MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

immunisation

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Currently, 15.2 percent of German adults have not even had their first COVID vaccination. A long-term study has recently investigated why some Germans do behave in this way.

Researchers from the University of Erfurt surveyed around 1,200 unvaccinated and 2,000 vaccinated people in Germany. Here is a summary of the findings:

  • 74% of the unvaccinated definitely do not want to be vaccinated against Corona
  • 6% are willing to get vaccinated
  • 37 percent of those who have not been vaccinated against Corona do not want to be vaccinated against anything
  • thus, about two-thirds of them are not principled vaccination refusers.

The researchers also asked the unvaccinated Germans about their reasons for deciding against vaccination:

  • 56% of the unvaccinated are afraid of vaccination
  • 64% of these people cite fear of vaccination consequences and side effects as their reason
  • 8% are even afraid of dying from the vaccination
  • 38% of the unvaccinated agree with the statement, “I am proud not to have been vaccinated against Covid-19”, while 60% of the vaccinated agree with the sentence “I am proud to be vaccinated against Covid-19.” Unvaccinated people also have much less trust in the federal government and the Robert Koch Institute than vaccinated people.
  • 86% of the unvaccinated Germans find the current debate unfair, arrogant, and moralizing.

Based on these findings, the researchers recommend that measures to combat the pandemic should focus above all on maintaining the trust of the majority of those who have been vaccinated. The researchers also advise that attention should be paid to respectful and factual communications, especially by VIPs.

Personally, I find the notion that 56% of the unvaccinated are afraid of vaccination the most interesting finding here. It means we need to communicate the safety aspect much better than we have managed so far. As there is good reason to believe that many of the unvaccinated people are proponents of so-called alternative medicine (SCAM) – see for instance here and here – a reasonable strategy should probably include making sure that SCAM practitioners inform their patients correctly and responsibly.

How can this be done?

I am not sure that I know the answer. But I know that there are psychologists who specialize in this sort of thing. It would, I think, be wise to create a multidisciplinary team to tackle the problem. Any solutions that could come out of such an exercise would come too late for the current Omicron wave. But there will be more to come, and we should be better prepared, I feel.

 

It was reported yesterday that the district court of Schönau in Germany has issued an order to arrest Dr. Mathias Poland, a family doctor who used to practice in Zell. He is accused of issuing certificates of favor to opponents of wearing masks during the pandemic. The order of arrest was “against a doctor from the district of Lörrach” for “issuing false certificates”.

The fact, that some German doctors have issued false exemptions from wearing masks has been known for some time. Similar things have also been reported from other countries. Often, these physicians in question seem to be practitioners of so-called alternative medicine (SCAM). To the best of my knowledge, this is the first time that a doctor has been arrested for such a crime.

So, what do we know about Mathias Poland?

His is what Dr. Poland tells us about himself (my translation):

I was born in 1958 and grew up in Stuttgart. From 1976 I studied medicine in Ulm, where I came into intensive contact with anthroposophy, which has accompanied me ever since. Further stations of my studies were Münster/Westphalia (D) and Poitiers (F). Doctorate in 1983 in Münster on a pediatric oncological topic. This was followed by further training as a specialist in general medicine in several clinics in northern Germany, acquisition of the additional qualification in homeopathy. Further training in anthroposophical medicine through numerous seminars. In 1990 I set up as a general practitioner and family doctor in Wehr/Baden (Germany) – in the following years I gained additional qualifications in Traditional Chinese Medicine and acupuncture at the University of Freiburg (Germany).

Recognition as an anthroposophical doctor by the GAÄD.

I became the doctor in charge of the Kaspar Hauser School Schopfheim 1999 – 2006. From 2009, I took over a GP practice in Zell im Wiesental (D) with an additional focus on proctology.

… Since 1.9.2019, I have been the senior physician in general medicine at the Arlesheim Clinic …

Anthroposophic medicine is a form of healthcare developed in the 1920s by Rudolf Steiner (1861–1925) in collaboration with the physician Ita Wegman (1876–1943). It is based on Steiner’s mystical ideas of anthroposophy. Why do anthroposophical doctors issue such false certificates? As far as I understand it (and to explain it very simply), anthroposophical medicine teaches that infections should not be fought against but accepted and experienced. Why? Because they are important milestones that make us better and more whole as human beings.

