The IOM and "completely expressed concerns"

11 Sep

If you’ve read my previous posts Dr. Bernadine Healy, you know I have some pretty serious concerns about how she represented the way the Institute of Medicine operated when they produced their report on Vaccines and Autism.  Those statements were made in interviews with Sharyl Attkisson.  Again, if you’ve been reading, you realize that Ms. Attkisson’s methods were a cause of concern for me as well.  I have voiced these concerns with CBS news via fax.

Dr. Healy made some pretty bold assertions, and Ms. Attkisson failed to even attempt to follow up on them.

The prime example is when Dr. Healy proposed that

…“There is a completely expressed concern that they don’t want to pursue a hypothesis because that hypothesis could be damaging to the public health community at large by scaring people. “First of all,” Healy said, “I think the public’s smarter than that. The public values vaccines. But more importantly, I don’t think you should ever turn your back on any scientific hypothesis because you’re afraid of what it might show.”

I’ve noted before, that a statement of that magnitude, calling into question the very methods and motives of the IOM deserved followup by Ms. Attkisson.  When someone makes a claim that an organization we all depend on to be independent and unbiased may have acted improperly, and unbiased reporter should make sure of the facts by checking with the real source before going ahead with the story.

Well, bloggers sometimes do the work that reporters fail to do.  In this case, AutismLibrary asked the IOM for comment on some of the way the IOM and its process in handling the 2004 Vaccines and Autism report have been portrayed.  Below (with permission) is the response that AutismLibrary received and blogged:

Thank you for your recent and very thoughtful message. As you know, the IOM’s Immunization Safety Review Committee most certainly did not suggest that scientific inquiry into the role of vaccines in autism should cease because the results could affect public perception of the value of childhood vaccinations. The public deserves better than that.

The committee’s 2004 report, Vaccines and Autism, states:

Determining causality with population-based methods such as epidemiological analyses requires either a well-defined at-risk population or a large effect in the general population. Absent biomarkers, well-defined risk factors, or large effect sizes, the committee cannot rule out, based on the epidemiological evidence, the possibility that vaccines contribute to autism in some small subset or very unusual circumstances. However, there is currently no evidence to support this hypothesis either.

After a paragraph in which the report follows that sentence with a discussion of the sparse literature regarding subsets of autism and the theoretical possibility of a vaccine-susceptible subpopulation, the report states:

While the committee strongly supports targeted research that focuses on better understanding the disease of autism, from a public health perspective the committee does not consider a significant investment in studies of the theoretical vaccine-autism connection to be useful at this time. The nature of the debate about vaccine safety now includes a theory that genetic susceptibility makes vaccinations risky for some people, which calls into question the appropriateness of a public health, or universal, vaccination strategy. However the benefits of vaccination are proven and the hypothesis of susceptible populations is presently speculative. Using an unsubstantiated hypothesis to question the safety of vaccination and the ethical behavior of those governmental agencies and scientists who advocate for vaccination could lead to widespread rejection of vaccines and inevitable increases in incidence of serious infectious diseases like measles, whooping cough, and Hib bacterial meningitis.

The committee urges that research on autism focus more broadly on the disorder’s causes and treatments for it. Thus, the committee recommends a public health response that fully supports an array of vaccine safety activities. In addition the committee recommends that available funding for autism research be channeled to the most promising areas.

Some readers have apparently failed to appreciate the full meaning and intent of the committee’s carefully written text. The report, as supported by the above-quoted paragraphs, clearly acknowledges the possibility that new information in support of hypotheses about susceptible subpopulations could emerge, at which time significant new research efforts might be appropriate. Whether the recent information about mitochondrial dysfunction will be the foundation for a major new research direction remains to be seen. The committee’s comment on the untoward consequences of discouraging vaccination was offered as an elaboration of their concerns about the unsubstantiated vaccine-autism hypothesis and not as support for their recommendations about an appropriate research agenda for understanding autism.

The scientists and clinicians on this committee evaluated the then-available scientific data in an unbiased manner. They reached their conclusions based on where the evidence led them. This principle—making recommendations only if supported by the evidence—guides all studies that IOM undertakes. I reiterate that the committee most certainly did not urge caution about pursuing the vaccine-autism connection in order to avoid frightening the public away from immunizations. The IOM stands ready to re-examine this issue should sufficient and relevant evidence emerge.

I almost put the entire last paragraph in bold for emphasis. Instead I’ll pull two lines out:

I reiterate that the committee most certainly did not urge caution about pursuing the vaccine-autism connection in order to avoid frightening the public away from immunizations

and

The IOM stands ready to re-examine this issue should sufficient and relevant evidence emerge

I read this as: there were no “completely expressed concerns” that affected the IOM’s study and that although they recommended rejecting the vaccine/autism hypotheses (thimerosal and MMR), they haven’t “turned their backs” on the subject. Should good research come forward (as with any subject in science) they will look again.

