The Subtle Way

Those of you have read this blog for some time probably know that I have contacted the local publication MN Parent before due to what I consider its lax fact-checking and tendency to promote anti-vaccine misinformation. I don't necessarily think this is a line of reasoning that the publishers or even the editor follow, but it appears in the pages of this big-circulation free publication from time to time. When I initially complained about MN Parent's profile of an anti-vaccine mother, in which none of her false assertions were fact-checked or even challenged, I initially received a very gracious response from the editor. However, when the next issue was published, the editorial response to my complaint (and the complaints of others) was to say that they don't fact-check parent quotes and shouldn't be expected to do so. They even went on to challenge CDC information about which state has the most cases of autism (the woman profiled claimed it was Minnesota).

While disappointing, I felt good about speaking up--and even better about the other parents who had apparently written in to complain.

Fast forward to last month. I picked up the November edition of Minnesota Parent and flipped to "20 Questions to Ask When You're Pregnant," written by "personality psychologist" Heidi Smith Luedtke. Number five was a straightforward question: "Should I get immunized?" Below is Luedtke's complete response in the article:

Your physician may recommend shots for the flu, hepatitis b, and tetanus (sic), especially if you're at risk. Live-virus vaccines and those for measles, mumps, and varicella (chicken pox) may be harmful during pregnancy. Speak up to make sure you're safe.

This is all sorts of wrong. First, it doesn't answer the question. Second, I think by "tetanus" the writer means the Tdap, which the ACIP (Advisory Committee on Immunization Practices) just recommended for all pregnant women, due to the increasing outbreaks of pertussis, a disease that is particularly devastating to infants.

But what is most interesting--and wrong--here is perhaps a bit subtle to those not involved in trying to increase immunization rates. Luedtke utilizes a scare tactic not uncommon among anti-vaccine activists: Trying to scare you off vaccines by bringing up totally irrelevant information.

Example: She brings up what I assume is the MMR vaccine (she says "measles, mumps" but leaves off the rubella component of the MMR vaccine, which is ironically the most devastating disease for a pregnant woman and her fetus) and the varicella vaccine. These are two vaccines that are NEVER offered to a pregnant woman. Never.

Here's what would happen. If you didn't know if you had been immunized for MMR, you would have a titers drawn to see if you were immune to rubella (I did this when pregnant). This would reveal your level of immunity. If you were not protected for rubella, your doctor would wait until you had given birth before immunization. As far as varicella goes, a pregnant woman would never be offered this vaccine either.

I'm not sure where the author is going with her comment about the Hep B vaccines--if you were a prostitute or drug user, your doctor might encourage you to get vaccinated, but the average pregnant woman would not need to worry about this.

It's pretty easy to locate the CDC's recommendations for vaccines during pregnancy. It would have been nice if the author of this piece--or better yet, her editor--had simply consulted this document instead of writing an error-ridden collection of nonsense designed to confuse a pregnant woman, at best, or scare her off vaccines, at worst.

As lagniappe, Luedtke directs pregnant women to "speak up to make sure you're safe." I don't know if Luedtke is actually opposed to vaccination, but the image she creates is of a vaccine-mad doctor coming at her with a syringe full of MMR vaccine. If it were me in that doctor's office, though, I'd speak up to make sure both of us--my baby and me--were safe by asking for my flu vaccine and Tdap.

Please speak up when you see members of the media mispeaking on vaccines. Most of the time, these are innocent mistakes (with potentially dangerous consequences) and the editors are glad to have them pointed out. The more often parents hold members of the media to a basic standard of accuracy, the better reporting we will get.

Letter to the Editor

UPDATE TWO: Unfortunately, the response from MN Parent was pretty disappointing. There was no real correction. Instead, there was a clarification that no study has been shown to link vaccines and autism. Instead of acknowledging the other errors in the piece, the editors felt they needed to validate the mother's search for "truth"--apparently even if in that search she misinforms thousands of parents--and use this as a reason they do not challenge her facts. Also, the editors disputed the information I gave them about the state with the highest rate of autism. I guess the CDC isn't reliable enough. It's enough to make me think that this publication has an anti-vaxxer pretty high on the masthead. It's really too bad...it's an otherwise nice magazine.


UPDATE: I received a gracious reply from the executive editor of MN Parent. There might be a correction run in the next issue. I will keep you updated.


