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

vaccination

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It has been reported that the American Board of Internal Medicine (ABIM) has revoked the certifications for two prominent US physicians. They are both (in)famous for leading an organization that promotes ivermectin as a treatment for COVID-19.

  • Pierre Kory, MD, is no longer certified in critical care medicine, pulmonary disease, and internal medicine, according to the ABIM website.
  • Paul Ellis Marik, MD, is no longer certified in critical care medicine or internal medicine.

Marik is the chief scientific officer and Kory is president emeritus of the Front Line COVID-19 Critical Care (FLCCC) Alliance, a group they founded in March 2020. The FLCCC gained notoriety during the height of the pandemic for advocating ivermectin as a treatment for COVID. It now espouses regimens of supplements to treat “vaccine injury” and also offers treatments for Lyme disease.

Kory and Marik stated, “we believe this decision represents a dangerous shift away from the foundation principles of medical discourse and scientific debate that have historically been the bedrock of medical education associations.” The FLCCC said in the statement that it, along with Kory and Marik, are “evaluating options to challenge these decisions.” Kory and Marik said they were notified in May 2022 that they were facing a potential ABIM disciplinary action. An ABIM committee recommended the revocation in July 2023, saying the two men were spreading “false or inaccurate medical information,” according to FLCCC. Kory and Marik lost an appeal. In a 2023 statement, Kory and Marik called the ABIM action an “attack on freedom of speech.”

To this, Wikipedia adds that, Marik is the inventor of the “Marik protocol”, also known as the “HAT” protocol, which proposes intravenous administration of hydrocortisone, ascorbic acid, and thiamine as a treatment for preventing sepsis for people in intensive care. Marik’s own initial research, published with four other authors in Chest in 2017, showed a dramatic evidence of benefit. The single-center, observational study compared outcomes of 47 consecutive sepsis patients who were treated with HAT during a 7-month period to 47 consecutive control patients during the preceding 7-month period. The study reported 19 deaths in the control group and 4 deaths in the treatment group. Marik’s findings received attention on social media and National Public Radio, but drew criticism from the wider medical community for being science by press conference. ER doctor Jeremy Faust was one of a number of skeptics of the results, noting the low reliability of the study design and potential for bias. The controversy prompted other groups to conduct studies of the HAT protocol. A systematic review of six randomized and five non-randomized controlled trials in 2021 eventually concluded that the claimed benefits of the protocol could not be confirmed.

In November 2022, Pierre Kory and the FLCCC began marketing a cocktail of supplements and drugs (e.g. ivermectin and nitazoxanide) for other viruses, influenza and Respiratory syncytial virus (RSV). Like the FLCCC-advocated COVID treatments, the recommendations lacked credible supporting scientific evidence. The cocktail could cost over $500.

Wikipedia also mentions that, in March 2024, Kory and Marik published an op-ed in The Hill claiming that long COVID was caused by COVID-19 vaccination instead of COVID-19 infection. The op-ed was republished by the German disinformation outlet Disclose.tv. The fact-checking website Health Feedback found that the op-ed relied on anecdotes that did not provide evidence to support the claim.

 

 

Recent studies have demonstrated that sociopolitical attitudes partially explain variance in (SARS-CoV-2) vaccine hesitancy and uptake. Other attitudes, such as those towards esoteric beliefs, so-called alternative medicine (SCAM), and religion, have also been proposed. However, pertinent studies provide limited direction for public health efforts, as the impact of such attitudes has been tested in isolation or on different outcomes. Moreover, related associations between SARS-CoV-2 immunization drivers as well as views towards other modes of immunization (e.g., routine pediatric immunization), remain unclear.

Based on a sample of ~7400 survey participants (Germany), where esoteric belief systems and SCAM (Waldorf, homeopathy) are rather prevalent, and controlling for other sociological factors, this study found that:

  • individuals with positive attitudes towards Waldorf education and homeopathy are significantly less likely to have received a (further) dose of SARS-CoV-2 vaccine compared to those with positive views of mainstream medicine;
  • for the former, immunization decisions are primarily driven by external pressures, and for the latter overwhelmingly by voluntary considerations;
  • attitudes influencing adult SARS-CoV-2 vaccine uptake similarly influence views towards routine pediatric immunization.