And why do doctors believe in anthroposophical medicine?

Search me!

Guest post by Tobias Katz

What do we know?

ICU admission

Taken from the BMJ (Ref 1): ICNARC latest report 31/12/21 showed that the proportion of patients admitted to critical care in December 2021 with confirmed covid-19 who were unvaccinated was 61%.

Prevention of infection

The government’s week 45 Covid surveillance report (Ref 3) is clear that vaccination prevention of infection (positive PCR, for Delta) effectiveness is estimated at 65% for Oxford-AstraZeneca and 80% for Pfizer.

Prevention of transmission

The Lancet’s (Ref 4) paper, suggests once infected, initial viral load is similar for vaccinated and unvaccinated individuals, suggesting likely equal chance of transmitting on the virus.

Protection of the individual

Ref 3, is clear cut that vaccination protects individuals from hospitalisation and severe infection (for Delta).

(Omicron) “Among those who had received 2 doses of AstraZeneca, there was no effect against Omicron from 20 weeks after the second dose. Among those who had received 2 doses of Pfizer or Moderna effectiveness dropped from around 65-70% down to around 10% by 20 weeks after the 2nd dose. 2 to 4 weeks after a booster dose vaccine effectiveness ranged from around 65 to 75%, dropping to 55 to 70% at 5 to 9 weeks and 40-50% from 10+ weeks after the booster.” (Ref 2)

Effectiveness here is measured by admission to hospital and shows the necessity for booster jabs when fighting Omicron.

Who are Dr James and Dr Malhotra?

Steven James, consultant anaesthetist, has recently been in the news for confronting Sajid Javid RE mandatory vaccinations for hospital and nursing staff. “The science isn’t strong enough” to support the policy he stated and “I’ve got antibodies”, suggesting that he’s as protected as he would be if he had a vaccine.

Aseem Malhotra, who goes by the name of ‘lifestylemedicinedoctor’ on Instagram is an extremely controversial cardiology consultant who seems to be Djokovic’s biggest fan and whose tweets are passionately quoted and forwarded by anti-vaxxers.

With tweets such as “Mark my words, with everything we know and don’t know about the current vaccine Novak Djokovic will ultimately be proven to be on the right side of history #BadPharma #truth #transparency #InformedConsent”:

And a retweet: “Dr Jordan Peterson Oh well. It’s just fertility. Women’s Periods May Be Late After Coronavirus Vaccination, Study Suggests”; he stirs the cooking pot of anti-establishment rhetoric and only deepens an already fractured relationship between doctors and their patients caused by the pandemic.

You’d think a mature, well-researched doctor would be able to tell the difference between the menstrual cycle and becoming fertile. You’d also hope he would not be short-sighted enough to support one of the most anti-science/anti-conventional medicine public figures in the world (see here)… Alas, no.

I feel as though both of these figures need to be reminded of their ethical duty of candour as doctors and reminded that their public actions have consequences. I may not completely disagree with Dr James (RE mandatory vaccinations) but the way in which he conducted himself during this nationally broadcasted video left many shaking with rage as it undermines many of his health professional colleagues. Me, included.

When a doctor appears on national news, opposing [mandatory] vaccination and offering incorrect explanations of why this is so, it should be obvious to them that their opinion will inevitably act as anti-vaccine propaganda, whether meant for this or not.

Malhotra’s ideas (cutting back on statins, healthy diet etc.) are often worth consideration/evaluation and as a new-age medical ‘influencer’ with 130k+ followers on Twitter, with ample publications behind him, he deserves to be listened to. Not necessarily agreed with, but listened to. But he also has a duty as a doctor to guard against complacency. Similar to James’ public actions, Malhotra’s tweets that are so one-sided give a biased, inaccurate and frankly dangerous view on the efficacy and safety profile of COVID vaccinations that have been safely and effectively used in millions of people to prevent hospitalisations. Is he doing it for the views? The hits? The likes? The retweets? To have people recognise him for his Pioppi diet?

What should we do?

