Archive | October, 2008

Too many falsehoods, too often

11 Oct

ResearchBlogging.orgThere are a number of falsehoods used in the vaccine-rejectionist arsenal. One, which we’ve discussed recently, is the idea that vaccine preventable diseases are in reality “not that bad.” Another is that deaths from vaccine preventable diseases were decreasing before vaccines were introduced, implying that the vaccines are getting credit for something that was already happening. Another is that somehow we are “overvaccinating” and that we can go back to an earlier schedule and be just fine. Another is that we vaccinate children too young.

We all know the current catch phrases. And that’s what they are, slogans, catch phrases…the efforts of marketing rather than science.

But, let’s take a look at a paper that covers a number of these falsehoods at once. This is an older paper, from 1994. The paper is National Trends in Haemophilus influenzae Meningitis Mortality and Hospitalization Among Children, 1980 through 1991.

As you can imagine, they were looking at the reduction in deaths and hospitalizations from meningitis caused by Haemophilus influenzae. This is what the Hib vaccine protects against. The first Hib vaccine licensed in the U.S. came out in 1985. However, it didn’t work for children >18 months of age, and had only moderate effectiveness for older children. A more effective vaccine was licensed in 1987 for children >18 months, and in 1990 for children >2 months.

Bottom line, good protection against Hib meningitis came to the U.S. in 1987.

So, if this actually worked, we should see trends changing about that time. Take a look at Figure 1 from the paper. (click to enlarge)

U.S. Hib deaths by year 1980 to 1991

The top trend is for Hib induced meningitis. The other two datasets are for Streptococcus pneumoniae and Neisseria meningitidis induced meningitis.

Note that the mortality was dropping with time before the introduction of the vaccine. Deaths declined by 40% from 1980 to 1987 (a span of 8 years) for Hib meningitis (with similar big drops in the other types). Dang. Good job, docs! But, that’s only part of the story. Take a look at what happens after 1988. Hib meningitis deaths drop at a much faster rate. After the introduction of the vaccine, Hib meningitis deaths dropped 90% in only 4 years.

But, you don’t have to geek out like me on the numbers, just look at that trend–in 4 years, Hib meningitis went from the highest cause of meningitis deaths, to tied with the lowest in this comparison.

That’s the sort of data that the mercury-causes-autism crowd were expecting to see in the autism rates starting a couple of years ago. (but, I digress…)

Note that there isn’t a change in the trends for the non Hib versions of meningitis graphed. It’s about as clear as data can get–introduce the vaccines, fewer people die. Note that the hospitalization rate is about 15x higher than the death rate. So, a lot of kids ended up in the hospital. I have to admit, I didn’t realize how really nasty this disease is. If about 1 in 15 of the people who go to the hospital die…well, dang, thank god there’s a vaccine.

I can already hear the response–but, why do we have to be so “aggressive” in giving these vaccines to such young children? Take a look at figure 3 from the paper.

Hib meningitis deaths for infants and young children 1980-1991

They broke the data down to infants (younger than 1 year old) and children 1-4 years old. Notice that the trend is the same for both age groups. More importantly, notice that the death rate is about 5x larger for the youngest children.

Yes, five times higher. But, protecting these young children is “aggressive”. If that’s aggressive, thank god for aggressive.

You may be wondering what prompted this little excursion to a paper from the 1990’s. Well, take another look at the citation:

Kenneth C. Schoendorf, John L. Kiely, William G. Adams and Jay D. Wenger (1994). National Trends in Haemophilus influenzae Meningitis Mortality and Hospitalization Among Children, 1980 through 1991 Pediatrics, 93 (4), 663-668

Note that one author, John L. Kiely? He recently wrote an Op-Ed for the Atlanta Journal Constitution on the importance of the MMR vaccine. Or, you may know him as EpiWonk.

But, to summarize:

Go back to the 1980 vaccine schedule? Had they not added Hib, thousands of kids would have died in the last 20 years. Many more would have suffered permanent injury.

We give too many vaccines? Based on what? Can we just do without the Hib?

Vaccines given too young? A 5x higher mortality rate for the youngest. Where’s the sense in delaying protection?

Vaccine preventable disease were becoming more manageable, so vaccines weren’t really doing anything. I guess if you believe in levitating dolphins, that argument works. For everyone else, the data are clear: vaccines work. They work well.

The myth of mild measles

9 Oct

One of the common arguments from vaccine rejectionists is “These diseases aren’t really that bad”. Often this includes graphs of death rates over time, with the suggestion that the diseases were already going away by themselves when the vaccination program started. It boggles the mind that intelligent people can make that claim, but they do.

The other argument is that with modern medicine and sanitation, the diseases were not a big problem. Again, mind boggling.

People will say, without any hint of irony, “I got the disease and I didn’t die.” The response being so obvious (the dead people aren’t here to speak) that I am astounded that these people make this claim.

More recently, I’ve seen a few blog posts where old news stories are picked out and people say, “See, they didn’t think these were that dangerous”. How many times can I say “mind boggling” in one post?

That all said, I decided to look through old news stories to see what people thought of Measles over time. As it turns out, some really good stories were in Time Magazine, so I will use that as the source.

Let’s scroll back to 1934. In a piece simply titled Measles, Time states:

New York City’s Health Commissioner Rice warned parents to beware of measles as a “very serious malady,” but assured them that this is not a “measles year” in New York. In the first ten weeks of last year the city had 9.562 cases and 44 deaths, against 413 cases and two deaths for the same period this year.

