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

Regular readers of this blog may have noticed that I seem to have taken on the role of the primary vaccine blogger of this little group of bloggers trying desperately to hold the forces of pseudoscience and magical thinking at bay in the face of powerful forces trying to “integrate” prescientific belief systems with science- and evidence-based medicine, a process that would be unthinkable in just about any other field of applied science, such as aeronautics or the physics used in engineering, just as creationists try to “integrate” religion with biology. Although I do have a strong interest in the antivaccination movement in general and the claim that vaccines, or the mercury in the thimerosal preservatives that was in many childhood vaccines in the U.S. until late 2001 or early 2002 (when they were taken out) are a major cause or contributor to autism, such had not been my intention. When I started here on SBM, I had intended to be a lot more diverse. Indeed, I had even had another topic entirely in mind for this week’s post, but, as happens far too often, news events have overtaken me in the form of a story that was widely reported at the end of last week. It was all over the media on Thursday evening and Friday, showing up on CNN, Larry King Live, the New York Times, and NPR. It happens to be the story of a girl from Georgia named Hannah Poling whose case before the Vaccine Injury Compensation Program (VICP), which had originally part of a much larger proceeding known as the Autism Omnibus in which nearly 5,000 parents are petitioning the VICP for compensation based on the claim that their children’s autism were caused by vaccines, was settled by the government. This settlement was based on the observation that Poling had a rare genetic mitochondrial disease that may have been exacerbated by a series of vaccines that she had, after which, among many other problems, Hannah regressed and developed some autism-like symptoms and then months later a seizure disorder. Instantly, it was being trumpeted all over the Internet, blogosphere, and media that the government had “admitted” that vaccines cause autism. One particularly excitable antivaccinationist named Kent Heckenlively (whom we’ve met before), even went so far as to foreshadow the propaganda blitz that was to come as he wrote on the antivaccine blog Age of Autism a full week before this news blitz began:

It’s official.  The sky has fallen.  The fat lady has sung.  Pigs are flying.

[...]

In a settlement, the settling party tries to admit as little as possible.  It’s like what I imagine the settlement claim against Bill Clinton in the Paula Jones case must look like.  Nowhere in the document does he admit to dropping his pants in a hotel room and asking her to kiss it.  It likely says something along the lines of he concedes they were in a hotel room together, they were alone, and something happened which formed the basis of her law suit.

But we all know what happened there.  And we know what this settlement means.

The government just dropped its pants.

One thing this shows us is just how the blogosphere can be bubbling with information that lets one predict a public relations blitz like this. The mainstream press seemed to have been totally blindsided by this story, but if reporters had only been checking the right blogs, they would have known about it a full week before, if not longer. In any case, since Thursday, there has been a very well orchestrated public relations campaign to frame this settlement as the government “admitting” that vaccines cause autism. It’s not, as I will try to explain, but framing it that ways has thus far been a very effective PR strategy for antivaccinationists. In my nearly three years of following this topic, I thought that I had never seen anything like it before.

But I had.

This case is nothing more than a demonstration that everything old is new again and that, no matter what the science says, it’s always all about the vaccines, the claims of antivaccinationists otherwise notwithstanding, as I will now show. What we are seeing now, as we did a few years ago, is the rebranding of autism as a condition in order to serve the purposes of the antivaccination movement.
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Posted in: Public Health, Science and Medicine, Science and the Media, Vaccines

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Toxic myths about vaccines

Ever since there have been vaccines, there has been an antivaccination movement. It began shortly after Edward Jenner discovered how to use the weaker cowpox virus to induce long-lasting immunity to smallpox, there has been resistance to the concept of vaccination, a resistance that continues to this very day. Reasons for this resistance have ranged from religious, to fear of injecting foreign substances, to simple resistance to the government telling people what to do. Some fear even the infitessimally small risk that vaccines pose for the benefit of resistance to disease far more than they fear the diseases themselves, a result of the very success of modern vaccines. Of course, vaccines, like any other medical intervention, are not without risks, making it easy for them to jump on any hint of harm done by vaccines, whether real or imagined, even though vaccines are among the very safest of treatments.

