Jul 11 2011
Anti-vaccine propaganda in The Baltimore Sun
The hypothesis that vaccines cause autism has been about as thoroughly falsified through research as any health hypothesis can be. Even if, by bending over backward into a back-breaking contortionist pose to be “open-minded”, some people will concede that there’s still a bit of room for reasonable doubt about whether there is no link between vaccines and autism in “susceptible” populations, there is no room for reasonable doubt left over whether vaccines caused the so-called “autism-epidemic” of the last two decades. They did not. Similarly, the mercury-containing preservative thimerosal, which used to be in several childhood vaccines until the end of 2001, when thimerosal was removed from all but some flu vaccines, has been about as cleared of being a cause of autism as it is possible for a substance to be. Basically, if thimerosal-containing vaccines were a cause of autism, we would have expected to see a decrease in autism prevalence beginning three to five years after the removal of thimerosal. Epidemiological studies have failed to find such a decline and have also failed to find evidence of correlation. I realize that anti-vaccine activists argue that there are still trace amounts of thimerosal in some vaccines, but, even so, thimerosal exposure in children fell almost overnight to levels lower than the 1980s, which was before the beginning of the “autism epidemic.” At the very least, one would expect autism rates to fall back to 1980s levels if thimerosal in vaccines were a driving force behind this “epidemic.” They haven’t. Quite the contrary, they’ve continued to climb.
So why does the manufactroversy that vaccines cause autism persist? There is no longer a scientific controversy; by and large, the question has been asked and answered. Vaccines do not cause autism, as far as we can detect. True, it’s impossible to completely prove a negative hypothesis, but if there is any way that vaccines do cause autism, it’s at a level below the ability of large epidemiological studies with tens or even hundreds of thousands of children to detect. Yet the fear persists.
One reason is that it’s very hard to eradicate a false belief, once entrenched. I’ve discussed many times how difficult it is to change people’s minds, as motivated reasoning leads them to seek confirming evidence and discount all else. Disconfirming evidence can even lead people to harden their beliefs even more. In particular, the hardcore anti-vaccine activists who persist in spreading the vaccine-autism myth have an interest and motivation in this mythology at least as potent as the interest pharmaceutical companies have in defending vaccines—more so, arguably, given the emotional attachment people have for their children. After all, all pharmaceutical companies are interested in, according to this mythology, is profit. If a parent, correctly or incorrectly, somehow comes to believe that something or someone has hurt his or her child, it is among the most potent motivations known to do something about it.
Another reason is that the concept has become entrenched in our culture—or at least parts of our culture—to the point where it appears regularly in the media, thus reinforcing the idea among those who don’t pay attention to the issue or those who do but haven’t decided if they believe that vaccines cause autism that maybe there is something to fear. Maybe there is still a controversy. A perfect example appeared in The Baltimore Sun over the weekend entitled We don’t know enough about childhood vaccines and subtitled Researcher asks: Are 36 doses of vaccine by age 2 too much, too little, or just right? I contend that the editors of The Baltimore Sun, by publishing this anti-vaccine propaganda, which would have been at home on the websites of the anti-vaccine blog Age of Autism or on the website of anti-vaccine groups SafeMinds, Generation Rescue, the International Medical Council on Vaccination or the National Vaccine Information Center (NVIC). Examining this article, written by Margaret Dunkle, described as a “senior research scientist at the Department of Health Policy at George Washington University and director of the Early Identification and Intervention Collaborative for Los Angeles County” and as having “a family member who is vaccine-injured,” is what I would consider a “teachable moment” in analyzing the tactics of the anti-vaccine movement.
Anti-vaccine propaganda in a major newspaper
Dunkle’s article begins rather oddly. At least, it could easily strike someone as odd if he isn’t familiar with the rhetorical techniques and bad science favored by propagandists like Dunkle:
The topics of vaccines and vaccine safety spark emotional outbursts at scientific meetings and family dinner tables alike. But many of these debates are remarkably fact-free. Surprisingly few people — not just concerned parents but also doctors, policy makers and even immunization experts — can answer this seemingly simple question: How many immunizations does the federal government recommend for every child during the first two years of life?
The answer is important because most states, including Maryland, faithfully follow the recommendations of the federal Centers for Disease Control and Prevention, codifying CDC guidelines into requirements for children to enroll in school, kindergarten, preschool and child care.
The irony of someone like Dunkle referring to debates over vaccines being “fact-free” is left for the amusement of the reader. Consider the old adage that everyone is entitled to his or her opinions but no one is entitled to his or her own facts. In the case of determining the number of vaccines that the Centers for Disease Control and Prevention recommends for children before age two, the anti-vaccine movement is a master at counting vaccines in such a manner as to make the CDC-recommended vaccine schedule appear to contain as large and scary a number of vaccines as possible. It does this by counting multivalent vaccines, such as the measles-mumps-rubella vaccine (MMR), as individual components, thus multiplying one dose or shot into three vaccines. If you count it up the right way, you can get a total of 36 vaccines, a number and anti-vaccine talking point that appears to date back to a full page ad run in USA Today by Generation Rescue three years ago:
Notice a number of fallacies all rolled up into one big poster-sized ad: “Too many too soon”; the “toxin” gambit; and confusing correlation with causation. Around the same time, Jenny McCarthy started showing up on Larry King Live! using this particular talking point. Prometheus once pointed out that he couldn’t find a way to come up with a total of 36 and thought that Generation Rescue screwed up. Be that as it may, Dunkle continues:
The critical number is how many doses of vaccine a child receives. Why? If a vaccine is strong enough to confer immunity against a disease, it is important enough to count separately.
No, the critical number is not how many doses of a vaccine a child receives. It is the number of antigens to which a child is exposed, and the number of antigens to which children are exposed is much lower than it was 25 years ago as whole cell-derived vaccines have been replaced with acellular vaccines, whatever the “true” number of vaccines as counted by Dunkle is. That’s what really matters.
Going back to find up that old chestnut of an ad on Archive.org, it occurred to me that Dunkle is a bit behind the times. Since that ad ran over three years ago, anti-vaccine groups have managed to find ways to inflate the seeming number of vaccines even higher than 36, such as 48. I tried to find the link, but I’ve even seen a blog post where the blogger was trying to claim that babies get over 60 vaccines before age two. Dunkle needs to get with the program. On the other hand, the number 36 appears to be the “official” talking point number used by most anti-vaccine groups since around 2008; so I’m not surprised that she chose it. I’m also not surprised that she’s bought into the “too many too soon” mantra that groups like Generation Rescue began promoting—surprise, surprise!—about three years ago, when Jenny McCarthy and her then-boyfriend Jim Carrey led a “march on Washington”-style rally under the banner of “Green Our Vaccines” to protest the vaccine schedule.
So where is Dunkle going with all this? Easy. She uses her complaint about the “36 vaccines” or “36 shots” as a prelude to citing a paper that claims to have found that there is a correlation between vaccine uptake and the prevalence of autism spectrum disorders:
A new Journal of Toxicology and Environmental Health study reports that the higher the proportion of infants and toddlers receiving recommended vaccines, the higher the state’s rate of children diagnosed with autism or speech-language problems just a few years later. This analysis is sure to rekindle the debate about vaccine safety.
Not really. It takes solid evidence and a quality scientific paper analyzed well to rekindle a debate. The paper to which Dunkle refers is anything but. Actually, it’s a truly execrable bit of data-mining by Gayle DeLong published earlier this year and entitled A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population. Prometheus and Sullivan have already had a go at this wretched bit of autism “science,” but I’ll comment as well, given that Dunkle used the paper as ammunition in her op-ed piece, that other anti-vaccine activists point to it as “proof” that “too many too soon” is a valid concern, and that DeLong’s paper has not yet been discussed here on SBM. In this case, better a month or two late than never, I say.
How bad can an epidemiology paper be?
Dunkle is actually a bit late promoting this study, as it’s been floating around the anti-vaccine blog underground for well over a month now. One thing that is very apparent from the article and DeLong’s analysis: DeLong is not a scientist. A quick perusal of almighty Google reveals that she is, rather, a faculty member in the Department of Economics and Finance in the Zicklin School of Business, Baruch College/City University of New York. As always, the fact that DeLong is clearly not a scientist doesn’t necessarily mean that she is wrong. Rather, her poor study design, clear lack of some very basic background knowledge about her study subject, and biased presentation are far more likely to indicate that she is wrong. Even so, somehow DeLong managed to get her manuscript accepted to the Journal of Toxicology and Environmental Health, a journal I only vaguely remember having heard of.
I can’t resist pointing out a bit of misinformation right in the abstract. For example, the reason for the rapid rise of autism in the U.S. is not, as DeLong characterizes it, really much of a “mystery.” It’s very likely the result of diagnostic substitution in the wake of the broadening of the diagnostic criteria for autism and autism spectrum disorders that occurred in the early to mid-1990s, as Paul Shattuck has shown and Steve Novella has discussed. Yes, there may have been a genuine increase in autism prevalence over the last 20 years (although even that is debatable), but, if such an increase has occurred, it appears to be so small that it’s not even clear that there was one.
DeLong carries on this sort of misinformation right in the text. Here’s one thing you should know about reading scientific papers. The introduction is where the authors try to “frame” the issue that led them to do the research and the hypothesis that derives from that issue in the most favorable way possible. To the knowledgeable reader or reviewer, a botched up introduction section that misrepresents the scientific consensus and the issues is almost always a sure sign that the science that follows will either (1) not support the authors’ hypothesis; (2) be of such poor quality that it doesn’t really support or refute any hypothesis at all; or even (3) cast doubt upon the authors’ hypothesis, even though the authors spin it otherwise. In this paper, for instance, DeLong argues that there “are several reasons why vaccines may trigger autism,” after which she lists a veritable laundry list of long-discredited anti-vaccine notions, bringing up (naturally!) old anti-vaccine bogeymen like mercury and aluminum. Nowhere is it mentioned that DeLong’s view is not the scientific consensus. Only one side is presented, the anti-vaccine side.
Another way you can recognize a bad introduction to a research paper is by the quality of the research that is cited. In DeLong’s case, the research cited is awful indeed, with citations to papers by SafeMinds and Age of Autism stalwart Mark Blaxill, the anti-vaccine father-son tag team of Mark and David Geier (otherwise known as the doctor with a suspended license and his son busted for practicing medicine without a license), Russell Blaylock (who counts HIV/AIDS denialism, antivax, and many other forms of pseudoscience as part of his repertoire), and Laura Hewitson, whose “monkey business” research was also published in the very same journal in which DeLong’s study appears. There’s more, but these are just some of the examples, perhaps the most egregious of which is a reference by anti-vaccine homeopath James Compton Burnett writing in 1884.
Then there’s the design of the study itself. First (and most egregious), there’s the issue of why DeLong combined speech or language impairments (SLIs) with autism diagnoses to do her analysis. DeLong appears to have used statistics that states are required to maintain under federal legislation, the Individuals with Disabilities Education Act (IDEA). Under IDEA, every school is required to provide data on children who have an Individual Education Plan (IEP), including the students’ primary classification. As Liz Ditz pointed out, IDEA classifications are not medical diagnoses. A child with a diagnosis of autism under IDEA may or may not actually have autism. Also, children with an IDEA classification of SLI are most commonly children with problems in fluency, articulation, or voice, not autism. Examples include apraxia and aphasias, voice disorders, stuttering, and language-based learning disabilities. It’s not for nothing that James Laidler characterized IDEA data as not being a reliable measure that can be used to track autism prevalence accurately.
Naturally, DeLong cites papers to justify lumping together SLIs and autism for purposes of her analysis. None of them support her hypothesis, and her citing them demonstrates that she does not have even a very basic understanding of her subject. For example, she confuses SLI (speech or language impairment) with SLI (specific language impairment). True, this nomenclature can be confusing, but if you’re going to write a scientific paper involving these topics, you need to know the language. DeLong clearly doesn’t know the language. At the very least, that this remained in her paper is a massive failure of peer review on the part of the journal, whose peer reviewers should have picked up on this. Finally, one of the three papers DeLong cited was apparently an error, but she later stated that she had meant to cite other papers, neither of which actually support her decision to lump SLIs together with autism either.
I’m left with the not-so-sneaking suspicion that the only reason that SLIs were lumped together with autism and ASDs for purposes of correlation with the percentage of children in each state receiving their full vaccine schedule is because the numbers somehow worked out the way that DeLong wanted them to. Otherwise, DeLong’s looking at mostly unrelated phenomena that have some degree of overlap. Certainly there appears to be no valid scientific or medical justification for combining the data from the IDEA classifications of SLI and autism.
Then there’s the methodology chosen for trying to find correlations, described here:
Children who are vaccinated at age 2 years may not develop autism until they are older. To determine the prevalence of autism for a specific cohort of children, the vaccination data from when the children were 2 years old is compared with autism prevalence when they are 8 years old. The relevant vaccination data for children who were 8 years old in 2001 are those from 1995, when the children were 2 years old. For children who turned 8 years old in 2002, the relevant vaccination data are from 1996, and so on. The earliest available data–vaccination data from 1995–were matched with autism prevalence up to 2007.
Besides DeLong’s having fallen for the ecological fallacy (group level comparisons rather than individual-level comparisons), she doesn’t provide much in the way of a good justification for why she chose ages 2 and 8 as their vaccine time point and prevalence time point. Then there’s the issue of confounders. DeLong tried to control for ethnicity, but in explicably she used the CDC’s National Immunization Survey rather than, say, U.S. Census data to derive ethnicity figures. Other potential confounders examined included family income, other disabilities, and the number of pediatricians in each state. Of course, states range in size from small to very large, and it can easily be argued that state level data are not “fine” enough to be used for this purpose. After all, many states are quite large, with huge differences in urbanicity. Think, for instance, California, with several large cities separated by huge swaths of rural and mountainous land. Or think Pennsylvania, which is in essence a 360 mile wide state with two very large cities, one east and one west, and several medium-sized cities clustered mostly in the east, all separated by miles upon miles of farm land or mountains. Urbanicity, as you might recall, can have a huge effect on the number of autism diagnoses, as I discussed three years ago. Naturally, DeLong made no attempt to control for urbanicity.
In other words, there’s no reason to put any real credence in DeLong’s study, especially given how small the observed effect appears to be. After reading this study, I was left wondering why on earth DeLong did it. After all, most of DeLong’s previous work appears to involve the study of banking, the FDIC, and financial risk taking. Why did she embarrass herself so by moving out of her specialty? After all, I would never think of trying to do a paper on economics or business and expect it to be accepted to peer-reviewed journal in the relevant academic discipline. As Dirty Harry Callahan once said, “A man’s got to know his limitations,” and I do, for the most part, know my limitations. DeLong apparently does not, and unfortunately Dunkle doesn’t recognize DeLong’s limitations, either.