It wasn’t a “measles year”, as in, this wasn’t a big outbreak. Yet, 44 2 people died. [see comments for correction]

OK, people will say, that’s before good medicine and sanitation. (boggle boggle boggle). How about more recently? How about 1966, just as the vaccine was being rolled out (or, as the rejectionists would have it, just about the time when measles decided to coincidentally morph into a mild disease). The title of the piece in Time magazine? End Measles Now. Take a look at the opening paragraph:

To the casual observer, the heavy snow, gale winds and high tides that struck most of the Northeast last week seemed to have turned Rhode Island into a disaster area. Like homeless refugees, long lines of crying children clinging to their parents snaked through the gloom. But it was not the storm that turned out the Sunday crowds. Rhode Island was engaged in a well-planned exercise in preventive medicine.

Yes, people were braving huge storms to go out and get their kids vaccinated against measles. Why? People realized that measles was still, in advanced-medicine-good-sanitation 1966, a major problem.

All over the country concern about measles is increasing. At the research level, physicians and other virologists have long been puzzled about how and when the measles virus attacks the brain, as it does in an estimated 4,000 U.S. cases of encephalitis each year

1966: 4,000 cases of encephalitis every year.

How about 1977? Clean, advanced 1977? An Alarming Comeback for Measles.

Adds Dr. Colette Rasmussen of the Cook County, Ill., public health department: “Too often the disease is looked upon as a sickness all children once had, as a kind of joke.” Unfortunately, measles is no laughing matter. While the overwhelming majority of victims recover in a week to ten days, some develop pneumonia or encephalitis. If the measles virus spreads to the brain, it can cause convulsions, coma and brain damage, and sometimes death.

1977: People still scared of the measles. But, people are starting to forget how bad measles was pre-vaccine.

And, then there’s today. In a piece, How My Son Spread the Measles, Time interviewed the mother of the child who imported the measles from Switzerland this year. They couldn’t use her real name, so they called her “Jane”. She describes the situation:

Jane says she did not know her son had been exposed to the measles while visiting Europe; and she didn’t know that her son was infectious. She and her husband select vaccinations for their children based on their age, their body’s ability to fight the infection, and the risks of the vaccination. Her infected son was not inoculated against measles. “We analyze the diseases and we analyze the risk of disease, and that’s how my husband and I make our decision about what vaccines to give our children.”

She gambled not only with her son’s life and health, but with the lives and health of other children. Other children, including those too young to be vaccinated against measles. But, she does feel “horrible” for the other people affected:

She adds about the outbreak, “I feel horrible for those children and their parents, but I want to protect all children from harm. And so by making sure there is more research done, we can help all children.”

Vaccines in general are a good thing, she says, but the problem is in the ingredients. Many vaccines contain mercury, formaldehyde, and aluminum, Jane argues. Thimerosal, which contains a mercury derivative, was once a common preservative in vaccines, she says. “This just can’t be good for you. Injecting yourself with aluminum can’t be good.”

She weighed the known risks of measles (death, brain damage, pneumonia, to name a few) against the perceived risks of vaccines (with the vague: “Injecting yourself with aluminum can’t be good”). Not a very quantitative comparison. But, she can make this decision because:

Because her children are healthy and well-nourished, Jane said they will sail through childhood diseases such as measles and chicken pox without trouble — and get lifelong immunity from the exposure. And she said, because the U.S. is a relatively healthy first-world country with a well-functioning health care system, she feels safe in making the choice to vaccinate selectively.

Let’s take a quick look at how an actual measles survivor recalls the measles:

I’m in a hospital bed, gasping for breath. Through the clear plastic of an oxygen tent, I see my Mom. Her face is red and she’s crying and crying. I feel hot. Every few hours a nurse opens the oxygen tent and gives me a shot. It hurts.

It’s 1959. I’m in second grade. I’d caught the measles, just like my brothers and sisters and friends. Except unlike them, my measles didn’t go away. It got worse and turned into something I’d never heard of: pneumonia. I spent a month in the hospital, survived, and spent a few more months recovering at home. But more than four million children got measles in the United States in that year and 385 died.

He doesn’t mention poor sanitation or bad medical care. Yes, it was 1959, but that’s supposedly when measles was becoming a “mild” disease. Yes, modern medicine kept him alive. Want to bet what his chances would have been 50 years earlier?

But, let’s look back at how “Jane” made her decision:

“Looking at the diseases mumps, measles and rubella in a country like the U.S…. it doesn’t tend to be a problem,” Jane said. “Children will do fine with these diseases in a developed country that has good nutrition. And because I live in a country where the norm is vaccine, I can delay my vaccines.”

Yes, because the rest of us are vaccinated and we vaccinate our children, she can delay vaccinating her kids. Well, sort of. Evidence shows that in reality, her kid did get a vaccine preventable disease because she “delayed” the vaccine. (It is an open question in my mind whether he child was ever going to get the MMR, but let’s move on).

What are the real risks of the measles….today…in the United States? From the Atlanta Constitution Journal piece:

Along with the pneumonia I had as a kid (1 to 6 percent of measles cases), the risks of measles include severe encephalitis (one per 1,000 cases) — about a third of which result in mental retardation. They also include one to 10 deaths for every 10,000 measles cases. Another risk is subacute sclerosing panencephalitis, a rare fatal illness (one per 100,000 measles cases) caused by an ongoing measles virus infection of the brain, in which symptoms of brain damage usually begin seven to 10 years after infection.

