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April is National Autism Awareness Month, and as of today April is nearly half over. Do you notice anything different compared to the last couple of years? I do. Can you guess what it is?

The anti-vaccine movement’s usual suspects haven’t been all over the mainstream media, as they usually are this time every year, often as early as April 1 or even March 31. In fact, over the last couple of years I had come to dread April 1, not because it’s April Fools’ Day (although the things that made me dread that particular day were often indistinguishable from an April Fools’ Day prank, so full of idiocy were they), but rather the expected carpet bombing of the media by the likes of Jenny McCarthy, J. B. Handley, and their ilk, some or all of whom would show up on various talk shows to spread their propaganda that vaccines cause autism. For instance, last year Jenny McCarthy and her former boyfriend Jim Carrey showed up on Larry King Live! with Dr. Jerry Kartzinel (her co-author on her latest book of autism quackery) and J. B. Handley, the last of whom even contributed a guest post on Larry King’s blog, in which he touted an incredibly bad, pseudoscientific “study” commissioned by Generation Rescue. The “study” (and calling it a “study” is way too generous) was no more than cherry-picked random bits of data twisted together into a pretzel of nonsense, as I described. Around the same time, Jenny McCarthy was interviewed by TIME Magazine, an interview in which she uttered these infamous words:

I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it’s their fucking fault that the diseases are coming back. They’re making a product that’s shit. If you give us a safe vaccine, we’ll use it. It shouldn’t be polio versus autism.

Soon after, Generation Rescue created a website called Fourteen Studies, which they promoted hither, thither, and yon. The idea of the website was to attack the main studies that failed to find a link between vaccines and autism and to promote the pseudoscientific studies that anti-vaccinationists like. In 2008, it was pretty much the same — well, worse, even. When she appeared on Larry King Live! with our old “friend,” anti-vaccine pediatrician to the stars, Dr. Jay Gordon, McCarthy shouted down real experts by yelling, “Bullshit!” (behavior trumpeted by Rachel Sklar of the Huffington Post).

This year? Oddly enough (and to me unexpectedly), there’s been almost nothing. J.B. Handley seems to be the man who wasn’t there. Well, not quite. It turns out that J. B. Handley has managed to get a little bit of fawning media attention, but just a little bit, in the form of an interview in The Bloomington Alternative entitled J. B. Handley: It’s unequivocal; vaccines hurt some kids. Apparently Mr. Handley has come down quite a bit in the world. Where’s his appearance with Jenny on Larry King Live! this year? Maybe it’s coming in the second half of the month. Or maybe the mainstream media, in the wake of the fall of Andrew Wakefield, have finally figured out how disreputable Generation Rescue is when it comes to vaccines. In the meantime Steven Higgs will have to do as a new mouthpiece for the anti-vaccine movement.

J.B. Handley: Anti-vaccine warrior that Steven Higgs loves

Regular readers of this blog will be able to spot the misinformation and anti-vaccine propaganda spewed by J.B. Handley in this article. There’s no doubt that Mr. Higgs is very impressed by J.B. from the very beginning of his article, which contains these characterizations of Mr. Handley:

  • It’s not like Handley doesn’t understand the vitriol regularly aimed at him by what he routinely calls “the other side.” He is a pointed, straight-talking pain in their asses.
  • McCarthy’s presence, Handley said, allows him to “hang out in the cheap seats and opine and write my own stuff and challenge people.” And in that regard, his style doesn’t earn him any props with the vaccines-are-sacrosanct crowd — the AAP, the pharmaceutical companies, and the government officials and researchers they financially support. He’s described their positions as “atomic stupidity” in articles he has written. Moron is a term he uses often, in print and in conversation.
  • Even over the telephone from two-thirds of a continent away, J.B. Handley exudes a large personality and supreme confidence in his experiences and conclusions about his son’s autism.

