Dr. Robert Sears Takes on Both Sides of the Great Vaccination Divide

The author of 'The Vaccine Book' presents his own alternatives to the CDC-recommended schedules kenneth m. ruggiano

After graduating and moving back to Orange County, Sears' interest in vaccines escalated. He started dissecting every ingredient in every vaccine pamphlet, highlighting each one and studying its side effects. Ethyl mercury in the preservative thimerosal, which some parents associated with autism, had already been removed from common childhood vaccines starting in 1999, but Sears discovered others that weren't exactly organic. "Some of the chemicals are very toxic and can cause cancer and reproductive problems," he says. "There are chemicals such as formaldehyde. MSG is in some vaccines. There are chemicals that are very similar to antifreeze. Some flu shots actually have a spermicide used as a preservative. But they're all in tiny amounts, and I believe they're probably safe because they're in such tiny quantities."

One chemical did stand out to him—aluminum. It's found in about half of vaccines, and Sears dedicates about 15 pages in his book to the potential dangers of it. (According to a paper published by the AAP, aluminum can cause neurological harm, but the quantity at which it's a threat has not been determined.)

In his practice, Sears would host monthly lectures about his findings. He'd ask parents why they were declining vaccines, and the most common answer was they didn't like the "overload." Back in the 1980s, doctors gave children a total of 12 vaccines throughout their childhood, with no more than three on the same visit. Now, Sears says, doctors give children 54 doses of 12 vaccines, sometimes with seven vaccines on the same day. Parents also expressed they only wanted to give their kids vaccines against diseases that posed a real threat, not long-shot illnesses. Sears listened.

"Most doctors aren't even willing to discuss vaccine options," he says. "They will say every single vaccine is absolutely important and just as important as any other vaccine. Those statements are very closed-minded. If you have disease such as meningitis that does occur in babies and kills babies, and then you have a disease such as Hepatitis B that doesn't occur in babies, how can you say the Hepatitis B vaccine is just as important? When parents hear those types of statements from doctors, they automatically tune them out. Because parents are smarter than that."

He also had an issue with the way vaccines are approved by the government. When a medical manufacturer makes a vaccine, a panel of doctors at the Food and Drug Administration must decide whether to approve it. Doctors on that panel might own stock in the vaccine manufacturers or even work for the vaccine manufacturers. "It's a huge conflict of interest," Sears says. "We're asking doctors to approve these vaccines when their whole life and professional world is being funded by the people that make that vaccine."

With all his material, Sears decided to write an easy-to-digest vaccine guide that presented information for each of the 12 standard vaccines and answered questions about every disease: Is it common? Is it serious? Is it treatable? When is the vaccine given? How is the vaccine made? What ingredients are in the final solution? Should you give this vaccine to your baby? For every vaccine, he included a section called "The Way I See It," in which he simply shared what makes the most sense to him. (Polio: get the shot. Hepatitis A: wait until the child is at least 2. And so on.) He designed two alternative vaccination schedules—one for parents who only wanted the most crucial shots for their children, and the other for parents who wanted to minimize the number of shots per visit to no more than two. Both spaced out the vaccines under the theory that tiny bodies could better process fewer shots at a time. With the alternative schedules, he says, he rarely sees the severe side effects he hears about from patients coming from other doctors' offices.

The Vaccine Book became a parent's bookshelf staple. Vanessa Showalter, a 39-year-old mom in Mission Viejo, started reading it while pregnant with her second child, Justin, now 2. She says she wanted to do things differently from the first time around after learning more about possible links to autism. "As a first-time parent, you really just go along with what the doctors tell you," says Showalter, whose first-born, Jacob, had all the standard vaccines. "Your baby is 2 days old, and the doctor wants to give him a shot, and you don't know any better, so you say yes." With Justin, Showalter went through Sears' book, making notes in the margins and picking out what she felt were "common diseases." She eventually came up with her own vaccination timetable, calling the process "empowering."