The authors concluded that their findings provide significant evidence informing a more nuanced design of public health and communication campaigns, and pertinent policies.

As the authors of this study point out, the attitudes towards mainstream medicine remained the single most influential factor for vaccine uptake. Individuals who viewed mainstream medicine highly favorably, received on average an estimated 1.48 (p < 0.001) more doses of SARS-CoV-2 vaccine than those who held very negative views. In contrast, those who viewed homeopathy highly positively received on average 0.51 (p < 0.001) fewer doses than those who viewed homeopathy highly negatively.

Regarding religious denominations, individuals self-classifying as Roman-Catholic or Protestant received on average 0.17 (p < 0.001) and 0.15 (p < 0.001) more vaccine doses than those self-classifying as non-denominational. The associations between other denominations and vaccine doses were statistically insignificant.

While these associations have been observed before or at least seem logical to me (and we discusses them frequently on this blog), one finding is, I think new (albeit not surprising, in my view): Supporters of the right-wing populist AfD received 1.37 (p < 0.001) fewer vaccine doses than the reference category Christian democrats.

So, does that in essence mean that the typical (German) vaccination hesitant person votes extereme right and loves SCAM?

Proponents of so-called alternative medicine tend to be critical of COVID-19 vaccines and often claim that they do more harm than good. Therefore, I have in the past repeatedly discussed studies that alleviate their concerns and will continue to do so in future. A new study will provide a valuable contribution to this ongoing discussion.

It has been shown that the first dose of COVID-19 vaccines leads to an overall reduction in cardiovascular events, and in rare cases, cardiovascular complications. There is less information about the effect of second and booster doses on cardiovascular diseases. Using longitudinal health records from 45.7 million adults in England between December 2020 and January 2022, this study compared the incidence of thrombotic and cardiovascular complications up to 26 weeks after first, second and booster doses of brands and combinations of COVID-19 vaccines used during the UK vaccination program with the incidence before or without the corresponding vaccination.

The findings reveaal that:

  • The incidence of common arterial thrombotic events (mainly acute myocardial infarction and ischaemic stroke) was generally lower after each vaccine dose, brand and combination.
  • The incidence of common venous thrombotic events, (mainly pulmonary embolism and lower limb deep venous thrombosis) was lower after vaccination.
  • There was a higher incidence of previously reported rare harms after vaccination: vaccine-induced thrombotic thrombocytopenia after first ChAdOx1 vaccination, and myocarditis and pericarditis after first, second and transiently after booster mRNA vaccination (BNT-162b2 and mRNA-1273).

The authors concluded that these findings support the wide uptake of future COVID-19 vaccination programs.

This England-wide study offers reassurance regarding the cardiovascular safety of COVID-19 vaccines, with lower incidence of common cardiovascular events outweighing the higher incidence of their known rare cardiovascular complications. No novel cardiovascular complications or new associations with subsequent doses were found. The findings thus support the wide uptake of future COVID-19 vaccination programs.

Vaccine hesitancy has been defined as a continuum of attitudes, ranging from accepting vaccines with doubts to rejecting them. For good reasons, the topic has featured regularly on this blog, e.g.:

This new study aimed to explore the heterogeneity of a childhood-vaccine-hesitant group by using a person-oriented approach, i.e. latent profile analysis.

A non-representative cross-sectional sample of vaccine-hesitant Slovenians (N = 421, Mage = 35.21, 82.9% women) was used to identify differences based on their

  • reliance on personal research (“self” researching instead of relying on science),
  • over-confidence in knowledge,
  • endorsement of conspiracy theories,
  • complementary and alternative medicine,
  • trust in the healthcare system.

The analysis revealed three profiles of vaccine-hesitant individuals. The most hesitant profile—vaccine rejecting—expressed the greatest reliance on personal research, expressed the highest endorsement of conspiracy theories and complementary and alternative medicine, showed moderate overconfidence in their knowledge, and expressed the highest levels of distrust in the healthcare system. Furthermore, the researchers found differences in sociodemographic structure and noted that the identified profiles differed in their attitudes regarding MMR, HPV, and Seasonal Influenza vaccinations.

