, ought to lower the notifications in the unvaxed and unknown groups - since if you're keeping your children away from doctors, there's no doctor to do the notifying. And in the relatively small (~63,000) unvaccinated population suggested by the 95% figure, a relatively small change in numbers could have a significant effect in percentage terms.
I have no data beyond the statements of antivaxers to suggest this is true, however. And we all know how reliable antivaxers are. (That's sarcasm, Greg)
Doctors assume the vaccine is protective,
Assumption is not needed. The figures clearly demonstrate a protective effect.
and are therefore less likely to report the disease in the vaccinated.
Again, . You see, the data don't show that at all.
So, I am very surprised each time I see examples like this (and they are common) showing that such a high proportion of their reports are in the vaccinated.
Again, you're failing at interpretation. If, as antivaxers so often say, the vaccination rate is 95%, then any incidence rate significantly lower than 95% in the vaccinated population shows a protective effect. Though in your head, that's a reporting bias? How convenient that this reporting bias mirrors your preconception that the vaccine is ineffective. In fact, what we're seeing isn't that surprising. No vaccine is 100% perfect. Some individuals WILL become symptomatic. No rational person disputes this, and the figures reflect it.
It occurs to me that there could be large numbers of vaccinated kids out there, running around with whooping cough but not reported to the system because their doctor was inclined to think they had bronchitis, croup, or whatever (because they should be 'immune' to whooping cough). On the other hand there might only be a small group who fit into this category. Who knows?
Not you, apparently. Can you hear a dog-whistle?
Anyway, let's get to the details of your complaints. If I'm not wrong your concerns are focussed on the semantics of terms: unvaccinated, fully vaccinated for age, partly vaccinated for age.
That, indeed, is a huge concern. But more anon.
First, you feel kids who have been partly vaccinated, but not received the full number of doses for their age should have been included in the unvaccinated group. I have no problem with you feeling that way Jason, but the data was in three columns - fully, partially, and not. This is how it was reported, and also how my summary treated it. You want to combine the partially with the not, presumably to make things look better for the vaccine. That's OK. I didn't combine any of them. I reported them separately which is the most open approach (i.e. not trying to push a barrow).
You're not trying to push a barrow? Greg, you're wheeling your wheelbarrow through streets broad and narrow, and any minute you'll start gabbling about "cockles and mussels alive alive-o". Any minute now I'll start calling you Molly. Pull the other one, it's got bells on.
Next, the ineligible. Many kids who became sick were too young to have been vaccinated. Again, you feel they should have been included with the unvaccinated group. And again, that's presumably to make things look better for the vaccine. But by definition, babies who are too young to have been vaccinated are in fact appropriately vaccinated for their age. Hence, they belong to both the fully vaccinated for age group, and the not vaccinated group. Although it's most appropriate to include them in the former (when comparing with a control cohort, as you did) I left them out altogether. Again, I was trying to not take sides. People can include them in whatever way they wish, as you have done.
Here's where it gets really funny, Greg. You see, there are footnotes on the image that you included in your blog post. You shrunk the image, so they're not very readable, but here's one of them:
"Ineligible equals cases coded as not applicable in NNDSS and includes all cases in less than 8 weeks of age. Those cases that were between 6 weeks and 8 weeks of age & received one dose from 2009 onwards were included in the fully vaccinated category"
All cases less than 8 weeks are ineligible. Those who received the correct does for age are in the vaccinated category. They're not fully vaccinated, but they're already included there. Didn't you accuse me of a lack of comprehension earlier, Greg? HOLY CRAP GREG, IS THAT YOUR ARSE HANGING OUT IN THE WIND??
Now, the messy part. You take the figures and compare them with the vaccination rate in the community (as a control cohort). That's a perfectly valid approach IF notifications are an accurate reflection of true incidence. In my opinion this is not likely, for the reasons I've already mentioned.
You didn't mention any reasons. Unless the reason was "I HAZ A BOOK!". Sadly for you, that's not good enough. Any nutcase can self-publish, Greg.
Also, when we get up around 90% it only takes a few percent out to completely change our assessment. But let's follow through with your approach for a moment.
The rates in the community can be found here: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-cdi350... (tables 1, 2, and 3)
The ~95% rate you quote is correct for 2-year-olds.
The 95% rate I quote is perfectly in context. Again, I refer you to the screenshot that graced my post. If you look carefully, it's your friend Dorey that quotes it, and I use it directly from there. I've always been suspicious of the figure when antivaxers have used it, for several reasons.
1. it's too-conveniently a round figure, meaning it's likely an estimate.