Rebecca Estepp, an activist with Talk About Curing Autism, a national organization that offers support and information to families, believes Sears' approach "makes far more sense than the CDC schedule." Her 14-year-old son, Eric, was diagnosed with autism at age 3, and she believes a Hepatitis B vaccine was the cause. "[Sears] spent a lot of time thinking about how to prevent infectious diseases while not creating chronic ones at the same time," says Estepp, who moved from Aliso Viejo to San Diego. "Vaccines should be a risk-benefit analysis." (Sears contends that there is no scientific proof that vaccines trigger autism, but he is pushing for more large-scale research to be done.)

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83 comments
UllaUmlaut
UllaUmlaut

@sesmithwrites Education push that most adults are not current on pertussis and are the main carriers =yes please

UllaUmlaut
UllaUmlaut

@sesmithwrites Debate maybe, but why are autism link people who are neither doctors nor scientists interviewed for all these articles?

corvusriley
corvusriley

@sesmithwrites the question shouldn't be "Should we vaccinate?" It should be "How do we vaccinate more people?"

breakfastinbeard
breakfastinbeard

The human body was NOT put together so well that "in nature" any more than ONE out of FIVE children survive to breeding age.

 

80% mortality rate. THAT's "natural".

NoLiabiltyForVacs
NoLiabiltyForVacs

If vaccines are safe then why are our doctors, nurses and vaccine companies free from liability? What other procedures to they do where they have  zero responsibility for the outcome, regardless of their own negligence? If a vaccine kills or harms you or your child, The maximum amount awarded is $250,000, and the money for the fund that covers it is paid  for by the people purchasing vaccines via a surcharge. To get any compensation, you have to hire a lawyer to file a "claim" and good luck getting anything, this law is set up to skirt liability. It is frightening and a violation of our tort rights, not to mention an insult that this was ever described as protecting the consumer. It only protects the medical community. The last thing we need is the AMA having more control over what we do to ourselves and our children. I urge everyone to read the Vaccine Protection Act, it changed my mind for good on this topic.  The last thing we need is for our state to dictate what we do to our bodies. Read the labels, these vaccines contain cell from human aborted fetuses, monkeys and chickens and they inject into your blood while taking no liability for the outcome. No thanks!

JustSayNo
JustSayNo

"The current schedule, as recommended by the AAP and CDC, is completely safe and thoroughly studied." Then why does VAERS exist? Sears is making how much profit from promoting choice, partnership in health care..relative to the doctors who have stock in pharm companies that are making how much profit from attempting to vaccinate every child with how many vaccines? I realize to many Americans do not want the responsibility of making their own choice let alone the having to put forth the extra effort to do the research themselves to be able to make an informed choice!

mellis28
mellis28

This article is completely irresponsible and misleading. There is no evidence for the safety of the delayed schedule Dr. Bob proposes. He merely preys on the vulnerability of new parents to make significant profit. The current schedule, as recommended by the AAP and CDC, is completely safe and thoroughly studied. I will continue to vaccinate my children according to THAT schedule.

daniel.weinstein1
daniel.weinstein1

I've just looked at the Cochrane Collaboration on the topic of flu vaccines. I can't find anything to support plasmarules' contention.  I did find a comment that there was insufficient data to evaluate the safety of the killed virus vaccine in children under 2, but that's hardly what he's claiming.  The same article is discussing how effective the vaccine is.  The anti-vaccination crowd will appear any time there is an open discussion like this.  It's frustrating hearing the same old tired arguments.  I feel for any parent who has to make choices about their child's safety, but it's sad that the misinformation and paranoia gets such a big megaphone.  

plasmarules
plasmarules

Lots of comments suggesting that anyone who doesn't want to vaccinate isn't following the science. Well the Cochrane Collaboration is the gold standard of science and they've shown that there is ZERO evidence the flu shot has any effectiveness for those under 2, yet the CDC still says vaccinate at 6 months. They've shown that the vaccine is pointless for healthy adults and doesn't affect transmission or complications but the CDC still says it's the best way not just to prevent getting the flu, but to protect others. So tell me who is really ignoring the vast bulk of science, parents or the CDC/AAP?

aflac6981
aflac6981

I get dirty looks from my daughters doctor even for denying the flu vaccine. I'm sorry, Is that one mandatory for school, NO, so stop trying to push it. The response: You know you are just playing with fire by doing that". Yes, I know, time to switch doctors. While I agree with some of the vaccines, I certainly do not agree with all of them. If I had known some of the things I do today, she would not have gotten half of the vaccines she has. But, I guess it's not too late to start delving into them and making my own choice. Besides, what child likes getting a shot? I don't remember getting nearly this many shots while I was growing up.