The authors concluded as follows: our findings not only further confirm the heterogeneous nature of vaccine-hesitant groups but also offer critical insights for public health interventions. By acknowledging the existence of distinct profiles within the vaccine-hesitant population, strategies can be tailored to address the nuanced beliefs and attitudes of these subgroups more effectively.

The authors suggest the following approaches:
  • Skeptics who already express a certain level of trust in healthcare, may be most receptive to messages from medical professionals. Given that skeptics are typically older, higher-educated men, interventions could focus on leveraging their existing trust in healthcare professionals and providing detailed, evidence-based information to address their specific concerns.
  • Self-directed researchers, who are characterized by high endorsement of CAM and conspiracy theories and moderate over-confidence, could benefit from interventions involving trusted community figures or CAM medicine experts who can bridge the gap between traditional and CAM perspectives. In addition, reaching out to younger women in this group through online platforms and providing credible information that counteracts misinformation could be effective.
  • Conventionalists, who have the highest trust in the healthcare system and tend to include more educated individuals with a left-leaning political orientation, may respond well to public health messages that emphasize the collective benefits of vaccination. Campaigns could focus on reinforcing their positive views on the efficacy, safety, and importance of vaccines while leveraging their trust in physicians and public health institutions.

The effectiveness of targeted interventions for each specific subgroup could then also be examined, employing insights from the present study. For instance, tailored communication strategies could be tested to determine which messages and messengers are the most effective in regard to changing attitudes and behaviors within each profile.

Individuals with large followings can influence public opinions and behaviors, especially during a pandemic. In the early days of the COVID pandemic, US president Donald J Trump endorsed the use of unproven therapies. Subsequently, a death attributed to the wrongful ingestion of a chloroquine-containing compound occurred.

This paper investigated Donald J Trump’s speeches and Twitter posts, as well as Google searches and Amazon purchases, and television airtime for mentions of hydroxychloroquine, chloroquine, azithromycin, and remdesivir. Twitter sourcing was catalogued with Factba.se, and analytics data, both past and present, were analyzed with Tweet Binder to assess average analytics data on key metrics. Donald J Trump’s time spent discussing unverified treatments on the United States’ 5 largest TV stations was catalogued with the Global Database of Events, Language, and Tone, and his speech transcripts were obtained from White House briefings. Google searches and shopping trends were analyzed with Google Trends. Amazon purchases were assessed using Helium 10 software.

From March 1 to April 30, 2020, Donald J Trump made 11 tweets about unproven therapies and mentioned these therapies 65 times in White House briefings, especially touting hydroxychloroquine and chloroquine. These tweets had an impression reach of 300% above Donald J Trump’s average. Following these tweets, at least 2% of airtime on conservative networks for treatment modalities like azithromycin and continuous mentions of such treatments were observed on stations like Fox News. Google searches and purchases increased following his first press conference on March 19, 2020, and increased again following his tweets on March 21, 2020. The same is true for medications on Amazon, with purchases for medicine substitutes, such as hydroxychloroquine, increasing by 200%.

The authors concluded that individuals in positions of power can sway public purchasing, resulting in undesired effects when the individuals’ claims are unverified. Public health officials must work to dissuade the use of unproven treatments for COVID-19.

Trump is by no means the only politician who misled the public in matters of healthcare through ignorance, or stupidity, or both. Other recent examples that we previously discussed include, for instance:

Yes, Trump is not the only, but he is the most influential and might well be the most ignorant one:

For this reason alone – and there are many more – I hope he will not soon become merely a dark and scary chapter in the history of the US.

Whooping cough is on the rise in many parts of the world; and it’s far from harmless. It has been reported that 9 infants died from whooping cough in England between November last year and the end of May 2024. Altogether a total of 7599 cases of whooping cough have been confirmed in England this year, with cases continuing to rise from 555 in January to 920 in February.

