Articles

2009: Shaping up to be a really bad year for antivaccinationists

I will begin this post with a bit of an explanation. Between one and two weeks ago, there appeared two momentous news about the manufactroversy regarding vaccines and autism. No doubt, many SBM readers were expecting that I, as the resident maven of this particular bit of pseudoscience, would have been here last week to give you, our readers, the skinny on all of this. Unfortunately, as some know, my wife’s mother died, coincidentally enough, on the 200th anniversary of Darwin’s birthday and a day when one of those two momentous bits of news was released to the public, which is why I used one of my handful of posts written and then held in reserve. I’m back now, though, and I don’t think it’s too late to comment on these bits of news because now that over a week has gone by what I’ve seen has led me to draw some conclusions that I might not have been able to do, had I done my usual bit and been first off the mark (at least among SBM bloggers) discussing the story.

2008: The Best of Years for the Antivaccine Movement

But first, let’s take a look at last year. In 2008, Jenny McCarthy was the new and fresh celebrity face of the movement that believes that autism and all manner of other neurodevelopmental disorders are caused by vaccines and that the government and big pharma are suppressing The Truth. She had emerged in the fall of 2007 after having tried to erase from the Internet her previous involvement in the “Indigo Child” movement in preparation for becoming an “autism advocate” who could write a book that could land her on Oprah’s show. Thanks to her and, perhaps even more so to the star power of her boyfriend Jim Carrey, who is just as wrong about vaccines and medicine as Jenny is, the antivaccine movement came roaring into prominence in a way that it had never managed to pull off before. After all, let’s face it, a former Playboy Playmate of the Year and a famous comedian are far more “interesting” public figures for various media outlets to interview than previous celebrities who spearheaded the vaccine manufactroversy, such as Robert F. Kennedy, Jr. or Don Imus and his wife Deirdre.

Indeed, Jenny’s combination of good looks and utter obnoxiousness led to her showing up all over the media in 2008. For example, on April 1 (appropriately enough), she appeared on Larry King Live! and shouted down physicians who had the temerity to tell her that her Google University knowledge was just plain wrong. The pinnacle of her influence came during the summer, when, having now supplanted J.B. Handley as the public face of the antivaccine group Generation Rescue and transforming GR into “Jenny McCarthy’s autism charity,” she led the “Green Our Vaccines” rally in Washington, DC. True, at most there were several hundred people there, but it got wide news attention, and Jenny was all over the news. She rapidly followed it up by releasing a second book Mother Warriors: A Nation of Parents Healing Autism Against All Odds and appearing on The Oprah Winfrey Show yet again.

When Amanda Peet joined the fray on the pro-vaccine side, it let the media to portray the vaccine issue as a celebrity cat fight. Meanwhile, thanks to Jenny’s ties with the Playboy organization and her celebrity friends, she was able to fill Generation Rescue’s coffers with the proceeds of celebrity “autism” events where luminaries such as Britney Spears, Charlie Sheen, and Hugh Hefner would show up. Add to that her promotion of Celebrities Against Autism and her partnering with professional wrestling and celebrity poker events with Lance Armstrong, and that’s a chunk of change that’s allowed GR and the equally antivaccine and quackery-friendly TACA to rebrand themselves in the eyes of the public as respectable autism charities, rather than crank organizations pushing a scientifically discredited idea and thereby endangering public health.

Then there was the Hannah Poling case, which has been extensively discussed here, both by me and Steve Novella. In brief, the government awarded compensation for vaccine injury through the Vaccine Injury Compensation Program to the family of a girl named Hannah Poling, manifested a regressive encephalopathy with features of autism spectrum disorder after a “catch up” vaccination session. It was later determined that Hannah suffers from a highly unusual mitochondrial disorder, which rendered her susceptible to neurologic injury from high fevers. She had high fevers after the vaccine, but she had also had a series of ear infections. The antivaccine movement has done its best to make Hannah its poster child as “smoking gun proof” that the government had admitted that vaccines can cause autism in susceptible children, when it had done nothing of the kind. Because the science is difficult, and because mitochondrial disorders are so uncommon, though, David Kirby and his fellow mouthpieces at Age of Autism had a field day twisting the scientific evidence and, as Mark Crislip likes to say, making therapeutic (or, in this case causative) mountains out of clinical molehills.

Truly 2008 was the high water mark of the antivaccine movement.

Still, not all was positive for the the disease promotion movement, even in 2008. For example, the second half of the year, after at least four years of no activity there was actual pushback against it. Amanda Peet spearheaded the Every Child By Two initiative, which was designed to encourage parents to have their children vaccinated. Not long after, Dr. Paul Offit, to antivaccinationists the Dark Lord of Vaccines, a veritable Darth Vader, Lord Sauron, and Satan Incarnate himself, released his excellent book telling in clear, easily accessible language, exactly why scientists conclude that vaccines do not cause autism and why the various “biomedical treatments” recommended for “vaccine injury” in the form of autism are virtually all quackery. Finally, as the year wound to a close, a group of scientists from Cornell tried to replicate the results of one of the godfathers of the antivaccine movement, Andrew Wakefield. Wakefield’s studies, starting in 1998 in The Lancet, had concluded that the measles virus in the MMR vaccine somehow invaded the gut and caused a syndrome that led to regressive autism and inflammatory bowel disease–and found no correlation between MMR vaccination and any such syndrome. Andrew Wakefield, as you recall, is the man who, more than anyone else, caused the anti-MMR scare in the U.K. and Europe that has resulted in the resurgence of measles. Indeed, he is a hero of the antivaccine movement, so much so that the antivaccine propaganda blog Age of Autism gave him the “Galileo Award” for 2008, completely ignoring the fact that, for a “maverick scientist,” it is not sufficient to be reviled. One must also be right, which Wakefield was most assuredly not.

Because one of the two body blows to the antivaccine movement that have already occurred in 2009 involves Andrew Wakefield, this is the perfect place to segue from the best of years for antivaccinationists to (thus far) the worst of years.

2009: The Worst of Years, thanks to Andrew Wakefield

As 2009 dawned, the antivaccine movement seemed strong and getting stronger. Having successfully framed themselves as “pro-safe vaccine, not antivaccine” and popularized the cleverly Orwellian slogans “Green Our Vaccines” and “Too Many Too Soon,” they had stoked fear of vaccination on both sides of the Atlantic, to the point where vaccination rates had begun to fall below the level necessary for herd immunity, and outbreaks of vaccine-preventable diseases were becoming apparent. In the U.K., thanks to Andrew Wakefield and the antivaccine movement his work had spawned, over the last decade, MMR vaccination rates had fallen below 80% (and in some parts of London, below 60%), leading a disease once considered defeated to come roaring back to the point where last year U.K. health authorities had to admit that it is once again endemic. Meanwhile in the U.S., outbreaks of vaccine-preventable diseaseas were occurring among unvaccinated populations, such as in Minnesota, while measles was also making a comeback.

One thing I could never understand about Andrew Wakefield is why so many believed him. The British press ate his bad science up and were complicit in contributing to the decline in vaccination rates that endanger public health now. I, for one, was not at all surprised at the first blow to the antivaccine movement that occurred in 2009, namely Brian Deer’s revelations that Andrew Wakefield had almost certainly falsified data used in his original 1998 Lancet paper. Specifically, and in brief, this is what Wakefield was found to have done:

However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children’s ailments as described in The Lancet were different from their hospital and GP records. Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.

A detailed account by investigative journalist Brian Deer (whom I met during his visit to the University of Michigan two weeks ago) can be found here, as can an account of how the MMR scare led to a return of the measles.

It’s not as though this revelation should have come as a surprise. After all, the signs had all been there right from the beginning that something was not right, indeed at least as early as 2002. Indeed, advocates of science-based medicine everywhere owe Brian Deer a huge debt of gratitude for having pursued this case for so long, as this is what he found out about Wakefield and his work. Moreover, it’s not as though warning signs weren’t there in the very paper. As Brian Deer described at the University of Michigan a couple of weeks ago, something didn’t smell right in the Lancet paper. What he meant was that the results looked too good to be true.

The original 1998 Lancet paper made two key claims based on its findings studying twelve children, which, according to the Wakefield, had been, “consecutively referred to the pediatric gastroenterology unit at the Royal Free Hospital and School of Medicine in London. First, it claimed that eight of the twelve children studied had manifested developmental regression within two weeks of the MMR vaccine, and one had developed regression after a measles infection, the clear implication being that there was a close temporal relationship between MMR vaccination and the onset of regression in 75% of the children. The second claim was that all 12 of the children demonstrated “intestinal abnormalities, ranging from lymphoid nodular hyperplasia to aphthoid ulceration.” Although the paper stated that the authors “did not prove an association between measles, mumps, and rubella vaccine and the syndrome described” and that “virological studies are underway that may help to resolve this issue,” Wakefield at his press conference to announce the findings stated that he had preliminary virological evidence showing measles virus in the gut. It took him four years to follow up these results with a paper in Molecular Pathology that reported measles virus in 75/91 children with ileal inflammation and children with developmental disorders. Although Wakefield was careful not to use the word autism in the actual text of the paper–or even the word vaccine–the implication of the paper was plain, and, if it wasn’t to some, Wakefield made sure to drive home what he thought the implication was: That the MMR is associated with a syndrome of developmental disorders, including autism, and inflammatory bowel disease.

Unfortunately for Wakefield, Deer’s instincts ultimately proved to be correct. The first shoe to drop was Deer’s 2004 Channel 4 documentary exposing Wakefield’s incompetence and conflicts of interest. As it turned out, Wakefield did not have the viral data in 1998. Indeed, a young investigator named Nicholas Chadwick had been unable to detect measles virus in any of the samples from the 12 children and had told Wakefield. Wakefield kept that data out of the original Lancet paper because it did not support his hypothesis. How, then, to explain Wakefield’s subsequent paper in 2002 that reported the detection of measles virus sequences in a large proportion of the ileal biopsy specimens of children with “autistic enterocolitis”? In 2007, during the beginning of the proceedings for the test cases in the Autism Omnibus case (more on that in the next section), Stephen Bustin, arguably the preeminent expert in the use of the polymerase chain reaction (PCR) to detect DNA sequences, testified for the government about the methods used in the laboratory that did the PCR analysis for Andrew Wakefield. Suffice it to say that this had to be about the sloppiest laboratory I’ve ever seen. Also suffice it to say that the negative controls were amplifying measles sequence, meaning that it was impossible to tell a signal was a true signal or a false positive. In fact, Bustin’s investigation concluded that what Wakefield was reporting was almost certainly all contamination from plasmids made in an adjacent laboratory. Ironically, this was the same laboratory that participated in the 2008 attempt to replicate Wakefield’s results. Clearly, it had cleaned up its act by then.

The other problem revealed in the 2004 documentary was that Andrew Wakefield had a massive conflict of interest. Teamed up with antivaccination crank extraordinaire Hugh Fudenberg, he had come up with a combination single agent vaccine/therapeutic (which he characterized as a “cure for autism“) agent based on the quack favorite “transfer factor.” Not only this, but he had filed patent applications for this concoction. In other words, Wakefield stood to profit handsomely if the MMR was discredited as being safe. Not long after these revelations, ten of the thirteen authors of the original 1998 Lancet report renounced its conclusions and asked to have their names removed from the paper.

But it was even worse than that.

At the end of 2006, the second shoe dropped. It turned out that Wakefield’s conflict of interest was even worse than that. In fact, it turned out that Wakefield had been paid by lawyers seeking to sue vaccine manufacturers for “injury” due to the MMR. In fact, his services had been bought and paid for to the tune of paid £435,643 in fees, plus £3,910 expenses. Neither this conflict of interest nor the conflict of interest inherent in having an alternative vaccine for measles, a single vaccine, with its patent pending were reported in the Lancet paper. It was these revelations that triggered an investigation by the General Medical Council in the U.K. into research malfeasance and ethic violations.