Sprinkle in anti-vaccine fallacies, mix, and bring to simmer
Besides the invocation of yet another bad study, the rest of Dunkle’s article is a concise listing of a number of common anti-vaccine fallacies. There is, of course, repetition of the “too many too soon” mantra. Then, of course, there’s the “aluminum” gambit:
In addition to the number of doses, vaccine ingredients can be problematic, especially for susceptible subgroups. First are adjuvants, substances added to boost effectiveness and allow smaller doses of vaccine antigen to be used. The most common adjuvant is aluminum, which is found in vaccines for hepatitis and diphtheria-pertussis-tetanus.
There is no convincing evidence that aluminum adjuvants in vaccines are dangerous or cause autism as administered, and there is a lot of evidence that they are safe.
Dunkle follows this up with a combination of the “mercury” gambit and the “toxins” gambit:
Second are preservatives — such as thimerosal, which is 49.6 percent mercury. Thimerosal is still contained in many flu shots, although it was, except for trace amounts, removed from other child vaccines a decade ago. Many child vaccines (including those for diphtheria-pertussis-tetanus, HIB, and hepatitis) contain formaldehyde, which was just added to the government’s list of known human carcinogens.
The hypothesis that mercury in vaccines somehow causes autism or autism-spectrum disorders is a failed hypothesis.
Moreover, the attempt to scare mothers with claims of all sorts of nasty chemicals in vaccines is nothing more than a toxic myth. I once chastised Santa Monica pediatrician to the stars’ children (including Jenny McCarthy’s son Evan), Dr. Jay Gordon, for invoking the “formaldehyde” bogeyman. Formaldehyde is actually a normal byproduct of human metabolism, and a typical 5 kg two-month-old infant has about 1.1 mg of formaldehyde circulating in his blood, which is five times more than any vaccine contains. As for formaldehyde’s recent addition to the list of carcinogens by the National Toxicology Program, it should be noted that this is for higher exposures. As the National Toxicology Program itself points out on its fact sheet:
Studies of workers exposed to high levels of formaldehyde, such as industrial workers and embalmers, found that formaldehyde causes myeloid leukemia, and rare cancers including sinonasal and nasopharyngeal cancer.
As always, the dose makes the poison, and the tiny amount of formaldehyde in vaccines is not the same thing as the amount of formaldehyde that to which industrial workers are exposed in industries where formaldehyde is manufactured or used extensively or to which embalmers are exposed. If you peruse the scientific report issued by the National Toxicology Program, you’ll see that all the supporting studies involved rather large exposures, far more than any vaccine exposure. Dunkle’s citing formaldehyde as a carcinogen has about as much relevance to vaccine safety as the observation that people can drown in lakes does to discussions of the optimal amount of water people need to drink each day.
Unfortunately, either through advocacy, knowing an editor, or taking advantage of an editor’s desire to publish something interesting and controversial, anti-vaccine groups and activists manage to get articles like this one by Margaret Dunkle into major newspapers. Sometimes, it’s reporters themselves who fall for harmful pseudoscience like this. (Sharyl Attkisson, Steve Higgs, and Steve Wilson, I’m talking to you.) In either case, such articles and reporting represent massive failures of fact-checking, objectivity, and journalistic responsibility, and that’s exactly what The Baltimore Sun is guilty of by publishing Margaret Dunkle’s propaganda.
129 Responses to “Anti-vaccine propaganda in The Baltimore Sun”
We could really use some science-based commenters over at that article. The anti-vaccine brigade is there in force.
What is it with economists and non-sticking to their field of expertise? I have also encountered this phenomenon with history and Professor Thomas James DiLorenzo’s modern neo-Confederate writings.
I would like to think that you have something to do with the Baltimore Sun posting this just 3 hours ago:
http://www.baltimoresun.com/news/opinion/oped/bs-ed-vaccines-misinformation-20110711,0,7382652.story
Small correction, it looks like the article was posted earlier this morning.
Feel free to post a link to this post.
the aluminum thing is a non-starter. Formula-fed babies (83% of babies in the US) receive an exponentially larger amount of aluminum than what’s in vaccines, and even exclusively breastfed babies receive an equivalent amount.
You don’t see anti-vaxxers going against the formula companies, though.
Spot on!
There are people around the globe who would be very willing to accept the vaccinations the anti-vax people don’t want. I’m sure I’m not the first to say it, but our very success with modern medicine may well have contributed to a false sense of security, where vaccines are viewed not only as not necessary they become poison to those fortunate enough to be healthy and an easy target for those who aren’t. When people don’t remember what epidemics are really like, it becomes easier to rationalize away the logical inconsistencies.
Ooops, that should be “they are seen as poison” not “they become poison.” in my last comment.
Hello friends –
There is no longer a scientific controversy; by and large, the question has been asked and answered. Vaccines do not cause autism, as far as we can detect.
Bogus argument. We haven’t looked. We have only asked if:
a) Thimerosal effects autism rates.
b) The MMR effects autism rates.
That’s all. There is not, absolutely is not any ambiguity on this issue.
True, it’s impossible to completely prove a negative hypothesis, but if there is any way that vaccines do cause autism, it’s at a level below the ability of large epidemiological studies with tens or even hundreds of thousands of children to detect.
I defy any reader of this site to provide a study that involves ‘tens of thousands of children’ that studies anything other than the MMR or thimerosal with regards to autism. If such studies are available, this should be a simple, simple task. These studies don’t exist, and the regular readers of this blog absolutely know this. You know this. Anyone who considers themselves a skeptic that is not taking Dr. Gorski to task for spouting this dingo kidney, fact free argument should be ashamed of themselves. There is a big difference, developmentally, between a newbord or two month old and a child who is a year old, when the MMR is given. This shouldn’t surprise anyone, so why pretend that studying the MMR is equivalent to studying the vast majority of the vaccine schedule, given at much, much earlier ages? Why?
No, the critical number is not how many doses of a vaccine a child receives. It is the number of antigens to which a child is exposed, and the number of antigens to which children are exposed is much lower than it was 25 years ago as whole cell-derived vaccines with acellular vaccines, whatever the true number of vaccines as counted by Dunkle is, and that’s what really matters.
This is an absolutely, positively, evidence free argument.
Why is the number of antigens a child is exposed to ‘what really matters’? Why? How on Earth did you come to this conclusion? This statement cannot be substantiated through the literature, or even, commen sense.
I challenge anyone, anyone to defend the idea that the number of antigens a child is exposed to is meaningful in this regard. What mechanism is supposedly at play to make a reduced number of antigens ‘critical’? What mechanism? Seriously.
The varicella vaccine has 69 antigens in it, but the Hep B only has 1 (see Dr. Gorskis link above for validation on this). Does this mean chickex pox vaccination is sixty nine times more anything than the Hep-B? Sixty nine times more, what? Does it then follow that the varicella vaccine has sixty nine times the immunological impact compared to the Hep-B vaccine? Does anyone think this is true?
Does anyone here have an explanation on why the CDC reports that the DTP (5 antigens) cause adverse reactions more frequently than the chicken pox vaccine (69 antigens), when it has so much fewer antigens in it? If addition is a meaningful metric for determining how a vaccine will affect an infant, someone please, please make sense of these facts for me.
This is what scares the heck out of me about this discussion; it doesn’t really matter that Delong, and AOA, and Safe Minds and the rest are idiots (they are), but the fact that other people are making dumb arguments does not give you free reign to generate evidence free statements and pretend they are meaningful. The tragic facts on the ground are that the ‘Antigen gambit’ is as good as it gets when someone wants to defend the fact that we really haven’t evaluated the vaccination schedule. That’s one point that AOA has correct, we haven’t studied the effects of the vaccine schedule, we just haven’t. Pretending otherwise is still pretend. This is a reality that isn’t going to change no matter how many times we count the antigens in the vaccination schedule, perform subtraction, and declare sanctimonious victory.
We can admit that vaccines work at preventing infection, they have saved millions of lives, and the threat of declining herd immunity is real while still having the intellectual courage to acknowledge we haven’t really studies the effects of our actions. Infancy is a priviledged timeframe and changes during that time can have difficult to predict, and lifelong effects; continuing to ingore this reality does nothing to change it.
- pD
Maybe Prometheus is Math-deficient. All he has to do is to visit the CDC website and count. 36 is spot on.
List them out Troll1/Troll2.
You can only get there by counting the MMR and DTaP as three each, yet ignore the other vaccines that have multiple strains of the same disease. Plus include the annual influenza shot that most still don’t get, and the vaccines recommended only to certain high risk populations.
You are the one who claims toddlers will gladly stay on the sidewalk. Show us you know how to get up to that magical number.
pD,
You’re not just exposing them to antigens but you’re infecting them with pathogens.
I can see clearly the degree of ignorance you have by comparing two different vaccines.
Don’t expect a squirrel to come out when you’re barking up the wrong tree.
You’re clueless and you can’t even start off with a valid claim.
Chris,
HepB x3
RV x3
D x4
T x4
aP x4
Hib x4
PCV x4
Influenza x1
Measles x1
Mumps x1
Rubella x1
Varicella x1
HepA x2
Total= 36
IPV x3
Chris,
Go figure. There’s no magic.
HepB x3
RV x3
D x4
T x4
aP x4
Hib x4
PCV x4
Influenza x1
Measles x1
Mumps x1
Rubella x1
Varicella x1
HepA x2
IPV x3
Total= 36
Waiting for analogies in 3….2….1….
Just like I said.
The MMR and DTaP are one vaccine each, though they have three separate antigens. There is no separate measles vaccine, and the same goes for mumps, rubella, tetanus, diphtheria and pertussis. To be consistent you need to list the ones that have separate antigens for each strain the same way. And no, I am not going to tell you what they are.
And like I said, you used “influenza”, a vaccine that not very many kids actually get.
Troll fail.
My response:
Oh Dear The Baltimore Sun is Running A Multiply-Mendacious Opinion Piece on Vaccine Safety
@PassionlessDrone
You make a few valid points but they are, I think, relatively nit-pickishy. The thrust of your argument still seems to amount to asking for proof of a negative.
What is to prevent me from asserting that vaccines cause psoriasis, rouse the rabble, and insist on rock solid proof that there is no link between the (nonexistent) explosion of infantile psoriasis and, say, the chicken pox vaccine?
The anti-vax mob has tried to link thimerosal to autism. Asked and answered. No link. If they believe there is some other link isn’t it incumbent upon them to lay out what they think that link to be and support the allegation with some plausible hypothesis?
And please, PLEASE, I beg of my fellow occasional commenters: do not feed the troll. As WLU suggested, it is like having a conversation with a lobotomy – but less meaningful and much less fruitful.
What windriven said. Rule 14.
Everyone keep in mind that if any of us respond, we’ll be waiting for logical fallacies and a demonstrably wrong understanding of biology in 3…2…1…
Dr. Gorski,
I think you are being a little unfair to Dunkle. Her aim might have been way off,but you have to give her credit on her bullseye drawing skills
Chris,
Hence, they are called polyvalent vaccines each with three different disease antigens combined in a single dose. So regardless on how they were prepared (monovalent or polyvalent), MMR and DTaP correspond to six different infectious disease antigens.
Oh I see your problem. You think that I’ve counted the MMR and DTaP each having with 3 different strains? NO! I’m not referring to serotype-specific strains but rather the MMR and DTaP are genus- specific which represents six infectious diseases.
Oh I’m pretty sure you don’t have anything to say this time.
It is highly recommended and you’re acting like a contrarian.
You don’t have any evidence for it. You know I have humiliated you again.
I shall ignore the troll now, since it has completely failed again.
Ahahahahahahahaha. Awesome.
@AllieP
Not so fast! I have actually encountered a number of moms who were anti-vaccine, anti-infant formula, and anti-fluoride all at the same time. It isn’t fun giving a talk knowing there is a triple-layer minefield for everything you say topped off by some of them actively lobbing bombs to get you to say something slightly debatable.
passionlessDrone,
Any evidence that any vaccines contribute to autism at all is questionable because, as Dr. Gorski mentioned, the rate of autism has not been found to be increasing, regardless of what changes in vaccine schedules have been made.
As for the antigens, I believe Dr. Gorski’s point was that anti-vaxers are counting vaccines inconsistently, sometimes claiming that it is the number of antigens that matters (so MMR counts as three) while other times claiming it is the number of doses with the same antigen (so multiple doses of the same antigens count as more than one). They should pick one or the other and stick with it; doing otherwise is deceptive.
It could be said that the number of doses matters because each dose contains the ingredients of concern (“toxins”), which would be a valid point if the ingredients were actually harmful.
When it is pointed out that the ingredients are NOT harmful, some anti-vaccine proponents claim that it is the number of different diseases immunized against that matters (i.e. number of antigens); that too many antigens in too short a time overloads the immune system. This is where Dr. Gorski’s statement matters; the number of antigens has actually decreased.
Get it?
William,
and simple Mathematics combined.
@AllieP
From what I’ve seen, anti-vax and anti-formula go hand-in-hand. Both harbor irrational suspicions that big corporations are secretively slipping their kids “toxins”, and that government-funded studies showing the products are safe only prove the government is complicit. They also tend to favor “natural childbirth”, homeschooling, and anything else they can do to protect their children from the government and corporate forces out to exploit their kids for financial and political gain.
“After reading this study, I was left wondering why on earth DeLong did it.”
“In DeLong’s case, the research cited is awful indeed, with citations to papers by SafeMinds…”
Perhaps that has something to do with the fact that she is a member of the executive board of SafeMinds:
http://www.safeminds.org/about/executive-board.html
(right above Deirdre Imus)
The Bible includes a piece of advice related to Rule 14:
“Answer not the fool according to his folly, lest you too become like him.”
- Proverb 26:4
Bacteriaphile,
You make no sense.
You’re not immunizing against diseases but rather you’re deliberately infecting them by inoculating them with disease antigens, not once, but repeatedly. Get it?
So a two year old child would have been intentionally exposed by ignorant parents and doctors to 14 infectious diseases 36 times. They stink like a cesspool indeed.
First of all, I have to agree with both the thrust of Dr. Gorski’s post and the critique presented by passionlessDrone.
The fact that there is no link between thimerosal or MMR and autism does not exculpate other vaccines components (antigens, adjuvants, preservatives, etc.). The simple fact is that we don’t know and we should be comfortable in being honest about that fact (if pD and I are mistaken, please provide the evidence).
Vaccines are, indeed, very safe as far as we know. That knowledge, however, has boundaries. So who has the burden of proof regarding the safety of childhood vaccinations and the risk of developing autism?
I think it depends on the claim is being made. The only honest statement that can be made is that there is no KNOWN link between any childhood vaccinations (or combinations) and autism. We cannot claim that DTaP or Varicella or Hep B do NOT cause autism any more than the anti-vaxers can claim that they do.
Bacteriaphile, however, correctly reminds us, that have no credible evidence that we actually have an autism epidemic (See Gorski above citing Shattuck). Is it even worth investing research funds to examine a link between other vaccines (or their components) and a non-existent epidemic?