“Atomic stupidity” describes a lot of what Mr. Handley says on a routine basis when it comes to vaccines and autism, although those of us who’ve butted heads with him in the past tend to refer to it as “burning stupid.” My sarcasm and intense dislike for Mr. Handley aside, given that most of the article consists of typical, run-of-the-mill Generation Rescue anti-vaccine nonsense that I and several of my co-bloggers have refuted time and time again, Mr. Higgs’ little opus might hardly have been worth my notice, much less blogging about, were it not for this passage, in which Higgs swallows whole J.B. Handley’s premature gloating about a post that Steve Novella wrote for SBM in February:

“Dr. Novella’s piece details a recent study published in the Journal of the American Academy of Child and Adolescent Psychiatry titled ‘A Prospective Study of the Emergence of Early Behavioral Signs of Autism’ that tried to figure out when signs of autism first emerge in babies,” Handley wrote. “Ironically, the study Novella references is quite supportive of the theory that autism is caused by the environment and most notably vaccines.”

The March 2010 study compared two groups of children, one at high risk for autism and one at low risk, and noted the onset of symptoms in children who developed autism. It found no difference in the frequency of visual contact, shared smiles and vocalizations at 6 months. The differences, however, “were significant by 12 months of age on most variables.”

In a blog post on the Web site Science-Based Medicine, Novella wrote, “What these results indicate is that clear signs of autism emerge between 6 and 12 months of age.”

Novella concluded that the study disproved a link between autism and vaccines. “Many children are diagnosed between the age of 2 and 3, during the height of the childhood vaccine schedule. This lends itself to the assumption of correlation and causation on the part of some parents.”

In an addendum to the blog, Novella acknowledged that he erred when he wrote that line, but he insisted, “Many parents blame their children’s autism on vaccines they received after the true onset of symptoms.”

While Handley didn’t comment on the addendum in his Age of Autism counterpost, he said the original line made him “shout and laugh at the same time.” Children have received 19 shots by 6 months — 52 percent of the total vaccination schedule — when the study says early symptoms of autism begin to appear.

Of course, Mr. Handley didn’t comment on (nor did Higgs link to) Steve’s followup post in his Age of Autism post, because Steve showed very clearly that Handley was, as usual, so wrong that he wasn’t even wrong. In essence, J.B. thought he had found a “gotcha” moment and that one erroneous statement that Steve made in his post was in fact an admission by mistake that the anti-vaccine movement is correct to point out a correlation between the peak ages of autistic regression and the height of the vaccine schedule. Steve admitted his error and then went on to describe clearly why his mistake was not evidence in favor of Mr. Handley’s position.

What was particularly interesting about Mr. Handley’s response was how much it showed that Mr. Handley has been changing his story and shifting the goalposts over the years. In particular, I noticed this paragraph in which J.B. stated:

More importantly, autism is not an event, it’s a process. It is exceptionally rare that I hear the story, “my son was 100% fine, and at 2 years old after one vaccine appointment he lost everything.” I have heard that story, but very rarely.

If Mr. Higgs had dug a little deeper, he might have realized that that’s exactly the sort of story I see time and time again presented by anti-vaccine believers, J.B. included, as “evidence” that vaccines cause autism.” Is this the same J.B. Handley who has touted at least since 2005 how common stories of children declining right after vaccines are? Let’s see, a couple of years ago he complained to the AAP:

Ms. Martin, let me give you a little insight into my world. If I wanted to find parents who had autistic children and who believed their child’s autism was impacted by vaccines, I wouldn’t need to email the nation’s pediatricians hoping I might find one or two. I could just open my window and yell, because these parents are everywhere in my neighborhood and town! Worse, our numbers continue to grow.

You see, not a day goes by without Generation Rescue receiving an email from a new parent who watched their child decline following a vaccination appointment with their pediatrician. While you search for the handful of parents with autistic children who may support immunizations, we can’t respond to emails fast enough from the thousands we hear from who feel vaccines contributed to their child’s autism.