But it was even worse than that. Unfortunately, it took two more years to find out just how bad.

Two weeks ago, Brian Deer reported in the Sunday Times that, not only had Andrew Wakefield had massive conflicts of interest, but he had falsified data in his original paper. Indeed, consistent with the revelations that there had never been any detectable measles viral sequences, Deer reported that one father had taken his child’s specimen to be tested by a different laboratory and that that laboratory had failed to find any trace of measles virus. More importantly, however, none of the children studied for the Lancet paper actually even came from the Royal Free Hospital’s catchment area of North London; indeed, none of them even came from London. In fact, they were not “consecutively referred,” either. Rather, they had been recruited through the anti-MMR antivaccine underground and 11/12 of them were involved in anti-MMR litigation. Thus, they were a highly selected group. In addition, ccording to Deer’s account of the records examined by the GMC, in most of these children autistic features were present before they had received their MMR vaccination and in others such features only became apparent after a much longer interval than a few days after MMR. In other words, what was reported in the Lancet paper in 1998 and what was found in the children’s medical records differed significantly.

In other words, one of two things happened, neither of which is flattering to Wakefield. Either he took the history only from parents, who were litigants in vaccine injury cases and for whom confirmation bias could easily have led to remembering incorrectly that their child’s behavioral changes were noted shortly after the MMR rather than before it or months later. If this was the case, Wakefield was incompetent for not having examined the medical records. Alternatively, Wakefield did examine the medical records and lied about them in the Lancet paper. If this is the case, he is dishonest.

In fact, I might have been willing to give Wakefield somewhat of the benefit of the doubt, viewing the discrepancies between the medical records and what he reported in the Lancet paper as being yet more evidence of his incompetence and his resultant shoddy research methodology rather than dishonesty, were it not for the major discrepancies between what Wakefield said about the histology of the biopsy specimens in the paper. What was reported in the paper does not jibe with what the pathologists who first examined the specimens saw, where, in all 12 cases, no abnormalities had been reported on the initial examination of the specimens. Yet Wakefield reported a distinctive pattern of gut inflammation, specifically “colitis and ileal-lymphoid-nodular hyperplasia.” The Lancet paper had pointed out the “uniformity” of the pathological changes. What had happened?

Not happy with the readings of the pathologists, apparently Wakefield’s research team met for a “research review” of the biopsy specimens. This in and of itself is not unusual. However, it is unusual that the research team overturned the original readings of so many of the specimens. It is even more unusual (i.e., suspicious) that the reinterpretations of the original readings all went in the same direction: towards a reading of inflammation consistent with Wakefield’s hypothesis that the measles virus from the MMR was somehow involved in causing gut abnormalities and autistic regression. Even if I wanted to attribute Wakefield’s problems to incompetence, it’s pretty hard to do, given the confluence of evidence from multiple sources pointing to malfeasance.

2009: The Worst of Years, as the Special Masters Weigh In

If the revelations about Andrew Wakefield’s research fraud were the only event thus far, 2009 would already be shaping up to be a bad year for antivaccinationists. However, less than a week after Deer’s revelations were reported, the long-awaited ruling in a huge legal action made up of approximately 5,000 parents who are convinced that vaccines caused their children’s autism. I’m referring to the Autism Omnibus proceedings.

In the U.S., because of rising litigation that jeopardized the vaccine program and threatened to drive pharmaceutical companies out of the vaccine business, Congress passed the National Childhood Vaccine Injury Act of 1986 (Public Law 99-660), which created the National Vaccine Injury Compensation Program (VICP). The idea was to create an alternative to the tort system through which people injured by vaccines could be efficiently compensated. Vaccine litigants, if denied compensation, could still sue in conventional courts, but all claims for compensation had to go first through the VICP. Moreover, the standards of evidence in the Vaccine Court of the VICP are arguably markedly lower than in conventional federal courts. For example, Daubert rules for scientific evidence do not apply. Indeed, all that is necessary is a scientifically plausible-sounding mechanism by which a plaintiff might have been injured by vaccines, and compensation can be awarded. In essence, lowering the Daubert standard and allowing “science” that has not yet been peer reviewed makes meeting the standard of evidence showing a 51% or greater chance that the plaintiff was injured by the vaccine in question easier because it opened the door to an antivaccinationist version of the Gish Gallup, forcing the defense to answer and refute all sorts of bad science.

Be that as it may, as the number of litigants claiming that vaccines caused their children’s autism ballooned to close to 5,000, threatening to bankrupt the VICP unless massive infusions of new money from Congress were provided, it was decided that the proceedings should be bundled into one massive legal action known as the Autism Omnibus. As part of this proceeding, litigants were to choose what they considered to be the best cases representing their hypothesis of causation by which vaccines could produce autism and other neurodevelopmental disorders. The court would hear these cases, make a rulings, and then these rulings would be used as the basis for all similar cases as follows:

The Petitioners’ Steering Committee (PSC) has advanced three different theories of “general causation,” i.e., how the vaccines involved can cause autism, in the Omnibus Autism Proceeding. The Office of Special Masters (OSM) has assigned three Special Masters to resolve the autism cases. The OSM instructed the PSC to designate three “test cases” for each of the three theories, a total of nine test cases. The three theories of “general causation” are: (1) the theory that MMR vaccines and thimerosal-containing vaccines can combine to cause autism; (2) the theory that thimerosal-containing vaccines can cause autism; and, (3) the theory that MMR vaccines, without regard to any thimerosal additive, can cause autism.

After more than a year and a half after the proceedings began, on February 12, the Special Masters released its decisions on the first three test cases, Cedillo v. HHS (Case No. 98-916V), Hazlehurst v. HHS (Case No. 03-654V) and Snyder v. HHS (Case No. 01-162V). In all three cases, despite the “best” that the antivaccine contingent could throw at the courts, the Special Masters decisively rejected all three hypotheses of causation. Indeed, the results surprised me, as I had expected, given the extremely low bar for evidence, that there would have been a little bit of wiggle room in the decisions that would leave the door open for the antivaccine fringe to claim that there was a possibility that further causation cases would be entertained. No such wiggle room was granted. Since the decisions together run hundreds of pages, this article has become quite long, and other bloggers have posted excerpts, I will be judicious in selecting key quotes.

First, from the ruling on Cedillo v. HHS, written by Special Master George L. Hastings, Jr., we have these:

  • “This case, however, is not a close case. The overall weight of the evidence is overwhelmingly contrary to the petitioners’ causation theories. The result of this case would be the same even if I totally ignored the epidemiologic evidence, declined to consider the video evidence, and/or excluded the testimony of Dr. Bustin. The result would be the same if I restricted my consideration to the evidence originally filed into the record of this Cedillo case, disregarding the general causation evidence from the Hazlehurst and Snyder cases. The petitioners’ evidence has been unpersuasive on many different points, concerning virtually all aspects of their causation theories, each such deficiency having been discussed in detail above. The petitioners have failed to persuade me that there is validity to any of their general causation arguments, and have also failed to persuade me that there is any substantial likelihood that Michelle’s MMR vaccination contributed in any way to the causation of any of Michelle’s own disorders.”
  • “Nor do I doubt that Michelle’s parents and relatives are sincere in their belief that the MMR vaccine played a role in causing Michelle’s devastating disorders. Certainly, the mere fact that Michelle’s autistic symptoms first became evident to her family during the months after her MMR vaccination might make them wonder about a possible causal connection. Further, the Cedillos have read about physicians who profess to believe in a causal connection between the MMR vaccine and both autism and chronic gastrointestinal problems. They have visited at least one physician, Dr. Krigsman, who has explicitly opined that Michelle’s own chronic gastrointestinal symptoms are MMR-caused. And they have even been told that a medical laboratory has positively identified the presence of the persisting vaccine-strain measles virus in Michelle’s body, years after her vaccination. After studying the extensive evidence in this case for many months, I am convinced that the reports and advice given to the Cedillos by Dr. Krigsman and some other physicians, advising the Cedillos that there is a causal connection between Michelle’s MMR vaccination and her chronic conditions, have been very wrong. Unfortunately, the Cedillos have been misled by physicians who are guilty, in my view, of gross medical misjudgment. Nevertheless, I can understand why the Cedillos found such reports and advice to be believable under the circumstances. I conclude that the Cedillos filed this Program claim in good faith.”

Next, from the second case, Hazlehurst v. HHS, Special Master Patricia Campbell-Smith concluded:

Having carefully and fully considered the evidence, the undersigned concludes that the combination of the thimerosal-containing vaccines and the MMR vaccine are not causal factors in the development of autism and therefore, could not have contributed to the development of Yates’ autism. The weight of the presented evidence that is scientifically reliable and methodologically sound does not support petitioners’ claim. Petitioners have failed to establish entitlement to compensation under the Vaccine Act.

Finally, from the third case, Snyder v. HHS, Special Master Denise Vowell wrote:

To conclude that Colten’s condition was the result of his MMR vaccine, an objective observer would have to emulate Lewis Carroll’s White Queen and be able to believe six impossible (or, at least, highly improbable) things before breakfast. The families of children with ASD and the court have waited in vain for adequate evidence to support the autism-MMR hypothesis. Although I have the deepest sympathy for families like Colten’s, struggling emotionally and financially to find answers about ASD’s causes, and reliable therapies to treat ASD’s symptoms, I must decide Colten’s case based on the evidence before me. That evidence does not establish an adequate factual basis from which to conclude that Colten’s condition was caused by his vaccines.

Petitioners have not demonstrated by a preponderance of the evidence that Colten’s condition was either caused or significantly aggravated by his vaccinations Thus, they have failed to establish entitlement to compensation and the petition for compensation is therefore DENIED.

Ow. That last one’s going to leave a mark.

A more emphatic refutation is hard to imagine. Even better, Special Master Hastings recognized one of the main drivers of the scare over the MMR and vaccines in general as a “cause” of autism: Money. Indeed, a veritable cottage industry of “biomedical” quackery, dubious therapies, and pseudoscience depends upon keeping the idea that vaccines cause autism alive. “Luminaries” of this cottage industry include the aforementioned Andrew Wakefield, who has now infested the United States (the State of Texas, specifically) with his brand of quackery at Thoughtful House, now that the U.K. is investigating him. Also included are Mark and David Geier, who have been touting the use of a powerful anti-sex steroid medication to treat autistic children, and, until recently, Dr. Rashid Buttar, who is now facing sanctions by the North Carolina Board of Medical Examiners and has been banned from treating children. Add to that ambulance-chasing lawyers like Clifford Shoemaker, who have been raking in money hand over fist, thanks to the fact that the VICP actually pays the petitioners’ attorney fees regardless of whether the petition results in compensation, and it is easy to see why this industry won’t easily let parents be disabused of the fears over vaccines that it has stoked. (Indeed, Shoemaker even tried to abuse the subpoena process in order to quash reports of how much money he was making representing VICP litigants, an action for which he was sanctioned by the courts.) In the case of Andrew Wakefield, attorneys looking for big payouts from the pharmaceutical industry have even paid for research. Meanwhile, as documented on this blog before, some researchers producing reports implicating vaccines in autism are actually petitioners in the Autism Omnibus, for example, Laura Hewitson, whose husband works for Wakefield, while compounding pharmacies advertise their supplements and other dubious “remedies” right on the Age of Autism.

