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Dr Viera Scheibner is a powerful voice in the anti-vaccination crusade. JULIE-ANNE O�HAGAN reveals her modus operandi and speaks to those who challenge her claims.
DR Peter McIntyre was always willing to publicly debate with anti-vaccination campaigner Dr Viera Scheibner, until she started claiming shaken baby syndrome was caused by childhood vaccinations.
�I�ve stood up on podia opposite Viera,� says Dr McIntyre, deputy director of the National Centre for Immunisation Research at the Children�s Hospital, Westmead.
�I�ve been prepared to talk, to debate her, but I refused to do that after she started peddling the notion that babies that have broken bones � shaken baby syndrome � that this is due to vaccines. I thought this unjustifiable, the absolute limit; to endanger the safety of infants.�
Dr Scheibner describes herself as a retired principal research scientist who formerly worked with the NSW Government. Her PhD is in micropalaeontology, which she says focused on �ecology, palaeontology and the reconstruction of past marine environments based on microscopic fossils and climates�.
She attributes shaken baby syndrome to brain swelling and bleeding, and bone fragility induced by vaccination.
When questioned about the motivation behind her claims that children can build a natural immunity to tetanus, that smallpox has not been wiped out but has been re-classified as other pox viruses, and that vaccines are the single biggest cause of SIDS, she says: �I only satisfy my conscience. I am a scientist � I don�t care if people agree or are against me, I know I am stating the truth.�
Dr Scheibner has written two self-published books against vaccination, and often addresses community gatherings in Australia and overseas. She has achieved substantial media coverage in almost 20 years of committed lobbying.
She says since 1996 she has been asked to write expert reports for the defence in about 80 cases of shaken baby syndrome in the UK, US and Australia.
�In many cases, when the prosecution received my report, the charges were dropped,� she says.
In Australia, she was the sole expert witness called to oppose immunisation in the Human Rights and Equal Opportunities Commission hearing in 1996 regarding the right of Maroochy Shire Council to exclude unvaccinated children from its child-care centre. The case was dismissed in favour of the council.
Dr Scheibner�s campaign was triggered in the mid-1980s when her late husband developed a baby monitor, which she says indicated increased infant stress levels at various stages post-vaccination. Since making this discovery, she says she has dedicated her life to exposing the flaws in Western medicine and spreading the word that �all vaccines are dangerous� and that �there is no role for vaccines�.
Like many who question established medical practice, Dr Scheibner is determined to be heard. �There is always a need for a � whistleblower,� she says. �They are killing and maiming children with injections; it�s a massacre.�
No one could argue with Dr Scheibner�s right to free speech, but how do claims that challenge empirically based medicine gain credence, particularly when they could endanger lives?
The Independent1newspaper in the UK recently reported that measles could again become an endemic disease in the UK because some parents are reluctant to inoculate children with the MMR vaccine, perhaps because of unsubstantiated claims that it causes autism.
Dr McIntyre, who is also clinical associate professor at the department of paediatrics and child health at the University of Sydney, is co-writer of an article soon to be published in the journal Vaccine that gives a detailed insight into how Dr Scheibner has made herself and her claims so widely known, and how health professionals can best respond (see box, page 22).
The article says Dr Scheibner�s credentials �may not be made explicit and the Dr title can imply medical training for audiences who may then regard information with the authority they normally ascribe to qualified health professionals�.
It says she is �an animated speaker, who may appear to those without a very detailed knowledge of the literature (including health professionals) to have an encyclopaedic knowledge of vaccination�.
�I do not express opinions,� Dr Scheibner told Australian Doctor.
�I quote published facts from orthodox medical literature. The Lancet, BMJ, the New England Journal of Medicine, the Journal of Infectious Diseases and the Journal of Immunology.�
And she does. But it�s her interpretation of the literature that Dr McIntyre challenges.
�Having masses of material which appears to be quoting specific journals gives an idea of authority,�he says.
�Doctors can feel intimidated for not reading the Journal of the Lithuanian Medical Society, they can feel deficient, particularly GPs. It�s unreasonable to expect them to cross-detail what�s in 10-20 papers.
�I�ve been to community meetings ... where I�ve seen her use this technique and put up overhead copies of journals. They are often old �some from 30-odd years ago.
�Unfortunately for Viera, I�ve made it my business to read all this stuff. I know what it says, or if I don�t, I�ll look it up. Invariably what transpires is that what Viera says has totally nothing to do with what the authors are talking about. Viera is looking at figures and is making them mean something she wants them to mean.
�It�s actually an incredibly interesting objective lesson in evidence-based medicine. Her case is based in obfuscation.