Nona
Nona

One step forward, two steps back.

belkin
belkin

Great article. If I'd had a pediatrician like Dr. Sears when my first baby was born, she would still be alive today. Our then-pediatrician said to 'bring your baby down for her shots' we obeyed like lemmings and our daughter died within hours of getting the hepatitis B vaccine at age 5 weeks, a vaccine for a sexually and blood transmitted disease that is given to most newborns today. The coroner found a swollen brain, the classic medical textbook definition of a vaccine adverse reaction. We've gone on to have two more kids who are unvaccinated, healthy and neurologically normal, unlike so many over-vaccinated kids today. After studying the risk of vaccine adverse reactions vs. the risk of diseases and disease complications, I'd have to be a total idiot to vaccinate my kids. I'm not an idiot, I'm a graduate of UC Berkeley Haas Business School and I am a quantitative financial market strategist (Salomon Brothers 1986-1991). Parents, do your homework on the risk of vaccine adverse reactions before you vaccinate. It's your family and your choice, don't be intimidated by government pseudo-scientific propaganda that won't even admit what a vaccine adverse reaction is. http://therefusers.com/about/vaccine-epidemic-how-corporate-greed-biased-science-and-coercive-government-threaten-our-human-rights-our-health-and-our-children/

Lawrencium
Lawrencium

"Rebecca Estepp, an activist with Talk About Curing Autism, a national organization that offers support and information to families..."

 

TACA also promotes unproven and potentially dangerous "alternative treatments" for autism. One such "treatment" is MMS, also known as bleach, which is administered as an enema to autistic children. TACA is joined at the hip with Jenny McCarthy.

 

Sears is a huckster. Too bad the OC Weekly didn't see through him.

cattycritic
cattycritic

@michellewoo exceptionally concerned even though we don't believe they cause autism.

sesmithwrites
sesmithwrites

@corvusriley Yeah, the antivax movement makes me want to scream on a pretty regular basis.

xtctopaz
xtctopaz

That's BS, back it up with a study or retract it.

Lawrencium
Lawrencium

 @NoLiabiltyForVacs - Doctors, nurses, and companies are not free from liability.  NVICP is a no-fault compensation system. It is far easier to win in vaccine court than in civil. The court pays your legal fees, win or lose, and there is no shortage of ambulance chasers ready to take your case. Provided you have one.

 

And no vaccine is injected straight into the bloodstream. I know that sounds scarier, but most vaccine are injected IM or sub-Q.

 

You are obviously not concerned with getting your facts straight. No wonder the anti-vaccine movement is marginalized to posting comments on the internet.

Tamale
Tamale

 @JustSayNo Have you ever actually taken a look at any of the VAERS data?  A kid gets vaccinated.  Two days later they die in a car accident.  It gets reported to VAERS.  Sears is making a heck of a lot more money than any family practice/pediatrician is making right now, I can tell you that.  Vaccines are not something doctors make any money from.  In fact, they LOSE money in some circumstances.  It's one thing to take the time to do research on your own about what your doctor recommends for your doctor, but not all 'research' is created equal, and the anti-vax movement is a perfect example of how scientifically illiterate Americans are. 

plasmarules
plasmarules

 @mellis28 How can it be "thoroughly studied" when it's constantly changing to add more vaccines and more boosters? That doesn't sound like a thoroughly thought out statement to me. Have you compared the schedule from 1982 until 2012?

plasmarules
plasmarules

 @daniel.weinstein1 Here's an interview with Cochrane's head of vaccines Dr. Tom Jefferson - http://www.spiegel.de/international/world/interview-with-epidemiologist-tom-jefferson-a-whole-industry-is-waiting-for-a-pandemic-a-637119-2.html

 

SPIEGEL: For a number of years, as part of the Cochrane Collaboration, you have been systematically evaluating all the studies on immunization against seasonal influenza. How good does it work?