Candour

Doctors, including James and Malhotra have an ethical responsibility not to spread imperfect information to a wide-receiving audience where their actions can be misconstrued and misrepresented so easily. Doing so may bolster anti-vaccine views, cause less ‘on-the-fence’ people to get the jabs and essentially lead to more preventable deaths.

More and more we are seeing social media take over and often act as the public’s primary source of news. More doctors than ever are now in the [social] media limelight. Some, such as Dr Alex George (mental health advocate) are promoting health responsibly. Others, seek to undermine it. In an era when Joe Rogan has more daily views than Fox News’ Tucker Carlson, to ignore and not rebut [health] social media giants like Malhotra would just worsen the situation. Malhotra and James need to be challenged by the scientific community, as the BBC so brilliantly did here.

Complacency

If doctors want to become socialite Instagram influencers, they must do this without complacency. I think this means being responsible when offering controversial and potentially public health implicating opinions where evidence isn’t clear cut.

Final thoughts

Using all the possible information above, as the vaccines are not 100% without risk, transmission is not completely cut post-vaccine and as we have a decent-ish way of monitoring infection (lateral flows and PCRs), I feel as though mandating vaccines for all NHS staff is currently unjust. I see Steve’s point. But I’d be extremely careful in how I’d make this point. And certainly not on live Sky News when the nation is watching, where it will inevitably be seized upon by the anti-vax community.

Saying this, the data is pretty clear that there is evidence that the vaccines offer protection against infection, reducing viral load quicker once infected and against hospitalisation and so if you’re a rational doctor who thinks that at least one time your lateral flow test may give a false negative, it makes complete sense to get your vaccine to protect your patients…

References

  1. https://www.bmj.com/content/376/bmj.o5?fbclid=IwAR2MgoD_vYo0FsaVsQdLxfeYCukuRu2RegcJa-HclA13byhH71g-AnNhnP8
  2. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1045329/Vaccine_surveillance_report_week_1_2022.pdf
  3. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1032859/Vaccine_surveillance_report_-_week_45.pdf
  4. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00690-3/fulltext

 

On this blog and elsewhere, I have heard many strange arguments against COVID-19 vaccinations. I get the impression that most proponents of so-called alternative medicine (SCAM) hold or sympathize with such notions. Here is a list of those arguments that have come up most frequently together with my (very short) comments:

COVID is not dangerous

It’s just a flu and nothing to be really afraid of, they say. Therefore, no good reason exists for getting vaccinated. This, I think, is easily countered by pointing out that to date about 5.5 million people have died of COVID-19. In addition, I fear that the issues of ‘long-COVID’ is omitted in such discussions

It’s only the oldies who die

As an oldie myself, I find this argument quite distasteful. More importantly, it is simply not correct.

Vaccines don’t work

True they do not protect us 100% from the infection. But they very dramatically reduce the likelihood of severe illness or death from COVID-19.

Vaccines are unsafe

We have now administered almost 10 billion vaccinations worldwide. Thus we know a lot about the risks. In absolute terms, there is a vast amount of cases, and it would be very odd otherwise; just think of the rate of nocebo effects that must be expected. However, the risks are mostly minor, and serious ones are very rare. Some anti-vaxxers predicted that, by last September, the vaccinated population would be dead. This did not happen, did it? The fact is that the benefits of these vaccinations hugely outweigh the risks.

Vaccines are a vicious tracking system

Some claim that ‘they‘ use vaccines to be able to trace the vaccinated people. Who are ‘they‘, and why would anyone want to trace me when my credit card, mobile phone, etc. already could do that?

Vaccines are used for population control

They‘ want to reduce the world population through deadly vaccines to ~5 billion, some anti-vaxxers say. Again, who are ‘they‘ and would ‘they‘ want to do that? Presumably ‘they‘ need us to pay taxes and buy their goods and services.

There has not been enough research

If those who make this argument would bother to go on Medline and look for COVID-related research, they might see how ill-informed this argument is. Since 2021, more than 200 000 papers on the subject have emerged.

I trust my immune system

This is just daft. I am triple-vaccinated and also hope that I can trust my immune system – this is why I got vaccinated in the first place. Vaccinations rely on the immune system to work.

It’s all about making money

Yes, the pharma industry aims to make money; this is a sad reality. But does that really mean that their products are useless? I don’t see the logic here.