This is where I’m a bit torn between Gorski & passionlessDrone. On the one hand, the benefits of vaccination are extremely well documented and there is currently low prior probability that any link exists since there’s no real epidemic. So why bother?
One reason might be that the Shattuck study could be wrong. Retrospective epidemiological studies are far from perfect. Maybe the increase in autism rates is only partially explained by changing diagnostic criteria. pD is also right in pointing out that there are significant differences between a 2 month old and a 12 month old (although that doesn’t mean that they are necessarily more susceptible to the post-natal induction of autism). Maybe we should just study it just to eliminate these arguments from the table.
But wait!! Won’t they just move the goal posts again? Studying MMR and thimerosal hasn’t removed them from table. I think this is my biggest reservation regarding this kind of research. Then again, I won’t fault anyone for conducting it. It would probably be money better spent if it was used to study multiple adverse outcomes rather than autism alone.
pD may be satisfied with such a study but the hard core anti-vaxers won’t. They’re convinced that vaccines cause autism and it’s just a matter of finding the actual mechanism (or not). We’d do much better to find the actual cause(s) of autism spectrum disorders.
In the meantime, I’m going to continue to whole heartedly recommend the current vaccine schedule because I know the benefits and despite the limitations of my knowledge have NO evidence demonstrating any link between vaccines and autism.
One final note regarding # of antigens vs. number of shots, vs. number of whatever. Unless there’s a link between A and B there’s no point in discussing what component of A is the causative agent. Until we know whether DTaP causes autism there’s no point in arguing whether it’s D, or T, or formaldehyde, or the needle stick itself or whatever.
NB–how do you quote text from another post in that separate bold way?
@SloFox
At the beginning of the section you want to quote, but blockquote between the less than/greater than symbols. At the end of the quote, put /blockquote between the symbols.
SloFox, here are the commands. Change the square brackets with less than and greater than symbols:
[blockquote] Put Text here. [/blockquote]
To bold: [b] put text here [/b]
To italicize: [i] put text here [/i]
To post a link: [a href="http://webpage.xyz"]put text here [/a]
And remember that there are several epidemiological studies that show no relationship between vaccines and autism. So trying to find what ingredient causes autism is actually quite silly, since there is no evidence that vaccines cause autism.
Hi Windriven –
The thrust of your argument still seems to amount to asking for proof of a negative.
The thrust of my argument was that we shouldn’t be engaging gross over simplifications, or indeed, stretching the truth, when making arguments concerning national health policy.
Regarding the utility of counting antigens, you might consider re-reading Dr. Gorski’s prose. Dr. Gorski wasn’t responding to any claim about the number of antigens, but rather, explicitly making the claim that the number of antigens a child is exposed to is ‘critical’, as opposed to the number of vaccines given. How is it nitpicky to ask him, or anyone, to explain critical towards what? This could all be solved very simply by pointing to the appropriate scientific literature that shows that the number of antigens in a vaccine is meaningful in terms of adverse reactions, or anything else. If his statement can’t be defended scientifically, one might begin to wonder, why make it at all?
This is a forum where, in most cases, the ability to back up arguments with appropriate references is deemed the currency of legitimacy. Dr. Gorski simply can not provide any such references to defend this claim of criticality. There shouldn’t be any free passes awarded due to expediency towards a preferred conclusion.
If they believe there is some other link isn’t it incumbent upon them to lay out what they think that link to be and support the allegation with some plausible hypothesis?
Yes. Of course. A few things:
1) The autism population has been shown repeatedly to have a dysregulated immune system. Saliently towards this discussion, the increased production of inflammatory cytokines in response to stimulation, increased levels of baseline cytokines, DAMPS, upregulators of toll like receptors, and a state of chronic neuroinflammation. I’m tight on time, but would be pleased to provide references towards any or all of these later this evening or tomorrow, if you would like. (?) I’d bet if you googled my handle and SBM, you’d find a good overview of what I am talking about.
2) There is a growing awareness of the concept of developmental programming; the idea that early life experiences can persistently modify physiology. There are well over two dozen animal models of early life immune challenges that find a bewildering array of behavioral and physiological outcomes with strong parallels to what is found in autism. I would specifically recommend research by Pittman or Bilbo in this regard. The research behind maternal (i.e., prenatal) immune challenge and subsequent increased risk of autism is strong; but that doesn’t mean that influences stop happening after birth.
That is the very short version. The real world awaits.
- pD
“Vaccines are, indeed, very safe as far as we know. That knowledge, however, has boundaries. So who has the burden of proof regarding the safety of childhood vaccinations and the risk of developing autism?”
The entity that is claiming the association must bear that burden, at least to the point of demonstrating that the association is unequivocal or nearly so. Otherwise, as I suggested earlier, what stops individuals and groups from claiming all manner of associations between their emotional/social/political target and some awful condition?
@pD
Please do not associate me with the antigen counting business. Not my argument.
I certainly agree with you on the importance of keeping strictly to the facts. But I would also point out that this is a blog, not a journal. Dr. Gorski and the other bloggers here have been pretty scrupulous about sticking to the facts but it isn’t realistic to expect an encyclopedic reiteration of all the particulars of the vaccine debate every time the subject arises. The blog would be eye-glazingly boring to all but vaccine debate virgins. That is why I characterized your objections as valid but perhaps a bit nit-picking. Today’s blog needs to be viewed as one part of Dr. Gorski’s continuing discussion in these pages of the vaccine issue.
The Shattuck study from a few years back is, of course, by no means the only study suggesting that diagnostic substitution is a primary driver of the “autism epidemic.” Steve Novella cites several of them in his post to which I link in my post, and there have been more recent ones since Steve’s post three years ago.
As for my language, I’m very careful to point out that we can’t ever completely prove a negative. Even so, multiple studies done in multiple countries by different investigators using different methods and populations have failed time and time again to find a correlation between vaccines and autism. It’s very compelling evidence. It all boils down to considering prior plausibility of the hypothesis (which is low), adding in plausibility based on the studies done thus far (which is even lower), and asking whether we’ve done enough research to conclude that it is highly unlikely that vaccines are a cause of autism (we have). The bottom line is that the hypothesis that vaccines cause autism is a hypothesis that is pining for the fjords. For simplicity’s sake, rather than repeating all the caveats each and every time I say it, I sometimes use the shorthand that goes something like this: As far as we can tell from existing studies, vaccines do not cause autism.
Impossible. How could they have a business when they don’t even know how to count let alone what to count. Yes, I’m talking about SBM bloggers like Chris, Prometheus, Gorski, et al.
Dr. Gorski:
It is my opinion that no more federal dollars go to anymore of these studies. If the folks at SafeMinds, NAA, NVIC, Generation Rescue and others who keep pounding on this dead horse of a while goose chase: then they can go ahead and fund them with their own funds.
Though they better be sure to have the proper IRB (Institutional Review Board) paperwork in place. Unlike the “study” by a bunch of lawyers in New York.
@pD
Why is the number of antigens a child is exposed to ‘what really matters’? Why? How on Earth did you come to this conclusion? This statement cannot be substantiated through the literature, or even, commen sense.
It’s true because Paul Offit said it is.
We have some fairly compelling evidence that autism is determined prior to birth by genetics and/or environmental factors, so arguments based on anything postnatal are suspect.
Just having to argue that the MMR shot contains 3 vaccines demonstrates how delusional vaccine zealots are. Anyway according to Wiki:
A vaccine is a biological preparation that improves immunity to a particular disease.
and according to merriam-webster, particular means:
of, relating to, or being a single person or thing
So since the measles, mumps and rubella are not a “single” thing, the shot contains 3 vaccines.
The number of vaccines given together is meaningless. In addition to the textbook definition, I have personal experience in animal studies. I have given two T-dependent immunizations at the same time and seen no interaction. I have given two T-independent immunizations at the same time and seen no interaction. I have given a T-dependent, T-independent and a mucosal immunization simultaneously and seen no interaction. They do not potentiate or inhibit one another unless designed to do so. The antibody repertoire is enormous and large changes in a few antibody titers are drops in a bucket.
The number of antigens given is meaningless. You are exposed to hundreds of thousands of antigens every day via skin, the mucosa, small wounds, etc. It is the immunogenicity of the antigen that matters, and the body does a great job of sorting out antigens to ignore and antigens to attack (there are exceptions of course). A minimum level of immunogenicity is required for the vaccine to “take” and form protective antibody titers with adequate memory. More immunogenicity in this case is not bad because the vaccine “takes” much better – measurable improvements in protection in clinical trials. You have to change the immunogenic mechanism entirely to get into significant health trouble, e.g. bacterial sepsis and LPS – a type I T-independent antigen.
Class dismissed.
I guess vaccine apologists find it hard to count from one to three than letting a toddler to walk in the sidewalk. They should not be trusted in any case nonetheless. They are dangerous.
If MMR equals 3 and add Varicella (ProQuad), how many now?
If DTaP equals 3 and add Polio (Kinrix), how many now?
If DTaP equals 3 and add Polio and Hep B (Pediarix), how many now?
I hope Dora the Explorer can help them this time.
@Th1Th2
Kasdfnqwefeuiofn. Aoewnt. 3909908 = 222134l9 szkl, therefore hawjkf asd;ikoniu!
Good. We’re all in agreement now.
JPZ,
What particular vaccine/s did you administer?
An obedient yet ignorant parent would have already exposed the naive child to 14 KNOWN infectious disease pathogens repeatedly up to 36 exposures by age 2. The number of ubiquitous antigens we are naturally exposed to is meaningless unless they were derived from known pathogens.
Vaccine antigens are not an exception. They are recognized as infectious antigens.
Again, that is demonstrably false. The more similar a vaccine is to the disease-causing microorganism, the better the immune response to the vaccine.
It has been demonstrated beyond doubt that Th1Th2 and Sid Offit are total idiots and have no idea about medicine or vaccines resembling reality. Whatever they spew is the product of their deranged minds. They are poster children for what’s wrong with education in the US. Pay no attention to them.
Windriven
“Kasdfnqwefeuiofn. Aoewnt. 3909908 = 222134l9 szkl, therefore hawjkf asd;ikoniu!”
I’m afraid that 3909908 is incorrect. If you knew anything, it would be obvious that you meant 390990. Of course, the subjective nature of your variables undermines your point.
@michele-
Thanks for pointing out my mistake. You’ll note that Th1Th2 missed it completely!
@micheleinmichigan
Are you mad! It is demonstratably false that 390990 and you of all people can’t even start off with a valid claim of 390990. You’re acting like a contrarian librarian! Don’t expect a squirrel to come out barking when you’re up the wrong tree. If you only understood that the definition of infectious requires a microorganism to get you to 390990. And I refute your 390990 by saying a pathogen requires a microorganism to szkl – you don’t have any evidence for it! Everything I have said is self-evident, and your requirements for data must mean you are in the pocket of the global conspiracy to protect children with vaccines. They are not being protected – you are killing them with whatever those things are in that hypo that I don’t understand but I must pontificate about because you keep replying! I must! It feels SO good! I will continue to make up any baseless argument whenever I like about 390990 without the need for facts because you know I have humiliated you once again!
Do you give up now or shall you send me more delightfully cutting arguments so that I might continue to excite myself enough to annoy you and your fellow baby killers? You fools! Nothing, NOTHING will stop me from posting as long as you replies fuel my enthusiasm!
Th17
The sad and funny thing is that the person that these posts are a response to may not even know he/she is being ridiculed. Kind of like much of the discussion that flew over his/her head.
@Chris
Of course! That is why we decided to ignore her and entertain ourselves with wacky posts at her expense. She really doesn’t have anything to do with our fun. Totally irrelevant and ignored.
390990.
Sweet.
It is more explanatory than 42 or 19.
“Everyone is entitled to his or her opinions but no one is entitled to his or her own facts”
This ‘power to the people – the masses are always right’ notion is explored to its fullest extent in John Locke’s ‘Two Treaties of Government’ – the book that greatly influenced Thomas Jefferson and his writing of ‘The Declaration of Independence’.
“If thimerosal-containing vaccines were a cause of autism, we would have expected to see a decrease in autism prevalence beginning three to five years after the removal of thimerosal” (BE)
Hatter’s went mad as a result of mercury being used in the production of ‘top hats’ to make them shine.
The mercury-containing preservative thimerosal … was ‘removed’ from all but some flu vaccines, has been about as cleared of being a cause of autism as it is possible for a substance to be”
Man on cell-phone: “Hello Zeke – that you?”
“Hi there Billy-Joe – yup – its me alright. Yu sound flummoxed Billy-Joe – what gives?”
“Its ma prize bull Zeke – he’s a salivatin, he’s aff his food – an his tongues kinda hard.”
“Sounds like yer bull’s got a case o ‘wooden tongue’.
“Ma bull means avrythin to the success of ma cattle farm Zeke. Wattle a do?”
When ma bull had ‘wooden tongue’ ah gave him turpentine.”
“Thanks Zeke” (click)
Two days later
Man on cell-phone: “Hello Zeke – that you?”
“Hi there Billy-Joe – yup – its me alright. Yu sound flummoxed Billy-Joe – what gives?”
“Ya know ya said ma bull had ‘wooden tongue’ and ah wuz to give him turpentine. Well ma bull jest keeled over an died on me.”
“Mine did too Bill-Joe – you have a nice day ya awl”
@ Harriet Hall
“We have some fairly compelling evidence that autism is determined prior to birth by genetics and/or environmental factors, so arguments based on anything postnatal are suspect.”
BRAVO Harriet – got it in one!
@ windriven –
Fair enough, and I imagine that your point regarding the interest of most to these points is small.
@ Harriet Hall –
We have some fairly compelling evidence that autism is determined prior to birth by genetics and/or environmental factors, so arguments based on anything postnatal are suspect.
I’ve been thinking about this lately, and I can’t figure out why we have drawn a sacred line at birth when the system we are trying to understand is so complicated and is clearly dynamic.
For example, if your mother smokes while pregnant, you are at a greater risk of asthma. Should we take this to mean that a mother who smoked during pregnancy might as well go ahead and smoke in the infants room while he sleeps? If a person suffers multiple concusions, should we not worry about future concusions, as they’ve already had one? Why is there no room for repeated insults acting in an additive, or synergistic way in these discussions? What is so special about the day of birth that means that we can no longer affect entangled and massively complex systems, for good or bad, with our actions?
This is salient towards vaccination because we have an abudnance of evidence that an immune challenge in utero is capable of disturbing the developmental trajectory towards autism. Recently, we also have evidence from multiple angles that implicates a state of chronic inflammation during pregnancy as an increased risk factor. As I mentioned above, a finding widely replicated in the autism population is a tendency towards a state of increased inflammation; be it baseline cytokine profiles, altered innate immune responses to some TLR ligands, increased levels of factors known to upregulate TLR responses, or a state of sustained and chronic neuroinflammation. Not only that, but much research points contains a directional correlation with severity; as measures of inflammation increase, so too do behavioral symptoms.