One of the biggest myths that antivaccinationists believe and like to use to stoke the fear of vaccines is the concept that they are full of “toxins.” The myth that mercury in the thimerosal preservative commonly used in vaccines in the U.S. until early 2002 was a major cause of autism is simply the most recent bogeyman used to try to argue that vaccines do more harm than good, as was the scare campaign engineered in response to Andrew Wakefield’s poor science claiming a link between the MMR vaccine and autism. Now that study after study have failed to find or corroborate a link between thimerosal in vaccines or vaccines in general and autism to the point where even the most zealous of zealots are having a hard time defending the claim that mercury in vaccines cause autism any more, predictably the campaign against vaccines has fallen back on the old “toxins” myth. If you peruse antivaccinationist websites, it won’t take long to find articles claiming that vaccines are full of the most terrifying and nasty toxins. Examples in the media abound as well. For example, Jenny McCarthy, comic actress and former Playboy Playmate who has been doing the talk show and publicity circuit lately to plug her book in which she claims that vaccines caused her son’s autism and that she was able to cure it with “biomedical” interventions and diet, recently gave an interview in which she said:

What I really am is “anti-toxins” in the vaccines. I do believe that there is a correlation between vaccinations and autism. I don’t think it’s the sole cause, but I think they’re triggering–it’s triggering–autism in these kids. A really great example is…is, sometimes obesity can trigger diabetes. I do believe that vaccines can trigger autism…It’s so much more than just mercury. That is one ingredient in the recipe of autism…I’m talking about all of them. I’m calling for cleaning out the toxins. People don’t realize that there is aluminum, ether, antifreeze, still mercury, in the shots…People are afraid of secondhand smoke, but they’re OK with injecting the second worst neurotoxin on the planet in newborns.

Another example of what I sometimes call the “toxin gambit” comes from Deirdre Imus, wife of shock jock Don Imus, with both husband and wife being well-known and reliable media boosters of the claim that vaccines somehow cause autism:

So, where are the evidenced based (conflict free) studies that prove the safety of these “trace” amounts and proof that there are “no biological effects” of any amount of mercury being injected into our children and pregnant moms? Also, where are the evidence based studies proving the safety of vaccines given to pregnant moms and our children that contain other toxins such as aluminum and formaldehyde?

The most recent example of this tactic comes from an organization called Generation Rescue, which just last week ran a full-page ad in USA Today, paid for in part by Jenny McCarthy and her present boyfriend Jim Carrey:

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Besides being one of the most egregious examples of a post hoc ergo propter hoc fallacy that I’ve ever seen from an antivaccination site, this Generation Rescue ad demonstrates clearly a new strategy (or, more properly, a resurrection of an old technique) now that science is coming down conclusively against mercury in vaccines as a cause of autism, a strategy of propagating fear by linking vaccines with “toxins.” So what’s the real story? Are there really deadly toxins in vaccines that parents should be worried about?
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Posted in: Public Health, Science and Medicine, Science and the Media, Vaccines

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Alternative Medicine, and the Internet

When I think back to my own ‘discovery’ of the skeptical movement, it grew out of my experience watching the James Randi Secrets of the Psychics NOVA special. After being enthralled with the special (and with several Randi books already in my library) I sought Mr. Randi out on the Internet. In chat rooms, blogs, forums and skeptical conferences such as TAM this is a tale I’ve heard repeated many times; folks heard about the JREF of CSICOP (now CSI) and then used the World Wide Web to learn more about these organizations.

Recently I began to wonder about my own personal pet peeve (unscientific medicine) and how it has benefited from the Web’s huge explosion and influence. Certainly there are plenty of great sites out there that help to show much of so-called Alternative Medicine for what it really is – blogs like this, Dr. Stephen Barrett’s Quackwatch.org site, the National Council Against Health Fraud, and many other important sites; still the number of sites extolling the virtues of science and critical thinking pale in comparison to those that forward notions embracing magical thinking and quack-related products and health claims. A quick examination of the web’s most popular search tool (Google) shows us the cold hard facts about who’s winning the war of medical woo:

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Posted in: Health Fraud, Science and the Media

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Another Acupuncture Claim

News bulletin on BBC NEWS International version, 8 Feruary 2008:“Acupuncture ‘boosts IVF chances.’ Acupuncture may increase the success rates of fertility treatment, according to a study. “

(Manheimer E, Zhang G, Udoff L, Haramati A, Langenberg P, Berman BM, Bouter LM. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. 2008 Feb 7)

First off, how plausible is the claim? The press release states that acupuncture had been used in China fior thousands of years for infertility. Has it? No medical historian writing I have seen made such an interpretation of ancient texts. Maybe I missed something…possible. But acupuncture was not used for specific disorders or purposes, but was used as a sort of panacea to cause balance of either the Yin and Yang or of the relationship of the individual with the 5 elements and the cosmos and the earth. There is nothing specific in claims of acupuncture in traditional Chinese Medicine history. Who gave the news people that misleading lead-in?

Second, what is the plausibility that acupuncture could possibly affect a laboratory procedure on tissue removed from the subject, regardless of timing? Negligible to none. There is no consistent and credible information that acupuncture is effective for anything, except as a conditiong agent for perception of symptoms.

So, does acupuncture increase the success of IVF?