“Jane” made a decision that put a dozen kids at risk of death or brain damage. The odds were in her favor, and they seem to be OK (if you can call taking an infant to the hospital, “OK”). “Jane” won’t know for seven to ten years whether her child, or any of the 12 he infected, will come down with subacute sclerosing panencephalitis (SSPE). At 1 in 100,000 , the odds are pretty good that they will all be OK. But, not zero.

But, let’s compare that to the real risk of MMR. Again from the AJC piece:

And the side effects of MMR? Fever, malaise, a mild rash, swollen glands and a stiff neck in about 5 percent of the patients, febrile seizures in about three out of 10,000, and temporary low platelet count in about three per 100,000 patients. About one in 1 million have an easily treated anaphylactic reaction. And no deaths. Not one.

Because of the relationship of the measles virus to encephalitis, vaccine safety experts have had an ongoing concern that the MMR vaccine might be a rare cause of this disease. Fortunately, all studies with controls have found no association between the MMR vaccine and encephalitis.

So, on the one hand (catching the measles), you have a 1 in 100,000 chance of death by SSPE, a 1 to 10 per 10,000 chance of death right away, about 0.3 per 10,000 chance of mental retardation. On the other hand (getting the vaccine) you have no deaths, febrile seizures in about 3 per 10,000, anaphylactic reaction in 1 per 1,000,000 and 5% with more mild symptoms. Yes, those are all real reactions. But, the balance is clearly tilted towards vaccination. Except, as “Jane” put it, “And because I live in a country where the norm is vaccine, I can delay my vaccines.” Yes, if others are protecting your child, you can “delay” vaccinating and, usually, get away with it.

Let’s do the comparison for “Outbreak Jane”, shall we? With about 10 people affected, the odds were roughly

0.3% that someone could have suffered brain injury
0.1 to 1% that someone could have died
0.01% chance that in the next 10 years one of these people will die of SSPE. Pretty low odds, but, that’s a lot of chips on the table. Would you be happy if someone made that bet for you or your child?

And, that last bit is important. “Jane” made the decision for other people. Some were people whose children were too young to vaccinate.

Still, Jane says she was surprised by the number of calls she got from friends who wanted to bring their unvaccinated children over to play with her kids while they were infectious. Like Jane, they see getting the measles as far healthier than the vaccine.

That’s just a googleplex of boggles.

She said the recent measles outbreak in her region prompted her to do more research. That work has made her even more certain that she and her husband are choosing wisely to be very selective about vaccinations. “This is a difficult choice for parents; choose the vaccine or choose the disease. I have chosen the disease by not vaccinating.”

She chose wisely? She chose “the disease by not vaccinating”? Yes, I agree, she did. The problem is, she also chose the disease for many people other than her own family.

Measles is far from mild. And, no, it isn’t as though people in the past thought so. They just accepted the sickness and death that inevitably came with measles outbreaks. Dr. Keily is quite correct in his piece on the AJC

My mother wasn’t wrong to be crying, back in 1959. The risks of measles are real. Americans were right to be elated when the measles vaccine became available.

The MMR vaccine doesn’t hurt kids. Letting them go without it will.

[note: some small changes have been made since this was first published. Most notably, I corrected a mistake where I put the odds of SSPE at 1 in a million, instead of the correct 1 in 100,000]

Autism and allergies

8 Oct

ResearchBlogging.orgAllergies are often a topic of discussion in the autism community. Much of the alternative- medicine approach works from the point of acting on allergies. I saw this paper and found it interesting, but wasn’t going to blog it until the PETA campaign (Got Autism) came up using the proposed sensitivity of autistics to casein.

The paper is Atopic features in early childhood autism, by B. Bakkaloglu, B. Anlar, F.Y. Anlar, F. Oktem, B. Pehlivantürk, F. Una, C. Ozbesler, and B. Gökler. As you might guess from the author list, this isn’t a U.S. or western European group. They are from Turkey. I have no reason to doubt the group’s quality, but that fact, together with the fact that the sample size is relatively small (30 autistic and 30 controls), suggests to me that this isn’t going to be the final word on this subject.

That said, the paper looks for allergic hypersensitivity (atopy) in a group of children with autism.

Here’s the abstract:

BACKGROUND: Autism is a developmental disorder of unknown etiology. Sensitivity to dietary and environmental antigens has been considered in its pathogenesis.

AIM: To examine immediate hypersensitivity in early childhood autism.

METHODS: We investigated 30 autistic children (23 boys, seven girls 2-4 years old) for atopic history, serum IgG, IgA, IgM, IgE levels, and skin prick tests (SPT) with 12 common antigens.

RESULTS: Nine/30 autistic children (30%) and 1/39 (2.5%) age-matched neurological controls from the same hospital had a family history suggestive of atopy (p<0.005). No patient in the autism and 28% in control group had symptoms of respiratory allergy (wheezing or asthma) (p<0.005), and 6/30 (20%) autistic vs. 7/39 (17%) control children had history suggesting other allergic disorders (p=ns). Eleven/23 (47.8%) autistic children had at least one positive skin test, similar to age-matched population controls. Serum IgG, IgA, and IgM levels were within age-appropriate limits. Serum IgE was elevated in four patients (13.3%). Specific IgE levels were negative in four cases with multiple SPT positivity.