Editor's Note: In the August 2011 issue of Minnesota Parent, a local free publication distributed in Minnesota, a mother was profiled in the magazine's "Real Parents" feature. The parent, Jennifer Vanderhorst-Larson, is the parent of a ten-year-old autistic child. She seems like a nice lady. However, in her profile, and uncorrected by the editors of the publication, she makes some statements about vaccines and autism that are egregious and false, including the jaw-dropping assertion that "1 in 28 Somali children" are autistic (They make up 1 in 28 in a population of diagnosed autistic children.) I was literally sick to my stomach after reading her profile and decided I had to speak up. Below find my letter to the editor. I am posting this to encourage other Moms and Dads Who Vax to speak up whenever the media fails to do its job when discussing this issue. When we remain silent, we agree. And members of the media cannot be allowed to fall down on the job on this issue, when lives are at stake. 

Dear Editors,

I was distressed and profoundly disappointed after reading the Real Parents in this month's Minnesota Parent. As a mother and journalist, I have always enjoyed the reportage and first-person accounts in your magazine. But upon reading Jennifer Vanderhorst-Larson's profile, I was struck dumb. You profile a mother of an autistic child who is involved with special education efforts. That's great. However, you allow her to speak as an expert on vaccines, autism, and even the incidence of autism in the Somali community, all the while not doing any fact-checking of her statements, and writing, as the editorial voice introducing her, that her child was diagnosed with autism after his fifteen-month vaccinations, instead of stating how old Cade was when he was diagnosed, which would have avoided creating a link in the reader's mind. As you know, study after study after study has found absolutely no link between vaccines and autism. As you also know, children and infants have fallen ill and died from vaccine-preventable diseases because people are not vaccinating their children because of a fear of this non-existent link.

Just to give you a sense of how badly Vanderhorst-Larson got her facts wrong, she says that there was no study on combo vaccines when her son was vaccinated nine years ago. In fact, in 1997, this study (http://cid.oxfordjournals.org/content/24/5/925.short) was published in Clinical Infectious Diseases about the safety of the MMR combo vaccine when given with another vaccine. In 2001, there was this study in the Pediatric Infectious Disease Journal (http://journals.lww.com/pidj/Abstract/2001/10000/Safety_and_immunogenicity_of_a_pentavalent.11.aspx) showing the safety of the dTap combo vaccine. Both were published ten or more years ago, before or within those first fifteen months of her son Cade's birth. More studies on combo vaccines have been published since (http://scholar.google.com/scholar?q=combination+vaccine+safety&hl=en&as_sdt=0&as_vis=1&oi=scholart). and all of them have found the combo vaccines safe. This was a crucial piece of information left out of the profile, and it makes me wonder if it was intentional. In any case, Vanderhorst-Larson's comment that there were no studies on combo vaccines when Cade was vaccinated is incorrect and misleading.

She also says Minnesota has the highest rate of autism. This is incorrect. In the latest, most comprehensive accounting of autism diagnoses in this country, the CDC found New Jersey had the highest incidence of autism, 1 in 94. 

Finally, in what I think is the most egregious mistake in her story, she says 1 in 28 Somali children in the Twin Cities have autism. She may not understand the statistics she is looking at: the Minnesota Department of Health estimated that of diagnosed autistic children in Minnesota, you could expect to find a Somali child in one of every 28 diagnosed children. This is a far cry from 1 in 28 Somali children, which is what she states in her profile. There is, in fact, no firm number on the incidence of autism in the Somali community--and that is why the CDC just funded a study to discover the incidence and to understand why it seems to be higher than other populations. I won't bore you with her misapplication of the word epidemic in connection to autism and the possibility that it is, in part, a genetic disorder.

It's disappointing to see the vaccine-autism myth handled in this way by a trusted local publication that aims to support and educate parents, and usually does. I believe the responsible thing to do in this case would to have been either to keep to Vanderhorst-Larson's area of expertise--education and founding IT companies--and edit out her comments on vaccines and statistics (unless you planned to fact-check those statistics and her claims about vaccines, which didn't happen) or to run an editor's note with her profile pointing out that autism and vaccines have not been found to have any link, despite numerous studies that have looked for that link. This is not a matter of opinion; if it were, I wouldn't be writing to you. This is a matter of science and public health, and it is reckless for a publication like yours to let a parent spread false, misleading, and downright scary information in a forum such as your Real Parents profile, which I bet is a very popular part of your magazine. (Definitely the first page I turn to!)  Errors like Vanderhorst-Larson's, which are very, very commonly heard in the anti-vaccination community, cannot go uncorrected. I beg you to run an editor's note correcting her misstatements of fact, lest a new parent read these comments and choose not to vaccinate her baby because of them. Let that parent, at least, make that decision based on facts, not falsehoods. Thank you.

Ashley Shelby