Those of us who support science- and evidence-based medicine were quite heartened by the revelations about Andrew Wakefield and the ruling in the Autism Omnibus. True, we wondered why it took 11 years for the revelations about Wakefield’s incompetence and outright fraud to see the light of day, but we were glad that they finally had. One reason is that, to the vast majority of lay people who are parents, the science is hard to understand, and the antivaccine movement had, more or less successfully, framed the issue as big pharma protecting its interests and a conflict between “brave maverick” doctors against government and pharma experts. However, fraud is something that people understand all too well. Demonstrating that Wakefield’s results were riddled not just with conflicts of interest but with outright scientific fraud made the issue very clear, driving home that there was no scientific basis to suspect that the MMR had anything to do with autism or other neurodevelopmental disorders. Similarly, the ruling of the Vaccine Court on the first three test cases surprised me. As I mentioned earlier, I had expected some wiggle room and was heartened to see that, contrary to what I had expected, science won unequivocally and resoundingly in court, at least in this case.

Antivaccinationists circle the wagons

The reaction of the antivaccine fringe to the rulings of the Special Masters and the revelations about Andrew Wakefield’s scientific fraud are instructive. Let’s examine the reaction to the Wakefield revelations first.

I don’t know about you, but if I passionatedly believed that the MMR vaccine causes autism or, even worse, caused autism in my child, I would be feeling very betrayed right now. In fact, I’d turn on Wakefield like a wild boar. But that’s just me. Apparently, that’s not the reaction of most of the antivaccine fringe. Indeed, the antivaccine propaganda blog Age of Autism and David Kirby, along with other antivaccine groups, immediately orchestrated a smear campaign against Brian Deer based on the flimsiest of pretenses. For example, in response to Keith Olbermann’s having correctly picked Andrew Wakefield as his “worst person in the world” for February 10, 2009, David Kirby cleverly played upon Olbermann’s hatred of Rupert Murdoch, pointing out that The Times of London is a Murdoch paper. This allowed Kirby to brag before the February 11 “Worst Person in the World” segment that he had persuaded Olbermann to name Brian Deer as one of the “worst persons in the world,” even publishing the script. Truly, Olbermann had been played for a fool by the antivaccine movement. The specious claim? That somehow Deer had a huge conflict of interest because he made the complaint to the GMC about Wakefield, a meme started by the British version of David Kirby, Melanie Phillips. It’s also a claim that, even if true, would mean nothing, as it does absolutely nothing to refute the findings in Deer’s reporting or the results thus far of the GMC’s investigation. Indeed, the ad hominems went beyond that. For example, Jane Bryant of OneClick Group has tried to paint Brian Deer as “out of control,” during which she couldn’t seem to resist trying homophobia on for size, stating:

By all accounts a gay man and therefore unlikely ever to have to face the multiple vaccine risk agonised over by parents from around the world in relation to their children, Brian Deer has made it his business to portray the parents of these autistic vaccine damaged children as deluded mendacious chancers.

I find this particularly ironic and despicable, given that chief antivaccine propagandist David Kirby is almost certainly also gay and that his previous jobs have included reporting for Outweek and The Advocate. One’s sexual orientation is completely irrelevant to one’s arguments. Only data, evidence, reason, and science should matter.

Finally, when all else fails, the antivaccine movement plays the conspiracy card, as John Stone of the British antivaccine group Cry Shame did on–where else?–Age of Autism:

And yet the medical and political establishment has been constructing its case against Wakefield on Deer’s reporting for the last five years. It was on the back of his first report that Wakefield was held to be “discredited” and the world was brow-beaten into believing it was so. UK National Health Service websites link up to Deer’s website, and the longest medical disciplinary hearing in British history was launched on the basis of his complaint. It is a game in which everybody hides behind everybody else, pretending they can’t be seen – but actually they are all standing there, and their trousers are down.

Never once does it occur to Stone or, for instance, any of the pro-Wakefield commenters here that the reason Wakefield is in such trouble is because he is a dishonest, incompetent, and unethical scientist. This, of course, is a perfect segue into the reaction to the Autism Omnibus rulings, which cranked the antivaccine fringe into ever more histrionic fits of conspiracy mongering. Indeed, leave it to our “old friend” J.B. Handley to connect the two by insinuating that the U.S. Department of Justice had tipped off Brian Deer somehow, so that his revelations could be published in close temporal proximity to the announcement of the first Autism Omnibus rulings:

That said, I found it rather odd that Brian Deer torpedoed Andy over the weekend with a seemingly made-up outrage piece, only days before the judges ruled in the Vaccine Court. The timing struck me as odd.

Meanwhile, the ever-reliable antivaccine advocate Kent Heckenlively, whose understanding of science is astonishingly bad, posted “analyses” of each decision. Some tidbits follow.

Regarding the Cedillo decision:

In his closing remarks he notes that the decision was not even close, and that the Cedillos have been misled by physicians who saw an opportunity to take advantage of a family who thought their child had been injured by a vaccine.

As much as those of who have children with autism and choose to help them are under great stress, I just viscerally respond to this attack against those physicians who are doing their best to help our children.  They choose to enter this fight, knowing they will be attacked, but strengthened by the conviction they can help some of our children.  To many of them, we owe our children’s future.  And when they have not been able to find the answer, they continue to fight.

It is apparent to anybody who looks at this unfolding tragedy that the pharmaceutical companies have no interest in helping us, the medical universities and research facilities can offer us no help, and now we know we have no friends in the vaccine court.

Regarding the Hazlehurst decision:

The sad truth of the matter is that we are massively out-gunned in terms of research dollars.  The medical personnel who undertake our cause do it knowing full well there will be many defeats.  Judges will be dazzled by experts who claim to know so much, except for the question of what causes autism.

And, finally, regarding the Snyder decision:

I’ve tried to figure out how to explain this decision, and the best I can come up with is an example from the book, “Blink” by Malcom Gladwell.  In the book Gladwell recounts the difficulty female musicians had in being hired by professional orchestras, particularly for the wind instruments.  They were thought to lack the lung capacity of men.  But when the auditions began to use screens, so the conductors couldn’t see the gender of the person playing, the number of women hired by professional orchestras increased five-fold.

Now the conductors would probably have sworn they were free of sexism, and may have truly believed it, but something else was clearly at work.  Although the claim was made that they were simply listening to the music and picking the best people, the different results obtained after the use of the screens showed a significantly different mental process going on.

I can only conclude that something similar is at work in the minds of the Special Masters, and perhaps many people who will look at what we allege.  Despite their efforts to carefully weigh the evidence, something else is tipping the scales.  I don’t believe it’s money, at least in the crudest sense of the word.  It’s money in the sense that it’s built the entire edifice and world-view in which the Special Masters are looking at these claims.

Or, to translate: The pharmaceutical companies paid for the verdict, and the judges were unconsciously biased against all those “brave maverick doctors” testifying for the plaintiffs.

But perhaps clearest, most blatant “it was fixed” argument comes from Dr. JayDon’t Call Me AntivaccineGordon in two posts he wrote for that repository for antivaccine posturing, The Huffington Post, entitled “There Is No Proof that Cigarettes Cause Cancer” and The Vaccine Court Was Wrong. Let’s take a look at his first bit of idiocy:

It took fifty years before the courts finally acknowledged that cigarette smoking causes cancer.

There were billions of dollars at stake.

The dozens of court decisions that there “was no proof” were supported by physicians, expert witnesses of all types and hundreds of millions of dollars spent on attorneys.

Experts and doctors alike stated over and over again that we need not continue studying this issue because there was just no proof.

Let me state very simply, vaccines can cause autism.

No real scientist would encourage us to stop studying this possibility.

Note the blatant straw man argument (“No real scientist would encourage us to stop studying this possibility”). Note the specious and false comparison that antivaccine advocates love to use: Comparing tobacco research to vaccine research. No matter how easy it is to demonstrate how wrong they are, they think it’s a slam dunk comparison that bolsters their paranoid, conspiracy mongering world view. After all, decades ago, scientists kept finding scientific and epidemiological evidence that tobacco smoking causes lung cancer and all manner of other health problems. Tobacco companies funded a well-financed denialist campaign of lies, bad science, and outright pseudoscience to try to convince the public that there was no link between smoking and cancer in order to protect their profits and forestall the regulation or banning of cigarettes by the government. So to antivaccinationists, it seems perfectly reasonable to claim that claiming that vaccines cause autism is the same thing, except with the evil big pharma vaccine manufacturers suppressing the “truth” to protect their profits and keep themselves safe from lawsuits.

Note another thing. Note the absolute certainty with which Dr. Jay states unequivocally that “vaccines can cause autism.” He even uses boldface and italics in the font, but that isn’t even enough to convey his level of certainty. He has to underline it too! (I congratulate him for his restraint in not using all caps as well.) Note that Dr. Jay’s certainty comes with no scientific evidence presented whatsoever to support it. None. Zero. Zip. Nada. This is very consistent with his past behavior, in which he apparently believes that simply asserting something is the same as proving it. It isn’t; argument by assertion is the lamest form of argument. In any case, apparently, just like the antivaccine movement for which he is an apologist, Dr. Jay just knows that vaccines cause autism, science be damned. Indeed, he demonstrates this utter belief–not science, belief–that the “proof” will someday be found:

The proof is not there yet. It will be found. Let’s hope it doesn’t take another fifty years and hundreds of court cases to convince the government and the public. Private industry is once again duping the FDA, doctors and the public. The conflicts of interest are obscene and illegal.

The diseases against which we vaccinate are still dangerous and still present in other countries and in America but simple risk/benefit analysis would show that the risks from the way vaccines are manufactured and administered far outweighs the risks of harm from these relatively rare illnesses.

Sure thing, Dr. Jay, and The Truth Is Out There. Fox Mulder and Dana Scully have taught us this, and Dr. Jay wants to believe. Oh, does he ever want to believe!

And that’s why these two victories for science will not, as many hope, put a damper on the antivaccine movement. They just won’t. To those who cling to the scientifically discredited idea that vaccines cause autism against the mountains of evidence that do not support it, as Kev points out, it is not about science. It is about winning and convincing people that they are right. It is about finding someone or something to “blame” for their children’s autism. To them, doctors have no authority. Scientists have no authority. The Special Masters have no authority. The scientific method means nothing. Only their personal experiences and the conclusions they draw from them, no matter how fallible humans are at drawing inferences from them, matter. To them, as Dr. Jay Gordon made explicit when he spoke to the “Green Our Vaccines” rally last summer, and said that his die hard belief that vaccines cause autism is based on states that he bases his conclusions that vaccines probably cause more harm than good on “over 30 years” of his own experience and above all (emphasis mine) “listening to you,” meaning the parents who believe vaccines “injured” their children.

That’s because the battle between parents who believe that vaccines cause autism and scientists is a battle about, more than anything else, two world views. Scientists, knowing how easily humans fool themselves into confusing correlation with causation when drawing conclusions from personal experience and anecdotes, rely on epidemiology and the scientific method to answer the question of whether vaccination is associated with autism. In contrast, the believers cannot accept that they can be fooled. Dr. Rahul K. Parikh described this conflict well in a recent article on the Omnibus decision:

Among those expressing shock and disappointment was Rebecca Estepp, the mother of an autistic child, who is one of the claimants and the national manager of the advocacy group Talk About Curing Autism. “It’s tough when you’re taking parent support calls and you hear the same story day after day,” she told the Wall Street Journal. “When does anecdotal evidence become enough?”

Her question isn’t a new one, especially in a society where belief, emotion and science so often conflict. For scientists, the answer to Estepp’s question is never. Developing a hypothesis from anecdotes or observations (whether one or a hundred of them) is merely the first step in a longer process. Next comes the hard part: testing that hypothesis to see if you can back it up with hard data, and then sharing the data with others to see if they can reproduce the findings, often multiple times.