In France too, cases of whooping cough are rising among all ages, the French health authority has warned, saying vulnerable groups should check their vaccinations are up to date. Cases of the illness – called coqueluche in French – have been rising since the start of 2024, states Santé publique France (SPF). It has called for people to be vigilant.

I have recently argued that this might be not least due to the irresponsible advice of homeopaths. But homeopaths are by no means alone in this.

According to advice from MOTHER EARTH LIVING several natural home remedies help alleviate whooping cough symptoms (as well as cold and flu symptoms) and clear the pertussis infection. A teaspoon of fresh garlic juice taken 2 to 3 times a day is a potent, effective treatment.

A pinch of the Indian curry spice turmeric, taken at least twice a day, relieves whooping cough symptoms and helps clear the bacterial infection. (Odorless garlic and turmeric capsules may not be as effective as fresh ingredients, whose odors can be minimized by chewing fresh mint).

Ginger has antiviral, antibacterial, antiparasitic, antifungal, anti-inflammatory and expectorant properties. It boosts the immune system, warms and induces sweating (which helps push fever and toxins out of the body), and calms coughs and sore throats quickly. It also stimulates appetite, which is important to sick individuals weakened by infection.

____________________

There are numerous further SCAM-sites that give advice to use this or that SCAM. The recommended treatments all have one thing in common: they do not work to prevent or treat whooping cough.

If one member of your family has caught the infection, please do me a favour:

avoid SCAM and see a real doctor.

 

We have recently heard much about spinal manipulations for kids. It might therefore be relevant to learn about an international taskforce of clinician-scientists formed by specialty groups of World Physiotherapy – International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in Paediatrics (IOPTP) – to develop evidence-based practice position statements directing physiotherapists clinical reasoning for the safe and effective use of spinal manipulation and mobilisation for paediatric populations (<18 years) with varied musculoskeletal or non-musculoskeletal conditions.

A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes).

Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.

1. It is not recommended to perform:

• Spinal manipulation and mobilisation on infants.

• Cervical and lumbar spine manipulation on children.

•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.

2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:

• Spinal mobilisation and manipulation on adolescents;

• Spinal mobilisation on children; or

• Thoracic manipulation on children for neck-back pain only.

3. No high certainty evidence to recommend these interventions was available.

Reports of mild to severe harms exist; however, risk rates could not be determined.

It was concluded that specific directives to guide physiotherapists’ clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.

Whether one agrees with these directions or not (and I am not sure I fully do), I have always thought that people who, despite the largely lacking or flimsy evidence for spinal manipulations, insist on having manual therapy should consult a physiotherapist, rather than a chiropractor or osteopath.

Why?

Because, in my experience, physiotherapist:

  • display less cult-dependent behaviours,
  • do not follow the gospel of charlatans, like Palmer and Still,
  • do not believe in the fiction of subluxation,
  • are not so money-minded,
  • less prone to use un- or disproven methods, like applied kinesiology, homeopathy, cranial osteopathy, etc.,
  • unlikely to try to sell you useless dietary supplements,
  • tend to judge better their limits of professional competence,
  • are far less likely to try to persuade you of BS related to anti-vax, anti-drug, anti-science, anti-EBM, etc.

Although the vaccine has many individual and social benefits, ‘Vaccine Hesitancy’ has led to an increase in the number of vaccine-preventable diseases.

The aim of this study is to determine the effect of ideas that cause vaccine hesitancy to comply with traditional medicine practices and drugs and to determine the ratio of parents’ preference for so-called alternative medicine (SCAM).

This study was performed on the parents who refused vaccination in their children under the age of 8 between the years 2017-2022. Parents of the vaccinated children who were matched for age and gender were determined as the control group. Demographic characteristics of families, education levels, compliance ratios for well-child follow-up and pregnancy follow-up, preference ratios for traditional medicine and/or SCAM applications were compared.