CONCLUSIONS: This study suggests allergic features based on history, skin tests, and serum IgE levels are not frequent in young autistic children despite family history. This discrepancy between predisposition and manifestation might imply immunological factors or environmental condition

That gives away the punch-line: they don’t see a correlation between allergic features and autism. It’s still worth looking a bit closer at the paper.

They recognize that autism is a broad spectrum, so they attempted to look at a group that was fairly similar:

Many studies examined hypersensitivity or intolerance to environmental and food antigens in autism: however, their interpretation and comparison may be difficult due to methodological differences or anecdotal nature of the information. In addition, autistic spectrum disorders are a mixed group: inclusion of patients of various ages and clinical phenotypes can cause discrepancies, which we intended to avoid by studying newly diagnosed cases with idiopathic childhood autism in a narrow age range.

The study looked at very young children, ages 2-4. Autism was measured by a CARS test. Autistic children had scores from 33-50, with a median of 44.5. Since a score of 30-36.5 is considered “mild/moderate” autism, these data indicates that the children were largely in the “severe” range.

They found that 30% of the autistic children had familial history of atopy, compared with only 2.5% of the control children. However, autoimmune disease was not present in high numbers in the parents. Those two facts are interesting on their own, and if that was the end of the study, I wouldn’t be surprised if it popped up in autism discussion forums. But, another interesting finding is that the atopy is not found in the autistic children.

The questionnaire for allergic symptoms indicated familial atopy in 30% of autistic children and 2.5% of hospital controls (p<0.005) (Table 1). Taken together, 3/30 children of the autism group (10%) and 15/39 of the hospital controls (61%) had a score of at least 1 (p<0.005), and the rate of reported allergic symptoms was 6/30 vs. 7/39 (p:ns). Groups did not differ significantly in early-life environmental factors likely to affect allergic state: area of residence, day care attendance, breast feeding, and birth order. Parental autoimmune disease was present in two autism (vitiligo, psoriasis) and one control case (arthritis) (p:ns). CARS scores of the autism group were 33–50, mean 43.6, and median 44.5.

But, given that my interest level was higher due to the PETA ads using the proposed casein sensitivity of autistics, I wanted to see what sensitivities they found:

Of total 276 skin tests applied, 27 (9.7%) were positive, most commonly against aspergillus and grass antigens, followed by cat fur and D. farinae. Eleven/23 (47.8%) of children who received skin tests had a positive result with at least one antigen and five of them, with multiple antigens. House dust mite sensitivity was seen in three (13%), pollen, five (21.7%), and mold, in six (26%) children.

Serum IgG, IgA, and IgM were within age-appropriate limits according to laboratory standards. Serum IgE was elevated in 4/30 cases (13.3%), all associated with allergic symptoms in the patient or in a family member, or SPT positivity. Antigen-specific IgE tests done in four out of five children with multiple SPT positivity were negative.

So, mold (aspergillus), grass, cat fur and dust mites (D. farinae) were the top. Not casein, not gluten.

Again, do I think this is the last word on autism and allergies? No. But, I do think it is a good example of newer studies than, say, PETA’s reliance on a 1995 paper.

PETA appears to have wanted just enough data to justify their billboard. I join many in the blogging community who found the use of people with autism–the misuse, I should say–abhorrent. Kev has already responded in his own way. It took me a while to find my own, rather obscure, method of response.

I am grateful that the billboard has been pulled. I would hope that PETA would issue an apology as well. I’m not holding my breath.

B BAKKALOGLU, B ANLAR, F ANLAR, F OKTEM, B PEHLIVANTURK, F UNAL, C OZBESLER, B GOKLER (2008). Atopic features in early childhood autism European Journal of Paediatric Neurology, 12 (6), 476-479 DOI: 10.1016/j.ejpn.2007.12.008

Kirby launches torpedo at Verstraeten, sinks Geier

8 Oct

The thimerosal/autism study by Thomas Verstraeten is one of the big targets for those with the vaccines/mercury cause autism agenda. For what it’s worth, Autism’s False Prophets goes into the history of the Verstraeten study and clearly explains the history of that study.  Not surprisingly, the answer is somewhat different than you might find in, say, Evidence of Harm.

In his recent briefing on Capital Hill,  David Kirby took another jab at the Verstraeten study. He tried to assert that (a) the NIEHS claimed that the Vaccine Safety Datalink was unusable for autism studies and that (b) the CDC agreed. He was incorrect, and, luckily, a staffer caught Kirby at it.

Mr. Kirby is trying to explain his actions in a blog post in which he posts an open letter to that congressional staffer.

Let’s consider something here: the congressional staffer, an M.D., knew enough about the subject to catch David Kirby misquoting the NIEHS. I wouldn’t have been quick enough on my feet to catch the misquote.  Now, David Kirby wants to educate this gentleman. Frankly, the information should be flowing the other way. If Mr. Kirby had shown himself open to such education, say when EpiWonk made it abundantly clear (twice) what Mr. Kirby’s mistakes were, perhaps it would be worth the staffer’s time to discuss this with Mr. Kirby. That said, let’s take a look at Mr. Kirby’s letter.

In regards to Mr. Kirby’s misquotes, he has recently “clarified” his position.  He is writing to the Doctor who corrected him in his briefing here:

As you rightly pointed out (and as I concurred that day) I omitted an important detail in regards to Dr. Gerberdings’s letter to the Committee. I regret that, and never meant to mislead people in the room.

It was a rather artless sin of omission.

