MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science

6 Sep

In a commentary for the Mayo Clinic Proceedings, Gregory A. Poland, MD writes about MMR and autism. In case you don’t get the idea of his stance from the title of the article, MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science, it starts out with a quote:

Nothing is more terrible than to see ignorance in action.

Johann Wolfgang von Goethe

I’m sure people will counter that they are very “smart” and “well educated” and, therefore, not ignorant when they promote the MMR/autism notion. Is it ignorance, willful ignorance, bias, dishonesty, some mix or something else entirely that is behind the perpetuation of the idea? I don’t know. On a very real level, it doesn’t matter. What matters is the fact that the MMR hypothesis was wrong and that those who continue to promote it are causing a very real danger to society.

That said, here are Dr. Poland’s views in the introduction to his paper:

It is a truism that acting in one’s perceived self-interest is not always in one’s self-interest. Perhaps nowhere is this truer in contemporary public health than for the issue of the measles-mumps-rubella (MMR) immunization and persistent fears about a possible connection with autism. Although each of these 3 diseases had been controlled in the United States with the widespread use of the MMR vaccine, in the past decade those gains have been slipping. Even though the United States has had fewer than 50 measles cases per year during the past decade (mostly imported from other countries), 156 cases have already been identified in the first 6 months of 2011. 1 European countries such as England, Wales, Italy, France, Spain, and Germany are also experiencing substantial increases in measles outbreaks.

Why should we be concerned? Measles is the most transmissible human disease known. Even with modern medical care, approximately 1 of every 3000 infected persons die, and many more are hospitalized or otherwise harmed as a result. Population coverage (herd immunity) needs to be in excess of 96% to prevent outbreaks. In addition, measles is a disease for which eradication is both possible and planned, a goal that obviously cannot be met given current vaccine coverage levels.

This predictable sequence of falling coverage levels, followed by outbreaks of disease, has occurred because of decreased public confidence in the safety of the MMR vaccine. In large part, this has resulted from incorrect assertions that the vaccine plays a role in the development of autism, an idea promoted by Andrew Wakefield. No credible scientific evidence, however, supports the claim that the MMR vaccine causes autism, and indeed, national medical authorities and scientific professional societies have unanimously …

This article is commentary (i.e. not a research article), but there are some good points and questions made:

Why in the face of nearly 2 dozen studies and every scientific committee rejecting such an MMR-autism connection does this myth persist?

As expected, he notes the celebrity aspect of the vaccine-causation notion. He also discusses the recent paper in the PACE Law Review.

Under “Moving Forward”, Dr. Poland writes:

At some point, a point I believe we have well passed, the small group of people who claim such connections, who have no new or credible data, and for which their assumptions and hypotheses have been discredited must simply be ignored by scientists and the public and, most importantly, by the media, no matter how passionate their beliefs to the contrary. Such individuals are denialists at best, and dangerous at worst. Unfortunately, the media has given celebrities who comment on an autism-MMR link far more attention than they deserve, and the public, unfamiliar with the background science, has confused celebrity status with authority. Such a phenomenon has not been lost on those wishing to continue the discussion. As an example, J. Hanlon, cofounder of Generation Rescue (an organization that advocates for an autism-MMR vaccine link) commented, in regard to the finding that both Andrew Wakefield and his assertion of a connection between autism and MMR vaccine had been discredited, that to those who believe vaccines cause autism “Andrew Wakefield was Nelson Mandela and Jesus Christ all wrapped in one.”

Prediction: we will hear all about how this commentary is obviously worthless because the author didn’t correctly cite J.B. Handley. If you are wondering what I mean, read again, Mr. Handley is referred to as J. Hanlon. I wish the author hadn’t made that mistake as such small errors are exploited in exactly this way. But, at the same time, this puts some perspective on the situation regarding Mr. Handley. He is a well known name in a very small community. He has become one of the go-to people for comments critical of vaccination (as in the Jesus Christ/Nelson Mandella article).

Prediction 2: Dr. Poland’s article will be called an attempt at censorship (see the conclusion below). Probably with no sense of irony by the same people who recently stated that Autism Speaks should “Shut up, shut down and go away.”