The fact that because a state of acute or chronic inflammation in utero is a risk factor for physical changes that mainfest behaviorally is no reason to believe that there is something magical about birth that means we can’t be interacting with the affected systems after birth.
There is a wealth of recent evidence that immune challenges in the periphery result in an immune response within the CNS. So lets assume that we have an infant whose particular path towards autism has been ‘determined’ by an gestational environment characterized by a state of inflammation. Within a few days of birth, they get Hep-B, sixty days later, they get several vaccinations, and again sixty days after that. If this infant has been ‘primed’ to respond more vigorously to immune challenges, what reason or evidence do we have that these insults aren’t having an effect? Thimerosal based studies are useless to us in this regard. MMR studies completely ignore the timeframe of the birth to a year, a period I think we can agree is critical, where CNS modelling is priviledged and not repeated. Unfortunately, that is all we have.
Yes the prenatal environment is important, but if I were to ask you what makes you think this absolves the postnatal period of any participation, I wonder what your response would be? What data would you use to support your position?
- pD
pD,
You don’t even know how to describe the word “primed” properly when it means primary infection in immunology. Now if you only knew you were deliberately exposing and infecting these naive babies through vaccination you won’t be asking such stupid question. No wonder you keep on barking up the wrong tree.
@ pD:
If memory serves, one of the stronger reasons to reject postnatal causation is due to structural abnormalities seen in autistic brains. A cell that is never in the right place to begin with produces one structure, while one that was there originally but lost postnatally produces a different structure. The abnormalities seen in autism are the former structure, indicating that the neurological development was already abnormal prior to the time those structures are established during gestation.
I don’t have references to hand right now, but should be able to dig some up later if someone else doesn’t beat me to it (and/or indicate that my memory is NOT serving me well).
@pd,
“what makes you think this absolves the postnatal period of any participation”
I didn’t say that.
@Scott – The “microcolumns” in the brain are smaller and more densely packed in an autistic individual. And that is determined during early fetal brain development.
@ Mark Crisplip –
NOTHING is more explanatory than “42″. Is it THE answer, you know…
Much as I admire the good Dr. G’s commentary generally, I think he left himself open with this one:
An immunologist would be better able to expand on this, but I don’t think there is any particular number of antigens, or epitopes on antigens, that would be “too many.” For many people this is counterintuitive, since it just seems obvious that exposure to a large number of antigens must “overwhelm” the immune system, and 36, or 42, or whatever number, is just obviously such a large number. Getting into the antigen-counting game, then, leads the discussion down an unproductive path.
In my view, passionlessDrone had a (minor) valid point there, but goes off the rails with
That statement is so ill-posed as to be meaningless. We have studied the effects of monovalent and multivalent vaccines, singly and in combination, with and without various components, in a broad variety of populations. That’s a lot of studies looking at many aspects of vaccines from different angles. If you really think that body of research does not justify the broad conclusion that vaccines do not appear to cause autism, then explain what you mean by “[studying] the effects of the vaccine schedule.” Until then, you’re just blowing smoke.
And Harriet Hall said it best in the fewest words. The heritability of autism is so well-established that anyone who ignores it can’t be taken seriously.
jre,
Funny. They couldn’t even count past 3.
@ windriven –
Not to stir things up, but consider how like you, no one, no one seems to want to take on defense of the ‘number of antigens’ argument. In Dr. Gorski’s defense, he didn’t make that up, he simply parrotted what was published by Paul Offit in his paper, Addressing Parents’ Concerns: Do Multiple Vaccines Overwhelm or Weaken the Infant’s Immune System?, here he states, in part:
Parents who are worried about the increasing number of recommended vaccines may take comfort in knowing that children are exposed to fewer antigens (proteins and polysaccharides) in vaccines today than in the past.
This paper was published in Pediatrics, but as we can see here, it is an absolutely meaningless heuristic. Does it concern you, at all, that this type of cotton candy, sciency-sounding idiocy was published in arguably the preeminent pediatric journal as a way of ‘addressing parents concerns’? Don’t you think if there were real, scientifically defendable arguments to be made, the ‘number of antigens’ argument would have gained the traction that it has? (Google “number of antigens” and autism to see how frequently this argument is used.)
@ Harriet Hall –
I didn’t say that.
OK. If you’d like to dance around the semantics between the difference between ‘arguments based on anything postnatal are suspect’ and ‘absolves the postnatal period of any participation’, I guess I can’t stop you, but on a site supposedly dedicated towards thoughtful analysis, that seems a particularly flacid response.
@ Scott –
I won’t argue against evidence for neuronal patterns that can only be achieved through prenatal modifications. But I would argue against the idea that because there can be prenatal origins, subsequent influences cannot have any effect on the condition.
Consider schizophrenia, which has similar evidence of brain alterations, including, changes to minicolumn structures. And yet, we have evidence that supplementation with vitamin d during infancy is protective of schizophrenia later in life, or that drug use later in adolescence is a risk factor for development of schizophrenia. Is there any particular reason that postnatal environmental factors might be influencing schizophrenia, but not autism?
If the causative agent weren’t as important as vaccines, if say, people thought Mountain Dew was causing autism in their infants, I do not believe the instistence of the prenatal and prenatal only argument wouldn’t be as zealous as what we see here. When politically expedient, the SBM crowd likes to point out studies that have shown that some percentage of children seem to spontaneously lose their diagnosis; what of the minicolumn structure in these cases? For an example, check out Orac’s piece “Age of Autism’s “Reporter of the Year” strikes (out) again” 1/3/09 where he states:
As many as 19% of children may progress so much that they lose their diagnosis of autistic spectrum disorder.
How curious that no one worries aloud about how difficult it is to alter minicolumn structure postnatally if we are talking about therapies like ABA (which absolutely, positively, do help a great number of children). If we can admit, and I think we must, that the course of autism can be changed, that developmental trajectories are not set in stone based on what happens in the womb when it coincides with our arguments, we must also accept the inverse, that what happens outside the womb may also be affecting our children in ways that don’t involve spontaneous recovery. So sure, there is evidence of prenatal disturbances to brain development, but that isn’t the end of the story.
- pD
And now cometh Thing 1 and Thing 2 to illustrate the point by example.
@ pD:
A reasonable point. It is certainly *possible* for postnatal factors to contribute. I would still argue that it can be considered nearly certain that prenatal factors are crucial, while there is no good evidence for postnatal factors.
The relevance of antigen counting, by the way, is that it is often claimed that vaccines “overwhelm the immune system” by exposing the child to so many different things so quickly. That is implicitly a statement about antigens. I don’t think anyone meant to claim that it’s the only thing that could *possibly* matter, but rather that it’s what’s normally *claimed* to matter. Which means that talking about anything else is demanding proof of a negative without anything suggestive of the positive, and therefore ridiculous.
I will additionally note that your “dysregulated immune system” angle is itself a slightly more sophisticated variant of “too many too soon,” is similarly implicitly a claim about antigens, and therefore it’s quite directly relevant to make the antigen-counting point.
I wouldn’t. The real guts of decision making about vaccines is done by experts with years of training working in committees who base their recommendations on a considerable and detailed understanding of the immune system, epidemiology and human development. In contemporary society, we must defer to experts. Not on everything, but on something like vaccination where the reality is complicated and based on empirical findings that require interpretation – I’m going to pick Paul Offit’s cotton candy explanation over some douchebag like Th1Th2 or Jennie McCarthy or Dan the Stay-At-Home-Dad-Who-Feeds-His-Kids-Only-Biodynamic-Foods-That-Don’t-Cast-A-Shadow. If parents really, really want to debate the vaccine schedule at a substantive level – get a fucking PhD in immunology. Don’t dick about on some internet forums, scream pharmanoia and proclaim victory. I trust, I have to trust, that sufficient research has been done by thousands if not millions of very smart people on vaccines and the number of antigens, or vaccines and their overall affects on health, such that the recommendations for vaccines can be trusted. Particularly in the face of the real consequences of actual disease and the real benefits of vaccination. Some asshole who can tell an antigen from a hole in his head doesn’t deserve my attention.
pD my apologies for the stridency of my above comments, I ‘m aiming them at the intenet at large rather than you specifically. My only point to you is that criticizing Pediatrics for producing an easy to understand paper for public consumption that didn’t go into the specific and detailed discussion of immunology behind the vaccination schedule is off base. The approach they used strikes me as pretty much the only way parents without post-doctorals in immunology can deal with such a complicated issue. What matters more to me than the amount of chatter on google about the number of antigens in vaccines is what people who have dedicated their lives to understanding the human immune system are concerned about.
Deep cleansing breath.
@ jre –
That statement is so ill-posed as to be meaningless. We have studied the effects of monovalent and multivalent vaccines, singly and in combination, with and without various components, in a broad variety of populations. That’s a lot of studies looking at many aspects of vaccines from different angles. If you really think that body of research does not justify the broad conclusion that vaccines do not appear to cause autism, then explain what you mean by ‘[studying] the effects of the vaccine schedule’. Until then, you’re just blowing smoke.
Well, I thought I was pretty clear early on when I said this:
We have only asked if:
a) Thimerosal effects autism rates.
b) The MMR effects autism rates.
That’s all. There is not, absolutely is not any ambiguity on this issue.
And this:
I defy any reader of this site to provide a study that involves ‘tens of thousands of children’ that studies anything other than the MMR or thimerosal with regards to autism.
I guess I didn’t think I needed to specify the autism again. (?) Sorry about that.
Regarding the studies on monovalent and multivalent vaccines, I think we need to be careful not to conflate safety and efficacy studies, which can detect acute reactions and if a vaccine works, with looking for subtle changes. I wonder, if the studies you mention took autism into consideration as an endpoint, I wonder, why did we perform retrospective analysis of the MMR? Why bother wasting researcher time to perform analysis that was already available? The ‘broad conclusion that vaccines to not appear to cause autism’ isn’t based on studying vaccination, but rather, the presence or absence of thimerosal, or the MMR. That’s it. If you have studies that show otherwise, just post the links. If you can’t do that, you’ve reached a ‘broad conclusion’ based on studies that don’t even ask the right question; and that means that you are just blowing smoke; . As to why we might want to study vaccination as a process, as opposed to particular vaccines or ingredients, see my response to Scott below.
@ Scott –
The relevance of antigen counting, by the way, is that it is often claimed that vaccines ‘overwhelm the immune system’ by exposing the child to so many different things so quickly.
I know. I get it. You need to do more than just say ‘the immune system is overwhelmed’; it is ultimately a meaningless phrase, and most of the time people make the claim, they can’t make any other significant claim.
At the same time, I don’t think that we should be content with outsmarting Jennifer McCarthy; which is largely what the orignal post was about.
I will additionally note that your ‘dysregulated immune system’ angle is itself a slightly more sophisticated variant of ‘too many too soon’, is similarly implicitly a claim about antigens, and therefore it’s quite directly relevant to make the antigen-counting point.
Only ‘slightly more sophisticated’? Ouch.
What I am proposing is different (I hope!), because I can make much more specific claims about how an early life immune stimulation could be changing infants in ways we don’t expect backed by a substantial layer of animal evidence.
In the first place, I’m not arguing for an ‘overwhelming’ of the immune system, but instead, the alteration of the immune system; just in ways other than the acquisition of antibodies for particular diseases. It turns out, there is a substantial amount of literature in the animal realm that this is possible if the insult occurs during critical developmental timeframes.
A month ago or so, Peripheral immune challenge with viral mimic during early postnatal period robustly enhances anxiety-like behavior in young adult rats. was published. Check out the abstract:
Inflammatory factors associated with immune challenge during early brain development are now firmly implicated in the etiologies of schizophrenia, autism and mood disorders later in life. In rodent models, maternal injections of inflammagens have been used to induce behavioral, anatomical and biochemical changes in offspring that are congruent with those found in human diseases. Here, we studied whether inflammatory challenge during the early postnatal period can also elicit behavioral alterations in adults. At postnatal day 14, rats were intraperitoneally injected with a viral mimic, polyinosinic:polycytidylic acid (PIC). Two months later, these rats displayed remarkably robust and consistent anxiety-like behaviors as evaluated by the open field/defensive-withdrawal test. These results demonstrate that the window of vulnerability to inflammatory challenge in rodents extends into the postnatal period and offers a means to study the early sequelae of events surrounding immune challenge to the developing brain. (my emphasis)
There really isn’t any debate as to whether or not an inflammatory event during development can modify behaviors. The question we need to be paying attention to is, when are the critical timeframes during which the immune system and behaviors are maleable to insults? If you pay attention, you can see that in this instance, the authors utilized viral mimics to achieve ‘remarkably robust and consistent anxiety behaviors’. Nice.
A study from last year with a similar, but saliently different methodology is, Early life activation of toll-like receptor 4 reprograms neural anti-inflammatory pathways, which didn’t evaluate for anxiety behaviors per se, but did find that animals receiving LPS at postnatal day 14 had persistent changes in the neuroinflammatory response. Importantly, here the researchers used bacterial mimics instead of viral mimics; it doesn’t matter what the trigger is, what matters is whether or not there is a robust immune response. This is why studying monovalent or multivalent vaccines is fine and good, but ignores the fact that both have the same functional impact in so far as triggering an innate immune response. An slightly older study shows this with some elegance, utilizing LPS, or direct TNF-alpha, with and without TNF-alpha antibodies to make the case the an immune response, and an immune response alone can persistently change seizure susceptibility. Postnatal inflammation increases seizure susceptibility in adult rats.
There are literally dozens of supporting studies that tell us the same thing; an inflammatory event during development, even without actual pathogens, can have long lasting effects in a variety of systems. We can’t detect this in studies that compare a monovalent vaccine to a multivalent vaccine, or a vaccine with thimerosal versus one without thimerosal. We might be able to gain some insight if we had measurements of the inflammatory response as a result of vaccination, but we don’t even have that.
The concept that physiology can be persistently modified without a real sickness is relatively new compared to our additions to the vaccine schedule. I don’t know if the effects observed in animals is happening in humans or not, but studying the MMR doesn’t tell us about the overwhelming majority of shots given at the earliest ages, and studying thimerosal doesn’t tell us anything except the effect of thimerosal. Our existing research set is blind to this possibility, and unless we can find a way to study vaccination as opposed to one vaccine versus another, or one ingredient versus another, we won’t gain any insight into whether or not our policies are affecting our children.
- pD
I don’t see anything in your argument which addresses why, if vaccines were to have such an effect, a skinned knee wouldn’t have the same effect (but more so). Ultimately still a number of antigens argument, AFAICT.
“yet ignorant parent would have already exposed the naive child to 14 KNOWN infectious disease pathogens repeatedly up to 36 exposures by age 2. ”
You seem to overlook a basic fact here: the child is going to be exposed to that many anyways. Exposed in an uncontrolled way which will lead to certain preventable illnesses.