2. it's only valid for this very small subsection of the community (0-4). Overall, our rates are shocking, especially in adults. Even fully vaccinated children can have their immune reactions overwhelmed by sufficient exposure, and that's easily available in our large pool of unvaccinated adults.
3. Dorey uses it all the time, and Dorey is wrong more often than she's right
For 1-year-olds however it is 91.8%, and for 5-year-olds 89.9% (both of which put a serious dent in your calculations).
I wonder how much of a dent it actually puts in the numbers? First of all, your dataset has NOTHING to do with five-year-olds. It's clearly marked "0-4 years" of age. So we need to throw that away. But still, let's make-believe that you're correct and hypothetically imagine that there are three different figures at play in the stats. Assuming the three age-groups are roughly equal in size (a reasonable-ish assumption and about the only one we can make in the face of such poorly-defined numbers), we eventually wash out at a figure of 92.23% ((91.8+95.0+89.9)/3). That's not a very big dent. It's really not a very big dent at all, Greg. Do you want me to use the "dingbat" label again now, Greg? Because you tried to deny you were innumerate earlier.
These percentages are of "appropriately vaccinated for age". Of course the rate in the community of the ineligible group is practically zero (and you wanted to include this group in the comparison, mind you... comprehension, again). So, if the data I published were a valid representation of true incidence there is still a 'please explain' in order. Vaccine efficacy appears to be markedly lower than we've been told. If, on the other hand, there are a disproportionate number of kids in the community who had whooping cough that wasn't reported (because their doctor thought they were 'immune' to it), we have a much greater problem for the vaccine.
Anyway, as I've already stated, I didn't draw any conclusions from the data because it is of poor quality. I merely presented it. You drew conclusions, and so did Meryl. Both of them are plausible
Meryl's isn't plausible at all, and that's the one you seem to be supporting. And Meryl was just responding to your whistling, anyway, we all know that.
and of course they are opposite.
You are not the reasonable middle-ground here Greg. Just so you know you can't get away with that either.
Finally, the really interesting part. You said:
"put simply, if you're vaccinated, you can still catch an infection, but it'll be far less severe than in a non-vaccinated individual. You'll most likely recover quicker, and you'll be less likely to develop severe complications, which in the case of pertussis include death.
<>Add in that factor and who knows where the dice will fall? One thing's for sure, they won't fall in Greg Beattie's favour."
Hallelujah! Jason, I've been arguing for ages that deaths are a more valid way of estimating a vaccine's usefulness.
Bingo! You've finally put on the clown make-up and gone for the big joke. You're not just an innumerate dingbat, but also utterly clueless in epidemiology and, more worryingly, basic science. You cannot judge the effectiveness of a vaccine based on death rates alone because, for one thing, death rates are too heavily impacted by other factors. Antibiotic use, timeliness of diagnosis, complicating infections, quality of medical care, ideological objections to conventional treatment - all of these become confounding variables which alter the death rate without altering the incidence rate, and it becomes correspondingly difficult - I would say almost impossible - to tease out exactly which factor is which. This is why control of variables is so important in epidemiology, and in fact in all scientific fields. Messy datasets are datasets from which one cannot draw strong conclusions, and trying to figure out vaccine efficacy from death rates is messy.
Death data isn't perfect but it's a hell of a lot closer to perfect than notifications.
See above, dingbat. Also, the word "data" is plural. "Death data aren't perfect, but they're a hell of a lot closer...".
At the very least, it is complete. Every death is recorded. We don't have to guess how many deaths are reported... they all are! And the bonus is they're an indicator of severity also, as death is the most severe outcome.
No, it's the only outcome, at least in your proposed dataset, out of several possible outcomes you'd find in a real dataset. You can get no idea of how many people were infected but permanently damaged from a long-term complication, for example. Or whether the recovery rate was in any way aided (or otherwise) by vaccination. Or any idea of possible community reservoirs of low-impact disease. There is, in fact, a minimum of useful analysis that can be gleaned from such a dataset. About the only redeeming feature I can picture is that the mathematics are relatively simple, which I guess fits with your track record thus far.
In fact, I would go so far as to call this statement moronically idiotic. Deaths tell you nothing about incidence other than the obvious "incidence was this much or higher, most likely the latter".
I carried out a very thorough examination of death data in my recent book and found little if any evidence of the whooping cough vaccine saving any lives whatsoever. That's another subject, though.
Based on your last couple of sentences, I wouldn't trust you to do a thorough examination of a plate of food, Greg
All the best, and thanks for your comments.
You're welcome, Greg. You're welcome.
Footnote: It's late. I can't be bothered tweaking the post any more, so I'm publishing it. I might update this post tomorrow. Who knows?
posted @ Wednesday, February 08, 2012 12:06 AM