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Vaxxed and the Tribeca Film Festival: How Robert De Niro learned the hard way about Andrew Wakefield and the antivaccine movement

Robert De Niro made a massive mistake last week.

Robert De Niro made a massive mistake last week. Fortunately, he started to make up for it.

One of the disadvantages of only doing one blog post a week here at Science-Based Medicine is that sometimes stuff happens at too fast a pace for me. If something happens on Tuesday, by the time Sunday rolls around and it’s time for me to do my weekly post, it’s often old news, too old to bother with. That’s why it’s a good thing that I have my not-so-super-secret other blog, where I can keep up with such events. On the other hand, the advantage of a once-a-week posting schedule is that there are times I can look back at a story that evolved over the last week and, instead of blogging about it in daily chunks, I can put together a post that tells the whole story and puts it in context. Something like that happened last week. The beauty of it is that I played a major role in bringing the story to public consciousness, followed the story as it evolved, and now can provide a fairly complete recounting. Or so I hope.

First, however, let’s take advantage of another good thing about waiting to blog about a story, namely getting to see the reactions of quacks to what happened. No one can do it better than everybody’s favorite all around quack, crank, and all-purpose conspiracy theorist Mike Adams, who greeted me yesterday morning with this headline: VAXXED film pulled from Robert De Niro’s Tribeca Film Festival following totalitarian censorship demands from pharma-linked vaccine pushers and media science trolls. What on earth is Adams talking about, you might wonder? In case you haven’t been following the news, here’s a link to the New York Times story on the same incident: “Robert De Niro Pulls Anti-Vaccine Documentary From Tribeca Film Festival.” Basically, the 2016 Tribeca Film Festival selected an antivaccine documentary directed by Andrew Wakefield for screening and then thought better of it after a major uproar and a whole boatload of bad press.

I’ll deal with Adams’ post a bit later because it’s so hilariously nutty but also because it is basically the propaganda line that antivaccinationists are putting on this PR debacle brought about by Andrew Wakefield and Robert De Niro. (I never thought I’d use those two names in the same sentence.) Let’s go back a week and see what I mean. (more…)

Posted in: Book & movie reviews, Science and the Media, Vaccines

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Neurotribes: A Better Understanding of Autism

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What is autism? What causes it? Is it genetic? Is it a consequence of something in our environment or lifestyle? What’s an “idiot savant” or an “autistic savant”? What happens when autistic children become adults? Why are so many of their parents scientists, academics, and engineers? If your grandfather’s Uncle Fred was a socially inept inventor with a lot of strange quirks, do you think he might have been autistic? Is autism really becoming more prevalent, or are we just getting better at diagnosing it? What’s happening with these people and what can be done to give them a better life?

Sorry to burden the list of recommended reading with yet another book, but if you are on the autism spectrum, if you know anyone who is autistic, if you think there is an epidemic of autism, if you think vaccines or environmental toxins cause autism, or if you are just interested in autism and want to understand it better, you will benefit from reading this new book by Steve Silberman: NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. You will walk away from the book with new insights and a new appreciation of the “neurodiverse.” (more…)

Posted in: Book & movie reviews, Neuroscience/Mental Health

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Antidepressants and Autism

Pregnant-woman-1-4-12-21A new study looking at the correlation of antidepressant use during pregnancy and the development of autism spectrum disorder (ASD) has been making headlines. While the results are likely significant, they are not as worrisome as the headlines may suggest.

The study: strengths and weaknesses

Overall the study design is solid. They followed 145,456 singleton full-term infants for a total of 904,035.50 person-years of follow-up. That is the strongest aspect of the study, its power. Typically when you capture large numbers you have to trade-off detail of information. As Lincoln might have said, you can capture a lot of information about a small number of people, or a small amount of information about a large number of people, but it is difficult to capture a lot of information about a large number of people.

The use of databases, especially in socialized countries, does help. In this case they used the ongoing population-based cohort, the Québec Pregnancy/Children Cohort. One compromise, however, is that they followed whether or not the mother filled a prescription for an anti-depressant. They did not capture whether or not the mother actually took the medication.

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Posted in: Neuroscience/Mental Health

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Antivaccine activists fund a study to show vaccines cause autism. It backfires spectacularly.