People should have the choice

I am all for it! But if someone’s poor choice endangers my life, I do object. For instance, I expect other people not to smoke in public places, stop at red traffic lights and drive on the correct side of the street.

Most COVID patients in hospitals have been vaccinated

If a large percentage of the population has been vaccinated and the vaccine conveys not 100% protection, it would be most surprising, if it were otherwise.

I have a friend who…

All sorts of anecdotes are in circulation. The thing to remember here is that the plural of anecdote is anecdotes and not evidence.

SCAM works just as well

Of course, that argument had to be expected from SCAM proponents. The best response here is this: SHOW ME THE EVIDENCE! In response SCAM fans have so far only been able to produce ‘studies’ that are unconvincing or outright laughable.

In conclusion, the arguments put forward by anti-vaxxers or vaccination-hesitant people are rubbish. It is time they inform themselves better and consider information that originates from outside their bubble. It is time they realize that their attitude is endangering others.

 

Like so many other anti-vaxxers, Djokovic is deep into so-called alternative medicine (SCAM).

An article in THE TELEGRAPH explains it quite clearly. Here are a few passages:

Here is an anti-scientific crank hiding in plain sight … [In his book Djokovic explains] how he suffered from recurring physical ailments – allergies, breathing difficulties, blocked sinuses – until he gave up gluten.

Nothing especially weird so far – until he explains how his gluten intolerance was diagnosed. A Serbian nutritionist called Dr Igor Cetojevic asked Djokovic to hold his right arm out at right angles and resist the pressure as he pushed down on it. Then the exercise was repeated, only this time while Djokovic held a slice of bread against his stomach. “I was noticeably weaker,” writes Djokovic, who adds that “kinesiological arm testing [has] long been used as a diagnostic tool by natural healers.” Yes, and mediums have long claimed to speak to the dead …

Here is a man who broke up his visits to Wimbledon with trips to the nearby Buddhapadipa Temple to meditate by a lake. A man who revealed two years ago that he has a “friend” in Melbourne’s Botanical Gardens – “a Brazilian fig tree that I like to climb”. Yes, Djokovic’s jet-setting spiritualism might sound charming in itself. But its side-effect has been credulousness.

Serve To Win [ND’s book] describes a so-called “researcher” taking two glasses of water and directing loving energy towards one, while swearing angrily at the other. “After a few days … [the angry glass] was tinted slightly green … the other glass was still bright and crystal clear”. Harmless, perhaps, if deeply dippy. But then, last year, Djokovic could be found hosting a former estate agent called Chervin Jafarieh on his Instagram Live channel. Jafarieh was selling bottles of Advanced Brain Nutrients at $50 apiece, which – like Djokovic’s resistance to the Covid vaccination – sounded contrary to the interests of public health…

… Djokovic expressed in a 2018 interview with Shortlist magazine. “I believe that it is our mission to reach a higher frequency through self-care by exploring and respecting our own avatar, our body and, by doing that, raising the vibration of the planet.” …

And so we return to the dark side of this whole peculiar tale. Were Djokovic just a journeyman player, his pseudo-scientific beliefs would be no more than a bizarre footnote. As it is, he is a powerful role model, particularly in the Balkans. Thousands of people have probably emulated his stance on vaccines. Some are likely to suffer consequences as a result…

Another article explains:

New York Times tennis reporter Ben Rothenberg tweeted out after the news of Djokovic’s visa rejection that the Serbian had been “wildly anti-science” over the years.

“Let’s not lose sight of how wildly anti-science Djokovic has publicly been for years,” Rothenberg began. “Here he was last year preaching about how you can change water with emotion.

“Naive, but maybe these real consequences today can be a reality check for his nonsense?”

Former New York Times reporter Steven Greenhouse said it was “sad to see such a brilliant tennis player join the anti-science, pro-poppycock anti-vaxxers”.

Tennis Channel producer David Kane added: “I sort of don’t care whether Australia bungled L’Affaire Novak because of political/media pressure. This is about someone who has been stridently anti-science and never indicated a good faith effort to receive this essentially mandatory vaccine.F around & find out, as they say.”