I think the lesson for me here is that, when you try to cram a two hour presentation into 25 minutes, it is wise to not include very complicated and, as you put it, “somewhat arcane” details that are difficult to explain in such a short period of time. In retrospect, I probably should have focused solely on the NIEHS report itself, and left the Gerberding letter out of the presentation entirely.

Mr. Kiby iscorrect, it is a confusing situation.  There are two documents–an NIEHS report and Dr. Gerberding’s response for the CDC. But, does that excuse misquoting the head of the CDC in his legislative briefing?

Here’s what David Kirby in his capital hill briefing “quoted” the NIEHS report as saying:

NIH: “We identified several areas of weakness that were judged to reduce the usefulness of the VSD for addressing the potential association between exposure to thimerosal and risk of ASD.”

That isn’t in either the NIEHS report or Dr. Gerberding’s response.  Here’s what Dr. Gerberding actually agreed to:

The panel identified several serious problems that were judged to reduce the usefulness of an ecologic study design using the VSD to address the potential association between thimerosal and the risk of AD/ASD.

Emphasis is mine.  But, we’ve already discussed that: Dr. Gerberding didn’t claim that the VSD has reduced usefulness in addressing the thimerosal/autism question. It made a claim that the ecological studies using the VSD had limitations. But, the recipient of Mr. Kirby’s letter would know that.

Back to Mr. Kirby’s open letter: David Kirby is now presenting his own interpretation of the NIEHS report, in place of Dr. Gerberding’s.

As I interpret things, the panel concluded that the database itself suffered from several weaknesses and limitations, which in turn reduced its usefulness for studies of autism risks from thimerosal (ie, Verstraeten) AND ALSO reduced the feasibility of future studies (ie, ecological ones) that are based on data collected within the VSD.

As EpiWonk aptly pointed out, Mr Kirby’s assertion is not the case. The NIEHS panel suggested a number of possible studies on autism using the VSD.  From the NIEHS report:

An alternate future study design that was viewed positively among panel members was a study of a high risk population, defined, in this instance, as siblings of individuals diagnosed with AD/ASD. A sibling cohort from the VSD would allow comparison of AD/ASD risk in siblings as a function of their thimerosal exposure through vaccination and the sample size would lend itself to supplemental data collection. A related study design based on sib-pairs or sets could be used to address discordant ASD/AD status in relation to thimerosal exposures. Another possibility that generated support by the panel was an expansion of the VSD study published by Verstraten et al (2004). The availability of several additional years of VSD data was seen as an opportunity to provide a more powerful test of any potential association between thimerosal and AD/ASD and would enable reconsideration of some aspects of the original study design (e.g., exclusion criteria). A related idea was to conduct a VSD retrospective cohort study using California-based MCOs linked with the California DDS, which would improve the diagnostic data and provide more complete ascertainment. For each of these designs, the ability to link medical records from mothers with those of their children was deemed critical.

As this reader interprets things, NIEHS seems to find that there is quite a bit of value in the VSD for studying autism, including an expansion of the Verstraeten study.

EpiWonk made the point first, but how can the NIEHS say that Verstraeten study design is not a good and that future use of the VSD is not useful, while at the same time suggest expanding Verstraeten?

The bottom line is that there are limitations to using the VSD alone in ecological studies of autism. One can overcome these limitations by going to chart reviews and other methods–as used in Verstraeten et al. and, more importantly, by VSD studies ongoing at CDC (one of which looks at autism).  As noted by Dr. Gerberding:

The VSD currently has a number of priority studies underway to address a range of important immunization safety questions, none of which utilize an ecologic study design. Instead, these current studies, including one study evaluating associations between thimerosal-containing
vaccines and autism, all evaluate individual-level data. This typically involves the review of individual medical charts to confirm the vaccines each individual received as well as the outcomes being studied. Studies using individual rather than group data provide stronger scientific evidence.

Mr. Kirby seems to be neglecting the fact that the CDC’s ongoing study (and the Verstraeten study) is not soley dependent on the VSD for the data.  He seems to be arguing that since the VSD, as a single data source, has limitations, the CDC can’t use it for any study. It’s like saying,

But, let’s take a closer look at what this says….and what Mr. Kirby is saying: The VSD on it’s own is not a good source of data to look at the thimerosal/autism question.

Now, anyone remember all the consternation that has been created by the fact that the VSD is not open to just any outside researcher?  Why should the VSD be opened to, say, Mark and David Geier?  Could they do the individual level data collection needed to make a VSD study valuable?

Apparently not. Recall this study by the Heather Young and the Geiers: Thimerosal exposure in infants and neurodevelopmental disorders: An assessment of computerized medical records in the Vaccine Safety Datalink

This was a study paid for by the petitioners in the Omnibus proceding.   It, on it’s own, was bad enough that EpiWonk disassembled it.  Twice.

The recent Heather Young/Geier paper didn’t look at individual level data.  Any future study by the Geiers almost certainly wouldn’t as well.  Given the argument by the NIEHS, Dr. Gerberding…and David Kirby, the above study and any proposed study by the Geiers on the VSD would be useless.

Some how I doubt Mr. Kirby will make statements confirming that. But, I can’t see how he could hold any other opinion, given the arguments he, himself, has made.

Peta – Idiots

7 Oct

The text below is from my good friend Ari Ne’eman. My own contribution is supplied in a link at the bottom of his text.

