s Inquiry into the Promotion of False or Misleading Health-Related Information or Practices | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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Recent Comments

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Inquiry into the Promotion of False or Misleading Health-Related Information or Practices

Judy Wilyman

articles by this author...

I have many years of experience as a science teacher and I have lectured in environmental health issues. I began a PhD in environmental health policy at Wollongong University in 2007 and lectured and researched in Environmental Health at Murdoch University from 2008 – 2010. I am currently completing my PhD at Wollongong University.

I'd like to draw your attention to an inquiry that is taking place in the NSW parliament. It is titled ˜Inquiry into the Promotion of False or Misleading Health-Related Information or Practices".
This inquiry is being held by the Committee on the Health Care Complaints Commission (HCCC).
This is the consumer watchdog that investigates consumer complaints or concerns.
The aim of the inquiry is to report on possible measures to address the promotion of unscientific health-related information or practices that may be detrimental to individual or public health.

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Here is a link to the inquiry and the terms of reference.

http://www.parliament.nsw.gov.au/Prod/Parlment/committee.nsf/0/6AF793E8FD4555BCCA257C0700041A56?open&refnavid=CO3_1

This is a worthy inquiry but the terms of reference state that they would like to target:

˜The publication and/or the dissemination of false or misleading information that may cause the community to mistrust an accepted medical practice."

This aim needs to be examined.

Preventing the dissemination of false and misleading information is a worthy aim.
However preventing any information that leads the public to ˜mistrust an accepted medical practice" that results in the suppression of proper scientific debate on health issues, then this is dangerous to public health.

In 2013 it is known that industry sponsored research in medicine has resulted in a peer-reviewed system of knowledge that is flawed.
This system is now providing false and misleading health information that doctors and governments are using to make important decisions on public health.
Here is a quote that sums up the flawed peer-reviewed system:

˜Members of corporate driven special interest groups, in virtue of their financial power and close ties with other members of the group often get leading roles in editing medical journals and in advising non-profit research organizations’ (Krimsky 2003 p.10).

Many prominent scientists and journal editors have now exposed this flawed system including Marcia Angell MD, former Chief Editor of the New England Journal of Medicine, for 20 years.
In addition, it is known that the following practices are rife in the current model of medicine in Australia:

* Doctors being paid to give presentations using pharmaceutical company slides with pharmaceutically funded research and statistics
* Doctors given free international trips and paid to give presentations to promote drugs
* Pharmaceutical sales representatives given large bonuses to sell a drug even after concerns were raised about the side-effects of the drugs
* The hidden industry ties of academics in universities and similarly in government advisory boards.
* The conflicts of interest in the media presentation of drugs and their side-effects
The conflicts of interest in Australia's National Immunisation Conference presented by the Public Health Association of Australia (PHAA).
This conference is funded by the pharmaceutical companies
The hidden ties between industry and the chief-editors on peer-reviewed journals, who are selecting against articles with negative findings on drugs/vaccines.
Little research funding being provided for research in the public interest. In particular, the possibility that the chemicals in the 11 vaccines now recommended to infants under 12 months of age, are causing the steep increase in chronic illness in our children.
If these practices are known to exist in the practice of medicine and they are not made transparent to the public, then it is important that everyone is allowed to present scientific information for debate.

It is also important that the public is included in decisions made on public health policy so they can present the science that is in the public interest. Industry representatives are not going to present this science for inclusion in health policies.
The suggestion that only ˜medical doctors can provide the science on health issues is a fallacy and it places the emphasis of the debate on the ˜qualifications" and not the ˜science".

The fact that it is possible for doctors to be educated with biased information due to industry sponsorship of their education means that they can provide  misleading information. Industry sponsored medical education and research puts public health at risk. Doctors are no longer being educated with disinterested science and therefore they should not be the only members of society presenting science for public debate.
Please take an interest in public health and write a submission to this inquiry.
Submissions close 13th December 2013.

Return to home

Submitted by Judy Wilyman on Mon, 27/01/2014 - 13:56.

