6 Ways the "Hot Spots" Study is Useless Propaganda

A scientifically dishonest report co-authored by Dr. Hotez declare certain communities in the United States "hot spots" which means, according to the study authors, those communities are "vulnerable" to having a horrible outbreak at any moment. Many of these declared 'hotspots' are centered in Idaho. This is fake news in the name of scientific study.

Titled, "The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties," Dr. Hotez's study purports to show the following (and note that the entire study is bathed in the recommendation of eliminating medical exemptions):

"Our findings indicate that new foci of antivaccine activities are being established in major metropolitan areas, rendering select cities vulnerable for vaccination-preventable diseases. As noted by the recent experience in Anaheim, California, low vaccination rates resulted in a measles outbreak. In contrast, state closure of NMEs has resulted in an increase of MMR coverage."

Let's get into the details, it's easiest to just number them, so here's 6 different ways this "study" is garbage that should be retracted:

1. Despite representations to the contrary, this study solely considers a single vaccineMMR. 

American children, if they are vaccinated to the CDC's schedule, actually received ELEVEN separate vaccines. Dr. Hotez's study only considers one of those vaccines—MMR—yet on T.V. he constantly makes it sound like he's discussing all vaccines. It's not a flaw of the actual study (like numbers 2-6), it's a flaw of how Dr. Hotez has misrepresented the study in public.

2. "Non-medical exemptions" is a flawed and inaccurate way to look at vaccination rates. 

Dr. Hotez uses reported "non-medical exemptions" in different states, counties, and cities, to be a proxy for a child who is "unvaccinated," but that's hardly true. Idaho 'requires' 32 doses of 6 vaccines prior to kindergarten registration. 99% of parents utilizing the PBE for their children are selectively vaccinating. The most commonly exempted vaccine? The chickenpox vaccine, which was introduced with the intention of saving time from work rather than protecting a child from a dangerous childhood disease. Parents opting to exempt their child from one or more vaccine have along with their doctor's recommendations responsibly vaccinated based on the individual needs of each child because one size does not fit all.

A child missing even 1 shot would fall under the category of "unvaccinated."

KINDERGARTNERS in Idaho Receive 32 doses of these vaccines prior to school.
*Their parents received 3 - 5 vaccines prior to kindergarten. Doses have DOUBLED since 2000.

(5) Diphtheria, Tetanus, Pertussis (DTaP)2 /
(2) Measles, Mumps, and Rubella (MMR)
(4) Polio3
(3) Hepatitis B
(2) Varicella (Chickenpox)
Hepatitis A

**click the vaccine name to be linked to the manufacturer vaccine insert.

3. Public health officials know exactly why vaccine exemptions are on the rise, and it has nothing to do with the "anti-vaccine movement." The entire premise of Dr. Hotez's paper is that the "anti-vaccine movement" has caused vaccine exemptions to rise, even stating, "A social movement of public health vaccine opposition has been growing in the United States in recent years."

But, public health officials know better. The reason vaccine exemptions have risen is very simple: they rise when you add more vaccines to the required schedule.

Take a look at this chart, this time from Oregon. Note that this is a chart produced by Oregon Health Authority and the words at the top of the chart are written by them: 

"When other vaccines have been added as school immunization requirements, non-medical exemption rates have increased for all vaccines."

The reasons for this are obvious. More vaccines means more complexity. Some parents just can't get all the doses done on time for the start of school, so they file an exemption. More doses and new vaccines also make parents wary. There are likely to be more exemptions for the brand new Hepatitis A vaccine rather than the decades-old polio vaccine.

As Oregon added vaccination requirements time and again to the school schedule between 2000 and 2015, they watched exemptions rise in kind, just as they expected.

Dr. Hotez's study NEVER acknowledges this well-known fact and simply blames the rise in exemptions on a social movement, without any facts to support his contention. It's profoundly dishonest.

4. Counties with tiny populations were exploited to create headline grabbing numbers.

Dr. Hotez's paper wasn't really written as a serious scientific paper, it was written to give news reporters scary-sounding statistics. Let's use an example from an article published by NBC News where the reporter, Maggie Fox, focused on a single county in Idaho. She told her readers:

"More than a quarter of kindergartners in Camas County, Idaho, lack at least some vaccinations because their parents have opted for nonmedical exemptions, researchers said Tuesday."

