Wear sunscreen

As a relatively pale person of northern European descent, I find sunscreen to be invaluable. ug-leeI have absolutely no problem being the guy with the light bulb nose. It’s way better than the Rudolph nose later, and undoubtedly superior to developing skin cancer or even just unsightly sunspots.

Now that the weather is getting nicer, sunscreen sales will be increasing, but not everyone is happy about this. There are a number of quacks out there who will peddle false information about vitamin D. Some of them will go the even more egregious route of saying sunscreen doesn’t protect against cancer.

Don’t let these quacks fool you. Sunscreen absolutely protects against the rays of the Sun which can and often do lead to cancer:

Sun protection is essential to skin cancer prevention – about 90 percent of non-melanoma skin cancers and 65 percent of melanomas are associated with exposure to UV radiation from the sun. Furthermore, years of scientific research have provided compelling evidence that the daily use of sunscreen helps lower the risk of non-melanoma skin cancers. Most recently, in a rigorous study of more than 1,600 adults over the course of a decade, researchers determined that subjects applying sunscreen with an SPF of 16 daily reduced their risk of melanoma by 50 percent.

Unlike quack medicine, sunscreen is safe and effective. I foolishly got a sun burn last month, acting on the assumption that “Maine”, “April”, and “sun burn” were three things I would never have to use in the same sentence. I was wrong. I’ve been making it a point to protect my skin every nice day we’ve had since. It can be tedious, and it’s not always convenient, but cancer treatment is often pretty tedious and inconvenient itself.

Uganda adopts circumcision, finds science works

This is no real surprise:

The growing uptake of medical male circumcision by men in the Rakai district of Uganda is leading to a substantial reduction in HIV incidence among men in one of the districts of the country worst affected by HIV, Xiangrong Kong of Johns Hopkins Bloomberg School of Public Health told the Conference on Retroviruses and Opportunistic Infections (CROI 2015) in Seattle, USA, on Thursday…

The study found that circumcision coverage in non-Muslim men increased from 9% during the Rakai circumcision study to 26% by 2011, four years after the trial concluded. Every 10% increase in circumcision coverage was associated with a 12% reduction in HIV incidence (0.88, 95% confidence interval 0.80-0.96).

HIV incidence reduction in women lags behind but is expected to catch up in coming years.

We’ve known for the better part of the past decade that circumcision literally saves lives by acting as a high efficacy vaccine that reduces female-to-male HIV transmission by 60% (which is better than the flu vaccine most years). That we’re seeing the positive results of implementing it as a policy isn’t surprising. Science just works.

Anti-science quacks find success in Maine in their fight against health and vaccines

Vaccine rates for young people entering school has been declining in recent years:

The rate of unvaccinated kindergartners in Maine continues to climb and is now the fifth highest in the nation, according to a U.S. Centers for Disease Control and Prevention report released Friday.

The percentage of Maine parents voluntarily opting out of vaccines for their children is alarming state public health officials who have been working to bolster immunization.

Nearly 800 public school kindergartners in Maine started the 2013-14 school year without receiving the required vaccinations for diseases such as whooping cough and measles because their parents opted not to immunize. That represents 5.2 percent of all kindergartners in the state, up from 3.9 percent the previous year.

This is in large part due to the anti-vax movement that has been steadily gaining ground since the 90’s. Indeed, although disgraced British doctor Andrew Wakefield had his 1998 study linking vaccines and autism debunked – no one ever reproduced his results, and it was no wonder since he outright made them up – he remains a hero of the anti-vax crowd.

One of the more favored canards of anti-vax quacks is to call herd immunity a myth. Do a quick search and one is liable to find any given quack claiming that herd immunity makes no difference to the health of a state. I recall reading some random anti-vax nobody argue that because vaccines are between 60-80% effective, even with 100% compliance, we could still see an epidemic. Of course, while he spoke of vaccines at-large in an intentionally general sense, he actually linked to CDC statistics on the flu vaccine. I guess it was a coincidence that he found it inconvenient to tell his readers that he was talking about one specific vaccine, huh? So is the high bar set by quacks.

At any rate, for herd immunity to be effective, there needs to be about a 95% vaccination rate. Of course, 100% would be the ideal because we’re talking about saving human lives, but with all the anti-government and anti-science kooks out there, 95% is actually a very achievable number that allows for some bumper space. Unfortunately, sometimes we see areas that fall well below that bumper space. For instance, when vaccine rates for whooping cough fell to 91% in California, communities there saw an outbreak in the disease. Thousands got sick and at least 10 infants died. What makes this all the more heart-breaking is that these infants were too young to be vaccinated, meaning they relied upon the herd immunity around them to remain safe. Anti-vax parents and the quacks they trust are at fault for these deaths. Frighteningly, Maine is on a similar path.

This is incredibly impressive

Daniel Radcliffe (perhaps better known as Harry Potter) recited “The Element Song” on The Graham Norton Show several years back. It’s damn impressive.

Science by comedy

I used to watch these videos mostly for their comedic value, but the truth is that they actually have a lot of basic science to offer:

The value of repetition

One of the most important things I heard while in college came from one of my favorite biology professors. It happened in an early intro class half-filled with bio majors, half-filled with people looking for a course with a lab. He was covering the basics of science itself, speaking to the value of repetition:

Science is all about reproducibility. If you can’t reproduce your data, it’s all a load of horseshit.

That isn’t to say a person can automatically discredit some new piece of research simply because it’s new and has therefore not yet been reproduced. What it means is that when scientists do attempt to reproduce previously found results, they need to be successful in order for the results to be accepted. An unfortunate side effect of human nature means that we don’t see negative results published as often as we should – unless, of course, they disprove what someone else has already published – but these results do still happen every single day. That’s just science.