“Not a day goes by …”? To me that sounded very much as though Handley was arguing that regression after vaccination is very common. Let’s look a bit more, say, from a post J.B. wrote before going on Larry King Live! last April:

Finally, we have tens of thousands of case reports of parents reporting that their child developmentally regressed, stopped talking, and was later diagnosed with autism after a vaccine appointment. The number of vaccines have risen along with autism rates, vaccines are known to cause brain damage, and parents report regression and later autism after getting them. Is it really so hard to believe we think vaccines are a trigger?

Wow. Tens of thousands of case reports! It appears to me that in his response to Steve there was more than a little bit of goalpost shifting. After all, the “stereotypical” (or “prototypical”) story of the anti-vaccine movement is of the child between the ages of 1 and 3 who is brought to the pediatrician, receives vaccines. Shortly thereafter, or so the anecdote goes, the child loses language and social skills and develops regressive autism. Never mind that, given the number of children who are vaccinated every year and the number of children who develop regressive autism, there are bound to be overlaps such that by random chance alone there will be many children who regress in reasonably close temporal proximity to vaccination. Never mind that no one has ever shown that this regression occurs more frequently in vaccinated children. Anecdotes like the ones J.B. was touting up until (apparently) now are the very “evidence” that the anti-vaccine movement uses to blame vaccination for autism. And, in all fairness, in a single child not studied in the context of populations, such an event can look all the world as though the vaccine caused the regression even when it did not. Even so, the point is that parents who believe vaccines caused their children’s autism don’t blame a process. They blame vaccines, often specific vaccines like the MMR.

In response to this article, I wrote Mr. Higgs an e-mail. I’ll admit that my tone was a bit peeved. However, it does bother me whenever a journalist give credence to the words of a man who, in addition to having a six or seven year history of spreading pseudoscience fueled by his unrelenting hostility towards vaccines, quite recently publicly gloated that he and his anti-vaccine movement were “early to middle stages of bringing the U.S. vaccine program to its knees.” My e-mail ultimately led to a three-way e-mail exchange between Mr. Higgs, Steve, and myself, and this led me to the definite conclusion that we have a budding Dan Olmsted on our hands.

Who is Dan Olmsted and why doesn’t any legitimate reporter want to be like him? Olmsted is currently the editor of Generation Rescue‘s anti-vaccine propaganda blog Age of Autism. What people who haven’t been following this issue a long time is that Olmsted used to be an investigative reporter and senior editor for United Press International (UPI). Between January 2005 and July 2007, he wrote a series of “investigative” reports in a series that he called Age of Autism (his first installment predating the Age of Autism blog by nearly three years). In the series, he totally bought into vaccine-autism pseudoscience and presented the conspiracy theory through a combination of the same logical fallacies and bad science that undergirds the anti-vaccine movement, including confusing correlation with causation to blame thimerosal in vaccines or vaccines themselves for autism.

Olmsted’s most infamous gaffe was to be, as far as I can tell, the man who originated the myth that the Amish don’t vaccinate and that as a consequence they don’t get autism, a fallacy that Olmsted first reported in a two-part story entitled The Amish Anomaly (Part 2 here) and revisited time and time again. Of course, the Amish do vaccinate, and there are autistic Amish. In fact, Olmsted even missed a clinic in the heart of Amish country that treats autistic Amish children. Unfortunately, facts didn’t stand in the way of a good myth, which has only grown in the five years since Olmsted first imagined it.

Ultimately, Dan Olmsted left UPI (whether he resigned or was fired, only he and UPI know) and is now the editor of the anti-vaccine crank blog Age of Autism, where he can “report” to his heart’s content, free of any pesky concerns about editors insisting on actual facts and science. Steven Higgs looks as though he’s ready to join him.

An anti-vaccine reporter

Unfortunately, when it comes to autism and vaccines, it’s not that uncommon for reporters to fall for the myth. The reasons aren’t hard to understand. If there’s one way for a reporter to establish a name for himself, it’s to uncover a big story, the bigger the better. One category of story that is particularly seductive is the huge health scare, particularly if it’s something seemingly benign that is causing it.

Something like vaccines.