Prediction 3: People will still refuse to see how strange the “Nelson Mandela and Jesus Christ” comment read to the majority of readers. OK, I am predicting the past here, but I expect this to go forward too. Dr. Poland didn’t pick this quote to place Andrew Wakefield in good light.

That all said, I agree with Dr. Poland. It is well past time for the MMR story to be set aside. Just because there are adherents to the idea doesn’t mean that news organizations need to give it false balance.

Dr. Poland concludes his article with a simple summary: the MMR/autism question has been investigated closely and no link is found. The decision to forgo immunization based on this fear is not without danger. Those who promote the MMR/autism link in the face of all the evidence are not working for the public good:

For anyone adhering to the scientific model of discovery, experimentation, and evidence, the trial is over and the jury back—there is no known scientific association between receipt of MMR vaccine and the subsequent development of autism. Making the decision to not immunize children with the MMR vaccine because of fear of such an association —rather than credible scientific evidence—places children and others at great risk as current measles outbreaks in the United States and Europe illustrate. Vaccine nihilists who continue to claim such associations are simply wrong, and they pedal an agenda other than for the public good. At this point, the antivaccine groups and conspiracy proponents promoting such an association should be ignored, much as thinking people simply ignore those who continue to insist that the earth is flat or that the US moon landing in 1969 did not really occur

He concludes simply but strongly:

There is no law against being foolish, nor any vaccine against ignorance; however, in the meantime the health of millions of children in the United States and worldwide is being placed at unnecessary and real risk through continued deliberate misinformation and discredited unscientific beliefs, and that should be a crime.

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27 Responses to “MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science”

  1. Stuart Duncan September 6, 2011 at 20:04 #

    It’s so wrong that this even needs to be written, or read… or discussed.

    I thought we had moved passed this to the “too many vaccines” argument or the “what about the other vaccines that haven’t been tested” argument or the “who cares if Jenny McCarthy’s son never had Autism?” argument?

  2. Prometheus September 6, 2011 at 20:16 #

    The usual “argument” I hear is “Yeah, so they’ve done studies showing that the MMR (and, to be fair, thimerosal) don’t cause autism, but what about all the other vaccines? And what about the other components of vaccines (e.g. formalehyde, “anti-freeze”, dead fetus parts, etc.)? And how about combinations (i.e. too many, too soon)?”

    In short, “You’ll never convince me that vaccines don’t cause autism as long as I can draw breath!”

    Outside of their own little (and shrinking) world, the die-hard advocates of “vaccines (in some mysterious and unexplained way) cause autism” are becoming – and may already have become – irrelevant. If you see them or hear about them these days, it is predominantly as a target of derision, as in “This is how ignorant and superstitious some people are.” It’s been a long, hard fall from grace, a fact that “Mr. Hanlon” knows only too well.

    Prometheus

  3. brian September 6, 2011 at 20:39 #

    Prometheus wrote:

    Outside of their own little (and shrinking) world, the die-hard advocates of “vaccines (in some mysterious and unexplained way) cause autism” are becoming – and may already have become – irrelevant. If you see them or hear about them these days, it is predominantly as a target of derision, as in “This is how ignorant and superstitious some people are.” It’s been a long, hard fall from grace, a fact that “Mr. Hanlon” knows only too well.

    Well, J. B. Handley (er, Hanlon) wrote this about his son’s autism: “If it really wasn’t the antibiotics and vaccines that got him, I’m wasting a hell of a lot of time and money treating the wrong things.”

    Yep.

  4. JJ September 6, 2011 at 21:28 #

    I think it’s interesting that Dr. Poland can’t even get the name of his enemy right and then complains about other people’s ignorance.

    If anyone cares, here’s a few of his funders according to the NEJM:

    Novavax Research
    Protein Sciences Research
    Wyeth Research
    Novartis Vaccines
    GlaxoSmithKline
    CSL Biotherapies – one of the world’s largest flu vaccine manufacturing facilities
    CSL Limited
    Pfizer Inc PI on 2 pneumococcal vaccine studies
    Merck & Co., Inc.
    Powdermed vaccine
    Novavax
    Emergent BioSolutions – a global biopharmaceutical company
    Theraclone Sciences
    MedImmune LLC
    Liquidia Technologies, Inc
    Avianax
    PaxVax, Inc.
    EMD Serono, Inc. – biopharmaceutical division of Merck

    • Sullivan September 6, 2011 at 21:36 #

      Dang,

      I forgot the prediction of “here’s his conflicts of interest”.