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Posted in: Acupuncture, Clinical Trials, Energy Medicine, Science and the Media

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Science by press release: A helmet to fight Alzheimer’s disease?

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Recently, I’ve had a number of people bring to my attention a news story that has apparently been sweeping the wire services and showing up in all sorts of venues. It is, on its surface, a story of hope, hope for the millions of elderly (and even the not-so-elderly) who are or will be afflicted by that scourge of the mind, memory, and personality, Alzheimer’s disease. This disease is one of the most feared of diseases. A progressive and fatal disease of the brain, it robs a person of his memory and personality, until he no longer recognizes loved ones and becomes too demented to care for himself. The pathophysiology involves the accumulation in the brain of a protein known as β-amyloid, which forms plaques outside of cells, while neurofibrillary tangles believed to be due to the hyperphosphorylation of a protein known as tau develop in dying cells. The exact mechanism by which neuron death occurs is not fully understood, but over time this process leads to a decrease in the amount of gray matter in the cortex. There is no known cure, and the current treatments that we have result in at best a modest delay of the inevitable dementia that accompanies progression of the disease.

Given this grim backdrop and the general aging of the population in developed nations, it is expected that there will be a large increase in the number of people developing Alzheimer’s disease over the next few decades. Naturally, this provides a great deal of incentive to develop more effective treatments. Not surprisingly, sometimes the treatments proposed may sound somewhat outlandish and may even be somewhat outlandish. The treatment about which people were e-mailing me falls into this category, and I haven’t decided yet whether it’s science or pseudoscience. It could be legitimate. What I do know, however, is that I don’t like the way its inventors are promoting it by press conference before any evidence of its clinical efficacy in humans has been accepted by a peer-reviewed publication, leading to a flurry of stories about a new possible “miracle cure” for Alzheimer’s disease grounded in not a lot of science. I’m referring, of course, to the “Alzheimer’s helmet” developed by Dr. Gordon Dougal and his colleagues Dr. Paul Chazot and Abdel Ennaceur at Durham University. Dr. Dougal is a director of Virulite, a medical company based in County Durham in the U.K. Here’s a widely cited article from the Daily Mail that describes the device:
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Posted in: Basic Science, Medical Ethics, Neuroscience/Mental Health, Science and Medicine, Science and the Media

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The infiltration of complementary and alternative medicine (CAM) and “integrative medicine” into academia

A few years back, my co-blogger Wally Sampson wrote a now infamous editorial entitled Why the National Center for Complementary and Alternative Medicine (NCCAM) Should Be Defunded. When I first read it, I must admit, I found it to be a bit harsh and–dare I say?–even close-minded. After all, plausibility aside, I believed at the time that the only way to demonstrate once and for all in a way that everyone would have to accept that many of these “alternative” therapies were no more effective than a placebo would be to do high-quality randomized clinical trials to test whether they worked, and NCCAM seemed to be the perfect funding agency to see that this occurred. Yes, this attitude in retrospect was quite naïve, as I have since learned the hard lesson over several years that no amount of studies will convince advocates of complimentary and alternative medicine (CAM) that their favored therapy doesn’t work, be it chelation therapy for autism or cardiovascular disease, homeopathy, reiki, or various other “energy” therapies that invoke manipulation of qi as a means of “healing,” such as acupuncture, but that is what I believed at the time.
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Posted in: Basic Science, Clinical Trials, Energy Medicine, Medical Academia, Public Health, Science and Medicine, Science and the Media

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On the nature of “alternative” medicine cancer cure testimonials

No doubt you’ve come across them before, either on the Internet, printed advertisements, or radio and TV ads: Alternative medicine cancer “testimonials.” They are the primary means by which “alternative” therapies for cancer (or just about any other disease) are promoted and the primary “evidence” that is used to “prove” the efficacy of non-evidence-based therapies. There’s no doubt that they sure can sound convincing. Typically, what you will see or hear is a chipper-looking and -sounding person who claims that this treatment “cured” his or her cancer. These testimonials almost always include many or all of these elements: First, the cancer patient receives the diagnosis, after which she is lost and suffering at the hands of “conventional” doctors, who either cannot or do not wish to understand and who cannot do anything for her. Often, this will take the form of the classic alt-med cliche that the patient was “sent home to die.” Then, when all hope seems lost, the patient discovers an alternative medicine “healer” or treatment. It is not infrequently described in quasireligious terms, like a revelation or something that brings the patient out of the darkness and into the light. Naturally, there is resistance from the patient’s doctors, family, and/or friends, who warn against it, with doctors warning of dire consequences if the patient abandons conventional medicine. But the patient, convinced by dubious practitioners, friends, and, of course, previous testimonials, “sees” that the treatment “works” in a way that medical science cannot and survives. Infused with fervor, the patient now wants to spread the word. Often, the patient is now selling the remedy. Perhaps you’ve seen such testimonials or heard them on the radio and thought: “Gee, this sounds great. I wonder if it works.”

