Tuesday, August 20, 2019

#2231: Bob Sears

Bob Sears is a California-based celebrity pediatrician. Though he was initially famous for his promotion of attachment parenting, he is currently best known as one of the central figures in the antivaxx movement, and is notable for his unorthodox and potentially dangerous views on childhood vaccination - though Sears vehemently rejects the “antivaccine” label, he is at the very least one of the most diehard antivaxx apologists out there. Sears is a vocal vaccine delayer, promoter of the nonsense “too many too soon” gambit, and a master antivaccine dogwhistle performer; he is also a mainstay at antivaccine conferences and meetings. No, seriously: Bob Sears is antivaccine.

His book The Vaccine Book: Making the Right Decision for your Child (2007) proposes, against accepted medical recommendations, two alternative vaccination schedules, a proposal that has garnered almost as much celebrity endorsement as it has received criticism from people who actually understand how this works based on medical evidence. Sears’s advice (or systematic misinformation) has contributed to dangerous under-vaccination in the national child population. The book has been accurately described as “basically a guide to skipping vaccines,” and it “may as well be called The Anti-Vaccine Book.” 

Rhetorically, Sears's book relies to a large extent on the balance fallacy in order “to compromise between mutually exclusive positions, like young-earth creationism and evolution” by handwaving and false and misleading claims. Of course, Sears knows very well what audience he is targeting, and the techniques he is using are well-established techniques for reaching them; it is thus little surprise that his book has also been highly successful among certain knowledge-challenged groups. There is an excellent discussion of his techniques, as well as his dangerous misrepresentations of the facts and evidence, here. For instance, Sears predictably (and, one has to suspect, deliberately) misuses the VAERS database to argue, falsely, that the risk of serious adverse events over the course of the current vaccine schedule is 1 in 2600. Then he says that the “risk of a child having a severe case of a vaccine-preventable disease is about 1 in 600 each year for all childhood diseases grouped together,” leading him ask whether “vaccinating to protect against all these diseases worth the risk of side effects?” Even disregarding his nonsense calculation of the risk of adverse events, even minimally intelligent readers should be able to identify the sleight of hand here: Yes, Sears weighs the risk of an adverse event against the risk of acquiring a vaccine preventable disease using current disease incidence rates, which, of course, are what they are precisely because of current vaccination rates. It is accordingly safe to conclude that Sears isn’t only a loon, but actively malicious. (He has also, on several occasions, lied about the danger of the diseases in question, of course.) Similarly, with regard to HIB, Sears admits that HIB is bad, but also “so rare that I haven’t seen a single case in ten years … Since the disease is so rare, HIB isn’t the most critical vaccine.” That it wouldn’t take long for him to see plenty of cases if people followed his advice, is not addressed. He also employs the appeal to vaccine package insert fallacy.

The rhetorical strategy described above is, of course, a mainstay of Sears’s marketing toward the antivaccine community. Though Sears admits that vaccines kinda work and are responsible for eradicating dangerous childhood diseases, he also said, in 2014, that he thinks “the disease danger is low enough where I think you can safely raise an unvaccinated child in today’s society.” It is notable that Sears encourages anti-vaccine parents not to tell others of their decision not to vaccinate, writing that “I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly,” clearly, and probably correctly, recognizing that his intended audiences don’t worry too much about the ethics of free-riding. After all, Sears doesn’t care about ethics either. It is not for nothing that Sears has been a house expert for the insane New Age pseudoscience website mothering.com, for instance. 

In 2008, Sears told the NY Times that 20% of his patients do not vaccinate at all, and that another 20% vaccinated partially, commenting that “I don’t think [vaccination] is such a critical public health issue that we should force parents into it.” The same year, he landed himself in some trouble when one of his “intentionally undervaccinated” seven-year-old patients was identified as the index patient that started the largest measles outbreak in San Diego since 1991, resulting in 839 exposed persons, 11 additional cases (all in unvaccinated children), and the hospitalization of an infant too young to be vaccinated, with a net public-sector cost of $10,376 per case. It is both disheartening and interesting to see Sears react to suggestions that he is kinda responsible here, but the reaction is relatively representative for the contortions Sears often gets himself into when he simultaneously respond to critics, tries to maintain a veneer of respectability and cultivate his status in the anti-vaccine movement, and attempts to escape blame of his moral failings. (Sears has predictably been attacked by other antivaxxers, too, over his lack of ideological purity).