I do have one simple question: Shouldn’t Sharyl Attkisson approached the IOM for comment before going forward with this story?

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7 Responses to “The IOM and "completely expressed concerns"”

  1. Kev September 11, 2008 at 08:28 #

    I think Ms Attkisson is simply part of a journalistic ‘tradition’ on the overall issue of vaccines and autism that just doesn’t do investigative journalism. What she does is simply repost press releases from antivax groups. I’d be amazed if she’d done anything else.

  2. john April 10, 2012 at 21:27 #

    so let me get this straight —sacrifice a few(or more than few), basically the asd kids on the alter of vaccines, so as not to scare a public that is ‘smart than that’ so that everyone else stays healthy,,,, sounds like something outta germany in the 1940s..WTF!
    The Truth and science is never the IOMs freind. protecting somebody’s money is their freind or doing the CYA move is their friend. logic and science are their freinds only in so much as they can twist and manipulate them to show what they WANT them to show. sacrificing asd kids at the alter of public health is shameful.
    science fact 1= HIGH th2 cytokines impair neuronal/synaptic pruning.
    fact2 thmerosal increseases Th2 cytokines.
    fact 3 asd kids R born with abnormally high TH2 cytokines.
    fact 4 vaccine cause significant and prolonged increase in Th2 cytokines –thats how they WORK.
    fact 5 bisphenols and other things also increase th2 cytokines
    fact 6 most of the public are absolutely f’ing stupid (in USA)
    fact 7 asd is multifactorial and high Th2 cytokine promote ASD.
    and in newborns who have desmorphin + urine , maybe the doc might want to wait 12 months to give the aggresive USA vaccine schedule.
    well there now i said it ..my apologies anybody at IOM who may have fainted or suffered the vapors as a consequence of my blasphemy.
    it is my opinion. jb

    • Sullivan April 10, 2012 at 22:32 #

      How about fact 0: Thimerosal has been tested, repeatedly, and found to not increase the risk of autism.

      Hard to “sacrifice a few(or more than few), basically the asd kids on the alter of vaccines,” if the data show there isn’t a hightened risk.

      “fact 6 most of the public are absolutely f’ing stupid (in USA)”

      Strange how people will reach or any possible way to claim that those with real expertise in vaccines talk down to the public, but it is OK for you to claim that the public is “f’ing stupid”.

      “NOW THERES an idea that IS based in science”

      With all due respect. No, your idea is not based in science. Your idea follows some science-like language, but it is not science based.

  3. john April 10, 2012 at 21:41 #

    and no, i do not have any asd kids.

    one more thing —because of the miracles of modern science , we can do labs on the asd at risk infant so we can know how high their th2 cytokines are in relation to their th1 cytokines ……who knew?! so maybe just maybe docs should check the infants who excrete desmorphin(unique to asd kids), and not give any vaccine until the asd kids th1/th2 ratio is the same or very similar to a NORmal kids. or maybe , just maybe give the asd at risk kid with high th2 levels 1/4 the dose of the vaccine and spread the the schedule out over 5 years …wow NOW THERES an idea that IS based in science, cuz kids who have high th2 cytokines would need far less vaccine to achieve the same result —-wonder why some numbskull like myself could figure that out but all these brainacs in IOM for some reason could not????

    well , go figure
    that my opinion

  4. McD April 11, 2012 at 06:51 #

    @john: Other equally likely hypotheses to consider:

    H1: Fairies have been stealing human infants and replacing them with their own fairy children for hundreds of years. There have been numerous documented instances of so-called “changelings” in the historical literature. The child develops normally until toddler-hood, when the fairies, jealous of the healthy human child, will steal it and substitute a fairy changling who does not develop normally and often develops a number of physical conditions as well. Many mothers in the internet will tell you that their kid is just a different kid – and they are a different kid – a Fairy changeling!!!!

    H2: It’s them damn aliens. Autistic kids are the result of alien-human hybrid experimentation. The problem is trying to get alien intelligence into a human brain, while retaining human emotions and social behaviors. The alien scientists collaborating with top human researchers have just not got it right yet, even though they have started mass experiments with human guinea pigs. It is working in some cases, so we get the Asperger kids some of whom are now advocating for autistic rights as a precursor to announcing that their super intelligence is a result of alien DNA. The classically autistic kids are the result of going too far – they are too intelligent for a human brain to cope with. This is of course why a lot of research focusses on genetics.

  5. McD April 11, 2012 at 06:54 #

    oops, I missed this vital disclaimer off when I pasted in my comment above:

  6. McD April 11, 2012 at 06:58 #

    Arrgh
    /satire

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