Tag Archives: virus

Faking Lateral Flow Tests: the problem with pH

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Fruit juices can be used to generate a fake positive on COVID-19 LFTs

On Thursday last week, I got a message from Prof Mark Lorch — my sometime collaborator on supercharacter-based ramblings.

“Have you seen the reports of kids fooling the Covid lateral flow tests and getting false +ve results by adding orange juice to the devices?” he wondered.

At this point, I had not – but I quickly got up to speed. Mark had previously made an excellent video explaining how lateral flow test (LFT) devices work, so it was just a case of working out, firstly, whether the false positives were reproducible, and secondly, speculating what, exactly, was causing them.

Thus ensued some interesting discussion which ultimately led to a couple of articles from Mark. One at The Conversation and another, slightly more recently, at BBC Future.

I won’t delve into LFT-related science, because Mark has covered it (really, check the video and those articles), but I am going to talk a little bit about pH – the scale chemists use to measure how acidic or alkaline solutions are – because as soon as news of this started to gain traction people, predictably, started trying it out themselves. And that was when things got really interesting.

Image

The buffer included with LFTs is effective at neutralising the pH of solutions, for example, cola

Now, firstly, and importantly: the test kits come with a small vial of buffer solution. Buffers are substances which resist pH changes. As I’ve written before, our bodies naturally contain buffer systems, because keeping the pH of our blood and other body fluids constant is important. In fact, if blood pH varies even a little, you’re in all sorts of serious trouble (which is how we can be certain that so-called “alkaline” diets are a load of hooey). Anyway, the important message is: don’t mix any liquid you’re testing with the contents of that phial, because that will neutralise it.

If you want to try this for yourself, just drop the liquid you want to test directly into the window marked S on the test.

That out of the way, let’s get back to pH. It’s a scale, usually presented as going from 0–14, often associated with particular colours. The 0 end is usually red, the 7 in the middle is usually green, while the 14 end is usually dark blue.

These colours are so pervasive, in fact, that I’ve met more than one person with the idea that acids are red, and alkalis are blue. This isn’t the case, of course. The red/green/blue idea largely comes from universal indicator (UI), which is a mixture of dyes that change colour at different pH values. There’s also a common indicator called litmus (people sometimes mix up UI and litmus, but they’re not the same) which is also red in acid and blue in alkali.

Some species of hydrangea produce pink flowers in alkaline soil, blue in acid soil.

There are actually lots of pH indicators, with a wide variety of colour changes. Phenolphthalein, for example, is bright pink in alkali, and colourless in acids. Bromocresol purple (they have such easy-to-spell names) is yellow in acids, and violet-purple in alkalis.

Many plants contain natural indicators. Just to really mix things up, some species of hydrangea produce flowers that are blue-purple when they’re grown in acidic soil, and pink-red in alkaline conditions.

Bottom line? Despite the ubiquitous diagrams, pH has nothing to do with colour. What it is to do with is concentration. Specifically, the concentration of hydrogen ions (H+) in the solution. The more H+ ions there are, the more acidic the solution is, and the lower the pH. The fewer there are, the less acidic (and the more alkaline, and higher pH) it is.

In fact, pH is a log scale. When the concentration changes by a factor of 10, the pH changes by one point on the scale.

This means that if you take an acid with pH of 2, and you dilute it 1 part to 10, its pH changes to 3 (i.e. gets one point more alkaline, closer to neutral). Likewise, if you dilute an alkali with a pH of 10 by 1:10, its pH will shift to 9 (again, closer to neutral).

And what this means is that the pH of substances is not a fixed property.

Louder for anyone not paying attention at the back: the pH of substances is not a fixed property!

Yes, we’ve all seen diagrams that show, for example, the pH of lemon juice as 2. This is broadly true for most lemons, give or take, but if you dilute the lemon juice, the pH rises.

Apple juice dropped directly into the test window gives an immediate “positive” result.

I am by no means an expert in commercial, bottled lemon juice, but I reckon a lot of them have water added – which may well explain why @chrismiller_uk was able to get a positive result, while @BrexitClock, using a French bottle of lemon juice, couldn’t.

Mark and I concluded that the pH you need to aim for is probably around 3–4. Go too low, and you don’t get a positive (and you might wipe out the control line, too). Likewise, too high also won’t work.