Mr. McMaugh is again missing the point of our discussion (23.01.2014). I have clearly stated on my website that the information I am providing is to 'complement' the information provided by the government. This is because the government is not providing all the science that is available in the medical journals and in government documents. I would not be providing this to you from the university if this was not the case.
Providing links to further pro-vaccine articles is not participating in the debate.
The question Mr. McMaugh should be asking is:

Why is the government using selective evidence to promote a public health policy?

This is evident from the many websites (like my own) that are now presenting the science demonstrating the risks involved with using multiple vaccines in developing infants ie. the other side of the vaccination debate that is not being provided in the media.
We are waiting for Mr. McMaugh to refute our arguments with evidence instead of hiding behind pro-vaccination links that minimise the risks without adequate science.
Ignoring some of the science, as Mr. McMaugh is doing, does not prove that 'vaccines are safe and effective' and it does not demonstrate that his interest in this issue is health.
Mr. McMaugh should be asking the government why parents are now having to research the medical journals for themselves to find all the science on the risks and benefits of vaccines. He needs to start debating the science related to our health and stop discussing the issue as if it is about 'pro- and anti- vaccination'. The debate is about the health of the community and parents are entitled to be provided with all the available scientific evidence.

Submitted by Judy Wilyman on Tue, 14/01/2014 - 09:48.

Mr.McMaugh - My position and arguments on vaccination are clearly described on my website www.vaccinationdecisions.net
along with my academic publications that have been published in peer-reviewed journals.
I will be quite clear - my position is not about anti-vaccination - it is about ensuring that all vaccines are supported by rigorous safety and efficacy trials.
Your desire to describe me as 'emotional,
unscientific and biased' is clear because you are ignoring the evidence of my scientific publications and comments presented for debate on my website. And, in addition, you have not provided a single scientific argument or reference to support your opinions.
Whilst the government does not provide funding for many of the scientific studies they do control the direction of research funding.
You have suggested that there are 'independent' studies that provide definitive evidence of the safety and efficacy of vaccines. Please could you provide me with these studies.
To date I have only seen studies that have been funded by vaccine manufacturers that claim vaccines are safe and effective. The references for my comments can be found on the publications page of my website. I look forward to you providing some independent science to support the opinions you have provided so far.

Submitted by Judy Wilyman on Mon, 06/01/2014 - 15:34.

Reply to Jarrad McMaugh (3.1.14)

Can I remind Mr.McMaugh that his original comment stated "who cares" if funding is not being provided to determine the safety and efficacy of vaccines? This is an emotional and insensitive remark to the many parents who put their faith in the science that is being used by doctors and governments in vaccination policies.
If the science was available Mr. McMaugh would not have to rely on the word "if" to present his argument. He states "if the balance is in favour of less death and morbidity then the outcome is still a positive one".
"If" Mr. McMaugh could demonstrate with evidence that this is the case then there would be no need for this discussion but as I pointed out in my original comment the government is not funding the studies that would provide definitive evidence for this conclusion. I welcome your participation in this discussion Mr. McMaugh but it is important to debate the issues and to support the arguments with evidence.

Submitted by Jarrod McMaugh on Sat, 11/01/2014 - 22:23.

Ms Wilyman

Firstly, I'm not presenting any facts or arguments, I am asking a question. It is not incumbent on me to provide evidence for a question (if such a thing were even possible).

Secondly, lets look further at your statement - "the government is not funding the studies that would provide definitive evidence for this conclusion".
The government does not fund many studies into the effectiveness of medical interventions at all. Why would they be required to provide funding in this area? Is it not better for them to provide funding for independent bodies to assess research (as they do in the form of PBAC etc)?

What I would really like to see from yourself is an article on this site stating your position on vaccines - what specifically about them do you oppose? Is it the idea of vaccines in general? Is it industrialization of the vaccination market?

Are you against the eradication of small pox and massively reduced incidence of polio? Are you against the reduction in death rates from measles and whooping cough?

Are you against the association of vaccines with autism - a link which has been proven to be a fabrication by Andrew Wakefield?