Even more accurately, Dr. Parikh states:

Now, read that headline again: “Vaccines Didn’t Cause Autism, Court Rules.” It doesn’t say, “Vaccines Didn’t Cause Autism, a Decade’s Worth of Rigorously Conducted and Verified Medical Research Rules.” That may not be as sexy as the recent headline, but it is the truth. The scientific community disproved the vaccine-autism connection long ago, multiple times.

Which is true (except that it’s well over a decade’s worth of research), and to which I would add: The scientific community only continues to study the vaccine-autism connection, churning out negative study after negative study because it hopes to convince those who are unconvinceable by science. Indeed, just how unconvinceable they are is summed up in this poem by Rolf Hazelhurst, the father of one of the three complainants:

If we win, we keep going.
If we lose, we keep going.
If we win, the going will be easier.
If we lose, the going will be more difficult.
However, the Court rules, we will keep going.

That is a religious, cultish attitude. A little thing like a news report revealing the hero of the antivaccine movement to be a scientific fraud or a court ruling that, even under the most favorable standards of evidence imaginable, vaccines do not cause autism will not change the mind of someone like this, nor will it make the antivaccine movement have second thoughts about its cultish beliefs. The only hope that we who support science-based medicine can have is that these two body blows to the antivaccine movement will finally–finally!–drive home the message to the media that, when it comes to the claim that vaccines cause autism, there’s no there there, as they say. We can also hope that the fence-sitters, those parents who may have heard Jenny McCarthy ranting about how vaccines caused her son Evan’s autism and how she cured him with various biomedical interventions may see these two repudiations of the myth that vaccines cause autism and be reassured.

A guy can hope, can’t he?

Posted in: Politics and Regulation, Public Health, Science and Medicine, Science and the Media, Vaccines

Leave a Comment (85) ↓

85 thoughts on “2009: Shaping up to be a really bad year for antivaccinationists

  1. daedalus2u says:

    I was at a talk by Dr Margaret Bauman last week, and she showed a time-line of neurodevelopment. One of the most well documented features of people on the autism spectrum is larger brains with more numerous minicolumns. The number of minicolumns is fixed in utero at ~6 weeks post conception. “Autism” can only be triggered before that time.

  2. TsuDhoNimh says:

    The number of minicolumns is fixed in utero at ~6 weeks post conception. “Autism” can only be triggered before that time.

    It’s the vaccines disturbing the chi of the universe and disrupting the development of the minicolumns in certain susceptible people.

  3. James Fox says:

    Dave, very glad to see you back posting and what a return !

    Rolf Hazelhurst’s “poem” was quite illustrative in that our popular media often lionizes this type of attitude as brave, more ethical and caring. My impression wasn’t so much that it was religious and cultish as it was regrettable and childish.

  4. pmoran says:

    One of the reasons for the persistence of of the “vaccines cause autism” belief is surely the general impression that these infants were developing quite normally until there was a vaccination and they almost immediately showed decline. I can understand why many would take the mother’s side, if she claims this. The opposing, “scientific” position will be seen to be sustained by obvious biases.

    One thing that impressed me in the journalist review of Wakefield’s cases is that nearly all of them had indications of brain abnormalities before the MMR episode that was held to be responsible for the illness. This seriously undermines the original basis for ever believing that vaccines are a major cause of autism, as well as supporting the view that it is primarily a genetic disoprder..

    Perhaps this kind of evidence should be being emphasized, and sought futher, as it strikes at the heart and soul of the anti-vax position. Is regressive autism even a well-documented condition? (I admit I am out of my depth here).

    Are others a little uncomfortable about taking such a journalistic exercise as gospel? We would not do so if it went against us. Have those findings been confirmed anywhere?

  5. David Gorski says:

    I think the arguments that need to be made are two-fold.

    First, the symptoms of autism, “regressive” or otherwise, are nearly always detectable to the trained eye by the ages of one two two. In fact, there are even some studies out there that suggest that autism can be detected in children as young as six months. (To me it seems that each subsequent study seems to push back earlier the time at which autism can be detected.) However, the signs are often subtle and easily missed by parents who don’t know what they’re looking for and even by many pediatricians. Consequently, to the parents, it appears that the child’s language developed normally. Actually, it is rather controversial in the autism community whether regressive autism is in fact a distinct clinical subset of autism spectrum disorders, rather than simply early onset autism diagnosed late. Here is a fairly good brief summary of the controversy:

    http://sfari.org/news/contradictory-results-on-regressive-autism-divide-researchers

    That is what happened in the Cedillo case, by the way. Videotapes of the child taken before she was vaccinated were shown to autism experts, who picked up multiple clear abnormalities in her behavior that are associated with ASD.

    So argument #1 is that many of the children who seemed to develop symptoms around the time of vaccination in fact had preexisting symptoms that just weren’t picked up.

    The second issue is based on the observation that most children with autism are diagnosed between ages 1-3. That’s a time when the several childhood vaccinations are usually given. If regressive autism is indeed a distinct clinical entity, then by random chance alone, one could expect a significant number of children to appear to regress in close temporal proximity to one or more vaccines. Epidemiology, however, does not detect any evidence that more children regress around the time of vaccines than would be expected by random chance alone. In other words, there is no correlation between vaccination and autism, regressive or otherwise.

    So the second argument is that there is no evidence that regression or the onset of autistic symptoms is correlated with vaccination above what would be expected to be observed by random chance alone.

  6. wertys says:

    Well written Dr Gorski. No surprise that this post has been extensively linked to. I’m going to send it to a few people I know as well !

  7. pmoran says:

    Thanks, David, — as I suspected.

    My drift was that I suspect antivaxers and potential antivaxers may have to be led by the hand through their own faulty processes of reasoning, if we are to have any hope of influence their beliefs. To do that successfully we first have to try to understand where they are coming from.

    We tend to be so utterly dismissive of anecdotal evidence that we overlook its critical role in the shaping of “alternative” beliefs. We typically will natter on at length about “what the studies show” to an audience already well primed to regard all that with suspicion, while missing crucial opportunities to expose faulty deductions at source. Or perhaps we do deal with them in Part E , subsection (iii), rarely ever reached by lay persons. We are so accustomed to the systematic treatment of data, that we have little sense of its value in advocacy.

    I began to think about this in relation to cancer quackery. The personal testimonial sustains this whole massive industry. Yet they are virtually invariably demonstrably false when examined with sufficient focus– and possibly the Achilles heel of this whole area of quackery.

  8. lou says:

    Dr. Gorski seems very adamant that the anti-vaccine movement is near its death and has suffered a terrific blow because of one man who, unfortunately, is a boob. Wakefield discredited himself, and the MMR autism link has been ‘severed’.

    However, you fellows neglect a major component to the argument. Heavy metals in preservatives? Anyone? I would love to hear how bad the science is that people are actually suggesting that aluminum can cause neural disorders.

    Gorski focuses on the ‘bad science’, which has no real meaning to anything regarding the actual issues with vaccinations. His arguments lack the logic to sustain a reasonable point. And the fan boys eat it up. I love science, I love good science, good testable science – which is why I am on the anti-vaccine side. Because it is completely backed by evidence; you may argue, “But Wakefield! Wakefield! Bad, dirty Wakefield!” again, nothing to do with anything. I could just as easily claim Dr. Salk and his sv40 polio fiasco proves that vaccines are all bad. This is what you are doing Dr. Gorski, and it is a shame – but expected from a member of the NIH.

    Ouch.

    Oh well. What difference does it make? You will continue to feel the way you do because you think what you know is right, and I will continue to feel the way I do because years of evidence and data have proven vaccines are harmful and cause short to long term side effects. That is just an example of infallible logic, Dr. Gorski. A lesson in reason, if you will.

  9. David Gorski says:

    Lou seems to be very good at straw men arguments. For example:

    Dr. Gorski seems very adamant that the anti-vaccine movement is near its death and has suffered a terrific blow because of one man who, unfortunately, is a boob. Wakefield discredited himself, and the MMR autism link has been ’severed’.

    Part of the point of this article is that the antivaccine movement has indeed suffered a severe blow because Wakefield has been utterly discredited, but that the diehards still consider him a hero.

    Here’s your best straw man:

    Gorski focuses on the ‘bad science’, which has no real meaning to anything regarding the actual issues with vaccinations. His arguments lack the logic to sustain a reasonable point. And the fan boys eat it up. I love science, I love good science, good testable science – which is why I am on the anti-vaccine side. Because it is completely backed by evidence; you may argue, “But Wakefield! Wakefield! Bad, dirty Wakefield!” again, nothing to do with anything. I could just as easily claim Dr. Salk and his sv40 polio fiasco proves that vaccines are all bad. This is what you are doing Dr. Gorski, and it is a shame – but expected from a member of the NIH.

    A “member of the NIH”? Do you have any clue what you mean by that? There is no such thing. Even people who work for the NIH aren’t called “members” of the NIH. My lab is NIH-funded, as are thousands of labs in the U.S. I’ve also served as an ad hoc member on an NIH study section. That’s it.

    In any case, Wakefield is simply emblematic of the entire antivaccine movement. There’s plenty more bad science being held up by antivaccinationists as “proof” that vaccines cause autism. Try clicking on the Vaccines category and doing some reading; we’ve covered this territory before on this blog. Of course, I’ll be happy to point you to some of my favorites:

    Mercury in vaccines as a cause of autism and autism spectrum disorders (ASDs): A failed hypothesis

    Toxic myths about vaccines

    The Infection Schedule versus the Vaccination Schedule

    The Hannah Poling case and the rebranding of autism by antivaccinationists as a mitochondrial disorder

    Paul Offit Takes On Robert Sears

    Peruvian Hamsters and Autism: Cui Bono?

    Mercury emissions from coal-burning power plants and autism: Is there a correlation?

    Monkey business in autism research

    Jenny McCarthy, Jim Carrey, and “Green Our Vaccines”: Anti-vaccine, not “pro-safe vaccine”

    Why the latest Geier & Geier paper is not evidence that mercury in vaccines causes autism

    The worst of times for antivaccine believers: Yet another study fails to show any link between the MMR vaccine and autism

    Dr. Jay Gordon – “Anti-Vaccination”

    Dr. Jay Gordon and me: Random encounters with an apologist for the antivaccine movement

    The fallacy of “balance” and “fairness” about unscientific health claims in the media: A case study

    No need to thank me. It’s my pleasure.

  10. Pingback: Continuing anger
  11. mattyv says:

    Wow, I can’t believe I read every word of that. It is surprising only because I am not a parent, know nobody with autism and generally have no vested interest in the topic at all. What made it worth reading was how the outstanding defence of science and logic. Excellent work!

    lou wrote: “I am on the anti-vaccine side. Because it is completely backed by evidence; you may argue, “But Wakefield! Wakefield! Bad, dirty Wakefield!” again, nothing to do with anything”.

    That argument might hold an ounce of credence were it not for the fact that the whole “science” of MMR causing autism hangs on the research of Wakefield. So, lou, Wakefield’s discrediting has *everything* to do with the issue. Without him, those who claim with religious fervour that MMR is linked to autism lose their already flimsy case that there exists some form of evidence for such a link.

    Time to head back to the drawing board to find a more logical way of playing down the importance of Wakefield to the whole movement… :P

  12. HCN says:

    lou said “However, you fellows neglect a major component to the argument. Heavy metals in preservatives? Anyone? I would love to hear how bad the science is that people are actually suggesting that aluminum can cause neural disorders. ”

    What does that paragraph have to do with the MMR vaccine?

    One way to spot that a person has no clue to the whole MMR/autism issue is when they claim that the MMR contains thimerosal and aluminum.