Sears has said that he created his alternative vaccine schedules to allow parents to vaccinate their children “in a more gradual manner” than by following the CDC-recommended schedule partially because vaccination risks causing “antigenic overload”. That idea is based on fundamental misconceptions and not on sound scientific evidence, and, interestingly, Sears even admitted that there was no published, peer-reviewed evidence to support the notion of vaccine overload, and claimed that “my precautions about spreading out vaccines are theoretical, a theoretical benefit to kids …”; PIDOOMA, in other words.

Health freedom
Sears is staunchly opposed to California Senate Bill SB277, which eliminated non-medical vaccine exemptions, and tried to fight it under the banner of “health freedom”, comparing non-vaccinating parents to Nazi-persecuted Jews during the Holocaust. Because that’s the kind of person he is. (It is a common gambit among antivaxxers.) When the bill passed, Sears responded by teaching antivaccine parents how to proceed to obtain exemptions without any medical justification, basically offering to sell medical exemptions for $180 apiece. No, seriously (details here; and Sears wasn’t the only one to do so). Sears and one Melissa Floyd, a self-proclaimed “data analyst”, subsequently launched a website and associated facebook group called the Immunity Education Group to spread misinformation about the law, the CDC, infectious diseases and vaccines (some examples here).

Sears was similarly opposed (i.e. unhinged) to bill AB 2109, a bill that would require pediatricians to counsel parents on the risks and benefits of vaccines, partially because of its ostensibly hidden agenda: “it isn’t difficult to see the REAL reason for the bill: to increase vaccination rates in our state by making it more difficult for parents to claim the exemption,” said Sears, identifying what for a hidden agenda must be counted as remarkably open and explicit. The point of the bill was otherwise to ensure that informed consent was actually informed, but Sears – who has otherwise been very concerned about “informed consent” – seems to have been mostly worried about liability issues that might arise from any legal duty to be honest with his patients being imposed on him. 

In 2016, the Medical Board of California released a six-page opinion accusing Sears of “gross negligence”, “Repeated Negligent Acts”, and “Failure to Maintain Adequate and Accurate Records” (quacks and antivaxxers were quick to run to his defense). And in 2018, the Medical Board placed Sears on 35 months of probation after he settled a case in which the Medical Board accused him of writing a doctor’s note exempting a two-year-old child from vaccinations without obtaining basic information about the patient (detailed discussion of the charges here). Per the terms of his probation, Sears is required to take 40 hours of medical education courses annually, attend an ethics class, be monitored by a supervising doctor, and will have to notify hospitals and facilities of the order, with restrictions on supervising physician assistants and nurse practitioners. Sears denied any wrongdoing, of course.

Oh, and he also runs an online store selling untested supplements at steep prices for all people in all sorts of different situations, such as the $18.99 (per 2015) Children Liquid Immune Boost supplement, presumably aimed at the same group who buys into his misinformation about vaccines. 

Bob’s brother Jim Sears, also a pediatrician, has been involved in the antivaccine movement as well, and appears for instance in the antivaccine propaganda movie Vaxxed, where he claims not to be antivaccine while simultaneously spreading antivaccine conspiracy theories and defending Andrew Wakefield.

Diagnosis: One of the central figures in the antivaccine movement (regardless of how he tries to market himself), and thus one of the most significant threats to the health, life and well-being of children in the US today. Utterly despicable.

1 comment:

  1. First time I heard about him it was by John Oliver, who debunked Sears'idea of "alternative vaccines" (sounds fun)

    P. S. :I am waiting for Rodney Howard-Browne