You asked this question of me earlier:
"what interests you are protecting in this policy because you are clearly not using scientific evidence to protect the health of the community"

I have no interests to protect. I am a pharmacist that dispenses no vaccines - all of the doctors in my local area provide vaccines direct to patients, so I derive no income from them at all.

I am also not making any scientific statements or claims at all - I am trying to elicit a response from yourself on this matter.

The reverse is not true however - you ARE making statements of a scientific manner, yet you phrase them in a manner that is unscientific, emotive, and biased at best. This reduces your credibility, which may well be a shame if you actually have a point to make that is worth making.

Therefore I ask again, could you provide the readers of this site with an article stating your position on vaccines, backed up with references that back up your position on the matter - I am not asking you to prove anything, but please; make an argument that is compelling, or if not compelling, at least make one that is consistent and logical.

Submitted by Judy Wilyman on Sun, 01/12/2013 - 14:53.

Jarrod - public health is about reducing the deaths and illness from all possible causes of disease. Your statement that 'vaccines reduce acute illness that cause death and chronic morbidity' is untruthful because it is not complete.

Some scientists are claiming that 'vaccines reduce acute illness that cause death and chronic morbidity' and even if this is the case (and there is a lot of evidence that many vaccines have not been proven safe and effective against the diseases they are stated to prevent) the fact remains that vaccines also cause 'death and chronic illness' and it is not acceptable to introduce vaccines without informing the public: 1) What percentage of the population is at risk from the infectious disease and 2) What percentage of the population is at risk from death and illness from the vaccine?

Your statements are simplistic and they do not represent a responsible attitude to public health. Your suggestion that your attitude is 'too blase' is an understatement and it puts public health at risk.

In the US which has set up a compensation scheme for the victims of vaccines they have paid out over US$2 billion in compensation - and these are only to the victims whose reactions occurred within 4 weeks of the vaccine. It is well known that the reactions can be delayed - months or years - so the real estimate of harm is unknown.

The only way you can make the simplistic statements above is by not acknowledging the harm that vaccines are known to cause in the population. In this case I would have to ask what interests you are protecting in this policy because you are clearly not using scientific evidence to protect the health of the community.

Submitted by Jarrod McMaugh on Fri, 03/01/2014 - 16:39.

I wish I had paid attention to this reply earlier so I could have responded.

Just I'd just like to make a few points:

1) You aren't very good at taking criticism, hence your use of inflammatory language such as "untruthful", and implying that I'm irresponsible.

I think you would agree that if someone makes a statement that is factual, but is not broad enough to cover the entire issue, then this would be considered "incomplete" rather than untruthful.

With regards to the simplicity of my statements - this was the entire point of my response. I was commenting on the total picture, not on specifics. This, by necessity, creates a simplistic view of things.

2) The fact that there is a compensation scheme for "victims" of vaccines does not, by virtue of its existence, prove that there is in fact more harm than good caused by vaccines.

3) you continually use the term "well known" - unless you'd like to reference your sources, then every time you say this, what you are saying is "in my opinion" or worse "I can't prove this but I know I'm right"

Anyway, I believe the point of you being given a forum on this website to discuss these matters is so that the discussions actually happen. I'm more than happy to participate in these discussions, but if you can't control your responses and compose them in a manner that isn't intended to inflame the responder, then I won't bother

Submitted by Jarrod McMaugh on Sat, 23/11/2013 - 14:33.

Regarding this point:

"Little research funding being provided for research in the public interest. In particular, the possibility that the chemicals in the 11 vaccines now recommended to infants under 12 months of age, are causing the steep increase in chronic illness in our children."

If this is the case (which I am not agreeing to - chronic disease may be increasing due to lifestyle and increased life expectancy). . . .

Anyway, if this is the case - who cares?

perhaps that attitude is too blase but the fact is that vaccines reduce acute illness that cause death and chronic morbidity.

If the balance is in the favour of less death, and reduce morbidity (even if this morbidity is shifted from one condition to another), the outcome is still a positive one.

I understand that you are passionate about what you believe, but it's not science if you approach things with an outcome in mind before you start your argument.

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