    Anyway, lou, since you came here to tell us the errors of the prevailing science, how about you provide us with some real evidence? Wakefield was such a great guy to tell us how bad the MMR is, measles is now returning to many developed countries (UK, Switzerland, Japan and this morning the news included that Ireland is experiencing a spike in measles). So why don’t you be a really cool guy and tell us exactly what actual scientific evidence there is that the MMR is worse than measles, mumps and rubella?

    Remember, it has to real science in a real journal that I can find in my local medical school library. No news reports, no random webpages and no videos. Thank you.

  13. Just like so much pseudoscience that people need to follow (Creationism, CAM, orthomolecular medicine, whatever), the anti-vaccine gang has lost on science. David, this was a perfect article. Too bad I can’t cut and paste it to the garbage Wikipedia article on the MMR vaccine controversy.

  14. Michael says:

    Thank you David for this article. If only I could cut and paste it to Wikipedia’s horrible article on the MMR Vaccine controversy, I’d be happy. Pseudoscience, in the form of creationism, alternative medicine, and astrology are bad enough, but the anti-vaccinationists are causing harm with the increase in cases of measles and other childhood diseases. Maybe Jenny McCarthy will issue an apology to those kids.

  15. realitybites says:

    In your effort to discredit the “fringe” anti-vaccination crowd, you discredit yourself as a scientist. If as you believe vaccinations are not causing the epidemic of developmental disorders, then you as a scientist should be alarmed. Something is obviously amiss, but your scientific mind can only pontificate on Jenni McCarthy, her beauty, and her connections to Playboy.

    I don’t feel as if you give a rat’s ass about the real issue, autism and its origins. But rather you like being a faux celebrity in a world where you adjudicate to those unfortunate souls who have been harmed by this autism epidemic. You make me think of the professor behind the curtain in the Wizard of OZ, pleading with Dorothy and friends to not pay attention when his façade was revealed as the curtain was pulled away.

    What then professor? What do you believe is the reasons behind this epidemic? And don’t tell me genetics. We all know that is a boatload of S—. Genetics never caused an epidemic without some outside influence. So answer the question all knowing Doctor, what is causing autism?

  16. David Gorski says:

    I notice your IP address maps to the Portland area. You wouldn’t happen to be somehow affiliated with J.B., would you?

    As for my supposedly fixating on Jenny McCarthy, she’s a fairly small part of post; I’d hardly call it a “fixation.” I spent way more time discussing the rulings and Wakefield’s incompetence and dishonesty.

  17. Militant Agnostic says:

    Did anyone else notice that Lou is calling aluminum a heavy metal? I guess thats why they make airplanes out of it.

  18. realitybites says:

    Sorry, don’t know JB. I know of him and I like reading his stuff at Age of Autism, but I believe he has a little boy he is fighting to recover. You on the other hand, why are you so involved?

    Again, I must pester you with the question, what is causing this epidemic? If you spent your time on this, even if you went barking up the wrong tree I would have more respect for you.

    As it stands you are just an aggressor with little or no understanding of the everyday lives of those who deal with this disorder and even less interest in supporting research to find the cause.

    JB is a father who will battle for his child. You are a doctor who wrote an incredibly long blog about the poor families who lost in a court system set up to make sure they failed. You admitted there wasn’t enough money to handle all of the claims.

    Doesn’t that make you just question what the hell is going on? No, you are too busy rejoicing in their loss. Strange I almost feel sorry for you. At least the children with autism have a chance for recovery.

  19. David Gorski says:

    It’s not as if bloggers here (and elsewhere) haven’t written about the “autism epidemic” before. The likely cause for the apparent increase in autism diagnoses? Two words: Diagnostic substitution. See:

    The increase in autism diagnoses: Two hypotheses
    Five easy graphs
    The alleged autism epidemic

    As for parents who lost, you should perhaps blame their lawyers for having put together such an awful case. I’ve read some of the transcripts; they were painful to read, so bad were the arguments made and pseudoscientific the experts.

    Consider this: If the proceedings are so rigged against the petitioners, why is it that the U.S. government pays their legal fees, win or lose? The government doesn’t usually do that. Have you ever heard of Clifford Shoemaker? What caused him to go after Kathleen Seidel with legal thuggery was Seidel’s revelation of just how much money he had made from representing Vaccine Court petitioners. In fact, the Vaccine Court goes beyond paying legal fees, even for those who lose, as Kathleen Seidel has explained. In fact, the law guarantees payment of attorney’s fees and costs incurred by petitioners in presenting a claim to the Vaccine Court, as long as the claim is brought in good faith and the costs are deemed reasonable and necessary.

    Read the Banks decision itself. The Special Master bends over backwards to be more than fair. He chides an expert witness on the Respondent side for being too nitpicky about evidence. He even writes:

    In response, Respondent’s expert stated that, although ADEM may result in “permanent neurological sequelae,” nevertheless “all the medical literature is negative in that regard;” however, soon thereafter, he corrected this statement by clarifying, “I can find no literature relating ADEM to autism or [PDD].” Tr. at 84-85. It may be that Respondent’s research reveals a dearth of evidence linking ADEM to PDD, but that is not the same as positive proof that the two are unrelated, something Respondent was unable to produce. Therefore, the statement that “all the medical literature is negative” is incorrect.

    In other words, Special Master Abell appears to be requiring science to prove with 100% certainty a negative, which science can’t do. In fact, he openly admits in the ruling that there is a dearth of evidence linking MMR to ADEM or ADEM to PDD-NOS, yet he ruled for the petitioner anyway.

    No, the Vaccine Court has lax rules, reimburses the respondents for legal fees win or lose, and, if anything, appears biased somewhat in favor of the petitioners. This is probably a good thing, given that the purpose of the court is to expeditiously compensate real vaccine injuries. David Kirby and Robert F. Kennedy, Jr. (not to mention J.B. Handley), the people from whom you most likely got the talking point about how “biased” the Vaccine Court is, simply don’t know what they’re talking about. Or they do know this but are lying about it. Take your pick.

    Finally, the reason I argue against antivaccinationists is because I do care about children. I also care about public health, which the misinformation, pseudoscience, and lies of the antivaccine movement endanger. The reason I argue against the autism quackery so many antivaccinationists subject their children to is because I do care.

  20. Chris says:

    realitybites was noted by Dr. Gorski to be in the Portland, OR area…

    Oh, oh… you better be careful then! The natural level of mercury is higher in areas around volcanoes. Who knows how much mercury and other nasty things Mt. St. Helens spews out each year?

  21. realitybites says:

    First, I must respond to Chris. If you were lucky enough to live in Oregon, your brain might actually be able to encompass a little more. Being landlocked makes a person go a little bonkers. After living in Oregon, you desire beautiful mountains, high desert hikes, or long walks along the ocean beaches. Oh yes, and fresh air that is not filthy from industrial waste being spewed into it 24/7.
    Now don’t make me go and compare Oregon to Michigan. I think houses are selling pretty cheap in Michigan these days. I think Militant you might have a better argument for mercury where Dr. Gorski lives.

    Now Dr. Gorski, using this argument that autism is just now being recognized, must you?
    There is no one trying to claim that anymore, no one! You will have to come up with something else. Just go visit a school where the money is running out and nobody knows how in the hell they are going to handle the huge onslaught of children coming in every year diagnosed with autism. Try contacting Easter Seals and ask them. They were just begging for help for children with autism from the federal government. And better yet, ask the government why congress has allotted funds to research autism and its causes. I want honest arguments from you doctor.

    Another thing that troubles me about you is your use of the term anti-vaccine. I have not met one mother, who had her child regress into autism say that they are anti-vaccine. JB Handley has never said that either. You present a false picture and then attack the perceptions you have falsely created. You try to make it as if there is no reasonable number of vaccines to give a child or a safer time schedule. Give me a break my kids all grew up in the eighties and they only received ten vaccines by the time they were six years old. They haven’t died from any horrific disease. Come to think of it Doc how many vaccines did you receive as a child?

    You refer to the vaccine court as if it is benevolent all knowing and all caring with no other interest at hand. No, it is a court set up to protect the vaccine industry period. Parents should have the right to sue vaccine manufactures the same as any other industry with twelve jurors. The purpose or this court was to prevent a class action suit, like the one that took place against the tobacco industry.

    Don’t profess to tell me that you care about children and then lump them in with the public health concerns. The public health is no more than statistics, numbers, and calculations to you and the scientific community you represent. If a child falls by the way-side in your effort to protect them, then so be it. After all, it is for the good of the herd or the vaccine industry, one in the same. I have completed my discussion with you. I leave you to your brethren and the church of protectionist-science.

  22. Harriet Hall says:

    “I leave you to your brethren and the church of protectionist-science.”

    Translation: I can’t compete on a scientific level, so I’m taking my toys and going home before giving you a chance to point out my errors.

  23. David Gorski says:

    realitybites clearly didn’t even bother to read the links I supplied that explain the concepts of broadening of the diagnostic criteria for autism and diagnostic substitution as the main drivers of the apparent increase in autism prevalence, not to mention that more aid exists for autistic children, encouraging the use of autism diagnoses above others. Instead, she mischaracterizes the arguments and data as “autism is just now being recognized,” an argument that reveals a shocking level of ignorance.

    As for the tired old “not antivaccine” canard, realitybites is laboring under a delusion. J.B. Handley is antivaccine, through and through. He views vaccines as causing autism and all manner of other problems, and at every turn he denies or downplays their benefits. Moreover, he sets an impossible standard and demands studies that are unethical or can’t be done as the “proof” he requires before he might consider vaccines to be maybe safe.

    He is also constantly shifting the goalposts and, whenever science and clinical trials exonerate vaccines of what he thinks they cause, he comes up with new things. For example, it used to be GR’s motto that autism was a “misdiagnosis for mercury poisoning,” the mercury coming from thimerosal that used to be in vaccines. When several years passed after the removal of thimerosal from nearly all childhood vaccines and autism rates didn’t decline, it became “too many too soon” and “toxins.” When science is failing to support that, suddenly it’s either mitochondrial disorders or acute disseminated encephalomyelopathies. Meanwhile he spreads fear mongering propaganda about vaccines at every turn.

    If that’s not antivaccine, I don’t know what is.

    I don’t blame realitybites, though, for making like Brave, Brave Sir Robin and bravely running away. As Harriet says, when antivaccinationists are getting pummeled with facts, science, and clinical data, they often whine about how “mean” advocates of science- and evidence-based medicine are being to them and then run away.

  24. realitybites says:

    I just could not resist

    The scientist. He will spend thirty years in building up a mountain range of facts with the intent to prove a certain theory; then he is so happy in his achievement that as a rule he overlooks the main chief fact of all–that his accumulation proves an entirely different thing.
    - Mark Twain “The Bee” essay

  25. David Gorski says:

    I can’t resist, either: Once again realitybites cannot refute a single thing in this post or in any of her critics’ comments.

  26. daedalus2u says:

    RB, as opposed to those who spends a lifetime building a mountain range out of beliefs where their only rule is to not let a single fact get in their way.

  27. The Blind Watchmaker says:

    Dr. Gorski,

    I am sorry to hear about your mother-in-law. Please pass my condolences on to Mrs. Gorski.

    Good post. Thanks.

  28. Chris says:

    realitybites said “First, I must respond to Chris. If you were lucky enough to live in Oregon, ”

    Honey, I am luckier… I live northwest of Mt. St. Helens. The wind usually blows the volcanic plumes towards you.

    Along with some basic biology, you need to work on your local geography: Portland, OR is not on the coast… that city is called Astoria. Oh, and I am an “east of the mountains” native of this region, the part that is actually a desert (that is why Bend has the “High Desert Museum”).