I mean, come on. How many infectious disease pathogens is a person exposed to every day? How many is the child exposed to the first time it meat strangers?
Vaccines are a control introduction to certain disease in a manner that allows the child’s immune system to adapt. They also decrease risk of the disease mutating, and the help protect the tiny number of people that can’t bu vaccinated for one reason or another.
As much as I hate to feed the trolls, I am concerned someone not familiar with the argument will think it’s valid and has merit.
Always important to remember the more often or not, the argument isn’t to convince the ignorant naysayer, but to present logical facts to the observers of the argument.
I mean, the naysayer has already made them selves so wrapped up in the emotions that can’t have a real logical argument..
“We can’t detect this in studies that compare a monovalent vaccine to a multivalent vaccine, or a vaccine with thimerosal versus one without thimerosal. ”
but we can look at data from population that where vaccinated with thimerosal , and ones that weren’t. In those case we don’t see a change in autism rates.
The same thing with population that get monovalent v. multivalent.
Again, we can look at non-vaccinated populations v. vaccinated.
So all the data is there, and there hasn’t been any good data showing any harm. There is tons of data showing harm that occurs non-vaccinated populations.
Geekoid, I had the same concerns but having dealt with Th1Th2′s nonsense and complete lack of understanding of the immune system (really what appears to be a willful misunderstanding), you just end up repeating yourself in each set of comments.
I honestly believe that this is a case where deleting their comments would be the best practice; the only other option I can see would be to write up a list of Th1Th2′s favourite logical fallacies and factual inaccuracies and link to it with every comment. Yes there is the risk that someone with no familiarity with the immune system might be convinced, but attempting to engage just wastes time.
It says a lot about the SBM editors that the Thing hasn’t been banned, actually. They have to be quite sick of its idiocy at this point, but value open dialogue enough to permit continued posting.
Geekoid,
Well, that’s exactly what vaccinators are doing hence they are the leading infection-promoters. But here’s a basic fact: There are children under two years old who have not been exposed to 14 known infectious disease pathogens with up to 36 deliberate exposures. They have not had any risks, complications or disease-related death whatsoever. Where else do you find of a child of having intentionally exposed to 14 known infectious diseases repeatedly up to 36 times in a span of only two years since birth? Don’t you feel happy for these children who have not been exposed and infected? You should but it seems like you’re not because of your willful intention to infect them.
I don’t know. Do you? Does the person have to plan for it just like planning in getting infected with the vaccine?
Well, the newborn is being intentionally exposed to HbsAg prior to hospital discharge I tell you that. Where else do you find of a baby being exposed to intentionally and purposely to such pathogenic agents?
Vaccination is the initiation of primary infection. Like you said, you introduce the infection and the body will adapt. Nothing so extraordinary about that. Ditto for natural infection. Therefore, vaccination does not protect when it inherently does not prevent infection in the first place. Well the reason why some people cannot be vaccinated is because it is both unethical and inhumane to purposely infect them whatsoever. Ditto for natural infection.
passionlessDrone:
Why would losing their diagnosis imply that something has happened to their minicolumn structure?
Autism diagnosis rests mainly on observation of the patient’s behavior and performance on various tests. Autistic patients have difficulty learning how to behave the way we consider appropriate, how to recognize subtle cues given off by other people, how to give off those cues themselves, etc. But that they have difficulty learning these things does not mean they are incapable of learning them. This is particularly true of those on the edge of diagnosis.
Eventually, a child might learn how to do all of these things, perhaps not as well as most kids, but well enough to no longer “test positive” for autism. The child loses the diagnosis. This does not mean the child is normal (whatever “normal” means anyway). It just means the child has attained the necessary skills to pass the tests and behave appropriately. It doesn’t mean learning social skills has actually gotten any easier for the child, and their skills such as reading emotions of other people may be present but slower and more deliberate than in most people. In other words, they can still possess the underlying neurological deficit without retaining the autism diagnosis.
Now, I’m not aware of any research to determine whether this is the case, but I would be very surprised if their brains actually changed in some fundamental way as a result of therapy. Small change would not surprise me, but nothing so fundamental. Still, it would be an interesting thing for someone to study.
@ Scott –
I don’t see anything in your argument which addresses why, if vaccines were to have such an effect, a skinned knee wouldn’t have the same effect (but more so). Ultimately still a number of antigens argument, AFAICT.
Several of the studies in the animal realm show distinct, critical timeframes during which effects are persistent. We start giving Hep-B at the day of birth (or first few days), and many shots at two and four months. Infants just don’t get skinned knees during this timeframe; and especially nowhere close to 95% of them. I’ve had this argument made to me several times. Do you have children? Have they skinned their knee right after birth, or when they were two or four months of age? Furthermore, if you look at adverse reaction charts, you’ll see that vaccines cause fever reactions up to 1/3 of the time (depends on the vaccine). Do you think skinned knees have the same effect? Vaccines are designed to induce an immune response, that’s their job; without one, they don’t do us any good. There’s a big difference between that and a skinned knee.
@ Callie Arcade –
Why would losing their diagnosis imply that something has happened to their minicolumn structure?
It wouldn’t. That’s the point. The point I was trying to make was that it is a nonsense argument that just because we have evidence of change that occurred before birth, we therefore, need not worry about what happens after birth. If we can help our children, even with their minicolum changes, we can also hurt them, and for this reason, I do not understand the fanaticism surrounding the gestational period as the only period worthy of consideration.
Now, I’m not aware of any research to determine whether this is the case, but I would be very surprised if their brains actually changed in some fundamental way as a result of therapy. Small change would not surprise me, but nothing so fundamental. Still, it would be an interesting thing for someone to study.
Indeed. I think the difficult part here is the fuzziness of brains actually changing.
That being said, there is evidence that some structures of the brain can be manipulated as a result of my topic de jour, peripheral inflammation; i.e.,
Long-term changes of spine dynamics and microglia after transient peripheral immune response triggered by LPS in vivo
or
Architectural changes to CA1 pyramidal neurons in adult and aged mice after peripheral immune stimulation
- pD
@ Rick –
“I have also encountered this phenomenon with history and Professor Thomas James DiLorenzo’s modern neo-Confederate writings.”
DiLorenzo is a big Hayek/vonMises supporter.
When your favored theory within your field (Austrian School econ) appears to contradict accepted reality in another field (history of the US), you have two choices: you can either reassess your theory to determine where it diverges from reality, or you can try your damnedest to prove that everyone in the other field is wrong. DiLorenzo has chosen the second option.
No idea if or why this would be more common among economists. Maybe trying to quantify the endless variation in human behavior gets to you after a while?
@ pD:
Fine. First breath, then.
Steven Salzberg’s letter to the editor has been published in the Sun.
I am still wondering why Dunkle’s piece was published in the first place.
@ WilliamLawrenceUtridge –
The real guts of decision making about vaccines is done by experts with years of training working in committees who base their recommendations on a considerable and detailed understanding of the immune system, epidemiology and human development.
Fair enough. But, my concerns are that our knowledge, today far, far exceeds the knowledge available to those experts when recommendations were made concerning the vaccince schedule.
Here’s an example, Ontogeny of Toll-Like Receptor Mediated Cytokine Responses of Human Blood Mononuclear Cells, which is a longitudinal study of how the immune response of infants changes over the course of time from birth to two years. From the abstract:
Our data contradict the notion of a linear progression from an ‘immature’ neonatal to a ‘mature’ adult pattern, but instead indicate the existence of qualitative and quantitative age-specific changes in innate immune reactivity in response to TLR stimulation.
This study was published in 2010, clearly, we still have a lot to learn about the system we have been tinkering with. Not one of the studies I posted below to Scott were from before 2008, some twenty years after we started adding doses and vaccine types to the vaccine schedule. The people who wrote the papers I am referring to are immunologists and neuroscientists. In a similar manner as you, I am, to some extent, relying on the peer review community to crystalize the information; and what study after study tells us in this regard is that we cannot assume that a faux infection is harmless if it occurs within critical developmental timeframes. When I ask, repeatedly, again and again, for studies in the vaccine area that can allay these concerns, no one ever posts an actual link; just conflations of safety studies, the skinned knee gambit, or the antigen counting game. Given that, I have some real skepticism that our standards, set in place many, many years before any of this research was available, is satisfactory considering what we seem to be observing in our children. It would seem we have different opinions in this regard. But that’s OK, at least it is OK with me.
@ Scott –
Fine. First breath, then.
Hm. I wonder, what frequency do you think newborns start getting a fever on their first day of birth? What percentage? According to the CDC, the Hep-B vaccine, given on the day of birth or first few days aftewards, causes a fever in ~ 7% of people. Do you really think this is equivalent to the first breath a baby takes? Seriously?
If we wanted more clinicial evidence of the failings of this argument, we could look to Effect of influenza vaccine on markers of inflammation and lipid profile
Despite wide use of the influenza vaccine, relatively little is known about its effect on the measurement of inflammatory markers. . . There was a significant increase in mean IL-6 (P < .01 absolute values, P < .001 normalized values) on day 1 after receiving the influenza vaccine. (snipped for length purposes)
This was published in 2006. I am going to go out on a limb and say that the participants took a few breaths in the twenty four hour period between testing, and yet, we could still detect a difference in cytokine values between the control and treatment group. Do you have any ideas on how to resolve the apparent paradox between these findings, and the idea that breathing is sufficient to initiate an inflammatory response?
Vaccines have to do something up and above the baseline exposure of everyday living; otherwise, we’d never generate immunity.
Keep digging.
- pD
Start getting bombarded with antigens causing massive immune responses, 100% of them.
pD, on a risk:benefit ratio, I would still argue that when the alleged impacts of vaccinations on humans that are sufficiently tenuous they are still being argued about after more than a century, on balance it’s better to vaccinate. The idea that vaccination somehow presents either a qualitatively different inflammation response than that which accompanies infection, bumps, or the very act of giving birth, is tenuous. The objections to vaccination aren’t coming from researchers presenting solid bench data that indicates it’s possibly a problem in rats; at best they’re still exploring relatively subtle issues with unknown implications for humans. The objections to vaccination, in the form of “BLARG STOP VACCINATING NOW BECAUSE IT IS DEATH!!!” as from Thing are based on “precious fluids” objections rather than being related to any solid set of empirical findings. All the public health efforts that vaccination has undertaken to eliminate or control vaccination-preventable diseases means the permanent effects from these diseases are essentially eliminated from most first-world countries. If we stop now, because of some possible subtle effects on rats that we haven’t reliably documented in humans, then we place ourselves in the Sisyphusian position of rolling the bolder back up the hill. But in this case, that bolder will kill and maim people on the way down. Polio could have been eliminated as a human pathogen were it not for one tiny pocket and pockets of vaccination resistance results in the spreading of unquestionable morbidity and mortality. If the calls for review came from researches who based it on replicable experiments, I’d be more inclined to listen. But are the researchers doing those studies finding inflammatory markers leading to behavioural disturbances in rats objecting to human vaccination? Are they convincing their peers? And have they already made up their minds and are merely experimenting as an exercise so they can publish?
Hep B can be transmitted from mother to child during birth; I’m OK with giving an immediate vaccination in that case.
Hi WilliamLawrenceUtridge –
pD, on a risk:benefit ratio, I would still argue that when the alleged impacts of vaccinations on humans that are sufficiently tenuous they are still being argued about after more than a century, on balance it’s better to vaccinate.
I absolutely agree. I am absolutely not advocating stopping vaccination, just an honest evaluation of our actions.
The idea that vaccination somehow presents either a qualitatively different inflammation response than that which accompanies infection, bumps, or the very act of giving birth, is tenuous.
Well, the quantitative measures aren’t tenous, they are overwhelmingly obvious. Getting a bump doesn’t give you a fever; most children don’t develop fevers from the birthing process. Vaccines have the effect of generating a fever in up to 1/3 of the cases.
Regarding qualitative differences in the immune response, unfortunately, we are starting to learn that the qualities of the immune response are different when you use parts of bacteria versus actual infection. For example,
LPS elicits a much larger and broader inflammatory response than Escherichia coli infection within the hippocampus of neonatal rats. was published about a month ago. Here is the abstract:
An immune challenge during the neonatal period can significantly affect the development of the nervous and immune systems, such that long-term abnormalities in immune function and behavior persist into adulthood. Given that immune activation and individual cytokines have been linked to the etiology of many developmental neuropsychiatric disorders, a complete characterization of the neonatal immune response within the brain is warranted. In this study, rats were treated peripherally on postnatal day (P) 4 with either a live Escherichia coli (E. coli) infection or lipopolysaccharide (LPS), two common models of neonatal immune activation. Inflammatory gene expression was measured within the hippocampus 2 and 24h later. We determined that E. coli and LPS produce very distinct inflammatory profiles within the brain. Infection with E. coli produced a robust, yet relatively IL-1 pathway focused activation of the neonatal immune system within the brain, while LPS produced a very broad and robust immune response within the brain.
Now, I know that there is a difference between LPS and vaccine, but the heart of vaccination with bacterial pathogens is that we do not include the entire bacteria; just the parts and pieces we want to generate a memory for. But as we can see above, there are qualitative differences between infection and faux infection.
There are also documented differences in what happens if we stimulate the immune response with microbial particles, or the bodies danger signals, the DAMPS; i.e.,
DAMPening Inflammation by Modulating TLR Signalling
which is free online, and reports in part:
DAMPs are vital danger signals that alert our immune system to tissue damage upon both infectious and sterile insult. DAMP activation of Toll-like receptors (TLRs) induces inflammatory gene expression to mediate tissue repair. However, DAMPs have also been implicated in diseases where excessive inflammation plays a key role in pathogenesis, including rheumatoid arthritis (RA), cancer, and atherosclerosis. TLR activation by DAMPs may initiate positive feedback loops where increasing tissue damage perpetuates pro-inflammatory responses leading to chronic inflammation. Here we explore the current knowledge about distinct signalling cascades resulting from self TLR activation.
(You might be interested in knowing there are several studies in the autism population that show an increase in the level of several types of DAMPS).
The adjuvants in vaccines are still largely mysterious in their function, however, it is thought that one mechanism by which they achieve their immunostimulatory response is by frustruating phagocytosis and the resultant cellular debris is detected as a damage associated molecular pattern.
If we stop now, because of some possible subtle effects on rats that we haven’t reliably documented in humans, then we place ourselves in the Sisyphusian position of rolling the bolder back up the hill.
Agreed.
If the calls for review came from researches who based it on replicable experiments, I’d be more inclined to listen. But are the researchers doing those studies finding inflammatory markers leading to behavioural disturbances in rats objecting to human vaccination? Are they convincing their peers? And have they already made up their minds and are merely experimenting as an exercise so they can publish?
It does seem like I stand alone. What to do?
- pD
…in rats.