Higgs certainly isn’t the first. After all, David Kirby was seduced by the idea that mercury in the thimerosal preservative that used to be in vaccines was the cause of autism. After he published Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy in 2004, whatever remained of his journalistic career went into the crapper, leaving him to blog for The Huffington Post and, of course, Age of Autism. Then there’s a local connection, Steve Wilson, who up until recently was an investigative reporter for a local television station here in Detroit and who also bought into the myth that mercury in vaccines causes autism, a report that I duly criticized him for, even though I did it with some trepidation. My cancer center has a good relationship with the TV station that Wilson used to work for, and I was concerned that I would catch some flak for criticizing his report, which was nothing more than a rehash of the standard anti-vaccine mercury fear mongering. The sad thing is that Wilson did some absolutely outstanding work uncovering the malfeasance of our former mayor Kwame Kilpatrick. Unfortunately, his skepticism when it came to vaccines was in reality a pseudoskepticism, showing that even good investigative reporters can be crappy science and medical reporters.

Whether Higgs has any redeeming qualities in terms of investigative reporting skills, I don’t know. What I do know is that he has thoroughly drunk the Kool Aid, as demonstrated in spades in a story he published a month ago entitled Do Vaccines Cause Autism? In it, he tries to refute a contention by Dr. Phil Landrigan in a recent paper in which Dr. Landrigan stated bluntly (and correctly): “There is no credible evidence that vaccines cause autism.” In the article, Higgs repeated a number of common anti-vaccine tropes, tropes so common that I don’t feel obligated to answer them all, given that virtually all of them have been discussed before right here on this very blog. Some of them are talking points straight from Generation Rescue. For example:

  • Higgs confuses correlation with causation when it comes to thimerosal. Unfortunately, there is a lot of evidence showing no correlation between thimerosal-containing vaccines and autism. The idea that thimerosal in vaccines cause autism is a failed hypothesis. It’s been tested scientifically and failed.
  • Higgs buys the Generation Rescue line that nations with higher vaccination rates have higher autism rates and that vaccination does not correlate with lower childhood mortality. This is about as bogus a study as I can imagine, incompetently performed using cherry-picked data and not even peer-reviewed.
  • Higgs cherry picks conclusions from a study of thimerosal-containing vaccines and neurodevelopmental disorders other than autism. That particular study produced results that were entirely consistent with random chance correlations from multiple comparisons. Indeed, if Higgs takes the negative correlations seriously, one wonders why he didn’t mention the positive correlations, where children receiving thimerosal-containing vaccines actually had better measurements of neurodevelopmental outcomes. In essence, Higgs cherry picks the bad results and ignores the good results when a careful reading of the study shows that, overall, the effects were consistent with random chance.

I could go on, citing more articles by Mr. Higgs and more refutations of the anti-vaccine talking points that he parrots, but I think you get the idea. If you don’t, I’ll cite Mr. Higgs’ own words:

I’ve spent most of the past 28 years journalistically investigating conflicts between environmental victims and experts in the relevant fields. And, I can say without qualification, the victims have been right and the experts wrong in every significant story I’ve covered. I can’t think of a single exception.

And with respect to vaccines and autism, I say again, without reservation, parents like J.B. Handley and grandparents like Dan Burton are right about vaccines and autism. The experts are wrong, and their behaviors — their vitriolic attacks upon those who disagree, their underhanded political tactics — suggest they know they were wrong.

Although Mr. Higgs denied this interpretation in his e-mails, both Steve and I interpreted this as an accusation of lying. Like Mr. Handley, Mr. Higgs seems incapable of considering the possibility that we have looked at the evidence and honestly come to a different conclusion. I don’t even think he realizes he is doing it, because he seemed surprised when we pointed out that this passage appears to be accusing us and every scientist who point out that science doesn’t support the idea that vaccines cause autism of not just being mistaken but dishonest. As for “vitriol,” I had to wonder if Mr. Higgs had actually seen some of J.B.’s antics, such as his misogynistic attacks on Amy Wallace, his attacks on Steve Novella, and, of course, me. Although J.B. was apparently not responsible for it, the most infamous of all was Generation Rescue’s portrayal on its propaganda blog Age of Autism of Steve Novella and Paul Offit, along with journalists Amy Wallace and Trine Tsouderos (both of whom had written exposes of the antivaccine movement in 2009) as baby-eating cannibals sitting down to a Thanksgiving feast of baby, an image so vile that it disgusted a fair number of Age of Autism’s regular readers and the criticism led to the image and post being thrown down the memory hole.

