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2. Immunisation 3/5 Data In Context

3. Which School? • You are a parent trying to choose between two schools by looking at their exam results. • 25 students from Grange Hill got an A* in science last year. • 44 students from Springfield School reached the same grade. • Which do you choose and why?

4. Implanon • Each group will need to read and discuss a news story, then: • Use what you are given to write a short paragraph on the effectiveness of Implanon. • Choose whether you would recommend Impanon to a friend based on the information in the news story.

5. Implanonvs alternatives • The contraceptive pill has an accepted success rate of 99% when used correctly. • The equivalent rate for condoms is 98%. Give advantages and disadvantages of Implanon compared to these two methods. Which of the three would you recommend to: • A 19 year old university student • A 30-year old female in a long-term relationship

6. Comparing Stories • What about differences between how the story was reported? • You have five minutes to compare the summaries you have written with those from other groups. • Can you explain any of the differences by referring to the original news stories?

7. Implanon Summary • Most stories quoted the figure of ~600 women who became pregnant while using it. • Some also mentioned that there had been over 1600 reports of other problems. • Very few stories included the total of women using it or showed in their coverage that the success rate was more than 99.9%.

8. Context of MMR • When investigating any possible link between the MMR vaccination and a rise in autism rates, we also need to understand the context. • How serious are measles, mumps and rubella? • What is happening to autism rates generally?

9. Measles, Mumps and Rubella • Complications and severe symptoms occur in about 0.1% of measles (including brain damage and death) • Between 1 and 10% of mumps cases lead to meningitis or sterility (more often in adults) • Complication in rubella are very rare for children and adults but it often causes brain damage to a foetus if a woman catches it while pregnant.

10. Autism... • is a complex condition but usually includes difficulties relating to the world, especially other people. • was first described in the 1940s. • has no known common cause. • is diagnosed in around 0.1% of people (in UK). • is thought to be related to the more common Asperger’s Syndrome (up to 0.6 % in UK).

11. Autism in USA (cases per 1000) Can you suggest any explanations for the increased prevalence this data shows?

12. A Link to MMR? • If a link was present, we would expect that as numbers of children vaccinated increased, so would the number of diagnoses of autism. • Rates would vary between vaccinated and non-vaccinated groups. • We would expect to see increasing numbers of autism diagnoses when countries introduced the MMR vaccination (and new autism cases would decrease when removed).

13. Evidence? • None of these links have been demonstrated. • In the developed world children receive vaccinations, including MMR, around the same time as symptoms of autism develop. • Rates of autism diagnosis are increasing but we are not sure if this is because it is more common or because of better diagnosis.

14. Infections vs Vaccines A clear link between vaccinations and reduced cases has been demonstrated.

15. Skeptics Say... • “The plural of anecdote is not data.” • What does this mean? • Can you suggest why people will often rely more on anecdotes than data? Can you give examples of how companies use this?