Jefferson: Not particularly good. An influenza vaccine is not working for the majority of influenza-like illnesses because it is only designed to combat influenza viruses. For that reason, the vaccine changes nothing when it comes to the heightened mortality rate during the winter months. And, even in the best of cases, the vaccine only works against influenza viruses to a limited degree. Among other things, there is always the danger that the flu virus in circulation will have changed by the time that the vaccine product is finished with the result that, in the worst case, the vaccine will be totally ineffectual. In the best of cases, the few decent studies that exist show that the vaccine mainly works with healthy young adults. With children and the elderly, it only helps a little, if at all.

SPIEGEL: But aren't those the exact groups that influenza immunization is recommended for?

Jefferson: Indeed. That's one of the contradictions between scientific findings and practice, between evidence and policy.

SPIEGEL: So, what's behind this contradiction?

Jefferson: Of course, that has something to do with the influence of the pharmaceutical industry. But it also has to do with the fact that the importance of influenza is completely overestimated. It has to do with research funds, power, influence and scientific reputations!

SPIEGEL: So, at the moment is it reasonable to keep vaccinating against seasonal influenza?

Jefferson: I can't see any reason for it, but I'm not a decision maker.

plasmarules
plasmarules

 @daniel.weinstein1 For adults: http://www.ncbi.nlm.nih.gov/pubmed/20614424 In the relatively uncommon circumstance of vaccine matching the viral circulating strain and high circulation, 4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms (risk difference (RD) 3%, 95% confidence interval (CI) 2% to 5%). The corresponding figures for poor vaccine matching were 2% and 1% (RD 1, 95% CI 0% to 3%). These differences were not likely to be due to chance. Vaccination had a modest effect on time off work and had no effect on hospital admissions or complication rates.andAn earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.

plasmarules
plasmarules

 @daniel.weinstein1 Here you go - http://www.ncbi.nlm.nih.gov/pubmed/18425905In children under two, the efficacy of inactivated vaccine was similar to placebo.andInfluenza vaccines are efficacious in children older than two but little evidence is available for children under two. ****There was a marked difference between vaccine efficacy and effectiveness.**** No safety comparisons could be carried out, emphasizing the need for standardisation of methods and presentation of vaccine safety data in future studies. It was surprising to find only one study of inactivated vaccine in children under two years, given current recommendations to vaccinate healthy children from six months old in the USA and Canada.

CEOTnLIndustries
CEOTnLIndustries

 @aflac6981 Which diseases are you comfortable with her contracting and passing on to others in your community?  You are already okay with her contracting influenza and passing it on to children who may have chronic conditions like asthma.  The Hib vaccine wasn't around when we were children.  Would you be okay with your daughter contracting Hib meningitis?Your doctor may be trying to protect your daughter.  Perhaps you should ask him why he wants you to get the flu shot.  A nice long conversation may change your mind.

kbear09090
kbear09090

 @belkin Did the autopsy specifically note the cause of death to be a vaccine reaction?

BillxT
BillxT topcommenter

No one says that vaccinatin is 100% safe. There are always risks, that's life. An analagous situation is do you go down in your airplane that's been disabled and is on fire or do you bail out? Do you think really we would be better off with endemic small pox, a true success story of modern medicine?

Lawrencium
Lawrencium

 @belkin -  Mr. Belkin is a hard-core anti-vaccine activist who makes no apologies for his wrong-headed views. His rock band, The Refusers, perform songs with such titles as "Vaccine Gestapo" and "Vaccination Uber Alles." He is the face of the anti-vaccine movement.

 

Still feel like compromising?

michellewoo
michellewoo

@cattycritic Thanks for reading. I have heard that as well. I do think it's important for doctors to acknowledge concerns.

Lawrencium
Lawrencium

 @xtctopaz -  Infant mortality has been estimated at about 40% in modern hunter-gatherer societies. The citations are easily found on Google scholar and elsewhere, xtc.

katyjohannabenson
katyjohannabenson

 @xtctopaz I don't know whether the stat quoted is supportable or not (my guess is not) but it's an irrefutable fact that nature is cruel; and were it not for modern medicine we'd be lucky to survive pregnancy, childbirth and infanthood. There's PLENTY of evidence to support that assertion.

gotthetshirt
gotthetshirt

 @Lawrencium

 FACTUALLY UNTRUE.  Look who needs to get his facts straight.  A FRACTION of vaccine injuries ever see a dime.  You ARE A MORON. 