Myself, I tried apple juice. I couldn’t find the indicator colour key for my indicator paper (I really must clear out the drawers one of these days) but it’s broadly the same as Mark’s cola photo, up above. In other words, the apple juice is about pH 3. And it gives a beautiful positive result, immediately.

One more interesting observation: Mark recorded some time-lapse video comparing orange juice to (sugar-free) cola. It shows the cola test line developing a lot more slowly. We’re not entirely sure why, but it may be pH again: orange juice almost certainly has a lower pH than cola.

For any parents reading this thinking we’re being terribly irresponsible, fear not: as Prof Lorch has made clear in his articles, you can identify a fake by waiting a few minutes and then dropping some of the buffer solution provided in the test window. As I said above, this will neutralise the pH, and the positive test line will disappear. Extra buffer won’t change a genuinely-positive test, because the antibodies bind very tightly (more technical info here). To quote Mark: “you’d need a swimming pool’s worth of buffer to have any chance of washing [the antibodies] off.”

Alternatively, you can just watch your teenager as they do their tests, and make sure they’re not getting up to anything nefarious…

Have you tried to trick an LFT? If you have, share your results! Look us up on Twitter: @chronicleflask and @Mark_Lorch or add a comment below. We’d love to see your photos!

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Sunshine, skin chemistry, and vitamin D

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The UK is on the same latitude as Northern Canada (Image Source: Wiki Commons)

As I write this it’s the last day of September in the U.K., which means we’re well into meteorological autumn and summer is, at least here, a distant memory. The weather is cooler and the days are getting shorter. Soon, the clocks will go back an hour, and we’ll shift from BST (British Summer Time) to GMT (Greenwich Mean Time).

Seasons in the U.K. are particularly marked because of our northerly latitude. British weather tends to be fairly mild (thanks, Gulf Stream), and it’s easy to forget just how far north we are – but a quick look at a globe makes it clear: London is actually further north than most of the major Canadian cities, while the Polar Bear Provincial Park in Ontario is roughly on the same latitude as Scotland’s capital city, Edinburgh.

Yes, I hear you say, but what on Earth (hoho) does this have to do with chemistry?

Well, a clever little piece of chemistry happens in human skin, and, if you live in the U.K., it’s about to stop. At least, until next spring.

Some clever chemistry happens in human skin.

There’s a substance in your skin called 7-dehydrocholesterol (7-DHC). It is, as the name suggests, something to do with cholesterol (which, despite its bad press, is an essential component of animal cell membranes). In fact, 7-DHC is converted to cholesterol in the body, but it’s also converted to something else.

You will have heard of vitamin D. It helps us to absorb calcium and other minerals, and if children, in particular, don’t get enough it can lead to rickets – which leads to weak bones, bowed legs and stunted growth. Vitamin D deficiency has also been linked to lots of other health problems, including increased risk of certain cancers, heart disease, arthritis and even type one diabetes.

More recently, vitamin D has been linked to COVID-19. It’s estimated that around 80-85% of people who contract COVID-19 experience mild or no symptoms, while the rest develop severe symptoms and, even if they recover, may suffer life-altering after-effects for many months. Early data suggest that patients with low vitamin D levels are much more likely to experience those severe symptoms. There’s a plausible mechanism for this: vitamin D helps to regulate the immune system and, in particular, helps to reduce the production of cytokines.

It’s possible that having inadequate levels of vitamin D may increase your chances of a severe response to COVID-19.

Cytokines are small proteins which are important in cell signalling, but if the body starts to produce too many in response to a virus it can cause something called a cytokine storm, which can lead to organ failure and death.

It’s proposed that having the right levels of vitamin D might help to prevent such cytokine storms, and therefore help to prevent a severe COVID-19 response. This is all early stages, because everyone is still learning about COVID-19, and it may turn out to be correlation without causation, but so far it looks promising.

One thing you many not know is that vitamin D is, technically, misnamed. Vitamins are, by definition, substances which are required in small quantities in the diet, because they can’t be synthesised in the body.

But vitamin D, which is actually a group of fat soluble molecules rather than a single substance, can be synthesised in the body, in our skin. The most important two in the group are ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3), sometimes known collectively as calciferol.