You want to inject me with vaccines and then dissect my brain? Why? We already know vaccines don't cause autism!

You want to inject me with vaccines and then dissect my brain? Why? We already know vaccines don’t cause autism!

Having written about pseudoscience and quackery continuously for over a decade and having engaged in conversations about it online for over 15 years, I’ve come to recognize a number of traits that are virtually the sine qua non of quacks and pseudoscientists and their believers. Obviously, one of them is a severe case of the Dunning-Kruger effect, a tendency of those with low expertise in a topic to overestimate their expertise and express far more confidence in their conclusions than warranted while those with high expertise know enough to know how much they don’t know about a topic and thus tend to express more uncertainty and caveats. Basically, the Dunning-Kruger effect describes how unskilled individuals express an illusory superiority, mistakenly believing their knowledge, competence, and ability to be much higher than it really is.

As a result of the Dunning-Kruger effect, coupled with other cognitive shortcomings suffered by all human beings (but seemingly amplified in believers in quackery and pseudoscience) that lead them to believe in pseudoscience, such as confusing correlation with causation, motivated reasoning, and the like, believers in pseudoscience are often so absolutely rock-solid in their beliefs that they are virtually impossible to reason with. It is incredibly difficult to change their minds, and disconfirming evidence often causes them to dig in all the more deeply to defend their beliefs. Not uncommonly, this leads them to commission studies designed to support their beliefs. But what happens when such a study does not actually support their belief? What happens when such a study backfires spectacularly and not only fails to support their belief, but emphatically so? Skeptics were re-treated to just such a spectacle last week when SafeMinds and other antivaccinationists were burned by a study they funded (subscription required):

Between 2003 and 2013, SafeMinds provided scientists from the University of Texas Southwestern School of Medicine, the University of Washington, the Johnson Center for Child Health & Development and other research institutions with approximately $250,000 to conduct a long-term investigation evaluating behavioral and brain changes of baby rhesus macaques that were administered a standard course of childhood vaccines. (The National Autism Association, another organization that has questioned vaccine safety, also provided financial support for this research.) The latest paper in the multiyear project was published Monday in the Proceedings of the National Academy of Sciences (PNAS). In it, the researchers concluded that vaccines did not cause any brain or behavioral changes in the primates.

Astute readers will recognize that I’ve written about similar papers before reporting that pediatric vaccines cause changes in behavior and/or brain structure in macaque monkeys. Specifically, way back in 2008, I noted the initial report of this ongoing study, first when preliminary results were reported as a poster presentation and then later another publication from the same group published in 2009. Steve Novella and a certain well-known friend of the blog have also described how poor experiments published from these studies in 2010 were, the latter of whom cited several other major criticisms of the study, not the least of which was some reporting of changes in the size of a part of the brain known as the amygdala that were…hard to believe. There were also a lot of issues with the control group chosen.

Basically, these abstracts and papers reported the results of an ongoing study looking at infant vaccines in macaque monkeys to see if there was an effect on socialization or changes in brain anatomy, the key hypothesis seeming to be that thimerosal-containing vaccines cause autism. (The investigators even added thimerosal to some of the vaccines because they weren’t being made with thimerosal anymore!) You can read the links I cited just now if you want the gory details; suffice to say that these were not good studies and not particularly good evidence that vaccines cause autism, as shown by the fact that homeopaths loved the study, and ultimately the paper examining hepatitis B specifically was withdrawn. Yet these reports were flogged for quite a while by the antivaccine movement as proof positive primate data that vaccines are Evil.

Fast forward to 2015. Now we have a much larger, much better study. It’s even by the same people. And guess what? It’s as negative as negative can be. No wonder SafeMinds and other antivaccinationists are unhappy. Let’s take a look. (more…)

Posted in: Science and Medicine

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Donald Trump and the dangerous vaccine politics of the 2016 Presidential race

Republican candidates Ben Carson and Donald Trump during the CNN Republican presidential debate at the Ronald Reagan Presidential Library and Museum on Wednesday, Sept. 16, 2015,

Republican candidates Ben Carson and Donald Trump during the CNN Republican presidential debate at the Ronald Reagan Presidential Library and Museum on Wednesday, Sept. 16, 2015