      JJ, did you forget to check that he’s Editor-In-Chief of the journal “Vaccine”?

      Sure, I wish he’d gotten Mr. Handley’s name correct. It’s only polite, for starters. Also, it gives people the automatic out to ignore what he has to say. For many, all you have to do is mispell a single word or get some trivial factoid incorrect in the “Andrew Wakefield is a scientific fraud” story to be dismissed.

      But, treat disabled children unethically. Lie. Hide (and lie) about conflicts of interest. Make unfounded recommendations to change the way vaccines are given. Do any of those things and we are expected to just sweep them under the table as long as they are promoting the vaccine-autism connection.

      That all said, I do find it interesting that he misspelled Mr. Handley’s name. Big fish. Very small (and shrinking) pond.

      • Sullivan September 6, 2011 at 22:53 #

        “can’t even get the name of his enemy right”

        Here’s a clue. They aren’t enemies. This isn’t some schoolyard fight. This isn’t some “vaccine war” as has recently been proposed. This is exactly the sort of language that is causing problems.

        Sure, there are those who pose this as a war. There are those who beat their chest and claim they will never back down from a fight (a ridiculous statement, by the way). Sure, there are people who see this as a battle between enemies. Those people tend to call themselves “autism advocates”. Professionals don’t see it that way and don’t use those terms.

      • Sullivan September 6, 2011 at 23:05 #

        For those writing the inevitable response….don’t forget last year’s paper:
        Fear, misinformation, and innumerates: How the Wakefield paper, the press, and advocacy groups damaged the public health

        “Sadly, we have moved from evidenced-based, to media- and celebrity-based medicine”

        and

        Autism advocacy groups and vocal parents share a significant and disproportionate blame for wasted time, money, and damage to children and the public health by their unyielding support and zealous adoption and promotion of Wakefield and his study results – despite a mountain of scientific evidence to the contrary. Indeed, as responsible researchers, in a variety of ways and with repeated studies, sought to reassure parents and family members of those with autism with science-based evidence that vaccines did not cause autism – many scientists were verbally and publicly attacked and harassed in the most uncivil manner. This is inexcusable and seriously diminishes the credibility of such organizations and individuals. Deep self-reflection would be appropriate.

        and

        An innumerate (the inability to use and understand numbers and mathematical concepts) press and public resonated with one another. An innumerate person or organization uses such phrases as “I don’t care what the data show. . .I believe. . .”.

        Perhaps the exact phrase wasn’t used often. But, show me a considered response to, say, Hornig et al. “Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study”….

  5. concerned asd mom September 7, 2011 at 02:09 #

    WHEW!! So elated to see scarcely anyone cares about LB/RB any longer. The world has certainly become a socially richer safer place by far.

    • Sullivan September 7, 2011 at 02:38 #

      Glad to bring some joy into your life.

  6. Andrew September 7, 2011 at 02:36 #

    Yep, now that the vaccine-autism myth is completely discredited, LBRB will probably get less traffic, but the traffic probably will be saner.

    • Sullivan September 7, 2011 at 02:45 #

      Yep, Andrew,

      some day I’ll be saying, “Remember when scientists and journalists used to take me to task for being unscientific and dangerous to public health? Ah, those were the days when I actually mattered”.

  7. sharon September 7, 2011 at 04:39 #

    Sigh! Just yesterday on an Autism Chat forum here in Australia I took to task a commenter who was running with the ‘Big Pharma, toxins, too many too soon’ nonsense. Once again an online group designed to offer parents the opportunity to connect and support each becomes divided by the MMR ‘debate’.
    As I said on the site, I look forward to the day this is a non issue with the ASD community, but it seems we are destined to go round and round for quite some time to come.