Shiitake mushrooms are a good source of vitamin D2.

Vitamin D2 is found in fungi, but it’s cleared more quickly from the body than D3, so needs to be consumed in some form daily. Mushrooms are a good source (especially if they’ve been exposed to UV light), so if you like mushrooms, that’s one way to go. Vitamin D3 is hard to obtain from diet – the only really good source is oily fish, although other foods are fortified – but that’s okay because, most of the time, we don’t need to eat it.

Which brings us back to 7-DHC. It’s found in large quantities in the skin, although exactly how it gets there has been the subject of some debate. It used to be thought it was formed from cholesterol via an enzymatic reaction in the intestine wall and then transported to the skin via the bloodstream. But the trouble with this idea is that the blood would pass through the liver, and 7-DHC would be reconverted to cholesterol, never having a chance to build up in skin. A more robust theory is it’s actually synthesised in the skin in the first place, particularly since higher levels are found in a layer closer to the surface (the stratum spinosum) than in the deeper dermis.

We make vitamin D in our skin when we’re exposed to UVB light from the sun.

Anyway, the important thing is that 7-DHC absorbs UV light, particularly wavelengths between 290 and 320 nm, that is, in the UVB range, sometimes called “intermediate” UV (in contrast with “soft” UVA, and “hard” UVC). When exposed to UVB light, one of the rings in the 7-DHC molecule breaks apart, forming something known pre-D3, that then converts (isomerises) to vitamin D3 in a heat-sensitive process.

In short, we make vitamin D3 in our skin when we’re in the sunshine. Obviously we need to avoid skin damage from UV light, but the process doesn’t take long: 10-15 minutes of midday sunlight three times a week, in the U.K. in the summer, is enough to keep our levels up.

Sun exposure is by far the quickest, and certainly the cheapest, way to get your vitamin D. If you live somewhere where that’s possible.

Here’s the thing, though, if you live in the U.K., for a chunk of the year, it’s just not. I’ve pinched the graph here from my husband, whose work involves solar panels, because it makes a nice visual point.

The amount of sunlight we’re exposed to in the U.K. drops sharply in autumn and winter.

From April – September, there’s plenty of energy available from sunlight. But look at what happens from October – March. The numbers drop drastically. And here’s the thing: it turns out that vitamin D production in human skin only occurs when UV radiation exceeds a certain level. Below this threshold? Well, no photocoversion takes place.

In short: if you live in the U.K. you can’t make vitamin D in your skin for a few months of the year. And those few months are starting… round about now.

The NILU has a web page where you can calculate how much vitamin D you can synthesise in your skin on a given day.

If you want to experiment, there’s a website here, published by the Norwegian Institute for Air Research (NILU), where you can enter various parameters – month, longitude, cloudiness etc – and it will tell you how many hours during a given a day it’s possible to synthesise vitamin D in your skin.

Have a play and you’ll see that, for London, vitamin D synthesis drops off to zero somewhere around the end of November, and doesn’t restart until sometime after the 20th of January. In Edinburgh, the difference is even more marked, running from the first week or so of November to the first week of February.

It’s important to realise that it tails off, too, so during the days either side of these periods there’s only a brief period during midday when you can synthesise vitamin D. And all this assumes a cloudless sky which in this country… is unlikely.

The skin pigment, melanin, absorbs UVB. (Image Source: Wiki Commons)

The situation is worse still if you have darker skin because the skin pigment, melanin, absorbs UVB. On the one hand, this is a good thing, since it protects skin cells from sun-related damage. But it also reduces the ability to synthesise vitamin D. In short, wimpy autumn and winter sunshine just isn’t going to cut it.

Likewise, to state the obvious, anyone who covers their skin (with clothing or sunblock), also won’t be able to synthesise vitamin D in their skin.

Fortunately, there’s a simple answer: supplements. The evidence is fairly solid that vitamin D supplements increase blood serum levels as well as, if not better than, sunshine – which, for the reasons mentioned above, can be difficult to obtain consistently.

Now, as I’ve said many times before, I’m not a medical doctor. However, I’m on fairly safe ground here, because Public Health England do actually recommend everyone take a vitamin D supplement from October to May. That is, from now. Yes, now.