I’ve been writing about vaccines and the antivaccine movement since the turn of the millennium, first in discussion forums on Usenet, then, beginning in 2004, on my first blog (a.k.a. the still existing not-so-super-secret other blog), and finally right here on Science-Based Medicine (SBM) since 2008. Vaccines are one of the most important, if not the most important, topics on a blog like this because (1) arguably no medical intervention has prevented more deaths and suffering throughout history than vaccines; (2) few medical interventions are as safe and effective as vaccines; and (3) there is a vocal and sometimes effective contingent of people who don’t believe (1) and (2), blaming vaccines for all sorts of diseases and conditions to which science, despite many years of study, has failed to link them. The most prominent condition falsely linked to vaccines is, of course, autism, but over the years I’ve written about a host of others, including sudden infant death syndrome, shaken baby syndrome, autoimmune diseases, and even cancer. In a similar vein, antivaccine activists will try to claim that vaccines are loaded with “toxins” or even tainted with fetal “parts” or cells because some vaccines’ manufacturing process involves growing virus in two cell lines that were derived from aborted fetuses many decades ago. Even the Catholic Church doesn’t say that Catholics shouldn’t use these vaccines, but that doesn’t prevent some antivaccine groups from portraying vaccines as virtually being made by scientists cackling evilly as they grind up aborted fetuses to make vaccines. (I exaggerate, but not by much.)

On a strictly scientific, medical level, antivaccine claims such as the ones described above are fringe, crank viewpoints. There is no serious scientific support for any of them and lots of scientific evidence against them, particularly the most persistent myth, namely that vaccines cause autism. It also used to be the case that, politically, antivaccine views tended to be those of the fringe. Unfortunately, in the current election cycle, those fringe views seem to be coming to the fore among prominent candidates for the Republican Presidential nomination. This was most evident at the second Republican Presidential debate last week, where Donald Trump spewed antivaccine tropes and neither of the two physicians also running for the Republican nomination mounted a vigorous defense of vaccines. Even candidates who have previously issued strong statements defending vaccines (Senator Marco Rubio and Louisiana Governor Bobby Jindal) remained silent.

(Video of the exchange can be found here.)

How did we get to this point? And why is it that antivaccine views, which in the past were stereotypically associated with crunchy lefties in the mind of the public, seem now to have found another comfortable home among small government conservatives, including the man who currently appears to be the frontrunner for the Republican nomination? In the days that followed the debate, there have been many discussions of Donald Trump’s antivaccine views, but none that take the long view. All seem to flow from the idea that it’s mainly just Donald Trump and his wacky views, rather than Trump being part of a more widespread phenomenon. I’ve frequently said that antivaccine beliefs tend to be the pseudoscience that knows no political boundaries, occurring with roughly equal frequency on the left and the right. However, it’s virtually inarguable that right now, in 2015, the loudest political voices expressing antivaccine views (or at least antivaccine-sympathetic views) are in the Republican Party. Yes, Robert F. Kennedy, Jr. is back in a big way, partying like it’s 1999 with Bill Maher over thimerosal-containing vaccines and autism, but neither he nor Bill Maher holds public office or is currently running for office. The über-liberal website The Huffington Post might have been promoting antivaccine propaganda since its inception, but its writers are not running for office, either, and of late it seems to be much less antivaccine than before. (more…)

Posted in: Neuroscience/Mental Health, Politics and Regulation, Vaccines

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Medical marijuana as the new herbalism, part 4: Cannabis for autism

Medical marijuana as the new herbalism, part 4: Cannabis for autism

When I first started writing about the claims made for medical marijuana and the cannabis oil derived from it, it didn’t take long for me to characterize medical claims for cannabis as the “new herbalism,” as opposed to pharmacognosy, the branch of pharmacology devoted to the study of natural products. The reason is simple. Although I support legalization of marijuana for recreational use, when I look at how medical marijuana has been promoted as a “foot-in-the-door” prelude to legalization, I see testimonials and flimsy evidence ruling over all. I see all the hallmarks of alternative medicine herbalism and none of the hallmarks of pharmacology. Here’s what I mean. Pharmacognosy examines an herb, plant, or other natural product and seeks to identify the chemicals within it that have pharmacological activity against a condition or a disease, the better to purify and isolate those chemicals and turn them into drugs. Herbalism, on the other hand, emphasizes the use of whole plants or extracts from plants, rather than the isolation of the most active compounds. Thus, herbal remedies often contain hundreds, or even thousands, of different compounds, of which only one or a few are active. Even extracts, such as cannabis oil, contain many compounds.