And a Guardian article provides further information:

His belief in alternative medicine is complemented by his commitment to alternative history. He frequently retreats to Visoko, in the hills of Bosnia and Herzegovina, where he meets up with the businessman Semir Osmanagic – whose claims that there are ancient man-made structures with magical healing powers, refuted by scientists, have turned the hills into a lucrative tourist destination. Djokovic has also expressed his support for the ultranationalist alternative historian Jovan Deretic, whose writings claim, among other things, that numerous European cultures, including ancient Greeks, Celts and Etruscans, are descended from Serbs.


I am quite confident that I play tennis as splendidly as Djokovic understands medicine. Yet, I do not pretend to be able to teach you how to do a perfect ‘top slice’. In contrast, Djokovic loves to take the role of ambassador for SCAM and other weird stuff.

His father stated that “Novak is the Spartacus of the new world who does not tolerate injustice, colonialism and hypocrisy but fights for the equality of all on this planet, regardless of skin color, religious belief and money they have.” Personally, I see this differently: Djokovic is badly affected by proctophasia; he tolerates no end of BS and fights for pseudoscience. And sadly, his views are all too persuasive to gullible consumers – not exactly what we need in a global health crisis!

In so-called alternative medicine (SCAM) we have an amazing number of ‘discoveries’ which – IF TRUE – should have changed the world. Here I list of 10 of my favorites:

  1. Diluting and shaking a substance makes it not weaker but stronger.

Homeopaths call this process ‘potentisation’. They use it to produce highly ‘potent’ remedies that contain not a single molecule of the original substance. The assumption is that potentisation transfers energy or information. Therefore, they claim, molecules are no longer required for achieving a clinical effect.

2. A substance that causes a certain symptom in a healthy person can be used to cure that symptom when it occurs in a patient.

The ‘like cures like’ principle of homeopathy is based on the notion that the similimum provokes an artificial disease which in turn defeats the condition the patient is suffering from.

3. Subluxations of the spine are the cause of most diseases that affect us humans.

DD Palmer, the inventor of chiropractic, insisted that almost all diseases are due to subluxations. These misplaced vertebrae, he claimed, are the root cause of any disease by inhibiting the flow of the ‘innate’ which in turn caused ill health.

4. Adjusting such subluxations is the best way to restore health.

Palmer, therefore, was sure that only adjustments of these subluxations were able to restore health. All other medical interventions were useless or even dangerous, in his view. Thus Palmer opposed medicines or vaccinations.

5. An imbalance of two life forces is the cause of all illnesses.

Practitioners of TCM believe that all illnesses originate from an energetic imbalance. Harmony between the two life forces ‘yin and yang’ means health.

6. Balance can be restored by puncturing the skin at specific points.

Acupuncturists are convinced that their needling is nothing less than attacking the root cause of his or her problem. Therefore, they are convinced that acupuncture is a cure-all.

7. Our organs are represented in specific areas on the sole of our feet.

Reflexologists have maps of the sole of a foot where specific organs of the body are located. They palpate the foot and when they feel a gritty area, they conclude that the corresponding organ is in trouble.

8. Massaging these areas will positively influence the function of specific organs.

Once the diseased or endangered organ is identified, the area in question needs to be massaged until the grittiness disappears. This intervention, in turn, will have a positive influence on the organ in question.

9. Healing energy can be sent into our body where it stimulates the self-healing process and restores health.

Various types of energy healers are convinced that they can transmit energy that comes from a divine or other source into a patient’s body. The energy enables the body to heal itself. Thus, energy healing is a panacea and does not even require a proper diagnosis to be effective.

10. Toxins accumulate in our bodies and must be eliminated through a wide range of SCAMs.

The toxins in question can originate from within the body and/or from the outside. They accumulate and make us sick. Therefore, we need to eliminate them, and the best way to achieve this is to use this or that SCAM

 

I could, of course, list many more such ‘discoveries’ – SCAM is full of them. They are all quite diverse but have one important thing in common: they are false (i.e. there is no good evidence for them and they fly in the face of science).

If they were true, they would have changed the world by revolutionizing science, physics, physiology, anatomy, pathology, therapeutics, etc.

ALL THESE UGLY FACTS DESTROYING SUCH BEAUTIFUL THEORIES!

WHAT A SHAME!!!