 

NoLiabilityForVacs
NoLiabilityForVacs

 @Lawrencium "no fault" is no liability. The doctors nurses and companies do NOT pay the compensation, it is paid for by every person who buys vaccines, as a surcharge. Who "wins" in vaccine court? Is the lives of your children worth more than $250,000? What if the hospital bill is more than that? What if there is gross negligence and your child is killed? Our bill or rights states that we have the right to tort, this is not the same thing. It is an insult to anyone injured by these vaccines. Your semantics regarding how the vaccine gets into the bloodstream is irrelevant, whether it be by I.V. or by a shot in the butt. It  gets into your bloodstream, as does cells of human fetuses, monkeys, chickens, not to mention aluminum and mercury. Your argument is weak. 

xtctopaz
xtctopaz

 @Tamale "the anti-vax movement is a perfect example of how scientifically illiterate Americans are." And yet time and again any study on which parents are delaying or skipping vaccines show it's educated & professional parents who are opting out.

plasmarules
plasmarules

 @Tamale You're talking about a few anomalies. Nice bit of misdirection.

Lawrencium
Lawrencium

 @Tamale "Sears is making a heck of a lot more money than any family practice/pediatrician is making right now"

 

Indeed. Sears's alternative schedule calls for twice as many office visits in the first year as the AAP schedule.

Tamale
Tamale

*Doctor recommends for your child

elizabeth
elizabeth

 @CEOTnLIndustries Have you even read the rest of the comments?  Look at the rest and you will see documented  studies that prove that the influenza vaccine actually does little to nothing for children and elderly in preventing the flu.  Why shoot your kids up with artificial chemicals to have no effect except the harm from the chemicals?  There's also been a study that shows unvaccinated kids have significantly LESS allergies, asthma, ADHD, autism, etc. than vaccinated kids.  After shooting them up with all those chemicals at such young ages, I wonder why......  So sad.  :(

JustSayNo
JustSayNo

 @CEOTnLIndustriesI wonder why the number of people suffering from asthma has doubled since 1980? I wonder why inants to age 4 make up the sharpest increase?The vaccine for Haemophilus influenzae type b was licensed in 1985 and was recommended on the schedule published in 1989. When the schedule was published again in 1994, the hepatitis B vaccine had been added. The hepatitis B vaccine was not new, as it had been licensed in 1981; however, between its licensure and 1990, the vaccine was recommended only for high-risk sub-groups of the population, such as infants of hepatitis B surface antigen-positive mothers, healthcare workers, intravenous drug users, homosexual men, and people with multiple sexual partners. However, immunization of high-risk groups wasn’t stopping transmission of the disease. That’s because about one-third of patients with acute disease were not in identifiable risk groups. The change of recommendation to immunize all infants was the result of these failed attempts to control hepatitis B by only immunizing high-risk groups and to prevent the one-third of cases that occurred in individuals not identified as high risk.

 

Lawrencium
Lawrencium

 @kbear09090 We're supposed to take Mr. Belkin's word for everything he tells us. That makes him no different than most of the "tens of thousands" of parents who tell "the same story."

JustSayNo
JustSayNo

 @Lawrencium

 No, I do not compromise when it comes to the health and well being of my children...I am also the face of the anti vaccine movement, a mother whose concern for her childrens' health and well being prompted me to do the work and research to make the INFORMED choice not to vaccinate my children as opposed to following the recommendations of those profiting from a) the vaccines themselves and b) the continuous treatment of the myriad diseases caused by compromised immune systems... 

belkin
belkin

 @Lawrencium Dear Lawrencium: Thanks for the kind mention of my band the Refusers, we are currently #14 in Seattle Rock (top 1% of 1900 local bands) on reverbnation (indie rock). Two steps above Heart. Music fans and the vaccine rights movement must have a different opinion about our music and message than Mr. Lawrencium. OCWeekly readers can check out our music (First Do No Harm, Get Your Mandates Out of My Body) for free here: http://www.reverbnation.com/artist/control_room/786155#!/therefusers

Watch our video here (287,000 views in 4 months) http://www.youtube.com/watch?v=Y9y4Pq7lXAw

Read our vaccine rights and science news blog here 

http://therefusers.com/category/refusers-newsroom/

and follow our facebook page here http://www.facebook.com/TheRefusers?sk=wall

Thanks again for your generous promotion of the Refusers, Lawrencium!