  29. realitybites says:

    Chris
    Geography lesson #1 Astoria is not on the coast it is several miles in from the ocean. Are you sure you are living in the Northwest? I never said I lived in Portland the doc did.

    I happen to own property on the coast and in Bend not far from where that High Desert Museum is located. So you see I actually do walk on the coast and in the Mountains areas and high desert of Bend. Do you like to ski?

    You on the other hand you grew up in the eastern part of Washington by the sound of it. There is not much in the way of hiking in the desert. It is kind of desolate. Why aren’t you living there any more? St Helens blew most of its dust over Eastern Washington. So I believe you are toxic.

    Now I will go back to the reality of facing a grandchild with autism who loves the beach, and the snow, but can’t tell me so.
    You see reality really does bite and life is just not the same since my grandson slipped away from us.

  30. Chris says:

    The science has been done, the link between vaccines and autism does not exist. It is a dead link… “It’s not pinin’! ‘It’s passed on! This link is no more! It has ceased to be! It’s expired and gone to meet its maker! It’s a stiff! Bereft of life, it rests in peace! If you hadn’t nailed it to the perch it’d be pushing up the daisies! Its metabolic processes are now ‘istory! It’s off the twig! It’s kicked the bucket, it’s shuffled off its mortal coil, run down the curtain and joined the bleedin’ choir invisible!! THIS IS AN EX-LINK!! ” (hat-tip to Monty Python and the dead parrot sketch)

  31. realitybites says:

    Chris, you are not a sceintist. A true sceintist would never say what you just said.

    I know that my grandson received a vaccine called Proquad. It is now off the market and no longer recommended by the CDC. It was a lovely four in one, MMR and varicella. The amount of varicella in this vaccine was increased from the single vaccine.
    My Grandson was spinning in circles two days after receiving this vaccine. We have a video. He was 13 months old. He had received a total of 22 vaccines by the time he was 13 months old. He had asthma when he was 6 months old after receiving five vaccine in one visit.
    Chris, how many vaccines were you required to have ? If you would offer yourself up, it would be interesting to take you and a couple hundred other volunteeer of your scientific persuasion and inject you all with 30 to 50 vaccines that are currently required in this country for children of school age. But the caveat would be, you would have take them all in one day. Because if there is no problem with vaccines then you should feel confident that you would be ok.
    It would be a great experiment and you would prove your point about vaccines. Up for a little Russian Roulette Chris?

  32. Chris says:

    The plural of anecdote is not data.

    If you have an issue with that vaccine there should be no issue with getting compensation. All you have to do is prove that it was a table injury (a table being the tabulated list of known reactions, like febrile seizure).

    That does not make all vaccines bad, and it shows that when issues were discovered there was a result.

    By the way, I am an Army brat. I have been vaccinated for smallpox, typhus, typhoid, yellow fever, diphtheria, pertussis, tetanus, measles (old one from the early 1960s, it was not a good one), polio and more recently influenza. I am too old to get the mumps vaccine (I got the actual disease the year the vaccine came out), and old enough to know of kids who became injured or died due to the actually getting measles, mumps, congenital rubella syndrome, rotavirus, chicken pox and haemophilus influenza type B.

    So what?

    What you have to show is that the vaccine is worse than the actual disease. Especially since right now many of the listed diseases are coming back with deadly consequences.

  33. realitybites says:

    Chris,

    I never said all vaccines are bad. Yours is a straw-man argument.

    My grandson’s story is anecdotal this is true. On the other hand your casual dismissal of a child’s suffering is a clear example of a personality unable to feel empathy for another.

    When you speak of your vaccine history it does not come close to what my grandson received in one year. If you are a child of the fifities or sixties most of us received vaccine at school and not as a baby. You never answered my question. Are you willing to have 22 vaccine in one day? It would be a magnificent experiment. Oh, if you are an army brat then would surely know that the army no longer recommends multiple vaccines.

    This vaccine issue is not about safety, it is about money. Robert F. Kennedy Jr. is not making money with this battle. David Kirby has shown publicly what he has made and it is not much to spit at. JB Handly is just busy spending his. So…………who is making all the money? HMMM…….. Do you know the answer?

  34. Dr Benway says:

    All that is “not self” is a foreign antigen. You are enveloped in them and taking them all the time.

    When you brush your teeth, you inject more antigens into your bloodstream than are present in all the vaccines combined.

  35. Chris says:

    True, there are more bacteria in your body than there are cells.

    Of course, most of them are nice bacteria. Many are those that we actually need, especially to digest certain sugars (like those in beans).

  36. David Gorski says:

    Are you willing to have 22 vaccine in one day

    Yes, if that were the vaccine schedule supported by evidence.

    Next question.

  37. HCN says:

    realitybites said “This vaccine issue is not about safety, it is about money. Robert F. Kennedy Jr. is not making money with this battle. David Kirby has shown publicly what he has made and it is not much to spit at. JB Handly is just busy spending his. So…………who is making all the money? HMMM…….. Do you know the answer?”

    The lawyers are making the money (did you not notice the tab to find a lawyer on the National Vaccination misInformation:
    http://neurodiversity.com/weblog/article/180/ (by the way, you should check more on Ms. Seidel’s blog on who is getting the money… like Clifford Shoemaker who tried to shut her up by issuing a big monster subpoena, but a judge told him to go back to school to learn what is kind of evidence he is allowed to ask for: http://neurodiversity.com/weblog/article/164/ )

    Actually, it is about the science. Something you have failed to show. What actual factual evidence do you have that the MMR (which has been used in the USA since 1971) is worse than measles, mumps and rubella? It has to be evidence I can find in a paper at my local medical school library that is not paid by lawyers (Wakefield) or those who are “professional expert” (Geier), or in Medical Hypotheses (just look up the word “hypothesis”).

    As far as money, it has been shown that Wakefield was paid by a lawyer to come up with specific research results, a whole lot of money! See:
    http://briandeer.com/wakefield/legal-aid.htm

    (I would also suggest you read “Autism’s False Prophets” to learn were lots of the money is. I just checked, there are 17 holds on the four copies at the Multnomah County Library, and at least one copy in the Deshutes Public Library … other interesting books that might help you with your grandson are:
    “Unstrange Minds” by RR Grinker, father of a an autistic daughter, see: http://www.unstrange.com/
    “Not Even Wrong” by Paul Collins, who lived in Portland at the time his son was diagnosed
    “Speed of Dark” by Elizabeth Mood, fiction by a parent of an autistic son… see: http://www.speedofdark-thebook.com/blog/)

    Please show us where David Kirby said he is making money from where, I’d like to see that. I honestly thought he was a paid by Handley, perhaps as part of his cut in “PR and advertisement” here:
    http://scienceblogs.com/insolence/2009/02/stupid_cubed_david_kirby_rfk_jr_and_gene.php#comment-1433376

    begin quote
    Generation Rescue Revenue/Expenses (from Form 990)

    2005 REVENUES $530,495
    Expenses
    Consulting $20,000
    Supplies $1,544
    Printing & publications $316
    Conferences & meetings $13,720
    Travel $2,885
    Meals $268
    PR & Advertising $347,335
    Google Ad Words $110,078
    TOTAL EXPENSES $496,146

    2006 REVENUES $318,695
    Expenses
    PR & Advertising $108,365
    Google Ad Words $11,550
    Market Research & Survey $232,500
    Supplies $353
    TOTAL EXPENSES $352,768

    2007 REVENUES $425,317
    Expenses
    Advertising $264,260
    Market Research $156,292
    Website Maintanance $3,418
    Bank Fees $728
    TOTAL EXPENSES $424,698

    2005-2007
    TOTAL REVENUES $1,274,507
    Expenses
    Advertising $841,588
    Market Research/Survey $388,792
    Consulting $20,000
    Conferences/Travel $13,988
    Office & Bank Expense $2,941
    TOTAL EXPENSES $1,273,612

    end quote

  38. HCN says:

    Oh, crud… I hit submit too soon… no matter, the NVIC have removed their “find lawyer” tab, I should have checked it earlier. Still it is the “National Vaccine MIS-Information Center” (when scientific data does not go the way they want, they just ignore it, or lie about it! — you can read about its founding in the book “Vaccine” by Arthur Allen, also at the Multnomah County Library, several copies with no holds, so no waiting required).

    Other folks making lots of money are the quacks who peddle their cures to desperate parents. These include Rashid Buttar (with his Buttar Cream, a transdermal chelation cream, he used to take money away from people who thought their fillings were evil, and he also steals from those who have cancer: http://neurodiversity.com/weblog/article/185/)… oh, and the other chelation quacks like Roy Kerry (who managed to kill a five year old by mainlining EDTA into him while the kid was strapped down because he struggle, and then got to become a DAN! doctor, http://scienceblogs.com/insolence/2006/11/the_complaint_against_dr_roy_kerry_kille.php) … and the Geiers with the unique treatment of chemically castrating children: http://neurodiversity.com/weblog/article/109/ … and of course, Dr. Bradstreet who was the fellow who tortured one of the kids in the Autism Omnibus test cases:
    http://neurodiversity.com/weblog/article/184/

    I have not even mentioned the cranial sacral therapists (it is a homeopathic head massage, someone recently suggested it for my son, I almost choked on the peach I was eating when I did a spit-take and started to laugh), nutrition nuts (see http://autism-watch.org/about/bio2.shtml , also someone who lives in Portland, OR), secret in, and of course what was “big” when my son was little — intensive physical therapy, also known as “patterning” (another good book: “No Time for Jello” by Berneen Bratt, and this http://www.srmhp.org/archives/patterning.html … I checked out the book “What To Do About Your Brain Damaged Child” from the library, it turned out to be a book length advertisement for Doman’s “institute” in Pennsylvania, basically total crap!).

    There are lots of opportunities to make money off of desparate parents. Also, if you read this blog, you should have read this (written by a doctor who practices in Portland, OR):
    http://www.sciencebasedmedicine.org/?p=289

    As it turns out, taking care of folks who get the diseases actually costs more than preventing the diseases with vaccines! Who would have figured that out… oh, wait, California and some other folks:
    http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=8855680
    http://archpedi.ama-assn.org/cgi/content/full/159/12/1136

    Oh, and since some diseases cause mental retardation, that was also looked at:
    http://archpedi.ama-assn.org/cgi/content/full/160/3/302

  39. realitybites says:

    You just proved your point about generation rescue, not much money there.
    As for David Kirby that is easy he provided that info. Go find it.

    You are all very strange like a bunch of schoolyard bullies.

    Are you forgetting I witnessed what happened to my grandson. It was very much like an experiment. Everyday I saw him after that vaccine, he got worse and worse. First sick, then language, then eye contact, then body, drooling, diarrhea, sick, sick little boy. When he lost his lanquage he started repeating his words and then there were no words. He stopped smiling. He was lost to us.

    And he did not start improving until we went to one of those doctors you all despise a DAN doctor.

    My grandson is like an ambassador for autism. He is a beautiful little boy. Everywhere we go people stop and comment on how cute or beautiful he is and that is when I tell them what happened to him and not one person, not one, has said oh no ,vaccines are safe. They all see him and understand when I tell them he received 22 vaccines by 13 months old.
    They all listen and agree with me that this vaccine thing is out of control. You people have really screwed things up and your all guilty for these sick kids and God help you win you realize.

    Dr. Gorski would you be willing to set up the experiment with a good two hundred or so volunteer adults including yourself to get those vaccines in one day?

  40. Dr Benway says:

    I heard a story in a podcast not long ago:

    A pediatrician was drawing up a vaccine when suddenly her patient, a young girl, had a grand mal seizure. She’d never had a seizure before, but others in her family had epilepsy and she may have had some risk factors (cerebral palsy? I can’t recall).