  8. joejoe September 7, 2011 at 16:46 #

    In 1999, my son received his MMr, vaccine immediately after he got a fever, his head went limp, got the measles itself, and a brain damage/autism diagnosis.This is what is really happening to children! Vaccines are not safe, and never were.Who ever said they were are nothing but ignorant or just spilling more lies. If vaccines were safe, the supreme court wouldn’t have ruled that vaccines were unavoidably unsafe, and the vaccine court known as the NVICP, wouldn’t have paid out billions of dollars over the last 27 years for autism injuries, so far they have located 83 children that received compensation for this!

  9. Science Mom September 7, 2011 at 17:31 #

    Joejoe, did you file a claim with NVICP? What supreme court ruling decided that “vaccines were unavoidably unsafe”? NVICP has not paid out billions for autism injuries, that is the estimate for any compensated vaccine injury and your 83 number is rather misleading as has been discussed here.

    • Sullivan September 7, 2011 at 19:05 #

      Science Mom,

      He is (I believe) referring to Bruesewitz v. Wyeth, which was decided earlier this year. In that case, it was determined that vaccine manufacturers could not be sued for design defect claims (side note–this was portrayed by some groups as a total liability coverage for the vaccine manufacturers. This is incorrect as other types of claims were not decided upon. Manufacturing defect and failure to warn were not argued by Bruesewtiz and, thus, not decided).

      The language is not from the Supreme Court, but from the law written by congress. Here is one example of the discussion of unavoidably unsafe:

      “Unavoidably unsafe products. There are some products which, in the present state of human knowledge, are quite incapable of beingmade safe for their intended and ordinary use. These are especially common in the field of drugs. An outstanding example is the vaccine for the Pasteur treatment of rabies, which not uncommonly leads tovery serious and damaging consequences when it is injected. Since the disease itself invariably leads to a dreadful death, both the marketing and the use of the vaccine are fully justified, notwithstanding the unavoidable high degree of risk which they involve. Such a product,properly prepared, and accompanied by proper directions and warning,is not defective, nor is it unreasonably dangerous. The same is true of many other drugs, vaccines, and the like, many of which for this veryreason cannot legally be sold except to physicians, or under the pre-scription of a physician. It is also true in particular of many new orexperimental drugs as to which, because of lack of time and opportunity for sufficient medical experience, there can be no assurance of safety, or perhaps even of purity of ingredients, but such experience as there is justifies the marketing and use of the drug notwithstanding a medically recognizable risk. The seller of such products, again with the qualifica-tion that they are properly prepared and marketed, and proper warning is given, where the situation calls for it, is not to be held to strictliability for unfortunate consequences attending their use, merely because he has undertaken to supply the public with an apparentlyuseful and desirable product, attended with a known but apparently reasonable risk.” Restatement 353–354.

      Pulling one sentence out for emphasis: ” The same is true of many other drugs, vaccines, and the like, many of which for this veryreason cannot legally be sold except to physicians, or under the pre-scription of a physician.”

      In another discussion, they note previous rulings that “Such a[n unavoidably unsafe] product, properly prepared, and accompanied by proper directions and warning, is not defective”

      One can not sue a manufacturer of a drug or biological for side effects that are unavoidable for some segment of the population, as long as the product was manufactured correctly and supplied with correct directions and warnings.

      Lupron, for a handy example, might be considered “unavoidably unsafe” as it has side effects even though it is manufactured correctly.

      This is likely why any reported side effect is included on the vaccine inserts. Much is made of inserts which include autism as a reported side effect. The manufacturers are covering their liability by warning people of whatever has been reported. This is not the same as side effects which have been demonstrated.

      JoeJoe is not really making his case stronger bringing up “unavoidably unsafe”. The fact that vaccines are placed in the category of “unavoidably unsafe” is a reason why he can not sue the manufacturer.

  10. Chris September 7, 2011 at 17:32 #

    joejoe, how is your lawsuit against the MMR vaccine going? You obviously have more substantial than your anecdote and that there is a vaccine court?

  11. Prometheus September 7, 2011 at 19:07 #

    Sullivan notes:

    “Here’s a clue. They aren’t enemies. This isn’t some schoolyard fight. This isn’t some ‘vaccine war’ as has recently been proposed.”