A total of 123 families, 61 of whom were vaccine refusal and 62 of the control group, were included in the study. It was determined that the ratio of parents who refuse vaccination have increased in the last five years. The education level was found to be higher in the SCAM group (p=0.019). The most common reasons for vaccine refusal were distrust of the vaccine content (72.1%) and noncompliance with religious beliefs (49.1%). It was also found that the ratios of prophylactic vitamin use and tetanus vaccination of mothers during pregnancy were lower in the SCAM group. While the rate of compliance with vitamin D and iron prophylaxis for infants was lower in the vaccine refusal group, the ratio of preference for SCAM was higher.

The authors conclused that vaccine hesitancy is a complex issue that affects public health, in which many individual, religious, political and sociological factors play a role. As with recent studies, this research shows that the most important reason for vaccine rejection is “lack of trust”. The higher education level in the vaccine refusal group may also be a sign of this distrust. Not only the rejection of the vaccine, but also the lack of use of vitamin drugs seems to be related to lack of trust. This may also cause SCAM methods to be preferred more. These results show that providing trust in vaccination is the biggest step in the fight against vaccine hesitancy.

We have discussed the link between SCAM and vaccination hesitancy many times before, e.g.:

This new study seems to imply that the common denominator of both SCAM use and vaccination hesitancy is distrust, distrust in vaccinations and distrust in conventional medicine. That makes sense at first glance but not when you think about it for only a minute.

I can see why people distrust conventional medicine (to some extend, I do it myself). But why should distrust motivate some people to put their trust into SCAM which is even less trustworthy than conventional medicine. The rational thing for a distrusting person would be to critically assess the evidence and go where the evidence leads him/her. This path cannot possibly lead to SCAM but would lead to the best available evidence-based therapies.

If we consider this carefully, we arrive at the conclusion that not distrust but a degree of irrationality is more likely be the common denominator between SCAM use and vaccination hesitancy.

What do you think?

It had been reported that five infants under three months of age have died from whooping cough this year, as cases continue to spread across the country.

The UK Health Security Agency (UKHSA) has reported 1,319 cases of whooping cough in England in March, up from 900 in February and bringing the total for 2024 so far to 2,800.

But there is help!

The “Leading Holistic Health Portal” (LHHP) informs us as follows:

As far as therapeutic medication is concerned, several remedies are available to treat whooping cough that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of whooping cough:

  • Cuprum met – in whooping cough accompanied with convulsions, or when the paroxysms are long and interrupted…
  • Coccus cacti – this remedy has paroxysms of cough with vomiting of clear, ropy mucus, extending in thick, long strings even to the floor…
  • Belladonna – in sudden violent paroxysms of whooping cough, without any expectoration, and the symptoms of cerebral congestion…
  • Spongia Tosta – excellent remedy for whooping cough; dryness of all passages; cough dry, barking croupy like a saw driven through a pine board…
  • Corallium Rubrum – violent spasmodic cough, whooping cough; a very rapid cough, the attacks follows so closely as to almost run in to each other…
  • Aconite – clear ringing whistling whooping cough, excited by burning sticking in larynx and trachea…
  • Arnica Montana – paroxysms of whooping-cough excited by a creeping and soreness in trachea, bronchi or larynx, generally dry, often with expectoration of frothy blood mixed with coagula…
  • Hyoscyamus – shattering spasmodic cough, with frequent, rapidly succeeding cough, excited by ticking, as from adherent mucus…
  • Hepar Sulph – hoarse croupy night cough; deep, dull, whistling cough, in the evening without, in the morning with expectoration of masses of mucus…
  • Drosera – Drosera is one of the remedies praised by Hahnemann; indeed, he once said thatDrosera 30th sufficed to cure nearly every case of whooping cough, a statement which clinical experience has not verified. Drosera, however, will benefit a large number of the cases, if the following indications be present: a barking cough in such frequent paroxysms as to prevent the catching of the breath…
  • Mephitis – Mephitis is useful in a cough with a well marked laryngeal spasm, a whoop…
  • Ipecac – Convulsive cough, where the child stiffness out and becomes blue or pale and loses its breath…
  • Antimonium tartaricum – With this remedy the child is worse when excited or angry, or when eating; the cough culminates in vomiting of mucus and food…
  • Cina –This is not always a worm remedy. It is a most excellent remedy in whooping cough. It has the same rigidity as Ipecac, the child stiffness out and there is a clucking sound in the oesophagus when the little one comes out of the paroxysm…
  • Magnesia phosphorica – This is the prominent Schuesslerian remedy for whooping cough, which begins as does common cold. The attacks are convulsive and nervous, ending in a whoop…

So, why do we have so many cases of whooping cough?