This all brings me to a recent piece of news:

Scientists have managed to repeat one of the biggest medical breakthroughs of the last few years.

Almost exactly one year ago, Johns Hopkins researchers made national headlines when they announced that they’ve vanquished the AIDS-causing virus from a child born to an HIV-positive mother in Mississippi. They began antiretroival treatment before the baby was 30 hours old. She’s now 3.5 years old and still virus-free, even without treatment in the last two years. Researchers have puzzled over how it happened, and many remain skeptical. The child was only the second person ever to be “cured” of HIV; the first was an adult through a stem-cell transplant. Since it’s difficult to prove that the body has been completely cleared of HIV, Nature explains, being “functionally cured” means the virus is effectively controlled and the immune system stays healthy without treatment.

Just yesterday, doctors announced that they have cleared the virus from a second baby infected with HIV. This girl was born in Los Angeles last April to a mother with advanced AIDS who had not been taking her medication. With aggressive treatment beginning just four hours after her birth, the virus was undetectable within 11 days, the New York Times reports.

A sample size of 2 does not scientific fact make (though there are upwards of 8 other unconfirmed cases around the world), but it cannot be understated how much this bolsters the legitimacy of attacking HIV in infants this way. It could turn out that the virus is still living somewhere in the bodies of these children – adults who have been functionally cured have had the virus return shortly after certain surgeries such as bone marrow transplants – so this remains a game of wait-and-see. However, if this proves to be an effect method for curing HIV, then not only will there be immediate benefits to HIV-positive newborns, but some insight may be spread into how we can better detect the hidden HIV in adults patients who are functionally cured.

Get vaccinated

It never ceases to amaze me just how many anti-vax people there are out there. Every time I bring up the topic it isn’t the pro-vaccine people who come out in support. No, instead it’s almost exclusively the anti-vax quacks. I suppose the same thing happens with circumcision, 9/11, and a history of Obama’s life: the anti-circumcision crowd, truthers, and birthers are going to immediately overwhelm the discussion. But even with this massive selection bias, the sheer number of nuts out there is incredible. I suspect to see as much regarding this post, should it garner a response at all. However, as a decent human being with a little bit of knowledge, I feel duty-bound to present a few vaccine facts.

Vaccines are incredibly safe. This is true of all vaccines, but especially of the flu vaccine. The most likely side effects anyone is going to suffer are mild soreness or a low grade fever. A study from about 10 years ago did find that one version of the swine flu vaccine from the mid-70’s was associated with a tiny increase in Guillain-Barré syndrome, but correlation is not causation. No one knows why there was such an association, but for this reason those with a history of the syndrome are cautioned and should speak with their doctor to assess their exact situation. Also, those with severe egg allergies are cautioned, plus those who are currently sick with one thing or another should wait.

Vaccines change each year because of evolution. From time to time I’ll hear an objection to the fact that the flu vaccine is different each year. Why, the argument seems to go, scientists are just guessing. That’s not true. While they are making an educated guess, it’s more than just throwing up a prayer and hoping they get it right. Each year’s vaccine is based upon the most recent research and information available. This is necessary because of the speed of a virus’ evolution.

Everyone over 6 months old should get vaccinated. This, of course, takes into account the caveats I’ve already presented, but for the vast majority of people, vaccination is recommended. Vaccines save lives, and if that’s not important enough to you for some crazy reason, they also save money by cutting down on sick days.

The flu vaccine is effective. Exactly how effective the flu vaccine is will vary from year to year, as well as from age group to age group. A person’s overall health is also a factor. In general, though, the vaccine’s effectiveness ranges from 50-80%. The most common (and most annoying) ‘counter’ to this is to look at absolute risk reduction. A person who does this is usually either a quack or has gathered information from a quack. It isn’t that absolute risk reduction is invalid. It’s a perfectly good way to understand how wide-spread a disease or sickness is and how our health policies are dealing with it. For the flu vaccine, the actual reduction in risk is about 1.5%. That sounds miniscule, but we can make a lot of things sound miniscule. What’s happening here is we’re looking at the total population and calculating the number who would get the flu without any vaccine. That’s a very small percentage. Then we’re looking at how likely it is that of the percentage that actually gets vaccinated is going to not get the flu as a result. Again, this is useful. However, when presented in the context of this discussion, it isn’t useful. It would be as if someone argued that since the absolute risk of contracting HIV in Tanzania is very low over, say, intercourse with 5 different partners, the 97-99% effectiveness of condoms is moot. Why, who needs condoms? You probably won’t contract it anyway! Pshaw.

Vaccines, not sanitation, have eradicated or nearly eradicated disease. While it’s obviously true that increased bathing, hand washing, and better filtered water have made us healthier and less likely to contract various diseases, these alone cannot get rid of disease. Smallpox has been eradicated for over 30 years now because of vaccines, not because more people than ever are buying bars of Irish Spring soap. Polio is nearly eradicated because of vaccines; India was recently declared polio free – that isn’t a country exactly known for its impeccable sanitation practices. Yellow fever persists because so many people go unvaccinated (even though the vaccine is 99% effective), and no amount of sanitation is going to change how many people die from it each year since its primary vector is the mosquito.

There are far more thorough sources out there that have vaccine facts covered in much better detail than I have here, so this is far enough for me. I simply wanted to address some of the issues that bother me the most about the vaccine misinformation floating about. For nearly every single person, vaccination is the smart option. The caveats are small and specific, the side effects minor and manageable. Get vaccinated.