    The war-like jargon has been adopted by the “vaccines-cause-autism” crowd primarily because they have no data to support their assertions. By framing this as a “war”, they have, at least tacitly, admitted that they cannot “win” on the data and so must approach this as a conflict of ideologies.

    This would work, except that the people on the “other side” (e.g. me, Sullivan, 99.9999+% of the medical and scientific community) aren’t wedded to a failing ideology. We still see this as what it truly is: a question of fact (i.e. Do vaccines cause autism?) and not one of dogma. As a result, the “vaccines-cause-autism” army is reduced to rattling their sabres and screaming insults whilst the rest of the world moves on.

    Prometheus

  12. Andrew September 7, 2011 at 23:58 #

    Sullivan:

    I think you misunderstood me, probably because I was unclear. When the anti-vaccine movement collapses, LBRB will probably get some decrease in traffic, because it will be able to become simply a place for people with an interest in the good of autistic children and adults to discuss how to promote that good. On that day, we’ll be able to say – “Man- remember when we had to wade through countless posts containing various misunderstandings and misrepresentations about vaccines – I’m glad those days are over, and we can concentrate on other things.”

    • Sullivan September 8, 2011 at 02:43 #

      Sorry about that Andrew.

  13. Science Mom September 8, 2011 at 12:19 #

    Thanks Sullivan. Context is everything isn’t it? I can’t believe how abused the Bruesewitz case is by anti-vaxxers.

  14. Jason Jensen September 11, 2011 at 06:58 #

    I find these responses comical. “Now that the vaccine Autism debate is over”. It is? So why did a study done at the University of Michigan this year show that 50% of parents in the US still feel that vaccines can cause Autism? Up from 25% the year before. All that campaigning the CDC, AAP, and IOM have been doing, and they still can’t change parents minds. For all of you who say, “the studies don’t show a link between vaccines and Autism”, I ask you, have you read the studies? Their awful. It’s like comparing a 2 Pack a day smoker to a one pack a day smoker and saying there is no difference in cancer rates. It’s absurd. THere are about 15 prominent studies quoted the CDC, that make the statement, “we fond no association”. Hmm. But when you look at the studies individually, you will find that they have never looked at Vaccinated vs. Univaccinated Studies. In 2005. The director of the CDC went on air and admitted, they they were told not to look in that, because they were afraid of what they would find. She said this in 2008. Autism rates in the Amish in the US (virtually unheard of….3 cases in Lancaster Co. PA in over 30 years. One of those was a child taken by the state and vacccinated. Autism rates in the US (1 in 65 males). or 1 in 90 children. Look at the most recent study from Stony Brook (SUNY), they found males who received all 3 Hep B shots, were 9 times more likely to require early intervention services, compared to males who did not ( or the shot was delayed). Nine times folks. A coincidence? Hmm. If Thimersol was safe, then why the mass campaign to take it out of vaccines? All they did was just double the dose of ALuminum they put in. No big deal. I have no respect for people that come on these blogs and accuse the Autism community of spreading myths & lies, when they have not even read one of these studies. You just read Time magazine or listen to The Today Show, and now your an expert. Hilarious. I’m a physician. I vaccinated my little boy. Within 1 week of his MMR…..banging his head. Stopped eatiing. Crying all the time. Etc. But I’m sure it was just a coincidence. One last thing. If vaccines are so safe…why the need for The Federal Vaccine Court? Every time your little one is shot up at your Dr’s office, you pay a tax on that vaccine. That $$ goes to a fund to compensate the unlucky kid who developed seizures & brain damage after his shots. Didn’t know that did you? Does your pediatrician tell you that? We (the US) have compensated over 2200 families with over 2. 5 Billion Dollars. But wait…I thought vaccines were completely safe? Tell that to every person who developed paralytic polio after receiving the Oral polio vaccine…..Oops. We better pull it of the market. It damaged 13,000 people including 500 deaths. Read the literature. Quit trusting CNN for your research. How many pharmaceutical adds do you see a day on CNN? Just wondering.