I have no problem with continuing to conduct basic research on the immune system. As for what to do – wait for research to confirm (or not) that immune system reacts differently to vaccination. The nice thing about research is it ultimately comes up with the right answer given enough time and effort. If there are subtle effects caused by vaccination, eventually we’ll either find out about it or they will be so subtle it’s frankly not worth worrying about because the benefits of vaccination outweigh the risks by orders of magnitude.
Let’s also note that even if every single case of autism were caused by vaccination, the benefits would STILL outweigh the risks by orders of magnitude.
pD:
I think “fanaticism” is a bit of an exaggeration, don’t you? They’re just saying it’s implausible to have major brain changes after birth, and indeed, most major brain changes occur early in gestation. Minicolumns in particular are fixed fairly early; the number can go down (due to cell death) but it can’t go up, and autism is often associated with *increased* minicolumn numbers; this particular trait, if indeed causal, cannot be something that occurs after birth. It just can’t. You can lose minicolumns after birth, but you can’t gain them. (Normally. I can accept that there could be a few extraordinary circumstances involving substantial brain regrowth after a massive brain injury very early in life, but that’s not at all the sort of environment insult we’re talking about here.) It doesn’t matter what environmental insults occur at that point.
Now, there can certainly *be* brain changes after birth, even quite dramatic ones. It’s just that, apart from tumors, they tend to be subtractive, not additive. It’s possible that subtractive effects could produce autistic symptoms, just as it’s possible (and in my opinion, highly likely) that autism arises from multiple causes, making it difficult to compare individual cases to find commonalities. The minicolumn connection would have to point to a cause in early gestation, though. It’s not fanaticism to point that out.
I guess what I’m trying to say is don’t just write people off as fanatics if they’re just persistent in an opinion. They’ve got good basis for their opinion. There is room for doubt, but they’re not just trying to avoid exploring vaccines as a cause of autism, as you seem to be implying. They have good reasons for suspecting that an environmental affect is at play only in very early development; this is the most important period in a child’s brain development, the most vulnerable, and the most likely to find the origins of other developmental disorders (FAS is the most obvious example) involving the central nervous system.
BTW, this is pretty minor, but it’s been a persistent typo used by many so I should probably say something. My name is Arcale, with an L, not Arcade. It’s a somewhat obscure Doctor Who reference. Long story, but the short version is that the Arcalians are Time Lords.
William,
No. Polio could have been eliminated a long time ago if they would just stopped deliberately inoculating the naive with poliovirus. As an outcome of continued vaccination, not only that they are still dealing with wild-type poliovirus, the vaccine has resulted to the creation of another mutant poliovirus called the VDPV. Just look at the sheer mess and cesspool of diseases you guys are promoting.
Hi Callie Arcale –
Let me apologize for hosing your name; I must have made the mistake the first time I read one of your posts and it stuck in my brain. I take very little solace in the fact that, apparently, I am not alone. It is especially sad because I do tend to enjoy your posts.
Regarding ‘fanatacism’, as an exaggeration, OK.
They’re just saying it’s implausible to have major brain changes after birth, and indeed, most major brain changes occur early in gestation. Minicolumns in particular are fixed fairly early; the number can go down (due to cell death) but it can’t go up, and autism is often associated with *increased* minicolumn numbers; this particular trait, if indeed causal, cannot be something that occurs after birth. It just can’t. You can lose minicolumns after birth, but you can’t gain them.
I guess the point I was trying to make all along was that because we have evidence of some facets of autism being created prenatally, that is no reason to believe that other timeframes cannot also participate. I don’t think anyone (?) was trying to debate that minicolumn numbers could or could not be changed (I wasn’t); my issue was that there is a difference between an inherited condition, and an immutable condition. If a condition is mutable, then the fact that there are prenatal causes doesn’t mean there can’t be postnatal exacerbations.
While the idea of multiple autisms has been around for a long time, if you want to talk about anything except the prenatal period, the conversation stops being intellectually honest. There might be lots of ways to have autism, but only one time to get it, and implicitly, no way to slide the scale of behavior once gestation is over. We all agree that there is a wide range of behaviors, and behavioral severity associated with autism, but the implication is that all of this is determined prenatally. Why? Why is there no room for factors outside of gestation to affect behavioral severity? You are clever enough to know this is an indefensible position.
The minicolumn connection would have to point to a cause in early gestation, though. It’s not fanaticism to point that out.
OK. But it requires large leaps of faith, and widescale disbelief of available information, to believe that once this happens, the rest of the developmental trajecotry is set in stone.
There is room for doubt, but they’re not just trying to avoid exploring vaccines as a cause of autism, as you seem to be implying.
But they are trying to find a way to avoid that conversation, in fact, they’re trying so hard, no one seems to care that Dr. Gorski’s claim that ‘the question has been asked and answered’ is total bunk. If our mechanism for determining the validity of this statement is the presence of scientific studies, this is an argument that cannot be defended. It is hypocrisy in a place that usually prides itself on taking a scientifcally objective standpoint. I asked someone, anyone to post studies on things other than thimerosal and the MMR and autism, and they didn’t. They cannot. This is a forum where statements are expected to be backed by evidence if requested; the fact that no one can ever provide evidence towards this, but instead, bobbleheaded in agreement along with the idea that ‘the question has been asked and answered’ tells me there is some significant dissonance happening here. It doesn’t matter if SafeMinds glommed onto thimerosal or the MMR and were wrong; we shouldn’t take any pride in being more clever than them; what ought to matter is has the question really even been asked, much less answered? We don’t have any data on that. The fact that no one seems to care about, or even acknowledge, this very large elephant in the room tells me that, indeed, they are trying to avoid discussing vaccines and autism. My worldview is that the prenatal period is critical, and the postnatal period also plays a part, I’m not sure what your views are exactly, but I do know that just pretending that gestation is the only time of importance is shortsighted, and likely, motivied by ideology, as opposed to critical analysis.
Making the fanaticism arugment was wrong and I should have used other terminology, and in all likelyhood, lots of people probably think the same thing about me and my theories on the issue. Irony.
- pD
<blockquote.Just look at the sheer mess and cesspool of diseases you guys are promoting.
Yes, just look at the “sheer mess” and “cesspool” of polio today, 1,000 cases a year versus the 350,000 cases in 1988 before WHO began its eradication program.
I’m going to chalk you up to a true believer, there’s no way any troll would make assertions this transparently stupid.
@pD,
Sorry to jump in late in the discussion, but part of your post caught my attention:
“I asked someone, anyone to post studies on things other than thimerosal and the MMR and autism, and they didn’t. They cannot…”
There seems to be a disconnect here about how researchers decide what to research. Studies exist for MMR and thimerosal because those have been seriously (or at least loudly) proposed as potential causes. They were studied and no causation is apparent. What else would you like to see studies for? Hand soap? Paper towels? Coffee? Sorry for the sarcasm, but the point is that you won’t get studies done for a substance unless there’s some reason to believe it might be a factor.
We have 30 years of ASD research, and ever-improving methods by which to study the brain, and as yet no postnatal environmental factor appears to have shown sufficient possibility as a cause as to warrant a larger study. Studies so far have shown no useful or promising connections between ASD and unusual exposures to known neuroactive chemicals. The people who have dedicated their professional lives to finding the real causes for these disorders aren’t clamoring for more studies of postnatal exposures.
The people on this board are not hypocritically ignoring your calls for data. They’re paying attention to what the dedicated researchers have shown, to this point, to be likely and unlikely. Whatever one’s “worldview”, it is not useful or fair to demand that someone take your random speculations seriously unless they can produce research that refutes your random speculations.
Oh Thing, I wish I had your naive, simplistic, worldview.
Actually I don’t, because it’s stupid and wrong. I do, however, wish the idealized world you believe in existed, I really, really do. Sadly, I live in the real world and must therefore use reality rather than delusion and made-up nonsense as my touchstone.
Anyway, live poliovirus is used because it’s easier to transport and administer than the inactivated version. In a perfect world we wouldn’t have to make the choice between logistics and safety, but sadly most of us live in reality. For anyone interested in what the real world has to say:
Vaccine-derived poliovirus (VDPV): Impact on poliomyelitis eradication.
And what does this confirm? Medicine occurs in messy reality where difficult decisions are based on risk versus benefit. Admittedly it means decisions are harder to make than living in a world rule by slogans and deliberate ignorance, but at least you stand a chance of doing something worthwhile.
The sole act of extinction perpetuated by the human race that I’m proud of.
@ Nate Dogg: I posted on RI this AM about the number of cases of wild polio virus confirmed YTD worldwide; information is current from the:
Polio Global Eradication Initiative
YTD 252 cases of Wild Polio (July 13, 2011)
An additional 15 cases of circulating vaccine-derivative polio virus (cVDP2) have been reported YTD (9 cases in Nigeria, 5 cases in Somalia and 1 case in Afghanistan). There are ongoing meetings taking place with input from scientists, epidemiologists and researchers who are working in the trenches to achieve the goal of total polio eradication, to decide a course of action to discontinue use of OPV, once this scourge of disease is eradicated from the face of the earth.
The New England Journal of Medicine (NEJM) has an interesting article about these discussions:
NEJM Health Care Policy and Reform “The Polio Endgame” (June 15, 2011).
Just ignore the trolls and remember Rule #14.
Hi geack –
There seems to be a disconnect here about how researchers decide what to research. Studies exist for MMR and thimerosal because those have been seriously (or at least loudly) proposed as potential causes. They were studied and no causation is apparent. What else would you like to see studies for? Hand soap? Paper towels? Coffee? Sorry for the sarcasm, but the point is that you won’t get studies done for a substance unless there’s some reason to believe it might be a factor.
There is no need to apologize for a sarcatic tone with me, geack!
If Dr. Gorski had something other than ‘the question had been asked and answered’, I wouldn’t have been so forceful in trying to illuminate the fact that this is a bogus claim.
Regarding paper towells, hand soap, and the rest, I get it, there has to be biological plausibility, and the point I’m trying to make is that there is such plausibility. I wonder, did you read my response at on 13 Jul 2011 at 10:47 am, where I gave a brief synopsis of a few animal studies that show that immune challenges during early life can persistently modify physiology and behavior with many similarities to what we see in autism?
It isn’t just that we have a lot of animal studies that tell us that a robust immune response in early development can have lifelong effects, we also have a ton of data implicating a dysregulaged immune response in the autism population.
For example, there are no less than five studies that a correlation between the degree of the immune dyregulation and behavioral severity (1,2,3,4,5). There are at least seven studies that give us evidence of a persistent state of neuroinflammation in the CNS in the autism population (6,7,8,9,10, 11, 12). Were you aware of these findings? There are many, many others that show altered immune parameters in this population, something that is usually glossed over as ‘immune abnormalities’ when discussed in the context of vaccination, but really, they point towards what is being found in a great number of other neurological conditions; a close intertwining of the CNS and immune system.
At this point, it is common for someone to try to educate me on the difference between correlation and causation, but that’s where the animal models come in. It isn’t just that we have evidence of exaggerated immune responses and ongoing immune activation in the autism population, and it isn’t just that we have animal models indicating that a vigorous immune response during critical timeframes can persistently program physiology, we have both. If there was a subgroup of children susceptible to changes based on vacciation based on the mechanisms described in animal models, children with autism would be good candidates. I’m not just whistling Dixie and waving my arms around at vaccines blindly.
We have 30 years of ASD research, and ever-improving methods by which to study the brain, and as yet no postnatal environmental factor appears to have shown sufficient possibility as a cause as to warrant a larger study. Studies so far have shown no useful or promising connections between ASD and unusual exposures to known neuroactive chemicals. The people who have dedicated their professional lives to finding the real causes for these disorders aren’t clamoring for more studies of postnatal exposures.
We have, for the most part, spent that thirty years chasing genetics in a largely futile effort. That being said, I am more of a believer in a non trivial, real increase in the rates of autism, and a ‘want to see better evidence exhonerating vaccines’ type of jerk on the internet than my postings on this site might lead you to believe. I’m not here to proclaim a vaccine induced epidemic per se, just to try to point out some pretty big blind spots in our existing research that is highly discordant with the narrative being presented. I happen to think there are lots of environmental, and cultural changes that could be affecting our kids prenatally that could be contributing to our apparent increases in autism rates, but that doesn’t mean I should blindly accept proclamations that have no evidentiary basis.
The people on this board are not hypocritically ignoring your calls for data. They’re paying attention to what the dedicated researchers have shown, to this point, to be likely and unlikely.
Somewhat. But this is still a place where claims are expected to be validated. If I claimed that ‘chelation cures autism’, I’d be swamped to demands to provide references to this point. But check out what Dr. Gorski wrote:
The hypothesis that vaccines cause autism has been about as thoroughly falsified through research as any health hypothesis can be.
How? With what data? With MMR data? With thimerosal data?
This wasn’t a nuanced statement about what dedicated researchers think is likely or unlikely. If something has been ‘thoroughly falsified’, the evidence should be easy to provide.
He also wrote this:
There is no longer a scientific controversy; by and large, the question has been asked and answered. Vaccines do not cause autism, as far as we can detect.
But we haven’t even bothered to try to detect it. This is intentional obfuscation on the part of Dr. Gorski. He knows full well that we haven’t looked at anything other than the MMR, yet for reasons known only to himself, he has decided to group all vaccines, including the overwhelming majority of the schedule given early in life, with the MMR, not given until a full year, at earliest, after birth. Why? For what reason?
This is, at most charitable, a statement that is misleading due to ignorance of the facts of what literature is available.
Whatever one’s ‘worldview’, it is not useful or fair to demand that someone take your random speculations seriously unless they can produce research that refutes your random speculations.
But my speculations aren’t random, they are based on a wide body of literature. On the flip side, the notion that ‘the question has been asked and answered’ or that data ‘thoroughly falsifying’ anything is based on zero literature.
Making demands that my speculations be taken seriously might not fair, so ignore them if you’d like, but there is no logical path to which my thoughts could be considered, ‘random’.
- pD
References:
1) Macrophage Migration Inhibitory Factor and Autism Spectrum Disorders Pediatrics Vol. 122 No. 2 August 1, 2008 pp. e438 -e445 (doi: 10.1542/peds.2007-3604)
2) Increased serum levels of high mobility group box 1 protein in patients with autistic disorder Progress in Neuro-Psychopharmacology and Biological Psychiatry Volume 34, Issue 4, 30 May 2010, Pages 681-683
3) Elevated plasma cytokines in autism spectrum disorders provide evidence of immune dysfunction and are associated with impaired behavioral outcome Brain, Behavior, and Immunity Volume 25, Issue 1, January 2011, Pages 40-45
4) Altered T cell responses in children with autism Brain Behav Immun. 2011 Jul;25(5):840-9. Epub 2010 Sep 15
5) Alterations of circulating endogenous secretory RAGE and S100A9 levels indicating dysfunction of the AGE-RAGE axis in autism Neurosci Lett 410(3):169-73 (2006)
6) Immunity, neuroglia and neuroinflammation in autism International Review of Psychiatry, December 2005; 17(6): 485 495
7) Immune transcriptome alterations in the temporal cortex of subjects with autism Neurobiol Dis. 2008 Jun;30(3):303-11. Epub 2008 Mar 10.