In contrast to pharmacognosy, herbalists make the claim that whole herbs and plant components possess a synergy that is missing from the purified active constituents and/or that the mixture is safer than the pure components because one compound can reduce the side effects of another without reducing therapeutic efficacy. When looked at closely neither claim stands up to scrutiny. Synergism between plant constituents is rare and very difficult to demonstrate, for example. In essence, herbalism turns back the clock 200 years to a time before scientists had developed the techniques and abilities to isolate active ingredients with pharmaceutical activity. Moreover, herbalism, in contrast to pharmacognosy, emphasizes anecdotes over scientific evidence.

Indeed, in my previous posts in this series on medical marijuana, one theme has emerged, which is that cannabis—specifically, a class of active chemicals in marijuana known as cannabinoids—has potential for some diseases but is not the panacea claimed by its proponents. It does not cure cancer, for instance, contrary to glowing testimonials promoted by people like Rick Simpson. For other conditions, the evidence is either not particularly compelling or only mildly promising.

So I reacted with considerable dismay on Friday night when I saw this news report on the 11 o’clock news, “Michigan panel recommends allowing marijuana for autism“:
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Posted in: Herbs & Supplements, Politics and Regulation

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GcMAF and the life and death of an autism quack

Bradstreet

[Editor’s note: This is an extra bonus post that has appeared elsewhere. This week’s post will appear in several hours.]

A mysterious apparent suicide and conspiracy theories

Three weeks ago, those of us who combat the antivaccine movement noted the then-very recent death of an autism quack and antivaccinationist (but I repeat myself) who’s been big in the “autism biomed” movement for a long time and was a regular fixture at autism quackfests like Autism ONE for many years. I’m referring, of course, to Jeff Bradstreet, whose body was found in a river on June 19, dead from a gunshot wound to the chest that appeared to have been self-inflicted. It didn’t take long (less than a week) for the antivaccine movement to start speculating about conspiracies in which Bradstreet had been “bumped off” by big pharma, as represented by comments like these:

  • “It’s obvious that he was deliberately killed off because he spoke out against federal deceit, CDC, etc and was a life-saver for many like myself.”
  • “He did NOT kill himself! He was murdered for who he was speaking against, what he knew, and what he was doing about it. He was brilliant kind compassionate doctor with amazing abilities to heal. He was taken. Stopped. Silenced.”
  • “If this does not stink to high heaven I don’t know what does. A fisherman finds his body with a gunshot wound that appears to be a self inflicted. Just how the hell would they know that. Amazingly they happen to find the gun in the river. Wow that is some amazing detective work.”
  • “What a tragic loss of a beloved doctor. I pray the authorities get to the bottom of this story…it seems highly unlikely that a Christian man would shoot himself in thy chest and conveniently fall into a river.”

You get the idea. Meanwhile, others insinuated the existence of, basically, pharma hit squads. Not long afterward, Bradstreet’s family started a GoFundMe page to “find the truth.”

Let me just say one thing. I understand, to some extent, what the Bradstreet family is going through. My family has not escaped without having had one of its members commit suicide. Although it was someone I wasn’t particularly close to, he was very close to family members I am close to. So I understand better than most the pain they are going through. They do have my sympathy. I’ve been there.

That being said, it appears that more information is coming out about what happened in the days leading to Bradstreet’s death. It’s even started to filter out to major media outlets, as in this story published yesterday in the Washington Post, “The mysterious death of a doctor who peddled autism ‘cures’ to thousands“:
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Posted in: Health Fraud, Vaccines

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The war in California over nonmedical exemptions to school vaccine mandates