The answer is: Almost certainly not.
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Posted in: Cancer, Health Fraud, Science and the Media, Surgical Procedures

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A Meeting of Incompatibles

On October 3,4, 2007, a conference at Harvard University School of medicine, the first annual “Fascia Research Conference“ was held, sponsored by a notable group of organizations. Organized by Thomas Findley, MD, Phd, Prof. of Physical Medicine and physiatrist at Veterans Administration Hospital East Orange, New Jersey. It was notable for several reasons, and is of interest to medical objectivists – also for several other reasons. First, the conference was the first research conference devoted solely to the study of fascia (a type of connective tissue) – stated to be a forgotten tissue. Second, it included scientific subjects such as intra-cellular structure and stress changes in fascial cells, but also unscientific ones such as on acupuncture and “Rolfing.”

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Posted in: Medical Academia, Science and the Media

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

Blogging on Peer-Reviewed ResearchOne of the most pernicious medical myths of recent years has been the claim, promulgated by a subgroup of parents of autistic children and facilitated by scientists of dubious repute, that somehow the mercury in the thimerosal (ethyl mercury) preservative used in common childhood vaccines in the U.S. until early 2002 causes autism. Although it had been percolating under the radar of most parents and scientists for several years before, this belief invaded the national zeitgeist in a big way in 2005, beginning with the publication of a book by journalist David Kirby entitled Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy. The fires of hysteria were stoked even higher by Robert F. Kennedy, Jr., who published a truly twisted and misleading piece of pseudojournalism and pseudoscience published simultaneously in Rolling Stone and on Salon.com entitled Deadly Immunity. Relying primarily on quote-mining of the transcripts of both a conference held Atlanta by the CDC to discuss the question of whether autism is related to thimerosal in vaccines and an Institute of Medicine report on vaccines while simultaneously misrepresenting the results of two studies by Verstaeten et al to paint a false picture of a government coverup, RFK Jr. almost single-handedly managed to stoke fears that vaccines were causing an “epidemic of autism.”

I say “almost” single-handedly, because, unfortunately, he had help. Relying on the dubious research of a variety of investigators, such as the father-and-son team of Dr. Mark Geier and David Geier, whose prodigious output of badly designed studies emanating from a lab in their home in suburban Maryland, done using a rubberstamp institutional review board stacked with friends and cronies to approve the studies, and published for the most part in non-peer-reviewed journals, activists loudly insisted that mercury in vaccines was the cause of most autism. Others claiming to demonstrate this link include Boyd Haley, a chemist from the University of Kentucky, and a few other vocal scientists and advocates, who claim that autism is, in essence, mercury poisoning. Facilitating the dissemination of this message were reporters such as David Kirby, activists such as Robert F. Kennedy, Jr., and media personalities such as Don Imus. Indeed, some activists claimed that some vaccines were “poisoning” our children, even going so far as show photos of autistic children with the label “mercury-poisoned“ underneath them on placards held aloft at protest rallies. They made quite a splash then, and still do to a lesser extent even today. There’s just one problem.
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Posted in: Dentistry, Neuroscience/Mental Health, Public Health, Science and the Media, Vaccines

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The Plant vs Pharmaceutical False Dichotomy

A recent web feature produced by the New York Times tells the story of Chris Kilham, “The Medicine Hunter.” Specifically it recounts his thoughts on the use of maca, a root native to South America, “said to have energy and libido enhancing properties,” according to the piece. The brief piece reflects the current attitudes popular in the public and promoted by mainstream media reflecting a false dichotomy between medicinal plants and pharmaceuticals. This false dichotomy is extremely counterproductive and ultimately harmful to consumers.

Kilham represents this false dichotomy when he says:

“My goal is to have more people using safe, effective, proven, healthful herbs, and fewer people using toxic, overly expensive, marginally effective, potentially lethal pharmaceutical drugs.”

There are many unwarranted assumptions in this statement. It seems to be implying that herbs are inherently more safe, less toxic, and more healthful than pharmaceuticals. It also assumes that there is a real difference between the two. Therefore Kilham seems to be saying something meaningful when he is actually just reflecting biased assumptions. This is made clear if we simply reverse his statement. Most people, for example, would agree if I said that “My goal is to have more people using safe, effective, proven, healthful pharmaceuticals, and fewer people using toxic, overly expensive, marginally effective, potentially lethal herbs.”

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Posted in: Herbs & Supplements, Pharmaceuticals, Science and the Media

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