8) Glial fibrillary acidic protein is elevated in superior frontal, parietal and cerebellar cortices of autistic subjects Cerebellum. 2005;4(3):206-10.
9) Elevation of tumor necrosis factor-alpha in cerebrospinal fluid of autistic children Pediatr Neurol. 2007 Jun;36(6):361-5.
10) Microglial activation and increased microglial density observed in the dorsolateral prefrontal cortex in autism Biol Psychiatry. 2010 Aug 15;68(4):368-76
11) Aberrant NF-kappaB expression in autism spectrum condition: a mechanism for neuroinflammation Front Psychiatry. 2011;2:27. Epub 2011 May 13.
12) Transcriptomic analysis of autistic brain reveals convergent molecular pathology Nature Volume: 474, Pages: 380 384 Date published: (16 June 2011) DOI: doi:10.1038/nature10110
@WLU
I thought one of the major problems with eliminating polio has been the need for a “cold chain” to maintain vaccine viability. My understanding was that the smallpox vaccine was so stable that you could drag it anywhere that people lived (truly remote places being largely unexposed anyway). Given a long shelf life, highly temperature stable polio vaccine, it might be pretty straightforward to eliminate polio (not easy, but do-able).
pD:
A couple points.
Reference 1, PMID 18676531, they used genotyping meaning they’re not looking for an environmental influence.
Reference 2 (PMID 20302902), 3 (PMID 20705131), 4 (PMID 20833247) and 5 (PMID 17101220) used matched controls; is autism caused by immune system dysregulation or does it cause immune dysregulation such as through an increase in chronic stress or anxiety levels? Probably other references as well, since I stopped looking after the 7th. Now let’s assume that autism is due to immune system dysregulation. Why would we jump to “vaccination”, a relatively minor immunological challenge, as the reason? Why not the hygiene hypothesis? Why not heritable immune dysfunctions? There are a multitude of possible reasons for immune dysfunction; why would we assume, or focus on vaccination at the expense of others without good reason? Your speculations may not be random, but they’re based on a very focussed set of literature interpreted through a lens that seems to assume a link rather than that link being one competing possibility among many.
Now let’s assume your assertion, that vaccines do have effects that possibly impact the brain. First, they aren’t obvious in that there has never been any robust indication that vaccination causes autism (it has been asserted, but never demonstrated). Second, the benefits of vaccination still outweighs their possible impact on the immune system (I’ll leave the demonstration to Penn & Teller). Not to mention vaccination may actually be protective against autism ( link).
Antivaccination nutters, by dint of their volume, rhetoric and general idiocy (see someThing in this thread) are severely curtailing the ability to do solid research on the topic. Scientists, policy makers and parents are still being done a disservice by these morons because there is now so little support for that sort of research. It’s like Peter Duesberg’s effect on certain types of cancer research – he may be right about oncogenes, but his AIDS denialism has so tainted his name, people are unjustifiably critical of his legitemate work. By asserting without proof that vaccination causes, worsens or is any way related to autism, they’re interfering with the real research that might uncover such a connection.
I’ll grant that vaccination could possibly cause autims, but I’ll also have to include in that grant the following possibilities:
- Santa Claus exists
- homeopathy is evidence of hitherto-unknown quantum effects
- the president of the United States and most world rulers are actually alien-lizard hybrids who rule humanity with an iron fist.
- global warming is caused by the growing popularity of gnocci
- HIV does not cause AIDS
- the Devil exist and it is he, not evolution, that is responsible for the changes in gene flows over time
- New York City does not exist and my visits there are simply the result of delusion
- Nickleback produces quality music that merely requires exposure to appreciate.
Now, obviously that last point is just a joke, Nickleback is terrible. But my overall point should be obvious – science should pursue promising hypotheses based on the data that exists to support it. We shouldn’t be attempting to prove or disprove the improbable based on the input of laypeople citing recognizably flawed claims that are not open to change.
JPZ, the NEJM discussion of the elimination of polio that lilady refers to is actually pretty interesting, and freely-available!
As for smallpox, I read Scourge: The Once and Future Threat of Smallpox a while back and found it both interesting and readable. And scary.
Hi WilliamLawrenceUtridgeon -
Reference 1, PMID 18676531, they used genotyping meaning they’re not looking for an environmental influence.
From reference 1:
Thus, the central hypothesis underlying this research was that a genetic predisposition to a particular level of MIF production may lead to a proinflammatory profile of cell activation that, if present during a neurodevelopmentally sensitive period, might contribute to the etiopathogenesis of autism.
It isn’t about genes, it’s about what happens as a result of having these genes, and that is create the propensity for a more robust immune response. Further, this hypothesis, that a proinflammatory profile of cell activation during critical timeframes has longlasting effects, is exactly what the animal models are showing. If you have a MIF promoter, you’ll create more MIF, and your toll like receptors will be upregulated. This means that compared to someone without the MIF promoter, a person with this allele will have a more robust immune response. Secondarily, plasma levels of MIF were also used in this study that confirmed the genetic findings, and found correlations between levels of circulating MIF and behavioral severity.
Reference 2 (PMID 20302902), 3 (PMID 20705131), 4 (PMID 20833247) and 5 (PMID 17101220) used matched controls; is autism caused by immune system dysregulation or does it cause immune dysregulation such as through an increase in chronic stress or anxiety levels?
Fair question and currently unanswered if the relationship is causal, but again, it isn’t like we don’t have models wherein you can cause persistent changes by immune activation during development. We do have those models.
Why would we jump to ‘vaccination’, a relatively minor immunological challenge, as the reason?
Because of the animal studies that I keep harping about that tell us that the immune challenge need not be robust, if it occurs within critical developmental timeframes. Our vaccine schedule is densely packed towards the first months of life, for good reason, but this also means that our MMR studies completely miss whatever combination of shots are given at two, four, and six months. Regarding the relatively minor nature of vaccination, we have to remember that our population of interest is reacting more vigorously than the control groups; because of our findings in 1-5 we cannot assume that the level of response in the autism group will be the same as the control group.
Or, if we read Immune transcriptome alterations in the temporal cortex of subjects with autism, one of the things it tells us is that:
The deregulation of these gene pathways might indicate that the profound molecular differences observed in the temporal cortex of autistic subjects possibly originate from an inability to attenuate a cytokine activation signal.
This possible difficulty in attenuating an inflammatory response is also supported by other studies that found corresponding decreases in immunoregulatory cytokines in the autism populatuion; i.e., Decreased transforming growth factor beta1 in autism: a potential link between immune dysregulation and impairment in clinical behavioral outcomes which also found correlations to behavioral severity, in this case, as the ability to modulate the immune response decreased (i.e., less tgf-beta1), the behavioral severity increased.
That’s a difficult set of data to get away from; if we are going to look for external mechanisms by which autism might be causing the immune dysregulation, we must find a way such that not only does it increase inflammatory cytokines, it must also decreases regulatory mechanisms, both of which correlate to behaviors. So sure, causality is difficult to prove, but if our only other option is to invoke the Santa Claus gambit, I’m sticking with something that has some data behind it.
Why not the hygiene hypothesis? Why not heritable immune dysfunctions?
Why can’t all of these things be operating together? I happen like both of these things as potentially interacting forces.
There are a multitude of possible reasons for immune dysfunction; why would we assume, or focus on vaccination at the expense of others without good reason?
Because the animal studies tell us it is possible and the ramifications for being wrong, for assuming no harm incorrectly in a process that touches every infant are staggering. It’s my idea of the precautionary principle, though I have been accused of being too precautionary in the past.
Your speculations may not be random, but they’re based on a very focussed set of literature interpreted through a lens that seems to assume a link rather than that link being one competing possibility among many.
Fair enough, but only within the context of what you see here. For whatever reason, the vaccine discussion rules skeptical discussion on the Internet. You might be surprized to learn I consider myself a skeptic. Not to self promote, but on my blog, I’ve got postings on environmental enrichment, PTSD and associated immunological profiles, the MET-C allele, and many other things other than vaccination. I’m interested in learning, mostly.
First, they aren’t obvious in that there has never been any robust indication that vaccination causes autism (it has been asserted, but never demonstrated).
Agreed, however, I would counter this is a function of not really having looked.
Second, the benefits of vaccination still outweighs their possible impact on the immune system
Only under the implication that the only choices are binary; i.e., vaccinate or don’t. I think we could be a lot more clever than that in time, but only if we actually evaluate if our actions might be having unintended effects.
Antivaccination nutters, by dint of their volume, rhetoric and general idiocy (see someThing in this thread) are severely curtailing the ability to do solid research on the topic.
Well, hopefully I’ve been restrainged enough not to earn the title of ‘antivaccination nutter’. I seriously doubt I could affect anyone’s ability to do solid research one way or the other.
I like a couple of Nickelback songs.
- pD
“Consider the old adage that everyone is entitled to his or her opinions but no one is entitled to his or her own facts.”
To further my attempts at adopting this august principle, perhaps Mr. Gorski could explain to me which fact I should adopt as factual in the following case of grapefruit and breast cancer.
One double blind, evidence based, peer reviewed study in the BMJ showed a link between grapefruit and breast cancer. There’s that fact. A year later, in the same journal, a new double blind, evidence based, peer reviewed study demonstrated a falsification of the link. There’s that fact. Or perhaps it’s best to wait until a further study is done that is even more factual, and if this is the case, be satisfied that this new ‘fact’, the 3rd in a series, can now be etched in stone. Maybe, though, it’s more prudent to wait a few years, or decades, or longer to make certain no other double blind, evidence based, peer reviewed study is devised that negates everything in the previous 3 studies.
So what is your opinion on all these facts?
pD, I was right along with you until you said you liked Nickleback. Now we can’t be friends.
And more seriously, if antivaccination nutters took your approach of saying “let’s examine” rather than “ZOMGVACCINATIONKILLSEVERYONE”, well, they wouldn’t be nutters. Examining something empirically is reasonable, and will lead to correct outcomes (with good method). The problem is, antivax nutters don’t use good methods, they aren’t reasonable, and are uninterested in actual empirical results.
@libby:
Dr. Gorski would almost certainly say that interpreting the body of literature on the topic will be the best place to start, and further research will help. Just because we don’t know the answer right now doesn’t mean we never will.
My opinion would be if you want to avoid cancer, don’t smoke. If you want to avoid breast cancer, breast feed, maintain a reasonable weight, drink moderately if at all, exercise and avoid hormone replacement therapy and pollution. Good advice overall from the mayo clinic.
http://www.mayoclinic.com/health/breast-cancer-prevention/WO00091
@pD
As someone trained in immunology, I like your thoughtful approach. Thank you for sharing your point of view!
@WilliamLawrenceUtridge –
And more seriously, if antivaccination nutters took your approach of saying ‘let’s examine’ rather than ‘ZOMGVACCINATIONKILLSEVERYONE’, well, they wouldn’t be nutters. Examining something empirically is reasonable, and will lead to correct outcomes (with good method). The problem is, antivax nutters don’t use good methods, they aren’t reasonable, and are uninterested in actual empirical results.
Believe me, I find myself highly conflicted over the fact that my line of thought can be seen as complimentary to the more conspiratorial elements of the online autism community, that being said, I haven’t figured a way to rationalize my way out of what look to be glaring problems with our existing data. In fact, as I’ve thought about this, I’d go so far as to say that right now, the last thing we need is a vaccinated / unvaccinated study; I think we need to learn a lot more before attempting something like this.
@ JPZ –
As someone trained in immunology, I like your thoughtful approach. Thank you for sharing your point of view!
Thank you very much! I’d be interested in your thoughts.
- pD
pD,
Oh yeah why don’t you give them the gun and force them to play Russian Roulette. That sounds like a good idea…not!
William,
Why would we jump to ‘vaccination’, a relatively minor immunological challenge, as the reason?
Oh really. Let’s count. An excellent immunization history would comprise of successful inoculation with 14 known infectious diseases with 36 series of exposures overall in a span of only 2 years after birth. Wherever did you hear of a child getting tortured deliberately this way?
Hear that silence? That’s the sound of Thing ignoring the thousands of antigens that are presented to the immune system within the first two years of life.
Feel that breeze on your skin? That’s Thing handwaving away the immunological challenge presented by a genuinely dangerous infection.
See that crowd at the funeral? That’s the family of the infant who died of pertussis before they could be vaccinated.
Taste that irony? That’s Thing comparing vaccination to torture.
Smell the napalm? That’s Thing’s stupid burning through all the papers that indicate vaccination is less risky than actually catching a disease.
William,
I must have missed 60 minutes, what are you saying? That those thousands of antigens are all pathogenic, or at least were derived from known disease causing microorganisms. Could you please identify the first ten from the thousands of antigens that you know of.
Where is the infection and what is the infectious agent? Don’t just tell a story.
Myth. It’s always an iatrogenic death.
And barbarism.
I’ll take the 0 risk any day. Do you have any problem with that?
Iatrogenic death you say? What did baby Cayla Smith die of? Unless the parents are lying, she died of pertussis, not iatrogenesis.
As for zero risk, I would dearly love to face zero risk. However, I live in the real world where no risk can be reduced to zero, ever. The closest we’ve ever gotten with infectious diseases is smallpox. Thanks to vaccination, the only risks are the containment of the samples held in the CDC and in Russia breaking down, or someone figuring out how to synthesize a live smallpox particle from its genome. Thank science for vaccination so no parent has to face this anymore.
Thing, you can pretend that diseases present fewer risks than vaccination but you’re simply wrong. I can’t argue with you because you dodge questions with coy non-sequiters and your starting assumptions about the immune system bear absolutely no relation to anyone whose understanding is science-based. It’s like arguing cosmology with a flat-earther astrologist. It’s like arguing about an antiretroviral treatment protocol with an AIDS denialist. It’s like arguing about cladism with a creationist. You’re a deluded moron.
I’d say it’s worse than any of those. The Thing goes beyond misguided into grossly delusional territory. It’s more like arguing with a computer program whose responses are randomly derived with no relation to your queries…
One could claim that it’s like arguing with the dining room table, but that’s unnecessarily insulting to perfectly good furniture.
Libby, I don’t like the name-calling either, but I do suggest that you have a great deal yet to learn about homeopathy and about medicine in general.
For example, it appears that you did not know that a few studies have already examined individualized homeopathic remedies with negative results. That is easily done in a blinded manner.
You also stated that homeopathic remedies may have to be individualized to work properly even after providing a list of studies of non-individualized remedies that you cherry-picked as supporting homeopathy. You cannot have it both ways.