For my last post of the year 2021, I take the liberty to borrow parts of a BMJ editorial entitled A NEW YEAR’S RESOLUTION OF HEALTH WORKERS:

The prospect of a return to normality seems within reach. But what will that normality look like? We believe that health workers, who have been at the frontline of the pandemic, must offer a vision of a healthier future. We must not let the terrible events of this year recast the pre-pandemic world in a glowing light. The normality we departed from at the onset of the pandemic was unjust, unsustainable, and shaped the evolution of, and responses to, the pandemic with devastating consequences, particularly for the most deprived and vulnerable.

The start of a new year offers an opportunity to question old ways of working and to ask how we can create a better future for everyone. It is a cliché to say that you should never waste a crisis. Just as in wartime and in the global financial crisis, many have profited greatly from the pandemic, whether as providers of online services or by taking advantage of the rush to procure essential goods such as personal protective equipment.

But many were far less fortunate, living in circumstances that rendered them vulnerable to an infection that spread especially rapidly through communities where successive generations had been living ever more precarious lives. As the recovery begins, the powerful groups who benefited from the social and economic systems that created those conditions will, once again, seek to shape the world to their advantage. Health workers cannot remain silent. They must offer a compelling vision of how we should reconfigure the world so that it produces and sustains health for all, resilient in the face of future threats…

A country navigating the pandemic is like a ship navigating treacherous and unpredictable waters in a storm. If the ship, its crew, and its passengers are to come through the experience unscathed it needs three things. First, it needs an experienced captain who understands the ship and commands the trust of the crew. Unfortunately, in some of the countries worst affected, captains were either away from the bridge, denied there was a storm, or had lost the trust of those on whom they depended.

Second, it needs a crew that is adequate for the size of the ship, that is well trained, and that is working as a team to achieve the same goal. Yet in too many countries, skeleton crews were working in health systems that were highly fragmented. Dissenting voices who raise the alarm about the integrity of the ship, the working of the team, or its leadership must not be silenced or lives can be lost. It also needs passengers who are as seaworthy as possible so that they can withstand the storm. One of the sentinel challenges of covid-19 was finding large segments of the population weighted by a disproportionate burden of preventable disease that predisposed them to severe covid-19 once infected.

Third, we need a ship that is securely constructed. Yet in many of the countries that have fared worst, we have been working in vessels that are full of holes. Social safety nets have been ripped asunder, allowing too many people to fall through the holes. We have made many demands on our people—to stay at home, to face loss of income—and we have added greater uncertainty to what were already difficult situations, particularly for certain racially and economically marginalised groups. The disproportionate exposure to covid-19 of many in these groups—a consequence of precarious jobs and social circumstances that denied them the luxury of social distancing—drove, in large part, the high burden of covid-19 among minority and marginalised groups worldwide.

As we look to the prospect of a covid-19 secure future, with effective vaccines, new treatments, and continued countermeasures as necessary, we must ask how we can strengthen the foundations of our societies, coming together to repair the torn safety nets. We must never be afraid to challenge our political leaders when they are going in the wrong direction, and we must insist that they really are guided by the science, and not just those bits that support their beliefs. And we must ensure that our fellow citizens are as healthy as possible so they can withstand the inevitable storms that lie ahead. We must insist that our health systems and other public systems are adequately staffed, with the tools needed to do the job, with teams that are working together, pulling in the same direction. If we do all this, then we, and the populations we serve, can be confident that we can weather any future storms.

___________________________

The editorial was written by 4 authors:

  1. Martin McKee, professor of European public health
  2. May C I van Schalkwyk, NIHR doctoral research fellow
  3. Nason Maani, assistant professor in public health evaluation
  4. Sandro Galea, dean

I think it is most sensible and thought-provoking and I suspect many of us agree with its sentiments. If it did not make you think, perhaps this information will do so:

The editorial was published one year ago in the Christmas issue of the BMJ

2020!

Yes, 2021 has disappointed many of our hopes and turned out to be a difficult year.

I wish us all that 2022 will be better, much better.

THE GUARDIAN published an interesting article about vaccination hesitancy yesterday. Here is a short passage from it:

One major missing piece of the puzzle, currently under consideration, is a strategy that gets to the bottom of why 5 million people remained unvaccinated, especially those in communities with an ingrained distrust of authority.