The reason is, of course, the currently very low vaccination rates.

And why are they so low?

Could one reason be that some healthcare practitioners advise us wrongly?

What the LHHP does not tell us is the fact that homeopaths (and other SCAM practitioners) often advise against vaccinating children against whooping cough (and other infections). Take, for instance, this section from an article entitled: “The Homeopathic Option for Whooping Cough“:

In my medical opinion, this overemphasis upon a preventative vaccination strategy is largely due to conventional medicine’s inability to treat whooping cough once it is diagnosed. Physicians understand that antibiotics are likely to have minimal if any effect upon the course of the illness once the cough has set in, and the same applies to cough suppressants. Antibiotic treatment is believed to reduce transmission to others if prescribed at the onset of the illness, but the odds of diagnosing whooping cough at this very early stage are highly unlikely.

Clinical experience indicates that homeopathic medicine is a viable option for pertussis. However, mainstream medicine’s general unwillingness to consider any therapy that is not manufactured by PhRMA tends to blind it to potentially new and/or unexplored treatments. And in the case of homeopathy, there is a long-standing undeniable bias that assumes that it is just not possible that it can work because it defies conventional medical beliefs about the nature of illness and how it can be treated.

Really, a long-standing undeniable bias?

And I thought it was called evidence!

In conclusion, I urge everyone to follow the official recommendations:

The whooping cough vaccine protects babies and children from getting whooping cough. That’s why it’s important to have all the routine NHS vaccinations. The whooping cough vaccine is routinely given as part of the:

If you’re pregnant you should also have the whooping cough vaccine – ideally between 16 and 32 weeks.

To this I might add: beware of the advice by homeopaths and other SCAM-practitioners who recommend against vaccinations.

Conspiracy theories, as often discussed here, plague the realm of so-called alternative medicine (SCAM), e.g.:

In fact, I did recently suggest that so-called alternative medicine is a conspiracy theory in disguise. Previous research has found that individuals who struggle with emotion regulation are more prone to believing in conspiracy theories. Emotional granularity – the ability to differentiate between nuanced emotional states – is a key component of effective emotion regulation, yet its relationship with conspiracy beliefs has not been explored thoroughly.

Psychologists from the Uni Graz in Austria conducted an experience-sampling study (165 participants, mean age = 26.3 years) including measures of emotion regulation and differentiation. The study started with an online survey that assessed participants’ sociodemographic (age, sex, and education) and trait measures. Following this, participants were asked to install an in-house developed app on their smartphones to obtain the emotional granularity specificity index. The app displayed two notifications each day for over a week (14 max.). Notifications were randomly displayed between 08:00 am and 10:00 pm with a minimum of at least 5 h between two notifications. Participants, on average, answered 57% of the notifications.

The findings revealed that individuals who endorse conspiracy theories engage in repetitive thinking about the causes and consequences of events and exhibit a reduced ability to distinguish between negative emotions. This effect, however, was observed only in the performance-based measure of emotion differentiation, not in the self-report measures.

The authors conclused that this suggests that enhancing emotional granularity may help individuals in regulating their emotions more effectively, thereby reducing their vulnerability to adopt conspiracy beliefs.

To reduce belief in conspiracy theories, one might, according to the authors, consider a training program to enhance emotion regulation and differentiation. A combination of cognitive control training on emotion regulation, which has been shown to reduce overthinking, as well as reflecting on and diversifying emotional experiences, could provide simple tools for assessing and regulating emotional experiences. This, in turn, may lead to decreased endorsement of conspiracy theories in the long run.

Perhaps we should recommend this to the chaps who recularly comment on this blog bursting with conspiracy theories?

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