I do need to stress one point here: DO NOT OVERDO IT. There always seems to be someone whose reasoning goes along the lines of, “if one tablet is good, then ten will be even better!” and, no. No. Excessive doses of vitamin D can cause vomiting and digestive problems, and can lead to hypercalcemia which results in weakness, joint pain confusion and other unpleasant symptoms.

If you live in the U.K. you should be taking a vitamin D supplement from October-May.

Public Health England recommend everyone in the U.K. take 10 micrograms per day in autumn and winter. Babies under one year should also be given 8.5–10 micrograms of vitamin D in the form of vitamin drops, unless they’re drinking more than 500 ml of infant formula a day (because that’s already fortified).

Amounts can get a little confusing, because there are different ways to measure vitamin D doses, and in particular you may see IU, or “international units“. However, if you buy a simple D3 supplement, like this one that I picked up at the supermarket, and follow the dose instructions on the label, you won’t go far wrong.

So, should you (and everyone else in your family) be taking a simple vitamin D supplement right around now? If you live in the U.K., or somewhere else very northerly, then yes. Well, unless you’re really keen to eat mushrooms pretty much every day. At worst, it won’t make much difference, and at best, well, there’s a chance it might help you to avoid a really unpleasant time with COVID-19, and that’s got to be a good thing.

But, look, it’s not toilet roll. Don’t go and bulk buy vitamin D, for goodness sake.

Until next time, take care, and stay safe.

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Vaccines are one of humankind’s best achievements, and we should all be shouting about it

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science-fiction-1819026_960_720Imagine aliens finally get around to visiting our planet…

“About two hundred years ago,” explains the alien scientific advisor – let’s call him Spuck – “humans developed a way to prevent disease which they call vaccination. It’s really quite fascinating. They use a needle to place a tiny quantity of a fluid into the muscle under the skin of their arm or leg. The substances are then absorbed into their bodies and cause their highly-evolved immune systems to generate an immune response without, and this is really quite ingenious, Captain, their having to contact the actual diseases or suffer the symptoms. This simple procedure has saved millions of lives worldwide, and saved many millions more from having to suffer less fatal, but none the less still deeply unpleasant, consequences of serious illnesses.”

“Sounds great, Spuck,” says the Captain – let’s call him Birk – “is there a downside?”

“Not really, Captain. Side effects are rare and extremely minor compared to the seriousness of the illnesses themselves.”

“Fantastic. Why are you telling me all this? I’ve got some green-skinned action I’d like to get back to, if you know what I mean.”

“Well, it’s interesting that you should mention unusual skin tones, Captain. A leader has recently come to power who, amongst other things, has expressed concerns about vaccination.”

“Valid concerns?”

“The scientific evidence suggests not, sir.”

“Sounds like an idiot, Spuck.”

“I couldn’t possibly comment, sir.”

“Huh. Sounds like he could definitely be detrimental to the future of their race, and besides, I’m bored. Let’s go and shoot some stuff in direct contravention of the Cardinal Directive. Set blazers to ki- I mean, stun. Beam me down, Dottie!”

***

Vaccination. It’s a hot topic at the moment, and one which is so important that I think anyone who has anything to do with science communication ought to be talking about it. I’m not a medical doctor, or an immunologist, or even a biochemist (for more qualified input on the subject, I refer you here, here and here), but I AM capable of recognising scientific consensus and of separating good-quality evidence-based information from conspiracy theory dross.

Vaccination is awesome.

Awesome is a word that is somewhat overused. But I mean it literally. As in, inspires awe. We should stop, for a moment, and just look at how bloody amazing vaccination is. Thanks to these simple, near-painless, injections – most of which we receive as young children and therefore don’t even remember – we are largely protected from the horrors of….