When it comes to vitriol, as “insolent” as I can be at times, Steve and I remain rank amateurs compared to the anti-vaccine movement, in particular J. B. Handley and his merry band of antivaccine propagandists at Age of Autism.

A closed mind

In my correspondence with Mr. Higgs, to which Steve Novella contributed, I came to the distinct impression that Mr. Higgs had come to view himself as a crusader and, based on his experience, has simplified environmental issues to viewing that experts are always wrong. His experience with previous environmental catastrophes and the reactions of companies responsible for them have led him to the point where he cannot imagine even the possibility that the claim that thimerosal in vaccines causes autism can possibly be wrong or that the experts who point out that science doesn’t support such a link might actually be correct this time. That’s how anti-expert and anti-intellectual Mr. Higgs has he become. Indeed, Steve Novella even called Higgs out on his anti-intellectualism, and, incredibly, Higgs’ response was that had lived in a college town for many years around intellectuals and therefore couldn’t possibly be anti-science or anti-intellectual.

But he is. His writings leave no doubt of that.

As a final example, I will mention two things Higgs cited. First, he cited this video as “the most persuasive evidence I have found thus far,” the one moment in time when he came to believe that vaccine cause autism:

Yes, that’s Bernadine Healy, former director of the NIH, and Mr. Higgs is quite enamored with her. Unfortunately, in recent years, she’s been flirting with the anti-vaccine movement, blaming the American Academy of Pediatrics, the CDC, and other health organizations and “just asking questions” about whether there is a connection between vaccines and autism. She’s also been promoting the idea of a “vaccinated versus unvaccinated” study, apparently not realizing the inherent difficulties involved in such a study. In essence, Dr. Healy, despite her previous position as NIH director (a position she was arguably unqualified for), is not an authority on vaccines. In fact, if you want an idea of how far down the rabbit hole of anti-vaccine lunacy Dr. Healy’s gone, consider that she was named as Age of Autism’s Person of the Year for 2008. If there’s one virtually completely reliable indication that a scientist or physician is well on the way to becoming an antivaccine crank (or has already become one), it’s being named Person of the Year by Age of Autism. It’s like the Nobel Prize, Oscars, Pulitzer Prizes, and Congressional Medal of Freedom for antivaccine crankery and autism quackery all rolled into one.

Finally, Mr. Higgs cited an article entitled Educating the Ohio Valley’s special kids. The interesting thing is that nothing in this article mentions vaccines as a cause of autism. Rather, the entire focus of the article appears to be on mercury and industrial pollution, the argument being that it is that that is correlated with the steadily increasing special education rolls in Evansville, IN. However, in his penultimate e-mail to me, Higgs cited this article and the leveling off of special ed enrollment in 2007 and 2008 as potential evidence for the thimerosal hypothesis, given that thimerosal was removed from most childhood vaccines by early 2002 and a 3 to 5 year delay would be expected after that happened before autism diagnoses would fall if thimerosal-containing vaccines were etiologically linked with autism. In his e-mail, Higgs asked, “I understand that two years does not constitute a long-term trend, but what other constant do you think every child in Indiana may have experienced in 2002 and 2003, other than vaccines?” Of course, as has been found in several studies in multiple locations and countries, there has been no convincing evidence of a leveling off or decrease in autism diagnoses five years after thimerosal was removed from vaccines in various countries, and there has been no convincing evidence of a leveling off or decrease in autism in California. The idea that thimerosal in vaccines causes autism led to a testable hypothesis. Every time this hypothesis has been tested, it has failed.