When I said a “vast amount of evidence from many different sources” you seemed to assume I was still talking about clinical studies. I was not. You can test the implications of some homeopathic theories in your own kitchen, and others by studying human illness in depth. You will find that homeopathic potentization cannot be shown to enhance the biological properties of any solution, in the manner typically claimed, and that principles that are critical to any therapeutic activity of homeopathic remedies, such as “like cures like” and the homeopathic “provings”, have no basis at all, when looked at alongside better established knowledge.
Of course a few still believe in homeopathy, even after all that, but they don’t do so because “the science” has persuaded them. They sustain belief because, just like you, they think they have seen convincing clinical benefits from homeopathy. They, like you, keep looking for loopholes, rather than making what I admit is a difficult concession: that the observed benefits are due to a mixture of psychogenic responses to medical interactions and well-known illusions.
This is where ALL the evidence best comes together.
That is also where we “are at” with you. You have produced nothing we have not seen many times before. We have presented our position and it is up to you what you make of it.
WilliamLawrenceUtridge: you rock! I love what you have to say and how you say it.
libby, you are still being an off topic troll. Last time I looked the article at the top of the page does not mention breast cancer, nor does it mention grapefruit.
Also, Dr. Gorski has both a medical degree and a separate PhD. You should show more intelligence by at least being on topic if you think referring to him as “Mr. Gorski” will give you any argument points.
@pmoran
I wasn’t aware that there were accepted studies that have been run where patients with a specific indication were examined by a group of homeopaths and given a specialized remedy or placebo. Do you have the link for those trials? Were they double-blinded or only blinded?
The presentation of traditional trials supporting the benefits of homeopathy was more to show the flaws of the system, rather than to come to a conclusion on the actual content. If I put into a calculator 2 + 2 and it spits out “4″, and the next day put the same equation into the same calculator and it spits out “5″, it’s either that I’m not inputting the right numbers, or the calculator is flawed. That is essentially what is happening when you use the same system to test the same treatment and you get differing results – either parts of the trials were not handled properly, or the system for testing is flawed.
Homeopaths provings, potentization, etc. do not have anything disproving them, we are merely faced with an inability to prove them. The absence of proof is not the proof of absence.
As for “like cures like”, that is a concept already employed in certain occasions by the medical industry – one example is in acne treatment. Patients are recommended to not over-wash their faces as by removing too much oil, their bodies will start producing more to compensate. In some cases, patients are recommended to add oil to their skin to “trick” their bodies into thinking there is already too much oil being produced, thereby slowing it’s internal production: http://www.acne.org/jojoba-oil.php
I don’t think that criticizing a clinical study based on the methods and standard operating procedures is exactly “looking for loopholes”. If that were the case, any critic of any trial in the world (including staff of the FDA and Health Canada) would fall under that category.
Utterly wrong. It’s in fact routine, expected, and inevitable for the results of experiments to differ. Dealing with that uncertainty is a core part of science. This is why it’s so important to consider the entire body of the literature; no single result can be trusted.
So you actually admit that there’s no evidence supporting it? Yet assume that it works? I’ve got some swampland in Antarctica to sell you!
There’s a gargantuan chasm between “some treatments are in some ways vaguely similar to the conditions being treated” and “substances causing the same symptoms always cure said symptoms.”
Chris:
Don’t encourage me. I should never be encouraged. I should always be corrected however, as I am wrong on a daily basis and welcome valid criticism.
Libby:
The burden of proof is always, always, always on the person claiming an effect. If homeopaths claim provings “work” it is up to them to demonstrate it. There are an infinite number of things that could be wrong, and it’s impossible to demonstrate things wrong in the first place. You can only demonstrate that something is right. This is basic epistemology. Are you familiar with Russell’s teapot? How about special pleading? Special pleading is used to explain away negative effects; scientific research always requires a certain amount of it during intial research on an uncertain phenomenon. But any investigation of a true effect should begin separating signal from noise in a relatively short timespan, and those results should be replicable by anyone using the same method. Further, controls should not interfere with this process, but should in fact make the signal clearer over time. Again, a failing of homeopathy is its splitting into different camps over the centuries rather than converging on an answer.
As for trials of individualized homeopathy, Linde & Melchart conducted a meta analysis in 1998 that concluded individualized homeopathy could be demonstrated effective only in low-quality trials. When the methodological quality of the trials increases, the effectiveness of homeopathy disappears.
As for your comment:
I’ve a couple things to say. In any test, you can expect to see random fluctuations; the p = 0.5 criteria that was the standard for many years meant that 1 out of 20 significant results were expected to be due to chance. That’s why replication is important, as is the us of specific statistical procedures when conducting multiple comparisons (otherwise you’re data dredging). Random variation is another reason researchers are encouraged to use the largest samples practical; it is expected that random variations and fluctuations in the subjects will balance each other out. If however, your comments are along the lines of “I know homeopathy works therefore science is wrong”, that means you’re not doing science anymore, and you’ve lost any reasonable credible justification for citing scientific research as you’re simply looking for any excuse to avoid changing your mind. May I suggest you pick up a copy of Mistakes were Made (but not by me) by Tavris & Aronson; it goes into, at length, the theory of cognitive dissonance which is the main reason people refuse to change their minds in the face of good evidence.
The “like cures like” argument is completely wrong. In any case where “like” genuinely cures “like”, such as vaccination or face washing, there is a recognized process by which a vaccine causes an immune response (or washing one’s face make it oilier in the long run) and why it works. Homeopathy for one thing focuses on symptoms (and often practitioners deny the germ theory of disease) and for another thing, takes the “like” that symptom and then dilutes it to the point that there’s no plausible process by which it could have any effect. Quantum entanglement doesn’t work (quantum effects wash out by the time you get to the size of molecules), “memory of water” doesn’t work (any “structures” in water are destroyed by Brownian motion in picoseconds). Homeopaths assert that like cures like, it has never been demonstrated that provings achieve anything meaningful or that dilution and succussion do anything but add heat to the system.
Again, an excellent book is Homeopathy, how it really works by Jay Shelton. If you can address the flaws Shelton cites regarding the research on homeopathy, and still successfully demonstrate that homeopathy works, you can collect $1,000,000 from Mr. James Randi.
Rule 14, especially for the homeopathic trolling.
Libby, here is one example of authentic homeopathic individualisation. Of course it would be double-blinded. Anything less is pointless wherever end-points are subjective.
Thorax 2003;58:317-321
Individualised homeopathy as an adjunct in the treatment of childhood asthma: a randomised
placebo controlled trial
A White, P Slade, C Hunt, A Hart and E Ernst
(no benefits over placebo)
Others have pointed out some of the reasons why in any field other than the subjective aspects of illness, wherine various illusions and psychology can have free play, homeopathic theory would not merit the least time of day.
[...] David Gorski at Science-Based Medicine has an excellent explanation of why this totally debunked idea is still so entrenched and pervasive in o…. He says: The hypothesis that vaccines cause autism has been about as thoroughly falsified [...]
pmoran:
You’re right when you said, “…here is one example…”
I showed “one” example of grapefruit linked to breast cancer which turned out to be false, unless the subsequent study falsifying it was false. Clearly double blind studies sometimes just get it wrong.
You do understand this is one branch of homeopathy, classical, which I don’t use. Being a solitary study of under 100 subjects is hardly conclusive, although this study is at least attempting to exhibit some integrity.
I find it odd you would on the one hand put faith in this very limited study and when I referred to the Australian meta-analysis on 22 cancers, your first criticism was that it wasn’t comprehensive enough, that it excluded non-adult cancers.
You can’t have it both ways.
Just a reminder: homeopathy and vaccines are not related subjects.
Though the HepB and HPV vaccines do prevent cancer.
Libby:
You’re right when you said, “…here is one example…”
I showed “one” example of grapefruit linked to breast cancer which turned out to be false, unless the subsequent study falsifying it was false. Clearly double blind studies sometimes just get it wrong.
————————-
This is not the only individualized study on homeopathy, and the only claim I was making at the time was that you may not know as much as you think about the science relevant to homeopathy. You did not know that such studies have been done.
Yes, double blind studies can give false results, but usually as false positives. Nearly always there are active homeopaths involved in the design and performance of the studies. Seeking vindication for their field they naturally choose to study those areas where they believe they are getting their best results.
So it is not at all unreasonable to expect the studies to be consistently positive if homeopathy worked as claimed, and if homeopaths (and persons like yourself ) were actually able to detect a clear therapeutic signal amidst all the noise and clutter of day-to-day medical activity.
Clinical studies merely attempt to eliminate all the noise, so that the signal is clearer, and the statistical yardsticks commonly applied are not that hard to reach. So why all the negative studies?
Homeopaths and other CAM practitio
ners instinctively understand this, which is why they then often turn around and try to find reasons why “scientific studies cannot test what we do”.
You do understand this is one branch of homeopathy, classical, which I don’t use.
——————————–
Yes, I know that homeopathy has no consistent conceptual basis, so that homeopaths can always claim that “you are not doing it right” when results are negative.
Being a solitary study of under 100 subjects is hardly conclusive, although this study is at least attempting to exhibit some integrity.
————————
That is offensive, especially when many homeopaths and ex-homeopaths are now prepared to admit that homeopathy “works” via placebo and other non-specific effects.
I find it odd you would on the one hand put faith in this very limited study and when I referred to the Australian meta-analysis on 22 cancers, your first criticism was that it wasn’t comprehensive enough, that it excluded non-adult cancers.
—————————-
We were not talking then about an either/or situation. It was being widely alleged that chemotherapy improves cancer survival by only 2%. I was pointing out that that figure was an average that included many common cancers where improved survival is not expected, but where, if used, chemotherapy may provide useful palliation, and that that figure does not apply to either childhood cancers or leukemias.
You can’t have it both ways.
I am not biased against homeopathy, only certain claims it makes. On these very pages I have defended the availability of homeopathic remedies, at least in those countries with strong traditions of its use.. We should limit the claims it is allowed to make, although most of the Western public does , I think, already have some idea of its limitations.
Limitations? As in: Homeopathy is nothing more than water or sugar pills with water mixed in?
pmoran:
“…the only claim I was making at the time was that you may not know as much as you think about the science relevant to homeopathy. You did not know that such studies have been done.”
You seemed unaware that a JAMA study demonstrated that gifting by drug companies resulted in non-rational prescribing. Does that compromise your knowledge of medicine?
“Yes, double blind studies can give false results, but usually as false positives. “
A good point I hadn’t considered.
“Nearly always there are active homeopaths involved in the design and performance of the studies. Seeking vindication for their field they naturally choose to study those areas where they believe they are getting their best results.”
If true, the question remains, why would homeopaths who are knowingly scamming the public submit themselves to a study by their competitor?
Further to the study you submitted (White et al), the homeopaths were so disgusted by the lack of objectivity and the cherry picking of data that they withdrew their names as authors.
“So it is not at all unreasonable to expect the studies to be consistently positive if homeopathy worked as claimed, and if homeopaths (and persons like yourself ) were actually able to detect a clear therapeutic signal amidst all the noise and clutter of day-to-day medical activity.”
My therapeutic signal is that every year my hayfever is gone. The placebo effect, typically lasting for short durations, is a poor explanation.
“…many homeopaths and ex-homeopaths are now prepared to admit that homeopathy “works” via placebo and other non-specific effects.”
Who are the homeopaths that are saying these things?
“On these very pages I have defended the availability of homeopathic remedies, at least in those countries with strong traditions of its use.”
Actually in my country the battle is being won to limit the availability of many items. That means that more and more options that I find effective are being closed out.
In Canada natural health products are now classified as drugs because they make medical claims. On the other hand, General Mills is allowed to place medical claims on their boxes of Honey Nut Cheerios (can help lower cholesterol & reduce the risk of heart disease) without suffering regulatory issues of any kind.
Libby, you may benefit from a thorough review of SBM’s postings in the vaccines and homeopathy categories. Most of your talking points are addressed there. You’re not really presenting much that is new, which is why your reception isn’t exactly rosy. We’ve seen arguments like these before; in fact, we’ve dealt with most of them. And again, you should read Jay Shelton’s book, Homeopathy: How it Really Works.
Most homeopaths probably do not think they are scamming people, any more than doctors who applied bloodletting and purgatives during the days of prescientific medicine thought they were scamming people. There are a myriad ways the human mind can fool itself, it doesn’t matter if you’re a doctor or a homeopath. We just hope that people will listen to the evidence and discard that which does not work. Doctors do, over years and decades if not over months; it depends on the evidence. Homeopaths may sincerely think they are helping people but that doesn’t mean they actually are.
Placebo is only one reason your allergies would go away. Allergies also drift, appear and disappear over the span of years. Without a specific test protocol, you simply don’t know. Correlation isn’t causation, but people often fool themselves into believing this is so.
Ah, health freedom, which is really the freedom to pay money out of pocket for unproven interventions. Although with a public health care system, it becomes the option to spend someone else’s tax dollars. It’s funny that so many people decry drug companies and support “health freedom” for “Big Herbal”, “Big Needle” and “Big Sugar” (homeopathy). Don’t homeopaths, acupuncturists and herbalists make a profit? What about the companies that supply them? Why do you advocate for “health freedom” for CAM interventions, but not prescription drugs, or surgery? Why is it unacceptable that drug companies promote their products when herbalists, acupuncturists and homeopaths do exactly the same thing, except with less evidence, zero mandatory quality control and far, far less oversight in general? That’s a double standard, which is hypocritical.
Honey Nut Cheerios has a medial claim on the box because there is evidence to support soluble fiber lowering cholesterol and reducing the risk of heart disease, the very specific claim made by the manufacturer. Most regulatory schemes are quite reasonable – you must have good quality evidence to claim a treatment effect. I would suggest they do not go far enough though – there should be restrictions on vague claims like “boost the immune system” and “support organ function”, which are made without evidence, are not defined objectively and don’t actually mean anything. There is evidence that Honey Nut Cheerios will do something– lower cholesterol and reduce the risk of heart disease because of the presence of soluble fiber. Wouldn’t you say that statement is more precise and therefore more valuable than “supports organ function” or “boosts the immune system”? Seriously, what’s the issue here, that a processed food is marketed as having health benefits when there is evidence to support it? Why should herb and supplement manufacturers get to make similar, or even broader claims, when they do not have any evidence to support it? That it’s “not natural” therefore it must be inherently bad? Have you fallen prey to the naturalistic fallacy?
@libby,
“My therapeutic signal is that every year my hayfever is gone. The placebo effect, typically lasting for short durations, is a poor explanation.”
We have tried to explain to you that there are other possible explanations. The fact that improvement follows taking a homeopathic remedy doesn’t prove that the improvement was caused by the remedy. That’s a logical fallacy: post hoc ergo propter hoc.
HH:
“We have tried to explain to you that there are other possible explanations.”
Placebo is the only one that stands out. The rest were a vague collection of mental delusions.
The fact that hay fever can naturally fade with time is another possible explanation, and one that the NIH doesn’t appear to consider a mental delusion.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001816/
By the way, all delusions are mental.
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