  • Polio – symptoms and complications include fever, vomiting, headache, back pain, joint pain and stiffness, permanent muscle weakness, permanent paralysis and death.
  • Mumps – symptoms and complications include fever, headache, meningitis, painful testicular swelling in males and ovarian inflammation in females, both of which can  result in permanent infertility, pancreatic inflammation and, occasionally, hearing loss. Death from mumps is rare, but does occur in about 1 in 10,000 cases.
  • Tuberculosis – symptoms and complications include fever, loss of appetite, severe fatigue, chest pain, coughing up of blood, scarring of the lungs, internal bleeding and death (death is considerably more likely if the patient does not have access to medical care).
  • Measles – symptoms and complications include fever, painful skin rash, diarrhoea, vomiting, ear infection which can result in deafness, eye infection which can result in blindness, laryngitis, pneumonia, bronchitis, liver infection, encephalitis, and increased likelihood of re-contracting diseases previously survived (measles essentially “wipes” your immune system). Oh yes, and death. As many as 1% of measles patients will die from the disease.

… and umpteen other, horrible diseases, the majority of which most people reading this will have never experienced. Because of vaccination.

Measles rash

A child with a measles rash. The disease can cause serious complications, including immune suppression.

The risks of vaccination are tiny. The most common complications are redness and swelling around the injection site and/or slight temperature which is easily treated with an antipyretic such as paracetamol or ibuprofen. Very occasionally people suffer a serious allergic reaction, but this inevitably happens quickly after the injection is given. Since vaccinations are usually administered in a medical setting, any allergic reaction that does occur can be quickly managed. There have been a few other genuine cases of serious, adverse reactions to vaccines, but problems are still very rare (the swine flu-narcolepsy link, for example, affected 1 in 55,000) and specific to particular vaccines, and the vaccine in question has been quickly investigated.

Like Birk, if you’ve had nothing to do with the anti-vaccination community, you may be thinking this all sounds good. Benefits massive, risks tiny. Fab. Let’s go.

However, the anti-vaccination crowd – a real, and not entirely new, thing – will tell you that this is all lies. They will tell you this loudly, and at length, and repeatedly. They believe that vaccinations cause every health problem from acne to zygomycosis, but particularly the neurodevelopmental condition known as autism.

Vaccines do not cause autism. At all. As Spuck said, the scientific evidence is clear. It’s absolutely ice-from-a-moutain-stream-in-the-middle-of-nowhere crystal clear. Just for one example, a meta analysis published in the journal Vaccine in 2014 looked at studies involving over a million children. The data revealed no relationship between vaccination and autism. None. Nada.

Vaccines, you see, do not cause autism. And actually, it’s about time we stopped wasting precious resources proving that over and over and over and over again and instead focused on what does cause autism, because that would be a question worth answering.

Infection rates dropped enormously in the US after the measles vaccination was introduced.

Infection rates dropped enormously in the US after the measles vaccination was introduced.

Anti-vaxxers will often repeatedly talk about mercury in vaccines. There’s mercury in vaccines, they’ll say, and that’s nasty stuff, so even if we haven’t proved it yet, they must be causing something bad. One problem there: there isn’t any mercury in vaccines. There’s a preservative called thimerosal (or thiomersal) in some flu vaccines – which are not the ones usually given to children – but thimerosal is no more mercury than salt is chlorine.

The anti-vax crowd get whackier after this. Some of them will tell you that vaccinations don’t, in fact, protect against against disease at all – despite huge evidence to the contrary (see also here), not to mention the simple fact that many of our grandparents and even parents remember these diseases, and their complications, as horribly commonplace.

Anti-vaxxers often state that deaths from these diseases were dropping before the vaccines were introduced. This is true. Deaths did drop, because medical science was developing rapidly. A measles patient receiving medical care is, indeed, less likely to die than one left to her own devices. If I may say so, duh.

What vaccines did is to massively reduce infection rates. But just to state the obvious: if people don’t catch a disease, they also can’t die from it.

In short, if an anti-vaxxer shows you a graph, it’s smart to check to the axes labels.

After that they get really loony, and some of them will even tell you things such as smallpox wasn’t eradicated, it was just renamed acne. Or polio has been reclassified as Guillain-Barré syndrome. These ideas are so utterly ridiculous they don’t even deserve rebuke.

This has started up again in the last few days, particularly in the UK, because of the nasty deposit of conspiracy crap that is the film Vaxxed. It’s available online, but I shall not be linking to it here.