�One classic example is of her showing a graph talking about the impact of Hib [Haemophilus influenzae type b] vaccine in the US. The number of cases under 18 months was going down before [children were] being immunised.�
Dr Scheibner said this meant children didn�t have to be immunised to be protected against the disease.
However, Dr McIntyre says: �What the paper was saying was that in vaccinating older children ... less spread to young children; they were not exposed to the bug.�
Dr McIntyre isn�t the only person who is holding Dr Scheibner to account for her claims.
Qakatak web site editor and Australian Skeptics member John Foley tries to put unsubstantiated medical claims in context, challenging their proponents to back up their assertions.
A former newspaper compositor, Mr Foley doesn�t hold any health-science qualifications, but says: �Dr Viera Scheibner looks at little fossils. I�ve got the same qualifications in immunology as she has. She can read books and so can I.�
When Mr Foley hears what he calls a �quack claim� he cross-references it.
�For example, I got hold of one [anti-immunisation] pamphlet that said vaccines contain things like mercury, dead rabbits, this, that and the other. I looked up MIMS� and it contained about 200,000 words in that section and the pamphlet quoted about 80 words of it.
Now if you wrote a 2000-word book about Captain Cook and I wrote 200 words about him crashing into a reef, you�d think he was a bad captain. Things are taken out of context and I don�t wear it for a moment.�
Mr Foley�s site has sections dedicated to claims about immunisation, cancer, acupuncture, chiropractic techniques, homeopathy and devices that claim to have health benefits.
He challenges all Australian governments to contest unsubstantiated medical claims and to introduce tougher fair-trading legislation.
�And all products with medical claims should be clearly marked, rather like cigarette warnings, that �there is no scientific basis for this product or service�. If that is there and people still want to do it, I have no problem at all.
�I don�t support or condemn the medical industry � but when I see children dying of whooping cough � because some lunatic says �don�t get immunised�, it�s agonising.�
So where does all this leave a GP when a patient arrives in the surgery thinking they have all the facts and won�t immunise their children because they�ve read that it does more harm than good?
AMA vice-president Dr Mukesh Haikerwal says effective communication is the key.
�Once someone has made up their mind, it�s usually very difficult to convince them otherwise. You need to work in with their beliefs and be systematic [and] rationalise, and ask them to be just as objective in their assessment of alternative choices as they are about traditional medicine. To go in with their eyes open.�
Dr Haikerwal says if doctors are concerned about a patient�s course of action, they should make their advice clear and document it in the patient�s notes.
Dr McIntyre says it�s important to remember that many people who make anti-vaccination claims aren�t malicious, but that they �have a fixed belief in the rightness of their ideas�and that when citing medical literature, �either the data is misinterpreted or reinterpreted � or that [they] usually don�t understand�.
�This is not to dismiss concerns about vaccine safety, and not to try to deny a vaccine has never done something bad. They have, and there are some well-publicised stuff-ups, like vaccinations not attenuated properly [and] polio contracted when it was meant to protect, but these are all from a long time ago and the results ended in major changes to how things are done. We can have a high degree of confidence � about vaccine safety these days.�
But Dr McIntyre says GPs should remain vigilant.
�[In Australia] we have high levels of immunisation and support for it, but there will be 2-3% against it. They are likely to have a very different view of the world and health. The group we have to concentrate on is the larger group of, say, 10-15% who are concerned, sceptical and want more information. That�s where it�s worthwhile putting in the effort. We need to present them with appropriate arguments, and illustrate the value of vaccines and the lack of validity of the arguments against them.�
HOW TO RESPOND TO ANTI-IMMUNISATION CLAIMS
Become familiar with the most common claims that vaccination opponents put forward.
Be available to speak to the media. Make your qualifications clear and define the qualifications of the claimant.
Acknowledge vaccines are not 100% effective and promote the importance of reporting vaccine-adverse events.
Avoid fact-for-fact debates, which can get lost in detail.
Respond to emotions and reframe debate towards protection of children from diseases.
Listen to claims and be open and responsive to them.
Draw attention to the overwhelming medical and scientific support for vaccination.
Use images and stories of those affected by disease to jog the community�s memory.
Obtain the support of other organisations, such as SIDS or autism support groups, which do not support claims that these conditions are linked to immunisation
Adapted from Leask, J and McIntyre, P. Public opponents of vaccination: a case study. Vaccine. Accepted 26 June 2003. Uncorrected proof available online at www.sciencedirect.com
1. Connor, S. Measles nearly endemic as parents refuse MMR jabs. The Independent. 11 August 2003.