    If the pediatrician had given the vaccine five minutes earlier, it would have appeared that the vaccine caused the seizure.

    Moral of the story: anecdotes can mislead us.

    We need to compare two large groups: those exposed and not exposed to X, before we can say that X causes Y.

  41. Dr Benway says:

    Dr. Gorski would you be willing to set up the experiment with a good two hundred or so volunteer adults including yourself to get those vaccines in one day?

    Do you realize that your question is a terrible insult and accusation? You are saying that Dr. Gorski knows the vaccines cause injury but he’s predending that they do not in order to fool the public.

  42. David Gorski says:

    It’s also a straw man. If the recommended vaccine schedule for an adult my age included the vaccines, then I’d have my doctor give them to me.

    realitybites is starting to sound like Jock Doubleday.

  43. realitybites says:

    The doctor already said he would. I did not ask him to until he volunteered. Would you join him?
    This is an experiment, it has nothing to do with the schedule for an adult. It is to prove that vaccine are safe. What better way to make your point that to take a boat load of them in one day. Hell your a grown man. All of you line up and away you go, that is only figuratively speaking.

  44. daedalus2u says:

    realitybites, The problem with your “experiment”, is that it wouldn’t change anyone’s belief. If Dr Gorski did line up a couple hundred adults who agreed to be injected (I would volunteer), you and the other anti-vaxers would simply ignore it or move the goal posts yet again.

    Your “experiment” isn’t designed to produce information or understanding or to demonstrate anything, it is simply designed to waste the time, money and resources of people who think that vaccines are safe enough to be used for what they are indicated for.

  45. HCN says:

    realitybites, you have proven that you will not read what does not comply to your preconceived notions. You are being very closed minded.

    I would suggest you get yourself down to the library and start working on some of the books I suggested, if not the web sites.

    And as far as studies go, I suggest you try this:
    http://photoninthedarkness.com/?p=154

  46. realitybites says:

    HCN,

    Hold on a minute I did not have any preconceived notions or I would not have ever allowed my grandchild to be immunized with such a crazy schedule. The odds are one of you will inevitably experience this nightmare called autism sooner or later and then you will swallow your swill and ask for forgiveness.

    daedalus2u,

    There is value in money well spent, the proof is in the pudding. Put your arms and butt, where your mouth is and get that experiment rolling.

    before you get started though you might want to read these quotes from the VHC

    We have preliminary findings from one of our many on-going research studies that suggest a relationship between adverse events and multiple vaccinations exist,” US Army Colonel Renata J. M. Engler, MD, director of the VHC, (a “collaborative network” of the Defense Department and the CDC), wrote to Rep. Carolyn Maloney (D-NY). “These findings will require validation, but heighten our concern for the current clinical practice of multiple vaccinations.”

    “The more drugs one is exposed to, the greater the likelihood of having an adverse event so as vaccine numbers increase, and (sic) we will see more people who have efficacy or safety issues,” Col. Engler said. “The standard of care (ie, in the context of mixing vaccines) is to minimize drug exposures because of the recognition that the more drugs being used, the greater the chance of a reaction and potentially a serious adverse event.”

  47. HCN says:

    from http://www.sciencebasedmedicine.org/?p=384#comment-13629 … have you posted an answer to:

    “What actual factual evidence do you have that the MMR (which has been used in the USA since 1971) is worse than measles, mumps and rubella? It has to be evidence I can find in a paper at my local medical school library that is not paid by lawyers (Wakefield) or those who are “professional expert” (Geier), or in Medical Hypotheses (just look up the word “hypothesis”).”

    ?

    Just curious… what science are you going on? (oh, you never referenced your Army quotes, that does not count… it has to be verifiable, you did not list the source of the comment, I only found it on Age of Autism or David Kirby and other anti-vaccine sources I do not trust. What part of “paper I can find in my local medical school library” did you not understand?).

    I looked at Dr. Benway’s website, and she posted maps from a Pertussis website showing the growing numbers of pertussis, http://pertussis.com/locate.html. Oregon is now in the red zone. That kills babies!

    Why would we want to have pertussis return?

    Or even tetanus (there is no herd immunity for that), diphtheria, measles, mumps, Hib, rubella or polio? How about rotavirus? I have had to hold an unconscious child in my arms while in an ambulance to take him to a hospital after seizures suffered due to dehydration from rotavirus. Tell me why that disease should not be prevented.

    Where is your science?

    And remember, it has to be verifiable and scientific. Not a random quote. I must be able to find the paper in my local medical school library, and it must not be in “Medical Hypothesis” (nor by the Geiers or Wakefield).

    What is your NON-anecdotal evidence?

  48. Dr Benway says:

    The odds are one of you will inevitably experience this nightmare called autism sooner or later and then you will swallow your swill and ask for forgiveness.

    I have a brother with autism.

    You speak as if you’ve somehow cornered the market on human suffering. You hurt moar and so you get to take moar. You are entitled to the biggest tantrum. We all must stop and watch and feel your amazing pain, else we’re heartless bastards.

    This narcissistic, over-blown display of self-righteousness has grown tiresome. Please play somewhere else now.

  49. durvit says:

    rb – the actual memo from Colonel Renata Engler (tinyurl preview – will go to AoA) is not the smoking gun you think it is and I wonder if you have read it through?

    [Maloney] Does the 1-2% rate of serious adverse events referenced on the third slide of the presentation apply only to service members or is the rate the same for all DoD personnel and their beneficiaries who receive immunizations? If the rate is lower for DoD personnel and beneficiaries, what would account for the difference?
    [Engler] The estimate of 1-2% who may need an immunisation healthcare consultation to address clinical questions raised applies to all populations and is an expert opinion estimate. There is a need for larger population surveys to improve our understanding of people’s experiences and perceptions coupled with the new focus on enhanced post licensure safety surveillance efforts mandated by the FDA. The more drugs one is exposed to, the greater the likelihood of having an adverse event so as vaccine numbers increase, and we will see more people who have efficacy or safety issues.
    The consultation does not prove or disprove causality association but it is from these consultations that we have refined our understanding of the questions, a critical first step to future refinement of research agendas. It is our firm belief that increased research into side effects that are more severe but may be short duration, may help us understand more severe adverse events (more rare at 1 in 10-1 00,000). However, our work over the past years has been humbling in relation to the knowledge gaps which the Institute of Medicine Reports has also highlighted.
    [Maloney] A statistic provided on the third slide of VHC’s report indicates that 24,000- 48,000 service members have suffered serious adverse events due to mandatory immunizations. Is this accurate?
    [Engler] No, this statistic refers to the potential number of service members, experiencing more serious side effects (not serious disease with prolonged duration), that may need a medical consultation about next dose and/or pre-treatment to reduce the severity of the side effects, etc. [Emphasis added.]

    With Dr Benway on this one, a number of regular commenters have mentioned family members with autism.

  50. realitybites says:

    Dr. Benway,

    You got it wrong, it is my grandson who is suffering. I go to sleep and wake up thinking about him. I pray everyday for his recovery. I cannot and will not forget what happened to him.

    And when I hear of you and people like you claiming that vaccines did not cause his autism, it makes my blood boil. I am mad for the mom I met a month ago. She has a two year old who physically is harming himself because of the pain he is in. You see he ended up in the hospital for a week after receiving Rotateq vaccine. He almost died. Now she has a baby who is so sick and she has not a clue how to help him. This is a two year old who she is afraid will physically hurt himself.

    I am mad for the grandmother, I met in the parking lot who experienced the same thing I did with my grandson. She speaks loudly too.

    Everywhere I go people tell me stories. My niece who has two neighbors and a cousin who all have autism. The woman I met at the restaurant who’s son she swares was damaged by vaccines. The woman at the doctor’s office. The woman at the store. Endless countless numbers, we are lining up in anger over what has happened.

    Dr. I am not here to look for empathy. Don’t you think that for a minute. This is about honesty. I am here to tell the truth as I know it and witnessed it. You can tell your story and in the end we will see who wins this battle.

    Merck came out with RotaTeq at the same time it came out with Proquad. along with two other vaccines.One of the others was gardasil (which Spain has removed from the market). Four in all. They were rushed out to market to make up for the losses Merck was experiencing from Vioxx. When a company is allowed this kind of leniency bad things usually result.
    as the saying goes, SHOW ME THE MONEY ( and that is where the trouble starts)

    http://www.redorbit.com/news/health/333019/merck_reveals_plans_for_rebirth__targeting_research_new_vaccine/

    As far as that extended quote from the hearing with representative Maloney, it did not lesson the point that the DOD is concerned about adverse events from to many vaccine exposures. It said that they were thinking ahead with reason!

  51. Calli Arcale says:

    I have a daughter with an autism-spectrum disorder and ADHD. I have a brother with autism. I have ADD. Another brother has ADHD. My other brother has dyslexia. My husband may have dyslexia (undiagnosed). I have three cousins with ADHD. His uncle has Asperger’s Disease and ADHD. Various other relatives show definite symptoms of various autism-spectrum disorders and other learning disorders, but were never diagnosed, probably in large part due to age (fifty years ago, you generally didn’t get diagnosed unless you showed significant intellectual delay) and negative attitudes towards psychiatric care in some of the older members of the family.

    None of us has ever had any unusual reaction to a vaccine, and all of us have kept up with the recommended vaccine schedules, including annual flu shots. The family members without learning disorders have also kept up on their vaccinations.

    Why are my anecdotes any less valid than yours, realitybites?

    The truth is, anecdotes are misleading. They can be useful for illustrative purposes, or for getting the mind started on a particular quest, but they cannot be relied upon for definitive conclusions. Your grandson regressed severely following a vaccination; how do you know the vaccine was to blame?

    Here in Minnesota, we got a foot of snow right after I washed my car. Did the carwash cause the snow? Of course not, and that’s obvious because we all understand that snow comes from clouds which have nothing to do with car washes. But most people don’t understand the immune system, the mechanism of vaccines, or the brain enough to realize how implausible the vaccine-autism connection really is, so people don’t dismiss that connection out of hand the same way they’d dismiss a connection between car washes and snowfall.

    Does the question of vaccines and autism deserve study? Not anymore. It did, and was studied, and was found lacking. That doesn’t mean we know all there is to know about it; we never know all there is to know about a topic. But since autism can be so devastating to families, I don’t think we can afford to waste time on implausible theories that have so far not stood up to testing. I think we also need to accept the very real possibility that autism may not be “curable” but may simply be the nature of some people, in which case it is imperative that we research ways to improve the quality of life of those people.

    BTW, of course the DoD is concerned about adverse effects from too many vaccine exposures. Do you know what kinds of vaccines our servicemen have to take? It’s not just the ones your children are advised to take. They have to get vaccinations which the general public is not advised to take because they have significant adverse affects and most people aren’t likely to benefit from them. (When’s the last time you were exposed to yellow fever, for instance?) For these vaccines, the risk outweighs the benefit unless you’re expecting some exotic travel or possible biowarfare exposure in the near future. Smallpox vaccine can be ugly, and there have been some very serious questions asked whether or not it’s a good idea to systematically vaccinate all personnel on the off chance that somebody weaponizes the tiny remaining stocks of the pathogen.

  52. daedalus2u says:

    One of the most reliably documented physical characteristics of autism is a larger brain with increased minicolumn number. The number of minicolumns is fixed at 6 weeks post conception. That is in the first trimester, shortly after neural tube closure (at 3-4 weeks). Exposure to thalidomide in that time frame causes autism too.

    Nothing that happens 2 or 3 years later can increase the number of minicolumns.

  53. Pingback: A. HALIM
  54. HCN says:

    A. Halim said some stuff… hoping someone would click on his website full of ad clicks.

    Do not click on his name.