No 10 even turned to an artificial intelligence (AI) company earlier in the year to determine the causes of vaccine hesitancy, but Whitehall sources acknowledge there is still a lack of understanding about how many of the unvaccinated remain so because of entrenched anti-vax ideology, misconceptions that could be turned around, a lack of time or transport to get to vaccine centres, or just apathy.

Yesterday, it was also reported in DER STANDARD that the Austrian Science Minister Martin Polaschek has commissioned a study from Statistics Austria, which for the first time was to look at the vaccination status of the population according to socio-economic characteristics.

The study yielded fascinating findings that might shed some light on the phenomenon of ‘entrenched anti-vax ideology’:

  • Across all age groups, the proportion of vaccinated persons, including recovered persons, is 67%.
  • Slightly less than four percent of the population are only recovered, and about 30% are neither one nor the other.
  • There are no marked differences between men and women.
  • The willingness to vaccinate is strongly related to the level of education.
  • The vaccination rate in the group of 25-64 year-olds with a university degree is about 84% and thus significantly higher than among those who have only basic education (68%).
  • In this age group, it also seems important whether someone has a job (76%) or not (69%).
  • People employed in the information and communication sector (85%) and public administration (83%) are the most likely to be vaccinated.
  • Workers in agriculture and forestry (67%) and construction (65%) are the least likely to accept vaccinations.
  • Health and social services personnel have a vaccination rate of 79%.
  • More than half of the 600,000 schoolchildren had already been vaccinated, and in the upper secondary school it was even 72%.
  • The rate among teachers is also high, at 85%.
  • 86% of the approximately 395,000 students at universities had been vaccinated.
  • As 92% of all medical students were vaccinated.
  • The vaccination rate among Austrian nationals, at about 70%, is clearly higher than that of people without an Austrian passport (52%).
  • The difference between those born in Austria and those not born in Austria is only five percentage points.
  • The willingness to be vaccinated is higher among people from Turkey (73%) than among those born in Austria (68%).
  • Among Germans and Afghans, it is around 72%.
  • People from Romania (43%) and the Russian Federation (45%) have the lowest vaccination rates.
  • The percentage of vaccinated people is highest among those between 75 and 84 years.

Similar findings have, of course, been reported from other countries. However, what seems new to me here is the finding that vaccination rates are strongly correlated to the level of education: the anti-vax brigade tends to be uneducated and ignorant. If confirmed, this suggests that education might be a way to make them accept vaccinations.

PS

Of course, correlation is not causality. But there seems to be a dose-response relationship between education and willingness to vaccinate. This makes a causal effect more likely.

 

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THOSE WHO KNOW NOTHING MUST BELIEVE EVERYTHING

 

 

I came across this article via a German secondary report about it entitled “Scientists discover what else protects from severe symptoms” (Forscher finden heraus, was noch vor schweren Symptomen schützt). The article rightly stressed that vaccination is paramount and then explains that, once you have caught COVID, nutrition can prevent serious symptoms.

Even though I rarely discuss standard nutritional issues on my blog (nutrition belongs to mainstream not so-called alternative medicine [SCAM], in my view), this subject did attract my attention. Here are the essentials of the original scientific paper:

Australian scientists studied the association between habitual frequency of food intake of certain food groups during the COVID-19 pandemic and manifestations of COVID-19 symptoms in adult outpatients with suspected SARS-CoV-2 infection. They included 236 patients who attended an outpatient clinic for suspected COVID-19 evaluation. Severity of symptoms, habitual food intake frequency, demographics and Bristol chart scores were obtained before diagnostic confirmation with real-time reverse transcriptase PCR using nasopharyngeal swab.

The results of the COVID-19 diagnostic tests were positive for 103 patients (44%) and negative for 133 patients (56%). In the SARS-CoV-2-positive group, symptom severity scores had significant negative correlations with the habitual intake frequency of specific food groups. Multivariate binary logistic regression analysis adjusted for age, sex, and occupation confirmed that SARS-CoV-2-positive patients showed a significant negative association between having higher symptom severity and the habitual intake frequency of legumes and grains, bread, and cereals.