Curious about Mr. Higgs’ graph, I decided to look at the numbers anyway. In this task I was assisted by some blog buddies of mine, including Liz Ditz, who pointed out that a large number of factors could account for such an increase in special ed numbers and a leveling off in 2007, including the starting of campaigns to identify learning disabilities and their eventual leveling off and the effect of funding incentives on special ed enrollment. Multiple people pointed out to me that this leveling off of special ed cases appears to be occurring among all age cohorts. If thimerosal had anything to do with a leveling off in special ed case loads, it should have a far more profound effect in the youngest groups. It didn’t.

Meanwhile, Joseph was kind enough to provide me with a spreadsheet based on actual data, with special education counts for Indiana coming from here and whole-population enrollment counts coming from the National Center for Education Statistics here. He produced for me four graphs.

The first graph shows all disabilities for children aged 6 to 21:

fig1

Not much of a change over the period covered, is there? Next, we have a graph of all disabilities in the age group that would be most likely to be affected; that is, if thimerosal had anything to do with developmental disabilities requiring special ed:

fig2

Then we have a the same graph for the age group between ages 12 and 17.

fig3

Note how it looks very similar to the graph for ages 3-5. If thimerosal had anything to do with diagnoses leading to enrollment in special ed programs, you would expect to see a huge difference between the 3-5 year age cohort and the teenage cohort.

Finally, let’s look at the graph for diagnoses of autism at age 6:

fig4

Nope. No sign of a decrease in autism diagnoses in 2006 or later, which is what would be expected if thimerosal, which was removed from most childhood vaccines in late 2001, were a major etiological factor in autism. We can conclude from these graphs that Mr. Higgs is either very naive when it comes to data analysis or he saw what he wanted to see and stopped looking. His rush to judgment also belies one of his claims in his e-mails, namely that the science and epidemiology aren’t that hard to understand or do. That is, of course, just plain wrong. They are hard to understand and even harder to do. If they weren’t, then anyone could do them. Unintentionally, Mr. Higgs demonstrated himself that something that looks simple is not, and his looking at it simply led him to make an obvious rookie mistake that led him to the wrong conclusion.

Another Dan Olmsted?

Although admittedly I started out trying to address Mr. Higgs with a bit more “insolence” than might have been advisable, I had a hard time restraining myself, given his swallowing of everything that J. B. Handley lays down and his falling for everything Handley says about Dr. Novella. In any case, I tried to be less “insolent” as the correspondence continued. It nonetheless became clear in our correspondence that Mr. Higgs is a true believer, who really does think that Andrew Wakefield has been unjustly abused by the medical establishement and, amazingly, that J. B. Handley knows what he is talking about. I tried to plant a seed by providing him with a number of links, both from SBM and elsewhere, that refuted key points of the anti-vaccine movement. He said point blank that he wasn’t going to read them, at least at first. Also, in his responses he pointedly called me “Mr.” Gorski, even though after the first e-mail he clearly must have known I am a physician, an intentional bit of disrespect that amuses me far more than offends me, given how often I’ve seen anti-vaccine advocates and alt-med practitioners use it against me. In that, if anything, Mr. Higgs appears less polite than the journalist whose path he seems to be following, Dan Olmsted, or maybe David Kirby, given his fawning three part series interviewing Kirby.

But why?

In Mr. Higgs’ case, I rather suspect that it is really a case of being a true believer. According to him, every environmental health threat he’s seen was accompanied by industry denials and coverups. That may well be true. However, that history has apparently led Mr. Higgs to be so distrustful of what the government and medical authorities say, so suspicious of what “experts” say, that he can’t even consider the possibility that, in the case of vaccines, the experts are actually correct. There is no link between vaccines and autism that science has been able to detect. As passionate as Mr. Higgs may be about environmental pollution, he is, quite simply, on the wrong side of this particular issue and well on the way to becoming another Dan Olmsted supporting the quackery that is DAN!.

Indiana deserves better.

ADDENDUM: Steve Novella has also blogged about this, and he has shown that I might be wrong. It’s not Dan Olmsted whom Mr. Higgs is emulating. It’s Robert F. Kennedy, Jr.

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Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.