I am happy to announce that PETA’s recent, “Got Autism?” billboard has been removed by the advertising company hosting it. The billboard misinformed the public about the autism spectrum by falsely implying that milk consumption was the cause of autism. Such advertising contributes to a state of public hysteria about the autism spectrum, fueling the fear and resulting prejudice that marginalizes us from society at large. It is unacceptable for autistic people, our families and supporters to be used as instruments in PETA’s political agenda or that of any other unscrupulous interest group. Our community came together to communicate the need for a swift withdrawal of this ill-informed piece of advertising, and I’m pleased to say that were able to achieve a swift result. That we were able to accomplish this so quickly and effectively speaks well for the autistic community and the cross-disability rights movement. Thank you all for your support.

If you’d still like to indicate to PETA the need to avoid exploiting the autistic community in its future advertising, you can write to them at info@peta.org as well as call them at 757-622-7382 and dial 0. You can also sign our petition on this topic, further indicating to PETA and the world that it does not pay to try to attack and exploit the autistic and cross-disability communities.

Incidents like this show the need for a strong and activist autistic self-advocacy movement, working closely with the broader disability rights community. By uniting on issues like this one, we can work to address the persistent biases that pervades the public discourse about autism in specific and disability in general. As we speak, the blind community is uniting against false and offensive depictions of their community in the new movie, “Blindness”. Over the last few months, disability rights activists from all parts of the community came together to fight against outdated and damaging portrayals of people with intellectual disabilities in the movie, “Tropic Thunder”. Less than a year ago, the disability community united behind our successful effort to stop the NYU Child Study Center’s “Ransom Notes” ad campaign, which portrayed children with disabilities as kidnap victims.

Like any other community, we have the right to be treated with respect, in media, in service-delivery and in all aspects of society. While responses to offensive depictions of disability in popular culture are not the only battle in the broader struggle for equity, inclusion, quality of life and opportunity for all people with disabilities, this issue must remain an important priority. Culture helps to shape the reality we live in. By challenging the exploitative and offensive public discourse on disability we find today, we can advance a broader agenda for disability rights. The disability community is on the march and we will not be stopped. Thank you once again for your effective action on this issue. I look forward to working with all of you once again in the future. Remember, “Nothing About Us, Without Us!”

Wise words from Ari. And now my own vitriolic, childish but very satisfying contribution.

Autism genes = genius

6 Oct

Fascinating report in the Sunday Times yesterday about how the same genes that confer autism also confer the skills necessary for genius:

…a study of autism among 378 Cambridge University students..[]..found the condition was up to seven times more common among mathematicians than students in other disciplines. It was also five times more common in the siblings of mathematicians.

And this from Patricia Howlin:

Patricia Howlin, professor of clinical child psychology at the Institute of Psychiatry at King’s College London, studied 137 people with autism; 39 of them (29%) possessed an exceptional mental skill. The most common was outstanding memory.

She said: “It had been thought that only about 5%-10% of people with autism had such skills, but nobody had measured it properly, and it seems the number is far higher. If we could foster these skills, many more people with autism could live independently and even become high achievers.”

This, to me, is simply confirmation of two things that I believe in – firstly that autistic people have much more ability than people think and that respectful and appropriate education will help and secondly, the scientific method will always reveal the truth sooner or later. It cannot be hurried to be accurate. There is a saying amongst Web Developers when clients ask for the impossible – cheap, fast, good. Pick two. The same thing applies in science I think. You can have it cheap and fast and it won’t be good. Etc, etc.

This is yet more evidence that the continual doom and gloom about autism perpetuated from certain quarters simply isn’t reality. There are, in fact, key skills that our civillisation needs that it seems autistic people have in abundance (try and imagine a world without maths).

Respect, self-confidence, appropriate education. Pick three, please.

Why now, Jenny?

6 Oct

I try to stay away from mind reading. It is all too prevalent on the internet: “I know why so and so did such and such.” That said, who didn’t find the timing odd of Jenny McCarthy’s Amanda Peet attack and that really strange interview where Ms. McCarthy “forgives” Barbara Walters?

For those who have been lucky enough to miss this mess, here are brief timelines.

Amanda Peet gave an interview to Cookie Magazine for their August issue. It went online about July 10th. In that interview, she commented that people who don’t vaccinate are parasites. A week later (about July 17), Ms. Peet came out with an apology. I thought it was very well written, and have since been pleased to confirm that yes, indeed, Ms. Peet wrote it herself.

Fast-forward to September 30. That’s when Jenny McCarthy decided that it was time to make a public statement about the apology. That’s what, 7 weeks later? Of course, it’s also a week after Jenny’s book debuted.

Story line two: Let’s go all the way back to September, 2007. Jenny McCarthy is on “The View” for her first autism-book tour. Barbara Walters committed a terrible “sin”: she actually treated it like an interview and questioned Jenny McCarthy. I’d like to show you the video, but the video is now pulled from YouTube and the link to the video from the more recent story (which included the bit from “The View” also doesn’t seem to work anymore.)

Some short time after taping “The View” Ms. McCarthy was at a TACA picnic where she is said to have made some rather rude suggestions towards Ms. Walters.

Fast-forward to the present. On September 29th, Ms. McCarthy “forgave” Barbara Walters.

No, really. After Ms. McCarthy got a bit cross on the show and then took it out on Barbara Walters at the TACA picnic, she “forgives” Barbara Walters.

Boggles the mind, doesn’t it?

In that same interview, according to Ms. McCarthy (and only according to her, since Ms. Walters seems above responding to this), there was a bit of a heated exchange backstage with Ms. Walters after taping “The View”. Ms. McCarthy gives no indication of whether she (Ms. McCarthy) lost her cool at all.