The war in California over nonmedical exemptions to school vaccine mandates

As I write this, I am currently at the Center for Inquiry (CFI) Reason for Change conference, where on Friday Steve, Harriet, and I did a panel on—what else?—alternative medicine and how it’s become “integrative medicine.” As a result, I’ve been very busy, which means that parts (but by no means all) of this post will look familiar to those of you who follow me at my not-so-super-secret other blog. However, it occurred to me after we did our panel discussion that there are important things happening in California that we’ve only barely touched on here on this blog. I’m referring, of course, to a bill (SB 277) that’s wending its way through the California legislature. SB 277, if passed, would eliminate nonmedical exemptions to school vaccine mandates. That’s not to say we haven’t discussed the issue of nonmedical exemptions, of which there are two types: religious and personal belief exemptions (PBEs), which can all be simply described as PBEs. Both Steve Novella and I have addressed them on SBM. For example, when an earlier bill (AB 2109) was passed that mandated that parents seeking PBEs consult with a physician or other listed health care professionals (which, unfortunately, included naturopaths) before a PBE would be granted, I documented how the antivaccine movement strenuously objected even to this minor tweak in the law that would make PBEs slightly more difficult to obtain. Unfortunately, even though, against all expectations, the bill passed, Governor Jerry Brown sabotaged it with a signing statement that betrayed California children by reinstating, in essence, religious exemptions. Specifically, Gov. Brown ordered the California Department of Public Health to include a check box on the form that parents could check to say they have religious objections to vaccines. Parents who checked that box could thus bypass even the anemic requirement to consult with a pediatrician before being granted a PBE.

The problem with nonmedical exemptions to school vaccine mandates is that vaccine-averse and antivaccine parents tend to cluster mostly in areas where white, affluent people live, as demonstrated in California and my own state of Michigan. So, even though antivaccinationists frequently tout high statewide vaccination rates as evidence that the process for obtaining PBEs does not need to be tightened up, they are disingenuously using a straw man argument against vaccine mandates, because it’s the pockets of low vaccine uptake that compromise local herd immunity that are the problem. We see these in Oregon, California, Michigan, and many other states with PBEs, and we also know that ease of obtaining PBEs is correlated with more PBEs and more outbreaks of vaccine-preventable diseases.

All of this came to a head earlier this year with what is now known as the Disneyland measles outbreak, a large multistate outbreak originating at Disneyland and traced to unvaccinated children. This outbreak so shocked California that the unthinkable happened. The possibility of passing a law eliminating nonmedical exemptions to vaccine mandates, something virtually everyone would have considered as much a fantasy as many of the characters played by the recently deceased great Christopher Lee played during his career, suddenly became an attainable goal. Senators Richard Pan and Ben Allen introduced SB 277, which would eliminate the personal belief exemption for children attending state licensed schools, daycares, and nurseries in California.
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Posted in: Politics and Regulation, Public Health, Vaccines

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A journey to alternative and integrative medicine apostasy

Julian the Apostate presiding at a conference of sectarians, by Edward Armitage, 1875

Julian the Apostate presiding at a conference of sectarians, by Edward Armitage, 1875

I’ve been blogging for over a decade now, a fact that I find really hard to believe looking back on it right now. I’ve told the story before, but it’s worth briefly recounting again because doing so will explain why the story I’m about to discuss caught my attention. My “gateway drug,” if you will, into skepticism was discovering Holocaust denial in the late 1990s on Usenet, a vast and sprawling conglomeration of thousands of discussion forums that began to fade away at the turn of the century with the rise of web-based forums and Google providing an interface to it to make it Google Groups. The forum where I first discovered Holocaust denial and learned to combat it, alt.revisionism, still exists, but long ago degenerated into a cesspool of racism, spam, and trolling. A couple of years later, around 2000 or so, I discovered quackery and the antivaccine movement, thanks to a Usenet newsgroup known as misc.health.alternative, which is where I honed my early skills applying science to medical claims. It’s also where I first encountered Peter Moran, a regular commenter here who greatly inspired me back then with his full-throated criticism of cancer quackery and his website that taught me reasons why cancer quackery could appear to work even when it did nothing to impact the progression of the cancer.