What Ms. Fox failed to mention, because reporters never look at the details, is the county she based here article on has 1,102 residents and only 7 kindergartners in the entire county! How many children are counted in that 25% number? 

In fact, Idaho really got picked on, largely because they have so many counties with populations that are tiny, making their statistics stand out, despite their insignificance. Idaho had eight of the Top 10 counties in Dr. Hotez's study for exemption rates. But populations in these counties are so low, we're talking about 320 combined children!

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5. Counties with larger populations were not exploited using percentages, but rather any county with more than 400 NMEs (non-medical exemptions)a completely arbitrary figurewas simply declared a "hot spot."

To put some of Dr, Hotez's numbers in perspective, let's take a look at the "heat map" he provided of "vulnerable counties" in the United States. All you needed to do to make this list was have 400 or more non-medical exemptions amongst kindergarteners in your county, population size had no bearing on Dr. Hotez declaring your county a "Hot Spot":

Screen Shot 2018-08-14 at 4.50.22 PM.jpg

Now, every one of these counties ended up having a news story run about the "hot spots" data and some scary declaration of how that county was "at risk." In all of these larger counties, Dr. Hotez never mentioned the total population, which is where his analysis really breaks down, just look at this analysis: 

 click to expand

This table shows every county Dr. Hotez fingered in his "heat map" where he arbitrarily designated any county as "at risk" if had more than 400 NMEs (non-medical exemptions) among kindergartners. This table takes the populations of each county and puts these numbers in context.

For example, in Oakland County, Michigan, having 686 kindergartners with a non-medical exemption out of a total population of 1.2 million people means roughly 1/10th of 1% of the county has a non-medical exemption. And this is a county Dr. Hotez is trying to say should be in some sort of state of emergency!

6. A central theme of Dr. Hotez's paper is that higher NME rates and infectious disease are correlated, but there's no data that supports this, and the term "hot spots" has no scientific basis whatsoever!

In the press, Dr. Hotez repeatedly refers to areas with high exemption rates as "hot spots." In the actual paper, Dr. Hotez uses the term "vulnerable communities." But, neither of these terms has a scientific basis. There is no data anywhere that shows exemption rates and disease outbreak are correlated, and Dr. Hotez never provides it. In a sense, the entire point of his paper—that these communities are more "at risk"—is simply never supported in any way, because the data to make the correlation he's trying to make doesn't exist! Said differently, his paper and its conclusions are unsupported by science. 

What can be done? JB Handley has an idea.

 First (of many) retractions? Click to read.

OK, we just looked at six ways that Dr. Hotez's paper is completely deceptive. Taking a huge step back, Dr. Hotez has created an imaginary world where we should all be scared to death that a disease outbreak is around the next corner. He's a classic fear-monger, likely getting daily thanks from the vaccine makers who support his entire existence. The best thing that could happen to this paper would be for PLOS Medicine to be forced to retract the entire paper. 

The only way that will happen is if people with scientific backgrounds challenge the paper in thoughtful letters written directly to the journal (and Dr. Hotez will be asked to respond), which is why I'm going to ramp things up and share with you every page of the actual study, and the notes to go along with it. 

I hope that this level of detail, and the realization that this entire paper is a hoax, will encourage some of you to take action. Note that one of the counties named by Dr. Hotez already did take action, and he had to "retract" his conclusions for that county.

Ok, so let's look at the actual study, page by page, with a number of additional observations about the hoax for the discerning reader:

First (of many) retractions? Click to read.

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Finally, A vaccine-industry insider has created an imaginary world where the next outbreak is imminent if we don't do something and—Gasp!—his idea dovetails perfectly with the aim of vaccine makers: remove all vaccine exemptions from parents and make vaccination mandatory for school attendance.

In trying to create this imaginary world, however, Dr. Hotez has exposed himself to the scrutiny he deserves for a sloppy, scientifically unsound hoax of a paper, and we hope people in positions of influence will start making noise to get the paper retracted.

Every mom and dad, grandparent are people of influence to those around them. Research for yourself and share the truth of why parents opt-out of some or all vaccines.

Hotspots: Why do parents Opt Out
Vaccine Safety Questioned

There is Risk. There must be Choice.

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