The film claims to reveal a massive cover-up at the Centre for Disease Control (the CDC) in America, and evidence that vaccines are generally evil and cause all manner of heinous negative health outcomes. Very little of it is true, and where a tiny nugget of true fact has been included it’s been so beaten and manipulated as to have lost all of its original meaning. There’s an excellent piece about it on Skeptical Raptor website, which I recommend reading before you google the term “vaxxed”. Consider it a sort of inoculation against the nonsense, if you like (hoho).

A Guardian article from 2010 reports on Wakefield.

A Guardian article from 2010 (click for link).

The main brain behind the film is Mr Andrew Wakefield, a former British doctor who was struck off the General Medical Council in 2010, when the GMC said he had acted “dishonestly and irresponsibly.” Wakefield was, it turned out, trying to patent his own measles vaccine. In an effort to further his own aims, he set out to discredit the widely-used MMR (measles, mumps and rubella vaccine) by fabricating results and, in particular, suggesting a link between the MMR and autism. He denied all this, of course, but a libel judge disagreed.

Wakefield is still pushing his message. He is not a particularly nice individual. Listen to him in this video clip, for example, where he responds to Bill Gates comment, made in 2015, that he (Gates) fears a pandemic could wipe out humanity in his lifetime. Actually, I’ll save you the trouble:

“Ho Chi Minh City, you may have seen this, an outbreak of [laughs] the plague in Ho Chi Minh City. The outbreak that they were not prepared for, they never prepared for, and that is the number of children with autism in Ho Chi Minh City has increased by nearly one hundred and sixty times over eight years. So, Bill, just for your edification, the plague that you’re talking about, the next plague, the next epidemic, it’s already here. It’s already here.”

Yes, you heard that right, according to Wakefield autism is a “plague”. Anyone reading this with an autism diagnosis? You have the plague. Nice, huh?

Andrew Wakefield describes autism as a "plague".

Andrew Wakefield describes autism as a “plague”.

For the record, the number of autism diagnoses in Ho Chi Minh has increased sharply over recent years, but this is may well be – as often turns out to be the case – largely due to to better diagnosis. Certainly there’s absolutely no suggestion that it’s linked to the introduction of a vaccine or vaccines. There might be an environmental factor – some sort of pollutant perhaps – but no one is certain at the moment. (To repeat myself: perhaps if we stopped wasting time endlessly disproving the link between vaccines and autism, we’d have a better idea.)

By the way, the woman in that video clip is Polly Tommey. She has an autistic son who’s now in his twenties. Back in 2010 she chose to try and raise awareness of autism by posing in a Wonderbra-style advert, and these days she follows the campaign trail with Wakefield, repeating the message that they “will win”. What exactly they’re going to win isn’t entirely clear. Would preventing vaccination, at the cost of many lives, really be a win?

Vaxxed was due to be shown at the Curzon cinema in Soho, London on Valentine’s Day. It was pulled after the cinema realised what the film was – they had merely leased their premises to private individuals and only realised what was going on when a number of science advocates started complaining.

In a statement, a spokesperson for Curzon Cinemas said:

“We do not wish to profit from a film that has demonstrably caused great distress.”

The heyevent.uk page on Vaxxed, explaining that the location will be "annnounced" two hours before the screening.

The heyevent.uk page on Vaxxed explains that the location will be “annnounced” two hours before the screening.

Tommey was predictably unimpressed by this outcome, which she blamed on “our little five trolls in England,” saying “Britain being who they are, being big wussy pussies, just strike it off.”

Unfortunately, the cancellation turned out to be less of a victory than it first appeared. The anti-vaxx crowd then set out to find a new venue. And this time, they kept it quiet. There are many, many places that will rent you a space to screen a film, and I’ll wager that few of them really check the nature of that film. So, the anti-vaxxers correctly reasoned, if we don’t tell people where it is, no one will be able to stop us. People who had previously bought tickets were told it would be in “Central London”, and that the venue would be revealed two hours before the show.

And so, it happened. At Regent’s University London, a private university which was, incidentally, recently identified as the most expensive place to study in the UK.

In hindsight, this might actually have been worse than a screening at an independent cinema. Dodgy film in a cinema – so what? “Official” screening at a university with Q&A sessions afterwards? Hm, sounds important and… academic. The press, naturally, made the most of it, with headlines such as “Disgraced anti‑MMR vaccine doctor Andrew Wakefield gets invitation to university in London.” Sure, the first line of the actual article says the university has been criticised, but who actually reads beyond the headlines these days? Sounds like he’s being taken seriously, doesn’t it?