But now, you see Ms. McCarthy understands what was going on with Barbara Walters. Remember that intro about “reading people’s minds”? Well, missing from the timeline above is the fact that Barbara Walters came out with, Audtion, a Memoir. In Audition, Ms. Walters discusses her life growing up with a special needs sister. Soooo, back to the mind-reading: Jenny McCarthy says that Barbara Walters was angry that she (Jenny) cured her son, while Barbara Walters had to go through tough times with her sister.

Yep.

Of course, did this “forgiveness” come out say, in May, when Audtion came out? No. Jenny McCarthy waited 4 months and “forgave” Ms. Walters…during the book tour for Warrior Mothers. (and after it was pretty clear that she wasn’t going to be a guest on “The View” this time).

Anyone want to guess how long before Jenny McCarthy apologizes to Ms. Walters for the rude statements?

Somehow I don’t think it’s going to happen. If I put on my mind-reading hat, I would say that these recent publicity events were, well, just that: publicity. Staged for the time when it benefited Ms. McCarthy.

I’m not shocked by the idea that a celebrity would work the press. Would anyone?

Let’s take another look at the timeline, shall we? Let’s take a look at how Jenny McCarthy’s book tours have created a buzz. As a measure, let’s use Google Trends. Google Trends gives you a rough idea of search engine traffic for specific terms. In this case, I chose “Jenny McCarthy” as the search term.

Let’s look back when Ms. McCarthy was doing the “Louder than Words” book tour, shall we? (click to enlarge)

It’s pretty impressive. For about 2 weeks, the search traffic was much higher than the average, reaching a peak of about 14 times the normal traffic for Jenny McCarthy.

Let’s expand this so we can see from 2007 to the present, shall we? (click to enlarge)

Google Trends for Jenny McCarthy 2007-2008

Google Trends for Jenny McCarthy 2007-2008

First, note that these data are week-by-week, not the day-by-day of the first figure. This smooths things out some, so the 14x peek we saw before is only about 7x in this graph. Still impressive. So, how about the traffic for “Mother Warriors”? I don’t see it either. Let’s zoom back in, but on the last 30 days. (click to enlarge)

Last 30 days Google Trends for Jenny McCarthy

Last 30 days Google Trends for Jenny McCarthy

(here’s the original graph from Google if you want to see it).

Warrior Mothers came out on the 23rd. See that little blip? This is a day-by-day trend, so we can compare to the first graph that showed a 14x spike in search traffic and a two-week increase. Instead, looks like it went up to about 1.7 and came back down fast.

But, wait, there’s another peak in early October? It goes to 4.

Remember those media events described above: the attack on Amanda Peet and the “forgiving” of Barbara Walters? Those happened on the 29th and 30th of September. After attacking Amanda Peet in the press, the Jenny McCarthy “buzz” went up.

Again, the timing is just too coincidental to suggest anything by a calculated decision by Ms. McCarthy.

Even though the buzz was low for Mother Warriors, this doesn’t mean that “Mother Warriors” is a flop. Supposedly it made “best seller” status.

As a rule of thumb, it takes about 100,000 copies of a book sold to get to be a “Best Seller”. As a second rule of thumb, that means about $350,000 for the author.

For “Louder than Words” Jenny McCarthy stated (if I recall correctly) that a portion of the proceeds would go to the UCLA autism program, if I recall correctly. I haven’t heard such a statement, or any statement about “Mother Warriors”.

Of course, she and Jim Carrey have been (and will almost certainly continue to be) proud supporters of Generation Rescue. They paid for a full page ad in USA Today–which I seem to recall being about $200,000. The thing is, I don’t consider that benefiting the autism community–or the community at large.

Jenny McCarthy’s potential for book profits are obvious. By improving her “brand” she also stands to gain from sales of her educational DVD’s and her soon to roll-out “Too Good by Jenny” products. That’s enough to set off conflict-of-interest alarm bells for many in the vaccines-cause-autism community. OK, that sets a pretty low bar, but you get the idea.

This sort of observation begs for comparison. As long as Jenny McCarthy is attacking Amanda Peet, let’s take a look at how much Amanda Peet makes from being a spokesperson for Every Child By Two and their Vaccinate Your Baby campaign.

ZILCH

Yes, that would be zero. As in nothing. As in she’s doing it because she thinks it’s the right thing to do. I somehow doubt the Generation Rescue crowd will believe that (or the fact that Amanda Peet wrote her own apology). They don’t seem to believe that anyone would act except out of financial self interest…well, except Ms. McCarthy. They also don’t want to admit that Paul Offit has no more conflict of interest, or acknowledge that he isn’t going to profit from Autism’s False Prophets. Seriously, I’ve seen them challenge whether he will actually donate the money.

A statement above sticks with me as I finish this post: Setting the Bar Low. When it comes to standards of behavior, yes, I think Ms. McCarthy has set the bar low. The question in my mind is this: Is she taking on the standards set by her organization or does she fit the organization because they have similar standards?

Sunday Solutions – No.3

5 Oct

Very quick one today as I’m busy with loads of stuff – mostly ScienceBlogs Book Club. Normal service resumed next week-ish 🙂

Jon Poling – no such thing as bad publicity

4 Oct

As broken by Kathleen and discussed further by Kristina, the Poling saga has taken another nasty twist and reveals the ‘respected’ Jon Poling as a scientist lacking even the most basic of scientific scruples.