    • Sullivan September 11, 2011 at 08:53 #

      Jason Jenson,

      The fact of the matter is I don’t rely on CNN or other news sources. I rely on the source material: papers and even raw data.

      I also spent a lot of time reading those who promote the vaccine epidemic hypothesis.

      The fact is, I understand your position better than you do. I understand, for example, the logic behind the “epidemic”. I understand that the hypothesis was that autism rates climbed as the number of vaccines and the thimerosal exposure from vaccines increased.

      The hypothesis holds that the autism rate was something like 1 in 10,000 in 1980. And has climbed by a factor of 100 in 30 years, coincident with the increased exposure to vaccines and thimerosal.

      In other words, the hypothesis itself is fundamentally based on a dose-response concept. The higher the dose, the higher the autism rate.

      Therefore it is not only appropriate, it is required that we look for a response to dose in vaccines and thimerosal.

      That us why whenever someone parrots the “one pack a day vs two pack a day” smoker argument, I know I am dealing with someone who doesn’t analyze their own assumptions. I know I am dealing with a person who has done a superficial analysis of the problem but convinced himself through rhetoric rather than logic.

      Tell me, for example, what is the exposure to mercury from vaccines to infants in the U.S. today. (the answer is that it is far lower than before the “epidemic” started). Have schools in your area shut down preschools and kindergartens for autistic kids due to lack of need? They sure haven’t here (or anywhere if we take education data seriously).

      Tell me, what is the risk of autism for kids who receive the MMR vs those who don’t? (answer: the same).

      If you spent as much Ike actually analyzing the mountain of data that exists as you appear to do retelling the same old talking points which were bad 10 years ago, you’d have cone to the same answer as 99.99+% of the researchers and physicians out there.

      By the way, even most autism parents don’t buy into the vaccine causation idea. 80% don’t buy it. Check this year’s IMFAR abstracts. Also check the polls that came ou after it was disclosed that Andrew Wakefield’s research was fraudulent. Even the general public was less likely to believe after that. Know the facts before you rely on the dea thatthe majority of people agree with you.

    • Sullivan September 11, 2011 at 08:56 #

      “s. In 2005. The director of the CDC went on air and admitted, they they were told not to look in that, because they were afraid of what they would find”

      Back that up, if you would be so kind.

      You don’t even remember the poor arguments made. You appear to be referring to Bernadine Healy’s assertion in 2008. She was (a) never with the CDC and (b) wrong.

    • Sullivan September 11, 2011 at 09:00 #

      “Look at the most recent study from Stony Brook (SUNY), they found males who received all 3 Hep B shots, were 9 times more likely to require early intervention services, compared to males who did not ( or the shot was delayed)”

      I’ve been looking at the data, not the paper. Quite recently. The authors were wrong.

      Had you read the paper, you’d know that your comment about the shots being delayed is not covered in the study. The survey they worked from didn’t ask that question.

      Seriously, you don’t even understand the logic behind your own position.

  15. Chris September 11, 2011 at 08:31 #

    Jason Jenson:

    But when you look at the studies individually, you will find that they have never looked at Vaccinated vs. Univaccinated Studies.

    Point #1: What do you have against paragraphs. Is hitting the “return key” beneath you?

    Point #2: Please provide us a “Vaccinated vs. Univaccinated Study” that would pass a modern Institutional Review Board. In short, that means one that will not cause harm to any human that is a participant. Surely, you know what that means.

    There would be Point #3, #4, etc… but first I would have to get through the wall of text.

Trackbacks/Pingbacks

  1. Autism Blog – MMR Vaccine and Autism: Vaccine Nihilism and … | My Autism Site | All About Autism - September 7, 2011

    […] Originally posted here: Autism Blog – MMR Vaccine and Autism: Vaccine Nihilism and … […]

  2. Autism and Vaccinations » Merced County retains up with overall vaccination prices - September 11, 2011

    […] MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science In a commentary for the Mayo Clinic Proceedings, Gregory A. Poland, MD writes about MMR and autism. In case you don't get the idea of his stance from the title of the article, MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science, … Read more on Left Brain/Right Brain […]

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