AutismNewsBeat
AutismNewsBeat

@michellewoo - Most MDs acknowledge concerns, but are frustrated by the amount of bad information out there. How about a story on vax myths?

Lawrencium
Lawrencium

 @NoLiabilityForVacs -  Wrong on both counts. Vaccine makers can still be sued in civil court - see Sykes v. Wyeth, for example. Regarding your expert opinion of how vaccines are delivered, your understanding of human anatomy and physiology is weak. Mode of delivery is an important factor for how quickly the body absorbs and reacts to substances. I don't expect you to admit you are wrong, much less to change your belief based on new evidence, but there may be others reading this who are interested in bettering themselves.

orangecreamroses
orangecreamroses

 @xtctopaz How many of them, though, are actually educated in science, medicine or statistics?  When you get to those numbers, I suspect it drops precipitously.  A few years ago on Frontline when they covered the vaccine debate, the "very educated" person featured was a PhD in English literature.  Her "research" was all done at Google U reading anti-vax sites.  

CEOTnLIndustries
CEOTnLIndustries

 @plasmarules Whether or not they are anomalies, VAERS does not prove causation.  In fact, it doesn't even prove that an event happened.  VAERS merely proves that someone thinks something happened and reported it.  It is a passive reporting system, and not proof of anything at all other than people have access to a computer and think things happened.

plasmarules
plasmarules

Comparison of Blood and Brain Mercury Levels in Infant Monkeys Exposed to Methylmercury or Vaccines Containing Thimerosal Environmental Health Perspectives, Aug 2005. Thomas Burbacher, PhD [University of Washington]. This study demonstrates clearly and unequivocally that ethyl mercury, the kind of mercury found in vaccines, not only ends up in the brain, but leaves double the amount of inorganic mercury as methyl mercury, the kind of mercury found in fish. This work is groundbreaking because little is known about ethyl mercury, and many health authorities have asserted that the mercury found in vaccines is the "safe kind." This study also delivers a strong rebuke of the Institute of Medicine's recommendation in 2004 to no longer pursue the mercury-autism connection.  Excerpt: "A recently published IOM review (IOM 2004) appears to have abandoned the earlier recommendation [of studying mercury and autism] as well as back away from the American Academy of Pediatrics goal [of removing mercury from vaccines]. This approach is difficult to understand, given our current limited knowledge of the toxicokinetics and developmental neurotoxicity of thimerosal, a compound that has been (and will continue to be) injected in millions of newborns and infants."

plasmarules
plasmarules

@Lawrencium

5.  Gender-selective toxicity of thimerosal.

 

Exp Toxicol Pathol. 2009 Mar;61(2):133-6. Epub 2008 Sep 3.

 

Branch DR, Departments of Medicine and Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada.

 

Abstract

A recent report shows a correlation of the historical use of thimerosal in therapeutic immunizations with the subsequent development of autism; however, this association remains controversial. Autism occurs approximately four times more frequently in males compared to females; thus, studies of thimerosal toxicity should take into consideration gender-selective effects. The present study was originally undertaken to determine the maximum tolerated dose (MTD) of thimersosal in male and female CD1 mice. However, during the limited MTD studies, it became apparent that thimerosal has a differential MTD that depends on whether the mouse is male or female. At doses of 38.4-76.8mg/kg using 10% DMSO as diluent, seven of seven male mice compared to zero of seven female mice tested succumbed to thimerosal. Although the thimerosal levels used were very high, as we were originally only trying to determine MTD, it was completely unexpected to observe a difference of the MTD between male and female mice. Thus, our studies, although not directly addressing the controversy surrounding thimerosal and autism, and still preliminary due to small numbers of mice examined, provide, nevertheless, the first report of gender-selective toxicity of thimerosal and indicate that any future studies of thimerosal toxicity should take into consideration gender-specific differences.

Lawrencium
Lawrencium

 @belkin -  Although I am a life-long fan of rock music, I do realize that scientific matters are best settled with rigorous, peer-reviewed research, as opposed to power chords and forced rhyme.

 
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