In a series of three letters from Jon Poling, his co-authors Frye, Zimmerman and Shoffner and lastly Roger Brumback, the editor of the Journal that published their case study of Hannah Poling, Jon Poling is revealed as a man perfectly prepared to game the system.

In his letter, editor Roger Brumback says (he calls his letter ‘the Appalling Poling Saga’) he says:

In the United States Federal Register of May 21, 2003 (volume 68, number 98), on page 27829, there is an entry (“145. Terry and Jon Poling on behalf of Hannah Poling, Vienna, Virginia, Court of Federal Claims Number 02-1466V”) mentioning a filing under the National Vaccine Injury Compensation Program listing of petitions received. This occurred before the manuscript was submitted for consideration by JCN and clearly represents a conflict of interest. Yet the authors made a definitive statement to the Editor-in-Chief and to potential peer reviewers that there was no conflict of interest (Figure 1).

Let no one tell you any different. Jon Poling did not ‘forget’ to tell the publishing journal about the fact his daughter was part of the Autism Omnibus, he purposefully misled the Editor-in-Chief by stating conclusively there was no conflict of interest. Being a gentleman, Brumback avoids calling Poling an out-and-out liar. Brumback goes on to say:

Although, according to the leaked testimony (available to be viewed on numerous websites) [Brumback is referring to the testimony leaked to David Kirby – KL], it does not appear that the JCN article was used in the legal proceedings, media linkage of the published article to the legal outcome implies scientific support from JCN for this legal opinion. Of course it is possible to view this media exposure along the lines of the quip: “There is no such thing as bad publicity—just publicity”.

Quite.

Two things stand out for me – aside from this pathetic litany of dishonesty of course.

Firstly, Jon Poling is his letter says:

A third party subsequently leaked, without our knowledge or permission, my daughter’s
identity and the government’s concession report to the media.

Now lets have a look at this timeline. ‘The media’ Poling is referring to above is David Kirby who posted the details to the HuffPo on Feb 26.

Starting a bare 9 days later, the Polings are holding a press conference, being interviewed on Good Morning America, Larry King Live, Cable News Network, USA Today and The Atlanta Journal-Constitution.

Wow. I guess Brumback is right – there is no such thing as bad publicity because in little over a week, the totally non-media savvy Poling’s had managed to get themselves interviews on the leading media outlets in the USA. And they expect us to believe they did it ‘without our knowledge’ of the documents being leaked to quote Poling.

Something else really stands out from Poling’s letter. Its this:

2001. Because our daughter has diagnoses of autism, regressive encephalopathy, and mitochondrial dysfunction, her case was placed in the Omnibus Autism Proceedings.

Before HHS government physicians conceded that Hannah’s July 2000 vaccinations triggered her encephalopathy…..

Woah there…..what? Triggered her _what_ ? Encephalopathy? Thats funny because David Kirby and the anti-vaccine world has been swearing up and down the HHS conceded her vaccinations triggered her _autism_ .

This is a true bombshell. Jon Poling, Hannah’s father has just stated that HHS conceded vaccinations caused her encephalopathy as oppose to her autism. He’s quite clear and specific. In the first paragraph I quote he lists three separate things:

….autism, regressive encephalopathy, and mitochondrial dysfunction…

and in the second, he states which of these three HHS conceded was triggered by vaccinations. Encephalopathy. Not autism.

Next time anyone tells you HHS conceded Hannah Poling’s autism was caused by vaccines, point them here where they can read the words of her father.

The age of unreason

4 Oct

A news report yesterday stated that a new poll from the Florida Institute of technology College of Psychology and Liberal Arts had:

…found that 24 percent of respondents believe vaccines carry the blame for the wide range of developmental delays, known as autism spectrum disorders, and as a result, shy away from vaccinating their children. Another 19 percent said they were unsure about vaccines’ role.

Florida Today reports the Dean of College of Psychology and Liberal Arts called the results:

….a surprise given the number of federal studies exonerating the mercury preservative thimerosal, once used widely in children’s vaccines, but rarely, if ever, included in vaccines today.

I have no reason to doubt Dr. Kenkel’s surprise given that she is clearly not a big fan of quackery but I do wonder how she ever thought just the presentation of science in a journal would win the day. As Paul Offit has documented in Autism’s False Prophets and as discussed today in Science Buzz, the media bears a not insubstantial role in promoting the idea that vaccines cause autism. That coupled with the scientific illiterates at AoA and doing the rounds pushing their new book does a great amount of damage. Indeed, recent posts at the ScienceBlogs Book Club from both Orac and myself discuss ways of reaching more people with clearer information about vaccines.

Is this part of a wider trend of unreason across the West? A 2005 CBS Poll found that slightly more people rejected evolution than accepted it (51% to 49%).

In a separate poll, CBS reported that 48% of people believed in ghosts, with 1 in 5 stating they had felt the presence of, or touched, a ghost.

A Sci-Fi Channel poll (probably not the most unbiased source!) in 2002 found that a staggering:

….72 percent of Americans believe the government is not telling the public everything it knows about UFO activity, and 68 percent think the government knows more about extraterrestrial life than it is letting on.

Its easy to just laugh these people off as harmless weirdos but it makes me worry for the state of the West. And when it starts to affect not just national but international health and international autism research then we have a big problem.

What do we do? Now that the vaccine/autism connection has been revealed to traverse the same ground as creationism, ufology and ghost hunting how do we get it back?

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