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Regent’s University’s response on Twitter on February 15th

Regent’s University responded pretty quickly to say that they hadn’t known what the film was, that they didn’t endorse its views, and that they would be revetting all their clients.

This provoked lots of complaints about freedom of speech, because many people seem to be under the misapprehension that freedom of speech means that any and all organisations and venues have a duty to allow them to repeat their nonsense. This is not what freedom of speech means. Freedom of speech means you can’t be chucked in prison for saying a thing (with some exceptions). It does NOT mean that everyone has to listen to you, or that you can say your thing wherever and whenever you like, whether the place renting you the space likes it or not.

More alarming still was the Q&A session at the end of the screening of Vaxxed. I watched some of it (one for the team, you’re welcome). There was much talk of “getting the message out there”, “sowing the seeds”, “people have to hear the message x times before they’ll start to accept it” and so on. In short, if you didn’t know it was all about vaccines it would start to sound an awful lot like…. well, at best a religion, and at worst a cult.

Wakefield was also asked if he would ever get his name cleared. This was his response:

Wakefield speaking at the end of the Vaxxed screening.

Wakefield speaking at the end of the Vaxxed screening.

“Well, cleared by whom? Here’s a… it’s a really important… cleared by whom? Do I want to be part of the medical profession again? [muttering from the audience] Do I want to be exonerated by the General Medical Council? Do I want to pay them an annual retainer fee? To be part of… Do I really? Is that… that takes time and effort. What is more important? Making films like this? Or trying to clear my name? [applause]“

Hang on. If he really cared about getting the science right, about doing the right thing by patients, wouldn’t getting his name cleared and being reinstated as a medical doctor be of utmost importance? If he’s right about vaccines, particularly the MMR vaccine, and if he truly wants to prove it for the good of humanity, what better way than to be exonerated?

But as he says, “that takes time and effort.” What he doesn’t add, of course, is that making films like Vaxxed, travelling around the world spreading his message and hobnobbing with Donald Trump, almost certainly makes him a lot more money than being a doctor ever did. And I’ll bet it’s more fun. Why would he go back to the long hours and hard work that being a regular old doctor entails?

Wakefield is playing an extremely unpleasant and disingenuous game. The really worrying thing is that he and other anti-vaccination campaigners might be gaining ground. Robert F. Kennedy Jr. and Robert De Niro recently announced a $100,000 “challenge” to prove the safety of thimerosal vaccines. Thimerosal has already been extensively investigated – no evidence has ever been found that its inclusion in vaccines causes neurological effects, but anyway, it’s only in a few flu vaccines. Of course, the implication is that all vaccines are unsafe and that no one can prove otherwise – and now those headlines are out there, and that seed has been planted, will people really read further into it? Or will they just decide to skip the visit to the doctor?

The consequences of that are potentially serious. A mumps outbreak was reported in Washington State a week ago, and cases of mumps and measles have also just been reported in Salt Lake County. Last autumn the Guardian reported that the proportion of under-twos receiving their first dose of the MMR vaccine had fallen for the third consecutive year, and there were several reports of measles outbreaks in the UK. Flu outbreaks are also a real concern: years of hearing the phrase “mild flu-like symptoms” have created the misconception that influenza itself is a mild disease. It is not. There have been over 100 deaths from flu in Germany this year alone. People in Germany have access to good healthcare. People are still dying.

Outbreaks put everyone at risk: vaccination is effective, but nothing is 100% effective. In the midst of a full outbreak, even the vaccinated are at risk of catching the disease, and of course, those who are too young to receive the vaccine, or who can’t have it because of a genuine allergy, or because they’re immunocompromised, will be in real trouble. Let’s not forget: measles in particular is a disease with a host of horrible complications, not to mention the potential to reduce a person’s previously acquired immunity to other diseases.

Do we really want to see measles and mumps come back? Really? Because that will ultimately be the result of all of this.

And unfortunately, Captain Birk and Mr Spuck aren’t actually there to fix this mess for us. We need to see sense ourselves.

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