The authors concluded that an increase in habitual frequency of intake of ‘legumes’, and ‘grains, bread and cereals’ food groups decreased overall symptom severity in patients with COVID-19. This study provides a framework for designing a protective diet during the COVID-19 pandemic and also establishes a hypothesis of using a diet-based intervention in the management of SARS-CoV-2 infection, which may be explored in future studies.

So, the authors seem to think that they found a causal relationship: A CHANGE IN DIET DECREASES SYMPTOMS. In different sections of the article, they seem to confirm this notion, and they state that they tested the hypothesis of the effect of diet on SARS-CoV-2 infection symptom severity.

Yey, the investigation was merely a correlative study that cannot establish cause and effect. There are many other variables that might be linked to dietary habits which could be the true cause of the observed phenomenon (or contributors to it).

What’s the harm? If the article makes people adopt a healthier diet, all is pukka!

Perhaps, in this case, that might be true (even though one could argue that this paper might support anti-vax notions arguing that vaccination is not important if it is possible to prevent severe symptoms through dietary changes). But the confusion of correlation with causality is both frequent and potentially harmful. And it is unquestionably poor science!

I feel that we need to be concerned about the fact that even reputable journals let such things pass – not least because the above example shows what the popular press subsequently can make of such misleading messages.

 

In Germany, the anti-vax movement is frighteningly strong and it constitutes one of the main reasons for the relatively immunization rate. In no small part, this is due to the many anti-vax Heilpraktiker who practice in Germany. In an attempt to put the record straight, the ‘Verband Klassischer Homöopathen Deutschlands’ (VKHD, Association of Classical Homeopaths of Germany) recently published an article entitled ‘Heilpraktiker – Homeopathy – Vaccination’ (Heilpraktiker – Homöopathie – Impfen). Here is a short excerpt (my translation):

… There is a clear conceptual similarity between homeopathy and vaccination [1]. From a historical point of view, this was already reflected in the early days of homeopathy, when its discoverer, Samuel Hahnemann, expressed himself very positively with regard to the smallpox vaccination newly introduced at that time [2]. Thus, it is historically wrong to insinuate that users of homeopathy have a fundamentally negative attitude towards vaccinations [3]. In this context, terms such as “vaccination opponents” or “vaccination refusers” are misleading and defamatory [4].

A critical (not skeptical) approach to the topic of vaccinations is basically a characteristic of people with medical expertise. Such an attitude corresponds to the critical consideration necessary in daily practice and in each individual case to advise on suitable therapy options [5]. Properly working alternative practitioners give differentiated advice accordingly [6]. A fundamentally vaccine-rejecting attitude is precisely not a characteristic of a critical assessment that has taken place. The same applies to an unreflective recommendation of vaccinations or therapy methods, without taking into account individual factors as well as scientific and social backgrounds [7].

For the VKHD, we cannot give exact figures on recovered, vaccinated, or unvaccinated members. It is not the responsibility of a professional association to demand such information from its members [8]. We assume that alternative practitioners who provide information on vaccinations do so in accordance with a responsible ethical attitude, regardless of their own vaccination status [9] …

I have taken the liberty of inserting some references into this text. They relate to my comments, which are as follows:

  1.  A conceptual similarity between vaccination and homeopathy exists only in the minds of homeopaths. They often claim that both use highly diluted remedies. This is wrong because homeopathic remedies do not usually contain active ingredients, whereas vaccines do. This fact also explains why homeopathics do not produce immune reactions, whereas vaccines do.
  2.  Correct! Hahnemann was in favor of vaccination. That is why he would be ashamed today if he knew how many homeopaths oppose vaccination.
  3. What has this got to do with ‘historical’? I assume that the ‘insinuations’ refer to the situation today. Further, I don’t think anyone is suggesting that all homeopaths are ‘fundamentally’ opposed to vaccination. However, that many of them are anti-vaxers is an indisputable fact.
  4. I would rather think they are accurate.
  5. Correct.
  6. How can they without any medical background?
  7. Is it to be implied here that real medical people do?
  8. Maybe not ‘demand’, but inquire or request would be possible and desirable, wouldn’t it?
  9. It is nice that you believe this. But belief is not evidence.

 

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