In December 2004, intrigued by all the news stories about blogging and having discovered a number of good blogs, I decided on one dark, gray Saturday afternoon to dip my toe in the blogosphere. On the spur of the moment I created the first iteration of my not-so-super-secret other blog on—what else?—Blogger. Much to my own amazement, over the course of a year I got my little hobby noticed, to the point where I was invited to join a blog collective; by late 2007 I had become prominent enough to be invited by Steve Novella to join this very blog at its founding, where I have remained for seven years, with no plans to move on any time soon. During my early days, though, there was one person who also inspired me, helping me to learn about the pseudoscience that undergirds the antivaccine movement and, in particular, the quackery making up what is known these days as the “autism biomed” movement. His name is James Laidler, and he was one of the ones who introduced me to this topic which I’ve written about many times both at my not-so-super-secret other blog and, of course, right here on SBM. In doing so, over the years I’ve catalogued why “autism biomed” seems compelling to many parents with children with autism, how antivaccine groups use fake “medical conferences” to sell autism biomed by giving a patina of medical respectability to rank quackery like bleach enemas, and providing a place where those selling unscientific treatments can find willing customers and where disreputable discredited “scientists” like Andrew Wakefield and Mark Geier can find adoring fans who believe their quackery.

I bring this up because last week WIRED published an excellent article about Jim Laidler, “An Alternative-Medicine Believer’s Journey Back to Science.” Appropriately enough, it’s by Alan Levinovitz, an assistant professor of religion at James Madison University. I say “appropriately enough” because, as has been noted here on a number of occasions, there are many religion-like aspects to alternative medicine in general but to the autism biomed movement in particular. Indeed, the two are often tied together, with the motivation for some alt-med being explicitly religious and belief in alt-med sharing some major characteristics with religion, particularly belief in miracles against evidence, charismatic leaders (like Andrew Wakefield) who can do no wrong, and mutually-supportive communities of believers who reinforce each others’ beliefs and ward off skepticism. Add to that the magical thinking, and it’s not for nothing that I’ve referred to the central dogma of alternative medicine as being that wishing makes it so. Indeed, it’s for good reason that I frequently point out that most “energy medicine” (particularly reiki) is basically faith healing that substitutes Eastern mysticism for Judeo-Christian religious beliefs.

In Levinovitz’s profile of Jim Laidler, we see a lot of this, and I learned some details that I didn’t know about Laidler before. Levinovitz also grasps the religion-like nature of alt-med by starting the article bluntly saying:

Jim and Louise Laidler lost their faith on a trip to Disneyland in 2002, while having breakfast in Goofy’s Kitchen.

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Posted in: Health Fraud, Neuroscience/Mental Health, Vaccines

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Still No Association Between MMR and Autism

Pictured: not a risk of autism

Pictured: not a risk of autism

A new study published this week in JAMA, “Autism Occurrence by MMR Vaccine Status Among US Children With Older Siblings With and Without Autism”, puts one more nail in the claim that the MMR is associated with autism.

You may wonder why, after years and multiple studies showing no association between the measles-mumps-rubella vaccine (MMR) and autism spectrum disorder (ASD) there would even be a need for such a study. The authors explain:

Despite research showing no link between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorders (ASD), beliefs that the vaccine causes autism persist, leading to lower vaccination levels. Parents who already have a child with ASD may be especially wary of vaccinations.

The study is a retrospective cohort study involving 95,727 children with older siblings. They looked at whether or not the older sibling had a diagnosis of ASD, whether or not they were vaccinated with MMR, and whether or not they themselves developed ASD. They found:

MMR vaccination rates (≥1 dose) were 84% (n = 78 564) at age 2 years and 92% (n = 86 063) at age 5 years for children with unaffected older siblings, vs 73% (n = 1409) at age 2 years and 86% (n = 1660) at age 5 years for children with affected siblings. MMR vaccine receipt was not associated with an increased risk of ASD at any age. For children with older siblings with ASD, at age 2, the adjusted relative risk (RR) of ASD for 1 dose of MMR vaccine vs no vaccine was 0.76 (95% CI, 0.49-1.18;P = .22), and at age 5, the RR of ASD for 2 doses compared with no vaccine was 0.56 (95% CI, 0.31-1.01; P = .052). For children whose older siblings did not have ASD, at age 2, the adjusted RR of ASD for 1 dose was 0.91 (95% CI, 0.67-1.20; P = .50) and at age 5, the RR of ASD for 2 doses was 1.12 (95% CI, 0.78-1.59; P = .55).

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Posted in: Vaccines

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