  55. realitybites says:

    Calli Arcale

    My God don’t you wonder what the hell has hit you and your family?

    I totally believe in a genetic connection for autism. My husband and my kids definitely hold similar characteristics. But what takes a gene and turns it on full blast?
    My husband has eye contact issues, he had sensory issues as a child, and he read from left to right. He had speech delay issues. He was able to outgrow his early issues and is a very gifted in science and math. He witnessed my grandson’s regression and he believes there is definitely a connection
    My daughter had shyness issues well beyond any I had ever witnessed. She was unable to speak or look others in the eye. She played varsity soccer for four years and never was able to stand next to her team mates. She went on to gain a scholarship to Notre Dame and majored in Biochemistry. She believes there is a connection between vaccines and autism.
    My other daughter had diarrhea all the while as a toddler. She had pretty serious gut issues. No doctor ever said this is a problem. She now is a dental student and is also believes in the autism vaccine connection.
    My son had serious speech delay. He did not process language normally. We worked with him and with much help, he improved dramatically. By second grade he was reading at eighth grade level. He is the father of my grandson and he also believes in the autism vaccine connection.
    My grandson’s genetic makeup mixed with an overload of vaccines was the perfect storm.

  56. Calli Arcale says:

    No, I don’t wonder what has hit my family; it seems quite clear to me that it’s genetic. I mean, we’ve got people who grew up in radically different situations, across generations, and who have the same symptoms. The genes are what we have in common. *shrugs* I don’t see how I can implicate vaccines when a) there is no dose-response relationship (e.g. my daughter is no worse than my brother, despite receiving *more* vaccines) and b) these disorders are seen in family members who have never been vaccinated. (Go back into my grandparents’ and great-grandparents’ generations, and there are a bunch of holy-rollers who felt that medical intervention was a sign of distrusting God. They weren’t diagnosed, of course, because nobody diagnosed shyness or being a bit of a bookworm as an ASD in those days.)

    BTW, constant diarrhea may or may not be a problem for a kid. Some kids are just runnier than others, but obviously there’s a point where it gets to be a problem. My other daughter (who interesting shows no signs of learning difficulties; even at age 2, I can tell she does not have the same issues as my older daughter) tends towards loose stools, but it doesn’t seem to bother her, and doctors have told us not to worry. She’s gaining weight, pees a healthy amount, and is a bright, vivacious toddler; for some children, loose stools are just the way it is.

    But what takes a gene and turns it on full blast?

    I admit I’m only a software engineer, but this is where the topic gets really interesting for me. Arguably because I’m a software engineer, since DNA is a kind of software. ;-)

    Genes are not as simple as “kid will have autism” or even “kid will have blue eyes”. Most traits are emergent properties resulting from the interaction of multiple genes, but what gets even more interesting is how they interact *over time*, especially during early fetal development. Your hands have the same genes as your eyeballs; how did your fingers know not to grow corneas? This isn’t entirely understood, although scientists are beginning to get a rough idea. It’s really quite fascinating.

    Some diseases with a genetic component are easy to figure out. Some forms of colorblindness, for instance, are due to defects in the genes that code for certain pigments in the cones of the eye. Knock out the gene, the pigment doesn’t get made, and the person can’t perceive the corresponding color.

    Others are more complex. Eye color, while apparently a simple trait with obvious inheritance properties, turns out to involve a lot of genes and isn’t entirely understood yet. Autism is more complex yet, and almost certainly is not a single gene.

    One intriguing line of research going on right now deals with the way the brain organizes itself. In autistics, it seems that the neurons of the brain don’t form connections as readily as in other people, and they’ve identified a genetic basis for this. It has to do with a particular protein being coded wrong. (Such simple things can have quite unexpected results, because of how interconnected our genes are.) People with such a defect aren’t stupid, and they can learn, but they do not learn the same way as normal people do. Depending on the severity, they may have an extremely difficult time getting their brains to form the necessary connections. That’s how we learn, you see — as we learn, we encourage our brains to maintain certain connections instead of other ones, which means that the faster we make connections, the faster we can learn and the more versatile we’ll be.

    Such a trait would not be influenced by vaccines, at least not directly. It would be there regardless. However, that’s not to say the environment can have no influence. If this theory of autism causation proves true (at least in most cases; I strongly suspect that some of the outliers are not the same disorder at all), then it stands to reason that things can aggravate the child’s existing learning difficulty. This is a learning difficulty that goes beyond academics; conventionally, learning disorder means something that screws around with your schoolwork, but I think the term should be broadened to cover the more critical forms of learning, such as learning how to recognize facial expressions — stuff that happens in the first few years of life, before a kid ever sees the inside of a classroom. So, if a child has such fundamental problems learning, then the child’s outcome will depend on a) how bad the difficulty is, b) how lucky the kid gets (because in human learning, there is always an element of luck — those neural pathways are forming at random), c) how much opportunity the child has to observe and experiment with stuff, and d) whether or not the child runs into any unforseen problem that interrupts his/her learning. I’m thinking like a serious illness, brain injury, anything requiring hospitalization, serious stress in the home, moving . . . and just think how much worse it would be if you were an immigrant kid trying to cope with autism *and* a move to a new country. (I kinda wonder if that isn’t part of the reason for the autism rate among Somalis in Minnesota. Kids who are on the edge between autism and normality are under significant stress and have major impediments to learning social functions even without any kind of learning disorder.)

    I’ve rambled long enough, and I think my hubby wants to go to bed, so I’ll close with this. Autism has been around a lot longer than vaccines; it’s just had different names. Sometimes I wonder if it persists in our population not because of toxins but because high-functioning autistics may have significant survival advantages. (The price for that is that some wind up as severe autistics.) Meticulous attention to detail, high spatial awareness, hyperfocusing, and an intuitive grasp of patterns that is less easily fooled by pareidolia. These things are advantageous, especially if they are only possessed by *some* of the group, with the rest of the group expressing a range of other advantages.

    Things that we often think of as disabilities may actually be good things in certain circumstances. Consider colorblindness. Seems like a bad thing, but although a colorblind person will have a harder time spotting the best fruit, they will be much better at spotting the predator lurking in ambush. This is why the military actually prizes its colorblind soldiers.

  57. realitybites says:

    Calli Arcale

    Autism comes from a variety of factors it is a combination of genetic and environmental influences. It is a spectrum with many types and degrees.

    Mild cases may be out grown were other may never function normally and may have other thing such as mental retardation, tourretts, epilepsy.
    `
    If heredity were the only factor, ASD percentages would not be on the rise. The percentages would remain at a fairly constant number. If anything it should be decreasing. Most severe diseases that solely have hereditary as a factor tend to decrease in numbers. When people become educated about their diseases most do not continue procreating either because of the disease or by choice.

    The fact that regressive autism comes on in early childhood and is far more likely to occur in boys implies a strong genetic link and rules out many environmental factors. There is not a life time of exposure to toxins. Vaccines occur early on and have been dramatically increased in the last fifteen years.

    It was not that long ago, mothers were being blamed for autism. Remember the term, “Refrigerator Moms?”

    The reason for a spectrum of disorders is most likely because different genes or combinations of genes are being damaged.

    In mild cases, the brain is less affected and gut issue are less severe. Where, in severe cases, the gut issues are multiplied, thus implying the gut may have something to do with being able to help repair the problem in the brain.
    With identical twin, you would expect them to remain fairly similar in development, but this is not always the case. Environmental damage to their genes can result in differences in gene development between twins. In some cases, one twin can have autism while the other will not.

  58. HCN says:

    According to my son’s neurologist the damage that caused his disorder may have happened in utero, and possibly not the seizures he suffered as an infant, and later while very very sick with rotavirus. So even though there was a definite incident, he still would not put the full blame on the seizures (using the phrase “may or may not be associated with a history of seizures).

    Really, truly… get these books and read them:

    “Unstrange Minds” by R.R. Grinker
    “Not Even Wrong” by Paul Collins

    Both by fathers of kids with autism.

    and in the fiction catagory:
    “Speed of Dark” by Elizabeth Moon, who has an adult son with autism and now she has a blog on the book:
    http://www.speedofdark-thebook.com/blog/

    and “The Curious Incident of the Dog in the Night Time” by Mark Haddon.

    Also, there is no real consensus that there is a rise in the incidence of autism, but a rise in diagnosis. When my son was little it was common for his speech delays to be dismissed (he is twenty years old). I was told over and over and over by “well meaning” people to wait and see, that he will talk when he was ready. But that did not happen, and even after ten years of speech therapy his speech is not normal.

    Actually, go back and read the links I left. I’ve been dealing with a disabled son for a long time.

    My son started a special ed. program when he was three years old over seventeen years ago. The speech therapist there told me that one reason that the district evaluates every child who comes in to catch kids who needed help. One time a pair of twins came to a regular ed. kindergarten with no speech at all, the parents never had them evaluated (it turned out they were both very hearing impaired). They were the victims of “Wait and see, they will talk when they are ready!”

    In my daughter’s private preschool there was a little boy whose speech was immature for his age. I gave his parents all of the speech/language resources I knew about (from the Scottish Rite Center for Childhood Language Disorders to the local university’s very low cost speech clinic), and yet they ignored it. I found out later from the preschool teacher that she tried and tried to get them to have their son evaluated, only to be ignored also. They did come in after the child started kindergarten to tell her that the school district was giving him special ed. therapy.

    This was all before the internet. Awareness has increased much more since then.

  59. Kappatoo says:

    Dear David,

    first of all apologies for reviving this issue.

    I am looking for a reference concerning the vaccination rates in the UK.
    You wrote: “[O]ver the last decade, MMR vaccination rates had fallen below 80% (and in some parts of London, below 60%)”
    , including a link which lead me to a blog called ‘Bad Science’: http://www.badscience.net/2009/02/legal-chill-from-lbc-973-over-jeni-barnetts-mmr-scaremongering/

    Here, I found this: “As Ben pointed out, MMR uptake in the U.K. dropped from 93% to 75% (below the level necessary for herd immunity) and to below 50% in London during the decade after Andrew Wakefield published his dubious research”.

    So I looked for Ben and found him on ‘Respectful Insolence’: http://scienceblogs.com/insolence/2009/02/help_ben_goldacre.php
    Ben says this: “MMR vaccine uptake has dropped from 93% to around 75%, and to below 50% in London.”

    But unfortunately, he didn’t give any reference to back this up. So far, I’ve been unable to find these numbers anywhere else. So, again, my question would be: Do you happen to have any reference concerning these numbers? I am just trying to write a paper (on a totally different topic) and would like to invoke the MMR controversy as an example.

    Thanks a lot in advance,
    Kappatoo

  60. Chris says:

    You should email Dr. Goldacre to ask him where that information is from. You can find his email on his blog at http://www.badscience.net .

    I would hazard a guess that the numbers come from NHS, and I believe I saw that information on a Reuters European news feed, which may have the actual source.

  61. Chris says:

    By the way if you clicked on the BadScience link you provided you would have found a bar plot of measles cases with red bars that get bigger on the right hand side. If you click on it you will find the article it came from:
    http://news.bbc.co.uk/2/hi/health/7872541.stm

    That is where the information came from. It also has links to the Health Protection Agency and NHS Immunisation.

  62. Kappatoo says:

    Chris,

    thanks for your help. I saw the graph you mentioned, but, as you said, it displays statistics concerning cases of measles – not the vaccination rates.

    Your hint concerning the HPA helped a lot. I finally found the numbers here: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733819251

    It seems like the peak was at 93% in 1992/93 and from 1995 to 1997. Numbers dropped to 80% in 2003/4.
    (Statistics for 2007/8: 85%)

Comments are closed.